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Real-world data are crucial to continuously improve the management of patients with rheumatic and musculoskeletal diseases (RMDs). The German RheumaDatenRhePort (RHADAR) registry encompasses a network of rheumatologists and researchers in Germany providing pseudonymized real-world patient data and allowing timely and continuous improvement in the care of RMD patients. The RHADAR modules allow automated anamnesis and adaptive coordination of appointments regarding individual urgency levels. Further modules focus on the collection and integration of electronic patient-reported outcomes in between consultations. The digital RHADAR modules ultimately allow a patient-centered adaptive approach to integrated medical care starting as early as possible in the disease course. Such a closed-loop system consisting of various modules along the whole patient pathway enables comprehensive and timely patient management in an unprecedented manner.

BackgroundInfectious conjunctivitis is contagious and may lead to an outbreak. Prevention systems can help to avoid an outbreak. ObjectiveWe aimed to evaluate if Google search data on conjunctivitis and associated terms can be used to estimate the incidence and if the data can provide an estimation for outbreaks. MethodsWe obtained Google search data over 4 years for the German term for conjunctivitis (“Bindehautentzündung”) and 714 associated terms in 12 selected German cities and Germany as a whole using the Google AdWords Keyword Planner. The search volume from Freiburg was correlated with clinical data from the Freiburg emergency practice (Eye Center University of Freiburg). ResultsThe search volume for the German term for conjunctivitis in Germany as a whole and in the 12 German cities showed a highly uniform seasonal pattern. Cross-correlation between the temporal search frequencies in Germany as a whole and the 12 selected cities was high without any lag. Cross-correlation of the search volume in Freiburg with the frequency of conjunctivitis (International Statistical Classification of Diseases and Related Health Problems [ICD] code group “H10.-”) from the centralized ophthalmologic emergency practice in Freiburg revealed a considerable temporal association, with the emergency practice lagging behind the frequency. Additionally, Pearson correlation between the count of patients per month and the count of searches per month in Freiburg was statistically significant (P=.04). ConclusionsWe observed a close correlation between the Google search volume for the signs and symptoms of conjunctivitis and the frequency of patients with a congruent diagnosis in the Freiburg region. Regional deviations from the nationwide average search volume may therefore indicate a regional outbreak of infectious conjunctivitis.

BackgroundBorreliosis is the most frequently transmitted tick-borne disease in Europe. It is difficult to estimate the incidence of tick bites and associated diseases in the German population due to the lack of an obligation to register across all 16 federal states of Germany. ObjectiveThe aim of this study is to show that Google data can be used to generate general trends of infectious diseases on the basis of borreliosis and tick bites. In addition, the possibility of using Google AdWord data to estimate incidences of infectious diseases, where there is inconsistency in the obligation to notify authorities, is investigated with the perspective to facilitate public health studies. MethodsGoogle AdWords Keyword Planner was used to identify search terms related to ticks and borreliosis in Germany from January 2015 to December 2018. The search volume data from the identified search terms was assessed using Excel version 15.23. In addition, SPSS version 24.0 was used to calculate the correlation between search volumes, registered cases, and temperature. ResultsA total of 1999 tick-related and 542 borreliosis-related search terms were identified, with a total of 209,679,640 Google searches in all 16 German federal states in the period under review. The analysis showed a high correlation between temperature and borreliosis (r=0.88), and temperature and tick bite (r=0.83), and a very high correlation between borreliosis and tick bite (r=0.94). Furthermore, a high to very high correlation between Google searches and registered cases in each federal state was observed (Brandenburg r=0.80, Mecklenburg-West Pomerania r= 0.77, Saxony r= 0.74, and Saxony-Anhalt r=0.90; all P

Single-case design (SCD) is a quantitative experimental technique in which participants serve as their own control. The use of an effect size in SCD allows evaluation of outcomes as well as comparison of outcomes via meta-analyses. Characteristics of SCD research make the selection of an appropriate effect size complicated. Additionally, there are a number of factors that complicate the use of SCDs as a means to improve academic skills. The purpose of this study was to examine patterns by which SCD effect sizes are used to quantify outcomes from academic interventions. To do so, a descriptive analysis of an extant database of SCD studies was conducted. The authors created frequency tables for each effect size identified in the database as well as graphs to show the extent to which the use of effect sizes changed over time. The authors also determined whether the most frequently used effect sizes were appropriate for summarizing changes in academic outcomes. Although many effect sizes have been developed, only a small number are routinely used in SCD research for academic skills. The most frequently used effect sizes were those that come from standardized statistics, compared with those that utilized principles of regression or Bayesian analysis.

Female faculty remain a minority in academic research and women are often perceived to lack the qualities needed to be successful scientists, which may contribute to discrimination and prejudice against female researchers. Research administrators play a pivotal role in the development of strategic, catalytic, and capacity-building activities designed to encourage faculty in attracting extramural research funding. The purpose of this investigation was to explore whether research administrators evaluate extramural grant applicants differently based on gender and different career ranks. Contrary to previous research examining faculty gender biases and stereotypes, our study showed that applicants were rated similarly in researcher competence across both male and female applicants by research administrators (Hypothesis 1). Our research also showed that female candidates were generally seen as more likeable (researcher collegiality) and were rated higher for mentoring potential than male candidates (Hypothesis 2). Furthermore, consistent with prior research, findings suggest that those in the senior career rank were more highly rated for research competence and skill (Hypothesis 3). Although we did not list a formal hypothesis, our findings did support the notion that senior career rank applicants are more highly rated for biosketch design and comprehension, most likely due to their perceived competence and advanced experience. These findings, while preliminary, suggest that traditional barriers related to perceived female researcher competence are not experienced as they interact with research administrators. The main implication of this study is that research administrators do not appear to significantly contribute to the previously reported discrimination and prejudice against the competence of female researchers.

Background: Human-animal interactions in human services are on the rise, with an increased focus on the welfare of animals involved as well as on client safety. Based on scientifically based training methods, it has been proposed that horses involved in therapy settings could benefit from learning proactive strategies to reduce stress. One possible strategy is audible exhale communication (AEC). Inviting horses to actively use this strategy with humans could enhance the welfare of horses in equine-assisted therapy (EAT), thereby increasing client safety., Methods: A pilot project was conducted to test the feasibility of training 20 therapy horses to use AEC as a veto signal for an activity, while therapists responded to the signals. The number of audible exhales from the horses was compared between the initial and final training sessions. Furthermore, we tested whether age, years of training experience, and therapy experience served as moderating variables for the outcome. Additionally, qualitative observations were made by therapists working with the horses., Results: It has become apparent that training the horses to use AEC was successful. After 6 months of training, the horses showed a significantly higher number of audible exhales than in the initial training session, with a large effect size. Neither age nor years of training or therapy experience was found to be a moderating variable. The horses were eagerly engaged with newly acquired tools. These showed fewer indications of stress, greater sense of relaxation, and more positive emotions., Conclusion: Based on the findings of this pilot study, training horses to use AEC might be a feasible approach to reduce stress in horses working in therapeutic settings, increase client safety, enhance human-animal relationships, and open up new possibilities for improving the therapeutic process. This method is applicable to all horses, regardless of their age, training level, or experience in therapy. For future research, it would be interesting to replicate and extend the approach by addressing the aforementioned limitations and using a randomized controlled design to investigate the introduction and impact of AEC in a therapeutic setting and to gain more comprehensive insights.

Abstract Background During the coronavirus disease 2019 (COVID-19) pandemic, inpatient nurses faced various work stressors. Little is known about organizational interventions that can mitigate the negative consequences of pandemic-related stressors. Objective The aim was to provide a synopsis of the literature concerning the types and outcomes of organizational interventions performed during the COVID-19 pandemic that directly (re)organized the work structures of inpatient nurses to address pandemic-related work stressors or to increase nurses’ ability to cope. Methods Within this preregistered systematic literature review, we searched four databases (PubMed, PsycINFO, PsycARTICLES, CINAHL) and two preprint databases (MedRxiv, PsyArXiv) for interventional studies of organizational interventions published between 01/2020 and 03/2023 (k = 990 records). We included 12 primary studies after title-abstract and full-text screening. A synthesis of results without meta-analysis was conducted. Risk of bias was assessed with the Cochrane risk-of-bias tool for randomized trials – version 2 (RoB-2) and Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool. Results All interventions were implemented in hospitals. The reasons given for implementation included pandemic-related work stressors such as a high workload, understaffing, and a lack of medical resources. To respond to the various work stressors, half of the studies took a multilevel approach combining organizational and person-oriented interventions (k = 6). Most studies (k = 8) took a secondary prevention approach, focusing on the organization of rest breaks (k = 5). With respect to outcomes, the studies examined nurse-related stress and resilience, turnover intention, job satisfaction, and other factors. Risk-of-bias analyses revealed that conclusions about the effectiveness of the interventions are limited due to confounding factors and self-selection. Conclusions The identified interventions provide a basis for future research to draw conclusions on the effectiveness of organizational interventions during pandemics. The promotion of adequate work breaks could be useful if the work stressors associated with strain and negative consequences cannot be changed directly. However, the same stressors (e.g., high workload) can hinder nurses from participating in offered interventions. This emphasizes the importance of directly addressing inpatient nurses’ work stressors. Registration Prospero-ID CRD42023364807 (March 2023).

Abstract Background Since skin cancer incidence and prevalence are rising steadily, the prevention of skin cancer has gained importance. People with high sun exposure at work are at special risk, and prevention measures by the employer may lower the risk, especially for keratinocyte carcinoma. Objectives The aim of the study was to evaluate the results of a large‐scale skin cancer screening campaign at the city drainage company Munich where the cohort consisted mainly of outdoor workers. Methods In 2023, a skin cancer screening campaign was conducted at the city drainage company Munich. Sun exposure and protection measures of each participant were assessed using a questionnaire. Dermatologists identified clinical signs for sun damage and skin cancer by whole‐body skin examination. Results A total of 290 participants (72.8% male; mean age 43.7 ± 11.5 years) were enroled. 36.6% showed clinical signs of sun damage correlating with male gender, higher age, and more hours spent outdoors per day. Clinical examination revealed a suspect finding of skin cancer, a preliminary stage, or a lesion requiring clinical control to avoid skin cancer development in 19.3% of participants. Participants with atypical melanocytic lesions were mostly female and showed a high skin cancer awareness. This was concluded from the fewer signs of sun damage, a higher percentage of previous screening participation, and more regular self‐examination. Conclusions Whole‐body examination for skin cancer screening at work is a valuable tool to encourage participation in this preventive measure. It may help identify people at risk either by clinical signs for sun damage or risk exposure which can be assessed with a simple questionnaire. Based on this result, the screening interval may be adopted individually.

The global burden of skin diseases affects over 3 billion individuals, posing important public health challenges worldwide, with profound impacts in both high-income and low-income and middle-income countries. These challenges are exacerbated by widespread disparities in access to dermatologic care and the prevalence of misinformation. This article, derived from the Skin and Digital Summit at the International Master Course on Aging Science critically evaluates how digital technologies such as artificial intelligence, teledermatology, and large language models can bridge these access gaps. It explores practical applications and case studies demonstrating the impact of these technologies in various settings, with a particular focus on adapting solutions to meet the diverse needs of low-income and middle-income countries. In addition, the narrative highlights the ongoing conversation within the dermatologic community about the role of digital advances in health care, emphasizing that this discussion is dynamic and the one that is continuously evolving. Dermatologists play an essential role in this transition, integrating digital tools into mainstream care to complement a patient-centered, culturally sensitive approach. The article advocates for a globally coordinated digital response that not only addresses current disparities in skin health care but also promotes equitable access to digital health resources, making dermatologic care more representative of all skin types and accessible worldwide.

Abstract This exploratory qualitative study aims to gain a people-centered understanding of the patient journey in axial spondyloarthritis (axSpA). Semi-structured interviews were conducted with 15 individuals diagnosed with axSpA, aged 18 years and older, who were purposively recruited from a rheumatologic practice in southern Germany. The interviews were carried out as web-based video calls between September and October 2021, audio-recorded, transcribed verbatim, and analyzed according to Kuckartz’s qualitative content analysis. Patient journey narratives encompassed both healthcare journeys and personal journeys. Healthcare journeys were characterized as fragmented and difficult to navigate, with diagnosis often marking a turning point toward more coordinated care. Post-diagnosis, new challenges emerged (e.g., time management for treatment). Personal journeys comprised perceptions of axSpA in social contexts (e.g., stigmatization) and the continuous interplay of comorbidities and biographical events with healthcare related to axSpA. This study proposes a people-centered perspective on the patient journey in axSpA, emphasizing the interplay of biographies, comorbidities, and social context with healthcare events. Recognizing these personal factors in clinical practice is encouraged to address complex health needs and tailor treatment to each individual. Further efforts should promote collaboration between medical disciplines and integrate healthcare and social support at all stages of the axSpA patient journey.

Abstract Web search data are associated with disease incidence, population interest, and seasonal variations. This study aimed to investigate seasonal and geographical variations of web search data for sarcoidosis and to explore its association with external factors and sarcoidosis incidence in Sweden. Therefore, sarcoidosis-related data from Google Ads Keyword Planer (2017–2020) were generated for Sweden according to its 21 counties. The relationship between search volume and season, region, population demographics, environmental factors, and the sarcoidosis incidence listed in the National Patient Register was assessed. Analyses revealed seasonal variations for Sweden with an overall peak in the spring and autumn. Geographical differences were observed, with a higher search volume for north-western counties and the lowest search volume for Stockholm County. At the country level, the search volume was positively associated with the sarcoidosis incidence. Higher male proportion and older mean age were associated with a higher search volume, while a higher proportion of foreign-born residents, humidity, and mean temperature were associated with a lower search volume. Our analyses detected correlations between web search data, sarcoidosis incidence, and external factors. Analyses of sarcoidosis web search data therefore appear to be a valuable approach to disease surveillance to address medical needs and public interest.

Silje Zink,1,2 Ingvild Kjeken,1,2 Marte Feiring1,2 1Diakonhjemmet Hospital, REMEDY Center for Treatment of Rheumatic and Musculoskeletal Diseases, Health Service Research and Innovation Unit, Oslo, Norway; 2Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, NorwayCorrespondence: Silje Zink, Diakonhjemmet Hospital, REMEDY Center for Treatment of Rheumatic and Musculoskeletal Diseases, Health Service Research and Innovation Unit, Postboks 23 Vinderen, Oslo, 0319, Norway, Email silje.zink@diakonsyk.noPurpose: The pressure on professionals within the healthcare workforce is increasing due to staffing shortages, economic demands and changing care models. Through boundary work theories, our study explores how task-shifting in hand osteoarthritis (OA) care impacts the professional boundaries and division of labor between rheumatologists and occupational therapists (OTs) in Norwegian specialist healthcare.Methodology: Seventeen semi-structured qualitative interviews were conducted at two hospitals in Norway. Participants included ten rheumatologists and five OTs. Data were analyzed using reflexive thematic analysis.Results: The analysis resulted in three themes (1) Forms of responsibility and task transfers, (2) Circumventing the rules to ensure efficient practices and appropriate patient care, (3) Broadening and specializing; movement of professional demarcations. Overall, we found that medical tasks in hand OA care are increasingly delegated to, and adopted by, OTs, blurring the rheumatologist-OT boundary. Some of the task delegations skirted Norwegian legal boundaries, in efforts to streamline clinic operations. OTs expanded their scope of practice by adopting new tasks, whereas rheumatologist increased their specialist status by shedding unwanted tasks.Conclusion: Task shifting between rheumatologists and OTs in hand OA care was characterized by boundary blurring activities. The results support a shift in hand OA management from rheumatologists to OTs.Keywords: professional boundaries, boundary work, interprofessional collaboration, hand osteoarthritis

Abstract Background Peptide receptor radionuclide therapy (PRRT) uses [177Lu]Lu-[DOTA0-Tyr3]octreotate ([177Lu]Lu-DOTA-TATE) to treat patients with neuroendocrine tumours (NETs) overexpressing the somatostatin receptor 2A (SSTR2A). It has shown significant short-term improvements in survival and symptom alleviation, but there remains room for improvement. Here, we investigated whether combining [177Lu]Lu-DOTA-TATE with chemotherapeutics enhanced the in vitro therapeutic efficacy of [177Lu]Lu-DOTA-TATE. Results Transfected human osteosarcoma (U2OS + SSTR2A, high SSTR2A expression) and pancreatic NET (BON1 + STTR2A, medium SSTR2A expression) cells were subjected to hydroxyurea, gemcitabine or triapine for 24 h at 37oC and 5% CO2. Cells were then recovered for 4 h prior to a 24-hour incubation with 0.7–1.03 MBq [177Lu]Lu-DOTA-TATE (25 nM) for uptake and metabolic viability studies. Incubation of U2OS + SSTR2A cells with hydroxyurea, gemcitabine, and triapine enhanced uptake of [177Lu]Lu-DOTA-TATE from 0.2 ± 0.1 in untreated cells to 0.4 ± 0.1, 1.1 ± 0.2, and 0.9 ± 0.2 Bq/cell in U2OS + SSTR2A cells, respectively. Cell viability post treatment with [177Lu]Lu-DOTA-TATE in cells pre-treated with chemotherapeutics was decreased compared to cells treated with [177Lu]Lu-DOTA-TATE monotherapy. For example, the viability of U2OS + SSTR2A cells incubated with [177Lu]Lu-DOTA-TATE decreased from 59.5 ± 22.3% to 18.8 ± 5.2% when pre-treated with hydroxyurea. Control conditions showed no reduced metabolic viability. Cells were also harvested to assess cell cycle progression, SSTR2A expression, and cell size by flow cytometry. Chemotherapeutics increased SSTR2A expression and cell size in U2OS + SSTR2A and BON1 + STTR2A cells. The S-phase sub-population of asynchronous U2OS + SSTR2A cell cultures was increased from 45.5 ± 3.3% to 84.8 ± 2.5%, 85.9 ± 1.9%, and 86.6 ± 2.2% when treated with hydroxyurea, gemcitabine, and triapine, respectively. Conclusions Hydroxyurea, gemcitabine and triapine all increased cell size, SSTR2A expression, and [177Lu]Lu-DOTA-TATE uptake, whilst reducing cell metabolic viability in U2OS + SSTR2A cells when compared to [177Lu]Lu-DOTA-TATE monotherapy. Further investigations could transform patient care and positively increase outcomes for patients treated with [177Lu]Lu-DOTA-TATE.

Abstract In recent years, the gauge group U 1 L μ − L τ $$ \textrm{U}{(1)}_{L_{\mu }-{L}_{\tau }} $$ has received a lot of attention since it can, in principle, account for the observed excess in the anomalous muon magnetic moment (g − 2) μ , as well as the Hubble tension. Due to unavoidable, loop-induced kinetic mixing with the SM photon and Z, the U 1 L μ − L τ $$ \textrm{U}{(1)}_{L_{\mu }-{L}_{\tau }} $$ gauge boson A ′ can contribute to stellar cooling via decays into neutrinos. In this work, we perform for the first time an ab initio computation of the neutrino emissivities of white dwarf stars due to plasmon decay in a model of gauged U 1 L μ − L τ $$ \textrm{U}{(1)}_{L_{\mu }-{L}_{\tau }} $$ . A key result is that current observations of the early-stage white dwarf neutrino luminosity at the 30% level exclude previously allowed regions of the parameter space favoured by a simultaneous explanation of the (g – 2) μ and H 0 anomalies. In this work, we present the relevant white dwarf cooling limits over the entire A ′ mass range. In particular, we have performed a rigorous computation of the luminosities in the resonant regime, where the A ′ mass is comparable to the white dwarf plasma frequencies.

Abstract Mortality of patients hospitalized with COVID-19 has remained high during the consecutive SARS-CoV-2 pandemic waves. Early discrimination of patients at high mortality risk is crucial for optimal patient care. Symmetric (SDMA) and asymmetric dimethylarginine (ADMA) have been proposed as possible biomarkers to improve risk prediction of COVID-19 patients. We measured SDMA, ADMA, and other L-arginine-related metabolites in 180 patients admitted with COVID-19 in four German university hospitals as compared to 127 healthy controls. Patients were treated according to accepted clinical guidelines and followed-up until death or hospital discharge. Classical inflammatory markers (leukocytes, CRP, PCT), renal function (eGFR), and clinical scores (SOFA) were taken from hospital records. In a small subgroup of 23 COVID-19 patients, sequential blood samples were available and analyzed for biomarker trends over time until 14 days after admission. Patients had significantly elevated SDMA, ADMA, and L-ornithine and lower L-citrulline concentrations than controls. Within COVID-19 patients, SDMA and ADMA were significantly higher in non-survivors (n = 41, 22.8%) than in survivors. In ROC analysis, the optimal cut-off to discriminate non-survivors from survivors was 0.579 µmol/L for SDMA and 0.599 µmol/L for ADMA (both p

Abstract Cornaux/Les Sauges (Switzerland, Late Iron Age) revealed remnants of a wooden bridge, artifacts, and human and animal skeletal remains. The relationship between the collapsed structure and the skeletal material, whether it indicates a potential accident or cultural practices, remains elusive. We evaluate the most plausible scenario for Cornaux based on osteological, taphonomic, isotopic, and paleogenomic analysis of the recovered individuals. The latter amount to at least 20 individuals, mostly adult males. Perimortem lesions include only blunt force traumas. Radiocarbon data fall between the 3rd and 1st c. BCE, although in some cases predating available dendrochronological estimates from the bridge. Isotopic data highlight five to eight nonlocals. No close genetic relatedness links the analyzed skeletons. Paleogenomic results, the first for Iron Age Switzerland, point to a genetic affinity with other Central and Western European Iron Age groups. The type of skeletal lesions supports an accidental event as the more plausible explanation. Radiocarbon data and the demographic structure of the sample may suggest a sequence of different events possibly including executions and/or sacrifices. Isotopic and paleogenomic data, while not favoring one scenario over the other, do support earlier interpretations of the last centuries BCE in Europe as a dynamic period from a biocultural perspective.

Abstract Background Systematically screening published literature to determine the relevant publications to synthesize in a review is a time-consuming and difficult task. Large language models (LLMs) are an emerging technology with promising capabilities for the automation of language-related tasks that may be useful for such a purpose. Methods LLMs were used as part of an automated system to evaluate the relevance of publications to a certain topic based on defined criteria and based on the title and abstract of each publication. A Python script was created to generate structured prompts consisting of text strings for instruction, title, abstract, and relevant criteria to be provided to an LLM. The relevance of a publication was evaluated by the LLM on a Likert scale (low relevance to high relevance). By specifying a threshold, different classifiers for inclusion/exclusion of publications could then be defined. The approach was used with four different openly available LLMs on ten published data sets of biomedical literature reviews and on a newly human-created data set for a hypothetical new systematic literature review. Results The performance of the classifiers varied depending on the LLM being used and on the data set analyzed. Regarding sensitivity/specificity, the classifiers yielded 94.48%/31.78% for the FlanT5 model, 97.58%/19.12% for the OpenHermes-NeuralChat model, 81.93%/75.19% for the Mixtral model and 97.58%/38.34% for the Platypus 2 model on the ten published data sets. The same classifiers yielded 100% sensitivity at a specificity of 12.58%, 4.54%, 62.47%, and 24.74% on the newly created data set. Changing the standard settings of the approach (minor adaption of instruction prompt and/or changing the range of the Likert scale from 1–5 to 1–10) had a considerable impact on the performance. Conclusions LLMs can be used to evaluate the relevance of scientific publications to a certain review topic and classifiers based on such an approach show some promising results. To date, little is known about how well such systems would perform if used prospectively when conducting systematic literature reviews and what further implications this might have. However, it is likely that in the future researchers will increasingly use LLMs for evaluating and classifying scientific publications.

Protein kinase C-iota (PKC-ι) is an oncogene overexpressed in many cancer cells including prostate, breast, ovarian, melanoma, and glioma cells. Previous in vitro studies have shown that 5-amino-1-((1R,2S,3R,4R)-2-3-dihydroxy-4-(hydroxymethyl)cyclopentyl)-1H-imidazole-4-carboxamide (ICA-1S), a PKC-ι-specific inhibitor, has low toxicity in both acute and sub-acute mouse model toxicological testing and is an effective therapeutic against several cancer cell lines showing significant reductions in tumor growth when treating athymic nude mice with xenografted carcinoma cell lines. To further assess ICA-1S as a possible therapeutic agent, chronic mouse model toxicological testing was performed in vivo to provide inferences concerning the long-term effects and possible health hazards from repeated exposure over a substantial part of the animal’s lifespan. Subjects survived well after 30, 60, and 90 days of doses ranging from 50 mg/kg to 100 mg/kg. Heart, liver, kidney, and brain tissues were then analyzed for accumulations of ICA-1S including the measured assessment of aspartate transaminase (AST), alkaline phosphatase (ALK-P), gamma-glutamyl transferase (GGT), troponin, and C-reactive protein (CRP) serum levels to assess organ function. Predictive in vitro/in silico methods were used to predict compound-induced direct hepatocyte toxicity or renal proximal tubular cell (PTC) toxicity in humans based on the high-content imaging (HCI) of compound-treated cells in combination with phenotypic profiling. In conclusion, ICA-1S shows low toxicity in both acute and chronic toxicology studies, and shows promise as a potential therapeutic.

Abstract Awareness is vital for cancer prevention. US studies show a strong link between web searches and cancer incidence. In Europe, the relationship remains unclear. This study characterizes regional and temporal relationships between cancer incidence and web searches and investigates the content of searches related to breast, cervical, colorectal, lung, prostate, and testicular cancer, brain tumors, and melanoma in Germany (July 2018–December 2019). Aggregate data from Google Ads Keyword Planner and national cancer registry data were analyzed. Spearman’s correlation coefficient (r S ) examined associations between cancer incidence and web search, repeated measures correlation (r rm ) assessed time trends and searches were qualitatively categorized. The frequency of malignancy-related web searches correlated with cancer incidence (r S = 0.88, P = 0.007), e.g., breast cancer had more queries than the lower-incidence cervical cancer. Seasonally, incidence and searches followed similar patterns, peaking in spring and fall, except for melanoma. Correlations between entity incidence and searches (0.037 ≤ r rm ≤ 0.208) varied regionally. Keywords mainly focused on diagnosis, symptoms, and general information, with variations between entities. In Germany, web searches correlated with regional and seasonal incidence, revealing differences between North/East and South/West. These insights may help improve prevention strategies by identifying regional needs and assessing impact of awareness campaigns.

The research administration profession is in a time of significant change. The traditional jack-of-all-trades role has become more fragmented into specialized advanced roles, with a more recent focus on research development. Workflows are increasingly becoming more electronically automated. The introduction of graduate degrees and professional certifications has introduced a new complexity within the office hierarchy. Moreover, recent global events have shifted the profession into a remote working environment, causing industry-wide voluntary employee turnover as employees consider new opportunities, work/ life balance, and cost of living ramifications. This qualitative study used semi-structured interviews to capture research administrators' experiences within four research questions: 1) how is a traditional research administration professional role defined today; 2) how does the chain of command respond to new professional roles; 3) how has the standardization of professional knowledge through education and certifications impacted the workforce; and 4) how does the distribution of tasks become fluid to get work done between the different research administration professionals? Practical implications of this research include understanding that traditional research administrator roles are flat with no hierarchy or room for professional growth within the individual or collective research offices. The creation of promotion opportunities in order to provide professionals a pathway to rise in ranks and achieve higher titles and commensurate wages is vital to the future success of the profession. Another practical implication of this research is the call to begin raising awareness of the professional certifications outside of the research administrative profession in order to gain further distinction and notoriety within the research landscape. The increased need for educational degrees, especially doctoral-level work, in order to gain academic reputation is restrictive to the future of the profession. The profession of Research Administration is in a time of rapid expansion. The aim of this study is to clarify the development of new professional roles in research administration. In doing so, this research maps the emerging extended professional roles and provides insight into the social and administrative processes that drive the development of these extended roles.

Background: The potential for promotion of intestinal colonization with healthcare-associated pathogens by new antibiotics used to treat infections due to multidrug-resistant Gram-negative bacilli is unclear. Methods: Mice treated for 3 days with daily subcutaneous phosphate-buffered saline (control), ceftazidime/avibactam, ceftolozane/tazobactam, ceftaroline, and meropenem/vaborbactam were challenged with 10,000 colony-forming units (CFU) of vancomycin-resistant Enterococcus (VRE) resistant to each of the antibioics or carbapenemase-producing Klebsiella pneumoniae 1 day after the final treatment dose. The concentrations of VRE or K. pneumoniae in stool were measured on days 1, 3, 6, and 15 after challenge. Results: Control mice had transient low levels of VRE or K. pneumoniae (8 log10 CFU/g of stool on day 1 after challenge) that persisted at >4 log10 CFU/g of stool through day 15 (P8 log10 CFU/g of stool) (P5 log10 CFU/g of stool), and ceftazidime/avibactam did not promote colonization (P>0.05). Conclusions: Our results suggest that several beta-lactam antibiotics recently developed for treatment of infections with resistant Gram-negative bacilli have the potential to promote colonization by healthcare-associated pathogens. Additional studies are needed to examine the impact of these agents in patients.

BackgroundThe integration of artificial intelligence and chatbot technology in health care has attracted significant attention due to its potential to improve patient care and streamline history-taking. As artificial intelligence–driven conversational agents, chatbots offer the opportunity to revolutionize history-taking, necessitating a comprehensive examination of their impact on medical practice. ObjectiveThis systematic review aims to assess the role, effectiveness, usability, and patient acceptance of chatbots in medical history–taking. It also examines potential challenges and future opportunities for integration into clinical practice. MethodsA systematic search included PubMed, Embase, MEDLINE (via Ovid), CENTRAL, Scopus, and Open Science and covered studies through July 2024. The inclusion and exclusion criteria for the studies reviewed were based on the PICOS (participants, interventions, comparators, outcomes, and study design) framework. The population included individuals using health care chatbots for medical history–taking. Interventions focused on chatbots designed to facilitate medical history–taking. The outcomes of interest were the feasibility, acceptance, and usability of chatbot-based medical history–taking. Studies not reporting on these outcomes were excluded. All study designs except conference papers were eligible for inclusion. Only English-language studies were considered. There were no specific restrictions on study duration. Key search terms included “chatbot*,” “conversational agent*,” “virtual assistant,” “artificial intelligence chatbot,” “medical history,” and “history-taking.” The quality of observational studies was classified using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) criteria (eg, sample size, design, data collection, and follow-up). The RoB 2 (Risk of Bias) tool assessed areas and the levels of bias in randomized controlled trials (RCTs). ResultsThe review included 15 observational studies and 3 RCTs and synthesized evidence from different medical fields and populations. Chatbots systematically collect information through targeted queries and data retrieval, improving patient engagement and satisfaction. The results show that chatbots have great potential for history-taking and that the efficiency and accessibility of the health care system can be improved by 24/7 automated data collection. Bias assessments revealed that of the 15 observational studies, 5 (33%) studies were of high quality, 5 (33%) studies were of moderate quality, and 5 (33%) studies were of low quality. Of the RCTs, 2 had a low risk of bias, while 1 had a high risk. ConclusionsThis systematic review provides critical insights into the potential benefits and challenges of using chatbots for medical history–taking. The included studies showed that chatbots can increase patient engagement, streamline data collection, and improve health care decision-making. For effective integration into clinical practice, it is crucial to design user-friendly interfaces, ensure robust data security, and maintain empathetic patient-physician interactions. Future research should focus on refining chatbot algorithms, improving their emotional intelligence, and extending their application to different health care settings to realize their full potential in modern medicine. Trial RegistrationPROSPERO CRD42023410312; www.crd.york.ac.uk/prospero

BackgroundPsoriasis is a chronic skin disorder with a high burden of disease. People affected with psoriasis increasingly use the internet for health-related reasons, especially those with younger age, higher education, and higher disease severity. Despite advantages such as enhancing the individuals’ knowledge with the use of digital media for health-related issues, disadvantages were also present such as quality control, and variability in the individuals’ health information literacy. While patients with psoriasis within medical settings generally trust physicians over digital media, they commonly withhold their web-based research findings from health care providers. ObjectiveThe study aims to (1) identify further factors associated with regular psoriasis-related internet use, (2) rank specific digital media platforms used, and (3) examine digital media within the physician-patient relationship among individuals with and without dermatological treatment. MethodsA cross-sectional, questionnaire-based study was conducted among individuals with self-reported psoriasis in Germany between September 2021 and February 2022. Participants were recruited via digital media platforms and in person at a University Hospital Department of Dermatology in southern Germany. The questionnaire asked about demographic and medical information, individual psoriasis-related digital media use, and the impact of digital media on the physician-patient relationship. Data were analyzed descriptively, and logistic regression models were performed to assess the factors associated with regular psoriasis-related internet use. ResultsAmong 321 individuals with a median age of 53 (IQR 41-61) years (nonnormally distributed; females: 195/321), female sex, shorter disease duration, moderate mental burden of disease, and good self-assessed psoriasis-related knowledge were associated with regular psoriasis-related internet use. Of the 188 participants with a mean age of 51.2 (SD 13.9) years (normally distributed) who used digital media 106 (56.4%) usually searched for information on psoriasis-based websites and 98 (52.1%) on search engines, primarily for obtaining information about the disease and therapy options, while social media were less frequently used (49/188, 26.1%). Nearly two-thirds of internet users (125/188) claimed that their physicians did not recommend digital media platforms. About 44% (82/188) of the individuals reported to seek for additional information due to the insufficient information provided by their physician. ConclusionsThis study revealed the importance of digital media in the context of psoriasis, especially among women, individuals with shorter disease duration, and moderate mental disease severity. The lack of physicians’ digital media recommendations despite their patients’ desire to receive such and being more involved in health-related decisions seems to be a shortcoming within the physician-patient relationships. Physicians should guide their patients on digital media by recommending platforms with evidence-based information, thereby potentially creating an adequate framework for shared decision-making. Future research should focus on strategies to prevent the spread of false information on digital media and address the needs of patients and physicians to enhance health-related digital media offerings.