Knowledge regarding and patterns of genetic testing in patients newly diagnosed with breast cancer participating in the iCanDecide trial

BackgroundThe current study reports rates of knowledge regarding the probability of a BRCA1 and/or S pathogenic variant and genetic testing in patients with breast cancer, collected as part of a randomized controlled trial of a tailored, comprehensive, and interactive decision tool (iCanDecide).MethodsA total of 537 patients newly diagnosed with early‐stage breast cancer were enrolled at the time of their first visit in 22 surgical practices, and were surveyed 5 weeks (496 patients; Response Rate [RR], 92%) after enrollment after treatment decision making. Primary outcomes included knowledge regarding the probability of carrying a BRCA1 and/or BRCA2 pathogenic variant and genetic testing after diagnosis.ResultsOverall knowledge regarding the probability of having a BRCA1 and/or BRCA2 pathogenic variant was low (29.8%). Significantly more patients in the intervention group compared with the control group had knowledge regarding the probability of a BRCA1 and/or BRCA2 pathogenic variant (35.8% vs 24.4%; P <.006). In multivariable logistic regression, the intervention arm remained significantly associated with knowledge regarding the probability of having a BRCA1 and/or BRCA2 pathogenic variant (odds ratio, 1.79; 95% confidence interval, 1.18‐2.70).ConclusionsThe results of the current study suggest that although knowledge concerning the probability of having a BRCA1 and/or BRCA2 pathogenic variant remains low in this patient population, the interactive decision tool improved rates compared with a static Web site. As interest in genetic testing continues to rise, so will the need to integrate tools into the treatment decision process to improve informed decision making.As interest in genetic testing increases, so will the need to integrate tools into the treatment decision process. Results from the current study suggest that although knowledge regarding the probability of a BRCA1 and/or BRCA2 pathogenic variant remains low in this patient population, the interactive decision tool improved rates compared with a static Web site.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146553/1/cncr31731.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146553/2/cncr31731_am.pd

Primary care provider–reported involvement in breast cancer treatment decisions

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149227/1/cncr31998.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149227/2/cncr31998_am.pd

To Study the Prevalence of ABO Incompatibility in O Blood Group Mothers and Assessment of IgG Subclasses (IgG1 And IgG3) in them and Its Correlation with Occurrence and Severity of ABO Hemolytic Disease of Newborn (ABO-HDN) in a Tertiary Health Care Centre in South India

INTRODUCTION: ABO Hemolytic disease of the newborn (ABO HDN) is an immune reaction that occurs most commonly in newborns of A, B or AB blood group born to mothers of O blood group. Following the introduction of Rh immunoprophylaxis, the prevalence of Rh haemolytic disease has come down drastically and now ABO-HDN is emerging as the most common cause of HDN in the developed countries. ABO HDN occurs due to transplacental transfer of maternal anti-A and anti-B IgG antibodies leading to immune haemolysis of fetal erythrocytes. IgG has 4 subtypes – IgG1, IgG2, IgG3 and IgG4, of which IgG1 and IgG3 are effectively transported across placenta via an Fc receptor. There is very limited literature on the prevalence and factors that impact on ABOHDN from India. Against the background of extremely variable health care facilities in our country, we thought it is critical to study factors that may predict the severity of ABO-HDN in mothers with O blood group. Early identification, diagnosis and intervention can reduce morbidity and mortality due to ABO hemolytic disease of newborn. OBJECTIVES: 1. To study prevalence of ABO incompatible pregnancies in O blood group mothers. 2. To study the correlation of maternal IgG anti-A and anti-B titers and IgG1/IgG3 subclasses with occurrence of ABO-HDN. METHODS: A total of 575 mothers with O blood group and a negative antibody screen were recruited for the study. Venous samples were collected after obtaining consent from the 203 mothers who delivered babies with either A or B blood group. Maternal anti -A and anti- B titers and IgG1 and IgG3 subtyping were performed in the collected samples. Babies were assessed by the neonatology team for the presence or absence of HDN using criteria as per the international guidelines. Pearson and Fischer’s exact chi square was used for comparison of categorical data. Univariate and binary logistic regression analysis was used for comparing the categorical data and to calculate the odds ratio. P value < 0.05 was considered significant. RESULTS: The prevalence of ABO incompatible pregnancies was estimated to be 35.3% in O blood group mothers and among them 37.4% cases developed ABO-HDN. There was an independent association between maternal IgG titer levels of ≥ 64 and presence of IgG1/IgG3 subclasses with the occurrence of ABO-HDN (p value < 0.001). Analysis of IgG1 and IgG3 subclasses showed statistically significant association with HDN at titers of 16, 32 and 64 (p value <0.05, <0.001and < 0.001 respectively

Phytochemical Screening, Antioxidant activity and Antimicrobial activity of the ethanol extract of the leaf petiole of Artocarpus heterophyllus Lam., A traditionally used medicine

Artocarpus heterophyllus Lam. belonging to family Moraceae is commonly known as jackfruit. The leaves, fruit, bark and roots have diverse medicinal properties and are used in the various traditional and folk systems of medicine to treat a variety of ailments. The present work evaluates the phytochemical screening, antioxidant property and antimicrobial activity of ethanolic extract of the leaf petiole of A. heterophyllus. &nbsp;Phytochemical screening revealed the presence of alkaloids, flavonoids, phenols, steroids, tannins and cardiac glycosides. Total phenolic content of the extract was estimated using Folin- Ciocalteau spectrometric method as 2.89 mg of gallic acid equivalent/g of leaf extract. The free radical scavenging activity was evaluated with DPPH (1,1-diphenyl-2-picrylhydrazyl), nitric oxide radical and hydrogen peroxide scavenging. The IC50 values of the ethanol extract of the plant for scavenging DPPH, nitric oxide and hydrogen peroxide were estimated as 152.2 ± 0.09 µg/ml, 941.17 ± 0.08 µg/ml and 154.1 ± 0.08 µg/ml respectively. The antibacterial activity of A. heterophyllus petiole extract was examined against five bacterial species namely, Pseudomonas aeruginosa, Escherichia coli, Bacillus cereus, Staphylococcus aureus and Klebsiella pneumoniae using agar well diffusion method. The preliminary phytochemical analysis indicated the presence of bioactive compounds responsible for the antioxidant activities. Therefore, it could be a potential source of natural antioxidant with adverse therapeutic properties.&nbsp

Artificial intelligence in medical education - perception among medical students

Abstract Background As Artificial Intelligence (AI) becomes pervasive in healthcare, including applications like robotic surgery and image analysis, the World Medical Association emphasises integrating AI education into medical curricula. This study evaluates medical students’ perceptions of ‘AI in medicine’, their preferences for AI training in education, and their grasp of AI’s ethical implications in healthcare. Materials & methods A cross-sectional study was conducted among 325 medical students in Kerala using a pre-validated, semi structured questionnaire. The survey collected demographic data, any past educational experience about AI, participants’ self-evaluation of their knowledge and evaluated self-perceived understanding of applications of AI in medicine. Participants responded to twelve Likert-scale questions targeting perceptions and ethical aspects and their opinions on suggested topics on AI to be included in their curriculum. Results & discussion AI was viewed as an assistive technology for reducing medical errors by 57.2% students and 54.2% believed AI could enhance medical decision accuracy. About 49% agreed that AI could potentially improve accessibility to healthcare. Concerns about AI replacing physicians were reported by 37.6% and 69.2% feared a reduction in the humanistic aspect of medicine. Students were worried about challenges to trust (52.9%), patient-physician relationships (54.5%) and breach of professional confidentiality (53.5%). Only 3.7% felttotally competent in informing patients about features and risks associated with AI applications. Strong demand for structured AI training was expressed, particularly on reducing medical errors (76.9%) and ethical issues (79.4%). Conclusion This study highlights medical students’ demand for structured AI training in undergraduate curricula, emphasising its importance in addressing evolving healthcare needs and ethical considerations. Despite widespread ethical concerns, the majority perceive AI as an assistive technology in healthcare. These findings provide valuable insights for curriculum development and defining learning outcomes in AI education for medical students