Undergraduate Students' and Interns' Perception towards Learning Environment at Dental Clinics, Qassim University, Saudi Arabia.

Background: Dental clinical educational environment plays a critical part in the inculcation of skills and enhancement of knowledge for the dental students. The objective was to assess undergraduate dental students' and interns' perceptions towards the clinical learning environment. Methods: Current cross-sectional study was conducted from December 2020 to February 2021, using the 24-item dental clinical learning environment inventory (DECLEI) on a six point Likert scale. The possible range of cumulative score for DECLEI was from 0 to 100 (interpretation poor to excellent). The inventory was emailed to 111 students and interns at College of Dentistry, Qassim University. The relationship between the independent variables and DECLEI scores was determined by using Pearson correlation test. SPSS version-23 was used for statistical analysis. Results: Overall response rate was 78.37%. The mean DECLEI score was noted as 67.5 ± 17.98. Among the factors, the highest mean score was documented for the systematic self-evaluation and the lowest mean score was observed for the item related to patients' punctuality for appointments. A factor-wise analysis of three subscales of DECLEI demonstrated the respondents had good perception towards all subscales with the highest mean score (72.3 ± 18.06) for Factor III and lowest mean score (61.3 ± 19.81) for Factor II. Overall, the DECELI was found to be reliable with the Cronbach's Alpha value of 0.94. The Pearson's correlation test showed the weak positive insignificant correlation of mean DECLEI score with gender and categories. Conclusions: Present study indicated more positive than negative perceptions of the dental students related to their clinical learning environment. The DECLEI helped in recognizing both strengths and shortcomings of the dental clinical learning environment.

Outcomes of Neurorehabilitation Among Patients With Prolonged Disorders of Consciousness.

BACKGROUND:  The impact of neurorehabilitation on patients with prolonged disorders of consciousness (PDOC) is not well known. We assessed the range of motion (ROM), muscle girth and power, level of consciousness, development of musculoskeletal deformity, and superficial sensation. METHODS:  A retrospective observational record-based study was done, which included the data of patients diagnosed with PDOC admitted at Thumbay Physical Therapy & Rehabilitation Hospital, Ajman, UAE, between 2020 and 2022. Data on the "range of motion", "muscle girth and power", "level of consciousness", "development of musculoskeletal deformity", and "superficial sensation" were collected and analyzed. The SPSS software version 27 (IBM Corp., Armonk, NY, USA) was used for analysis. The chi-square test was used to assess association, and the t-test was used to test the mean difference. RESULTS:  We assessed the data of 21 patients with PDOC. The superficial sensation was found to have increased significantly (p<0.025). There was a decrease in the proportion of patients with musculoskeletal deformities during the follow-up period. The ROM, muscle girth, and muscle power were also preserved without significant deterioration. However, the level of consciousness measured by the Glasgow coma scale (GCS) showed no improvement. CONCLUSIONS: Our research showed that neurorehabilitation significantly improves superficial sensation and prevents the development of musculoskeletal deformities. However, the mean level of consciousness remained the same. There was also no decrease in ROM. Both muscle girth and power were preserved over two years.

Self-doubt masked in success: Identifying the prevalence of impostor phenomenon among undergraduate dental students at Qassim University.

Objective: To investigate the prevalence of impostor phenomenon (IP) among undergraduate dental students and explore its relationship with gender and academic year. Methods: This study involved observational cross-sectional research involving undergraduate dental students (first to fifth year) at Qassim University Dental School, between February and April 2021. An electronically administered, 20-item pre-validated Clance Impostor Phenomenon Scale (CIPS) was used for data collection. Data analysis was performed using SPSS version 23. Mean IP scores of both genders were compared using t-tests, one-way ANOVA and Post-Hoc tests to establish the relationship between year-wise IP scores. Results: The response rate was 80.59% (162 respondents). The results indicated that 8.8% of the participants had mild IP experiences, 84.1% had moderate to severe IP experiences, and 7.05% exhibited intense IP experiences. The mean IP score was highest and lowest in the third and fourth-year dental students, respectively. A statistically significant relationship was identified between year wise IP scores, while no significant difference was observed based on gender. Conclusions: Impostor phenomenon is prevalent in substantial frequencies amongst dental students. This may have damaging physical and mental effects with negative consequences and could subsequently affect their intellectual and professional developments. The implementation of a modified curriculum and self-development plans are some of the recommended solutions.

Caldicellulosiruptor bescii Adheres to Polysaccharides via a Type IV Pilin-Dependent Mechanism.

Biological hydrolysis of cellulose above 70°C involves microorganisms that secrete free enzymes and deploy separate protein systems to adhere to their substrate. Strongly cellulolytic Caldicellulosiruptor bescii is one such extreme thermophile, which deploys modular, multifunctional carbohydrate-acting enzymes to deconstruct plant biomass. Additionally, C. bescii also encodes noncatalytic carbohydrate binding proteins, which likely evolved as a mechanism to compete against other heterotrophs in carbon-limited biotopes that these bacteria inhabit. Analysis of the Caldicellulosiruptor pangenome identified a type IV pilus (T4P) locus encoded upstream of the tapirins, that is encoded by all Caldicellulosiruptor species. In this study, we sought to determine if the C. bescii T4P plays a role in attachment to plant polysaccharides. The major C. bescii pilin (CbPilA) was identified by the presence of pilin-like protein domains, paired with transcriptomics and proteomics data. Using immuno-dot blots, we determined that the plant polysaccharide xylan induced production of CbPilA 10- to 14-fold higher than glucomannan or xylose. Furthermore, we are able to demonstrate that recombinant CbPilA directly interacts with xylan and cellulose at elevated temperatures. Localization of CbPilA at the cell surface was confirmed by immunofluorescence microscopy. Lastly, a direct role for CbPilA in cell adhesion was demonstrated using recombinant CbPilA or anti-CbPilA antibodies to reduce C. bescii cell adhesion to xylan and crystalline cellulose up to 4.5- and 2-fold, respectively. Based on these observations, we propose that CbPilA and, by extension, the T4P play a role in Caldicellulosiruptor cell attachment to plant biomass.IMPORTANCE Most microorganisms are capable of attaching to surfaces in order to persist in their environment. Type IV (T4) pili produced by certain mesophilic Firmicutes promote adherence; however, a role for T4 pili encoded by thermophilic members of this phylum has yet to be demonstrated. Prior comparative genomics analyses identified a T4 pilus locus possessed by an extremely thermophilic genus within the Firmicutes Here, we demonstrate that attachment to plant biomass-related carbohydrates by strongly cellulolytic Caldicellulosiruptor bescii is mediated by T4 pilins. Surprisingly, xylan but not cellulose induced expression of the major T4 pilin. Regardless, the C. bescii T4 pilin interacts with both polysaccharides at high temperatures and is located to the cell surface, where it is directly involved in C. bescii attachment. Adherence to polysaccharides is likely key to survival in environments where carbon sources are limiting, allowing C. bescii to compete against other plant-degrading microorganisms.

Genomic and physiological analyses reveal that extremely thermophilic Caldicellulosiruptor changbaiensis deploys uncommon cellulose attachment mechanisms.

The genus Caldicellulosiruptor is comprised of extremely thermophilic, heterotrophic anaerobes that degrade plant biomass using modular, multifunctional enzymes. Prior pangenome analyses determined that this genus is genetically diverse, with the current pangenome remaining open, meaning that new genes are expected with each additional genome sequence added. Given the high biodiversity observed among the genus Caldicellulosiruptor, we have sequenced and added a 14th species, Caldicellulosiruptor changbaiensis, to the pangenome. The pangenome now includes 3791 ortholog clusters, 120 of which are unique to C. changbaiensis and may be involved in plant biomass degradation. Comparisons between C. changbaiensis and Caldicellulosiruptor bescii on the basis of growth kinetics, cellulose solubilization and cell attachment to polysaccharides highlighted physiological differences between the two species which are supported by their respective gene inventories. Most significantly, these comparisons indicated that C. changbaiensis possesses uncommon cellulose attachment mechanisms not observed among the other strongly cellulolytic members of the genus Caldicellulosiruptor.

Donor predictors of allograft utilization for pediatric heart transplantation.

Pediatric heart transplantations are limited by the supply of donor allografts. We sought to determine the cardiac allograft utilization rate for pediatric donors and identify donor factors that predict graft use for transplantation. The United Network for Organ Sharing deceased donor database was queried from April 30, 2006, to March 31, 2014. Donor risk factors that might affect graft use for cardiac transplantation were evaluated. The pediatric cardiac graft utilization rate was calculated, and logistic regression modeling was performed to determine the relationship of risk factors with graft use for transplantation. During the study period, 6682 eligible cardiac donors <18 years of age were identified, and 3758 (56.2%) grafts were utilized for transplantation. Grafts from male donors (OR 1.181) were significantly associated with graft utilization. Graft donor age >1 year (OR 0.363), non-O blood type (OR 0.586), CDC 'high-risk' donor status (OR 0.676), use of inotropes (OR 0.718), use of >2 inotropes (OR 0.328), and donor left ventricular ejection fraction <50% (OR 0.045) were significantly associated with graft nonutilization. The pediatric cardiac allograft utilization rate and risk factors for graft use for transplantation have been identified. Additional studies will be needed to assess the donor-recipient relationship on pediatric transplant outcomes.

Stroke volume variation as a guide for fluid resuscitation in patients undergoing large-volume liposuction.

BACKGROUND: : The potential for fluid overload in large-volume liposuction is a source of serious concern. Fluid management in these patients is controversial and governed by various formulas that have been advanced by many authors. Basically, it is the ratio of what goes into the patient and what comes out. Central venous pressure has been used to monitor fluid therapy. Dynamic parameters, such as stroke volume and pulse pressure variation, are better predictors of volume responsiveness and are superior to static indicators, such as central venous pressure and pulmonary capillary wedge pressure. Stroke volume variation was used in this study to guide fluid resuscitation and compared with one guided by an intraoperative fluid ratio of 1.2 (i.e., Rohrich formula). METHODS: : Stroke volume variation was used as a guide for intraoperative fluid administration in 15 patients subjected to large-volume liposuction. In another 15 patients, fluid resuscitation was guided by an intraoperative fluid ratio of 1.2. The amounts of intravenous fluid administered in the groups were compared. RESULTS: : The mean amount of fluid infused was 561 ± 181 ml in the stroke volume variation group and 2383 ± 1208 ml in the intraoperative fluid ratio group. The intraoperative fluid ratio when calculated for the stroke volume variation group was 0.936 ± 0.084. All patients maintained hemodynamic parameters (heart rate and systolic, diastolic, and mean blood pressure). Renal and metabolic indices remained within normal limits. CONCLUSION: : Stroke volume variation-guided fluid application could result in an appropriate amount of intravenous fluid use in patients undergoing large-volume liposuction. CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, II.