Single Course Research Articles

Long-term efficacy of washed microbiota transplantation in overweight patients.

Faecal microbiota transplantation holds promise in mitigating fat accumulation and improving obesity. This study aimed to evaluate the long-term efficacy of washed microbiota transplantation (WMT) among overweight patients. The clinical data pertaining to the treatment of patients with WMT were collected retrospectively. Compared alterations in body mass index (BMI), blood glucose, blood lipids and blood pressure prior to and following WMT treatment. Comprehensive efficacy evaluation and atherosclerosis cardiovascular disease (ASCVD) grading evaluation were carried out, with an analysis of gut microbiota composition before and after WMT. A total of 186 patients were included (80 overweight, 106 normal weight). WMT not only had the effect of improving overweight patients to the normal weight patients (p < .001), but also could significantly reduce BMI in the long term by restoring gut microbiota homeostasis (p < .001). In addition, the BMI improvement value of multi course was more significant than that of single course or double course. WMT had a significant ASCVD downgrade effect on the high-risk and medium-risk groups outside 1 year, while it did not increase the risk of upgrading ASCVD for low-risk group. WMT could significantly reduce the BMI of overweight patients and still had an improvement effect in the long term.

A Multimodal Antibacterial Platform for Visualizing Reactive Oxygen Species Generation and Promoting Wound Healing

AbstractPhoto‐activated therapeutic strategies have great potential for preventing bacterial infections, especially infections associated with drug‐resistant bacteria, owing to their minimal tendency to induce drug resistance. A single course of light‐based therapeutics may lack the desired efficacy. The use of a high‐power excitation source or high doses of photo‐activated agents may cause excessive damage to normal tissues. Herein, a multimodal antibacterial platform that combines photodynamic and photothermal therapies has been developed. The fluoro‐substituted coumarin compound (TCF) and Prussian blue nanocubes (PB NCs) are integrated into the bacterial cellulose (BC) to form a versatile wound dressing (BC‐TCF‐PB). Fluoro‐substitution in TCF is found to enhance its production of 1O2 by boosting the intersystem crossing. Furthermore, the generated 1O2 can react with the thiocarbonyl group in TCF to form a highly emissive product. In situ self‐reporting fluorescence of TCF allows for the visualization of 1O2 generation, and assessment of the bacterial eradication. In addition, the BC‐TCF‐PB platform exhibits synergistic antibacterial effects on the methicillin‐resistant Staphylococcus aureus (MRSA), and provides an effective solution for infection control and wound healing. Thus, the BC‐TCF‐PB dressing, with self‐reporting of the reactive biocide generation in situ, has offered valuable insights into effective wound management.

Stereotactic radiosurgery (SRS) for non-small cell lung cancer (NSCLC) in the oncogene-addicted era: A real-world UK tertiary center experience.

e14011 Background: 30-50% of NSCLC patients develop brain metastases (BM). Re-evaluation of the role of SRS is required with evolving understanding of molecular subtypes of NSCLC and increasing intracranial efficacy of systemic agents. Methods: We conducted a retrospective analysis of NSCLC patients receiving SRS at our centre from 05/16-11/23. Primary objective was median overall survival (mOS months). Analysis was performed on Prism 10.1.1. Multivariate analysis was conducted using Cox Proportional Hazards Regression, with age, gender, KPS, BM size, total BM volume and oncogene status as predictor variables. Extraction from medical records was undertaken by authors, with local R&amp;D committee approval. Results: 237 patients were evaluable. 59% (N=139) were oncogene-addicted (oNSCLC) and 41% (N=98) non-oncogene-addicted (non-oNSCLC). Median duration of follow up was 43.3m. m OS was 11.9m overall. For oNSCLC mOS was 13.1m vs 8.8m for non-oNSCLC (HR 1.49, P=0.02). mOS was 20.7m for EGFR sensitizing NSCLC (N=48) vs 10.5m without (HR 1.40 P=0.12). mOS for ALK+ (N=22) was 29.3m vs 11.6m for non-ALK+ (HR 1.90, P=0.05). mOS for KRAS+ (N=32) was 11.6m vs 12.0m without (HR 0.91, P=0.68). Significantly inferior mOS was seen for single (N=186 [78%]) vs multiple (N=51[22%]) SRS courses (8.4m vs 38.8m, [HR 0.34 P=&lt;0.0001]). SRS at diagnosis of BM (N=118) had a mOS of 12.3m vs at nadir (N=9, not reached [HR0.44, P=0.18]), progression on 1st line TKI (N=31, 22.1m [HR 1.1, P=0.79]) and at any other time (N=157, 7.8m [HR 1.33, P=0.11 ]). There was no significant difference in survival for patients diagnosed with brain metastases at the diagnosis of metastatic disease compared to those who developed brain metastases during their disease course (12.3m vs 10.6m [HR 1.18, P=0.33]). Survival of those with 1 site of metastatic disease (18.3m) was numerically improved compared to those with 2 (10.7m, HR 1.26, P=0.25) sites, and statistically significant compared to those with 3 (10.1m, HR 1.69, P&lt;0.02) and ≥4 (4.4m, HR 4.41, P&lt;0.0001) sites. Conclusions: Median OS in oNSCLC was superior to non-oNSCLC, driven by numerically superior survival in EGFR+ and ALK+ cohorts. Significantly improved OS was observed in patients with multiple vs single SRS treatments, however this may be confounded by biases. Patients treated with SRS at nadir had numerically superior OS to those treated at other timepoints, however this must be interpreted with caution due to small sample size. Further prospective research is needed to interrogate these findings and guide local therapies in NSCLC with BM. [Table: see text]

The ethical student scale: development of a new measure

Purpose The purpose of this study is to develop the “ethical student scale” to understand the underlying factors that lead to the decisions of cheating and plagiarism and where business students are developmentally from a moral perspective and to help academic institutions assess how best to develop ethical education throughout the curriculum. This three-dimensional nine-item scale based on Kohlberg’s moral development model is proposed to serve as a valuable tool for educators who are struggling with identifying the best approach to help their students make ethical choices both within and outside of the walls of their educational institutions and once they join the workforce. Design/methodology/approach Four survey design studies were conducted to determine what factors had previously been identified to both negatively and positively impact the propensity of a university student to engage in cheating and/or plagiarizing (Study 1, N = 179), to preliminarily validate the three dimension nine item scale that emerged from Study 1 (Study 2, N = 87); to test the construct validity of the three-dimensional nine-item scale (Study 3, N = 235); and to test the nine-item scale for convergent, divergent and predictive validity (Study 4, N = 201). The four surveys were administered to undergraduate students at two universities in the Northeast in the USA. Findings To shed light on the underlying factors that lead to the decisions of cheating and plagiarism, the authors propose three factors that are engaged when students make these types of ethical decisions: rules and enforcement as an external control, personal morality as an internal control and social influences as a social control (Kohlberg, 1976). Through four studies, this paper presents a three-dimensional nine-item scale based on Kohlberg’s moral development model to determine the factors that influence the propensity of a university student to engage in cheating and/or plagiarizing. The proposed scale showed strong reliability across the three dimensions. Research limitations/implications The limitations of the scale are that this research was restricted to an academic setting. The relationship between the academic environment, the resulting behaviors of students and the subsequent behavior of these students as managers also needs investigation to determine if business ethics education does have an impact on increasing ethical decision-making. Practical implications The ethical student scale attempts to measure the development stage of students in a university setting and has the potential utility to help higher education institutions better understand the moral development of their students and what drives their decisions to engage in an ethical manner. Being a short yet reliable tool, ethical student scale may help business schools develop programs beyond a single business ethics course to instill ethical decision-making in students. Social implications One of the goals as business educators is to produce ethical managers. The ethical student scale can help us develop a more integrated approach to business ethics education. As the students become managers and leaders in organizations, the social implications for more ethical decision-makers and organizations are widespread and vital to the community and the economy. Originality/value Ethical student scale is an attempt to quantify what types of controls (external, social, or personal) help develop ethical students and ethical managers. Based on Kohlberg’s moral development model, this three-dimensional nine-item scale which shows strong reliability will serve as a valuable tool for educators who are struggling with identifying the best approach to the issue of unethical decisions and behaviors as they try to create strategies to help their students make ethical choices both within and outside of the walls of their educational institutions and once they join the workforce.

The “toxic window” of amoxicillin exposure during pregnancy on long bone development in fetal mice

AimsAmoxicillin is a broad-spectrum beta-lactam antibiotic used to treat infectious diseases in pregnant women. Studies have shown that prenatal amoxicillin exposure (PAmE) has developmental toxicity on fetal development. However, the effect of PAmE on long bone development has not been reported. This study aimed to investigate the “toxic window” of PAmE on long bone development and explore its possible mechanism in fetal mice. Materials and methodsPregnant mice were administered amoxicillin by gavage at different stages (gestational day (GD)10–12 and GD16–18), different doses (150 and 300 mg/kg·d) and different courses (single and multiple courses). Fetal femurs were collected at GD18 and bone development related indicators were detected. Key findingsThe results showed that PAmE significantly reduced the length of the femur and primary ossification center of fetal mice, and inhibited the development of fetal growth plate. Meanwhile, PAmE inhibited the development of bone marrow mesenchymal stem cells, osteoclasts and endothelial cells in fetal long bone. Further, we found the fetal long bone developmental toxicity induced by PAmE was most significant at late-pregnancy (GD16–18), high dose (300 mg/kg·d) and multiple-course group. Besides, PAmE inhibited the expression of Wnt/β-catenin signaling pathway in fetal long bone. The β-catenin mRNA expression was significantly positively correlated with the development indexes of fetal long bone. SignificancePAmE has toxic effects on long bone development, and there was an obvious “toxic window” of PAmE on the long bone development in fetal mice. The Wnt/β-catenin signaling pathway may mediate PAmE-induced fetal long bone development inhibition.

Short and long(er)-term returns of self-efficacy’s latent growth: class attendance and longitudinal impact on knowledge, proximal and distal interest

The broad relationship between students’ self-efficacy and interest has been highlighted for decades. This, along with the inherently developmental nature of learning, calls for a more thorough examination of the way fluctuations in students’ self-efficacy influence their interest in learning within a single course over an academic year and beyond. The present study investigated how the latent growth of students’ self-efficacy beliefs over time influenced their interest in a particular subject area, both short-term (3 weeks) and long-term (47 weeks). Data were collected at eight intervals: four times for self-efficacy within one academic year and three times for domain interest during the following academic year, primarily through weekly e-learning activities at a Japanese university. Attendance over three academic semesters, standardised achievement over one academic year (with prior knowledge control), and domain interest were modelled as outcomes in a latent structural equation model that encompassed a latent curve for self-efficacy beliefs throughout the course of study. The distinct contributions of both the baseline and the growth rate of self-efficacy beliefs to the variance in students’ domain interest over the short and longer term were confirmed by the study. Over the course of two academic years, it was found that the growth rate of self-efficacy, relative to its baseline, became increasingly more important for key learning outcomes such as students’ domain interest.

The use of two or more courses of low-dose systemic dexamethasone to extubate ventilator-dependent preterm neonates may be associated with a higher prevalence of cerebral palsy at two years of corrected age

BackgroundOur objective was to determine whether the use of two or more courses of low-dose systemic dexamethasone for extubation of ventilator-dependent preterm infants after the first week of life, as proposed in the DART study, is associated with greater neurodevelopmental harm at two years of corrected age, compared to a single course. MethodsRetrospective review at seven level III neonatal intensive care units. Preterm infants who underwent only one course of systemic dexamethasone for extubation were grouped into DART-1; those who underwent two or more courses were grouped into DART-2. Data and outcomes of infants in DART-2 were compared with those in DART-1. Results150 preterm infants were studied: 104 in DART-1 and 46 in DART-2. Patients in DART-2 had a lower gestational age (25 vs. 26 weeks, p = 0.031) and greater morbidity. The average dexamethasone cumulative dose for patients in DART-1 was 0.819 mg/kg, vs. 1.697 mg/kg for patients in DART-2. A total of 14 patients died. The neuromotor and neurosensory assessments at two years of corrected age revealed in the DART-2 survivors, after the multivariate analysis, a higher prevalence of cerebral palsy with functional motor class 2 (OR = 6.837; 95%CI: 1.054–44.337; p = 0.044) and ophthalmological problems requiring the use of glasses (OR = 4.157; 95%CI: 1.026–16.837; p = 0.046). ConclusionsIn this cohort, the use of more than one course of systemic dexamethasone in low doses for extubation of ventilator-dependent premature infants after the first week of life was associated, at two years of corrected age, with a higher prevalence of cerebral palsy with functional motor class 2 and ophthalmological problems requiring the use of glasses.

The effectiveness of an online short-format Recovery College model: a co-learning model to support mental health

BackgroundOur societies are facing mental health challenges, which have been compounded by the Covid-19. This event led people to isolate themselves and to stop seeking the help they needed. In response to this situation, the Health and Recovery Learning Center, applying the Recovery College (RC) model, modified its training program to a shorter online format. This study examines the effectiveness of a single RC training course delivered in a shortened online format to a diverse population at risk of mental health deterioration in the context of Covid-19.MethodsThis quasi-experimental study used a one-group pretest-posttest design with repeated measures. Three hundred and fifteen (n = 315) learners agreed to take part in the study and completed questionnaires on wellbeing, anxiety, resilience, self-management, empowerment and stigmatizing attitudes and behaviors.ResultsAnalyses of variance using a linear mixed models revealed that attending a RC training course had, over time, a statistically significant effect on wellbeing (p = 0.004), anxiety (p < 0.001), self-esteem/self-efficacy (p = 0.005), disclosure/help-seeking (p < 0.001) and a slight effect on resilience (p = 0.019) and optimism/control over the future (p = 0.01).ConclusionsThis study is the first to measure participation in a single online short-format RC training course, with a diversity of learners and a large sample. These results support the hypothesis that an online short-format training course can reduce psychological distress and increase self-efficacy and help-seeking.Trial registrationThis study was previously approved by two certified ethics committees: Comité d’éthique de la recherche du CIUSSS EMTL, which acted as the committee responsible for the multicenter study, reference number MP-12-2021-2421, and Comité d’éthique avec les êtres humains de l’UQTR, reference number CER-20-270-07.01.

Reshaping immune cells and the antigen-specific repertoire by anti-CD3 mAb teplizumab in Type 1 diabetes

Abstract Teplizumab, a FcR non-binding anti-CD3 mAb, is approved to delay progression of type 1 diabetes (T1D) at-risk patients. Previous investigations described the immediate effects of the 14-day treatment, but longer-term effects of the drug remain unknown. We analyzed the phenotypes, transcriptome, and repertoire of peripheral blood and autoreactive CD8+ T cells from individuals at-risk for T1D, before and after teplizumab. There were changes in CD4+ and CD8+ T cells at 3 months and 18 months after treatment in genes related to immune regulation. The differential gene expression in the T cells increased after drug was cleared. Persistent EOMES expression was a predictor for the time to clinical T1D diagnosis. Our trajectory analysis showed differentiation into cells with gene signatures related to immunoregulation and exhaustion after teplizumab treatment. This analysis aligned with inhibition of expansion of autoreactive CD8+, which was observed with the placebo, but not following teplizumab. These findings illustrate that a single course of teplizumab can instigate substantial T cell changes at 3 months, with evolution of CD8+ T cell exhaustion up to 18 months. Teplizumab restrains the expansion of autoantigen reactive CD8+ cells, suggesting mechanisms underlying operational tolerance.

Abstract 2003: Epigenetic And Phenotypic Modulation Of Adventitial Fibroblasts In Atherosclerosis By Coronary Artery Risk Gene Tcf21

The vascular adventitia has long been postulated to play a key role in atherosclerosis, but the relevant adventitial cell populations and the mechanisms by which they influence atherosclerosis have remained elusive. To characterize relevant adventitial cells and their regulators, we have combined single cell multi-omic murine and human data with human genetics. Single cell transcriptomic and epigenetic analysis of both murine and human arterial tissue revealed a unique population of adventitial fibroblasts (AdvFib). Transcriptome and epigenome analysis revealed disproportionate enrichment for coronary artery disease (CAD) GWAS risk loci and genes in AdvFib, suggesting that AdvFib actively contributes to disease. Leveraging this rich information, we created a novel AdvFib specific CreERT2 murine model to enable AdvFib specific genetic manipulation. Murine lineage tracing using this novel AdvFib-specific model of atherosclerosis revealed early expansion and transcriptomic alteration of AdvFib during plaque development, akin to phenotypic modulation of SMC. Cell-cell communication analysis demonstrated an increase in AdvFib-driven crosstalk with other cell types during early phases of atherosclerosis, including activation of pro-inflammatory (Il6, Ccl2/7, Cxcl12) genes. Computational enrichment analysis of regulatory region of genes associated with AdvFib modulation points to a prominent role for TCF21 , a CAD GWAS risk gene. Single cell time course data of atherosclerosis demonstrates that Tcf21 is expressed primarily in AdvFib with dynamic alteration of its expression during atherosclerosis. AdvFib-specific Tcf21 loss in murine model of atherosclerosis resulted in altered expression of ECM and inflammatory genes, with corresponding changes in recruitment of inflammatory cells. Mechanistically, through histone modification cut-and-tag in human coronary AdvFib, we showed that TCF21 regulates AdvFib activation through epigenetic reprograming of key cytokine and cell fate regulators by binding and altering H3K27Acetylation. Collectively, our results begin to establish the role of AdvFib in atherosclerosis and highlight the importance of TCF21 in this process through a precise epigenetic mechanism.

Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel.

Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology that is used to treat respiratory and heart failure. The U.S. military has used ECMO in the care of combat casualties during Operation Enduring Freedom and Operation Iraqi Freedom as well as in the treatment of patients during the recent Coronavirus Disease 2019 pandemic. However, few Military Health System personnel have training and experience in the use of ECMO therapy. To address this dearth of expertise, we developed and evaluated an accelerated ECMO course for military medical personnel. To compare the efficacy of an accelerated ECMO course for Military Health System critical care teams. Seventeen teams, each consisting of a physician and nurse, underwent a 5-h accelerated ECMO course. Similar to our previous live-tissue ECMO training program (phases I and II), each team watched prerecorded ECMO training lectures. Subjects then practiced priming the ECMO circuit, cannulating ECMO, initiating ECMO, and correcting common complications on an ECMO simulation model. An added component to this phase III project included transportation and telemedicine consultation availability. Training success was evaluated via knowledge and confidence assessments, and observation of each team attempting to initiate ECMO on a Yorkshire swine patient model, transport the patient model, and troubleshoot complications with the support of telemedicine consultation when desired. Seventeen teams successfully completed the course. All seventeen teams (100%) successfully placed the swine on veno-arterial ECMO. Of those, 15 teams successfully transitioned to veno-arterial-venous ECMO. The knowledge assessments of physicians and nurses increased by 12.2% from pretest (mean of 62.1%, SD 10.4%) to posttest (mean of 74.4%, SD 8.2%), P < .0001; their confidence assessments increased by 41.1% from pretest (mean of 20.1%, SD 11.8%) to posttest (mean of 61.2%, SD 18.6%). An abbreviated 1-day lecture and hands-on task-trainer-based ECMO course resulted in a high rate of successful skill demonstration and improvement of physicians' and nurses' knowledge assessments and confidence levels, similar to our previous live-tissue training program. When compared to our previous studies, the addition of telemedicine and patient transportation to this study did not affect the duration or performance of procedures.

Complete Versus Incomplete Antenatal Corticosteroid Therapy and Number of Doses of Surfactant Used Posnatally: A Single-Center Study

Introduction: Antenatal corticosteroid therapy reduces the risk of developing RDS in premature infants. A single complete course of two doses of betamethasone is recommended between 24 weeks and 34 weeks. There are few data on the neonatal effects of an incomplete course of antenatal corticosteroid therapy. The main objective of our study is to evaluate the effectiveness of a complete versus incomplete course of antenatal corticosteroid therapy on the number of doses of surfactant received postnatally. Methods: This is a single-center retrospective study, including 145 newborns with RDS, divided into 2 groups according to the number of doses of antenatal corticosteroid therapy (1 dose; n = 23 and 2 doses; n = 95). Results: The clinical characteristics of the newborns were similar in the 2 groups. The number of doses of surfactants received postnatally and the severity of RDS are not influenced by the number of doses of antenatal corticosteroid therapy. On the other hand, the number of doses of surfactants received is influenced by the term of birth, the presence of an neonatal sepsis and by resuscitation in the delivery room. The severity of RDS is not influenced either by the interval between the last dose of antenatal corticosteroid therapy and delivery, nor by the cause of prematurity. We did not note any statistically significant difference in clinical improvement (duration of intubation, duration of non-invasive ventilation), the need for postnatal corticosteroid therapy and the risk of occurrence of morbidity and mortality (mortality rate, occurrence of BPD, IVH, severe NEC) between the two groups. Conclusion: just like a complete course, an incomplete course of antenatal corticosteroid therapy can also act on the severity of RDS. Prospective randomized studies should be considered for a formal determination of the neonatal effects of a complete versus incomplete course of antenatal corticosteroid therapy, including the trial BETADOSE.

Prenatal acetaminophen exposure and the developing ovary: Time, dose, and course consequences for fetal mice

Acetaminophen is an emerging endocrine disrupting chemical and has been detected in various natural matrices. Numerous studies have documented developmental toxicity associated with prenatal acetaminophen exposure (PAcE). In this study, we established a PAcE Kunming mouse model at different time (middle pregnancy and third trimester), doses (low, middle, high) and courses (single or multi-) to systematically investigate their effects on fetal ovarian development. The findings indicated PAcE affected ovarian development, reduced fetal ovarian oocyte number and inhibited cell proliferation. A reduction in mRNA expression was observed for genes associated with oocyte markers (NOBOX and Figlα), follicular development markers (BMP15 and GDF9), and pre-granulosa cell steroid synthase (SF1 and StAR). Notably, exposure in middle pregnancy, high dose, multi-course resulted in the most pronounced inhibition of oocyte development; exposure in third trimester, high dose and multi-course led to the most pronounced inhibition of follicular development; and in third trimester, low dose and single course, the inhibition of pre-granulosa cell function was most pronounced. Mechanistic investigations revealed that PAcE had the most pronounced suppression of the ovarian Notch signaling pathway. Overall, PAcE caused fetal ovarian multicellular toxicity and inhibited follicular development with time, dose and course differences.

Frontline combination of dasatinib and low-intensity chemotherapy in adults with de novo Philadelphia chromosome-positive acute lymphoblastic leukemia

ABSTRACT Background Studies on dasatinib-based low-intensity induction regimens and post-remission strategies are limited in China. Therefore, we conducted a single-center phase 2 trial in newly diagnosed adult patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) to establish the efficacy and safety of this treatment approach. Research design and methods Patients received one month of dasatinib plus low-intensity chemotherapy and two months of dasatinib monotherapy for induction, followed by a single course of high-dose methotrexate for consolidation. Subsequently, they underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) or tyrosine kinase inhibitor (TKI)-based treatment for maintenance therapy between October 2015 and August 2022. Results Twenty-two patients were enrolled. Median age was 45 years (range, 20–71). The rates of major and complete molecular responses in the third month were 18.2% and 40.9% respectively. With a median follow-up of 15 months (range, 5–89), the estimated 3-year disease-free survival (DFS) and overall survival (OS) were 52.4% and 73.2%, respectively. The TKI-based cohort had a significantly poorer DFS (p = 0.014) and OS (p = 0.008) than the allo-HSCT cohort. Conclusions Our results suggest that dasatinib-based low-intensity chemotherapy is safe and effective as an induction strategy in the Chinese population. Allo-HSCT plays a crucial role in the long-term outcomes of patients with Ph+ ALL. Clinical trial registration The trial was registered at ClinicalTrials.gov as NCT02690922.

Teleteaching in paediatric rheumatology: an Asia Pacific League of Associations for Rheumatology experience

Aim: To evaluate the reach and potential effectiveness of teleteaching of health providers in paediatric rheumatology by observing the pattern of sessions, attendance, and attendees’ feedback in paediatric rheumatology teleteaching sessions across the Asia Pacific region. These were conducted by the Asia Pacific League of Associations for Rheumatology (APLAR) Paediatric Rheumatology Special Interest Group (Paeds Rheum SIG) as an APLAR academy activity. Methods: A retrospective, descriptive analysis of electronic records of synchronous telehealth sessions held between July 2021 to July 2023. These followed three formats: case-based webinars, single topic modular online course, and a hybrid one-day short course. The topics of sessions, attendees’ registration details, specifically primary area of practice/specialty, geographic location, and their satisfaction as per feedback forms were noted. Results: Case-based webinars had an average attendance of 200 per webinar: majority adult rheumatologists, paediatric rheumatologists (PRs), or paediatricians. The modular course consisted of nine sessions with an average of 63 participants per session. Specialties comprised PRs, adult rheumatologists with immunologists, and general paediatricians. The one-day hybrid course had over 600 attendees. Attendees were adult rheumatologists, general physicians, paediatricians, and PRs. Although the majority (79.3%) of attendees from these sessions were from APLAR member nation organisations (MNOs), a significant percentage (20.7%) were from non-APLAR MNOs and even non-Asia Pacific regions. The attendees’ feedback for all three formats showed a high level of satisfaction with case-based webinars being most favoured. Conclusions: Teleteaching in paediatric rheumatology has the potential to fulfill the dire need for improved expertise of health professionals managing children with rheumatic diseases. Case-based, interactive sessions of shorter duration and a blended hybrid format may garner the most attendance and best learning outcomes.

The experience with subcutaneous allergen-specific immunotherapy with pollen allergens in patients with atopic dermatitis

BACKGROUND: Atopic dermatitis is a chronic inflammatory skin disease, the key pathogenetic mechanisms of which include activation of T2-immune inflammation, IgE-specific sensitization to various allergens, and disruptions of epidermal barrier functions. Allergen-specific immunotherapy is the only pathogenetic treatment method that can prevent the progression of the disease and the development of the atopic march. Currently, clinical experience has been accumulated in using allergen-specific immunotherapy for atopic dermatitis, yet the existing evidence base does not allow for definitive conclusions regarding the indications for conducting allergen-specific immunotherapy, especially in atopic dermatitis associated with pollen allergy.&#x0D; AIMS: Determination of the clinical significance of sensitization to pollen allergens in atopic dermatitis, determination of indications for allergen-specific immunotherapy with pollen allergens and assessment of the effectiveness and safety of this method in atopic dermatitis patients.&#x0D; MATERIALS AND METHODS: A comparative controlled study to evaluate the effectiveness of subcutaneous allergen-specific immunotherapy with pollen allergens of birch or cereal grasses in 78 adult atopic dermatitis patients was conducted. A single course of subcutaneous allergen-specific immunotherapy with water-salt solutions of tree pollen allergens was administered to 33 patients, and grass pollen allergens were administered to 21 patients with atopic dermatitis. The comparison group ― patients with atopic dermatitis who received standard therapy for the disease without allergen-specific immunotherapy ― 24 patients. The primary endpoints of the study were to evaluate the effectiveness of therapy based on the reduction in the severity of atopic dermatitis symptoms, based on the absolute and relative number of patients who achieved a reduction in SCORAD score by 75% and IGA 1/0.&#x0D; RESULTS: In patients receiving one course of subcutaneous allergen-specific immunotherapy with tree pollen allergens, SCORAD 50 achieved 26, 33, 47% and SCORAD 75 achieved 10, 20 and 33% after 16, 32 and 52 weeks, respectively. In patients who received one course of subcutaneous allergen-specific immunotherapy with grass pollen allergens, SCORAD 50 reached 31, 40, 58% and SCORAD 75 ― 14, 28 and 43% after 16, 32 and 52 weeks, respectively. In the comparison group, the number of such patients was significantly smaller: SCORAD 50 reached 24, 32, 37% and SCORAD 75 ― 13, 22 and 26% after 16, 32 and 52 weeks, respectively. Similar results were obtained when studying the IGA. In all study groups, an improvement in the quality of life of patients was noted, which was reflected in a decrease in the DLQI index by 4 or more points in 12, 25 and 37% of patients receiving one course of subcutaneous allergen-specific immunotherapy with tree pollen allergens, in 14, 28 and 43% in patients after 16, 32 and 52 weeks, respectively. However, the number of such patients in the comparison group was significantly lower: 13, 22 and 26%, respectively.&#x0D; CONCLUSION: Allergen-specific immunotherapy is an effective way to treat atopic dermatitis patients, provided there is proven sensitization to pollen allergens.

SPIRAL PEDAGOGY: DEVELOPING A QUANTITATIVE HABIT OF MIND IN MARKETING STUDENTS

ABSTRACT In marketing, the traditional approach for teaching quantitative concepts uses individual courses, such as marketing research and business statistics. While this pedagogy is common, research indicates it is difficult for students to master quantitative concepts in a single course. Instead, quantitative reasoning (QR) requires repeated practice, so students develop a quantitative habit of mind. While the integration of analytics across the marketing curriculum could help students deepen their understanding of quantitative concepts, program-wide curricular change tends to be slow because it requires the coordination of multiple instructors across several courses. The current study investigated an innovative alternative – spiral pedagogy – that integrated quantitative concepts into a marketing management course. The study analyzed 384 QR assessments from 40 students before, during, and after the course. The time of the assessment had a large effect on students’ use of QR (ηp 2 = .93) and quantitative confidence (ηp 2 = .89). Qualitative feedback also indicated the spiraled lessons fostered a quantitative habit of mind that helped students beyond the classroom.

Magnesium supplementation therapy to prevent cisplatin-induced acute nephrotoxicity in pediatric cancer: a randomized phase-2 trial.

The present study aimed to examine the effect of magnesium (Mg) supplementation on cisplatin-induced nephrotoxicity (CIN) in pediatric cancer patients. The present phase-2, open-label, multicenter, randomized controlled trial enrolled patients aged less than 20years who were scheduled to receive cisplatin-containing chemotherapy and randomly allocated them at a ratio of 1:1 to a Mg supplementation arm with even-numbered chemotherapy courses (arm AB) or another arm with odd-numbered courses (arm BA). Analysis objects were reconstructed into two groups depending on whether the chemotherapy course had Mg supplementation (group B) or not (group A). The primary outcome was the proportion of chemotherapy courses resulting in elevated serum creatinine per chemotherapy course. The secondary outcomes included efficacies evaluated using other biomarkers and the safety of the Mg supplementation. Twenty-eight patients were randomly allocated to either group (16 to arm AB and 12 to arm BA). The baseline characteristics of the groups were similar. There was no significant difference in the proportion of courses with increased serum creatinine between the groups (group A: 10% vs. group B: 6%; P = 0.465) nor was any significant difference observed in other biomarkers during any chemotherapy course. The Mg value during chemotherapy was significantly higher in group B than that in group A. No adverse events related to magnesium administration were observed. The study design, which treated a single chemotherapy course as a study object, failed to detect a statistically significant benefit of Mg supplementation for preventing CIN in pediatric cancer patients. JRCT ( https://jrct.niph.go.jp/ ) Identifier UMIN000029215 jRCTs031180251. UMIN-CTR ( http://www.umin.ac.jp/icdr/index.html ) Identifier UMIN000029215.

Impact of scaffolding and hands-on assignments within mechatronics on student learning outcomes of KEEN's entrepreneurial mindset

Scaffolding learning and incorporating hands-on activities are proven pedagogical techniques that improve student engagement. A growing movement within engineering education has been to educate beyond the technical skills and foster an improvement in students’ entrepreneurial mindset. A modified version of a validated self-efficacy tool is used here to assess the impact that scaffolding and hands-on activities within a Mechatronics course have on developing the three student learning outcomes associated with the Kern Entrepreneurial Engineering Network's entrepreneurial mindset: “curiosity,” “connections,” and “creating value” (3Cs). A total of 229 students were considered in this study. Presurveys and postsurveys were used to collect self-efficacy ratings for confidence, success, motivation, and anxiety with respect to each of the 3Cs. Additionally, for comparisons a baseline behavioral tool was assessed along with students self-reported prior experiences relevant to the course and overall time spent on course activities. The group was split into high-performers and low-performers for the purpose of analysis. For all 3Cs, aspects of student perceived confidence and success significantly increased between the presurveys and postsurveys for the entire group. However, student perceived motivation was not significantly improved for any of the 3Cs. Interestingly for “connections,” student perceived anxiety decreased only for the high-performing group. This study suggests that changes in these 3Cs can be identified within a single course when subaspects of the mindset are considered.

Pedagogical strategies to enhance learning and awareness of acoustics within our engineering school community

Acoustics is taught at the École de technologie supérieure (ÉTS, Montreal, Canada) in a single advanced specialization course during the final year of the mechanical engineering bachelor's program. This course aims to equip students with the skills needed to measure and reduce noise based on the theoretical foundations of industrial acoustics and associated experimental techniques. The fact that the science of acoustics is not well-known among engineering students, coupled with the optional nature of this course, results in an average enrollment of only about thirty students each year (across two distinct sessions), a number further reduced since 2020 due to the unfortunate impact of the pandemic. Paradoxically, Quebec lacks engineers trained in this discipline and often recruits them from abroad. This presentation will aim to showcase various strategies and pedagogical tools that have been used and experimented with in recent years (e.g., flipped classroom, in-class experiments, cellphone measurements, community service-oriented semester projects). The goal is to ensure the quality and enjoyment of student learning and to contribute to raising awareness about acoustics and noise-related issues within the ÉTS community.