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  1. Rosani NS, Zamin RM, Aman RRAR, Zuhdi ASM, Danaee M, Zulkafli IS
    Rev Cardiovasc Med, 2025 Feb;26(2):25252.
    PMID: 40026505 DOI: 10.31083/RCM25252
    BACKGROUND: Additional bifurcations at the left main coronary artery (LMCA) could modify the geometry of the left coronary system, disturbing haemodynamic flow patterns and potentially altering endothelial shear stress (ESS). A low ESS has been implicated in atherogenesis. The emergence of the ramus intermedius (RI) from the LMCA creates additional branching, but the specific role of the RI in plaque deposition at the left coronary system remains unclear. This study sought to elucidate the potential effects of the RI on plaque formation at the LMCA and its bifurcation.

    METHODS: A retrospective cross-sectional single-centre study was conducted using data from 139 female patients who were identified to have low risk of cardiovascular disease. These patients underwent cardiac computed tomography angiography between January 2017 and December 2018. Contrasted multiplanar coronary images taken during the best diastolic phase were analysed for the presence (experimental group) or absence (control group) of the RI. Measurements of plaques were done at the LMCA and at a 10 mm distance from the ostia of daughter arteries. Plaque data at the left bifurcation region were analysed using descriptive statistics, chi-square, and binary logistic regression tests. A p-value of <0.05 was considered statistically significant.

    RESULTS: Amongst these low-risk patients, 33.8% (n = 47) had an RI. In the presence of RI, there was an eight-fold increased risk of plaque deposition at the LMCA (adjusted odds ratio, aOR = 8.5) and a three-fold increased risk of plaque deposition at the proximal left anterior descending (pLAD), especially on its lateral wall (aOR = 3.5). However, the RI did not influence plaque deposition at the distance of 10 mm from the ostium of the proximal left circumflex artery.

    CONCLUSIONS: These findings suggest that the RI increases the risk for atherosclerosis plaque deposition by three to eight-fold at the pLAD artery and the LMCA.

  2. Hadie SNH, Yusoff MSB, Arifin WN, Kasim F, Ismail ZIM, Asari MA, et al.
    BMC Med Educ, 2021 Jan 14;21(1):50.
    PMID: 33446203 DOI: 10.1186/s12909-020-02467-w
    BACKGROUND: The Anatomy Education Environment Measurement Inventory (AEEMI) evaluates the perception of medical students of educational climates with regard to teaching and learning anatomy. The study aimed to cross-validate the AEEMI, which was previously studied in a public medical school, and proposed a valid universal model of AEEMI across public and private medical schools in Malaysia.

    METHODS: The initial 11-factor and 132-item AEEMI was distributed to 1930 pre-clinical and clinical year medical students from 11 medical schools in Malaysia. The study examined the construct validity of the AEEMI using exploratory and confirmatory factor analyses.

    RESULTS: The best-fit model of AEEMI was achieved using 5 factors and 26 items (χ 2 = 3300.71 (df = 1680), P

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