The effect of simulation of sectional human anatomy using ultrasound on students' learning outcomes and satisfaction in echocardiography education: a pilot randomized controlled trial.

BACKGROUND: Effective teaching methods are needed to improve students' abilities in hand-eye coordination and understanding of cardiac anatomy in echocardiography education. Simulation devices have emerged as innovative teaching tools and exhibited distinctive advantages due to their ability to provide vivid and visual learning experiences. This study aimed to investigate the effect of simulation of sectional human anatomy using ultrasound on students' learning outcomes and satisfaction in echocardiography education. METHODS: The study included 18 first-year clinical medical students with no prior echocardiography training. After randomization, they underwent a pre-test to assess basic knowledge. Following this, the students were divided into two groups: traditional teaching (traditional group) and simulation of sectional human anatomy using ultrasound (digital group). Each group received 60 min of instruction. Post-tests were assigned to students at two different time points: immediately after the lecture, and one week later (referred to as post-tests 1, and 2). In addition, anonymous questionnaires were distributed to students after class to investigate their satisfaction with teaching. RESULTS: Both groups showed significant improvement in their scores on post-test 1 compared to pre-test (traditional group: from 33.1 ± 8.8 to 48.1 ± 13.1, P = 0.034 vs. digital group: from 35.0 ± 6.7 to 58.0 ± 13.2, P = 0.008). However, there were no significant differences between the two groups in several post-test comparisons. Student satisfaction ratings revealed that the digital group experienced significantly greater satisfaction in areas such as subject interest, teaching style, course alignment, and interaction compared to the traditional group. Additionally, 80% of the digital group strongly endorsed the use of simulation of sectional human anatomy using ultrasound for echocardiography teaching, highlighting its effectiveness. CONCLUSIONS: Simulation of sectional human anatomy using ultrasound may improve students' understanding of echocardiography and satisfaction with the course. Our study provides evidence supporting the use of simulation teaching devices in medical education. Further research is needed to explore the long-term impact of this teaching method on students' learning outcomes and its integration into the medical curriculum. TRIAL REGISTRATION: http://www.chictr.org.cn (registration number: ChiCTR2300074015, 27/07/2023).

Control of nitrogen and odor emissions during chicken manure composting with a carbon-based microbial inoculant and a biotrickling filter.

Although aerobic composting is usually utilized in livestock manure disposal, the emission of odorous gases from compost not only induces harm to the human body and the environment, but also causes loss of nitrogen, sulfur, and other essential elements, resulting in a decline in product quality. The impact of biotrickling filter (BTF) and insertion of carbon-based microbial agent (CBMA) on compost maturation, odor emissions, and microbial population during the chicken manure composting were assessed in the current experiment. Compared with the CK group, CBMA addition accelerated the increase in pile temperature (EG group reached maximum temperature 10 days earlier than CK group), increased compost maturation (GI showed the highest increase of 41.3% on day 14 in EG group), resulted in 36.59% and 14.60% increase in NO3--N content and the total nitrogen retention preservation rate after composting. The deodorization effect of biotrickling filter was stable, and the removal rates of NH3, H2S, and TVOCs reached more than 90%, 96%, and 56%, respectively. Furthermore, microbial sequencing showed that CBMA effectively changed the microbial community in compost, protected the ammonia-oxidizing microorganisms, and strengthened the nitrification of the compost. In addition, the nitrifying and denitrifying bacteria were more active in the cooling period than they were in the thermophilic period. Moreover, the abundance of denitrification genes containing nirS, nirK, and nosZ in EG group was lower than that in CK group. Thus, a large amount of nitrogen was retained under the combined drive of BTF and CBMA during composting. This study made significant contributions to our understanding of how to compost livestock manure while reducing releases of odors and raising compost quality.

A meta-analysis of the efficacy of programmed cell death 1/its ligand inhibitors plus cytotoxic T-lymphocyte-associated antigen 4 inhibitors in non-small cell lung cancer.

Background: Immune checkpoint inhibitors (ICIs), either as monotherapy or in combination with chemotherapy, have improved the therapeutic outcome for non-small cell lung cancer (NSCLC). However, the efficacy of combination therapies, such as programmed cell death 1(PD-1)/its ligand (PD-L1) and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitors, in targeting different pathways remains unclear. We performed a meta-analysis to determine whether the addition of a CTLA-4 inhibitor to PD-1/PD-L1 therapy improves the efficacy of PD-1/PD-L1 monotherapy in NSCLC. Methods: We systematically searched various electronic databases for suitable trials. Only randomized controlled trials (RCTs) comparing the clinical efficacy of PD-1/PD-L1 with and without CTLA-4 were included in the analyses. The meta-analysis software RevMan 5.3 was used for statistical analyses. Results: A total of seven RCTs were retrieved. The results suggested that the combination of CTLA-4 and PD-1/PDL-1 inhibitors did not show enhanced efficacy over PD1/PDL-1 inhibitor monotherapy as determined by overall survival (OS) (HR = 0.98, 95% CI = 0.84-1.14, p = 0.79), progression-free survival (PFS) (HR = 0.92, 95% CI = 0.81-1.06, p = 0.25), and objective response rate (ORR) (HR = 1.08, 95% CI = 0.96-1.21, p = 0.19). Furthermore, the combination immunotherapy was associated increased toxicity as evidenced by increased incidence of any type adverse events (AEs) (RR = 1.06, 95% CI = 1.00-1.13, p = 0.03), grade ≥3 immune-mediated AEs (RR = 1.58, 95% CI = 1.36-1.82, p < 0.05), and treatment discontinuation (RR = 1.83, 95% CI = 1.46-2.28, p < 0.05). Conclusion: Combining anti-CTLA-4 with anti-PD-1/PD-L1 therapy did not improve the therapeutic efficacy, and was associated with greater toxicity than anti-PD-1/PD-L1 monotherapy in patients with advanced NSCLC. Further investigation of the combination immunotherapy in specific subsets of patients is warranted to identify and define the patient-specific benefits of this combination. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023435399.

Effectiveness of preoperative ultrasonography in predicting metachronous contralateral inguinal hernia in children: a single-arm prospective study using a historical control for comparison.

PURPOSE: To analyze the value of ultrasonography in predicting metachronous contralateral inguinal hernia (MCIH) and diagnosing contralateral persistent processus vaginalis (CPPV) in children with unilateral inguinal hernia, a prospective study was conducted. METHODS: All participants underwent a preoperative ultrasound on the contralateral groin. Patients in group A1 received operating procedure according to ultrasound results (patients with negative contralateral US results received hernia repair on the affected side), and patients in group A2 received operation according to laparoscopic results (patients received hernia repair and CPPV ligation). All patients were followed up 2 years and compared to a historical control (group B) who underwent open hernia repair only on the affected side regardless of contralateral US results. RESULTS: In groups A1 and A2, laparoscopic exploration revealed the presence of a CPPV in 490 cases. Ultrasound was found to be accurate in 104 out of the 490 cases with four false-positive and 386 false-negative results. This yielded an accuracy of 59.3%, a sensitivity of 21.2%, and a specificity of 99.2%. 10 patients in group A1, and 74 patients in group B developed MCIH. The accuracy, sensitivity, and specificity of the value of ultrasonography in predicting MCIH were 89.3%, 52.4%, and 92.5%, respectively. CONCLUSIONS: Preoperative ultrasonography of the contralateral groin is currently unable to accurately detect CPPV, but it appears to be a promising method in predicting MCIH by using rigorous diagnosing criteria.

Comparative and phylogenetic analysis of complete chloroplast genomes from seven Neocinnamomum taxa (Lauraceae).

The genus Neocinnamomum is considered to be one of the most enigmatic groups in Lauraceae, mainly distributed in tropical and subtropical regions of Southeast Asia. The genus contains valuable oilseed and medicinal tree species. However, there are few studies on the genus Neocinnamomum at present, and its interspecific relationship is still unclear. In order to explore the genetic structure and evolutionary characteristics of the Neocinnamomum chloroplast genome and to resolve the species relationships within the genus, comparative genomic and phylogenetic analyses were performed on the whole chloroplast genome sequences of 51 samples representing seven Neocinnamomum taxa. The whole Neocinnamomum chloroplast genome size ranged from 150,753-150,956 bp, with a GC content of 38.8%-38.9%. A total of 128 genes were annotated within the Neocinnamomum chloroplast genome, including 84 protein coding genes, 8 rRNA genes, and 36 tRNA genes. Between 71-82 SSRs were detected, among which A/T base repeats were the most common. The chloroplast genome contained a total of 31 preferred codons. Three highly variable regions, trnN-GUU-ndhF, petA-psbJ, and ccsA-ndhD, were identified with Pi values > 0.004. Based on the whole chloroplast genome phylogenetic tree, the phylogenetic relationships among the seven Neocinnamomum taxa were determined. N. delavayi and N. fargesii were the most closely related species, and N. lecomtei was identified as the most basal taxon. In this study, the characteristics and sequence variation of the chloroplast genomes of seven Neocinnamomum taxa were revealed, and the genetic relationship among the species was clarified. The results of this study will provide a reference for subsequent molecular marker development and phylogenetic research of Neocinnamomum.

Fractional amplitude of low frequency fluctuation in drug-naïve first-episode patients with anorexia nervosa: A resting-state fMRI study.

To characterize the fractional amplitude of low-frequency fluctuation (fALFF) in drug-naïve first-episode female patients with anorexia nervosa (AN) using resting-state functional magnetic resonance imaging (rs-fMRI).Whole brain rs-fMRI data were collected from 7 drug-naïve first-episode female patients with DSM-5 AN and 14 age-matched healthy female controls. fALFF values were calculated and compared between the two groups using a two-sample t test. Correlation analysis between the fALFF values in the entire brain and body mass index (BMI) was performed.Compared with the healthy controls, increased fALFF values were observed in the AN patients in their right hippocampus and left superior frontal gyrus, while decreased fALFF values were observed in their left rectus and left middle occipital gyrus. Moreover, low BMI was significantly associated with decreased fALFF in the left inferior frontal gyrus but increased fALFF in the left calcarine. In particular, the z-standardized fALFF (zfALFF) value of the left rectus was positive associated with BMI.Our findings suggest that spontaneous brain activity in the frontal region, hippocampus and rectus, characterized by fALFF values, was altered in drug-naïve, first-episode female patients with AN.

Regional homogeneity and functional connectivity analysis of resting-state magnetic resonance in patients with bipolar II disorder.

To explore the characteristics of local brain activity in patients with bipolar depression and its correlation with clinical features.In accord with the diagnostic and statistical manual of mental disorders-IV of bipolar disorder, 21 patients were enrolled while 21 healthy controls were matched with similar gender, age, level of educations. A 3.0T GE magnetic resonance scanner was used to collect the imaging data, and a 2-sample t test was performed. Regional homogeneity (ReHo) method was used to estimate regional activation patterns through indices of localized concordance. ReHo values were compared between groups. Seed-based correlation analysis was used to analyze functional connections.In the patients' group, ReHo (regional homogeneity) values of resting state functional magnetic resonance imaging data on the right cerebellum 4 and 5 area, cerebellar vermis 6 area, left insula were positively correlated with Hamilton depression scale (HAMD) scores. ReHo values on the left of the triangle of inferior frontal gyrus, right inferior frontal gyrus of orbital region showed negative correlation with HAMD scores. The value of ReHo in the patients' group was positively correlated with the patients' Hamilton anxiety scale score in the right fusiform gyrus, and negative correlation was found in the left insula. The ReHo value of the patients' group was negatively correlated with the patients' Montgomery Asberg depression rating scale score in regions of the midbrain. The value of ReHo in patients' group was significantly reduced in the right central front.The depression and anxiety severity of bipolar depression patients may be associated with the consistency activity of left insula, right cerebellum, and cerebellar vermis related area, fusiform gyrus. In addition, the ReHo of the midbrain neurons activity may be associated with depression level of patients with bipolar II disorder.

Altered microstructure of brain white matter in females with anorexia nervosa: a diffusion tensor imaging study.

OBJECTIVE: Structural studies have reported anorexia nervosa (AN) patients with abnormal gray matter in several brain regions and dysfunction in some connected neural circuits. However, the role of white matter (WM) in AN patients has rarely been investigated. The present study aimed to assess alterations in WM microstructure of the entire brain in females with AN using a voxel-based method on diffusion tensor imaging (DTI) data. MATERIALS AND METHODS: The study enrolled 8 female patients with AN and 14 age-matched females as controls (CW). The DTI data was collected from each subject to calculate the fractional anisotropy (FA) maps of the whole brain by the DTI-Studio software. Subsequently, a 2-sample t-test (P<0.05, corrected) was performed to detect the difference in FA maps of AN and CW group, and a Pearson's correlation analyzed the relationship between mean FA value of brain regions and body mass index (BMI). RESULTS: Compared with CW, AN patients revealed a significant decrease in FA maps in the left superior frontal gyrus, medial frontal gyrus, anterior cingulate cortex, middle frontal gyrus, inferior frontal gyrus, thalamus, and bilateral insula. Moreover, significantly positive correlations were established between the mean FA value of the left inferior frontal gyrus, insula as well as thalamus and BMI in AN patients. CONCLUSIONS: Our findings supported the presence of WM abnormality in patients with AN. The significant differences of FA maps, in patients with AN, were associated with their aberrant BMI. The results further improved our understanding of the pathophysiological mechanisms underlying AN.

Effects of 5-hydroxytryptamine 2C receptor agonist MK212 and 2A receptor antagonist MDL100907 on maternal behavior in postpartum female rats.

Maternal behavior in rats is a highly motivated and well-organized social behavior. Given the known roles of serotonin (5-HT) in emotion, motivation, social behavior, and major depression - and its known interaction with dopamine - it is likely that serotonin also plays a crucial role in this behavior. So far, there are surprisingly few studies focusing on 5-HT in maternal behavior, except for maternal aggression. In the present study, we examined the effects of 5-HT2C receptor agonism and 5-HT2A receptor antagonism on maternal behavior in postpartum female rats. We hypothesized that activation of 5-HT2C receptors and blockade of 5-HT2A receptors would produce a functionally equivalent disruption of maternal behavior because these two receptor subtypes often exert opposite effects on various brain functions and psychological processes relevant to rat maternal behavior. On postpartum Days 5, 7, and 9, Sprague-Dawley mother rats were given a single injection of 0.9% NaCl solution, the 5-HT2C agonist MK212 (0.5, 1.0 or 2.0 mg/kg, ip), or the 5-HT2A antagonist MDL100907 (0.05, 0.5 or 2.0 mg/kg, ip). Maternal behavior was tested 30 min before and 30 min, 120 min, 240 min after injection. Acute injection of MK212 significantly disrupted pup retrieval, pup licking, pup nursing, and nest building in a dose-dependent fashion. At the tested doses, MDL100907 had little effect on various components of rat maternal behavior. Across the 3 days of testing, no apparent sensitization or tolerance associated with repeated administration of MK212 and MDL100907 was found. We concluded that rat maternal performance is critically dependent on 5-HT2C receptors, while the role of 5-HT2A receptors is still inconclusive. Possible behavioral mechanisms of actions of 5-HT2C receptor in maternal behavior are discussed.

[Relationship between the grading of periventricular echodensities and periventricular white matter cystic lesions in preterm infants].

OBJECTIVE: To understand the relationship of the grading of periventricular echodensities (PVE) with the morbidity and the occurrence time of periventricular white matter cystic lesions in preterm infants. METHODS: A retrospective, single-centre cohort study of 120 preterm infants with PVE diagnosed by ultrasonography between February 2005 and May 2008 was performed. The infants had a median gestational age of 32 weeks and a median birth weight of 2 230 g. RESULTS: Fifty-two infants (43%) were diagnosed as having PVE I, 42 infants (35%) having PVE II, and 26 infants (22%) having PVE III. The grading of PVE was closely related to birth weight, but not with gestational age. The total morbidity of periventricular white matter cystic lesions was 24% (29/120). The morbidity of the cystic lesions in PVE III patients (65%) was significantly higher than that in PVE II patients (21%) (<0.01). The PVE III patients developed the cystic lesions earlier than the PVE II patients. CONCLUSIONS: The grading of PVE is closely related to the morbidity and the occurrence time of periventricular white matter cystic lesions in preterm infants.

[Ultrasonographic findings of intussusception complicated by intestinal necrosis in children].

OBJECTIVE: The information on the ultrasonographic features of pediatric intussusception complicated by intestinal necrosis is limited at present. This study aimed to investigate the ultrasonographic findings of this disorder in children in order to provide references for selecting a right means of reduction in clinical practice. METHODS: The ultrasonographic findings of 48 children with intussusception complicated by intestinal necrosis and who underwent operative reduction between 2004 and 2006 were reviewed retrospectively. RESULTS: The type of intussusception was closely correlated to the development of intestinal necrosis and the ileo-ileo-colonic intussusception was the most common one resulting in intestinal necrosis. The bowel wall of the invaginated segment was obviously thickened and the center of the invaginated segment was often accompanied with swollen lymph node and appendix caecalis. The intussusceptional fluidify, the expanding of distal segment accompanied with the thickened bowels wall, and weakening or disappearance of enterokinesia were the appearances of necrosis of most of bowel walls. The secondary intussusception was an important factor resulting in intestinal necrosis, and sound image of primary lesion was found in some patients. Seroperitoneum was a common manifestation in all of infants with intussusception complicated by intestinal necrosis. CONCLUSIONS: There are some obvious sonographic characteristics of intussusception complicated by intestinal necrosis in children. The means of intussusception reduction may be selected according to ultrasonographic characteristics.