The modification process of RNA methylation is a dynamic reversible regulatory process that is mainly catalyzed by “Writer” m6A methyltransferase, removed by “Eraser” m6A demethylase, and recognized by the m6A binding protein, thereby, linking m6A modification with other mRNA pathways. At various stages of the life cycle, m6A modification plays an extremely important role in regulating mRNA splicing, processing, translation, as well as degradation, and is associated with gametogenesis and fertility for both sexes. Normal gametogenesis is a basic guarantee of fertility. Infertility leads to trauma, affects harmony in the family and seriously affects the quality of life. We review the roles and mechanisms of RNA m6A methylation modification in infertility and provide a potential target for infertility treatment, which can be used for drug development.Eukaryotic messenger mRNAs contain many RNA methyl chemical modifications, in which N Infertility is a reproductive dysfunction that is characterized by a succession of sexual events and interruption of new life. Accordingly, an inability to get pregnant after 12 months of unprotected intercourse is broadly defined as infertility . InfertiThe process through which mature germ cells are formed is called gametogenesis. Gametogenesis is indispensable to the general health and well-being of various species. Overtime, gametes link the various stages of species’ development. Compared to somatic cells, after a series of mitosis and meiosis during the differentiation process, germ cells produce sperms and oocytes. Sexually mature gametes combine during fertilization to produce the all-powerful oosperm . An impoThe transforming growth factor beta-1 proprotein-like (TGF) -β family member proteins  are essential for primordial germ cells (PGC). They act as precursors of male and female gametes to produce oocytes and sperms. Directional interruption of Bmp2, Bmp4, Bmp8b, or BMP signal transducers, SMAD family member s1, 4 and 5, or protein kinase (ALK2) indicates a loss or decrease of PGCs . In mammSperm production is a complex asynchronous differentiation process that is divided into three stages based on the cell types found: Spermatogonia are formed through mitosis, spermatocytes are formed through meiosis, and the haploid stage of sperm cells or sperm formation . ContinuOogenesis is a long-term process in mammals that begins in the embryonic period and ends in menopause. In oogenesis, two basic processes are necessary; the formation and maturation of oocytes and folliculogenesis. Follicles are reproductive units composed of oocytes, somatic cells and follicles. Oteocytes are made up of cumulus granulosa, mural granulosa and theca cells. In the embryonic stage, oogonia are the precursors of female gametes, expanding in number through mitosis. They differentiate into primary oocytes, grow in the follicle and undergo meiosis. Meiosis has a complex early stage that can be divided into five phases: leptotene, zygotene, pachytene, diplotene and diakinesis. Various key events, including homologous chromosome pairing, synapsis and recombination or crossover initially occur in the first period of the prophase . In fema6A modification and its functions as a whole, briefly introduced m6A methyl transferase (“author”), dimethyl enzyme (“eraser”) and binding protein (“reader”)  . Then, wreader”) . FinallyBoth DNA and histone proteins can control gene expression through dynamic reversible chemical modification. Similar to DNA and proteins, RNA, which form the center of the central dogma transmit genetic information. Chemical modification of RNA molecules is more diverse and abundant when compared to DNA. Apart from the four basic bases, there are more than 170 chemically modified nucleotides, which play various roles in many different types of cellular RNAs, including rRNA, tRNA and mRNA, and snRNAamong others . Approxi6A) exerts the most significant effect on gene expression, and is the first modification that has been shown to regulate mRNA abundance. N6-methyladenosine (M6A) modification was first described 40 years ago. M6A was first discovered in mouse L cell polyA-RNA, and was subsequently confirmed to be the most widely distributed and highest internal modification in mRNA  of 3′-UTR, especially in the area near the stop codon , demethylase (eraser) and m6A binding protein (reader). Demethylase is a proof that m6A modification is dynamically reversible.Among these modifications, N6-methyladenosine  catalyzes m 200 kDa . Both MEnslation . METTL3  oocytes . HAKAI,  are modulators that regulate germ cells. After knocking out METTL3 or METTL14, it was found that mppressed . Moreovee of SSC . The knoe of SSC . These rogenesis .6A  is a non-steroidal anti-inflammatory drug that is considered to be a highly selective FTO inhibitor. As an ethyl ester MA derivative, MA-2 can effectively inhibit the growth of glioblastoma stem cells (GSC) and tumor formation induced by GSC. It also has a significant inhibitory effect on the expression of FTO  are closely associated with YTHDC1, a key nuclear factor in the processing of precursor mRNA transcripts. Knockout of YTHDC1 changes the length of the 3′UTR. This is because, extensive selective polyadenylation occurs in oocytes, leading to alternative splicing defects in oocytes.In vitro pulldown assays proved that YTHDC2 preferentially binds m6A  group was significantly higher than that in the YTHDF2cKO group, implying that proliferation of spermatogonia is inhibited after YTHDF2 knockout. Morphologically, wild-type spermatogonia are polygons while YTHDF2cKO spermatogonia are fusiform or round. Cell-adhesion assays revealed that YTHDF2 has a significant effect on the adhesion and spread of spermatogonia .YTHDF2 has the ability to regulate oocytes to reach metaphase stage of meiosis II. During early zygotic development, these oocytes can remain in the metaphase stage of meiosis II. Large amounts of YTHDF2 in GV and MII oocytes imply that it is also expressed during oocyte maturation, spermatogenesis or follicular development. YTHDF2 has been detected in the cytoplasms of germ cells and somatic cells . When th6A modification and its methyltransferase and demethylase, binding protein have an extremely important impact on gametogenesis.With developments in methylation modifications of RNA, studies on RNA methylation modification have gradually developed from relatively concentrated functional research to studies on disease. To maintain generations, the harm caused by reproductive health and its influencing factors to humans should be urgently resolved. RNA methylation modification is an important epigenetic phenomenon. MWe have discussed the role and mechanism of RNA methylation modification in infertility. The mechanism involves the cooperation of METTL3 and METTL14 to control timely translation of methylation transcription, thereby, appropriately regulating the production of proteins that are necessary for spermatogenesis. METTL3 regulates the differentiation of spermatogonia and plays an important regulatory role in oocyte maturation. KIAA1429 plays a vital role in follicle formation and has a regulatory on normal spermatogenesis. The correct regulatory mechanism of YTHDC2 on meiosis in gamete development has not been clearly elucidated. YTHDF2 regulates spermatogonia proliferation and has a role in the maturation of oocytes.6A regulators, potential preventive and treatment methods for infertility can explored. Proteins for m6A regulation can be used as biomarkers to reflect gametogenesis disorders in both sexes and to achieve preventive treatment of infertility. Precise treatment of gene targets such as METL3, WTAP, KIAA1429, FTO, ALKBH5, YTHDC1, YTHDC2, and YTHDF2, by regulating m6A modification ensures normal gametogenesis and exerts a better therapeutic effect on infertility. Entacapone, MA drugs, STM2457, butyrate, miR-186, miR-4429, miR-600 and let-7G, Rhein, MA-2 inhibitors, as well as folate, betaine and methionine methylation donors can be used in the treatment plans for gametogenesis disorders.Secondly, by identifying specific mRNA methylation can prevent and treat infertility by regulating gametogenesis. This discovery has important research significance in theory and practice. However, the mechanisms involved have not been clearly established. For example, it has not been determined whether the specific molecular mechanism that causes infertility is associated with other diseases. Moreover, it has not been determined whether other RNA methylation modification proteins affect gametogenesis. To comprehensively understand the regulatory mechanisms of RNA methylation on infertility, studies should determine how RNA methylation affects gametogenesis under the stimulation of the external environment, drugs and poisons.XL, HW, BL, ZQ, JL, BX, WL, and ZX: revising the manuscript. YD: conception and design, revising it critically for important intellectual content, and final approval of the version to be published. All authors substantially contributed to the review and read and approved the final manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


The statistical analyses were performed running logistic and multinomial regression and calculating odds ratio estimation using R software version 4.0.0. The non-Yoga group was more likely to use substances and unhealthy food and less likely to have good quality sleep. Yoga practitioners reported good physical ability and endurance. Yoga group also showed less anxiety, stress, fear, and having better coping strategies than the non-Yoga group. The Yoga group displayed striking and superior ability to cope with stress and anxiety associated with lockdown and COVID-19. In the Yoga group, participants performing meditation reportedly had relatively better mental health. Yoga may lead to risk reduction of COVID-19 by decreasing stress and improving immunity if specific yoga protocols are implemented through a global public health initiative.Uncertainty about Coronavirus disease 2019 (COVID-19) and resulting lockdown caused widespread panic, stress, and anxiety. Yoga is a known practice that reduces stress and anxiety and may enhance immunity. This study aimed to (1) investigate that including Yoga in daily routine is beneficial for physical and mental health, and (2) to evaluate lifestyle of Yoga practitioners that may be instrumental in coping with stress associated with lockdown. This is a pan-India cross-sectional survey study, which was conducted during the lockdown. A self-rated scale, COVID Health Assessment Scale (CHAS), was designed by 11 experts in 3 Delphi rounds  to evaluate the physical health, mental health, lifestyle, and coping skills of the individuals. The survey was made available digitally using Google forms and collected 23,760 CHAS responses. There were 23,290 valid responses (98%). After the study's inclusion and exclusion criteria of yogic practices, the respondents were categorized into the Yoga ( WHO declared Coronavirus disease 2019 (COVID-19), originating from Wuhan, China, caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2), as a pandemic on March 11, 2020. To prevent spread and provide sufficient time for hospitals' readiness, the Governments worldwide had to impose “Lockdown” in their respective countries. Under lockdown, people were restricted from remaining outdoors with certain exceptions resulting from emergencies.India imposed the world's most extensive lockdown on March 23, 2020 . Many pePrevious studies have evidenced increased post-traumatic stress disorder (PTSD) after epidemic or natural calamities such as SARS, earthquake, or a tornado, including COVID-19 –10. WangIn the current study on the COVID-19 pandemic, it has been reported that the impact on psychological stress might be more pronounced due to persistent global media feeds and internet access. The present COVID Health Assessment Scale (CHAS) survey was designed to evaluate the physical and mental health and coping skills of participants who practiced yoga and those who did not. Several studies have shown that Yoga brings a positive change in physical and mental health by regulating the hypothalamic–pituitary–adrenal system, sympathetic nervous system, reducing the cortisol, and improving immunity indicated by an increase in CD4, heart rate, fasting blood glucose, cholesterol, and low-density lipoprotein levels –20. ThusThe current study received ethical approval from Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA) University, Karnataka, India. CHAS, a unique self-assessment scale, was designed for the survey in 10 different languages, English, Hindi, Assamese, Bengali, Kannada, Malayalam, Marathi, Odia, Tamil, and Telugu. A committee consisting of 11 experts was constituted who undertook three rounds of discussions as per Delphi protocol and agreed to the CHAS questionnaire that assessed the positive and negative aspects of physical and mental health, lifestyle, and associated coping methods during the lockdown period . Among 1Questions 11–15 accessed COVID-19 exposure of participants; these included self-reported symptoms, travel history, details of interaction with COVID-19–positive patient, and quarantine history. Physical health was accessed by rating physical strength and endurance (question 16) and disease history (question 17). In question 16, two extreme options were considered as a single option during analysis.Twelve questions (questions 18–29) were included in CHAS to assess the mental health during the lockdown. The questions were designed to evaluate fear and anxiety during the lockdown and evaluate the individual's general personality or character. Standard neuropsychological questionnaires were not used to evaluate stress and anxiety.The coping ability of participants was accessed by a direct question with four options, i.e., “Poor,” “Average,” “Very good,” and “Excellent” (question 30). During analysis, “Poor” and “Average” were merged into a single attribute, i.e., “Poor.” Similarly, “Very Good” and “Excellent” were merged to constitute “Good.” Questions 31–38 enquired about different activities of participants during lockdown; these questions indicate coping strategy of participants during lockdown. Questions 39–42 in lifestyle domain also provide information on coping strategy.The survey items for CHAS were prepared on Google forms and circulated in public through social media. Snowball method was used to acquire the data nationwide. Phone calls and special requests were sent to different sections of the society  to acquire data within this short period. No inclusion and exclusion criteria were defined during the circulation of CHAS. Hence, the received responses showed diversity in age, gender, occupation, education, and other demographics . This stn = 470). The remaining 23,290 responses were evaluated to assign participants in Yoga and non-Yoga groups. Inclusion criteria were age should be ≥18 years and all respondents should be residing in India. Yoga and non-Yoga group was defined according to the responses of question numbers 52, 53, 55, 56, and 57 of the CHAS questionnaire  (Yoga postures), Pranayama (Yogic breathing exercises) (question 56), and meditation (question 57) for a few hours to more than 6 h per week during the lockdown. Participants, who replied “Did Yoga” for questions 52 and 53, but marked “Don't practice” for questions 55–57 were excluded from the Yoga group. According to these criteria, 9,840 participants qualified for the Yoga group.The Yoga group was defined as individuals who performed Yoga both before (question 52) and during (question 53) the lockdown, which included practicing one or more among Asana, Pranayama, and meditation , practitioners who practiced only Asana (n = 149), only Pranayama (n = 89), and only meditation . The combination of two practices among Asana, Pranayama, and meditation was not considered as a sub-group.Furthermore, the Yoga group was divided into four sub-groups, i.e., Yoga practitioners who practiced Asana (question 55), Pranayama (question 56), and meditation (question 57). Following the aforementioned inclusion criteria, 3,377 participants were accepted in the non-Yoga group.The non-Yoga group included respondents who did not perform Yoga before (question 52) or during (question 53) the lockdown and replied “Don't Practice” for the questions on 2 test; logistic and multinomial regression was used. Age, gender, occupation, education, and working status during lockdown were used as covariates.R Statistical software, version 4.0.0, was used for data cleaning, extraction, and analyses. The arsenal package in R was used to determine cross-tabulations and χThe dependent variables were the study groups. We used multiple predictors in each of the regression models. Sequential contrast was used for ordinal variables. The predictors were selected based on the domains presented in the survey. The domains were demographic details, physical health, mental health, coping strategy, and lifestyle.Participants with no symptoms are less likely to be in the non-Yoga group than participants with cough, fever, breathing difficulty, and other symptoms . The symAlthough the proportion of participants using substances was lower in both groups, the non-Yoga group was more likely to depend on alcohol, tobacco, and other substances . The nonParticipants of the non-Yoga group were less likely to have food in a disciplined manner  and were less likely to be vegetarian  . The nonThe Yoga group reported very good physical strength and endurance, with only 7.5% of participants reporting an average or below average physical strength and endurance . The nonThe non-Yoga group reported higher anxiety and fear than the Yoga group when asked about “down-hearted” feeling, low energy (30.9%), anxiety due to COVID-19 (63.9%), fear of getting infected, related suffering (53.4%), fear of death (28.7%), fear of financial difficulties (63.0%), fear of the unknown (57.0%), and fear of spreading infection (65.9%) .Furthermore, the non-Yoga group was less goal-driven and oriented toward perfection in their activities (15.9%), less helpful and caring (5.2%), more insecure (50.2%), not open to new ideas (6.6%), and do not enjoy sharing their thoughts (9.7%) than the Yoga group .Most of the Yoga group members reported good coping ability (82.8%), while most of the non-Yoga (58.8%) group reported poor coping ability thereby highlighting a significant difference in two groups .Asanas, meditation, and religious/spiritual activities besides using the Internet, reading/writing, cooking, and exercise (>50%).Asanas, Pranayama, and meditation has a different influence on outcome variables than practicing one of these three yogic practices, individually. Asana (49.7%) and Pranayama (39.3%) were favored by young people between the ages of 20 and 30 years. The consolidated Yoga practice was preferred mainly by participants of 31–40 years (24.5%).We also examined whether practicing a combination of Asana group might have lower physical health, whereas co-morbidities were higher in the meditation group (19.3%). Good mental ability was revealed by lower anxiety and stress in the meditation group, followed by the combined group, Asana and Pranayama, sequentially. In addition, the ability to cope with the stress of COVID-19 was highest and comparable in the meditation group (85.3%) and the combined yoga group (83.2%). The preference of watching TV during lockdown was least in the meditation group (30.2%); their preferences included reading/writing (90.0%) and meditation (96.5%). The combined group preferred a range of activities, including reading/writing (92.2%), cooking (75.7%), exercise (93.2%), Yogasana (96.9%), meditation (97.1%), and religious activity (86.2%). TV watching was preferred by the Pranayama group (66.3%) followed by the Asana group (62.4%), and the Internet was preferred by the Asana group (87.9%) followed by the Pranayama group (76.4%). The aforementioned observations suggest that meditation might be more effective in reducing stress and anxiety and improving coping abilities in lockdown situations.Physical health, predicted by strength and endurance, revealed that the Despite limited public health intervention strategies, Yoga has remained the mainstay for improving well-being, disease risk reduction, and improving mental and physical health , 24, 25.Asanas, Pranayamas, and meditation. It makes an individual self-aware of his/her body, mind, thoughts, and soul. The Yogic teaching is based on the fundamentals of Yama (restraints) and Niyama (observances)  . Yama inal goals . Thus, oThe present study extends the above hypothesis operationalized as an investigation carried out when the world is gripped with fear and uncertainty due to an impending pandemic. In this context, the present study has evaluated the outcomes of physical and mental health, including lifestyle and coping strategies of Yoga and non-Yoga groups, during the lockdown imposed by COVID-19 pandemic. A CHAS questionnaire was generated following the Delphi protocol and was circulated among the Indian mass by snowball method as Google Forms. Phone calls and special requests were sent to different sections of the society including ~200 universities, Corporate companies, healthcare institutions, government organizations, wellness centers, and their networks to acquire data. The data were collected between May 9, 2020 and May 31, 2020; data were downloaded daily.n = 9,840) were Yoga practitioners, which is much higher than the previous report of 11.8% of a nationwide randomized structured survey in 2017 . Hence, introducing Yoga in the healthcare system would be beneficial for the patients, HCWs, and other service providers: they may successfully cope with psychological stress –37. Strean kriya . Perceivan kriya . Not limIt has been shown that meditation can potentially decrease the risk of acquiring cold and flu by improving physiological function and quality of life . Yogic bAsana, only Pranayama, and only meditation groups. Meditation seemed to evoke beneficial outcomes than those practicing all, i.e., Asana, Pranayamas, and meditation. However, a longitudinal randomized trial is imperative to establish evidence. Our observation that the younger population preferred Asanas and Pranayama, while meditation was mainly preferred by the elderly, can help deliver innovative yoga protocols that make meditation more attractive to the young population and, consequently, useful for mental hygiene if presented as integrated yoga protocols (available at www.svyasa.edu.in). Our report highlights that a large number of subjects practiced consolidated Yoga , proving the acceptability of an integrated module for school and college teachers. This could partly be due to the widespread popularity of both the Common Yoga Protocol released by the Ministry of AYUSH on the eve of International Day of Yoga, celebrated on June 21, as well as the widely published efficacy of Diabetic Yoga Protocol and COVID-19 Yoga Protocols released by the S-VYASA University (Asana, Pranayama, and meditation.It is pertinent to note that we had stratified the Yoga group into a consolidated Yoga group, only iversity , 48. TheThe study is limited by the fact that the sampling does not generate a study group that represents the general population as it was collected through social media. Second, the duration and regularity of Yoga practice before the lockdown was not assessed in the Yoga group, which would have given details of practice before lockdown. The same was assessed for lockdown period. Third, a proportionately higher number of younger subjects were found represented in the non-Yoga group; this might have influenced the outcome in a few components of the scales like the use of the Internet, physical strength, and others. Fourth, the self-reported COVID-19 symptoms could not be verified and RT-PCR for COVID-19 was not performed to establish increased susceptibility of non-Yoga group because of the lockdown restrictions. Fifth, a non-standard questionnaire was used. Mental health was not evaluated by any neuropsychological questionnaire such as the Perceived Stress Scale, but was based on the responses of CHAS.Asanas, Pranayamas, and meditation, available through digital media, cannot be ascertained unless another validation study is carried out. In addition, we did not explore means to rule out repetitive form filling by the same individual due to error or intention; however, there were no rewards or benefits attached to completing the survey. Because the survey was administered online, the possibility of cognitive bias in the study was minimal; however, we entirely relied on the answers provided online without verifying the IP address, consistent with similar reports published elsewhere.We also could not rule out the role of physical exercises in improving mental and physical health; however, outdoor activities were restricted due to the lockdown. Furthermore, whether the restrictions mentioned earlier provided the environment conducive for the practice of The raw data supporting the conclusions of this article will be made available by the authors, upon eligible request.The studies involving human participants were reviewed and approved by Swami Vivekananda Yoga Anusandhana Samsthana. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.RN conceptualized the study, supervised data collection, and involved in discussions during article preparation. AA conceptualized the article. MR and MSS wrote and edited the article and contributed in data presentation. MNKS conceptualized the study. RK and JI performed the statistical analyses. AS created the scale and administered it nationally. HN envisioned the study, and inspired and guided the study to its completion imparting quality assurance. RN, AA, and VS critically reviewed and edited the article. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The composition and stability of microbial communities in aquaculture water are crucial for the healthy growth of shrimp and present considerable risk to aquatic ecosystems. The modified clay (MC) method has been proposed as an efficient and safe solution for the mitigation of harmful algal blooms (HABs). Currently, the effects of MC on microbial communities in aquaculture water remain unknown. Here, we adopted the MC method to regulate shrimp-culture water quality and evaluated the effects of MC on the composition and stability of phytoplankton together with bacteria communities through high-throughput sequencing. On the one hand, a prominent change in the composition of microbial community was observed, with green algae becoming the most abundant genera and pathogens being infrequent in the MC-treated pond, which was more conducive to the growth of shrimp than that in the control pond. Moreover, MC could increase the diversity and stability of the microbial community structure in the water column, which had a higher anti-interference ability, as demonstrated by the analysis of the diversity and molecular ecological network. Taken together, MC could reduce the possibility for the occurrence of HABs and maintain a stable microbial community, which is beneficial for the health and high yield of shrimp. Shrimp aquaculture has grown rapidly over several decades to become an economically important global industry . CurrentThe modified clay (MC) method is one of the few methods that can be used for the mitigation of HABs ever applied in the field, with no major risks to the environment at low concentrations . The priTo date, the outcomes of MC treatment among microbial communities have scarcely been investigated. To further characterize the effects of MC on microbial communities in a natural environment, we applied the MC method in a shrimp aquaculture pond. We focused on the following two aspects: (i) how the MC affects the microbial community composition and structure, and (ii) whether these effects are advantageous for shrimp growth. Therefore, high-throughput sequencing technology was used to analyze the differences in phytoplankton and bacterial community composition in aquaculture water after regulation by MC. Simultaneously, based on random matrix theory, we constructed phytoplankton and bacterial molecular ecological networks in aquaculture water and analyzed the differences in microbial network structure, species interaction, and key species. Furthermore, we identified the key environmental factors affecting the structure of the microbial community in the water, which can provide theoretical support for a new model of MC technology that leads toward healthy aquaculture.2) and depth (1.2–1.5 m) , feed type, and schedule. The ponds were located outside, and a suitable level of dissolved oxygen was maintained using an impeller aerator. In the control pond, shrimp were cultured in the traditional model. In the experimental pond, we applied MC to control the microbial community and water quality . These ponds were approximately the same size (1000 m2–1.5 m) a,b, cult quality c,d, whilThe experiment clay was natural clay mineral kaolin, obtained from Yankuang Beihai Kaolin Co., Ltd. . The elemental composition and content of the clay were determined by XRF, as shown in 3) and ammonium ion (NH4+)), nitrate nitrogen (NO3−-N), nitrite nitrogen (NO2−-N), active phosphate (PO43−-P), active silicate (SiO32−-Si), total nitrogen (TN), and total phosphorus (TP). Biological samples included chlorophyll a (Chl a) samples, DNA samples, and bacterial density.In this study, samples were collected 12 times during shrimp aquaculture, which were 29 June, 30 June, 3 July, 24 July, 28 July, 18 August, 26 August, 2 September, 6 September, 9 September, and 13 September. The water samples were collected at approximately 50 cm below the water surface and then transported back to the laboratory in 30 min for analysis of physical and chemical parameters. Field observation and sampling indicators included temperature (T), salinity (S), pH, turbidity (TUR), dissolved oxygen (DO), and nutrient content, including total ammonia nitrogen  at a depth of 50 cm. For the analyses of nutrient content, samples were filtered through glass-fiber filters , fixed with chloroform, and then stored at −20 °C. The concentrations of nutrients were analyzed using a continuous flow analyzer . For the Chl a measurement, 100 mL of seawater was filtered using Whatman GF/F filters after initial filtration through a 200 µm nylon sieve. The filter membrane was wrapped in aluminum foil and stored in a dark environment at −20 °C prior to spectrophotometric analysis. In addition, the samples were fixed with paraformaldehyde  and stored in a freezer at −80 °C before bacterial density determination. After SYBR Green I  staining was performed in the dark for 15 min, the bacterial concentration was determined by flow cytometry  [The temperature, turbidity, dissolved oxygen, salinity, and pH of surface seawater were recorded in situ with a YSI EXONJ, USA) .Surface water samples were filtered through a 200 µm nylon sieve to eliminate the interference of zooplankton; following filtration, the samples were passed through a cellulose acetate membrane filter (0.22 µm). The 0.22 µm filters were collected in a centrifuge tube, stored in liquid nitrogen at −196 °C, and then transferred to a –80 °C freezer for storage. Microbial DNA was extracted using the HiPure Soil DNA Kits  according to the manufacturer’s protocol. The 16S rDNA target region of the ribosomal RNA gene was amplified by PCR  using V3-V4 gene universal primers 341F (5′-CCTACGGGNGGCWGCAG-3′) and 806R (5′-GGACTACHVGGGTATCTAAT-3′) . For 18SIn order to obtain high-quality clean reads, raw reads were further filtered using FASTP  . During VPA, we grouped environmental factors. Physical parameters included T, S, pH, TUR, and DO; nutrients included TAN, NO3−, NO2−, PO43−, and SiO32−; and TN and TP were classified as organic matter. The function of the bacterial community was annotated and predicted based on the OTU classification table obtained by using the FAPROTAX  database [Shannon index was calculated using Qiime software (version 1.7.0) to compare the diversity of the microbial community. The R language Vegan package (version 2.5.3) was used for intragroup Bray–Curtis distance index calculation, Welch’s database . Excel 2http://ieg4.rccc.ou.edu/mena [The Molecular Ecological Network Analysis (MENA) Pipeline was applied to evaluate the effects of MC on bacterial interspecies interactions using an open-access pipeline available at edu/mena  , which does not rule out the influence of multiple copies [Nannochloris and Gyrodinium in both ponds. In the later stage (8.26–9.13), the phytoplankton composition in the control pond was transformed, dominated by Heterosigma and Gyrodinium, while the phytoplankton composition in the MC-treated pond was maintained as Nannochloris and Gyrodinium. In addition, Heterosigma accounted for the highest proportion (13.09%) in the control pool, which was higher than that in the MC-treated pond (0.92%) ; we mainly observed Heterosigma akashiwo, an HAB organism. In the MC-treated pond, Nannochloris accounted for the highest proportion in the water, with an average relative abundance of 29.9%, which was significantly higher than that of the control pond . Moreover, for Dinophyceae, including Gyrodinium, Stoeckeria, etc., their presence in the control pond (30.02%) was higher than that in the MC-treated pond (25.37%) overall . In addition, the microscopic examination results showed that the use of MCs reduced the occurrence of HAB species and was mainly green algae; no toxic algae were detected (unpublished data). For example, in the control pond, the density of H. akashiwo, an HAB species, was 1.26 × 105 cells/mL on 2 September, while the MC-treated pond was not detected.After quality control, we obtained 2,728,684 effective tags, with an average N50 of 343 bp, by 18S rDNA gene sequencing. After removing nonalgal OTUs, 212 and 222 algal OTUs were obtained in the control pond and MC-treated pond, respectively. Taxonomic analysis of all samples identified 6 phyla, 16 classes, 22 orders, 29 families, 33 genera, and 38 species. The top 10 algal reads at the genus level were defined as the dominant phytoplankton genera. Species abundance in different samples was shown in e copies . In the Synechococcus CC9902 demonstrated the highest abundance in the two ponds. The average abundance in the control pond and the MC-treated pond was 18.74% and 21.27% , respectively, which decreased with the shrimp culture time. Marivita accounted for 4.15% in the control pond and 2.13% in the MC-treated pond, with a significant difference . In addition, the dominant probiotics and opportunistic pathogens at the genus level in aquaculture were analyzed . Compared with the control pond, the proportion of probiotic genera increased, and that of pathogenic bacterial genera decreased in the water of the MC-treated pond. In addition, the results of flow cytometry showed that the average bacterial density in the water of the MC-treated pond was slightly higher (7%) than that in the control pond , indicating that the bacterial alpha diversity increased significantly after MC treatment , was higher than that in the control pond. The median bacterial ACE index in the MC-treated pond was 2119.6, which was significantly higher than that of the control pond, at 1501.4 , indicating that the differences of phytoplankton community composition in the control pond varied more significantly over time than that in the MC-treated pond. Meanwhile, the mean Bray–Curtis distance of bacterial community in the control pond at different times was also higher than that in the MC-treated pond.Furthermore, the microbial community dissimilarity in beta-diversity among different times based on Bray–Curtis distance was estimated . We founThe microbial molecular ecological network analysis suggested that the network topological indexes of phytoplankton and bacteria in water were different between the control pond and the MC-treated pond , with thSimilarly, in the bacterial molecular ecological network c,d, the Venn analysis was performed on the nodes (at OTU level) in the phytoplankton molecular ecological network for the control pond and the MC-treated pond . Only 41Topologically, different OTUs (nodes) play distinct roles in the network. According to the simplified classification used in pollination networks, the topological roles of the OTUs identified in these networks are shown as a Zi–Pi plot in As an important primary producer in aquaculture water, phytoplankton plays a fundamental role in material circulation and water self-purification . In addiH. akashiwo, which may have adverse effects on the growth of L. vannamei, such as slow growth, enteritis, liver disease, and even death [H. akashiwo bloomed at the end of August and the beginning of September in the control pond, resulting in drastic changes in water color. However, there was no dramatic change in water color in the MC-treated pond, and green algae, such as Nannochloris, accounted for a high proportion. Nannochloris has high lipid, protein, and linoleic acid content, and it is widely used for biodiesel [t-test, p < 0.05), after the harvest of L. vannamei on 17 October 2020  could also describe the bacterial variance. The changes in the physical parameters were essentially the same in the two ponds; they were not the main factors causing the differences in the bacterial communities. Organic matter quality is partly responsible for changes in bacterial community composition [a was an important environmental factor affecting the bacterial community, indicating that some bacteria may have a symbiotic relationship with phytoplankton [The results of environmental factor analysis  showed tposition . MC has position . Chl a wplankton , and theHigh-throughput sequencing technology and random matrix network construction theory were used to analyze the effects of MC on the microbial community structure and the interaction network between different species at the pond scale. The use of MC maintained a microbial community composition that was favorable for shrimp growth, mainly composed of green algae, a lower content of pathogens, and a higher content of probiotics. Furthermore, the diversity and stability of phytoplankton and bacteria in the MC-treated pond were higher than those in the control pond, and the molecular ecological network of the MC-treated pond had high anti-environmental interference ability. MC can not only directly affect the key species of the microbial molecular ecological network but also indirectly affect water-quality parameters, thus changing the microbial composition and community structure. These findings provide novel information concerning the improvement of microflora in aquaculture environments, which is helpful to maintain the health and high yield of shrimp.


Obsessive-Compulsive Disorder (OCD) is a chronic neuropsychiatric disorder associated with unpleasant thoughts or mental images, making the patient repeat physical or mental behaviors to relieve discomfort. 40-60% of patients do not respond to Serotonin Reuptake Inhibitors, including fluvoxamine therapy.The aim of the study is to identify the predictors of fluvoxamine therapy in OCD patients by Bayesian Ordinal Quantile Regression Model.This study was performed on 109 patients with OCD. Three methods, including Bayesian ordinal quantile, probit, and logistic regression models, were applied to identify predictors of response to fluvoxamine. The accuracy and weighted kappa were used to evaluate these models.th quantile regression model, marital status  and family history  had a direct effect, and cleaning  and somatic  dimensions had reverse effects on response to fluvoxamine therapy.Our result showed that rs3780413  and cleaning dimension  had reverse effects on response to fluvoxamine therapy in Bayesian ordinal probit and logistic regression models. In the 75Response to fluvoxamine is a multifactorial problem and can be different in the levels of socio-demographic, genetic, and clinical predictors. Marital status, familial history, cleaning, and somatic dimensions are associated with response to fluvoxamine therapy. The preet al. found an association between the response to fluoxetine in a longer period of illness, older age, and more severe symptoms in OCD patients . Storch and patients . On the reatment . Hollandsponders . Nakatanreatment . A meta-reatment .et al. could not show the relationship between 5-HTTLPR genotypes and response to fluvoxamine [Although Bella voxamine , responsIn the present study, we aimed to investigate the association between the demographic, clinical, and genetic factors with Fluvoxamine therapy in Iranian OCD patients. Here, response to treatment was considered an ordinal variable by three categories: refractory, non-responder, and responder. The ordinal probit or logistic models have usually been proposed for modeling the ordinal outcomes. Both models focus on the cumulative probabilities of the ordinal response variable to take into account the ordinality between the categories in the modeling . We knowIn addition to these two models, we used Bayesian quantile ordinal regression model to find predictors of fluvoxamine therapy in Iranian OCD patients.22.1et al. [In the present study, we used information of 109 OCD patients referred to Imam Hossein Hospital in Tehran, Iran, between 2014 and 2017. They gave consent for their information to be used in the research. Ethical approval for this study was obtained from ethics committee of the Public Health School and Neurosciences Research Center in Shahid Beheshti University of Medical Sciences . More information about the dataset is available in the article of Hasanpour et al. . Briefly2.2The socio-demographic variables were age, gender, educational status, occupation, marital status, ethnicity, and the clinical variables included family history of OCD or other mental illnesses, age of disorder onset (under or over 18 years old), and duration of illness.et al. [Moreover, we used five dimensions, including aggression /checking,contamination/cleaning,symmetry/ordering/repeating/ counting/hoarding, sexual and somatic, which have been explored from the Y-BOCS checklist by Asadi et al. . In each2.3SLC6A4 gene, HTR2A gene SNPs , and SLC1A1 gene SNPs .The salting out method was used to extract genomic DNA from peripheral leucocytes. PCR-RFLP method was used to determine genetic variants of the studied variations. Genotypes for each polymorphism were also confirmed by Sanger sequencing of PCR products . The gen2.4S1 and S2). The Bayesian approach could cover the lack of information due to the small sample size by using prior information on the regression coefficients. In all of the mentioned models, the normal prior distribution with large variance (non-informative prior distribution) is considered for estimating the regression coefficients. The inference was made based on 12000 iterations after 3000 were burned. The performance of all the models was evaluated using the Akaike Information Criteria (AIC), weighted kappa, and accuracy.Statistical analyses were performed using R software version 3.6.3  and Matlab 2016b. The continuous variables were expressed as mean and standard deviation, and the categorical variables were expressed as frequency and percentages. In order to identify the predictors of pharmacotherapy in OCD patients , we used Bayesian ordinal quantile regression , Bayesia31 indicates the distribution of the socio-demographic, clinical variables, and polymorphisms of the selected genes by three categories of the pharmacotherapy results in OCD patients. 64% (70) of patients in the study were female, 72% (79) of patients reported undergraduate education, 57% (62) reported unemployed patients, 83% (91) reported family history of OCD or other mental diseases, 64% (68) of patients had more than 5 years of disease duration, and 66% (72) of patients had been diagnosed after the age of 18. Table 2 indicates the posterior means and standard deviations of parameters in three simple Bayesian ordinal regression models: logistic, probit, and quantile for P 0.25, 0.50 and 0.75.Table 3) in each approach, all the covariates by a p-value less than 0.2 in Table 2 were included in the model at the beginning and were removed one by one according to a significance criterion . The performance indexes AIC, weighted kappa, and accuracy of each model are reported in Table 3.In order to find the final model  have the biggest values of the accuracy and weighted kappa and were the simplest models, they could not find any relationship between socio-demographic variables and the response to fluvoxamine treatment in the OCD patients.4th quantile regression model had a better performance than ordinal logistic and probit regression models, and in the model which included rs3780413 and contamination/cleaning dimensions, ordinal logistic and probit regression models had performed better than 75th quantile regression model (Tables S1 and S2).The current study takes into account the simultaneous effects of environmental, genetic, and clinical factors on fluvoxamine therapy and uses three ordinal regression models to identify fluvoxamine therapy predictors. Although we could not see the significant difference among the performance characteristics of these models including accuracy and weighted kappa, the predictors staying in each model were not similar. The socio-demographic predictors played important roles in quantile regression models that could be a proxy of the inequality distribution of these predictors in the population. The ordinal probit and logistic identified rs3780413 had a significant effect on fluvoxamine therapy in OCD patients. Our results could not confirm the findings of Rahman 2016 that shows the Bayesian quantile ordinal regression models provide a better model fit relative to the ordinal probit model . We obseet al. and Mataix-Cols et al. showed that the patients without contamination/cleaning and hording dimension had a better response to treatment with fluvoxamine/SSRIs in separate studies [et al. [Nakatani  studies , 29. Liv [et al. . Having  [et al. . Based oCYP2D6, CYP2C19, SLC6A4 (5HTTLPR and STin2), HTR1A (rs6295), HTR2A , SLC6A2 (rs5569), TPH1 (rs1800532). In this study, we investigated the effect of 5-HTTLPR polymorphisms of SLC6A4 gene, HTR2A gene SNPs , and SLC1A1 gene SNPs . Our study revealed that SLC1A1 polymorphism, rs3780413, is associated with response to fluvoxamine therapy.Based on previous studies -34, seve


Virtual reality (VR) produces a virtual manifestation of the real world and has been shown to be useful as a digital education modality. As VR encompasses different modalities, tools, and applications, there is a need to explore how VR has been used in medical education.The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research.We performed a search of 4 bibliographic databases in December 2020. Data were extracted using a standardized data extraction form. The study was conducted according to the Joanna Briggs Institute methodology for scoping reviews and reported in line with the PRISMA-ScR  guidelines.Of the 114 included studies, 69 (60.5%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models  and virtual worlds , which were mainly used for anatomy education. Most of the VR modalities included were semi-immersive  and were of high interactivity . There is limited evidence on the use of more novel VR modalities, such as mobile VR and virtual dissection tables , as well as the use of VR for nonsurgical and nonpsychomotor skills training  or in a group setting . Only 2.6% (3/114) of the studies reported the use of conceptual frameworks or theories in the design of VR.Despite the extensive research available on VR in medical education, there continue to be important gaps in the evidence. Future studies should explore the use of VR for the development of nonpsychomotor skills and in areas other than surgery and anatomy.RR2-10.1136/bmjopen-2020-046986 Traditionally, medical education comprises both theoretical learning in classrooms and clinical training in hospitals where students are able to gain clinical experience . This iscut digital models to reveal cross-sectional images; examples include the Anatomage Table [VR is defined as an educational tool that uses computer technology to create a 3D image or environment that one can interact with in a seemingly real or physical way . VR is age Table . Virtualge Table -12. Avatge Table . Mobile ge Table .soft skills such as empathy and communication skills [VR can have diverse application in medical education. It has so far been most commonly used for the development of technical competencies, such as surgical skills, or for developing the ability to visualize anatomy in 3D. Examples of its applications include surgical technique training, the development of 3D visualization skills, and training for procedures such as cardiopulmonary resuscitation (CPR) -18. Howen skills ,19,20. TGiven the wide array of tools available in the VR toolbox and the diverse areas in which VR can be applied, there is a need to systematically identify the current VR applications used in medical education, as well as to identify any gaps in the current research of VR in medical education as reported in the literature. Although there are reviews aiming to map different applications of VR used in other types of health care education such as nursing and dentistry education, there seem to be none focusing on medical students’ education ,22. ExisThe objective of this scoping review is to identify the different VR tools and applications in undergraduate or preregistration medical education as reported in the literature. We also aim to identify any gaps in the existing literature and provide suggestions for future research on the use of VR in medical education.The scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews , which cThe objective of this scoping review is to outline the different VR modes available and the applications of VR in undergraduate or preregistration medical education. In line with the objectives of this scoping review, we have developed the following research questions:How is VR used in undergraduate or preregistration medical education?What are the main features of the VR applications in undergraduate or preregistration medical education?What VR tools are available for undergraduate or preregistration medical education?To which aspects of undergraduate or preregistration medical education has VR been applied?A comprehensive search of the literature was performed using the following electronic databases: MEDLINE (Ovid), Embase (Elsevier), Cochrane Central Register of Controlled Trials (Wiley), and Education Resources Information Centre (Ovid). As a first step, a limited search using keywords was conducted in MEDLINE. The search strategy was piloted to check the appropriateness of the keywords and databases. In all retrieved papers, an analysis of the words contained within the title and abstracts as well as index terms was performed to develop a full search strategy. Thereafter, a second search using all the identified keywords and index terms was performed across all databases in December 2020. Finally, the third step included screening of the reference lists of all studies selected for this scoping review to look for additional sources. The complete search strategies for all databases can be found in The study selection followed a two-step screening process, which consisted of a title and abstract screening, followed by a full-text review. In both steps, 2 independent reviewers (JHW and SV) screened the articles against the eligibility criteria. Any disagreements were discussed, and if no consensus could be reached, a third reviewer (BMK) was consulted. We considered eligible studies based on the criteria presented in The first step involved the screening of the title and abstract of the studies using EndNote X9. To qualify for the full-text scan, the title and abstract had to (1) focus on the use of VR for educational use only and (2) have medical students as the target population. VPs, that is, computer-generated programs that simulate real-life clinical scenarios, can also be delivered in a VR format. In this scoping review, we included VR-based VPs. We also included studies on VR-based serious gaming education. Augmented reality   and mixeWe considered all primary studies, including experimental, observational, and qualitative study designs. Systematic reviews and meta-analyses were also considered. The full texts of the included studies were retrieved and their citation details imported. Studies excluded at this stage are described in Inclusion criteriaStudies on undergraduate or preregistration medical students in any geographical settingStudies involving the use of virtual reality together with another modality such as immersive virtual reality, virtual reality–based serious gaming, and virtual reality–based virtual patientsAll primary studies, regardless of study design, and relevant systematic reviewsExclusion criteriaStudies focusing only on virtual patient simulation, augmented reality, mixed reality, or serious gaming, without any involvement of virtual realityStudies published before 2010Studies in languages other than EnglishOpinion pieces, viewpoints and conceptual frameworks, and conference abstractsRelevant data were extracted from all included studies by 2 independent reviewers (JHW and SV). A structured data recording form developed by the reviewers was used and the information recorded using Microsoft Excel 2013. The full data extraction form can be found in To characterize and summarize the results, a map of the data extracted from the included papers was presented in a diagrammatic or tabular form. In alignment with the objectives of this study, we provided an overview of the target participants, content of VR programs, types of studies included, and the context of each included study. The tabulated and charted results were accompanied by a narrative summary, which described how the results met the objectives and aims of this scoping review. We reported the findings in line with the PRISMA-ScR checklist . Using tpresence experienced by the user due to the illusion rendered by the VR modality [semi-immersive VR, which does not fall into either of the 2 categories .We classified VR modalities based on the extent of immersion or interactivity. Immersion can be defined as the sensation of being disconnected with reality  or the amodality . The levmodality . VR has modality . For thiInteractivity in VR refers to the extent to which the user can influence the content or form of the VR environment . This caA stakeholder consultation was undertaken on August 12, 2021, with the aim of discussing and improving the presentation of our findings. No ethics approval was required as per Nanyang Technological University ethics board guidance. The stakeholder consultation consisted of a 1-hour-long web-based seminar. The audience comprised 18 researchers in the fields of medical education, digital health professions education, and health service research, as well as educators. The stakeholders were invited to share any comments, questions, or suggestions in relation to our study. In addition, we also specifically asked them to share their views on the most important aspects of our findings for researchers and educators, recommendations for future research, and suggestions on any other research in the field of VR or medical education that we should take note of. We have analyzed and presented our findings in this manuscript in line with the information collated through this stakeholder consultation.Our searches identified a total of 9400 studies after duplicates were removed, of which 288 (3.06%) were selected for full-text review. Of these 288 studies meeting the criteria for full-text review, 174 (60.4%) did not meet the inclusion criteria, resulting in 114 (39.6%) studies being included in this scoping review .Of the included studies, most studies were either randomized controlled trials  or other experimental design studies . Of the 114 studies, 14 (12.3%) were cross-sectional studies -49, 3  compared VR against a traditional learning method , 27 (28%) evaluated VR modalities by changing another variable  ,49,53-94Of the 114 studies, 30 (26.3%) were from the United States, 11 (9.6%) each from the United Kingdom and Germany, 9 (7.9%) each from Canada and Denmark, and 13 (11.4%) from Asia. Other countries were uncommon, with notably no studies being published from Africa or any low-income country.Ethics approval was mentioned in 61.4% (70/114) of the studies, and the source of funding was mentioned in 40.4% (46/114) of the studies. Among the 46 studies that received funding, 19 (41%) received funding from the university, 12 (26%) received charitable funding, 9 (20%) received government-backed funding, and 6 (13%) received private funding.There was generally an increase in frequency of publication from 2010 to 2020, with 7.9% (9/114) of the studies published in 2010 and 17.5% (20/114) of the studies published in 2020 .On the basis of our review of the literature on VR in medical students’ education, we categorized the findings from the included studies as follows: (1) students, (2) VR modalities, (3) development, (4) input and output devices, (5) extent of immersion and interactivity, (6) subjects taught, (7) teaching strategies, and (8) assessment methods. These categories will be explored next.Of the 114 studies, 76 (66.7%) involved ≤50 students, 20 (17.5%) involved 51-100 students, and 18 (15.8%) involved >100 students. All years of study of medical students were generally well represented, with a slight tendency to include lower-year medical students.Most of the studies 108/114, 95.7%) took place in a university setting, with the remainder  taking place in a hospital setting ,114-118., 95.7% tOf the 114 papers, 69 (60.5%) concerned surgical VR simulators ,107-138,Most surgical VR simulators were evaluated using either RCTs  or experimental studies . Similarly, most 3D anatomical models were also evaluated by either RCTs  or experimental studies . Virtual worlds were mainly evaluated using experimental studies  or cross-sectional studies . Mobile VR was mainly evaluated through RCTs , whereas virtual dissection tables were mainly evaluated through experimental studies  ,136,148 Among the studies using 3D anatomical models, most  were developed in-house by the authors themselves, with the exception of some studies in which commercial products were used. They include Surgical Theater’s Precision VR visualization platform, which is a commercial product used to visualize cerebrovascular anatomy using a controller , and DIVAmong the 20 studies involving virtual worlds, 15 (75%) were developed in-house, whereas the remaining 5 (25%) used virtual worlds that are commercial products, including products such as MicroSim , Body InAmong the 4 studies involving the use of virtual dissection tables, 2 (50%) used the Anatomage Table ,146, 1  used the Touch Surgery app, a mobile surgical training platform ,65,152, The most common commercial products described in the literature are summarized in VR modalities and types of tools usedSurgical VR simulatorsLAP MentorARTHRO MentorEyesi Virtual Simulatorda Vinci Surgical SimulatordV-TrainerVBLaST suturing simulatorVirtual worldsMicroSimBody InteractOtago virtual hospitalVirtual dissection tablesAnatomage TableSectra Virtual Dissection TableVH Dissector ProMobile VRTouch Surgery appaVOR appOf the 114 studies, 35 (30.7%) used a VR modality that was developed in-house. The information used in development can be broadly classified into four different categories: development of 3D anatomical models, virtual worlds, VPs , and probes and haptic devices.Of the VR modalities developed in-house, 37% (13/35) were 3D anatomical models. Of these 13 studies, 12 (92%) developed 3D anatomical models that used some form of transverse 2D images in their development, either through magnetic resonance imaging or computed tomography images or transverse cross-sectional images of human cadavers. The information was imported into a software program that could convert the 2D images into 3D models  . Any defprimitives or prisms [Of the VR modalities developed in-house, 43% (15/35) were virtual worlds. Virtual worlds followed a somewhat similar development pathway but differed in terms of the software and information used and the outcomes of development. Whereas 3D anatomical models aim to produce a model that can be manipulated by the user on a screen, the structures in 3D worlds do not require as great a degree of manipulation; they mainly involve the users exploring the models and interacting with other users through an avatar, and this influences the software used in development. Structures in virtual worlds were mainly built from standard building shapes such as blocks, spheres, and tubes and are called r prisms . Of the Of the 15 studies that examined virtual worlds, 4 (27%) used VPs ,50,101. gamification to improve students’ use of the simulator.Of the 35 studies that used a VR modality that was developed in-house, 7 (20%) examined the development of probes and haptic devices. Of these 7 studies, 5 (71%) ,145,154.In all the studies with VR modalities developed in-house, the main persons in charge of development of the VR modality were the authors themselves. In addition, 60% (21/35) of the studies mentioned the inclusion of additional experts such as ear, nose, and throat (ENT) surgeons; radiologists; or other specialists in the area of interest to help with validation of the study , 147,155profiles when navigating new patient encounters.There were generally very few frameworks or theories applied in the development of VR simulators in medical education. Among the 35 studies that used a VR modality developed in-house, only 3 (9%) involved any frameworks or theories when developing the VR modality. The study by Lorenzo-Alvarez et al , which iOf the 114 studies, 71 62.2%) used a haptic surgical tool as their input interface ,148,156 .2% used The delivery devices used include the use of screens in most of the studies 100/114, 87.7%) [7.7% 8,9,170,171,Most of the studies included modalities that were of high interactivity 79/114, 69.3%) ,173,174,.3% ,173,In terms of immersion, most of the studies included modalities that were semi-immersive 68/114, 59.6%) [.6% 59,6-170,176,Of the 114 studies, 14 (12.3%) were both of high interactivity and fully immersive ,145,154.From the studies, six broad subjects taught were identified: surgical psychomotor skills, anatomy, clinical management of various conditions, radiology, communication, and nonsurgical psychomotor skills.The most common subject taught was surgical psychomotor skills, with 62.3% 71/114) of the studies including it as a subject taught  of the s,147,148.Of the 114 studies, 4 (3.5%) taught a combination of subjects. Of these 4 studies, 2 50%) combined the teaching of clinical management and communication ,50, 1 . Of these 39 studies, 23 59%) explored basic laparoscopic handling skills % explore, 131,148Of the 71 studies with a focus on surgical psychomotor skills, 7 (10%) involved arthroscopic VR modalities. Of these 7 studies, 3 (43%) provided training in basic arthroscopic skills ,120,121,Among the remaining 35% (25/71) of the studies that examined surgical psychomotor skills, specific procedures were involved, such as ENT ,124,138,Among the studies that explored anatomy, the most prevalent topic was neuroanatomy 6/21, 29%) ,72,155, % ,72,155Of the 16 studies that included clinical management, 4 (25%) included CPR as a management procedure ,70,140, Of the 4 radiology studies, 3 (75%) pertained to general radiology -78 and 1Of the 114 studies, 3 (2.6%) involved VR training for nonsurgical psychomotor skills, including intravenous cannulation , ultrasoMost of the studies  were conducted outside of the medical students’ curriculum, whereas 9.6% (10/114) of the studies assessed VR modalities that were incorporated into the curriculum. Among these 10 studies, the most common method of incorporating VR modalities into the curriculum was either by incorporating 3D anatomical models or virtual dissection tables into anatomy education  ,97,146 oMore than half of the studies involved students engaging in self-directed learning with the VR modalities they were provided 71/114, 62%) [, 62% 14,166,167.Of the 42 studies with guided VR training sessions, 26 (62%) asked external experts to guide the students in the topic explored through VR ,147,154.Between the self-directed and guided VR trainings, most of the studies incorporated an introductory session where time was allocated for students to become familiar with the VR system they were provided. Among the 71 self-directed studies, 58 82%) used an introductory session % used an,155,166.Of the 71 studies with guided teaching, 36 (51%) incorporated an introduction for the VR modality ,147,154,There was a wide variation in VR use periods in the studies. Hence, they were categorized into the following time periods: <1 day, 1 day to 1 month, 1-6 months, 6-12 months, and >1 year. For studies with duration >1 month, the 6-month threshold was chosen to distinguish between an academic semester and an academic year.The most common lengths of teaching periods were <1 day  ,166,167 Fewer studies opted for longer teaching periods. Of the 114 studies, 16 (14%) used teaching periods lasting 1-6 months ,146,148,Of the 114 studies, 4 (3.5%) investigated attainment of proficiency over time, and thus a predetermined training duration was not applicable ,128,133,The studies had variations in the number of students who were taught using 1 VR device. Hence, the studies were categorized into those that used VR modalities that facilitated teaching an individual and those that facilitated group teaching (>1 person). Some VR modalities were more flexible: they allowed for teaching either an individual or a group.Most of the study designs involved individual students taught using VR modalities 97/114, 85.1%) [, 85.1% ,166,167.There were distinct group sizes that were characteristic of the modality of VR used. Some studies used small teaching groups of approximately 2-4 students . These VIn this scoping review, we mapped out the existing VR modalities used in undergraduate medical education, including the characteristics of the VR modalities, target population, tools used in development, educational elements, and the outcomes measured of each VR modality. We found 114 studies that were relevant to our objective, including 47 (41.2%) RCTs, 49 (42.9%) other experimental study designs, 14 (12.3%) cross-over studies, 3 (2.6%) case studies and cases series, and 1 (0.9%) meta-analysis. Most of the papers were published from Europe or the United States. Approximately half of the papers reported the use of surgical VR simulators, with the next most common being 3D anatomical models and virtual worlds. Other VR modalities such as virtual dissection tables and mobile VR were less common. The included studies usually used haptic tools or a mouse as input devices and a screen as a delivery device. Most of the studies were semi-immersive with a high degree of interactivity. The most common subject taught using VR simulators was surgical skills, and the most common mode of training was self-directed. There was a large variation in the duration of teaching. Most studies reported only a single type of outcome measurement, with the most common being skills outcomes. The timing of assessment was most often immediately after the intervention. Most VR modalities were also designed for individual delivery rather than group delivery.Although surgical VR simulators, 3D anatomical models, and virtual worlds are relatively well represented in the literature, there is limited evidence on the use of virtual dissection tables and mobile VR. Indeed, there are a number of systematic reviews evaluating the use of surgical VR simulators in health professions education at both postgraduate and undergraduate level, most of which favor VR, especially for nonsimulation training -179. TheMost of the studies included in our review did not report, or refer to, educational or behavior frameworks or theories used in the development of VR applications. This has also been observed in studies on other digital modalities used in health professions education . HoweverWe also observed several studies exploring the development of particular 3D anatomical models and virtual worlds that had a considerable overlap in terms of the process of development. There is a need for stronger collaboration and easier sharing among educators and researchers in this novel field. This could be achieved through a common platform or database of VR medical education tools and insights similar to Radiopaedia for radiology and GitHub for software engineering.There is a clear lack of studies from low- and middle-income countries. Adoption of VR tools shown to be effective in high-income countries might not be possible in other settings because of context-specific limitations such as lack of financial resources, knowledge, or technology ,182. Givsoft skills such as communication skills or empathy. The manner in which health care professionals communicate with patients is argued to be as important as clinical knowledge but often goes underemphasized [We also observed a distinct lack of studies focusing on the use of VR for developing phasized ,101. VPsImmersive VR modalities not only offer a realistic experience to the user, but they also have the additional benefit of spatial understanding . The higOnly a few studies reported on the integration of VR training presented in the study into medical school curricula ,70,141. We performed a comprehensive search of 4 major bibliographic databases in this review. We covered the search period starting from 2010 to include all available studies on VR-based training for medical students’ education. Our screening and data extraction were also conducted in parallel and independently to ensure reliability and reduce bias in our findings. The topic that we explored was also novel, particularly in the context of undergraduate medical education.This scoping review was limited to studies published in English. Because of the large number of studies on VR, we only focused our research on the use of VR in medical students’ education and thus the use of VR in other health care professionals’ education and training was not captured in this review. Diverse terminology was used to describe VR; therefore, we may not have captured some studies because of the unfamiliar terminology used. In the categorization of the diverse terminology used in the studies, details specific to singular studies may have been lost. Although this review is as comprehensive as possible, there may still be smaller but important studies that were published only as abstracts that were left out of this review. In accordance with scoping review methodology, there was no quality assessment of the included articles; thus, the included studies may be biased or incomplete in terms of some of the information reported.The use of VR in medical education is a rapidly expanding and exciting field of study. Current research is mostly centered on surgical VR simulators, virtual worlds, and 3D anatomical models by comparing them with traditional modes of learning. Novel VR modalities such as mobile VR and virtual dissection tables, which are potentially more portable and allow for group learning, respectively, are less well represented in the literature. As an increasing number of medical schools turn toward incorporating VR into their curriculum, there is a need to evaluate these novel VR modalities as well as describe the methods used to incorporate VR into the curriculum. The use of VR to develop communication skills or to allow students to work in a team is also lacking. Most of the VR modalities described are only designed for a single user, which is unlike situations arising in a health care team. The use of modalities such as virtual worlds to create scenarios that require teamwork and communication should be more widely explored.


Bulki-01 (96), BaHajidu (90), and Werer- 963 (76) obtained higher score values as preferred by farmers, whereas lower score values were observed for Manipinter variety (45). The aforementioned varieties Bulki-01, BaHajidu and Werer-963 were also preferred using selection criteria set by farmers as 1st, 2nd, and 3rd in rank order respectively. Hence, based on farmers’ preference values and biological data, these three groundnut varieties were recommended for pre-extension demonstration and large-scale production in Dawuro Zone and areas with similar agro-ecologies.Groundnut is a leguminous seed that contains a lot of oil and protein with high energy content. However, improved varieties were hardly evaluated based on farmers' preference criteria and their participation. Therefore, a participatory variety selection was carried out in Taricha Zuriya district in Dawuro Zone on the mother-baby approach on farmers' fields in the 2019 and 2020 main cropping seasons, aiming at evaluating the performance of groundnut varieties through farmers' participation and assessing their preference criteria. Six released groundnut varieties were tested using a randomized complete block design with four replicates at farmers' fields. The mother trial was done at one model farmer field , whereas the baby trials were done at four farmers' fields by considering farmers as replication per village. Combined analysis of variance for two years showed a highly significant (P < 0.001) to significant (P < 0.01) differences among groundnut varieties for grain yield, days to 50 % flowering, days to maturity, seeds per pod, pods per plant, 100 seed weight, except for both stand count at emergence and harvest. Among the tested varieties, BaHajidu (1805.84 kg ha Baby trial; Groundnut; Mother trial; Participatory. The altitudes ranged from 500-3600 m a.s.l. The major soil type which comprises about 91.1 % in the zone is Leptosols.2.2o 10′N, 37o 3′E; field 2: 7o 11′N, 37o 4′E; field 3: 7o 13′N, 37o 6′E and field 4: 7o 14′N, 37o 7′E with an altitude of 1500–1523 m a.s.l), which was considered as baby trials. Mother trial was planted to exploit researcher data whereas the baby trials were planted in farmers' fields to take farmers' preferences into account during variety evaluation. The plot size was 14.4 m2 of six rows of 4 m long in the spacing of 0.6 m and 0.1 m inter and intra rows, respectively. The harvestable area was four rows of 4 m long i.e. 9.6 m2. Four farmers' fields were used for evaluation and each farmer was used as replication. Sowing was done during the onset of rainfall. All the recommended cultural practices such as weeding, earthing up, fertilization, etc. were applied during the study period. The common fertilizer rate recommendation of legume crops i.e. half of 121 kg ha−1 NPS was used. NPS consists, Nitrogen, phosphorous, and sulfur in one pack (19 N–38 P2O5 +7S)This study evaluated six improved groundnut varieties , sourced from Haramaya University . Six gro2.31.Stand count at emergence: It was recorded as the number of plants in the plot at emergence2.Stand count at harvest: It was recorded as the number of plants in the plot at harvestable maturity3.Days to 50% flowering: It was recorded as the number of days from sowing to 50% of the plants in the plot started flowering4.Days to maturity: It was recorded as the number of days from sowing to the stage when 90% of the plants in a plot have changed the color of their pods to yellow.5.Number of pods per plant: This was determined as the mean value of five randomly sampled plants obtained by counting the total number of pods per plant.6.Number of seeds per pod: The mean number of seeds per pod was obtained by counting the number of seeds collected from five mature pods from each five sampled plants.7.−1): This was measured after harvesting the whole pods from the middle four rows of each plot and converted to kilograms per hectare after sun drying.Dry pod yield , days to 50 % flowering (DF 50%), days to 90% maturity (DM 90%), 100 seed weight (g) and grain yield were collected on a plot basis. The data recording for each trait (8) was carried out as follows.Diseases  and insect pests (termite) are the problems of groundnut at field conditions, and weevil is the storage pest reported in the region but we did not collect diseases and insect pests data in these trials. Farmers’ evaluation and selection data were collected on a plot basis from the four baby trials of each field. Farmers' field visits were organized at different stages of plant growth  and harvest for farmers to share experiences and evaluate varieties in the trials. Two (2) Agricultural Development Agents, sixteen (16) men, and four (4) women farmers have participated in the selection process. The ranking procedure was explained to participants and then each criterion was ranked from 1 to 5  for each variety, the ranking was done on consensus where differences have been resolved through discussion. During the direct matrix ranking, farmers gave the importance (a relative weight) score of the selection criteria were ranked from 1 to 3  and a variety performance score for each trait of interest was given based on their level of importance based on the common agreement of evaluators. The scores for each variety were multiplied by the relative weight of a given trait to get the final result and then added with the results of other characters to find out the total score of a given variety.2.4The recorded agronomic data were subjected to the analysis of variance (ANOVA) using SAS, 9.2 version , and mea33.1Comparison of errors squares of the mean over two years showed homogeneity of variance. The analysis of variance (ANOVA) revealed highly significant to the significant varietal difference among the six groundnut varieties for all the traits studied  indicati−1) showed highly significant (P < 0.001) to significant differences (P < 0.05) and their values were illustrated in Tables The mean of groundnut varieties in terms of stand count at 50% emergence, days to 50% flowering, days to 90% maturity, stand count at harvest, seeds per pod, pods per plant, hundred seed weight, and pod yield  was recorded in BaHajidu, which yielded 17.53 % over Werer-962, which had the lowest (1536.30 kg ha−1) numerical yield and was statistically inferior to the other varieties. The yield differences of these varieties could be due to their differences in genetic characteristics and the nature of agroecological adaptability, which is in agreement with the conclusions of Relatively, the lower yield value was recorded for groundnut variety Werer-962. Varieties Manipinter and Sedi gave reasonable yield without significant yield differences among these varieties . The hig−1 in eastern and southern Ethiopia, which is in contrast to the present findings. The significance of yield trait has been reported by many authors in different legume crops, such as groundnut  and the third longer physiological maturity (144.30 days) were observed for the variety BaHajidu.Earliness or lateness in the days to maturity might have been due to their inherited characters, early acclimatization to the growing area to enhance their growth and development. The observed difference in earliness traits  were due to differences in genotype, environment, and the genotype by environment interaction as groundnut show variability in growth habit, seed characteristics, maturity, and adaptation.This is in agreement with the report of 3.2They set the criteria; seed color, early maturity, marketability, adaptability, resistance to an insect pest, pod number, good taste, large pod size, high pod yielding, and resistant varieties to select the best variety.Groundnut varieties preference using traits identified by the district farmers themselves showed that Bulki-01, BaHajidu, and Werer-963 were preferred by farmers. Bulki-01 (96) scored the highest value and Manipinter scored the lowest value (45). BaHajidu (90) and Werer-963 (76) were ranked by farmers as the second and third best varieties, respectively . Likewis4The results of the current study indicated that the groundnut variety BaHajidu had the highest mean pod yield, although not significantly different from yields obtained from varieties Bulki-01, and Werer-963. Yields from the mentioned varieties were statistically similar and were selected by farmers due to their better yield, seed color, marketability, and adaptability. Therefore, the varieties were selected for incorporating into the local farming systems.The present selection process also verified that farmers were skillful in selecting important traits for grain yield and identity varieties best suited to their locality. Overall, participatory variety selection has been efficient and honest in identifying suitable crop varieties through partnerships with resource-poor farmers. These high-yielding and farmers’ preferred varieties Bulki-01, Werer-963, and BaHajidu were recommended for pre-extension demonstration and large-scale production for Taricha Zuriya district in the Dawro Zone and related agro ecologies.Demelash Bassa Belayneh: conceived and designed the experimets, performed the experiments, analyzed and interpreted the data, wrote the paper.Yasin Goa Chondie: Designed and performed the experiments, edited the written paper.Agricultural Growth Program -II (AGP-II) project.This research was supported by Data included in article/supplementary material/referenced in article.The authors declare no conflict of interest.No additional information is available for this paper.