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The Community of Inquiry (CoI) Framework describes success factors for collaborative online-based learning. The CoI Survey is a validated instrument to measure these factors from the perspective of course participants. Until now, no validated translation of this Survey to German was available. The aim of this work was to translate the original English Survey to German and to validate the translated Survey instrument. After a systematic translation process, we validated the German translation in two higher education settings in two countries (entire data set of n=433 Surveys). By conducting item analysis, reliability analysis, exploratory factor analysis, and confirmatory factor analysis, we were able to confirm the reliability and validity of the German CoI Survey. Only one item (CP6) shows cross-loadings on two factors, a finding that was already discussed for the original CoI Survey. To conclude, the validated German version of the CoI Survey is now available.

Abstract In the present study, Pušnik et al. investigated whether the XBB.1.5-adapted booster can overcome the persistent imprinting of SARS-CoV-2 immunity by wild-type based vaccines. The findings demonstrate increased plasma neutralization against the homologous variant following the booster vaccination. Formation of de novo humoral response against the mutated epitopes of XBB.1.5 variant’s surface proteins was observed in 3/20 individuals. The booster vaccination had no significant effect on T-cell response.

Abstract Several studies have suggested the imprinting of SARS-CoV-2 immunity by original immune challenge without addressing the formation of the de novo response to successive antigen exposures. As this is crucial for the development of the original antigenic sin, we assessed the immune response against the mutated epitopes of omicron SARS-CoV-2 after vaccine breakthrough. Our data demonstrate a robust humoral response in thrice-vaccinated individuals following omicron breakthrough which is a recall of vaccine-induced memory. The humoral and memory B cell responses against the altered regions of the omicron surface proteins are impaired. The T cell responses to mutated epitopes of the omicron spike protein are present due to the high cross-reactivity of vaccine-induced T cells rather than the formation of a de novo response. Our findings, therefore, underpin the speculation that the imprinting of SARS-CoV-2 immunity by vaccination may lead to the development of original antigenic sin if future variants overcome the vaccine-induced immunity.

Abstract Determining SARS-CoV-2 immunity is critical to assess COVID-19 risk and the need for prevention and mitigation strategies. We measured SARS-CoV-2 Spike/Nucleocapsid seroprevalence and serum neutralizing activity against Wu01, BA.4/5 and BQ.1.1 in a convenience sample of 1,411 patients receiving medical treatment in the emergency departments of five university hospitals in North Rhine-Westphalia, Germany, in August/September 2022. 62% reported underlying medical conditions and 67.7% were vaccinated according to German COVID-19 vaccination recommendations (13.9% fully vaccinated, 54.3% one booster, 23.4% two boosters). We detected Spike-IgG in 95.6%, Nucleocapsid-IgG in 24.0%, and neutralization against Wu01, BA.4/5 and BQ.1.1 in 94.4%, 85.0%, and 73.8% of participants, respectively. Neutralization against BA.4/5 and BQ.1.1 was 5.6- and 23.4-fold lower compared to Wu01. Accuracy of S-IgG detection for determination of neutralizing activity against BQ.1.1 was reduced substantially. We explored previous vaccinations and infections as correlates of BQ.1.1 neutralization using multivariable and Bayesian network analyses. Given a rather moderate adherence to COVID-19 vaccination recommendations, this analysis highlights the need to improve vaccine-uptake to reduce the COVID-19 risk of immune evasive variants. The study was registered as clinical trial (DRKS00029414).

SARS-CoV-2 vaccination and breakthrough infection scenarios increasingly differ on an individual and population level. Here, the authors analyzed humoral and cellular immune responses in various antigen exposure scenarios and identified combinations providing enhanced immune response.

The Community of Inquiry (CoI) Framework describes success factors for collaborative online-based learning. The CoI Survey is a validated instrument to measure these factors from the perspective of course participants. Until now, no validated translation of this Survey to German was available. The aim of this work was to translate the original English Survey to German and to validate the translated Survey instrument. After a systematic translation process, we validated the German translation in two higher education settings in two countries (entire data set of n=433 Surveys). By conducting item analysis, reliability analysis, exploratory factor analysis, and confirmatory factor analysis, we were able to confirm the reliability and validity of the German CoI Survey. Only one item (CP6) shows cross-loadings on two factors, a finding that was already discussed for the original CoI Survey. To conclude, the validated German version of the CoI Survey is now available.

BackgroundWorldwide vaccination campaigns significantly reduced mortality caused by SARS-CoV-2 infection and diminished the devastating effects of the pandemic. The first approved vaccines are based on novel mRNA technology and elicit potent immune responses offering high levels of protection from severe disease.MethodsHere we longitudinally assessed adaptive immune responses during a 12-month follow-up period after the initial immunization with 2 doses of mRNA vaccines and after the booster dose in blood and saliva.ResultsOur findings demonstrate a rapid waning of the anti-spike IgG titers between months 3 and 6 after the initial vaccination (1.7- and 2.5-fold decrease in plasma and saliva, respectively; P

Abstract Background Fluid management in patients after subarachnoid hemorrhage (SAH) aims at the optimization of cerebral blood flow and brain oxygenation. In this study, we investigated the effects of hemodynamic management on brain oxygenation by integrating advanced hemodynamic and invasive neuromonitoring. Methods This observational cohort bi-center study included data of consecutive poor-grade SAH patients who underwent pulse contour cardiac output (PiCCO) monitoring and invasive neuromonitoring. Fluid management was guided by the transpulmonary thermodilution system and aimed at euvolemia (cardiac index, CI ≥ 3.0 L/min/m2; global end-diastolic index, GEDI 680–800 mL/m2; stroke volume variation, SVV

The increasing volume of unstructured textual data in healthcare, particularly in nursing care reports, presents both challenges and opportunities for enhancing patient care and operational efficiency. This study explores the application of Latent Dirichlet Allocation (LDA) topic modeling to analyze freetext nursing narratives from inpatient stays in three different clinics, aiming to uncover the latent thematic structures within. Utilizing the R programming environment and the visualization tool LDAvis, we identified three main themes: "Patient Well-being," "Patient Mobility and Care Activities," and "Treatment and Pain Management," the latter combining two closely related but initially distinct topics due to their overlapping content. Our findings demonstrate the potential of LDA topic modeling in extracting meaningful insights from nursing narratives, which could inform patient care strategies and healthcare practices. However, the study also highlights significant challenges associated with the method, including the sensitivity to parameter settings, the lack of updates for key software packages, and concerns about reproducibility. These issues highlight the need for meticulous parameter validation and the exploration of alternative text analysis methodologies for future research. By addressing these methodological challenges and emphasizing the importance of comparative method analysis, this study contributes to the advancement of text analytics in healthcare. It opens avenues for further research aimed at developing more robust, efficient, and accessible tools for analyzing freetext data, thereby enhancing the ability of healthcare professionals to use unstructured data to improve decision making and patient outcomes. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic spurred an unprecedented shift towards digitalization, prompting a surge in telehealth practices. This paper explores the impact of the pandemic on telemedicine through a comprehensive analysis of scientific publications. Utilizing a bibliometric approach, the study examines trends in telemedicine research before and after the onset of Covid-19. The systematic search in PubMed yielded 8,454 pre-Covid-19 publications (2016-2019) and 16,633 post-Covid-19 publications (2020-2023). A total of 21,989 distinct keywords were extracted. Co-occurrence maps reveal evolving thematic clusters, with "mhealth" and "ehealth" dominating pre-Covid-19, while "Covid-19" emerges as a top keyword post-pandemic. The Top-10 keywords shift post-Covid-19, reflecting dynamic research priorities. The bibliometric approach illuminates a heightened exploration of telehealth solutions post-pandemic, emphasizing the enduring impact of the crisis on academic discourse. Changes in key terms and shifts in key term ranking indicate dynamic research priorities and a broader consideration of multidimensional healthcare challenges. Acknowledging study limitations, the analysis offers a high-level perspective, focusing on authors' keywords. Despite challenges, the study provides a systematic overview, revealing the emergence of new telemedicine application domains and the need for further in-depth analyses. Future research directions may explore the ecological impact of telemedicine applications and other intriguing aspects, contributing to a comprehensive understanding of telemedicine's scholarly trajectory. [ABSTRACT FROM AUTHOR]

This study scrutinizes free AI tools tailored for supporting literature review and analysis in academic research, emphasizing their response to direct inquiries. Through a targeted keyword search, we cataloged relevant AI tools and evaluated their output variation and source validity. Our results reveal a spectrum of response qualities, with some tools integrating non-academic sources and others depending on outdated information. Notably, most tools showed a lack of transparency in source selection. Our study highlights two key limitations: the exclusion of commercial AI tools and the focus solely on tools that accept direct research queries. This raises questions about the potential capabilities of paid tools and the efficacy of combining various AI tools for enhanced research outcomes. Future research should explore the integration of diverse AI tools, assess the impact of commercial tools, and investigate the algorithms behind response variability. This study contributes to a better understanding of AI's role in academic research, emphasizing the importance of careful selection and critical evaluation of these tools in academic endeavors. [ABSTRACT FROM AUTHOR]

Secondary use of clinical health data implies a prior integration of mostly heterogenous and multidimensional data sets. A clinical data warehouse addresses the technological and organizational framework conditions required for this, by making any data available for analysis. However, users of a data warehouse often do not have a comprehensive overview of all available data and only know about their own data in their own systems - a situation which is also referred to as 'data siloed state'. This problem can be addressed and ultimately solved by implementation of a data catalog. Its core function is a search engine, which allows for searching the metadata collected from different data sources and thereby accessing all data there is. With this in mind, we conducted an explorative online market survey followed by vendor comparison as a pre-requisite for system selection of a data catalog. Assessment of vendor performance was based on seven predetermined and weighted selection criteria. Although three vendors achieved the highest score, results were lying closely together. Detailed investigations and test installations are needed for further narrowing down the selection process. [ABSTRACT FROM AUTHOR]

Background: The integration of Information Technology (IT) into private medical practice is crucial in modern healthcare. Physicians managing office-related IT without proper knowledge risk operational inefficiencies and security. Objectives: This study determines the relevance of specific IT topics in medical practice and identifies the training needs of physicians for enhancing IT competencies in healthcare. Methods: In March 2023 a cross-sectional online survey was conducted with physicians comprising nine IT-related topics in Tyrol, Austria. Results: The survey results highlighted a strong perceived relevance and high demand for IT education among physicians working in their medical practice, especially in areas of core medical IT and security. The majority of responses indicated high relevance (76.7%) and high demand (69.7%) for IT topics in medical practice. Conclusion: The findings underscore a significant need for targeted IT training and support in medical practices, particularly in areas related to the medical practice and security. Addressing these needs could lead to improved healthcare delivery and better management of technological resources in the healthcare sector. [ABSTRACT FROM AUTHOR]

Die Digitalisierung im Gesundheitswesen erfordert eine kontinuierliche Weiterqualifikation der betroffenen Berufsgruppen. Die Universität UMIT hat daher 2017 einen online-gestützten, postgraduellen Universitätslehrgang gestartet. Beim didaktischen Design lag ein Schwerpunkt auf der Flexibilität des Lernens, um so den Anforderungen der berufstätigen Teilnehmer/innen besonders zu entsprechen. Dabei wurde neben Flexibilität von Ort und Zeit des Lernens auch Flexibilität z. B. beim Setzen eigener Lernziele und bei Lerninhalten ermöglicht. Wir stellen das gewählte didaktische Design vor und beleuchten auf Basis einer Analyse von Log-Daten, studentischer Evaluationen sowie studentischer Reflexionen die Akzeptanz sowie die Herausforderungen des flexiblen Lernens aus Sicht der Lernenden.

Background and Aims Endoreduplication, the duplication of the nuclear genome without mitosis, is a common process in plants, especially in angiosperms and mosses. Accumulating evidence supports the relationship between endoreduplication and plastic responses to stress factors. Here, we investigated the level of endoreduplication in Ceratodon (Bryophyta), which includes the model organism Ceratodon purpureus. Methods We used flow cytometry to estimate the DNA content of 294 samples from 67 localities and found three well-defined cytotypes, two haploids and one diploid, the haploids corresponding to C. purpureus and Ceratodon amazonum , and the diploid to Ceratodon conicus , recombination occurring between the former two. Key Results The endoreduplication index (EI) was significantly different for each cytotype, being higher in the two haploids. In addition, the EI of the haploids was higher during the hot and dry periods typical of the Mediterranean summer than during spring, whereas the EI of the diploid cytotype did not differ between seasons. Conclusions Endopolyploidy may be essential in haploid mosses to buffer periods of drought and to respond rapidly to desiccation events. Our results also suggest that the EI is closely related to the basic ploidy level, but less so to the nuclear DNA content as previously suggested. [ABSTRACT FROM AUTHOR]

The growing use of technology for mathematics in higher education opens new pedagogical and technological challenges for teachers. The objective of this study was to analyze the teaching approaches and technology-related pedagogical competencies of 29 mathematics teachers (15 females and 14 males) from nine European countries. After conducting semi-structured interviews, the Approaches to Teaching Inventory (ATI-16) and the Technological Pedagogical Content Knowledge (TPACK) framework survey were applied. The results show large individual variations in teaching approaches, technological competencies, and institutional support. One-third of teachers apply a more student-centered approach, one-third a more teacher-centered approach, and one-third a mixed approach. Educating and supporting teachers in embracing educational technologies thus needs to be tailored strongly to individual needs and the available institutional support resources and infrastructure.

Lernen als konstruktiver und sozialer Prozess funktioniert am besten in Interaktion mit anderen Personen. Insbesondere in online-basierten Lernsettings sind Interaktion und Kooperation der Studierenden ein wichtiger Faktor für erfolgreiches Lernen. In dieser Arbeit schlagen wir zunächst Indikatoren für das Monitoring der Aktivität und Interaktivität von Studierenden sowie Lehrenden in kooperativen online-basierten Lernsettings vor. In einer Fallstudie werden die Indikatoren dann am Beispiel von drei Online-Kursen eingesetzt. Die Ergebnisse zeigen, dass die Indikatoren wichtige Aufschlüsse über die Aktivität und Interaktivität der Studierenden liefern können. Ergänzt um Daten zur Arbeitsbelastung, um Prüfungsergebnisse und um Lehrevaluierungen können auch Aussagen zur Qualität der Lernprozesse und zum Lernerfolg gemacht werden.

Introduction: After six years of medication errors' (MEs) collection and analysis in a pediatric unit of a French University Hospital, the number of MEs was no longer decreasing. We then decided to set up pharmaceutical training and tools and evaluate their impact on the occurrence of ME. Materials and methods: This monocentric prospective study was carried out in the form of audits of prescriptions, preparations, and administrations before and after intervention (A1 and A2). After the analysis of A1 results, feedback was given to the teams, some tools for the proper use of medication (PUM) were distributed, and A2 was conducted. Finally, A1 and A2 results were compared. Results: Each audit included 202 observations. A total of 120 MEs were identified during A1 and 54 for A2 (p < 0.0001). The observation rate with at least 1 ME decreased from 39.11% to 21.29% (p < 0.0001), and no observation had more than two MEs during A2 in contrast to A1 (n = 12). Human factors were responsible for the majority of MEs. The audit feedback allowed professionals to feel concerned about ME. The PUM tools received an average satisfaction rating of 9/10. The staff had never participated in this type of training, and all felt it was useful to apply PUM. Conclusion: This study showed a significant impact of pharmaceutical training and tools on the pediatric PUM. Clinical pharmaceutic actions allowed us to reach our objectives and satisfied all the staff. They must, therefore, be continued to limit human factors' impact and thus contribute to the safety of drug management in pediatrics. [ABSTRACT FROM AUTHOR]

Background: Worldwide vaccination campaigns significantly reduced mortality caused by SARS-CoV-2 infection and diminished the devastating effects of the pandemic. The first approved vaccines are based on novel mRNA technology and elicit potent immune responses offering high levels of protection from severe disease. Methods: Here we longitudinally assessed adaptive immune responses during a 12-month follow-up period after the initial immunization with 2 doses of mRNA vaccines and after the booster dose in blood and saliva. Results: Our findings demonstrate a rapid waning of the anti-spike IgG titers between months 3 and 6 after the initial vaccination (1.7- and 2.5-fold decrease in plasma and saliva, respectively; P<0.0001). Conversely, the frequency of spikespecific memory B cells increased during this period (2.4-fold increase; P<0.0001) while the frequency of spike-specific CD4+ and CD8+ T cells remained stable for all assessed functions: cytotoxicity, IFNγ, IL-2, and TNFα expression. Booster vaccination significantly improved the antibody response in plasma and saliva, with the most profound changes observed in the neutralization capacity against the currently circulating omicron variant (25.6-fold increase; P<0.0001). The positive effect of booster vaccination was also evident for spike-specific IgG+ memory B cell (2.4-fold increase; P<0.0001) and cytotoxic CD4+ and CD8+ T cell responses (1.7- and 1.9-fold increase respectively; P<0.05). Conclusions: Collectively, our findings offer a detailed insight into the kinetics of adaptive immune response following SARS-CoV-2 vaccination and underline the beneficial effects of a booster vaccination. [ABSTRACT FROM AUTHOR]

The Clinical Information Systems (CIS) section of the IMIA Yearbook of Medical Informatics systematically screens about 2,500 publications from more than 1,000 journals annually to find the best CIS publications. The editors of the CIS section have noticed a trend toward patient-centered care supported by AI and machine learning and increased research in cross-institutional data sharing, particularly in telemedicine. As a result, they adjusted their search query to include the MeSH term "telemedicine." As a preliminary step and to get a sense of the historical development of telemedicine research activity, they performed a bibliometric analysis of all previously published papers in PubMed indexed with the tag "Telemedicine" as MeSH Major Topic. They retrieved 29,289 publications from 1976 to 2022 and used their titles and abstracts to create a bibliometric network that visualizes the most relevant terms, their frequency and relationship to each other, and the chronological sequence of their publication. The development over time also shows a clear move toward patient-centeredness. Interestingly, the term "Covid," which has only recently come into use, takes on a central role in the network. [ABSTRACT FROM AUTHOR]

Data-driven decision-making in health care is becoming increasingly important in daily clinical use. A data warehouse, storing all the clinically relevant information in a highly structured way, is a primary basis for achieving this goal. We are developing a clinical data warehouse where more than 20 years of clinical data can be persisted, and newly generated data from different sources can be integrated. A back room was created to store all hospital information system data in a PostgreSQL database. Due to the enormous number of diverse forms in the hospital information system, a broker service was developed that integrates the individual data sources into the data warehouse as soon as they are released for storage. The front room represents the interface from the infrastructure to the targeted analysis. Database query and visualization tools or business intelligence tools can display and analyze processed and interleaved data. In all areas of business and medicine, structured and quality-adjusted data is of major importance. With the help of a clinical data warehouse system, it is possible to perform patient-centered analyses and thus realize optimal therapy. Furthermore, it is possible to provide staff and management with dashboards for control purposes. [ABSTRACT FROM AUTHOR]

Background: Dashboards provide a good retrospective view of the development of the disease. Yet, current COVID-related dashboards typically lack the capability to predict future trends. However, this is important for health policy makers and health care providers in order to adopt meaningful containment strategies. Objectives: The aim of this paper is to present the Surviral dashboard, which allows the effective monitoring of infectious disease dynamics. Methods: The presented dashboard comprises a wide range of information, including retrospective and prognostic data based on an agent-based simulation framework. It served as the basis for informed decision-making and planning of disease control strategies within the federal state of Tyrol. Results: By visualizing the information in an understandable format, the dashboard provided a comprehensive overview of the COVID-19 situation in Tyrol and allowed for the identification of trends and patterns. Conclusion: The presented dashboard is a valuable tool for managing pandemics such as COVID-19. It provides a convenient and efficient way to monitor the spread of a disease and identify potential areas for intervention. [ABSTRACT FROM AUTHOR]