Reflect to interact - fostering medical students' communication through reflection-focused e-learning.

BACKGROUND: Previous research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician-patient communication to foster learning. METHODS: We investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students' reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students' levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0-18). RESULTS: Students of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length. CONCLUSIONS: Our study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.

Modeling ferroptosis in human dopaminergic neurons: Pitfalls and opportunities for neurodegeneration research.

The activation of ferroptosis is being pursued in cancer research as a strategy to target apoptosis-resistant cells. By contrast, in various diseases that affect the cardiovascular system, kidneys, liver, and central and peripheral nervous systems, attention is directed toward interventions that prevent ferroptotic cell death. Mechanistic insights into both research areas stem largely from studies using cellular in vitro models. However, intervention strategies that show promise in cellular test systems often fail in clinical trials, which raises concerns regarding the predictive validity of the utilized in vitro models. In this study, the human LUHMES cell line, which serves as a model for human dopaminergic neurons, was used to characterize factors influencing the activation of ferroptosis. Erastin and RSL-3 induced cell death that was distinct from apoptosis. Parameters such as the differentiation state of LUHMES cells, cell density, and the number and timing of medium changes were identified as determinants of sensitivity to ferroptosis activation. In differentiated LUHMES cells, interventions at mechanistically divergent sites (iron chelation, coenzyme Q10, peroxidase mimics, or inhibition of 12/15-lipoxygenase) provide almost complete protection from ferroptosis. LUHMES cells allowed the experimental modulation of intracellular iron concentrations and demonstrated a correlation between intracellular iron levels, the rate of lipid peroxidation, as well as the sensitivity of the cells to ferroptotic cell death. These findings underscore the importance of understanding the various factors that influence ferroptosis activation and highlight the need for well-characterized in vitro models to enhance the reliability and predictive value of observations in ferroptosis research, particularly when translating findings into in vivo contexts.

Effects of Tetrahydrolipstatin on Glioblastoma in Mice: MRI-Based Morphologic and Texture Analysis Correlated with Histopathology and Immunochemistry Findings-A Pilot Study.

BACKGROUND: This study aimed to investigate the effects of tetrahydrolipstatin (orlistat) on heterotopic glioblastoma in mice by applying MRI and correlating the results with histopathology and immunochemistry. METHODS: Human glioblastoma cells were injected subcutaneously into the groins of immunodeficient mice. After tumor growth of >150 mm3, the animals were assigned into a treatment group (n = 6), which received daily intraperitoneal injections of orlistat, and a control group (n = 7). MRI was performed at the time of randomization and before euthanizing the animals. Tumor volumes were calculated, and signal intensities were analyzed. The internal tumor structure was evaluated visually and with texture analysis. Western blotting and protein expression analysis were performed. RESULTS: At histology, all tumors showed high mitotic and proliferative activity (Ki67 ≥ 10%). Reduced fatty acid synthetase expression was measured in the orlistat group (p < 0.05). Based on the results of morphologic MRI-based analysis, tumor growth remained concentric in the control group and changed to eccentric in the treatment group (p < 0.05). The largest area under the receiver operating curve of the predictors derived from the texture analysis of T2w images was for wavelet transform parameters WavEnHL_s3 and WavEnLH_s4 at 0.96 and 1.00, respectively. CONCLUSIONS: Orlistat showed effects on heterotopically implanted glioblastoma multiforme in MRI studies of mice based on morphologic and texture analysis.

Training in medical communication competence through video-based e-learning: How effective are video modeling and video reflection?

OBJECTIVE: The present study investigated the efficacy of the didactic approaches of video modeling (VM, best-practice examples), video reflection (VR, problem-based approach), and the combination of both (VMR) in fostering medical communication competence in a video-based digital learning environment. METHODS: N = 126 third-year medical students who participated in the pre-post study were assigned to either the intervention groups (VM, VR, and VMR) or the wait-list control group. The efficacy of the three approaches was assessed by means of a situational judgment test (SJT) of medical communication competence. To investigate the differences between the wait-list control and the intervention groups (H1), between the single-mode and combined conditions (H2), and between VM and VR (H3), we applied planned contrast analyses. RESULTS: The planned contrasts showed that the VR condition significantly improved learning outcomes in comparison to the VM condition (H3). The decreased mean scores of the VM condition offset the increased mean scores of VR, and thus no significant differences could be found in H1 and H2. CONCLUSIONS: Our study provides promising evidence that VR fosters medical communication competence more effectively than VM. PRACTICAL IMPLICATIONS: Medical students' learning in video-based digital environments can be facilitated by the use of interactive VR.

Using the theory of planned behaviour to predict pre-service teachers' preferences for scientific sources.

BACKGROUND: Despite the growing emphasis on research-based teacher education and calls for evidence-informed practice, teachers tend to prefer experiential over scientific knowledge sources to inform their actions, justify decisions and analyse educational problems. This tendency already occurs as early as during initial teacher education, and it is possibly bolstered by school internships where mentors emphasise the value of practical over scientific knowledge. AIMS: The present study applied the theory of planned behaviour (TPB) to investigate under what conditions pre-service teachers intend to use and prefer scientific sources from educational research. METHODS: The study's participants were 343 pre-service teachers in a half-year school internship who indicated their attitudes towards educational research, behavioural control (i.e. self-efficacy), perceived subjective norm, intentions of using research and preference for scientific sources in a survey. Perceived subjective norm was established by measuring whether pre-service teachers believed their mentors considered research-based knowledge. RESULTS: In line with the predictions of the standard TPB model, structural equation modelling confirmed the effects of positive attitudes, self-efficacy and perceived subjective norm on pre-service teachers' intentions of using research. In turn, intentions and self-efficacy predicted preferences for scientific sources but not the use of scientific sources when planning a lesson in the internship. CONCLUSIONS: Pre-service teachers' scientific source preferences are shaped not only by personal dispositions but also by the social context of school.

Method of Manufacturing Structural, Optically Transparent Glass Fiber-Reinforced Polymers (tGFRP) Using Infusion Techniques with Epoxy Resin Systems and E-Glass Fabrics.

Recently, fiber-reinforced, epoxy-based, optically transparent composites were successfully produced using resin transfer molding (RTM) techniques. Generally, the production of structural, optically transparent composites is challenging since it requires the combination of a very smooth mold surface with a sufficient control of resin flow that leads to no visible voids. Furthermore, it requires a minimum deviation of the refractive indices (RIs) of the matrix polymer and the reinforcement fibers. Here, a new mold design is described and three plates of optically transparent glass fiber-reinforced polymers (tGFRP) with reproducible properties as well as high fiber volume fractions were produced using the RTM process and in situ polymerization of an epoxy resin system enclosing E-glass fiber textiles. Their mechanical (flexural), microstructural (fiber volume fraction, surface roughness, etc.), thermal (DSC, TGA, etc.), and optical (dispersion curves of glass fibers and polymer as well as transmission over visible spectra curves of the tGFRP at varying tempering states) properties were evaluated. The research showed improved surface quality and good transmission data for samples manufactured by a new Optical-RTM setup compared to a standard RTM mold. The maximum transmission was reported to be ≈74%. In addition, no detectable voids were found in these samples. Furthermore, a flexural modulus of 23.49 ± 0.64 GPa was achieved for the Optical-RTM samples having a fiber volume fraction of ≈42%.

Comparison of topical benzyl benzoate vs. oral ivermectin in treating scabies: A randomized study.

BACKGROUND: Scabies is an itchy, parasitic infection of the skin. Recent reports indicate there is a decreasing efficacy of the standard treatment of choice, topical 5% permethrin cream. OBJECTIVE: To evaluate the comparative efficacy, safety and tolerability of topical benzyl benzoate (BB) with oral ivermectin in the treatment of scabies. METHODS: Patients with dermoscopy-verified scabies visiting the dermatologic outpatient clinic were assessed for enrolment in the study. In total, 224 patients were enrolled and sequentially randomized into two equally sized groups. Group A received topical 25% or 10% BB for the daily use over a period of three consecutive days, group B received oral ivermectin (200 µg/kg body weight) twice, 1 week apart. Treatment outcome was evaluated by dermoscopy at a 3-week follow-up visit. RESULTS: Treatment resulted in a cure rate of 87% in group A and 86% in group B. After initial therapy failure in group A, six out of eight patients showed treatment response upon repeated application of BB, five of five when retreated with ivermectin and two of two with BB plus ivermectin, respectively. In group B, successful retreatment was observed in three out of three patients with ivermectin, two of two patients with BB and 11 of 11 patients with the combination of BB plus ivermectin, respectively. Tolerability and safety profile of oral ivermectin was excellent, while BB produced short burning sensations in 14%. CONCLUSION: Topical BB and oral ivermectin have shown comparable good therapeutic efficacy. Therefore, both agents constitute an adequate first-line therapy in the treatment of scabies. A combination of both agents may be considered in recalcitrant and extensively infested cases, additionally to crusted scabies.

How Do Experts Treat Patients with Bullous Pemphigoid around the World? An International Survey.

Many treatments are currently proposed for treating patients with bullous pemphigoid (BP). We assessed treatment modalities of BP depending on the different countries, BP extent, and patients' comorbidities. We surveyed worldwide experts about how they treat patients with BP. A total of 61 experts from 27 countries completed the survey. Severe and moderate BP were treated with oral prednisone (61.4 and 53.7%, respectively) or superpotent topical corticosteroids (CSs) (38.6 and 46.3%, respectively). Conventional immunosuppressants were more frequently combined with oral prednisone (74.5%) than with superpotent topical CS (37.5%) in severe BP. Topical CSs were mainly used in Europe in mild (81.1%), moderate (55.3%), and severe (54.3%) BP. In the United States of America and Asia, systemic CSs were mainly proposed for treating severe (77.8 and 100%, respectively), moderate (70 and 77.8%, respectively), and also mild (47.1 and 33.3%, respectively) BP. Most experts reduced the initial dose of oral CS in patients with diabetes mellitus (48.1%) or cardiac insufficiency (40.2%) but rarely changed BP treatment in patients with neurological disorders or neoplasia. This survey showed major differences in the way patients with BP are treated between AmeriPac countries (United State of America, Latin America, and Australia) and Asia on the one hand and Europe and the Middle East on the other hand.

Phospholipids alter activity and stability of mitochondrial membrane-bound ubiquitin ligase MARCH5.

Mitochondrial homeostasis is tightly controlled by ubiquitination. The mitochondrial integral membrane ubiquitin ligase MARCH5 is a crucial regulator of mitochondrial membrane fission, fusion, and disposal through mitophagy. In addition, the lipid composition of mitochondrial membranes can determine mitochondrial dynamics and organelle turnover. However, how lipids influence the ubiquitination processes that control mitochondrial homeostasis remains unknown. Here, we show that lipids common to the mitochondrial membranes interact with MARCH5 and affect its activity and stability depending on the lipid composition in vitro. As the only one of the tested lipids, cardiolipin binding to purified MARCH5 induces a significant decrease in thermal stability, whereas stabilisation increases the strongest in the presence of phosphatidic acid. Furthermore, we observe that the addition of lipids to purified MARCH5 alters the ubiquitination pattern. Specifically, cardiolipin enhances auto-ubiquitination of MARCH5. Our work shows that lipids can directly affect the activity of ubiquitin ligases and suggests that the lipid composition in mitochondrial membranes could control ubiquitination-dependent mechanisms that regulate the dynamics and turnover of mitochondria.

A video-based situational judgement test of medical students' communication competence in patient encounters: Development and first evaluation.

OBJECTIVE: We developed and evaluated the Video-Based Assessment of Medical Communication Competence (VA-MeCo), a construct-driven situational judgement test measuring medical students' communication competence in patient encounters. METHODS: In the construction phase, we conducted two expert studies (npanel1 = 6, npanel2 = 13) to ensure curricular and content validity and sufficient expert agreement on the answer key. In the evaluation phase, we conducted a cognitive pre-test (n = 12) and a pilot study (n = 117) with medical students to evaluate test usability and acceptance, item statistics and test reliability depending on the applied scoring method (raw consensus vs. pairwise comparison scoring). RESULTS: The results of the expert interviews indicated good curricular and content validity. Expert agreement on the answer key was high (ICCs> .86). The pilot study showed favourable usability and acceptance by students. Irrespective of the scoring method, reliability for the complete test (Cronbach's α >.93) and its subscales (α >.83) was high. CONCLUSION: There is promising evidence that medical communication competence can be validly and reliably measured using a construct-driven and video-based situational judgement test. PRACTICE IMPLICATIONS: Video-based SJTs allow efficient online assessment of medical communication competence and are well accepted by students and educators.

On predictors of misconceptions about educational topics: A case of topic specificity.

A large variety of misconceptions about learning, teaching, and other educational topics is prevalent in the public but also among educational professionals. Such misconceptions may lead to ill-advised judgments and actions in private life, professional practice, and policymaking. Developing effective correction strategies for these misconceptions hinges on a better understanding of the factors that make individuals susceptible to or resilient against misconceptions. The present study surveyed students from educational and non-educational fields of study to investigate whether the endorsement of four typical educational misconceptions can be predicted by study-related variables (i.e., field of study and study progress) and by students' cognitive ability (i.e., numeracy), epistemic orientations, general world views (i.e., conservative orientation), and education-related values (i.e., educational goals). A sample of N = 315 undergraduates in teacher education and education- and non-education-related fields of study completed an online survey. Results from structural equation models showed that the pattern of effects strongly varied across the specific misconceptions. The two misconceptions related to teaching factors (i.e., class size and effectiveness of direct instruction as a teaching method) were the most strongly affected by the field of study and had an association with conservative orientation. In contrast, the misconception about the effectiveness of grade retention as an educational intervention was more prevalent among the students emphasizing conventional educational goals, such as discipline. None of the investigated explanatory variables proved predictive of the misconception about the "feminization" of education as an educational-equity topic. Moreover, neither numeracy nor epistemic orientation was found to have any effect on the endorsement of educational misconceptions. These findings emphasize the topic dependency of the factors that make individuals susceptible to misconceptions. Future research and intervention approaches need to consider the topic specificity of educational misconceptions.

Inheritance of pheromone profiles from aged D. melanogaster.

Through aging, D. melanogaster males and females change their social spacing. Flies are initially more social, but reduce sociability as they grow older. This preferred social space is inherited in their progeny. Here, we report that in females, the profiles of cuticular hydrocarbons (CHC), which are known to promote social interaction between individuals, similarly are affected by age. Importantly, for a subset of those CHC, the progeny's CHC levels are comparable to those of their parents, suggesting that parental age influences offspring CHC expression. Those data establish a foundation to identify the relationship between CHC levels and social spacing, and to understand the mechanisms of the inheritance of complex traits.

When preservice teachers' prior beliefs contradict evidence from educational research.

BACKGROUND: Knowledge from educational research frequently contradicts preservice teachers' prior beliefs about educational topics. Such contradictions can seriously affect their attitudes towards educational research and can counteract efforts taken to establish teaching as a research-based profession. AIMS: Inspired by Munro's (2010, J. Appl. Soc. Psychol., 40, 579) work on science discounting, this study examined whether preservice teachers tend to devalue the potency of educational research when evidence contradicts their beliefs. SAMPLE: We used data from 145 preservice teachers from different German universities. METHODS: In an experimental design, participants indicated their prior beliefs about an educational topic (i.e., effectiveness of grade retention) before and after reading either confirming or disconfirming scientific evidence. Dependent variables were, first, whether participants devalued the potency of science to study this focal topic and whether they generalized this devaluation to further related and unrelated topics; second, whether participants preferred non-scientific over scientific sources to inform themselves about the focal topic as an indirect measure of science devaluation. RESULTS: Interaction effects on both outcome variables confirmed that participants devalued educational research and its sources when scientific evidence conflicted with their prior belief. Yet, results did not corroborate any generalization of devaluation to further topics. Despite the devaluation, participants indicated belief revision in the direction of the evidence read. CONCLUSIONS: Preservice teachers may indeed critically question educational research when scientific evidence conflicts with their prior beliefs. However, they may also adapt their assumptions in light of strong evidence. More research is needed to clarify the conditions of devaluation and belief revision.

How can communicative competence instruction in medical studies be improved through digitalization?

The teaching of communicative competence plays an increasingly important role in medical education. In addition to traditional teaching formats, such as role-plays with simulated patients, technology-based approaches become more important in medical education. Teaching materials are increasingly augmented by videos of simulated doctor-patient conversations. This combination allows the content of teaching materials to be demonstrated with video or for videos to create a basis for reflection activities. In addition, conversation videos can illustrate different qualities of clinical communication and serve as illustrative material for describing particular issues in more detail. In addition to teaching clinical communicative competence, the assessment of this competence also plays an important role in medical educational research. So far, this has mainly been conducted through direct observation using checklists or rating scales. Relatively little is known about the assessment of communicative competence using standardized online-based tests. Situational Judgement Tests (SJTs) offer a promising approach in this respect. The BMBF-funded (BMBF = Bundesministerium für Bildung und Forschung - Federal Ministry of Education and Research) joint project voLeA (Entwicklung videobasierter Lehr- und Assessmentmodule zur Gesprächskompetenz im Medizinstudium = Development of video-based teaching and assessment modules for communicative competence in medical studies) addresses these two issues. Specifically, the project is engaged in developing e-learning modules to promote communicative competence and an assessment of this competence using an SJT. The present paper focuses on the benefits of technology-based learning and assessment units for clinical communicative competence in medical studies, using the voLeA project as an example.

Sleep-length differences are associated with altered longevity in the fruit fly Drosophila melanogaster.

Sleep deprivation has been shown to negatively impact health outcomes, leading to decreased immune responses, memory loss, increased activity of stress and inflammatory pathways, weight gain, and even behavioral changes. These observations suggest that sleep deprivation substantially interferes with important physiological functions, including metabolic pathways of energy utilization. Many of those phenotypes are correlated with age, suggesting that disrupted sleep may interfere with the aging process. However, little is known about how sleep disruption affects aging and longevity. Here, we investigate this relationship using eight representative fruit fly lines from the Sleep Inbred Panel (SIP). The SIP consists of 39 inbred lines that display extreme short- and long-sleep patterns, and constitutes a crucial Drosophila community resource for investigating the mechanisms of sleep regulation. Our data show that flies with short-sleep periods have ∼16% longer life span, as well as reduced aging rate, compared to flies with long-sleep. In contrast, disrupting normal circadian rhythm reduces fly longevity. Short-sleep SIP flies moreover show slight metabolic differences to long-sleep lines, and to flies with disrupted circadian rhythm. These data suggest that the inbred SIP lines engage sleep mechanisms that are distinct from the circadian clock system.

Harnessing artificial intelligence (AI) to increase wellbeing for all: The case for a new technology diplomacy.

The field of artificial intelligence (AI) is experiencing a period of intense progress due to the consolidation of several key technological enablers. AI is already deployed widely and has a high impact on work and daily life activities. The continuation of this process will likely contribute to deep economic and social changes. To realise the tremendous benefits of AI while mitigating undesirable effects will require enlightened responses by many stakeholders. Varying national institutional, economic, political, and cultural conditions will influence how AI will affect convenience, efficiency, personalisation, privacy protection, and surveillance of citizens. Many expect that the winners of the AI development race will dominate the coming decades economically and geopolitically, potentially exacerbating tensions between countries. Moreover, nations are under pressure to protect their citizens and their interests-and even their own political stability-in the face of possible malicious or biased uses of AI. On the one hand, these different stressors and emphases in AI development and deployment among nations risk a fragmentation between world regions that threatens technology evolution and collaboration. On the other hand, some level of differentiation will likely enrich the global AI ecosystem in ways that stimulate innovation and introduce competitive checks and balances through the decentralisation of AI development. International cooperation, typically orchestrated by intergovernmental and non-governmental organisations, private sector initiatives, and by academic researchers, has improved common welfare and avoided undesirable outcomes in other technology areas. Because AI will most likely have more fundamental effects on our lives than other recent technologies, stronger forms of cooperation that address broader policy and governance challenges in addition to regulatory and technological issues may be needed. At a time of great challenges among nations, international policy coordination remains a necessary instrument to tackle the ethical, cultural, economic, and political repercussions of AI. We propose to advance the emerging concept of technology diplomacy to facilitate the global alignment of AI policy and governance and create a vibrant AI innovation system. We argue that the prevention of malicious uses of AI and the enhancement of human welfare create strong common interests across jurisdictions that require sustained efforts to develop better, mutually beneficial approaches. We hope that new technology diplomacy will facilitate the dialogues necessary to help all interested parties develop a shared understanding and coordinate efforts to utilise AI for the benefit of humanity, a task whose difficulty should not be underestimated.

Structure-Odor Activity Studies on Derivatives of Aromatic and Oxygenated Monoterpenoids Synthesized by Modifying p-Cymene.

Thymoquinone was recently reported as having a unique pencil-like odor and being the impact compound for the cedar-like and cedar wood-based product smell such as pencils. The compounds thymol and carvacrol are structurally related odorants commonly found in plants and foods such as thyme and oregano, also having a significant contribution to their overall aroma. However, a systematic elucidation of the sensory properties in this class of oxygenated, aromatic monoterpenoids has not been carried out. To close this gap and gain new insights into structure-odor relationships leading to pencil-like and woody odors, 19 structurally related derivatives of p-cymene starting from thymol and carvacrol were synthesized and characterized. The compounds had odor thresholds ranging from 2.0 ng/L air to 388.8 ng/L air, being lowest for thymol and carvacrol and highest for thymohydroquinone. The compounds smelled mostly thyme-like, oregano-like, and pencil-like with phenolic, earthy, and medicinal variations in their odor character, which could be successfully linked to structural motifs.

Penetrating traumatic brain injury resulting from a cockerel attack: case report and literature review.

Traumatic brain injury is common in children and can lead to death or considerable, long-lasting morbidity. We present the case of a 10-month-old female child who presented after being attacked by a cockerel in a chicken coop. Following a seizure, an MRI scan revealed an intracerebral haemorrhage underlying a stab-type wound inflicted by the bird. Animal bite injuries are common worldwide but they rarely cause intracranial injuries. Domestic hens are rarely dangerous but can become defensive or aggressive during breeding periods or when protecting their territory. To date, only a handful of articles have reported on wounds inflicted by chicken beaks. Those reported were largely facial or ocular injuries. Infectious complications have also been encountered post-injury. This is to our knowledge the first report of a bird attack resulting in significant penetrating traumatic brain injury. Children should be cautioned by guardians to avoid unsupervised contact with chickens, particularly during breeding. Attacks to the neurocranium when they occur must be taken seriously and not treated as humorous or insignificant. Imaging appropriate to the child's clinical condition should be pursued and appropriate intervention and antibiotic treatment should be implemented.