Cross-sectional Survey of Medical student perceptions of And desires for Research and Training pathways (SMART): an analysis of prospective cohort study of UK medical students

Objective: Clinician-scientists are critical to medical innovation and research. However, the number of clinician scientists in the UK has been declining steadily over the last decade. One of the cited reasons is poor student recruitment to academic training pathways. The SMART study aims to assess current student perceptions on research and identify key factors influencing whether a student is interested in research. Design: We conducted a cross-sectional survey study between January and May 2022. Setting: This was a multi-centre national study with data collected across 40 universities offering medical courses in the UK. Participants: Participants were UK medical students enrolled in medicine for 21/22 academic year. Main outcome and measure: The main outcomes were related to participant perceptions on research and whether they were interested in engaging with research in their future career. These measures were correlated with demographic and non-demographic details using regression analyses. Results: One thousand seven hundred seventy-four individuals participated in the SMART survey from 40 medical schools. Nearly half the participants felt there were barriers preventing them from doing research (46.67%) and almost three-quarters felt it was at least somewhat difficult to combine research with medical school (73.49%). Of the options available, most commonly students did not want to pursue an academic career (43.11%) or training pathway (42.49%). However, most participants felt it was useful to do research at medical school (59.54%) and were also interested in doing more research in the future (69.16%). Regression analysis identified many factors influencing student’s perceptions of research including year of study, gender, socioeconomic status, family background, research exposure at medical school, ethnicity, and country of pre-university education. Conclusions: The SMART study is the first of its kind in the UK, shedding light on medical student perceptions. While some express strong interest in academic careers, a larger proportion show a broader interest in research. Demographic factors like gender, parental occupation, and socioeconomic status play a role. Further exploration is needed for specific groups to address barriers, promote research, and boost academic pathway recruitment

3D bioactive composite scaffolds for bone tissue engineering

Bone is the second most commonly transplanted tissue worldwide, with over four million operations using bone grafts or bone substitute materials annually to treat bone defects. However, significant limitations affect current treatment options and clinical demand for bone grafts continues to rise due to conditions such as trauma, cancer, infection and arthritis. Developing bioactive three-dimensional (3D) scaffolds to support bone regeneration has therefore become a key area of focus within bone tissue engineering (BTE). A variety of materials and manufacturing methods including 3D printing have been used to create novel alternatives to traditional bone grafts. However, individual groups of materials including polymers, ceramics and hydrogels have been unable to fully replicate the properties of bone when used alone. Favourable material properties can be combined and bioactivity improved when groups of materials are used together in composite 3D scaffolds. This review will therefore consider the ideal properties of bioactive composite 3D scaffolds and examine recent use of polymers, hydrogels, metals, ceramics and bio-glasses in BTE. Scaffold fabrication methodology, mechanical performance, biocompatibility, bioactivity, and potential clinical translations will be discussed

Burden of disease attributable to ambient fine particulate matter exposure in Taiwan

There is compelling epidemiological evidence that links air pollution to increased risk of mortality from cardiopulmonary disease and lung cancer. We quantified the burden of mortality attributable to ambient fine particulate matter (PM2.5) among the Taiwanese population in 2014 at the national and subnational levels. Methods: Subnational PM2.5 exposure levels were obtained from Taiwan Air Quality Monitoring Network. Relative risks were derived from a previously developed exposure-response model. Population attributable fraction for cause-specific mortality was estimated at the county level using the estimated ambient PM2.5 concentrations and the relative risk functions. Results: In 2014, PM2.5 accounted for 6282 deaths [95% confidence interval (CI), 5716–6847], from ischemic heart disease (2244 deaths; 95% CI, 2015–2473), stroke (2140 deaths; 95% CI, 1760–2520), lung cancer (1252 deaths; 95% CI, 995–1509), and chronic obstructive pulmonary disease (645 deaths; 95% CI, 418–872). Nationally, the population attributable mortality fraction of PM2.5 for the four disease causes was 18.6% (95% CI, 16.9–20.3%). Substantial geographic variation in PM2.5 attributable mortality fraction was found; the percentage of deaths attributable to PM2.5 ranged from 8.7% in Hualian County to 21.8% in Yunlin County. In terms of absolute number of deaths, New Taipei and Kaohsiung cities had the largest number of deaths associated with PM2.5 (874 and 829 deaths, respectively) among all cities and counties. Conclusion: Ambient PM2.5 pollution is a major mortality risk factor in Taiwan. Aggressive and multisectorial intervention strategies are urgently needed to bring down the impact of air pollution on environment and health

Genotypic and Phenotypic Characterization of Chikungunya Virus of Different Genotypes from Malaysia

<div><h3>Background</h3><p>Mosquito-borne Chikungunya virus (CHIKV) has recently re-emerged globally. The epidemic East/Central/South African (ECSA) strains have spread for the first time to Asia, which previously only had endemic Asian strains. In Malaysia, the ECSA strain caused an extensive nationwide outbreak in 2008, while the Asian strains only caused limited outbreaks prior to this. To gain insight into these observed epidemiological differences, we compared genotypic and phenotypic characteristics of CHIKV of Asian and ECSA genotypes isolated in Malaysia.</p> <h3>Methods and Findings</h3><p>CHIKV of Asian and ECSA genotypes were isolated from patients during outbreaks in Bagan Panchor in 2006, and Johor in 2008. Sequencing of the CHIKV strains revealed 96.8% amino acid similarity, including an unusual 7 residue deletion in the nsP3 protein of the Asian strain. CHIKV replication in cells and <em>Aedes</em> mosquitoes was measured by virus titration. There were no differences in mammalian cell lines. The ECSA strain reached significantly higher titres in <em>Ae. albopictus</em> cells (C6/36). Both CHIKV strains infected <em>Ae. albopictus</em> mosquitoes at a higher rate than <em>Ae. aegypti</em>, but when compared to each other, the ECSA strain had much higher midgut infection and replication, and salivary gland dissemination, while the Asian strain infected <em>Ae. aegypti</em> at higher rates.</p> <h3>Conclusions</h3><p>The greater ability of the ECSA strain to replicate in <em>Ae. albopictus</em> may explain why it spread far more quickly and extensively in humans in Malaysia than the Asian strain ever did, particularly in rural areas where <em>Ae. albopictus</em> predominates. Intergenotypic genetic differences were found at E1, E2, and nsP3 sites previously reported to be determinants of host adaptability in alphaviruses. Transmission of CHIKV in humans is influenced by virus strain and vector species, which has implications for regions with more than one circulating CHIKV genotype and <em>Aedes</em> species.</p> </div

Comparative infection, replication kinetics, and dissemination of each Malaysian CHIKV strain in <i>Ae. aegypti</i> (⧫, black bars) or <i>Ae. albopictus</i> (⋄, white bars).

<p>The CHIKV isolates MY/06/37348 (Asian) and MY/08/065 (ECSA) were used. Following ingestion with MY/06/37348, infection rates of midguts of mosquitoes (A), replication in midguts as measured by a TCID₅₀ titration assay with plotted means ± SD of triplicates (B), and dissemination rates in salivary glands of mosquitoes (C) were determined. Following ingestion with MY/08/065, midgut infection (D), midgut replication (E), and salivary gland dissemination (F) were measured. Asterisks indicate significant differences (*p<0.05, **p<0.01). The denominator used to calculate midgut infection rates was the number of mosquitoes sampled, and the denominator for dissemination rates was the number of midguts with detectable virus titre. Denominators are shown (n).</p

Amino acid differences between Malaysian Chikungunya strains of Asian and East/Central/South African genotypes.

<p>Amino acid differences are reported following alignment of sequences obtained in this study from the Bagan Panchor strains MY/06/37348 and MY/06/37350 (Asian genotype), and the Johor strains MY/08/065 and MY/08/068 (ECSA genotype). The first amino acid named is found in the Asian strains, while the second amino acid is found in the ECSA strains. Differences at sites reported to be mosquito adaptation determinants in other alphaviruses are underlined.</p

Comparative replication kinetics of Malaysian CHIKV strains in cells.

<p>The CHIKV isolates MY/06/37348 (Asian, •) and MY/08/065 (ECSA, ○) were used. Replication was measured by virus titration using a TCID₅₀ assay in (A) Vero, (B) rhabdomyosarcoma, (C) C6/36, and (D) CCL-125 cells. Means ± SD of 3 independent experiments are plotted. Asterisks indicate significant differences (<i>p</i><0.05) at the same time-points.</p

Iron-catalyzed efficient synthesis of amides from aldehydes and amine hydrochloride salts

10.1002/adsc.201200020Advanced Synthesis and Catalysis35481407-1412ASCA