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Medical students in the early preclinical years may find the depth of knowledge demanded for basic and clinical sciences challenging. Self-directed learning however necessitates identifying the depth of knowledge required. While multimedia depiction of the sciences may enhance learning, they are not tailored to the learning objectives for any given year curriculum. This study explored students' experiences of a modified seminar format learning called "nCuSP". It encapsulated a flexible blended learning experience using digital technology, and provided specific content to meet learning objectives. A mixed methodology was used. The first quantitative phase measured participants' experiences of nCuSP and usual seminars. The second qualitative phase used focus group discussions to probe participants' learning experiences. There were 356 responses from first- and second-year students. Their consensus was that the nCuSP format led to improved overall learning (80.1% vs. 19.9%). When contrasted with usual seminars, nCuSP led to better understanding of key concepts (67.550 p<.001) and knowledge consolidation (75.073 p<.001). Participants' seminar preparation improved with nCuSP compared to usual seminars (89% vs. 8%), including higher peer interaction (93.2% vs. 6.8%) and problem-solving skills (88% vs. 12%). There were four focus group discussions with 14 participants representing both first and second years. Four main themes were identified: overwhelm, prior knowledge, interaction, and time. Findings suggest that the nCuSP seminar format based on blended learning using digital technology is a highly appreciated pedagogical approach in a module-based PBL-driven undergraduate medical education program. The online version contains supplementary material available at 10.1007/s40670-026-02708-5.
The teaching team optimized and reformed the teaching methods and assessment strategies of Biology and Cell Biology laboratory courses to enhance students' interest and teaching quality. This reform was based on the existing theoretical framework and experimental content of the course, introducing cutting-edge research topics related to the curriculum for discussion. Students selected topics of interest, conducted literature searches and readings in teams, and reported on their findings in class. This study collected self-reported data from students via questionnaire surveys, focusing on analyzing students' understanding of the difficulty of the course, prior knowledge of related fields, interest in the discussion topics, and exploring the correlation between these factors and students' self-reported level of comprehension of the seminar content. It was found that students' self-reported strong interest in the discussion topics was more strongly correlated with a higher self-assessed understanding of the seminar content. Course questionnaire results showed that over 80.3% (≥ 49/61) of students expressed interest in the seminar topics, and over 98.1% (≥ 60/61) of students reported fully or partially understanding the seminar content, gaining valuable insights from the discussions. Students' satisfaction with the seminars exceeded 95.0% (≥ 58/61), with evaluations indicating that the seminars played a positive role in providing learning opportunities, understanding academic frontiers, and improving comprehensive abilities. In conclusion, the literature-based discussion teaching has promoted teaching practices and laid the foundation for further deepening teaching reforms.
Diet and exercise advice are routinely the primary interventions given for weight loss; however, frequently result in poor weight loss outcomes. While modern pharmaceuticals are highly effective, there exists a need for a non-pharmaceutical adjunct therapy for lifestyle change-mediated weight loss. Recently, the gastrointestinal delivery of a bitter hop-based nutraceutical has been shown to stimulate increases in glucagon-like peptide-1 (GLP-1) and cholecystokinin (CCK). Our aim was to determine if this same bitter hop nutraceutical is an effective adjunct therapy during prescribed weight loss programs. This was a randomized, double-blind, parallel treatment study. One hundred and fifty adult males and females were recruited and required to undertake a 24-week weight loss program consisting of monthly lifestyle advice group seminars. Daily treatments of either placebo or 500 mg of a bitter hop extract (BHE) were given to the participants, who were instructed to take half the daily dose at least 1 h before the two major meals of the day. Body weight, bioelectrical impedance analysis (BIA) of body composition, and subjective appetite and craving measures were taken every four weeks. One hundred and twenty-eight participants completed the program. The BHE treatment group exhibited a greater reduction in weight (3.8%) and fat mass (3.9 kg) after 24 weeks when compared to placebo control (p < 0.05), and a total reduction of 4.3% body weight and 4.5 kg fat mass when compared to baseline values (p < 0.05). There was a proportionally similar reduction in BIA-estimated visceral fat area in the BHE treatment group relative to the placebo control (p < 0.05), and neither group exhibited any loss in BIA-estimated skeletal muscle mass. These data suggest that appetite suppressing nutraceuticals may be a useful adjunct therapy for individuals receiving lifestyle change advice for the purpose of weight loss. Australia and New Zealand Clinical Trial Registry (ANZCTR- ACTRN12625001011471).
Few programs exist to train learners in advancing equity in perioperative care. In response, the UCSF Center for Health Equity in Surgery and Anesthesia (CHESA) launched the CHESA Fellowship in 2021. This 18-month, non-ACGME fellowship uses asynchronous modules, expert-led seminars, mentored research, and community building to equip fellows with the skills to advance perioperative equity worldwide. This report describes the fellowship's structure and evaluates its early impact on alumni career development. We conducted a mixed-methods fellowship evaluation comprising alumni and end-of-year surveys, focus groups, and a list of fellow-authored publications. Surveys assessed skill development, scholarly output, and satisfaction with curriculum elements. Qualitative data from focus groups were coded to highlight fellows' experiences and identify areas for improvement. Since 2021, CHESA has trained 80 fellows across 18 countries and 12 specialties; 71.3% are from LMICs and 48.8% are female. Surveys demonstrated strong satisfaction with faculty mentorship, project work, and community-building. Fellows reported acquiring skills in academic writing, mentorship, and leadership, with 53.8% developing new collaborations with co-fellows and 75.0% integrating fellowship learning into their clinical practice. Among alumni, 76.5% reported advancement into new leadership roles or clinical positions. Across cohorts, alumni published 364 manuscripts during or after the fellowship, with 58.8% focusing on health equity. Fellow and faculty feedback identified needs for enhanced research support and faculty development, which were incorporated into subsequent program iterations. The CHESA Fellowship offers an innovative model for building global perioperative leadership. The part-time, virtual format allows fellows to complete the program alongside clinical duties, while seed grants for LMIC fellows support locally driven scholarly projects. By prioritizing cross-border collaborations between fellows, building long-term partnerships with LMIC institutions, and ensuring diversity across geography, specialty, and sex, the fellowship balances accessibility with mentorship and community-building. Alumni report high satisfaction and translate their training into academic, clinical, and advocacy outcomes that advance perioperative equity.
This single-center, parallel-group randomized controlled educational intervention study evaluated the short-term outcomes of an integrated, multicomponent teaching package combining a Small Private Online Course (SPOC)-based blended teaching system with full-cycle training among medical imaging interns. Sixty eligible interns undertaking clinical placements in the Department of Interventional Radiology at Deyang People's Hospital between May 2023 and May 2024 were randomly assigned in a 1:1 ratio to the experimental or control group using a random number table (30 per group). The control group received conventional clinical internship teaching, whereas the experimental group received a package comprising the SPOC platform, micro-video modules, online quizzes, face-to-face seminars, case-based learning, structured instructor feedback, and stage-specific full-cycle training. Outcomes included self-reported perceived job competency, self-directed learning ability, teaching satisfaction, and department-specific end-of-rotation examination performance. Prior academic performance and digital literacy were assessed at baseline. At the single immediate post-intervention assessment, the experimental group reported higher perceived job competency, self-directed learning ability, and teaching satisfaction and achieved higher examination scores than the control group. However, several self-reported outcomes approached the upper limits of their scales. The findings therefore indicate favorable short-term between-group differences in perceived educational outcomes and department-specific examination performance. Because all outcomes were assessed only once immediately after the intervention, the study does not establish sustained learning, long-term knowledge retention, or meaningful improvement in subsequent clinical performance. In addition, because multiple educational components were implemented concurrently, the findings reflect the overall effect of the integrated package and cannot be attributed to the SPOC platform or any single component. Faculty development outcomes were not assessed. Multicenter studies with longitudinal follow-up and institutions differing in faculty capacity, teaching resources, and digital infrastructure are needed to evaluate durability, generalizability, implementation feasibility, resource requirements, workload, cost, and scalability.
Financial planning (FP) is one of the leading challenges for retirees. Research shows a gap in how informal financial counselling (IFC), psychological empowerment, and risk aversion contribute to retirees' FP in the post-retirement phase. This study aimed to examine the role of IFC in retirees' FP, with psychological empowerment as mediator and risk aversion as moderator. A cross-sectional survey design was followed. Data were collected from 490 (66% male, 34% female) government retirees from Punjab, Pakistan. The analysis revealed that IFC significantly contributes to retirees' FP. Additionally, psychological empowerment mediates the relationship between IFC and FP, highlighting the importance of empowering retirees to make financial decisions. Although risk aversion positively influences FP, it does not significantly moderate the IFC-FP relationship. The findings highlight the need for targeted interventions, such as workshops, seminars, peer-group discussions, and accessible financial counselling programs, to enhance retirees' financial preparedness.
Since its establishment by the World Health Organization (WHO), the surgical safety checklist (SSC) is variably adopted worldwide despite evidence of advantages related to its use. To our knowledge, no data exists about the use of the SSC in DRC. We aimed to report the frequency of its use and reasons for its non-use. Using Google Forms, a survey was conducted in the Democratic Republic of the Congo public hospitals for 20 days (25 April to 15 May 2024). Fifty-nine hospitals were included in the survey, and 32 (54.2%) are using the SSC for a mean time of 4 (± 2) years. Of these, 16 (50%) use it regularly, with a surgeon coordinating the checklist process in 14 hospitals (43.8%). Twenty-seven hospitals do not use the SSC due to the absence of training for its use in 16 hospitals (59.3%) or due to the unavailability of the SSC in 15 hospitals (55.6%). Half of the public hospitals in DRC have used the SSC for an average of 4 years. Lack of previous training and unavailability of the SCC are the main reasons of its non-use. Seminars and training on the use of SSC would allow its use in these health facilities.
Patients with asthma can effectively manage their condition and minimize its impact on their everyday life by practicing asthma self-management. This study aimed to explore knowledge, perceptions, experiences, barriers, and facilitators of asthma self-management among asthma patients in Malaysia. A qualitative study using a phenomenological approach was conducted from February 2025 to May 2025 among 19 asthma patients aged 18 and above through semi-structured online and face-to-face individual interviews. All interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis through NVivo® software to identify key themes. Later relevant themes were applied deductively to the three self-management tasks (medical, behavioural, and emotional management) described by Corbin and Strauss. To improve interpretation, two overarching themes, (1) impacts of asthma and (2) self-management of asthma, were constructed. Within "impacts of asthma," one main theme, "living with asthma," was identified. Under "self-management of asthma," four main themes were identified: (i) medical management, (ii) behavioural management, (iii) emotional management, and (iv) factors influencing asthma self-management. Asthma patients demonstrated a good understanding of the disease and self-management strategies; gaps remain in the area of self-monitoring. Patients' perceived self-efficacy and beliefs towards traditional methods and asthma medication influenced self-management practices. Asthma counselling seminars and the provision of an asthma action plan can facilitate asthma management. Furthermore, addressing barriers such as passive smoking and workplace difficulties through policies is essential.
West Nile Virus (WNV) can cause severe neurological disease in humans, making public awareness crucial for prevention. The study aims to investigate the knowledge and attitudes of individuals living in Northern Cyprus regarding sources and transmission routes of this disease. In this cross-sectional study, 389 people participated. Data were collected using a questionnaire designed by researchers. The survey included questions about participants' awareness, sources of information, knowledge of WNV transmission routes, and preventive measures. It was conducted face-to-face. Descriptive statistics were used to analyze data, and results were expressed as frequencies and percentages. Chi-square tests assessed p-values and significance. 80.1% of participants had never heard of zoonotic diseases. When asked about the transmission route of WNV, 59.7% correctly identified animal or insect bites as the mode of transmission. In terms of precautions, 60.7% reported taking measures such as window screens and bed nets to protect from mosquito bites, while 39.3% did not. As hypothesized, a significant association was shown between nationality and knowledge of zoonotic disease (p=0.026). In addition, gender was significantly associated with preventive measures (p=0.008), with females more likely to show protective behaviors compared to males. Results indicate a general lack of awareness about zoonotic diseases among the population of Northern Cyprus; however, a larger proportion reported taking personal precautions against mosquito bites. The Ministry of Health can organize training sessions and seminars to increase public awareness about WNV. Additionally, municipalities should take mosquito and larval control measures, particularly in summer.
Oncology nurse navigators play a critical role in addressing patients' physical, emotional, social, and spiritual needs. However, gaps in existing training programmes often limit the effective integration of holistic care principles and therapeutic relationship skills into clinical practice. Online education offers potential flexibility and scalability, yet evidence regarding its effectiveness for developing these competencies remains limited. This study employed a quasi-experimental design comprising two sequential phases of online training aimed at bridging theoretical foundations and practical application in oncology nursing navigation. Healthcare professionals across Taiwan participated in Phase One, which consisted of online dialogic seminars focusing on foundational concepts of holistic care. Phase Two involved situation-based simulations and structured reflective discussions to strengthen applied skills. Holistic care competence and therapeutic relationship skills were assessed at baseline (T1), mid-training (T2), and post-training (T3) using validated self-report instruments. Data were analysed using paired t-tests and repeated measures ANOVA. A total of 337 healthcare professionals completed Phase One, of whom 34 oncology nursing professionals met eligibility criteria and participated in Phase Two. Statistically significant improvements were observed in holistic care competence, with paired t-tests indicating significant gains from T1 to T2 across all dimensions (t = - 9.65 to - 13.00, all p < .001). In Phase Two (n = 34), repeated-measures ANOVA confirmed significant improvement in holistic care competence across T1, T2, and T3 (F(1.50, 49.47) = 14.83, p < .001, η2p = .310, Greenhouse-Geisser corrected). Therapeutic relationship skills also improved significantly (F(1.35, 44.56) = 12.18, p < .001, η2p = .270), with the majority of improvement occurring from T1 to T2 (d = 0.59, p = .002). Effect sizes from T1 to T3 ranged from medium to large across holistic care dimensions (Cohen's d = 0.81-1.07). The findings suggest that an interactive online training programme incorporating scenario-based learning and reflective discussion was associated with enhanced holistic care competence and therapeutic relationship skills among oncology nursing professionals. Baseline therapeutic relationship skills predicted learning gains across all holistic care dimensions, indicating that relational competence may function as a foundational infrastructure for holistic care learning; accordingly, positioning relational skills training as an early component of oncology nursing curricula may optimise learning outcomes across all dimensions of holistic care. While the results are context-specific, this approach demonstrates potential as a feasible and scalable model for advancing professional education in oncology and palliative care settings.
The Center for Future Faculty is an innovative, multi-institutional model addressing the nurse faculty shortage through a collaborative, competency-based approach. Four regional universities partnered to prepare aspiring nurse educators via graduate coursework, mentored fellowships, and seminars aligned with National League for Nursing CNE® competencies. Seven students completed the inaugural year; most planned to pursue educator roles, and course evaluations showed high satisfaction and skill development. Partners benefited from strengthened faculty pipelines and shared academic resources. Early outcomes suggest that regional partnerships can sustainably expand nursing education capacity and advance health equity by cultivating a diverse, well-prepared future faculty workforce.
While Canada has established a robust settlement program, significant limitations remain in developing coordinated, integrated, responsive, and sustainable service pathway systems. Contributing challenges include limited awareness and underutilization of pre-arrival and settlement services, as well as a predominant focus on short-term "basic" resettlement needs rather than on long-term mental health and primary service supports. Using a community-based participatory research and mixed-methods research design, we co-designed a concept-to-practice Service Pathways Model comprising four core components: (1) a centralized referral database, (2) a systems navigator role, (3) mobilization of pre-arrival services, and (4) integrated social and health post-arrival services. The proposed model has the potential to: (i) strengthen referral loops, (ii) reduce service fragmentation, (iii) enhance coordination and integration across systems, and (iv) promote positive mental health, resilience, and settlement outcomes among newcomers in the Region of Peel (Canada) and similar contexts experiencing significant newcomer influxes. Further refinement and pilot testing of the model is recommended to assess its implementation feasibility, effectiveness, and underlying theory of change. Such findings will inform how coordinated service pathways can strengthen the responsiveness and sustainability of Canada's settlement system and improve outcomes for immigrant and refugee families.
Kidney ischemia-reperfusion (I/R) injury is an unavoidable complication of kidney transplantation that contributes to acute kidney injury (AKI), chronic kidney disease (CKD), and limited long-term graft survival. Elevated serum phosphate has been implicated not only as a consequence of renal dysfunction but also as an active mediator of kidney injury. Tenapanor, an intestinal sodium/hydrogen exchanger 3 inhibitor approved for the treatment of hyperphosphatemia in dialysis patients, may therefore have renoprotective potential; however, its effects on renal I/R injury remain unclear. Here, we show that oral administration of tenapanor suppresses renal calcium phosphate deposition after I/R, mitigates AKI progression, and reduces subsequent renal fibrosis in rats. These findings suggest that tenapanor mitigates renal I/R injury and may represent a potential pre-transplant strategy to improve long-term graft outcomes.
Comprehensive preoperative patient education is critical for optimizing postoperative outcomes and long-term weight management after bariatric surgery. Traditional in-person educational sessions, however, generate considerable greenhouse gas emissions, primarily due to participant travel. Telemedicine offers an environmentally sustainable alternative with the potential to reduce the carbon footprint within obesity care. This study aimed to quantify savings in greenhouse gas emissions and assess patient acceptance of virtual preoperative obesity educational sessions compared to conventional in-person courses. Between January and December 2024, N = 183 patients attending a virtual preoperative educational seminar for individuals with obesity-integrated into standard bariatric surgical preparation-were surveyed regarding their hypothetical travel behavior, had the seminar been held in person. Distances from participants' residences to the seminar location and preferred transportation modes were used to calculate avoided CO₂ emissions utilizing the Transport Emission Model (TREMOD) developed by the German Federal Environment Agency. The average one-way travel distance was 33.08 km, with 83.6% of participants indicating they would have traveled by private vehicle, predominantly powered by internal combustion engines. Transitioning to the virtual format resulted in a total avoidance of approximately 1.792 metric tons of CO₂ equivalent emissions over the study period. Patient acceptance of the virtual format was high, with 93.4% of the cohort rating it as equivalent or superior to in-person sessions. Notably, 25% of the participants stated they would not have attended the mandatory session if held exclusively in person, indicating that the virtual format successfully bridged a significant attendance gap. Given the increasing prevalence of obesity and the critical role of preoperative education in bariatric care, telemedicine represents an effective strategy to meaningfully reduce travel-related emissions. Virtual educational interventions eliminate CO₂-intensive journeys while maintaining broad accessibility and high patient satisfaction. Integrating telemedicine into obesity surgery care pathways can thus significantly contribute to sustainable, climate-conscious healthcare delivery.
Metastatic renal cell carcinoma remains clinically challenging because of heterogeneous outcomes and limited predictive biomarkers for immunotherapy. We performed an explainable machine learning analysis using data from the multicenter retrospective Meet-URO 15 study, including 571 patients with metastatic renal cell carcinoma treated with second-line or later nivolumab. Clinical and inflammatory variables were used to develop classification models for disease control rate, progression-free survival at 3 and 9 months, and overall survival at 6, 18 and 24 months, as well as survival models for continuous progression-free and overall survival. Model performance was assessed using weighted F1-score for classification and concordance index for survival analysis, with interpretability provided through Shapley additive explanations. The best classification performance was observed for 6-month overall survival using a support vector machine model combined with minimum redundancy maximum relevance feature selection, achieving an F1-score of 0.81 on the test set and 0.77 in external validation. In survival analysis, random survival forest achieved a test-set concordance index of 0.68 for overall survival. Inflammatory indices, IMDC score, hemoglobin, lymphocytes and platelets consistently emerged as relevant prognostic features. These findings support explainable machine learning as a transparent approach to refine outcome prediction in immunotherapy-treated metastatic renal cell carcinoma.
Persistent inequities in the biomedical research workforce highlight the need for early, sustained training approaches that support individuals from backgrounds historically underrepresented in science and medicine. We present results of a 4-year evaluation of an HIV mentored research program for pre-doctoral students from colleges in the San Francisco Bay Area. The Center for AIDS Research (CFAR) Scholars Program took place at the University of California, San Francisco from 2022-2025. We conducted an evaluation across four cohorts of scholars (n = 23) before and after each year of the program. Scholars were individually mentored by a CFAR investigator, completed an independent research project, attended weekly didactic HIV seminars, and participated in professional development activities, along with clinical and community shadowing. We implemented pre- and post-program surveys to assess research skills, confidence, career clarity, program experiences, and mentorship quality each year. Qualitative data were collected through scholar focus groups and in-depth interviews with faculty mentors. Across cohorts, scholars demonstrated consistent gains in research readiness, understanding of scientific processes, tolerance for research challenges, and clarity about their career paths. The proportion of scholars reporting high confidence in pursuing academic work increased from 52.2% to 86.4%, and interest in HIV research increased from 30.4% to 68.2%. All scholars reported a clear understanding of what a career scientist's job entails, which was a significant improvement from baseline. Qualitative findings highlighted the central role of responsive and engaged mentorship, structured programming, and a strong sense of belonging within an HIV research community. Over four years, the UCSF CFAR Scholars Program showed sustained feasibility and a large impact in strengthening research skills, scientific identity, and HIV career interest among early-stage trainees. These findings support early mentored research pathways as an effective strategy to diversify and strengthen the HIV research workforce.
The latest drug-eluting stents (DESs) are the gold standard for patient treatment during percutaneous coronary intervention (PCI). The latest advancements in DES innovation have resulted in the development of new stent technologies with reduced thickness in the struts. The new DES design, ultrathin-strut DESs, features struts measuring less than 70 μm in thickness. The evidence for these devices is derived from observational studies, extensive meta-analyses, and randomized trials with long-term outcomes. The investigation is focused on determining the comparative performance of ultrathin-strut DESs and conventional new-generation DESs across various clinical settings and patient lesion profiles. The objective of the seminar is to examine recent advancements in the use of very thin DESs and the potential of computational modeling in coronary arteries during PCI. An analysis of the mechanical performance of ultrathin DESs has been conducted in terms of radial expansion and stresses within the stent-vessel system. Residual stresses generated by the crimping process will also be considered.
International students face numerous challenges in both their academic and social lives when relocating to a new country for their university studies. The foreign language can have an impact on international medical students' performance in patient encounters. Particularly in the context of psychosocial medicine, a deficiency in communication skills can negatively impact the doctor-patient-relationship. This is the first study that uses natural language processing (NLP) as well as traditional rating scales to assess the improvement of international students' communication skills after attending a communication training seminar. N = forty-two international students participated in the study, which followed a pre-post-design. Diagnostic interviews with standardized patients (SP) were videotaped before and after the three-day training seminar, which was comprised of short lectures and communication trainings with SPs regarding the topic of psychosomatic medicine. Transcripts of diagnostic interviews were analyzed with NLP. Videotaped clinical encounters were assessed by three raters with binary and global rating instruments. For the comparison between pre- and post-assessment of all NLP communication parameters and rating results, two-way ANOVAs and Wilcoxon tests were calculated, respectively. NLP communication parameter results showed a decrease in talk-turns, interruptions, number of questions and talking over, and an increase in talk-turn-length in post-assessment compared to pre-assessment. There were no significant pre-post changes observed in binary checklist results. Significant pre-post changes were observed in global rating score and ratings from global rating domains 'interview structure' and 'verbal expression'. International students significantly improved their communication style in psychosomatic medicine towards a more patient-centered approach. Changes in NLP communication parameters and improved interview style and verbal expression suggest that international students may have listened to patients more carefully. Furthermore, NLP has shown to be a viable tool to evaluate communication parameters in a doctor-patient-relationship and assess the effectiveness of communication training for international students.