Interprofessional education (IPE) enhances collaboration among healthcare professionals, improving patient care outcomes. This study investigates dental students' attitudes toward IPE in Sudan, focusing on its implications for teamwork, patient-centered care, and interprofessional collaboration. A cross-sectional survey was conducted from March to September 2024 with 382 dental students from 3 universities in Khartoum: the University of Khartoum, Neelain University, and Almughtaribeen University. Data were collected using a self-administered online questionnaire assessing attitudes toward IPE, patient care, and collaboration. Statistical analysis was performed using Statistical Package of Social Sciences, version 29 (IBM Corporation). Most students expressed moderate support for IPE. They recognized its benefits for teamwork, communication, and problem-solving. Students from the University of Khartoum scored highest. Most participants emphasized the importance of patient-centered care, particularly effective communication and trust. However, 35% of students acknowledged biases toward other professions that could negatively impact healthcare delivery. Cultural competence was also a key concern, with students supporting the need for respect for diverse patient backgrounds. Dental students in Sudan show moderate readiness for IPE. The findings highlight the importance of integrating IPE into dental curricula to improve collaboration and patient care. Institutional support for IPE is crucial to address biases and prepare students for effective team-based practice.
This study aimed to evaluate complete blood count-derived inflammatory markers in women with threatened abortion and to investigate their association with threatened abortion. This retrospective cohort study included 802 pregnant women presenting before 20 weeks of gestation. Hematological parameters were compared between women with threatened abortion and healthy pregnant controls. Neutrophil, lymphocyte, platelet, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values were evaluated. Multivariable binary logistic regression analyses were performed to identify factors independently associated with threatened abortion, with primary hematological parameters and derived inflammatory indices assessed in separate models to reduce multicollinearity. Women with threatened abortion had significantly lower lymphocyte counts and higher NLR and PLR values than controls (all P < .001), whereas neutrophil and platelet counts did not differ significantly. In multivariable analysis, lower lymphocyte count and higher neutrophil count were independently associated with threatened abortion. In the model including inflammatory indices, both NLR (odds ratio = 2.017, 95% confidence interval = 1.450-2.805; P < .001) and PLR (odds ratio = 1.033, 95% confidence interval = 1.022-1.044; P < .001) were independently associated with threatened abortion. Threatened abortion was characterized by lower lymphocyte counts and higher NLR and PLR values. These readily available inflammatory indices may serve as useful adjunctive markers for clinical assessment; however, prospective multicenter studies are needed to confirm their predictive utility.
Atrial fibrillation (AF) is associated with increased risk of stroke due to left atrial appendage (LAA) thrombus formation. Two-dimensional speckle tracking imaging (2D-STI) may provide valuable insights into left atrial and LAA functional changes associated with thrombus formation. This study aimed to evaluate the functions of the left atrium (LA) and LAA in patients with non-valvular AF by using 2D-STI and explore echocardiographic parameters associated with the presence of LAA thrombus. In this comparative cross-sectional study, consecutive patients with non-valvular AF who were scheduled for radiofrequency ablation were screened. Finally, 68 eligible AF patients and 30 age-matched healthy controls were included. All AF patients underwent preoperative transthoracic echocardiography, transesophageal echocardiography, and two-dimensional speckle tracking imaging, and were classified according to the presence or absence of LAA thrombus detected by transesophageal echocardiography into the thrombus group (n = 32) and the non-thrombus group (n = 36). The healthy controls were included as a reference group for comparison of echocardiographic parameters. The left atrial appendage emptying velocity (LAAEV), left atrial global longitudinal strain (LAGLS), and LAA global longitudinal strain (LAAGLS) were measured and compared between groups. Compared with the control group, AF patients showed significantly reduced LAAEV, LAGLS, and left atrial appendage global longitudinal strain (all P < .05). In AF patients, the thrombus group had significantly lower LAAEV, LAGLS, and left atrial appendage global longitudinal strain compared to the non-thrombus group (all P < .05). Multivariable logistic regression analysis showed that LAAEV and left atrial strain during reservoir phase were significantly associated with the presence of LAA thrombus. 2D-STI can quantitatively evaluate the functional changes of the LA and LAA. LAAEV and left atrial strain during reservoir phase may serve as useful echocardiographic markers for assisting clinical evaluation of LAA thrombus.
Gestational diabetes mellitus (GDM) is a common pregnancy complication with short- and long-term adverse outcomes for mother and child. The Finnish Diabetes Risk Score (FINDRISC) is a simple, validated questionnaire for type 2 diabetes risk, but its ability to identify GDM is not well established. In this multicenter cross-sectional study, 797 pregnant women at 24 to 28 weeks of gestation who attended 3 tertiary hospitals in Istanbul, Türkiye, between June and September 2024 completed the Turkish FINDRISC at the same visit as their routine GDM screening. GDM was diagnosed by the 1-step (75-g oral glucose tolerance test [OGTT]) or two-step (50-g glucose challenge test followed by 100-g OGTT) approach. Univariable and multivariable logistic regression and receiver operating characteristic analysis were performed. GDM was diagnosed in 104 women (13.0%). The FINDRISC score was higher in women with GDM (median 8 [interquartile range 6-12] vs 7 [4-10]; P = .001); each 1-point increase was associated with 8% higher odds of GDM (OR 1.08; 95% confidence interval, 1.03-1.13). The area under the receiver operating characteristic curve was 0.599 (95% confidence interval, 0.542-0.655). At the optimal cutoff (≥8 points), sensitivity was 62.5%, specificity 53.2%, positive predictive value 16.7%, negative predictive value 90.4%, and negative likelihood ratio 0.70; 37.5% of GDM cases scored below this cutoff. A cutoff of ≥4 points yielded 88.5% sensitivity but would have avoided OGTT in only 22.0% of women. In multivariable analysis, age ≥ 35 years (adjusted OR 2.40), body mass index > 30 kg/m2 (adjusted OR 2.88), and non-daily fruit/vegetable intake (adjusted OR 1.70) were independently associated with GDM. When administered at 24 to 28 weeks, FINDRISC showed poor discrimination for concurrently diagnosed GDM. Its negative predictive value largely reflects the low prevalence of GDM, and no cutoff combined acceptable sensitivity with a meaningful reduction in OGTTs. FINDRISC should not replace universal OGTT screening; pregnancy-specific risk models evaluated prospectively in early pregnancy are needed.
The triglyceride glucose-weight-adjusted waist index (TyG-WWI), integrating glycolipid metabolism and central obesity, may offer a novel approach to identifying metabolic dysregulation linked to hypertension, yet its association with hypertension among general adults remains inadequately characterized. In this cross-sectional analysis of 2716 adults (aged ≥ 20 years) from the National Health and Nutrition Examination Survey 2015 to 2018, hypertension was defined by self-reported physician diagnosis. Multivariable logistic regression, restricted cubic splines, subgroup analyses, and exploratory mediation analyses were applied, accounting for the complex survey design with fasting subsample weights. Of 2716 participants, 890 (32.8%) had hypertension. After full adjustment, each unit increase in TyG-WWI was associated with a 2% increase in the odds of hypertension (OR = 1.02, 95% confidence interval: 1.01-1.03, P < .001). A nonlinear dose-response relationship was observed (P for nonlinearity < .05), with risk accelerating at higher TyG-WWI levels; participants in the highest quartile had 72% higher odds than those in the lowest quartile (OR = 1.72, 95% confidence interval: 1.21-2.46; P for trend < .001). Subgroup analyses showed stronger associations in females and in normal-weight individuals. Exploratory mediation analyses suggested that body mass index and uric acid may account for 30.49% and 7.95% of the association, respectively; these estimates are descriptive and should not be interpreted as evidence of biological mediation. Higher TyG-WWI was independently associated with a higher prevalence of self-reported hypertension among United States adults across all body mass index categories. These findings support TyG-WWI as a promising composite marker for hypertension risk stratification; the exploratory mediation estimates warrant confirmation in prospective studies.
