Single Course Research Articles

Leveraging the corporate university model to develop and deliver customized course content

Purpose These experiences can provide two significant findings for researchers and other organizations seeking to develop similar training programs. Design/methodology/approach This paper documents how a financial institution developed a customized bank accounting course for its employees through the well-researched and frequently used “Corporate University Model.” It did so through leveraging the educational expertise of a local university professor, and the subject matter expertise of bank managers. The organization followed up on this success by developing a customized risk management course. As before, the bank utilized the Corporate University Model. However, the content was more specialized than that of the previous course since it related to the unique operations of the organization. Therefore, the bank found it necessary to make some adjustments to its development and delivery approach. Findings First, even though corporate universities are often depicted as complex separate entities within companies, the Corporate University Model can be successfully utilized to develop and deliver individual courses that are managed by individual departments. Second, the bank’s risk management course demonstrated how a professional instructor could be used in conjunction with a company’s subject matter experts to effectively deliver course content. This approach is very effective with course content that is unique to the organization’s specific operations. Research limitations/implications While literature indicates that corporate universities often involve the creation of a separate entity, which can be difficult to configure due to their complexity (Lui Abel and Li, 2012), the leveraging of the CU model to construct and deliver single courses has not been explored. Additionally, the existing models do not discuss how roles outlined in the CU model (Patrucco et al., 2017) may change due to content complexity. From a limitation standpoint, it would be helpful to apply this approach to additional courses and organizations. Additionally, data could be collected to evaluate course effectiveness by learning goal. Practical implications This case study shows that the CU model has value for individual courses that continue to reside and be managed in the departments that developed them. Additionally, it shows that even though a professional instructor may not have all requisite knowledge in more specific knowledge domains, this can be solved by involving SMEs in content delivery. This still allows the benefit of a professional instructor who is skilled in course delivery and development. Originality/value These findings provide insights that have not been described in other papers that detail the application of the Corporate University Model. This helps to expand the manner in which companies can attain its benefits.

EXTH-27. POLYCOMB OVERACTIVITY DRIVES TUMORIGENESIS IN AGGRESSIVE CUSHING’S DISEASE

Abstract INTRODUCTION Aggressive Cushing’s disease (CD) tumors (Ki67 > 3%) exhibit rapid growth, poor postsurgical outcomes, and resistance to conventional therapies. Polycomb group (PcG) proteins are canonical epigenetic silencers that can drive tumor aggressiveness. We asked if PcG underlies rare but fatal pituitary tumor progression. METHODS We performed paired multiome analysis (single nucleus RNAseq and ATACseq) in 5 aggressive CD adenomas, and adjacent normal gland. We verified protein expression with multiplexed immunohistochemistry (mIHC) and PcG activity by H3K27me3 ChIPseq. Aggressive murine pituitary tumor cells ATT20 were treated using PcG inhibitors (DZNep, tazemetostat), HDAC inhibitor (vorinostat), or siRNA (Ezh2, Suz12). PcG binding to the POMC promoter was assessed by reverse chromatin immunoprecipitation (rChIP). We treated one patient off-label with oral vorinostat 400mg daily for 6 days prior to radiation. RESULTS PcG loci (EZH2 and EED) were more accessible in aggressive CD adenoma versus normal gland corticotrophs, and EZH2, SUZ12 and EED mRNA was robustly overexpressed. mIHC confirmed SUZ12, EZH2 and H3K27me3 overexpression, and ChIPseq confirmed polycomb overactivity in aggressive CD adenomas. Polycomb inhibition by DZNep, vorinostat, or siRNAs led to proliferative arrest and Pomc suppression in ATT20 cells (P < 0.05 versus controls). Vorinostat enriched Suz12 at the Pomc promoter (P < 0.01), confirming direct silencing. In a patient with aggressive CD and hypercortisolemia despite two prior surgeries, a single course of vorinostat decreased cortisol (24mcg/dL to 7.5mcg/dL) and ACTH (63.7pg/mL to 44.9pg/mL) prior to radiation therapy initiation. CONCLUSIONS PcG hyperactivity is associated with a more aggressive CD phenotype. We report here the therapeutic potential of HDAC inhibition against aggressive CD adenomas in a first-in-human application.

Immunotherapy-Based Strategies for Treatment of Type 1 Diabetes.

Type 1 diabetes (T1D) is more than an insulin-deficiency disease-it is an autoimmune disease, and the field is moving towards adopting disease-modifying immunotherapy as part of clinical care during T1D development. Recent successful immunotherapies as well as therapies that missed the mark are reviewed. T cell-directed therapies may allow for the greatest preservation of β cell function but also come with more side effects. Anti-cytokine therapies are very promising but likely need chronic administration. Antigen-specific therapies while safe have not produced meaningful results. Most successful trials have been conducted in adolescents and adults with stage 3 T1D (clinical T1D) with preserved C-peptide (up to 60% more compared to placebo) demonstrated 1-2 years post treatment. HbA1c and total insulin dose are less likely to be significantly different between treated and placebo groups because most participants in studies are meeting glycemic targets and because of the heterogeneous nature of these measures. In the prevention space (delaying progression from stage 2 to stage 3 T1D) the outcome is more discrete, and a T cell-directed therapy, teplizumab, has received FDA approval. Even negative studies with promising mechanistic and safety profiles have added value. What is clear, a single administration or short course of an immunotherapy is unlikely to provide sustained freedom from exogenous insulin.

Splanchnic and cerebral oxygenation during cyclic phototherapy in preterm infants with hyperbilirubinemia

Cyclic phototherapy (cPT) can achieve a reduction in total serum bilirubin comparable to that achieved with standard continuous PT in preterm infants. Our aim was to assess the effect of cPT on splanchnic (rSO2S) and cerebral (rSO2C) oxygenation measured by near-infrared spectroscopy (NIRS). We prospectively studied 16 infants with a gestational age of 25–34 weeks with hyperbilirubinemia requiring PT. Splanchnic regional oxygenation (rSO2S), oxygen extraction fraction (FOES), and cerebro-splanchnic oxygenation ratio (CSOR) were recorded before, during, and after cPT discontinuation. We found that rSO2S, FOES, and CSOR did not change during the study period. The overall duration of single or multiple courses of PT was 6.5 (6.0–13.5) h, but by cycling PT, the actual exposure was 3.0 (1.5–4.9) h. Twelve patients (75%) required 15 min/h cPT, and four (25%) required prolonging cPT to 30 min/h. None of the patients developed enteral feeding intolerance.Conclusions: cPT treatment of hyperbilirubinemia in preterm infants does not affect splanchnic oxygenation or intestinal oxygen blood extraction, likely due to the short exposure to PT light, and it could contribute to decreasing the risk of feeding intolerance.What is Known:• The assumption that phototherapy (PT) is innocuous with no serious adverse effects has been questioned.• Cyclic phototherapy (cPT) can achieve a reduction in total serum bilirubin comparable to that achieved with standard continuous PT in preterm infants.What is New:• Splanchnic and cerebral oxygenation measured by near-infrared spectroscopy did not change during KMC.• cPT can contribute to decrease the risk of feeding intolerance likely due to the short exposure to PT light.

The application of curriculum analytics for improving assessments and quality assurance in higher education

Curriculum mapping is a necessary process for establishing evidence of where learning outcomes are taught and assessed in higher education programmes. Mapping ensures the credibility of the institution and programme offerings and provides students with a clear understanding of what they can expect to learn and achieve during their academic studies. Well-mapped curricula that reference relevant standards and articulate aligned assessments are foundational for effective teaching and learning. Curriculum quality assurance measures are commonly accepted as a means of assuring accurate mapping. Assurance processes are, however, resource-intensive, error-prone and reflect human biases. Few studies have adopted an analytical approach to ensure programme quality assurance steps are traceable to a fundamental level of these maps: single courses and their assessment items. In this study, we adopted a novel curriculum analytics methodology to validate the mapping of professional standards to course-based assessments in a higher education degree program. Using an Australian initial teacher education programme as a case study, we applied and analysed results from a structured methodology that may be implemented across other disciplinary programs. Practical implications for quality assurance in higher education and the methodological contributions of this novel approach are further discussed. Implications for practice or policy: Quality assurance mechanisms in higher education serve to demonstrate that specific accreditation standards have been attained or maintained. An evidence-based approach is needed to ensure curriculum mapping and quality assurance. This study's novel curriculum analytics approach provides a robust foundation for demonstrating assessments’ compliance with accreditation standards at the degree program level. A data-driven approach for quality assurance presents opportunities for wider and scalable applications across other institutions.

Complete remission after glucocorticoid therapy in a patient with primary hypophysitis.

Primary hypophysitis is a rare disease that may have variable clinical presentations. The main treatment options are clinical observation, immunosuppressive drugs, and surgery. Glucocorticoids are used as first-line medical therapy; however, non-responsiveness and recurrences are the major problems. We present a 30-year-old male patient who had an excellent radiologic response to a single course of glucocorticoids. The patient presented with malaise and severe headaches of acute onset. Cranial MRI revealed a pituitary mass compressing the optic chiasm. Hormonal evaluation studies were consistent with anterior pituitary hormone dysfunction except for the growth hormone axis. There was a mild compression on the optic chiasm in the pituitary MRI. The patient was started on methylprednisolone therapy at a dose of 80 mg/day. The pituitary MRI revealed complete regression of the mass after 2 months, and there was a complete recovery of pituitary functions after 6 months. There is no consensus on the optimal dose and duration of glucocorticoid therapy for primary hypophysitis in the literature. We report that steroid therapy, even in lower doses, might be effective in mild-to-moderate cases. Primary hypophysitis is a rare disease with a varied clinical course, and hence the treatment strategies should be individualized. There is no consensus on the optimal dose and duration of glucocorticoid therapy. Glucocorticoid therapy may induce complete remission in some patients, especially with a mild-to-moderate disease course and during the acute phase of the disease.

Effects of dexamethasone on short-term and long-term outcomes in late preterm infants with twin pregnancy: an observational study

Objective: To investigate the effect of prenatal dexamethasone on short-term outcomes and long-term neurological development in late preterm infants with twin pregnancy. Methods: A total of 315 pregnant women with twin pregnancy and their preterm infants who delivered in Peking University Third Hospital from January 2019 to December 2022 were retrospectively analyzed. The clinical data of pregnant women and preterm infants were collected. They were divided into non-medication group (93 pregnant women and 186 preterm infants), medication after 34 weeks group (123 pregnant women and 246 preterm infants), and medication before 34 weeks group (99 pregnant women and 198 preterm infants). Short-term outcomes of preterm infants were analyzed, including the incidence of neonatal respiratory distress syndrome (NRDS), wet lung, hypoglycemia, neonatal septicemia, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD) and neonatal necrotizing enterocolitis (NEC). "Ages and Stages Questionnaire-Third Edition (ASQ-3) scale" was used to follow up the late neurological development of preterm infants at the corrected age of 6-54 months, and the level of neurological development was compared. Results: (1) General conditions: the gestational age at delivery in the non-medication group [36.1 weeks (35.6, 36.6 weeks)] was later than that in the medication after 34 weeks group [36.1 weeks (35.2, 36.4 weeks)] and medication before 34 weeks group [35.2 weeks (34.2, 36.2 weeks)] groups, and the differences were statistically significant (all P<0.05). After correcting for gestational age, there was no significant difference in birth weight among the three groups (H=3.808, P=0.149). There were no significant differences in gender and the proportion of small for gestational age among the three groups (all P>0.05). (2) Short-term outcome: the incidence of wet lung was 7.0% (13/186), 11.0% (27/246) and 16.2% (32/198) in the non-medication group, medication after 34 weeks group and medication before 34 weeks group, respectively, and the difference was statistically significant (P=0.018). There were no significant differences in the incidence rates of NRDS, hypoglycemia, sepsis, IVH, BPD, and NEC among the three groups (all P>0.05). Logistic regression analysis with gestational age and newborn birth weight as confounding factors showed that early gestational age (OR=0.884, 95%CI: 0.837-0.933, P<0.001) and increased incidence of selective intrauterine growth restriction type I (OR=2.967, 95%CI: 1.153-7.639, P=0.024) could both lead to an increased incidence of wet lung. (3) Long-term outcomes: a total of 109 pregnant women completed the follow-up, and 218 preterm infants with a corrected age of 6-54 months at the end of follow-up were enrolled, including 86 cases in the non-medication group, 66 cases in the medication after 34 weeks group, and 66 cases in the medication before 34 weeks group. There were no significant differences in the scores of communication, gross motor, fine motor, problem solving and personal-social among the three groups (all P>0.05). Conclusion: Prenatal administration of a single course of dexamethasone does not affect the neonatal birth weight and short-term outcomes of twin late preterm infants, and has no adverse effect on the neurological development of twin late preterm infants with a corrected age of 6-54 months.

Social class and lunch: differences in midday meal format in Santiago, Chile

PurposeThe social sciences have extensively studied meals; nonetheless, a few have investigated the menu format, with all the data originating from European countries. Within this framework, the novelty of this research is that it analyses the relationship between social class and lunch structure among adults in a Global South city: Santiago, Chile.Design/methodology/approachThe study worked with data from the Survey of Commensality in Adults (&gt;18) of the Metropolitan Region, which used a questionnaire and a self-administered eating event diary. The analysis unit was lunches (n = 3,595). The dependent variable was the structure of the lunches (single course, starter with a main course, a main course with dessert or a full-course menu with starter, main course and dessert). The independent variable was the individual’s social class (either the working, intermediate or service class).FindingsThe data showed that lunches are mostly semi- or fully structured (only 44.5% of the lunches reported by the participants contained a single course). The odds of eating a single course were lower in the service class than the working one and the odds of eating a full-course meal were higher in the service class than the working one.Originality/valueThe results provide new quantitative evidence from a representative sample of a Global South city about the relevance of social class as a differentiating factor in food, specifically regarding the existence of simpler meals among the lower classes.

Perceptions of students on artificial intelligence-generated content avatar utilization in learning management system

PurposeThis study aims to explore students’ perceptions of the use of an artificial intelligence-generated content avatar (AIGC avatar) within a learning management system (LMS).Design/methodology/approachThis qualitative research involved seven postgraduate students. Data were collected through individual, in-depth interviews. The videos of the AIGC avatar, created using Leonardo, ChatGPT and Heygen, were uploaded to the LMS to communicate with students for the purposes of a welcome note, assignment guide, assignment feedback, tutorial reminders and preparation as well as to provide encouragement and study tips. Students were interviewed at the end of the semester.FindingsThe findings of this study indicated that the majority of participating students held positive perceptions regarding the use of the AIGC avatar in the LMS. They reported that it enhanced their perceived instructor’s social presence and motivation to learn. The assignment guide and feedback were particularly valued by the participants. While some students noted the AIGC avatar’s lack of naturalness, others appreciated the clear and professional speech it delivered.Research limitations/implicationsThe study was confined to seven students from a single course at one institution, which may limit the generalizability of the findings. Future research could involve a larger and more diverse group of participants.Practical implicationsThe findings may offer education providers an alternative solution for engaging students in an LMS.Originality/valueThis study highlights the potential of AIGC avatars to replace text-based communication in LMS and enhance students’ perceived instructor social presence.

Long-term Tolerance to Islet Transplantation via Targeted Reduction of beta cell-specific T cells.

Activated beta-cell reactive CD4 + and CD8 + T effector cells undergo a profound DNA-damage response which is targetable by small molecule inhibitors of the p53 and cell cycle pathways that lead to apoptosis. The use of a combination of MDM2 and WEE1 inhibitors, which termed "p53 potentiation with checkpoint abrogation" (PPCA), conferred significant therapeutic efficacy in treating mouse models of new onset T1D. Specific targeting of these T effector cells by PPCA results in a loss of inflammatory T cell subsets, notably proliferation CD4 + Th0 and Th1 subsets and CD8 + T effector memory cells, as determined by single cell RNA-seq studies with the preservation of T regulatory cells. When autologous islet grafts are given to established diabetic NOD mice, a single course of PPCA results in long-term islet graft acceptance, restoration of normoglycemia and loss of beta cell specific CD4 + and CD8 + T cells. PPCA shows promise as a potential means of estimating islet graft tolerance in T1D recipients of islet graft transplantation.

La Maison Des Comptables: A Tax Research, Data Management, and Data Visualization Case

ABSTRACT This teaching case integrates the tax and accounting information systems curricula to help students apply research-based outcomes to critical business processes. The setting involves sales and excise tax compliance for out-of-state alcohol shipments, a complex context given the variation between state laws and nuances in the application of general tax rules created by the 21st amendment. The various case components require students to research state tax law, employ data management techniques to apply those laws to a large dataset, and create data visualizations to aid managers with business decision-making. Components of the case can be implemented concurrently or sequentially across multiple courses in the accounting curriculum or as a stand-alone case in a single course. Requiring students to identify and apply tax law across multiple courses helps students see through individual course silos and understand how various accounting disciplines are interconnected. JEL Classifications: M49; M41.

Impact of antenatal corticosteroids on subcortical volumes in preterm infants at term-equivalent age: A retrospective observational study

ObjectiveAntenatal corticosteroids (ACS) is a well-established treatment for women at risk of preterm birth that improves neonatal outcomes. However, several concerns have been raised regarding the potential long-term adverse effects of ACS on the offspring’s developing brain. Here we investigated the association between ACS and subcortical segmental volumes in preterm infants at term-equivalent age. Study designThis retrospective observational study was conducted using the clinical data of preterm singleton infants born between 220/7 and 336/7 gestational weeks at Nagoya University Hospital in 2014–2020. Subcortical volumes of the bilateral thalami, caudate nuclei, putamens, pallidums, hippocampi, amygdalae, and nuclei accumbens were evaluated using an automated segmentation tool, Infant FreeSurfer, and compared between neonates exposed to a single course of ACS (n = 46) and those who were not (n = 13) by multiple linear regression analysis (covariates: postmenstrual age at magnetic resonance imaging, infant sex, and gestational age at birth). We compared each subcortical volume stratified by gestational age at birth (<28 vs. ≥28 gestational weeks). ResultsMultivariate analyses revealed significantly smaller volumes in the bilateral amygdalae (left, p < 0.03; right, p < 0.03) and caudate nuclei (left, p < 0.03; right, p = 0.04) in neonates with ACS. Significantly smaller volumes in these regions were observed only in neonates born at 28 weeks of gestation or later. ConclusionsACS was associated with smaller volumes of the bilateral amygdalae and caudate nuclei at term-equivalent age. This association was observed exclusively in infants born at 28 weeks of gestation or later.

Online Learning from the Peers in Higher Education

The main reason for the research is to find out what factors affect the student's participation and engagement to peer learning in the university's online course. Today's higher education has a strong foothold in learning theories and pedagogical approaches that focus on collaborative learning, networking and working with peers. Now when digital technology and eLearning platforms have established their place in the infrastructure of educational institutions, we should have the keys to implementing modern education in practice. The hypothesis of the article suggests that we do not yet know how to exploit the capabilities of modern learning technology in a way that students can learn from their colleagues, peers. The practical objective of this article is to create information for planning online courses and organizing weekly tasks. The research data for this paper was drawn up from two different online implementations of the single university course. Students conducted a Moodle-based survey in which they were asked about the pedagogical approach and tools of the course. One aspect of the research is to increase the understanding of the students' opinions of peer activities in an online course. The theoretical background of the research is based on theories of active learning and learning communities. The research data are also reflected in the scientific literature on peer learning and peer assessment. According to the results, students' opinions on peer learning are quite positive. Students are able to appreciate the learning opportunities offered by assignments and activities, which are open and visible to everyone during the course. Most of the students were not interested in peer assessment, but preferred feedback and grade produced by the teacher. Most of the students opposed the small group assignments of the online course. According to the data, students feared that their contribution was considered weak in the eyes of others in the course. The results of this document underline the need for further research into peer learning in higher education. Many strategies that utilize collaborative learning may be useful, but there are still questions about the individual needs, fears and motivation of peer learning. In addition, it would be important to find a way to strengthen mutual trust through online courses.

The development and current directions of a diversity specialty clinic: Implications for multicultural training in psychology.

Addressing systemic injustices and racism in training and clinical service provision are key next steps in clinical science. While the APA Multicultural Guidelines and accreditation standards have long emphasized this need, most graduate programs offer a single course on diversity, equity, and inclusion topics, which is inadequate to train and sustain culturally humble providers and redress systemic injustices and racism within psychology. Few "real-world" examples exist to guide the development of training models. We provide background on the development and components of a specialty clinic, the University of New Mexico's Cultural Counseling Center, whose mission is providing culturally informed clinical services to diverse clientele, and to infuse multicultural training throughout the graduate program. Informed by the racial-spatial framework for psychology and critical race theory, we describe our approach intended to: 1) offer applications for the operationalization and delivery of multicultural and antiracist training; 2) enhance supervisory models; and 3) increase awareness of structural competence. Our clinic, developed collaboratively among students and faculty, serves as a safe forum for dialogue around structural injustices and seeks to improve treatment for diverse clients and those underserved in mental health care. We discuss issues of student and faculty engagement and offer the perspectives of faculty and students of color, case examples illustrating our services, and current efforts to expand and formalize community collaborations. We offer a model that integrates coursework, informal activities, and multicultural supervision for comprehensive student training and that promotes a departmental culture of dialogue and support around equity, diversity, and justice.

O-100 Chronic endometritis - research and practice

Abstract Chronic endometritis is an inflammation of the endometrium characterized by the presence of plasma cells. Plasma cells can be identified on H&amp;E and CD138 immunohistochemical staining by their characteristic appearance. There is a large body of evidence supporting the association between chronic endometritis and recurrent pregnancy loss (RPL), with a prevalence of approximately 30% among women with RPL (McQueen 2021). A limitation of the current literature, however, is heterogeneity of diagnostic criteria utilized and there is no consensus on the exact definition or number of plasma cells required. The treatment of chronic endometritis is oral antibiotic therapy and removal of any associated uterine pathology such as retained pregnancy tissue. Studies show that a single course of antibiotics has a cure rate of 60-94% when endometrial biopsies are repeated following treatment (Johnson 2010, McQueen 2014). Following antibiotic treatment, if resolution of chronic endometritis confirmed, women with RPL have improved live birth rates (Kimura 2019; Pirtea 2021).

Effect of prenatal glucocorticoid therapy on hearing screening in premature infants

Objective:To explore the effect of prenatal glucocorticoids therapy on hearing screening in premature infants Methods:Data of 693 preterm infants with gestational age of 24-34+6weeks admitted to theJiangxi Maternal and Child Health Hospital within 24 h after birth from June 2022 to June 2023 were retrospectively analyzed. The infants were divided into the DXM group （544 cases） and the non-DXM group （149 cases） based on whether dexamethasone （DXM） was administered prenatally. General data of preterm infants and parturients in two groups were compared, and the effects of different doses and timing of DXM on hearing screening were analyzed. Results:In the terms of preliminary hearing screening. the pass rate of initial hearing screening in DXM group was significantly higher than that in non-DXM group（53.9% vs 35.6%）, with statistical significance（P<0.05）. Further subgroup analysis showed that the passing rate of preliminary hearing screening in adequate prenatal dose（=4 doses） DXM group（58.1%） was significantly higher than that in insufficient group（48.0%） and excessive group（42.4%）, with statistical significance（P<0.05）. Administering DXM 48 hours to 7 days before birth resulted in a higher pass rate for initial hearing screening compared to administration <48 hours or >7 days before birth （56.4% vs. 48.6%）, with a statistically significant difference （P < 0.05）. In terms of re-hearing screening, the pass rate of secondary hearing screening was not significantly correlated with DXM treatment（P>0.05）, but was significantly correlated with gestational age, birth weight, hospital stays, invasive mechanical ventilation, and common neonatal diseases（bronchopulmonary dysplasia, respiratory distress syndrome）（P<0.05）. Among them, bronchopulmonary dysplasia was an independent risk factor forsecondary hearing screening referral（P<0.05）. Conclusion:A single course of adequate dexamethasone use within 48 h-7 d of prenatal has a positive effect on the preliminary hearing screening of preterm infants.

Washed Microbiota Transplantation Is Associated With Improved Lipid Profiles: Long-Term Efficacy and Safety in an Observational Cohort From South China.

Dyslipidemia is one of the main risk factors of chronic metabolic diseases. Our previous studies have shown that washed microbiota transplantation (WMT) has a significant improvement effect on patients with hyperlipidemia and hypolipemia in the Chinese population. The purpose of this study was to further explore the long-term efficacy and safety of WMT in patients with hyperlipidemia. Clinical data of patients who received WMT for multicourse were collected. Changes of blood lipid indexes before and after WMT, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), lipoprotein A, and Apolipoprotein B. A total of 124 patients were enrolled, including 56 cases in the hyperlipidemia group and 68 cases with normal lipids. The mean observation time was 787.80 ± 371.45 days, and the longest follow-up time was 1,534 days. TC and non-HDL-C in the hyperlipidemia group with 1-4 courses of WMT were significantly reduced ( P < 0.05); TG decreased significantly after the second course ( P < 0.05); low-density lipoprotein cholesterol also significantly decreased after the fourth course of treatment ( P < 0.05); TG, TC, and non-HDL-C significantly decreased in single course, double course, and multiple course, respectively ( P < 0.05). In terms of time period, over 1 year, the improvement in multicourse treatment was more significant than the single and double-course ones. In terms of comprehensive efficacy, WMT restored 32.14% of patients in the hyperlipidemia group to the normal lipid group ( P < 0.001), of which 30.00% recovered to the normal lipid group within 1 year ( P = 0.004) and 65.38% were reassigned to the normal lipid group over 1 year ( P = 0.003). In addition, over the 1-year treatment period, WMT significantly degraded the high-risk and medium-risk groups of atherosclerotic cardiovascular disease risk stratification in hyperlipidemia cases. There were no serious adverse events. WMT had a long-term improvement effect on patients with hyperlipidemia. The effect of multiple courses over 1 year was more significant than that of single/double courses and also had a significant destratification effect on the risk of atherosclerotic cardiovascular disease with high safety. Therefore, WMT provides a safe and long-term effective clinical treatment for patients with dyslipidemia.

Development of a method of teaching trainee doctors foreign language professional communication based on an integrated approach

Introduction. The integrated approach, being one of the innovative approaches in teaching a foreign language for professional communication, contributes to the parallel development of both students’ foreign language communication skills and their professional competencies within a single academic course. To attain effective outcomes in the dual objective of training, it is crucial not only to meticulously choose the integrated course content, considering its subject-thematic focus, but also to devise a practical training method that mirrors the specifics of future medical specialists' professional activities. The aim of this research is to develop a method of teaching trainee doctors foreign language professional communication based on an integrated approach. Materials and methods. First year trainee doctors of the Clinical Laboratory Diagnostics specialty of Derzhavin Tambov State University (Russian Federation) were the participants of the experimental study. In the control group (N = 20), students studied the language for special purposes, and in the experimental group (N = 20) students studied using an integrated approach. Evaluation of students’ progress was based on seven criteria. The Student's statistical t-test method was used for the results process. Results. The integrated approach effectiveness was confirmed during experimental study, which reflected the mastery of the professional thesaurus by trainee doctors (t=3.19 at p≤0.05), in the development of writing (t=4.8 at p≤0.05), speaking skills (t=4.8 at p≤0.05) and solving professional cases on the studied language (t=2.17 at p≤0.05). However, the study did not confirm the integrated approach advantages in the grammatical speech skills formation of trainee doctors (t=1.45 at p&gt;0.05), in the development of listening skills (t=1 at p&gt;0.05) and reading skills (t=1.45 at p&gt;0.05). The results obtained can be explained by the fact that by the beginning of experimental work, students had already developed the following language and speech skills at a high level (B1-B2). Conclusion. The novelty of the study is in the development of a method for teaching trainee doctors professional foreign language during an integrated course. The prospects for the work are to further study the potential of the integrated approach in teaching students who speak the language at level A2-B1. It is anticipated that the effectiveness of the integrated learning method will be evaluated on a group of students with a foreign language communicative competence level of A2-B1. Additionally, the methodology is of research interest as it aims to identify the speech skills of foreign language interaction, categorized by types of speech activity, in a specific professional field of communication.

Betamethasone treatment-to-delivery interval, retreatment, and severe intraventricular hemorrhage in infants

Antenatal corticosteroids decrease the incidence of severe intraventricular hemorrhages (grades 3,4) in preterm infants. It is unclear whether their beneficial effects on intraventricular hemorrhage wane with time (as occurs in neonatal respiratory distress) and if repeat courses can restore this effect. Prior randomized controlled trials of betamethasone retreatment found no benefit on severe intraventricular hemorrhage rates. However, the trials may have included an insufficient number of infants at risk for intraventricular hemorrhage to be able to adequately address this question. Severe intraventricular hemorrhages occur almost exclusively in infants born <28 weeks, whereas only 7% (0%-16%) of the retreatment trials' populations were <28 weeks. To determine if the risk of severe intraventricular hemorrhage in infants delivered <28 weeks increases when the betamethasone treatment-to-delivery interval increases beyond 9 days and to determine if betamethasone retreatment prior to delivery decreases the rate of hemorrhage. Observational study examining the incidence of intraventricular hemorrhage before (epoch 1) and after (epoch 2) a practice change that encouraged obstetricians to retreat pregnant women still at high risk of delivery before 28 weeks' gestation when >9 days elapsed from the first dose of betamethasone. Multivariable analyses with logistic regression using generalized estimating equations techniques were conducted to examine the rates of intraventricular hemorrhage among 410 infants <28 weeks' gestation who either delivered between 1-9 days (n=290) after the first 2-dose betamethasone course or delivered ≥10 days (and eligible for retreatment) (n=120). After adjusting for potential confounding variables, infants who delivered ≥10 days after a single betamethasone course had an increased risk of either severe intraventricular hemorrhage alone or the combined outcome severe intraventricular hemorrhage or death before 4 days (OR (95%CI): 2.8 (1.2, 6.6)) compared with infants who delivered between 1-9 days after betamethasone. Among the 120 infants who delivered ≥10 days after the first dose of betamethasone, 64 (53%) received a second/retreatment course of antenatal betamethasone. The severe intraventricular hemorrhage rate in infants whose mothers received a second/retreatment course of betamethasone was similar to the rate in infants who delivered within 1-9 days and significantly lower than in those who delivered ≥10 days without retreatment (OR (95%CI): 0.10 (0.02, 0.65). Following the change in guidelines, the rate of retreatment in infants who delivered ≥10 days after the first betamethasone course (and before 28 weeks) increased from epoch 1 to epoch 2 (25% to 87%, p<0.001) and the rate of severe intraventricular hemorrhage decreased from 22% to 0% (p<0.001). In contrast, the rate of severe intraventricular hemorrhage in infants who delivered 1-9 days after the initial betamethasone dose (who were not eligible for retreatment) did not change between epochs 1 and 2 (12% and 11%, respectively). Although betamethasone's benefits on severe intraventricular hemorrhage appear to wane after the first dose, retreatment with a second course appears to restore its beneficial effects. Encouraging earlier retreatment of women at high risk of delivery before 28 weeks was associated with a lower rate of severe intraventricular hemorrhages among infants delivering <28 weeks.

Washed microbiota transplantation improves sleep quality in patients with sleep disorder by the gut-brain axis.

The clinical impact of washed microbiota transplantation (WMT) from healthy donors in sleep disorder (SD) patients is unclear. This study aimed to investigate the effect of WMT in SD patients. The clinical data were collected from patients with different indications receiving 1-3 courses of WMT, divided into two groups by 7 points of PSQI scale. The score of PQSI and SF-36 scale was used to assess the improvement in sleep quality and life quality among patients with sleep disorders following WMT. Finally, 16S rRNA gene amplicon sequencing was performed on fecal samples of patients with sleep disorders before and after WMT. WMT significantly improved sleep quality in patients with sleep disorder in the short and medium term. WMT significantly improved sleep latency, sleep time and total score in the short term. WMT significantly improved sleep quality and total score in the medium term. In terms of sleep quality and sleep latency, the improvement value also increased with the increase of treatment course, and the improvement effect of multiple treatment course was better than that of single and double treatment course. In the total score, the improvement effect of double and multiple treatment was better than that of single treatment. WMT also improved quality of life in the sleep disorder group. WMT significantly improved general health, vitality, social function and mental health in the short term. WMT significantly improved role-physical, general health, vitality, and mental health in the medium term. WMT regulated the disturbed gut microbiota in patients with sleep disorders. In the normal sleep group, WMT had no effect on the decline of sleep quality in the short, medium and long term, and had an improving effect on the quality of life. WMT could significantly improve sleep quality and life quality in patients with sleep disorders with no adverse events. The improvement in sleep quality resulting from WMT could lead to an overall enhancement in life quality. WMT could be a potentially effective treatment for patients with sleep disorders by regulating the gut microbiota.