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Academic writing is a salient skill for medical students all over the world. Academic writing starts with composing effective paragraphs, laying the foundation for students' advancement in writing during college. This study investigated common mistakes in English paragraph writing committed by the first-year medical students of the Medicine Faculty at Kabul University of Medical Sciences. Additionally, it measured the challenges that Medicine Faculty students tackled in paragraph writing. This quantitative study was conducted through an action research design. The data were collected from 52 medical students, and their work was analyzed using the developed rubrics. The data were analyzed in the SPPS 26 version, and the descriptive statistics were reported. The findings revealed that participants obtained the highest means in the mechanics of paragraph writing (22 out of 25), and they received the lowest means (12 out of 25) in the contents of a paragraph. In English for Medical Purposes (EMP), students should improve their content finding, paragraphing, summarizing, and referencing skills for their assignments and research writings. Medical students should give detailed attention to every characteristic of academic paragraph writing because they give readers a full grasp of the contents of their written works.

PurposeTo describe progression of best-corrected visual acuity (BCVA), full-field stimulus thresholds (FST), and electroretinography (ERG) over 4 years in the USH2A-related Retinal Degeneration study and to assess their suitability as clinical trial endpoints.DesignProspective natural history study.ParticipantsParticipants (n = 105) with biallelic disease-causing sequence variants in USH2A and BCVA letter scores of ≥54 were included.MethodsBCVA, FST, fundus-guided microperimetry, static perimetry, and spectral domain OCT were performed annually and ERG at baseline and 4 years only. Mixed effects models were used to estimate annual rates of change with 95% confidence intervals. Associations of change from baseline to 4 years between BCVA, FST, ERG, and other metrics were assessed with Spearman correlation coefficients (rs).Main outcome measuresBest-corrected visual acuity, FST, and ERG.ResultsThe annual rate of decline in BCVA was 0.83 (95% confidence interval: 0.65-1.02) letters/year. For FST, the change was 0.09 (0.07-0.11) log cd.s/m2/year for white threshold, 0.10 (0.08-0.12) log cd.s/m2/year for blue threshold, and 0.05 (0.04-0.06) log cd.s/m2/year for red threshold. Changes were 22.6 (17.4-28.2)%/year for white threshold, 26.0 (20.3-32.1)%/year for blue threshold, and 12.3 (8.7-16.0)%/year for red threshold. The high percentage of eyes with undetectable ERGs at baseline limited assessment of change.ConclusionsBest-corrected visual acuity was not a sensitive measure of progression over 4 years. Full-field stimulus threshold was a more sensitive measure; however, additional information on the clinical relevance of changes in FST is needed before this test can be adopted as an endpoint for clinical trials.Financial disclosuresProprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

BACKGROUND: Infection with the COVID-19-causing pathogen SARS-CoV-2 is associated with disruption in the human gut microbiome. The gut microbiome enables protection against diverse pathogens and exhibits dysbiosis during infectious and autoimmune disease. Studies based in the United States and China have found that severe COVID-19 cases have altered gut microbiome composition when compared to mild COVID-19 cases. We present the first study to investigate the gut microbiome composition of COVID-19 cases in a population from Sub-Saharan Africa. Given the impact of geography and cultural traditions on microbiome composition, it is important to investigate the microbiome globally and not draw broad conclusions from homogenous populations. RESULTS: We used stool samples in a Ugandan biobank collected from COVID-19 cases during 2020-2022. We profiled the gut microbiomes of 83 symptomatic individuals who tested positive for SARS-CoV-2 along with 43 household contacts who did not present any symptoms of COVID-19. The inclusion of healthy controls enables us to generate hypotheses about bacterial strains potentially related to susceptibility to COVID-19 disease, which is highly heterogeneous. Comparison of the COVID-19 patients and their household contacts revealed decreased alpha diversity and blooms of Enterococcus and Eggerthella in COVID-19 cases. CONCLUSIONS: Our study finds that the microbiome of COVID-19 individuals is more likely to be disrupted, as indicated by decreased diversity and increased pathobiont levels. This is either a consequence of the disease or may indicate that certain microbiome states increase susceptibility to COVID-19 disease. Our findings enable comparison with cohorts previously published in the Global North, as well as support new hypotheses about the interaction between the gut microbiome and SARS-CoV-2 infection.

PURPOSE: The Foundation Fighting Blindness (FFB) Consortium is a collaboration of 41 international clinical centers that manage patients affected with inherited retinal diseases (IRDs). The annual Consortium gene poll was initiated in 2020 to capture the genetic cause of disease in patients with IRD and associated clinical practices of Consortium sites. Data from the 2022 gene poll are reported here. METHODS: In 2022, academic, private practice, and government ophthalmology clinics that are members of the Consortium centers were polled to identify per-case IRD genetic causality from a list of 387 syndromic and nonsyndromic IRD genes. The survey also assessed how genetic testing was obtained and clinical practices of the sites. RESULTS: Thirty centers responded and reported genetic data from 33,834 patients (27,561 families). Disease-causing variants were reported in 293 of 387 genes. The most common genetic etiologies were ABCA4 (17%), USH2A (9%), RPGR (6%), PRPH2 (5%), and RHO (4%). The top 100 genes accounted for the genetic cause of disease in 94.4% of patients. Two-thirds of the centers had at least one genetic counselor. In the 21 US sites, genetic testing was commonly obtained through sponsored programs (95%, FFB-My Retina Tracker Programs or Spark-ID Your IRD), whereas in the 9 non-US sites, genetic testing was commonly obtained using either patient- or public health system-funded testing pipelines. Clinical work-up of patients with IRD most commonly included updating history, eye examination, and optical coherence tomography. CONCLUSIONS: This report provides the largest assessment of genetic causality in the IRD patient population across multiple continents to date.

In the past decade, there has been a notable rise in foodborne outbreaks, prominently featuring Escherichia coli as a primary pathogen. This bacterium, known for its prevalence in foodborne illnesses and as a reservoir of antimicrobial resistance, was isolated from raw vegetables, soil, and water samples collected from rooftop and surface gardens in urban (Dhaka North City Corporation; DNCC and Dhaka South City Corporation; DSCC) and peri-urban (Gazipur City Corporation; GCC) areas of Bangladesh. In this study, 145 samples including vegetables (n = 88), water (n = 27) and soils (n = 30) from DNCC (n = 85), DSCC (n = 30), and GCC (n = 30) were analyzed to assess the prevalence of E. coli using culture, biochemical tests, and PCR targeting the malB gene. E. coli was detected in 85 samples, indicating an overall prevalence of 58.62% (95% CI: 50.48-66.31). In urban areas (DNCC and DSCC), the prevalence rates were 44.70% and 80.0%, respectively, with surface gardens showing higher contamination rates (70.83%) than rooftop gardens (46.57%). In the peri-urban GCC, overall prevalence of E. coli was 76.7%, with rooftop gardens more contaminated (93.33%) than surface gardens (60.0%). Antibiogram profiling of 54 randomly selected isolates revealed 100% resistance to ampicillin, with varying resistance to ciprofloxacin (25.92%), tetracycline (14.81%), cotrimoxazole (14.81%), imipenem (9.25%), and fosfomycin (1.0%). Notably, all isolates were susceptible to ceftazidime, gentamicin, chloramphenicol, nitrofurantoin, and cefotaxime. Multidrug resistance (MDR) was found in 14.81% of isolates. The blaTEM gene was present in 81.48% of the isolates, while the tetA gene was detected in 3.70%. These findings underscore the urgent global health concern posed by the significant presence of E. coli in fresh vegetables, highlighting the need for improved safety measures and monitoring to prevent the spread of antimicrobial resistance through the food chain.

Statin drugs lower blood cholesterol levels for cardiovascular disease prevention. Women are more likely than men to experience adverse statin effects, particularly new-onset diabetes (NOD) and muscle weakness. Here we find that impaired glucose homeostasis and muscle weakness in statin-treated female mice are associated with reduced levels of the omega-3 fatty acid, docosahexaenoic acid (DHA), impaired redox tone, and reduced mitochondrial respiration. Statin adverse effects are prevented in females by administering fish oil as a source of DHA, by reducing dosage of the X chromosome or the Kdm5c gene, which escapes X chromosome inactivation and is normally expressed at higher levels in females than males. As seen in female mice, we find that women experience more severe reductions than men in DHA levels after statin administration, and that DHA levels are inversely correlated with glucose levels. Furthermore, induced pluripotent stem cells from women who developed NOD exhibit impaired mitochondrial function when treated with statin, whereas cells from men do not. These studies identify X chromosome dosage as a genetic risk factor for statin adverse effects and suggest DHA supplementation as a preventive co-therapy.