Invasive ventilation saves lives but carries major risks, including ventilation-associated lung damage and long-term functional impairment. Data from recent studies compel reassessment of the evidence for every step of the clinical treatment pathway. This updated clinical practice guideline is based on pertinent publications retrieved by a systematic search in Medline, Embase, and the Cochrane Library up to April 2023, supplemented by further high-quality studies published up to June 2024. The recommendations were developed in evidence-to-decision-frameworks (EtDF) according to GRADE, with the participation of intensive-care nurses and early career clinician-scientists. For patients in acute respiratory failure, it is suggested that noninvasive respiratory support techniques should be used so that intubation can be avoided. It is further suggested that spontaneous breathing should be enabled early on during invasive ventilation. For the first time, the use of various techniques for titrating the positive end-expiratory pressure (PEEP) is suggested for patients with moderate to severe acute respiratory distress syndrome (ARDS). In such patients, techniques aiming at a higher PEEP can lower mortality by 9% in absolute terms (95% confidence interval [1; 16]) compared to lower-PEEP strategies. Strong recommendations are given against the routine use of muscle relaxation or corticosteroid therapy in moderate to severe ARDS. For patients with ARDS with a persistent, severe gas exchange disturbance after conservative options have been exhausted, veno-venous extracorporeal membrane oxygenation should be considered. VvECMO for patients with severe ARDS should be carried out at centers that are experienced in treating patients with severe ARDS and that fulfill specific structural requirements. The goals of ventilator therapy should be to enable spontaneous breathing as soon as possible, keep respiratory parameters in the protective range, and adjust PEEP individually. Muscle relaxation or corticosteroids should not be part of the routine treatment of moderately severe ARDS.

Animal models of critical illness span diverse species and experimental approaches, reflecting the biological complexity of severe disease states while being constrained by animal welfare requirements and country-specific regulatory, infrastructural, and workforce factors. Persistent challenges remain, including limited reproducibility, fragmented standards, and the need for ethical alignment across borders. This review examines these shared structural challenges in critical illness animal research across the Asia-Pacific region. While alternative and complementary methodologies are increasingly incorporated into preclinical research, their adoption remains uneven. We argue that alignment with globally recognized preclinical frameworks, including the 3Rs and disease-specific standards, such as MQTiPSS, is essential. This review discusses actionable strategies-centered on harmonized standards, shared resources, and international collaboration-to strengthen research rigor, support early career researchers, and enhance the translational relevance of critical illness animal research.

ABSTRACT Research aims The benefits of parenting interventions for child and family outcomes following pediatric brain injury are well documented. However, training in pediatric neuropsychology largely emphasizes a focus on assessment, as well as syndrome- or disorder-specific interventions. Greater attention to transdiagnostic intervention is warranted, particularly pediatric neurorehabilitation programs that are family-centered and evidence-based. This study evaluated the acceptability of a didactic and skill-based transdiagnostic training model for pediatric neuropsychologists, and its outcomes on their knowledge, behavior, and early fidelity in delivering Interact-North in a pediatric brain injury population. Methods We evaluated a neuropsychologically informed training and supervision model for Interact-North, a virtual transdiagnostic parenting intervention for children with acquired brain injury. Outcomes of training were evaluated, informed by the Kirkpatrick framework, across the last two cohorts of trainees (2023 n = 7; 2025 n = 11), who consisted of PhD level early career and trainee neuropsychologists. Training included a two-day workshop with didactic learning and role-play components. Following training, Interact-North trainees participated in biweekly group and individual supervision, as well as case-shadowing. Training outcomes included trainees’ impressions of training, knowledge, behavior (i.e. skills) for both the 2023 and 2025 cohorts, and results (i.e. treatment fidelity, assessed in clinician checklists after each treatment session) for the 2023 cohort only. Results Overall, participants endorsed highly favorable impressions of training (i.e. 4.91/5.00) and high relevancy to their career/clinical work. Role play was rated highest in utility (i.e. 4.93/5.00). Self-reported competency improved significantly following the training. The focus and value of individual and group supervision were also highly rated. Trainees demonstrated 95% program fidelity in their first case. Implications for the field Findings suggest that this transdiagnostic neuropsychological intervention training model is successful in improving skill and clinician confidence with uniform acceptability in its importance to extend neuropsychological competencies in evidence-based family focused pediatric neurorehabilitation.

A prospective cohort study of intraoperative parathyroid gland management by early and advanced career surgeons based on viability assessment by visual perception and indocyanine green (ICG) fluorescence imaging.

Development and implementation of an innovative mentoring committee for early-career faculty members.

Resilient futures: Acknowledging the shared challenges of early career food system researchers in uncertain times

Addressing immune challenges and stress in young adults is crucial due to the impact of academic and early career pressures. Self-massage, a cost-effective technique, may provide health benefits. This study aimed to investigate the effects of self-massage on immune function, stress, and quality of life in young adults. Secondary objectives included evaluating the feasibility, adherence, and safety of the intervention. A total of 38 healthy young adults (58% women, aged 18-26 years) were randomly assigned to a self-massage group (n = 18) or a control group (n = 20) for an 8-week intervention. Outcome measures included immune status, perceived immune function, perceived health, stress levels, and quality of life, which were analyzed using mixed-effects repeated measures analysis of covariance (ANCOVA) with the pretest as a covariate. The self-massage group adhered to the protocol without adverse events. The self-massage group demonstrated significant improvements in immune status compared to the control group (p = 0.044) and a significant within-group change (p = 0.028). While significant time effects were observed for all outcomes, within-group improvements were noted only for perceived immune status (p = 0.032) and perceived general health (p = 0.022) in the self-massage group. Self-massage enhances immune function and perceived general health in young adults, offering an effective approach. Future research should incorporate objective measures of the immune system, examine its long-term effects, and investigate its integration with other relaxation techniques to validate and expand these findings.

Purpose: This study aimed to develop and validate a multidimensional role transition scale for new graduate nurses (RTS-NGN) that captures both the theoretical perspectives and contextual characteristics of Korean clinical settings.Methods: An initial item pool was generated through an extensive literature review and then refined through expert content validation and pilot testing. Psychometric evaluation was performed using two separate samples. Exploratory factor analysis identified the underlying structure, while confirmatory factor analysis verified construct validity. Convergent validity was examined using the average variance extracted (AVE) and composite reliability (CR), and discriminant validity was confirmed by comparing the square root of AVE with inter-factor correlations. Concurrent validity was assessed using a Transition Shock scale. The reliability was assessed using Cronbach’s alpha and CR.Results: A six-factor structure comprising the following 35 items was finalized: clinical competence, communication competence, professionalism, self-efficacy, stress management, and organizational adaptation. The model demonstrated a good fit (comparative fit index >.90, Tucker–Lewis index >.90, root mean square error of approximation <.08). The AVE and CR supported convergent validity, and discriminant validity was confirmed for all factors. A moderate negative correlation with the Transition Shock scale provided evidence of concurrent validity. The internal consistency reliability was excellent across all subscales.Conclusion: The RTS-NGN is a psychometrically sound instrument that captures the positive and multifaceted aspects of role transition among new graduate nurses. It can be used to assess transition readiness, evaluate educational and residency programs, and guide organizational strategies to support early career nurses.

Adopting Keyhole Strategies in Microvascular Decompression Surgery for Vascular Compression Syndromes in Early Career Academic Practice: Outcomes, Technical Nuances and Complication Avoidance

Paid full-time summer undergraduate research programs (SURPs) increase persistence in science, technology, engineering and math (STEM) degrees and later careers. Research disruptions during the summer of 2020 due to the COVID-19 pandemic required a transition to Emergency Remote Teaching (ERT) and created the opportunity to explore whether online-only SURPs were feasible. Data science projects emerged as a particularly feasible option for both mentors and students. A total of 65 students working with 49 mentors employed at five different research sites matriculated into a 10-week full-time paid SURP in 2020, with most projects focused on data science. Program implementation and impact were explored using online student surveys before (n = 62) and after (n = 56) participation, interviews with students conducted after the program ended (n = 10), online surveys of mentors conducted after the program ended (n = 35), and data on persistence in relevant fields. Scholars reported satisfaction with the program and described how the program developed their scientific skills and interest in data science. Mentors surveyed reported that they would be willing to invite another undergraduate student to perform research under their direction using a distance model. About half of the mentors reported that mentoring students online took about the same amount of time as mentoring in-person. Students who completed the program in-person in 2019 and those who participated in the remote program in 2020 had similar early career trajectories, with approximately 60% of both cohorts remaining in related fields five to six years later. Our experience suggests that an online SURP can be feasibly implemented across multiple sites, with positive impacts on student interest in data science.

ABSTRACT Internationally, support provided to teachers during their early career phase has long been referred to as ‘induction.’ However, little is known about the induction provided to early career teachers who are insecurely employed as substitute teachers. This article reports on a critical policy study that examined the Australian policy guidelines for teacher induction. Drawing on human resource development concepts for supporting new employees, this examination considers how induction policies understand early career substitute teachers and support them to perform their jobs and develop their careers. The findings show that the induction guidelines are more concerned with teachers who have job security, rather than providing an overall system of practices that develop all new teachers regardless of their employment mode. This limitation means that the guidelines are unlikely to support early career substitute teachers in insecure employment to maximise their development. A conceptual framework is offered for early career teacher induction that provides guidance for supporting the onboarding and development of new teachers.

ABSTRACT Educational leadership has increasingly been approached as a complex and situated phenomenon, where gender and narrative perspectives provide critical insights into identity construction. This article examines the gendered construction of leadership identity through the biographical narrative of Carla, principal of a Technical and Vocational Education and Training (TVET) institution in northern Chile. Drawing on a qualitative case study with a narrative approach, we conducted four semi-structured interviews to explore how her life trajectory – shaped by gender, context, and personal history – influenced her development as an educational leader. Using a reflexive thematic analysis, we reconstructed her story across five stages: childhood and adolescence, higher education, early career in education, transitions from teaching to management, and principalship. Findings show how Carla integrated traits traditionally coded as ‘masculine’ with care and empathy, challenging gender norms while building a hybrid leadership identity. Although resilience enabled her to thrive in masculinized contexts, she perceived gender as an external or ‘neutral’ factor. We conclude by underscoring the importance of embedding gender reflection in leadership preparation programs and fostering practices of care and mentorship, where solidarity among women can function as a strategy of resistance and social transformation.

The COVID-19 pandemic generated a distinctive body of narrative writing that sought to make sense of front-line medical experience under conditions of uncertainty and crisis. This article examines Emma Goldberg's Life on the Line: Young Doctors Come of Age in the Pandemic (2021) as a mediated, multivoiced account of early career physicians navigating professional, ethical and embodied transformation during COVID-19. Drawing on Narrative Medicine and Medical Humanities scholarship, the analysis introduces the concept of the 'third object' to examine how experience, memory and moral meaning are collaboratively reconstructed through interview-based story-telling rather than autobiographical memoir. In contrast to British COVID physician memoirs, such as Rachel Clarke's Breathtaking, which foreground first-person, retrospective self-narration within the institutional context of the National Health Service (NHS), Life on the Line operates through editorial mediation, creating a relational narrative space in which embodied knowledge and ethical reflection are collectively produced. Through close reading of Goldberg's six physician profiles, the article explores embodiment, memory, moral witnessing and professional formation under pandemic conditions. It argues that mediated story-telling functions as an ethical and epistemic intermediary during periods of epistemic collapse, extending Narrative Medicine beyond memoir-based models and contributing to ongoing debates in Medical Humanities about narrative form, care and meaning in crisis. This article finds that during COVID-19, narrative mediation did not merely record medical experience but became the primary mechanism through which clinicians reconstructed epistemic stability, ethical orientation and professional identity when clinical knowledge itself was unstable.

Purpose This study aims to explore how an early career teacher (ECT) improved her lesson through a pre-lesson and a research lesson and how this process supported shifts in her noticing. Design/methodology/approach In a school-based lesson study (LS), a case study approach was employed through participant observation and interviews. The focus was on Aya, a second-year teacher at an elementary school in Japan, who conducted her first research lesson, and how her noticing shifted through lesson improvement. Findings This study revealed shifts and challenges in her noticing as she conducted a pre-lesson in another classroom at the same grade level and implemented the research lesson. Practical implications Implications for future professional development programs with ECTs were suggested. This research contributes valuable insights to enhancing teacher practice and student learning outcomes by illuminating the nuanced dynamics of noticing as an ECT. Originality/value This study contributes concrete findings on how school-based LS in Japan leads to improvement of lessons through the case study of an ECT and provides insight into what needs to be discussed to support ECTs' noticing.

Interstitial cystitis: a phenotype and rare variant exome sequencing study.

Despite growing recognition of the need for cross-disciplinary research collaborations to tackle complex issues, the impact of such collaborations is rarely documented. This study applied an impact framework to assess the impact of a cross-disciplinary disability research collaboration, the Centre of Research Excellence in Disability and Health (CRE-DH) (2016-2023). We report on the utility of the impact framework for this task and propose a set of actions to ensure the effectiveness of impact evaluations for other cross-disciplinary collaborations. We retrospectively applied the Framework to Assess the Impact from Translational health research (FAIT) to the CRE-DH, which included a modified payback framework, an economic analysis and a narrative account of the impact generated by the collaboration. The impact assessment covered the period 2016-2024. Data were gathered from project records, reports and publications and secondary analysis of interviews conducted with external and internal stakeholders. Data were mapped to five impact domains: knowledge advancement, capacity strengthening, policy contribution, economic impact and community benefit. The $5.4million (2024 AUD) initially invested in the CRE-DH delivered an additional investment of $39.9million (2024 AUD) (sensitivity analysis $26.5-53.2million) in leveraged grants, consultancies and fellowships. Collectively, CRE-DH members produced 148 publications, 4 books, 15 book chapters, 48 reports, 17 fact sheets and 132 media articles. Publications were mentioned in the media more than 3400 times and cited in 45 policy documents. The CRE-DH funded and developed 9 early career disability researchers, and held 11 external events to strengthen capacity in disability research with policymakers and disability organizations. A total of 29 policy submissions were made, with those focussing on coronavirus disease 2019 (COVID-19) and its disproportionate impact on people with disability having particular influence on government policy. Applying FAIT retrospectively to assess a cross-disciplinary research collaboration's impact allowed us to examine multiple benefit domains. The CRE-DH demonstrated impact in advancing knowledge, strengthening capacity, influencing policy and generating economic benefits; evidence on quantifiable community benefit is not yet available. However, our assessment was limited by insufficient data collection on some critical issues, such as disability representation. As a result, we propose several recommendations for applying FAIT in future research collaborations.

Evidence shows that non-medical prescribing is as effective as medical prescribing in a range of acute and chronic conditions and is well accepted by a diverse range of key stakeholders. Pharmacists in the UK are set to acquire prescribing skills at an earlier stage in their training, with prescribing integrated into the first five years of training and the ability to prescribe from the point of registration from August 2026. Therefore, reliable and reproducible methods of assessing their ability to prescribe safely need to be in place. The UK Prescribing Safety Assessment (PSA) could be a standard method to assess prescribing skills across professions. To examine the performance of post-registration Foundation pharmacists in the PSA and to explore their views on its suitability as a development tool before enrolling on an independent prescribing (IP) course. Pharmacists in Scotland 12months into the post-registration Foundation programme were invited to sit a 30-question, blueprint-aligned online PSA in September 2024. Mean scores and facility scores were determined. (Facility is a measurement of how easy a question is: higher facility index = question is considered easier; lower facility index = question is considered more difficult). An online evaluation questionnaire gathered feedback on content and appropriateness, analysed using thematic analysis. Seventy-one of 128 (55.5%) eligible pharmacists sat the PSA; mean total score was 72.5% (SD 10.2). Domain-level mean scores (facility) were: Prescription Review 13.51/16 (0.84); Providing Information 4.96/6 (0.83); Dose Calculations 6.85/8 (0.86); Adverse Drug Reactions 6.51/8 (0.81); Drug Monitoring 5.61/8 (0.70); Planning Management 5.01/8 (0.63); Data Interpretation 3.41/6 (0.57); Prescription Writing 26.62/40 (0.67). The questionnaire was completed by 16/71 (22.5%) PSA sitters: most agreed the assessment was appropriate for their stage and helpful preparation for an IP course; some community pharmacists considered hospital-based content less relevant. Formative participation in the UK PSA by post-registration Foundation pharmacists provided domain-level performance data and was regarded by respondents as useful preparation for an IP course. Findings suggest potential value in situating the PSA during the Foundation Training Year, with consideration of sector relevance and targeted support for domains such as prescription writing and data interpretation.

ABSTRACT Exploring emerging language teacher identity (LTI) in language pedagogy in Hungary is a new field of research. Early career teaching is a hectic phase in one’s own professional development, as it is decisive how LTI develops and what factors affect its transition. This paper draws on a complex conceptual framework of LTI, which claims that language teacher self-perception is shaped by a combination of personal experiences, professional context and sociocultural environment. Hungarian pre-service trainees (N = 10) majoring in English or German and their mentor teachers (N = 8) participated in our study after completing the short 15-hour teaching practicum. Semi-structured interviews were recorded with the participants, whose responses were analysed, compared and categorised based on four focal points: (1) trainees’ language awareness, (2) classroom assessment, (3) perceived generational differences in teaching, and (4) emerging language teacher identity. Findings reveal generational gaps between trainees and mentor teachers, particularly in digital literacy, and surprisingly between trainees and their own pupils as well. The development of pre-service trainees’ identity as language teachers demonstrates that identification with the teaching role is often shaped by contextual factors related to the practicum that can simultaneously have both supportive and adverse effects.

Summary This article is the first in-depth examination of the Swedish artist Gudrun Åhlberg’s early career in the 1940s and 50s. Drawing on archival materials and the critical reception of the artist, the article details her approach to surrealism and her participation in the surrealist-oriented Imaginist Group alongside Max Walter Svanberg and other artists. Åhlberg’s art during these years was characterized by a figurative surrealism with frequent depictions of nature, often coupled with references to mediumism. The article situates these works in the context of surrealist art, poetics, and theory. More specifically, it places her paintings and gouaches in relation to her visit to the exhibition Le Surréalisme en 1947 in Paris and her concurrent discovery of the art of Victor Brauner. As a member of the Imaginist Group and a participant in the 1949 exhibition Surrealist Manifestation in Stockholm, Åhlberg was an important force in the renewal of surrealism that was taking place in Sweden at the time. But when she and her artist husband Gösta Kriland, a fellow imaginist, divorced in 1950, she was excluded from the continued activities of the group. The article discusses this exclusion in terms of a patriarchal dynamic.

A SETAC Pellston Workshop® on "Improving the Usability of Ecotoxicology in Regulatory Decision-Making" was held in August 2015. One outcome of the workshop was a publication, which highlighted the challenges ecotoxicologists of the future face in applying academic research to regulatory decision making. The authors proposed that training students on issues of relevance and reliability will lead to improvements in the applicability of academic research for regulatory decision making, whilst also setting out the importance of cross-sector partnerships in preparing academics for a career in regulatory ecotoxicology. As nearly a decade has passed since the initial workshop, we believe it is important to reevaluate previously identified challenges faced in applying academic research to regulatory decision-making, highlight challenges not previously identified, and assess the uptake of proposed training and skills. A survey was developed and deployed online to gain understanding of the challenges early career researchers (ECRs) face in applying academic research to regulatory decision making, and the training and skills received throughout their career. 52 ECRs responded to the survey. Just over a quarter of respondents (27%) considered themself to be part of a training network, however approximately half of all respondents state that they have received training to understand the regulatory context of their research (52%); ecotoxicology methodologies or guidelines (44%); and principles of quality assurance and good laboratory practice (54%). We explore why ECRs may or may not receive training, and assess the extent to which they agree that it has improved the applicability of their research for regulatory decision making. We conclude that whilst some areas of training have developed, some remain a challenge (i.e., interdisciplinarity, cross-sector partnership) and set out a series of recommendations for ECRs to overcome new and existing challenges in applying their research to regulatory decision making.