Educational efficacy of medical humanities in empathy of medical students and healthcare professionals: a systematic review and meta-analysis.

BACKGROUND: Medical humanities education is an important part of medical education. The purpose of this study was to determine the effectiveness of medical humanities in improving empathy among medical students and healthcare professionals. METHODS: PubMed, Embase, EBSCO-ERIC, Web of Science were searched systematically for studies in the English language. The last retrieval date is May 1, 2023. Best Evidence Medical Education (BEME) Global Rating Scale and Kirkpatrick-based results were used to evaluate the quality of literature. In this study, a meta-analysis of continuous data was conducted. RESULTS: The pooled results by single-arm test meta-analysis showed a benefit with medical humanities programs in empathy (SMD 1.33; 95% CI 0.69-1.96). For single-arm trials of medical humanities program interventions of less than 4 months, 4 months to 12 months, and more than one year, the standardized mean differences(SMD) between post-test and pre-test were 1.74 (P < 0.05), 1.26 (P < 0.05), and 0.13 (P = 0.46), respectively. The results showed a significant difference in the effect of medical humanities programs on male and female empathy (SMD - 1.10; 95% CI -2.08 - -0.13). The SMDs for the study of course, the course combined reflective writing, and the course combined reflective writing and practice as intervention modalities for medical humanities programs were 1.15 (P < 0.05), 1.64 (P < 0.05), and 1.50 (P < 0.05), respectively. CONCLUSION: Medical humanities programs as a whole can improve the empathy of medical students and health professionals. However, different intervention durations and different intervention methods produce different intervention effects.

Machine learning-based automated sponge cytology for screening of oesophageal squamous cell carcinoma and adenocarcinoma of the oesophagogastric junction: a nationwide, multicohort, prospective study.

BACKGROUND: Oesophageal squamous cell carcinoma and adenocarcinoma of the oesophagogastric junction have a dismal prognosis, and early detection is key to reduce mortality. However, early detection depends on upper gastrointestinal endoscopy, which is not feasible to implement at a population level. We aimed to develop and validate a fully automated machine learning-based prediction tool integrating a minimally invasive sponge cytology test and epidemiological risk factors for screening of oesophageal squamous cell carcinoma and adenocarcinoma of the oesophagogastric junction before endoscopy. METHODS: For this multicohort prospective study, we enrolled participants aged 40-75 years undergoing upper gastrointestinal endoscopy screening at 39 tertiary or secondary hospitals in China for model training and testing, and included community-based screening participants for further validation. All participants underwent questionnaire surveys, sponge cytology testing, and endoscopy in a sequential manner. We trained machine learning models to predict a composite outcome of high-grade lesions, defined as histology-confirmed high-grade intraepithelial neoplasia and carcinoma of the oesophagus and oesophagogastric junction. The predictive features included 105 cytological and 15 epidemiological features. Model performance was primarily measured with the area under the receiver operating characteristic curve (AUROC) and average precision. The performance measures for cytologists with AI assistance was also assessed. FINDINGS: Between Jan 1, 2021, and June 30, 2022, 17 498 eligible participants were involved in model training and validation. In the testing set, the AUROC of the final model was 0·960 (95% CI 0·937 to 0·977) and the average precision was 0·482 (0·470 to 0·494). The model achieved similar performance to consensus of cytologists with AI assistance (AUROC 0·955 [95% CI 0·933 to 0·975]; p=0·749; difference 0·005, 95% CI, -0·011 to 0·020). If the model-defined moderate-risk and high-risk groups were referred for endoscopy, the sensitivity was 94·5% (95% CI 88·8 to 97·5), specificity was 91·9% (91·2 to 92·5), and the predictive positive value was 18·4% (15·6 to 21·6), and 90·3% of endoscopies could be avoided. Further validation in community-based screening showed that the AUROC of the model was 0·964 (95% CI 0·920 to 0·990), and 92·8% of endoscopies could be avoided after risk stratification. INTERPRETATION: We developed a prediction tool with favourable performance for screening of oesophageal squamous cell carcinoma and adenocarcinoma of the oesophagogastric junction. This approach could prevent the need for endoscopy screening in many low-risk individuals and ensure resource optimisation by prioritising high-risk individuals. FUNDING: Science and Technology Commission of Shanghai Municipality.

[Separation of Chlorophyll Fluorescence from Scattering Light of Algal Water Based on the Polarization Technique].

Once chlorophyll molecules within the planktonic algae cells absorb light energy, they will release energy in the form of chlorophyll fluorescence emission. The elastic scattering light of particles in water is partially polarized, while chlorophyll fluorescence is unpolarized, so we can use the properties to separate the fluorescence signal from total scattering spectra for further retrieval the concentration of chlorophyll. But for coastal waters, the approach feasibility is still unclear. Based on this, we conducted the experiment in laboratory to analyze the influence of different concentrations of inorganic particles (IOP) and chlorophyll on the fluorescence extraction using polarization discrimination technique. The results indicate that, for algae water with different concentrations of IOP, the fluorescence peak will decrease while the concentration increase, but the retrieval result is still reliable when the concentration up to 300 mg·L(-1). For algae water with different concentrations of chlorophyll, the concentration of chlorophyll more higher, the efficiency of extracted fluorescence using polarization method is better, for common water, this approach can still work. The study proves that the polarization method is also applicable for complex water; it is of great importance for further detecting the concentration of chlorophyll in coastal waters using remote sensing.

A Ni-free ZrCuFeAlAg bulk metallic glass with potential for biomedical applications.

The mechanical properties and biocompatibility of an Ni-free Zr-based bulk metallic glass (BMG) Zr60.14Cu22.31Fe4.85Al9.7Ag3 were investigated in detail to evaluate its potential as a biomaterial. The BMG was found to have a low Young's modulus of 82±1.9GPa, a high strength of 1720±28MPa and a high fracture toughness of 94±19MPam(1/2), as well as good fatigue strength over 400MPa. The corrosion behavior of the alloy was investigated in simulated body fluid (SBF) by electrochemical measurements, which indicates that the Zr-based BMG has a better corrosion resistance than pure Zr and Ti6Al4V. X-ray photoelectron spectroscopy analysis revealed that the passive film formed on the BMG surface is enriched in Al- and Zr-oxides, which could account for the good corrosion resistance of the BMG. On the other hand, metal ion release of the BMG in SBF was determined by inductively coupled plasma mass spectrometry after the BMG was immersed in SBF at 37°C for 30days, showing a ppb (ngml(-1)) level of metal ion release. The in vitro test via cell culture indicates that the BMG exhibits a cytotoxicity of Grade 0-1, which is as good as Ti6Al4V alloy. Cell adhesion morphological analysis shows that the cells were flattened and well spread out on the surfaces of the BMG, showing that the BMG had good biocompatibility. The combination of good mechanical properties and biocompatibility demonstrates that the Ni-free Zr-based BMG studied in this work is a good candidate for a new type of load-bearing biomedical material.

Evaluation of a new method for placing nasojejunal feeding tubes.

AIM: To compare fluoroscopic, endoscopic and guide wire assistance with ultraslim gastroscopy for placement of nasojejunal feeding tubes. METHODS: The information regarding nasojejunal tube placement procedures was retrieved using the gastrointestinal tract database at Tongji Hospital affiliated to Tongji Medical College. Records from 81 patients who underwent nasojejunal tubes placement by different techniques between 2004 and 2011 were reviewed for procedure success and tube-related outcomes. RESULTS: Nasojejunal feeding tubes were successfully placed in 78 (96.3%) of 81 patients. The success rate by fluoroscopy was 92% (23 of 25), by endoscopic technique 96.3% (26 of 27), and by guide wire assistance (whether via transnasal or transoral insertion) 100% (23/23, 6/6). The average time for successful placement was 14.9 ± 2.9 min for fluoroscopic placement, 14.8 ± 4.9 min for endoscopic placement, 11.1 ± 2.2 min for guide wire assistance with transnasal gastroscopic placement, and 14.7 ± 1.2 min for transoral gastroscopic placement. Statistically, the duration for the third method was significantly different (P < 0.05) compared with the other three methods. Transnasal placement over a guidewire was significantly faster (P < 0.05) than any of the other approaches. CONCLUSION: Guide wire assistance with transnasal insertion of nasojejunal feeding tubes represents a safe, quick and effective method for providing enteral nutrition.

Response gene to complement-32 enhances metastatic phenotype by mediating transforming growth factor beta-induced epithelial-mesenchymal transition in human pancreatic cancer cell line BxPC-3.

BACKGROUND: Response gene to complement-32 (RGC-32) is comprehensively expressed in many kinds of tissues and has been reported to be expressed abnormally in different kinds of human tumors. However, the role of RGC-32 in cancer remains controversial and no reports have described the effect of RGC-32 in pancreatic cancer. The present study investigated the expression of RGC-32 in pancreatic cancer tissues and explored the role of RGC-32 in transforming growth factor-beta (TGF-ß)-induced epithelial-mesenchymal transition (EMT) in human pancreatic cancer cell line BxPC-3. METHODS: Immunohistochemical staining of RGC-32 and E-cadherin was performed on specimens from 42 patients with pancreatic cancer, 12 with chronic pancreatitis and 8 with normal pancreas. To evaluate the role of RGC-32 in TGF-ß-induced EMT in pancreatic cancer cells, BxPC-3 cells were treated with TGF-ß1, and RGC-32 siRNA silencing and gene overexpression were performed as well. The mRNA expression and protein expression of RGC-32 and EMT markers such E-cadherin and vimentin were determined by quantitative reverse transcription-PCR (qRT-PCR) and western blot respectively. Finally, migration ability of BxPC-3 cells treated with TGF-ß and RGC-32 siRNA transfection was examined by transwell cell migration assay. RESULTS: We found stronger expression of RGC-32 and higher abnormal expression rate of E-cadherin in pancreatic cancer tissues than those in chronic pancreatitis tissues and normal pancreatic tissues. Immunohistochemical analysis revealed that both RGC-32 positive expression and E-cadherin abnormal expression in pancreatic cancer were correlated with lymph node metastasis and TNM staging. In addition, a significant and positive correlation was found between positive expression of RGC-32 and abnormal expression of E-cadherin. Furthermore, in vitro, we found sustained TGF-ß stimuli induced EMT and up-regulated RGC-32 expression in BxPC-3 cells. By means of siRNA silencing and gene overexpression, we further demonstrated that RGC-32 mediated TGF-ß-induced EMT and migration in BxPC-3 cells. CONCLUSIONS: The results above indicated that RGC-32 might be a novel metastasis promoting gene in pancreatic cancer and it enhances metastatic phenotype by mediating TGF-ß-induced EMT in human pancreatic cancer cell line BxPC-3.

[Effects of Pingchuan Recipe on airway remodeling in mice with bronchial asthma].

OBJECTIVE: To study the effects of Pingchuan Recipe, a compound traditional Chinese herbal medicine for treating bronchial asthma, on macrophage inflammatory protein-1alpha (MIP-1alpha) and immunoglobulin E (IgE) contents and CD86 expression in a mouse model of bronchial asthma, and to investigate the mechanism of Pingchuan Recipe in regulating airway remodeling in mice with bronchial asthma. METHODS: Fifty BALB/c mice were randomly divided into normal control group, untreated group, dexamethasone group, low-dose Pingchuan Recipe group and normal-dose Pingchuan Recipe group. Bronchial asthma in mice was induced by intra-abdominal injection of mixed ovalbumin and stimulation by inhaling 5% ovalbumin. Mice in the normal control group and the untreated group did not receive treatment, but mice in the other groups were administered intragastrically with 50 g/ (kg * d) Pingchuan Recipe, 25 g/ (kg * d) Pingchuan Recipe and 0.75 mg/ (kg * d) dexamethasone, respectively. After consecutive treatment for 8 weeks, the MIP-1alpha contents in peripheral blood and bronchoalveolar lavage fluid (BALF) were measured by an avidin biotin complex-enzyme-linked immunosorbent assay (ABC-ELISA) system, and the IgE contents in serum and BALF were measured by ELISA method. Direct immunofluorescence-flow cytometry was used to detect the percentages of CD86(+) and CD3(-) CD86(+) cells in peripheral blood and BALF. General histological changes of the lung tissue were observed by HE staining and collagen fiber staining 12 weeks after activation. RESULTS: Compared with the normal control group, the contents of MIP-1alpha, the percentages of CD86(+) cells and CD3(-) CD86(+) cells in peripheral blood and BALF, and the contents of IgE in serum and BALF were raised significantly (P < 0.01). The contents of MIP-1alpha, the percentages of CD86(+) cells and CD3(-) CD86(+) cells in peripheral blood and BALF, and the contents of IgE in serum and BALF in the treated groups were lower than those in the untreated group (P < 0.01). The contents of MIP-1alpha in peripheral blood and BALF and the contents of IgE in serum and BALF had no significant differences among the treated groups (P > 0.05). The percentage of CD3(-) CD86(+) cells in peripheral blood in low-dose Pingchuan Recipe group was lower than that in the dexamethasone group. Compared with the untreated group, the collagen deposition in the wall of bronchiole in the treated groups was decreased. CONCLUSION: Pingchuan Recipe can decrease the contents of MIP-1alpha, IgE and the expressions of CD86 in peripheral blood and BALF, which may be one of its mechanisms in improving chronic airway inflammation and inhibiting airway remodeling.