Additional file 1: Table S1. of Emotional intelligence and academic performance of medical undergraduates: a cross-sectional study in a selected university in Sri Lanka

Socio-demographic factors and academic performance at final MBBS examination (n = 130). This table shows the association between socio-demographic factors and examination results at the final MBBS examination. (DOCX 17 kb

Scoring system to assess the severity of lumbar disc degeneration in T2 weighted midsagittal MRI of lumbar spine.

<p>Scoring system to assess the severity of lumbar disc degeneration in T2 weighted midsagittal MRI of lumbar spine.</p

Single Nucleotide Variants of Candidate Genes in Aggrecan Metabolic Pathway Are Associated with Lumbar Disc Degeneration and Modic Changes

<div><p>Introduction</p><p>Lumbar disc degeneration (LDD) is genetically determined and severity of LDD is associated with Modic changes. Aggrecan is a major proteoglycan in the intervertebral disc and end plate. Progressive reduction of aggrecan is a main feature of LDD and Modic changes.</p><p>Objectives</p><p>The study investigated the associations of single nucleotide variants (SNVs) of candidate genes in the aggrecan metabolic pathway with the severity of LDD and Modic changes. In-silico functional analysis of significant SNVs was also assessed.</p><p>Methods</p><p>A descriptive cross sectional study was carried out on 106 patients with chronic mechanical low back pain. T1, T2 sagittal lumbar MRI scans were used to assess the severity of LDD and Modic changes. 62 SNVs in ten candidate genes (<i>ACAN</i>, <i>IL1A</i>, <i>IL1B</i>, <i>IL6</i>, <i>MMP3</i>, <i>ADAMTS4</i>, <i>ADAMTS5</i>, <i>TIMP1</i>, <i>TIMP2</i> and <i>TIMP3</i>) were genotyped on Sequenom MassARRAY iPLEX platform. Multiple linear regression analysis was carried out using PLINK 1.9 in accordance with additive genetic model. In-silico functional analysis was carried out using Provean, SIFT, PolyPhen and Mutation Taster.</p><p>Results</p><p>Mean age was 52.42±9.42 years. 74 (69.8%) were females. The rs2856836, rs1304037, rs17561 and rs1800587 variants of the <i>IL1A</i> gene were associated with the severity of LDD and Modic changes. The rs41270041 variant of the <i>ADAMTS4</i> gene and the rs226794 variant of the <i>ADAMTS5</i> gene were associated with severity of LDD while the rs34884997 variant of the <i>ADAMTS4</i> gene, the rs55933916 variant of the <i>ADAMTS5</i> gene and the rs9862 variant of the <i>TIMP3</i> gene were associated with severity of Modic changes. The rs17561 variant of the <i>IL1A</i> gene was predicted as pathogenic by the PolyPhen prediction tool.</p><p>Conclusions</p><p>SNVs of candidate genes in <i>ACAN</i> metabolic pathway are associated with severity of LDD and Modic changes in patients with chronic mechanical low back pain. Predictions of in-silico functional analysis of significant SNVs are inconsistent.</p></div

Haplotype frequencies and their associations with the severity of lumbar disc herniation.

<p>Haplotype frequencies and their associations with the severity of lumbar disc herniation.</p

Selected genes which are involved in aggrecan and its metabolic pathway.

<p>Selected genes which are involved in aggrecan and its metabolic pathway.</p

Assessment of the x-ray features of lumbar disc degeneration—lateral x-ray of lumbar spine.

<p>Arrows—A–no disc space narrowing/anterior osteophyte (grade 0 lumbar disc degeneration), B–mild disc space narrowing and small anterior osteophyte (grade 1 lumbar disc degeneration), C–small anterior osteophyte and moderate disc space narrowing (grade 2 lumbar disc degeneration) [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0181580#pone.0181580.ref003" target="_blank">3</a>].</p

Summary of the sample characteristics of 106 patients who underwent both MRI scan of lumbar spine and genetic association analysis.

<p>Summary of the sample characteristics of 106 patients who underwent both MRI scan of lumbar spine and genetic association analysis.</p

Type II Modic changes in lumbar spine.

<p>Hyperintense changes in both T1 (A) and T2 (B) weighted images.</p

Significant SNVs and their functional predictions.

<p>Significant SNVs and their functional predictions.</p

Type I Modic changes in lumbar spine.

<p>Hypointense changes in T1-weighted images (A) and hyperintense changes in T2 weighted MRI images (B).</p