Sarcoidosis is thought to result from the interaction between an unknown environmental antigenic trigger and the host's genetic susceptibility. We hypothesized that sarcoidosis, or one of the disease subsets, could be associated with single nucleotide polymorphisms of C-C chemokine receptor 2 (CCR2) gene. Eight single-nucleotide polymorphisms in CCR2 were studied in a total of 304 Dutch individuals (90 non-Löfgren sarcoidosis, 47 Löfgren's syndrome, 167 control subjects). From the investigated CCR2 polymorphisms, nine haplotypes were deduced (haplotypes 1–9). In patients with Löfgren's syndrome, a strongly significant increase in the frequency of CCR2-haplotype 2, which includes four unique alleles (A at nucleotide position –6752, A at 3,000, T at 3,547, and T at 4,385), was observed compared with control subjects (74% vs. 38% respectively, p < 0.0001), whereas no difference was found between non-Löfgren sarcoidosis and control subjects (both 38%). The association between CCR2-haplotype 2 carriage frequency and Löfgren's syndrome (odds ratio, 4.4; p < 0.0001) remained significant after adjustment for human leukocyte antigen haplotype DRB1*0301-DQB1*0201 (odds ratio, 11.5; p < 0.0001) and female sex (odds ratio, 3.2; p = 0.003), two known risk factors for Löfgren's syndrome. In conclusion, this report describes a strong association between CCR2-haplotype 2 and Löfgren's syndrome. Further studies are needed to understand the molecular mechanisms underlying this association.

Infants who are exclusively breastfed in the first six months of age receive adequate nutrients, achieving optimal immune protection and growth. In addition to the known nutritional components of human breast milk (HBM), i.e., water, carbohydrates, fats and proteins, it is also a rich source of microRNAs, which impact epigenetic mechanisms. This comprehensive work presents an up-to-date overview of the immunomodulatory constituents of HBM, highlighting its content of circulating microRNAs. The epigenetic effects of HBM are discussed, especially those regulated by miRNAs. HBM contains more than 1400 microRNAs. The majority of these microRNAs originate from the lactating gland and are based on the remodeling of cells in the gland during breastfeeding. These miRNAs can affect epigenetic patterns by several mechanisms, including DNA methylation, histone modifications and RNA regulation, which could ultimately result in alterations in gene expressions. Therefore, the unique microRNA profile of HBM, including exosomal microRNAs, is implicated in the regulation of the genes responsible for a variety of immunological and physiological functions, such as FTO, INS, IGF1, NRF2, GLUT1 and FOXP3 genes. Hence, studying the HBM miRNA composition is important for improving the nutritional approaches for pregnancy and infant’s early life and preventing diseases that could occur in the future. Interestingly, the composition of miRNAs in HBM is affected by multiple factors, including diet, environmental and genetic factors.

Sarcoidosis and Crohn’s disease are heterogeneous systemic diseases characterised by granulomatous inflammation.Caspase recruitment domain(CARD)15is a major susceptibility gene for Crohn’s disease, and specifically for ileal and fibrostenotic subtypes. TheC-C chemokine receptor(CCR)5gene has been associated with both parenchymal pulmonary sarcoidosis and perianal Crohn’s disease.This study explored associations betweenCARD15polymorphisms,CCR5haplotype and distinct pulmonary sarcoidosis subtypes. 185 Caucasian sarcoidosis patients were genotyped forCARD15andCCR5polymorphisms. The genetic data were compared with 347 healthy controls and were examined for associations with serial pulmonary function tests and chest radiographs. CARD15genotypes did not differ between the unselected sarcoidosis cohort and controls. However, patients carrying the functional2104T(702W) polymorphism were more likely to have radiographic stage IV disease at 4-yr follow-up. All patients possessing bothCARD15 2104TandCCR5HHChaplotype had stage IV disease at presentation. Carriage of2104Twas associated with worse forced expiratory volume in 1 s, whereas carriage of theCARD15 1761G (587R)polymorphism was associated with better lung function.For the first time, an association between twoCARD15polymorphisms and specific sarcoidosis phenotypes has been demonstrated, as well as an additive effect of possessingCARD15 2104TandCCR5HHChaplotype.

Background: Shifting the educational system from a traditional to an online context during COVID-19 necessitated several considerations to assure students’ satisfaction with e-learning. Aim: This study aims to explore the factors influencing students’ satisfaction with e-learning during the COVID-19 crisis. In particular, it tests multiple mediations, student factors, and system quality between students’ satisfaction and each course evaluation and instructor’s performance. Methodology: In this cross-sectional study, 258 undergraduate and postgraduate students enrolled in online courses at multiple Malaysian universities were recruited using non-probabilistic purposive sampling. Data were collected using a questionnaire that assessed four factors that influenced students’ satisfaction with e-learning during the COVID-19 crisis (i.e., instructor performance, course evaluation, student factors, and system quality) and analyzed using the partial least squares route structural equation modelling (PLS-SEM). Results: The results indicated that the four factors were significantly associated with students’ satisfaction with e-learning during COVID-19. Student factors and system quality were the most factors predicting students’ satisfaction with e-learning. Findings indicate statistically significant relationships between the instructor’s performance, student factors, course evaluation, and system quality on students’ satisfaction. Furthermore, the results depict that both course evaluation and system quality serially mediate the relationship between instructors’ performance and students’ satisfaction. Conclusion: This study finds that improving and enhancing student factors and system quality is critical for students’ satisfaction with e-learning. Furthermore, e-learning platforms should contain new advances of computer-mediated technologies that enable collaboration, which is a critical factor in the success of e-learning systems.

Background: Healthcare workers are often overworked, underfunded, and face many challenges. Integration of artificial intelligence into healthcare service provision can tackle these challenges by relieving burdens on healthcare workers. Since healthcare students are our future healthcare workers, we assessed the knowledge, attitudes, and perspectives of current healthcare students at Qatar University on the implementation of artificial intelligence into healthcare services. Methods: This was a cross-sectional study of QU-Health Cluster students via an online survey over a three-week period in November 2021. Chi-squared tests and gamma coefficients were used to compare differences between categorical variables. Results: One hundred and ninety-three QU-Health students responded. Most participants had a positive attitude towards artificial intelligence, finding it useful and reliable. The most popular perceived advantage of artificial intelligence was its ability to speed up work processes. Around 40% expressed concern about a threat to job security from artificial intelligence, and a majority believed that artificial intelligence cannot provide sympathetic care (57.9%). Participants who felt that artificial intelligence can better make diagnoses than humans also agreed that artificial intelligence could replace their job (p = 0.005). Male students had more knowledge (p = 0.005) and received more training (p = 0.005) about healthcare artificial intelligence. Participants cited a lack of expert mentorship as a barrier to obtaining knowledge about artificial intelligence, followed by lack of dedicated courses and funding. Conclusions: More resources are required for students to develop a good understanding about artificial intelligence. Education needs to be supported by expert mentorship. Further work is needed on how best to integrate artificial intelligence teaching into university curricula.

Rationale: Genetic factors are likely to influence the clinical course and pattern of sarcoidosis, a granulomatous disease of unknown origin. Objectives: We tested this hypothesis for C-C chemokine receptor 5 (CCR5), a molecule involved in recruitment and activation of mononuclear cells. Methods: In addition to the known CCR5 Delta 32 insertion/deletion, we evaluated a further eight single-nucleotide polymorphisms in 106 British patients and 142 British unaffected subjects, and second-setted the results in 112 Dutch patients and 169 healthy Dutch control subjects. Measurements and Main results: In the British population, the frequency of one of the identified haplotypes (HHC) was strongly associated with the presence of parenchymal disease (radiographic stage ⩾ II versus stages 0 and I) at presentation (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.96–13.7; corrected p = 0.02), at 2 (OR, 6.6; 95% CI, 2.5–17.6; corrected p = 0.006), and at 4 years follow-up (OR, 6.8; 95% CI, 2.5–18.0; corrected p = 0.0045). In the Dutch population, the same association was seen at 2 (OR, 6.7; 95% CI, 2.8–16.4; corrected p = 0.002), and 4 years follow-up (OR, 9.0; 95% CI, 3.5–23.1; corrected p = 0.0009). Conclusions: No association between the CCR5 haplotype HHC and susceptibility to sarcoidosis was observed, indicating that this relevant gene only operates after disease induction. In summary, we report a strong association between CCR5 haplotype HHC and persistent lung involvement in sarcoidosis.