Succinyl-CoA:3-ketoacid-CoA transferase (SCOT) is a mitochondrial enzyme that catalyzes the reversible transfer of coenzyme-A from acetoacetyl-CoA to succinate to form acetoacetate and succinyl-CoA. mRNAs of SCOT and ATP citrate lyase were decreased 55% and 58% and enzyme activities were decreased >70% in pancreatic islets of the GK rat, a model of type 2 diabetes. INS-1 832/13 cells were transfected with shRNAs targeting SCOT mRNA to generate cell lines with reduced SCOT activity. Two cell lines with >70% knockdown of SCOT activity showed >70% reduction in glucose- or methyl succinate-plus-β-hydroxybutyrate-stimulated insulin release. Less inhibition of insulin release was observed with two cell lines with less knockdown of SCOT. Previous studies showed knockdown of ATP citrate lyase in INS-1 832/13 cells does not lower insulin release. The results further support work that suggests mitochondrial pathways involving SCOT which supply acetoacetate for export to the cytosol are important for insulin secretion.

Objective: The sympathetic nervous system (SNS) is linked to glucose, lipid, and protein metabolism. The α_2A‐adrenergic receptor (ADRA2A) is involved in the SNS and mediates inhibition of insulin secretion and lipolysis. The association of ADRA2A single‐nucleotide polymorphisms (SNPs) with obesity and/or type 2 diabetes (T2D) was investigated.Design and Methods: Genotyping was performed in a case–control study of 1,177 Swedish individuals, including lean and obese subjects with normal glucose tolerance (NGT) and T2D patients. ADRA2A mRNA expression was measured in pancreatic islets isolated from T2D patients and nondiabetic subjects.Results: SNP rs553668 was associated with T2D in men (odds ratio [OR] = 1.47; 95% confidence interval [CI] = 1.08–2.01; P = 0.015) but this association was lost after adjusting for age and for body mass index (BMI). Associations were also detected when comparing obese NGT and lean NGT subjects (OR = 1.49; 95% CI = 1.07–2.07; P = 0.017), and in obese (OR = 1.62; 95% CI = 1.06–2.49; P = 0.026), but not in lean T2D. In women, multiple logistic regression regarding SNP rs521674 demonstrated an increased OR of 7.61 (95% CI = 1.70–34.17; P = 0.008) for T2D when including age as a covariant. Correcting for BMI removed the significant association. When age was included in the model, association also found when obese T2D patients were compared with lean NGT subjects (P = 0.041). ADRA2A mRNA expression in human pancreatic islets was detectable, but with no statistically significant difference between the diabetic and the control groups.Conclusions: ADRA2A genetic polymorphisms are mainly associated with obesity and possibly with T2D in a Swedish population.

Blended learning is a key educational methodology, particularly in medical education, and involves integration of online and face-to-face interactions to enhance flexibility and engagement. Blended learning gained increased popularity during the COVID-19 pandemic due to social restrictions. Following control of the pandemic, face to face teaching and learning activities have been restored. However, some institutions continue to deliver some teaching online. This study explores the perceptions and experiences of undergraduate medical students from 15 institutions across seven countries regarding remote online learning in the post-pandemic era. This cross-sectional study utilized an online survey to gather insights into the use of learning resources, interactivity in online sessions, barriers to online learning, and preferences for learning modalities. Descriptive data were summarized by frequency, categorical comparisons were assessed with chi-squared tests, and t-tests were used for continuous data. The findings of the current study show a general preference for blended learning (47.78%) over traditional face-to-face instruction (41.48%). Key benefits of blended learning reported by the participants by comfort, flexibility, reduced travel, and ability to learn at own pace. The key barriers identified were internet connectivity issues and family distractions. The study also highlighted the limitations of online learning in replacing clinical experience and practical skills acquisition, with 69.26% of respondents affirming that online learning does not sufficiently substitute for direct patient contact. The findings underscore the importance of integrating face to face and remote online teaching and learning frameworks to align with educational objectives, particularly in fostering interactivity and practical skill development. The study suggests that while blended learning has many benefits, its effectiveness is highly context-dependent and requires thoughtful implementation to meet the diverse needs of medical education.

Background: Non-proliferative diabetic retinopathy (NPDR) is a significant complication of long-term diabetes in Sudan. This study aimed to determine the prevalence and risk factors of diabetic retinopathy among Sudanese individuals with type 2 diabetes mellitus who are taking oral antidiabetic medication. Methods: This cross-sectional, facility-based study recruited 196 individuals with type 2 diabetes at the Jabir Abu Eliz Diabetes Health Center in Khartoum State. Data were collected through a structured questionnaire, which patients filled out after providing informed consent. The data were analyzed using the Statistical Package for the Social Sciences (SPSS). Logistic regression was performed to predict factors associated with diabetic retinopathy. Results: The mean age of the patients was 50.1 ± 10.7 years. The prevalence of NPDR was 78 (39.8%). Bivariate analysis revealed that age, education level, and residence (Pvalue < 0.05) were significantly associated with diabetic retinopathy. Additional factors that were significantly associated with diabetic retinopathy included the duration of diabetes, the presence of other comorbidities, HbA1c, and fasting blood glucose in 68 (87.2%) individuals (P-value < 0.05). Conclusion: The study revealed a prevalence of 39.8% for NPDR in this cohort. A longer duration of diabetes and poor control are the primary risk factors for diabetic retinopathy in Sudan. Further research is necessary to determine whether intensifying therapy or administering insulin may reduce the prevalence of retinopathy.

Introduction: This study aimed to determine the maximum mouth opening (MMO) among a group of Sudanese adults. Reduced mouth opening (MO) can lead to difficulties in mastication and social interactions, potentially impacting dental treatment planning. Comparing the MMO values between males and females, relating each subject’s 3-4 finger width to inter-incisal distance was the method used. Methodology: A total of 277 undergraduate students (179 females and 98 males), aged 18–25 years, participated in the study. MMO was measured as the vertical inter-incisal distance using a digital vernier caliper. Participants were also assessed on the number of fingers they could fit vertically between their incisors, with the normal range defined as 3–4 fingers. The finger width in millimeters was then compared to the previously measured MMO. Additionally, the ratio between MMO and maximum lateral mandibular movements (right and left excursions) was recorded. Results: The overall mean MMO was 52.64 ± 6.4 mm, with males exhibiting a significantly higher mean MMO (56.33 ± 6.77 mm) compared to females (50.62 ± 5.19 mm). Approximately 69.3% (n=192) of participants could place four fingers vertically between their incisors. A statistically significant difference was found when comparing the mean MMO to the finger width measurements (p < 0.001). The mean lateral excursion was 9.13 mm, and a significant correlation between MMO and lateral excursion was observed, with a ratio of approximately 1:5.6 Discussion: The mean MMO was 52.6 mm, higher than most previous studies, possibly due to ethnic and physical differences. Males showed greater MMO than females, likely due to larger mandibular size, although females may have relatively greater joint mobility. Most subjects could insert four fingers vertically between their incisors, unlike other populations, reflecting higher MMO in this group. Lateral mandibular movement averaged 9.13 mm, consistent with other studies, and a weak positive correlation was found between vertical and lateral mouth movements, especially in males. Conclusion: The mean MMO in this Sudanese adult population was 52.64 mm, with males demonstrating significantly greater mouth opening than females. Most participants (69.3%) could accommodate four fingers inter-incisally. The ratio of MMO to lateral excursion was higher than previously reported in the literature, suggesting potential population-specific variations.

Prior research suggests links between prenatal psychological distress (PPD) and adverse birth outcomes. Yet, effects of independent and comorbid PPD domains, sociodemographic variations, and timing of exposure remain inconsistent. This study examined associations between PPD, preterm birth (PTB), and other birth outcomes, and assessed variations by maternal race/ethnicity and age. This retrospective study utilized data from the ECHO Program. PPD was assessed using the 10-item Edinburgh Prenatal Depression Scale, 3-item EPDS anxiety subscale, 10-item perceived stress scale, and/or PPD identified from medical records. Multivariate logistic regression examined associations, adjusting sequentially for cohort, maternal age, race/ethnicity, smoking, and alcohol consumption (Model 1), household income (Model 2), and pre-pregnancy body mass index (Model 3). Analyses were stratified by maternal racial/ethnicity and age. Sensitivity analysis investigated associations by PPD assessment time and social support. In total, 6656 pregnancies were included. PPD was associated with higher odds of PTB (aOR = 1.34, 95%CI 1.10-1.63, p = 0.00). Higher associations appeared among Black (aOR = 1.66, 95%CI 0.98, 2.80, p = 0.06) and Hispanic women (aOR = 1.58, 95%CI 1.14, 2.20, p = 0.01), and women <25 years (aOR = 1.64, 95%CI 1.32,2.04, p = 0.00). Depression or anxiety assessed in the first trimester and perceived stress in the third trimester increased PTB odds, whereas adequate social support reduced odds (aOR = 0.76, 95%CI 0.39,1.48, p = 0.42). PPD increases the risk of adverse birth outcomes, with effects varying by maternal race, age, and timing of exposure assessment. Adequate social support may buffer effects. Longitudinal prospective research and mechanistic studies are needed to establish causal pathways and identify vulnerability windows.