BACKGROUND

Continuing Medical Education (CME) serves as a cornerstone for maintaining clinical competence and improving patient care. In the Philippines, CME has become increasingly digital, with the UP Med Webinars emerging as a leading platform for physician education over the past decade. Despite this growth, there has been limited evaluation of how well these webinars align with national health priorities, particularly those reflected in PhilHealth hospital admissions and claims data, which provide insights into the country's disease burden and healthcare utilization patterns.

OBJECTIVES

This study aimed to determine the extent to which the topics and reach of UP Med Webinars correspond with the Philippine health system’s most pressing clinical demands. Specifically, it aimed to analyze the trend in number of webinars by year; analyze the distribution of webinar topics by medical field; assess physician attendance as a proxy for clinical interest and engagement; evaluate the alignment between UP Med Webinar content and national health priorities based on PhilHealth’s top conditions, procedures, and reimbursed claims.

METHODS

The study used a qualitative content analysis of all Continuing Professional Development (CPD)-accredited UP Med Webinars from 2015 to 2024, supported by descriptive statistics. Webinar titles were coded thematically and categorized by topic and medical field. Attendance figures were analyzed to identify high-demand topics. These results were compared with PhilHealth Claims Reports (2020–2024), focusing on the top reimbursed medical diagnoses and procedures, to assess alignment with disease burden and health service delivery trends. These findings can help inform strategic planning for CME programs to ensure they remain responsive to the country's evolving public health needs.

RESULTS

From 2015 to 2024, a total of 686 CPDaccredited UP Med Webinars were conducted, attended by 685,994 participants. The annual number of webinars and attendees steadily increased, peaking during the COVID-19 pandemic (2020–2022) with heightened demand for virtual CME and pandemic-related topics. Internal Medicine consistently emerged as the most frequently covered field, accounting for 54.1% of webinars and 48.8% of total attendance, followed by Obstetrics and Gynecology (14.4% of webinars; 19.6% of attendance) and Pharmacotherapeutics (6.0% of webinars; 6.9% of attendance). Certain fields, including COVID-19 and Psychiatry, attracted disproportionately high attendance despite fewer sessions, indicating strong interest during periods of public health urgency. The top 10 webinar topics included Diabetes, Pregnancy, Cancer, Hypertension, Reproductive Health, COVID-19, Heart Disease, Antimicrobial Treatment, Vertigo, and Vaccination, reflecting a mix of chronic disease management, maternal health, infectious diseases, and emergent health concerns.

Comparison with PhilHealth claims data (2020– 2024) revealed a high disease burden in Internal Medicine, Obstetrics, and Pediatrics, with top medical conditions including Pneumonia, Dengue, Hypertensive emergencies, and Stroke. These findings indicate a strong alignment between the most covered webinar topics and national healthcare utilization trends, particularly in high-burden clinical areas.

CONCLUSION

Findings suggest that the UP Med Webinars have generally aligned with national health priorities, as indicated by PhilHealth claims data, particularly in highburden fields such as Internal Medicine and Obstetrics. However, gaps in coverage for certain high-priority conditions and procedures point to opportunities for more inclusive and data-driven CME planning. Aligning CME content with evolving health system needs can enhance its relevance, support clinical practice improvements, and ultimately contribute to better population health outcomes in the Philippines.

Education, Medical, Continuing ; Medicine ; Health Priorities

INTRODUCTION

There is significantly increased morbidity among patients who undergo major amputation because of diabetic foot ulcers (DFU) . Various risk factors contribute to this outcome with endothelial dysfunction potentially linked to poor wound healing. The Neutrophil Lymphocyte Ratio (NLR) may indicate endothelial dysfunction.

OBJECTIVES

This study aimed to evaluate the accuracy and utility of NLR as a predictor of major amputation in patients admitted for DFU, whose white blood cell counts (WBCs) were elevated or normal. Major amputation is defined as amputation above the tibiotalar joint.

METHODOLOGY

This retrospective cohort analysis included patients admitted at East Avenue Medical Center for DFU. The primary endpoint was major amputation of the lower extremities. Data were analyzed using Receiver Operating Characteristic (ROC) analysis and logistic regression.

RESULTS

The study included 280 DFU patients, predominantly male (62.86%) with a mean age of 57.01±10.72 years. Elevated WBC was found in 176 patients (62.86%) while 104 had normal WBC (37.14%). Major amputation of the lower extremity was performed on 112 patients (40%), with 81 having elevated WBC and 31 normal WBC. The median NLR in patients with elevated WBC undergoing major amputation was 12.86 (IQR: 2.36-95) compared to 5.71 (IQR: 1.91-31.67) in those who did not, indicating NLR as an independent predictor of major amputation (Adjusted OR 1.23; 95% CI 1.14-1.34; p < 0.001). ROC analysis showed an AUC of 0.8234 with an optimal cutoff of 9.33 (72.8% sensitivity, 86.3% specificity). Other predictive variables included University of Texas Stage 3D (Adjusted OR 8.20; 95% CI 2.52-26.75; p < 0.001), Wagner Grade 4 (Adjusted OR 4.6; 95% CI 1.28-16.55; p=0.019), and severe infection (Adjusted OR 2.91; 95% CI 1.22-6.93; p=0.016). For patients with normal WBC, median NLR was 18 (IQR: 1.54-45.5) in those who had major amputation versus 3.13 (IQR: 1.14-12.29) in those who did not undergo major amputation. ROC analysis showed an AUC of 0.9068 with an optimal cutoff of 6.92 (87.1% sensitivity, 98.6% specificity). NLR was also an independent predictor in these subjects (Adjusted OR 1.48; 95% CI 1.14-1.92; p=0.003) alongside smoking history (Adjusted OR 9.14; 95% CI 1.26-66.56; p=0.029) and UT3D (Adjusted OR 17.38; 95% CI 2.21-136.59; p=0.007).

CONCLUSION

Forty percent of DFU patients had major amputations. NLR independently predicted major amputation in DFU patients with both elevated and normal WBC.

Human ; Diabetes Mellitus ; Amputation

INTRODUCTION

Most cancer-related deaths globally are caused by lung cancer. The diagnosis is typically made following the evaluation of respiratory symptoms such as chronic cough or incidental finding of pulmonary lesions such as nodules and mass. Cardiac metastasis occurs in 2-18% of lung cancers, but cardiac tamponade complicating malignant pericardial effusion is an extremely rare and life-threatening initial presentation of non-small cell lung carcinoma.

CASE REPORT

A 59-year-old-male with a smoking history of 72 pack-year presented at the emergency room with severe dyspnea and was assessed to be in cardiac tamponade. The patient arrested for 16 minutes but returned to spontaneous circulation after 650mL of serosanguinous fluid was removed by pericardiocentesis. The work-up for infectious and immunologic causes was negative. Chest CT scan with contrast did not reveal any pulmonary mass. However, the pericardial fluid cytology immunohistochemical stains pointed to a primary lung adenocarcinoma. PET scan was requested which confirmed hypermetabolic focus in the left lung base. included patients admitted at East Avenue Medical Center for DFU. The primary endpoint was major amputation of the lower extremities. Data were analyzed using Receiver Operating Characteristic (ROC) analysis and logistic regression.

CONCLUSION

This case showed an extremely rare situation where life-threatening cardiac tamponade was the initial presentation of non-small cell lung adenocarcinoma, which highlights the need for vigilance in atypical presentation. Comprehensive diagnostic approach, including PET scans and cytologic analysis, must be done when standard imaging is inconclusive.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Cardiac Tamponade ; Adenocarcinoma Of Lung

BACKGROUND

The Philippines has been significantly affected by the HIV epidemic in the Asia-Pacific region, with a notable increase in new cases over the past decade. Despite efforts to promote HIV testing, access to treatment, and awareness campaigns, progress has been slow, particularly among youths. Tangere, a market research application, conducted surveys during and after the COVID-19 pandemic to assess HIV knowledge among Filipinos.

OBJECTIVES

This study aimed to evaluate changes in HIV awareness among young Filipinos during and after the COVID-19 pandemic using data collected via Tangere’s surveys. Specifically, it sought to analyze demographic characteristics, sources of HIV information, and knowledge regarding HIV transmission, prevention, and stigma.

METHODS

Tangere collaborated with the investigators to develop a questionnaire assessing HIV knowledge among young Filipinos. Surveys were conducted during and after the COVID-19 pandemic, targeting subscribers aged 18-35 years, primarily from the National Capital Region and Luzon area. Data analysis involved calculating frequencies and percentages to summarize demographic characteristics and HIV knowledge. An Independent-Samples Proportions procedure was used to compare HIV knowledge during and after the pandemic.

RESULTS

The survey revealed that while respondents generally possessed reasonable knowledge about HIV, there were notable changes in the awareness during and after the pandemic. Social media and television were identified as primary sources of HIV information. Knowledge regarding HIV transmission and prevention increased postpandemic, particularly concerning preventive measures such as pre-exposure prophylaxis (PREP) and motherto-child transmission (MTCT). However, persistent misconceptions and stigma surrounding HIV remained, indicating the need for continued education and advocacy efforts.

CONCLUSION

The study underscores the importance of utilizing social media platforms for HIV awareness campaigns, especially among youths who are disproportionately affected by the epidemic. Despite improvements in knowledge, the Philippines has yet to achieve global HIV prevention goals. Continued efforts to enhance awareness, particularly regarding recent advancements in HIV prevention and treatment, are essential for curbing the epidemic and improving public health outcomes nationwide.

Human ; Knowledge ; Attitude ; Hiv ; Covid-19 ; Pandemics

BACKGROUND AND OBJECTIVE

The COVID-19 pandemic has disrupted the sports industry, resulting in the postponement of events worldwide. This posed a significant burden in the mental and emotional well-being of athletes due to uncertainties and diminished training levels. As an adaptation, bubble camps emerged as a new approach to resuming training and tournaments under stringent regulations of the COVID-19 protocols. In the national context, the University Athletic Association of the Philippines (UAAP) has adapted the bubble set-up by implementing antigen testing, RTPCR, and other health protocols as a prerequisite to bubble training. However, uncertainties in the future of sports continue to present as a psychological toll to the well-being of student-athletes despite the sense of normalcy instilled by bubble training. Existing literature on bubble training is grounded heavily on the quantitative assessments of an athlete's well-being in a bubble set-up and its effectiveness in mitigating COVID-19 transmission, thereby lacking insights that may be obtained from qualitative data. This study explored the experiences of UAAP Season 84 studentathletes in a bubble set-up by examining personal and contextual factors that impacted their well-being.

METHODS

The study employed a qualitative descriptive phenomenological approach based on Seligman's WellBeing Theory. A purposeful sampling technique was used to recruit UAAP student-athletes through online dissemination of Google Forms for recruitment. Only three student-athletes from UAAP fit the eligibility criteria. Data were collected through on-site and online interviews using a semi-structured interview guide to reveal a narrative of the student-athletes' bubble training experiences, common themes, and patterns. The NVivo software program was used for data analysis, utilizing a deductive thematic approach.

RESULTS

The lived experiences of three UAAP studentathletes were classified into six major themes: (1) Availability and Accessibility of Services; (2) Restrictions; (3) Mental Health; (4) Fostering Relationships; (5) Support Systems; and (6) Individual Growth. Accounts of both positive and negative training perceptions and outcomes regarding the bubble set-up were noted from all student-athletes. The set-up provided studentathletes with easy access to training facilities and services, eventual development of mental fortitude and  perseverance, improved interpersonal relationships, and opportunities for individual growth. However, the restrictions, isolation, internal and external pressures, and routinary nature of the set-up contributed to the elevated levels of stress and anxiety, eventually leading to fatigue and burnout.

CONCLUSION

The study elucidates on the multi-faceted experiences of UAAP student-athletes in bubble training, underpinning the essence of the adequacy of training services and facilities, enhanced support systems, and prompt policy development that caters to improving the holistic well-being of student-athletes amidst adverse changes in the trajectory of sports.

Human ; Qualitative Research ; Universities ; College Athletes ; Athletes

METHODOLOGY

A survey was conducted among 463 adults in Manila, achieving a valid response rate of 92.3% (427 responses analyzed). Participants represented diverse socioeconomic backgrounds. The survey explored perceptions regarding AAA of healthcare services for neurological emergencies.

RESULTS

Across income levels (poor, middle, rich), participants favored private hospitals for accessibility and convenience, such as emergency room access and prompt care. Private hospitals were also preferred for availability of diagnostic equipment, medications, specialist expertise and 24/7 care. Public hospitals, however, were preferred for affordability, particularly for emergency visits, medications, tests, neurologist consultations and ambulance services.

DISCUSSION

Findings reveal a clear preference split: private hospitals are valued for accessibility and resources, while public hospitals remain the affordable choice. This reflects ongoing systemic and socioeconomic challenges in Manila’s healthcare landscape.

CONCLUSION

The study provides actionable insights for policymakers and healthcare providers seeking to improve emergency neurological care. Addressing gaps in access and affordability can enhance patient outcomes and satisfaction while promoting more equitable healthcare delivery.

Human ; Male ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Adult ; Emergencies ; Perception

OBJECTIVES

To explore the lasting lived experiences of Filipino adults who were isolated due to COVID-19 as late adolescents and examine how these experiences shaped their health consciousness

METHODS

This qualitative study employed an interpretative phenomenological analysis using Colaizzi’s method. Six participants aged 18 and above, who were aged 17–19 during their COVID-19 diagnosis and isolation, were recruited. One-onone semi-structured interviews were conducted and thematically analyzed.

RESULTS

Four main themes emerged: (1) Sources of Stress including academic disruptions, isolation, symptoms and healthcare inefficiencies; (2) Attitudes Toward the Experience ranging from fear to calm acceptance and social responsibility; (3) Coping Strategies such as external support and personal mechanisms like spirituality and hobbies; and (4) Impact of COVID-19 which encompassed interpersonal growth, normalization of illness and varying degrees of health behavior change.

CONCLUSION

While the experience of isolation during adolescence posed significant stress, it also offered opportunities for personal and interpersonal growth. Most participants exhibited increased health consciousness, though behavior change was limited. These insights highlight the value of integrating health behavior interventions for young adults shaped by pandemic experiences.

Human ; Male ; Female ; Adolescent: 13-18 Yrs Old ; Adolescent ; Consciousness ; Behavior ; Covid-19 ; Methods ; Social Responsibility ; World Health Organization ; Young Adult ; Health ; Diagnosis ; Health Behavior

Lactylation (Kla), a protein post-translational modification characterized by the covalent conjugation of lactyl groups to lysine residues in proteins, is widely present in living organisms. Since its discovery in 2019, it has attracted much attention for its role in regulating major pathological processes such as tumorigenesis, neurodegenerative diseases, and cardiovascular diseases. By mediating core biological processes such as signal transduction, epigenetic regulation, and metabolic homeostasis, lactylation contributes to disease progression. However, the lactylation donor lactyl-CoA has a low intracellular concentration, and the specific enzyme catalyzing lactylation is not yet clear, which has become an urgent issue in lactate research. A groundbreaking study in 2024 found that alanyl-transfer t-RNA synthetase 1/2 (AARS1/2), members of the aminoacyl-tRNA synthetase (aaRS) family, can act as protein lysine lactate transferases, modifying histones and metabolic enzymes directly with lactate as a substrate, without relying on the classical substrate lactyl-CoA, promoting a new stage in lactate research. Although exercise significantly increases lactate levels in the body and can induce changes in lactylation in multiple tissues and cells, the regulation of lactylation by exercise is not entirely consistent with lactate levels. Research has found that high-intensity exercise can induce upregulation of lactate at 37 lysine sites in 25 proteins of adipose tissue, while leading to downregulation of lactate at 27 lysine sites in 22 proteins. The level of lactate is not the only factor regulating lactylation through exercise. We speculate that the lactate transferase AARS1/2 play an important role in the process of lactylation regulated by exercise, and AARS1/2 should also be regulated by exercise. This review introduces the molecular biology characteristics, subcellular localization, and multifaceted biological functions of AARS, including its canonical roles in alanylation and editing, as well as its newly identified lactate transferase activity. We detail the discovery of AARS1/2 as lactylation catalysts and the specific process of them as lactate transferases catalyzing protein lactylation. Furthermore, we discuss the pathophysiological significance of AARS in tumorigenesis, immune dysregulation, and neuropathy, with a focus on exploring the expression regulation and possible mechanisms of AARS through exercise. The expression of AARS in skeletal muscle regulated by exercise is related to exercise time and muscle fiber type; the skeletal muscle AARS2 upregulated by long-term and high-intensity exercise catalyzes the lactylation of key metabolic enzymes such as pyruvate dehydrogenase E1 alpha subunit (PDHA1) and carnitine palmitoyltransferase 2 (CPT2), reducing exercise capacity and providing exercise protection; physiological hypoxia caused by exercise significantly reduces the ubiquitination degradation of AARS2 by inhibiting its hydroxylation, thereby maintaining high levels of AARS2 protein and exerting lactate transferase function; exercise induced lactate production can promote the translocation of AARS1 cytoplasm to the nucleus, exert lactate transferase function upon nuclear entry, regulate histone lactylation, and participate in gene expression regulation; exercise induced lactate production promotes direct interactions between AARS and star molecules such as p53 and cGAS, and is widely involved in the occurrence and development of tumors and immune diseases. Elucidating the regulatory mechanism of exercise on AARS can provide new ideas for improving metabolic diseases and promote health through exercise.

Neuroscience is a significant frontier discipline within the natural sciences and has become an important interdisciplinary frontier scientific field. Brain is one of the most complex organs in the human body, and its structural and functional analysis is considered the “ultimate frontier” of human self-awareness and exploration of nature. Driven by the strategic layout of “China Brain Project”, Chinese scientists have conducted systematic research focusing on “understanding the brain, simulating the brain, and protecting the brain”. They have made breakthrough progress in areas such as the principles of brain cognition, mechanisms and interventions for brain diseases, brain-like computation, and applications of brain-machine intelligence technology, aiming to enhance brain health through biomedical technology and improve the quality of human life. Due to limited understanding and comprehension of neuroscience, there are still many important unresolved issues in the field of neuroscience, resulting in a lack of effective measures to prevent and protect brain health. Therefore, in addition to actively developing new generation drugs, exploring non pharmacological treatment strategies with better health benefits and higher safety is particularly important. Epidemiological data shows that, exercise is not only an indispensable part of daily life but also an important non-pharmacological approach for protecting brain health and preventing neurodegenerative diseases, forming an emerging research field known as motor neuroscience. Basic research in motor neuroscience primarily focuses on analyzing the dynamic coding mechanisms of neural circuits involved in motor control, breakthroughs in motor neuroscience research depend on the construction of dynamic monitoring systems across temporal and spatial scales. Therefore, high spatiotemporal resolution detection of movement processes and movement-induced changes in brain structure and neural activity signals is an important technical foundation for conducting motor neuroscience research and has developed a set of tools based on traditional neuroscience methods combined with novel motor behavior decoding technologies, providing an innovative technical platform for motor neuroscience research. The protective effect of exercise in neurodegenerative diseases provides broad application prospects for its clinical translation. Applied research in motor neuroscience centers on deciphering the regulatory networks of neuroprotective molecules mediated by exercise. From the perspectives of exercise promoting neurogenesis and regeneration, enhancing synaptic plasticity, modulating neuronal functional activity, and remodeling the molecular homeostasis of the neuronal microenvironment, it aims to improve cognitive function and reduce the incidence of Parkinson’s disease and Alzheimer’s disease. This has also advanced research into the molecular regulatory networks mediating exercise-induced neuroprotection and facilitated the clinical application and promotion of exercise rehabilitation strategies. Multidimensional analysis of exercise-regulated neural plasticity is the theoretical basis for elucidating the brain-protective mechanisms mediated by exercise and developing intervention strategies for neurological diseases. Thus,real-time analysis of different neural signals during active exercise is needed to study the health effects of exercise throughout the entire life cycle and enhance lifelong sports awareness. Therefore, this article will systematically summarize the innovative technological developments in motor neuroscience research, review the mechanisms of neural plasticity that exercise utilizes to protect the brain, and explore the role of exercise in the prevention and treatment of major neurodegenerative diseases. This aims to provide new ideas for future theoretical innovations and clinical applications in the field of exercise-induced brain protection.

The pathogenesis of cardiovascular diseases (CVD) is complex, and dynamic imbalances in protein acylation modification are significantly associated with the development of CVD. In recent years, most studies on exercise-regulated protein acylation modifications to improve cardiovascular function have focused on acetylation and lactylation. Protein acylation modifications are usually affected by exercise intensity. High-intensity exercise directly affects oxidative stress and cellular energy supply, such as changes in ATP and NAD⁺ levels; moderate-intensity exercise is often accompanied by improvements in aerobic metabolism, such as fatty acid β-oxidation and TCA cycle, which modulate mitochondrial biogenesis. The above processes may affect the acylation status of relevant regulatory enzymes and functional proteins, thereby altering their function and activity and triggering signaling cascades to adapt to exercise’s metabolic demands and stresses. Exercise regulates the levels of acylation modifications of H3K9, H3K14, H3K18, and H3K23, which are involved in regulating the transcriptional expression of genes involved in oxidative stress, glycolysis, inflammation, and hypertrophic response by altering chromatin structure and function. Exercise can regulate the acylation modification of non-histone-specific sites in the cardiovascular system involved in mitochondrial function, glycolipid metabolism, fibrosis, protein synthesis, and other biological processes, and participates in the regulation of protein activity and function by altering the stability, localization, and interaction of proteins, and ultimately works together to achieve the improvement of cardiovascular phenotypes and biological functions. Exercise affects acyl donor concentration, acyltransferase, and deacetylase expression and activity by influencing acyl donor concentration, acyltransferase, and deacetylase. Exercise regulates the abundance of acyl donors such as acetyl coenzyme A, propionyl coenzyme A, butyryl coenzyme A, succinyl coenzyme A, and lactoyl coenzyme A by promoting glucose and lipid metabolism and improving intestinal bacterial flora, which in turn affects protein acylation modification, accelerates oxidative decarboxylation of pyruvic acid in the body, and activates the energy-sensing molecule, adenosine monophosphate-activated protein kinase (AMPK), to improve cardiovascular function. Exercise may affect protein acylation modifications in the cardiovascular system by regulating the activity and expression of adenoviral E1A binding protein of 300 kDa (p300)/cyclic adenosine monophosphate response element-binding protein (CBP), general control nonderepressible 5-related N-acetyltransferases (GNAT), and alanyl-transfer t-RNA synthetase (AARS), which in turn improves cardiovascular function. The relationship between exercise and cardiovascular deacetylases has attracted much attention, with SIRT1 and SIRT3 of the silence information regulator (SIRT) family of proteins being the most studied. Exercise may exert transient or long-term stable cardiovascular protective benefits by promoting the enzymatic activity and expression of SIRT1, SIRT3, and HDAC2, inhibiting the enzymatic activity and expression of HDAC4, and mediating the deacylation of metabolic regulation-related enzymes, cytokines, and molecules of signaling pathways. This review introduces the role of protein acylation modification on CVD and the effect of exercise-mediated protein acylation modification on CVD. Based on the existing studies, it analyzes the possible mechanisms of exercise-regulated protein acylation modification to improve CVD from the perspectives of acylation modification donors, acyltransferases, and deacetylases. Deciphering the regulation of cardiovascular protein acylation and modification by exercise and exploring the essential clues to improve cardiovascular disease can enrich the theoretical basis for exercise to promote cardiovascular health. However, it is also significant for developing new cardiovascular disease prevention and treatment targets.