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Mei Liu,1,* Sili Guo,1,* Xiaohan Li,1,* Yang Tian,1 Yanjie Yu,2 Lili Tang,1 Qimei Sun,1 Ting Zhang,1 Mingwei Fan,3 Lili Zhang,1 Yingjiang Xu,4 Jiajia An,5 Xiangqian Gao,6 Lei Han,7 Lei Zhang1 1Department of Endocrinology and Metabolism, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China; 2Department of Ultrasound Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China; 3Department of Gastroenterology, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China; 4Department of Interventional Vascular Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China; 5Department of Clinical Laboratory, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China; 6Department of Pathology, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China; 7Department of Reproductive Medicine, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lei Zhang, Department of Endocrinology and Metabolism, Binzhou Medical University Hospital, Binzhou, Shandong, People’s Republic of China, Email binzhouzhanglei@outlook.comBackground: GLP-1 receptor agonists (GLP-1 RA) have been proven to treat several metabolic diseases; however, the effects of GLP-1 RA on polycystic ovary syndrome (PCOS) remain unclear. Here, we aimed to investigate whether semaglutide, a novel GLP-1 RA, could alleviate ovarian inflammation in PCOS mice.Methods: Female C57BL/6J mice were subcutaneously injected with dehydroepiandrosterone for 21 days to establish the PCOS model. Then the mice were randomly divided into three groups: PCOS group (n = 6), S-0.42 group (semaglutide 0.42 mg/kg/w, n = 6), and S-0.84 group (semaglutide 0.84 mg/kg/w, n = 6). The remaining six mice were used as controls (NC). After 28 days of intervention, serum sex hormones and inflammatory cytokine levels were measured. Hematoxylin and eosin staining was used to observe the ovarian morphology. Immunohistochemical staining was used to detect the relative expression of CYP19A1, TNF-α, IL-6, IL-1β, and NF-κB in ovaries. CYP17A1 and StAR were detected using immunofluorescence staining. Finally, the relative expressions of AMPK, pAMPK, SIRT1, NF-κB, IκBα, pIκBα, TNF-α, IL-6, and IL-1β were measured using Western blotting.Results: First, after intervention with semaglutide, the weight of the mice decreased, insulin resistance improved, and the estrous cycle returned to normal. Serum testosterone and IL-1β levels decreased significantly, whereas estradiol and progestin levels increased significantly. Follicular cystic dilation significantly improved. The expression of TNF-α, IL-6, IL-1β, NF-κB, CYP17A1, and StAR in the ovary was significantly downregulated, whereas CYP19A1 expression was upregulated after the intervention. Finally, we confirmed that semaglutide alleviates ovarian tissue inflammation and improves PCOS through the AMPK/SIRT1/NF-κB signaling pathway.Conclusion: Semaglutide alleviates ovarian inflammation via the AMPK/SIRT1/NF‑κB signaling pathway in PCOS mice.Keywords: GLP-1 receptor agonist, polycystic ovary syndrome, semaglutide, inflammation

Wenyu Li,1 Yanqiu Hou,1 Jiayu An,1 Linxuan Chen,1 Shan Lu1,2 1School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, People’s Republic of ChinaCorrespondence: Shan Lu, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hang Kong Road 13, Wuhan, 430030, People’s Republic of China, Tel +86 15827079650, Email shanlu@hust.edu.cnPurpose: The objective of this study was to explore the connection between family doctor contract services and preventable hospitalizations. Additionally, we sought to examine the role of primary health care quality as a mediating factor in the link between family doctor contract services and preventable hospitalizations among patients with hypertension.Patients and Methods: This cross-sectional study was performed in Dangyang (Hubei Province, Central China) and Xishui (Guizhou Province, Western China) counties in July–August 2023. Participants comprised 625 patients selected via a multi-stage sampling method. Causal mediation analysis was conducted to explore the effect of family doctor contract services on preventable hospitalizations and the mediating effect of primary healthcare quality on this relationship.Results: Utilization rate of family doctor contract services of hypertensive patients was 58.6%, score of primary health service quality was 70.75 and incidence of preventable hospitalizations was 28.2%. Amongst hypertensive patients, utilization of family doctor contract services decreased the occurrence of preventable hospitalizations, with a total effect of − 0.22 (p < 0.001). Primary healthcare quality mediates the association, with a mediate effect of − 0.05 (p < 0.001), explaining 22.73% of the total effect.Conclusion: Improving the utilization of family doctor contract services and primary healthcare quality may result in lower rates of preventable hospitalizations amongst hypertensive patients.Keywords: family doctor contract services, preventable hospitalizations, primary healthcare quality, hypertension, mediation analysis

Haotian Chen, Juan Zhi, Lei Wang, Zibin Jin, Jin Xu, Fei Xing, Chao Wen, Qianyu Wang, Chunmei Chen, Weiou Li, Ermeng Xu, Jie An, Lingxin Wei Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of ChinaCorrespondence: Lingxin Wei, Department of Anesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, People’s Republic of China, Tel +86 010 85557917, Email weilx3934@sina.comPurpose: Esketamine have anesthetic and analgesic properties. This study aimed to observe the enhancing effect of subanesthetic doses of esketamine (0.15– 0.3 mg/kg/h) with dexmedetomidine and remifentanil during anesthesia for liposuction surgery.Patients and Methods: A total of 155 subjects were randomized with a 1:1 ratio to Group E (esketamine-dexmedetomidine/remifentanil, n=78) or Group C (saline-dexmedetomidine/remifentanil group, n=77). The primary outcome was satisfaction of patient and surgical team with the procedure. The secondary outcomes were the postoperative Athens Insomnia Scale (AIS) and Hospital Anxiety and Depression Scale (HADS) scores, hemodynamic and respiratory changes, drug consumption, adverse event rates, and predictors associated with patient satisfaction.Results: Patient and surgical team satisfaction with the procedure was significantly higher in Group E than in Group C (4.7 ± 0.6 vs 4.2 ± 0.7, P < 0.001; 4.7 ± 0.5 vs 4.4 ± 0.7, P = 0.005). The postoperative AIS (4 [1, 6] vs 5 [2, 9], P = 0.012) and HADS-A (1 [0, 3] vs 2 [0, 6], P = 0.012) scores were significantly lower in Group E than in Group C. Hemodynamic and respiratory parameters were more stable in Group E than in Group C, with the lower opioids consumption of sufentanil (0 [0, 4] vs 5 [2.5, 7.7], P < 0.001) and remifentanil (700 [480, 900] vs 800 [500, 1200], P = 0.023) in Group E compared to Group C. On ordinal logistics regression, postoperative sleep quality (OR, 0.70; 95% CI, 0.62– 0.79), anxiety level (OR, 0.77; 95% CI, 0.62– 0.95) and recovery time in post-anesthesia care unit (PACU) (OR, 0.69; 95% CI, 0.56– 0.98) were identified as significant predictors associated with patient satisfaction.Conclusion: A subanesthetic dose of esketamine (0.15– 0.3 mg/kg/h) as an adjuvant can improves the sedative and analgesic effects of dexmedetomidine and remifentanil during anesthesia for liposuction surgery.Clinical Trial Registration: ChiCTR2400080363.Keywords: esketamine, sedation, analgesia, satisfaction, liposuction

Minghua Li,1,&ast; Jiawei Gui,1,&ast; Hao Wang,2 Jun An,3 Ruoqing Wu,1 Xiaotong Liu,1 Bo Wu,1 Hui Xiao1 1Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, People’s Republic of China; 2Department of Otolaryngology-Head and Neck Surgery, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, 210019, People’s Republic of China; 3Department of Otolaryngology-Head and Neck Surgery, Xuzhou Central Hospital, Xuzhou, 221009, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hui Xiao, Email 13946129836@163.comBackground: Laryngeal cancer was one of the most common malignancies of the head in those years. It has become one of the most common causes of death due to its high recurrence rate and high metastasis rate. It was well known that platelets, especially activated platelets, promote the proliferation, division, and invasion of tumor cells. Activated platelets promote cancer progression and metastasis. However, the prognostic value of platelet aggregation function in laryngeal cancer remains poorly understood. The purpose of this study was to investigate the predictive significance of platelet aggregation function in laryngeal cancer.Materials and Methods: Between January 2015 and December 2016, we conducted a retrospective analysis of 203 patients who were diagnosed with laryngeal cancer consecutively. The patients were stratified by platelet aggregation function into two groups: low “adenosine diphosphate induced light transmittance aggregometry (ADP-induced LTA) ≤ 15.1” and high (ADP-induced LTA > 15.1). Pathological tissues from different parts of the operation were collected and the pathologist determined the pathological type. We assessed the prognostic significance of platelet aggregation function using Kaplan-Meier curves and Cox regression.Results: The low cohort had a significantly higher lymphocyte count than the high cohort. Compared with the high cohort, the low cohort had significantly lower levels of platelet-to-lymphocyte ratio (PLR), ADP-induced LTA, and Interleukins (IL)-6. The ADP-induced LTA (hazard ratio, 1.212; P < 0.001) was independently related with 5-year overall survival rate.Conclusion: Patients with ADP-induced LTA > 15.1 experience poor outcomes. Platelet aggregation function, when elevated, could be a new prognostic indicator for laryngeal cancer.Keywords: laryngeal carcinoma, platelet aggregation function, platelet-to-lymphocyte ratio, inflammation, overall survival rate

This article explores the nature, strengths and limitations of Roman, Christian, Kantian and utilitarian ethics and their legacy in some modern theories of educative leadership that are educative in intent and outcome. It is shown that Roman, Christian, Kantian, and utilitarian ethics have profoundly shaped transformational, instructional, distributed, and ethical leadership theories. Roman ethics emphasize civic duty, virtue, and community service, influencing leaders to inspire collective goals and improve educational outcomes. Christian ethics highlight love, compassion, and moral integrity, guiding leaders to act as ethical exemplars and nurture followers. Kantian ethics focus on duty, universal principles, and respect for individuals, promoting ethical consistency and dignity in leadership practices. Utilitarian ethics prioritize maximizing happiness and well-being, driving leaders to achieve positive changes and balance individual needs with the greater good. It concludes that these ethical foundations (a) continue to inform contemporary educative leadership practices and (b) underpin recent scholarship that has shown how Roman, Christian, Kantian, and utilitarian ethics can shape moral school leadership and ethical decision-making, offering school leaders a nuanced approach to promote learning and social justice, fairness, and community well-being.

Science misinformation represents a significant challenge for the scientific community. Hispanic communities are particularly vulnerable due to language barriers and the lack of accessible information in Spanish. We identified that a key step toward enhancing the accessibility of information for non-native English-speaking communities involves imparting science communication education and training to Hispanic youth. Our goal was to provide them with the skills to become science ambassadors who can effectively engage with their communities and bridge communication gaps. To address this, we developed the first science communication training program in Spanish for Hispanic high school and undergraduate students in Puerto Rico. The program called "+Ciencia" aims to provide training and education on science communication for Hispanic minorities through experiential and collaborative learning. In the short term, our multifaceted approach works to counter misinformation and promote science literacy within the broader community. Over the long term, our grassroots efforts with students will evolve into a generation of professionals equipped with strong engagement skills and comprehensive training in science communication with a specific focus on Hispanic audiences. Herein, we describe the components of this educational program and provide open access to educational materials and articles developed by three cohorts.

Misinformation regarding vaccine science decreased the receptiveness to COVID-19 vaccines, exacerbating the negative effects of the COVID-19 pandemic on society. To mitigate the negative societal impact of the COVID-19 pandemic, impactful and creative science communication was needed, yet little research has explored how to encourage COVID-19 vaccine acceptance and address misconceptions held by non-Science, Technology, Engineering and Mathematics majors (referred to as non-majors). We have previously demonstrated that including expert guest lectures in the vaccine module in the non-major introductory biology course helps combat students' vaccine hesitancy. In the present study, we further address how learning about vaccines impacts student knowledge and impressions of the COVID-19 vaccines through a podcast assignment. As a part of this assignment, non-majors created podcasts to address COVID-19 vaccine misconceptions of their choice. We coded pre and post, open-ended essay reflections (n = 40) to assess non-majors' knowledge and impressions of the COVID-19 vaccines. Non-majors' impressions of the vaccines improved following the podcast assignment with more than three times as many students reporting a positive view of the assignment than negative views. Notably, eight of the nine interviewed students still ended the course with misconceptions about the COVID-19 vaccines, such as the vaccines being unnecessary or causing fertility issues. In a post semi-structured interview following this assignment, students (n = 7) discussed the impact of looking into the specific misconceptions related to COVID-19 vaccines themselves, including improved science communication skills and understanding of different perspectives. Thus, podcasts can provide opportunities for students to improve engagement in valuable societal topics like vaccine literacy in the non-majors classroom.

Nicotine is a major alkaloid in tobacco plants and an addictive component of tobacco products. Some bacteria grow on tobacco plants and have evolved the ability to metabolize nicotine. As part of our microbiology teaching lab, we used minimal media with nicotine as the sole carbon source to isolate nicotine-degrading bacteria from tobacco leaves and commercial tobacco products. Students then identified these bacteria using 16S rRNA sequencing and biochemical assays and assessed their ability to catabolize nicotine using UV spectroscopy. Students were able to isolate and identify 14 distinct genera that can metabolize nicotine. This modification of the commonly used unknown project gave students firsthand experience using selective media, and students got the opportunity to work with largely uncharacterized microbes with a real-world connection to public health, which increased student engagement. Students had the opportunity to think critically about why nicotine-degrading microorganisms associate with tobacco plants, why there are different bacteria that use the same specialized metabolism, and how these organisms are isolated from other bacteria using selective media.

Higher education institutions continually increase the demands on college instructors. Yet, all too often, many college instructors have had little to no preparation for teaching in higher education. What is needed is a comprehensive and clear list of characteristics expected of effective college teachers, both in-person and online, comprised by those who are focused on studying the subject matter deeply. To assess the characteristics deemed essential for college instructors to possess, a nationwide, modified Delphi technique was employed, eliciting opinions from an established panel of experts. At the conclusion of a three-round Delphi study, 46 of the 55 original items submitted by the panelists reached consensus of agreement. The 46 items were then categorized to establish six overarching themes associated with effective college teaching. The categorized themes and characteristics determined in the study of effective college teachers should be used as a comprehensive and clear list to provide college faculty with expectations of effective teaching. Additional research is needed to convert the items found in this study into an effective college teaching instrument. Such an instrument should be validated for use across academia as a starting point for the development, training, and support of future and current college teachers.

Abstract Background Withholding parenteral nutrition (PN) until one week after PICU admission facilitated recovery from critical illness and protected against emotional and behavioral problems 4 years later. However, the intervention increased the risk of hypoglycemia, which may have counteracted part of the benefit. Previously, hypoglycemia occurring under tight glucose control in critically ill children receiving early PN did not associate with long-term harm. We investigated whether hypoglycemia in PICU differentially associates with outcome in the context of withholding early PN, and whether any potential association with outcome may depend on the applied glucose control protocol. Methods In this secondary analysis of the multicenter PEPaNIC RCT, we studied whether hypoglycemia in PICU associated with mortality (N = 1440) and 4-years neurodevelopmental outcome (N = 674) through univariable comparison and multivariable regression analyses adjusting for potential confounders. In patients with available blood samples (N = 556), multivariable models were additionally adjusted for baseline serum NSE and S100B concentrations as biomarkers of neuronal, respectively, astrocytic damage. To study whether an association of hypoglycemia with outcome may be affected by the nutritional strategy or center-specific glucose control protocol, we further adjusted the models for the interaction between hypoglycemia and the randomized nutritional strategy, respectively, treatment center. In sensitivity analyses, we studied whether any association with outcome was different in patients with iatrogenic or spontaneous/recurrent hypoglycemia. Results Hypoglycemia univariably associated with higher mortality in PICU, at 90 days and 4 years after randomization, but not when adjusted for risk factors. After 4 years, critically ill children with hypoglycemia scored significantly worse for certain parent/caregiver-reported executive functions (working memory, planning and organization, metacognition) than patients without hypoglycemia, also when adjusted for risk factors including baseline NSE and S100B. Further adjustment for the interaction of hypoglycemia with the randomized intervention or treatment center revealed a potential interaction, whereby tight glucose control and withholding early PN may be protective. Impaired executive functions were most pronounced in patients with spontaneous or recurrent hypoglycemia. Conclusion Critically ill children exposed to hypoglycemia in PICU were at higher risk of impaired executive functions after 4 years, especially in cases of spontaneous/recurrent hypoglycemia.

Jiaji An,1 He Di,2 Zixuan Yang,3 Meifang Yao2 1School of Finance, Jilin University of Finance and Economics, Changchun, People’s Republic of China; 2School of Business and Management, Jilin University, Changchun, People’s Republic of China; 3Shenzhen Finance Institute, School of Management and Economics, Chinese University of Hong Kong, Shenzhen, People’s Republic of ChinaCorrespondence: He Di, School of Business and Management, Jilin University, 2699 Qianjin Ave, Changchun, 130012, People’s Republic of China, Email dihe@jlu.edu.cnPurpose: Silence is a typical negative behaviour exhibited by employees when they are faced with tension and stress and is influenced by a number of factors. Leaders have an important influence on employees’ emotions and behaviour, but the research is not yet clear enough. In this paper, we focus on the research frontier of self-deprecating humour of leaders, aiming to analyse its effect on employee silence and discuss the mechanism of the role of leader-member exchange (LMX) in it, based on social exchange theory.Methods: We conducted a regression analysis and bootstrap test for mediating effects based on 2531 data from 151 financial institutions in mainland China. A simple random sampling was taken of the target population to ensure an unbiased sample. Using Harman’s single-factor test to check the data for common method bias. Regression analysis and Bootstrap test were used to analyze the correlation between variables and mediating effect models.Findings: (a) Leader self-deprecating humour significantly reduces employee silence and effectively improves the quality of LMX; (b) There is a significant negative relationship between LMX and employee silence; (c) LMX plays a mediating role in the process of self-deprecating humour influencing employee silence and this mediating effect is complete; (d) Affective exchange between leaders and employees appears to be an essential factor in reducing stress from leaders and reducing employee silence.Originality/Value: We attempt to open the black box of the mechanism of action between leader self-deprecating humour and employee silence, enrich and expand the application of social exchange theory to negative employee behavior, and provide new theoretical knowledge and empirical evidence from developing countries.Practical Implications: The results of the study indicated that self-deprecating humor of leaders can significantly inhibit employee silence through high levels of LMX. Moreover, the mediating role played by LMX was complete. Therefore, organizations should not only focus on the role of leadership humor, but also to achieve mutual respect and trust between leaders and subordinates, and an emotional exchange that goes beyond economic relationships.Keywords: leader self-deprecating humour, employee silence, leader-member exchange, mediating effect

Zhiyong Lyu,1 Jing Li,2 Jinghui Zhen,1 Wei Shi,3 Qingying Meng,1 Wei Zhou,1 Jingyun An,1 Kaihu Yao,3,&ast; Fang Dong1,&ast; 1Department of Clinical Laboratory Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China; 2Department of Clinical Laboratory, Capital Institute of Pediatrics, Beijing, People’s Republic of China; 3Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fang Dong; Kaihu Yao, Department of Clinical Laboratory Center, Beijing Children’s Hospital Affiliated to Capital Medical University, No. 56 Nan Lishi Road, Beijing, 100045, People’s Republic of China, Email fangd32@163.com; yaokaihu@bch.com.cnIntroduction: Streptococcus pneumoniae (S. pneumoniae) is a major pathogen causing death in children. Few studies have evaluated the importance of S. pneumoniae in the identified bacteria in clinical work. This retrospective study aimed to reveal the rank of S. pneumoniae in determined bacteria isolated from children in Beijing, China, as well as the antimicrobial resistance of this pathogen.Methods: The number of specimen for bacterial culture and of bacterial species were cumulated and ranked based on the data of the two largest children’s hospitals in Beijing from 2015 to 2021. The temporal change of S. pneumoniae culture, as well as the clinical data of S. pneumoniae isolates were collected and analyzed. The minimum inhibitory concentrations of antimicrobial agents were determined by BD Phoenix 100 automated system or Vitek 2 automated system for antimicrobial susceptibility testing. The breakpoints recommended by CLSI were adopted.Results: During the 7-year study period, a total of 45,631 bacterial isolates were cultured from 462,144 submitted specimens, in which S. pneumoniae was the third frequent agent following S. aureus and H. influenza, and accounting for 8.79% of the isolates (4011/45,631). In the 4011 S. pneumoniae isolates, 2239 and 997 ones were, respectively, isolated from sputum and bronchial lavage fluid. Most of S. pneumoniae strains were identified in winter (34.7%) and spring (26.1%), and were mainly isolated from patients under 5 years old (77.1%). Low susceptible rate (27.6%) of CSF isolates was determined to penicillin according to the parenteral meningitis breakpoints, while high susceptible rate (56.9%) of non-CSF isolates was obtained according to the parenteral non-meningitis breakpoints. The isolates showed low sensitivity to erythromycin and tetracycline (< 5%). All isolates were susceptible to vancomycin and linezolid.Conclusion: The present results demonstrated that S. pneumoniae was one of the most commonly detected bacteria in current pediatric clinical tests, especially in young children under 5 years old, which emphasized the importance of prevention. Penicillin could still be the first empiric choice to treat non-meningitis pneumococcal infections, while erythromycin should not be involved in the treatment.Keywords: Streptococcus pneumoniae, antimicrobial resistance, children, China

Tomas M Grippo,1 Marc Töteberg-Harms,2 Michael Giovingo,3 Brian A Francis,4 Ronald RMPC de Crom,5 Brian Jerkins,6 Jacob W Brubaker,7 Jella An,8 Nathan Radcliffe,9 Robert Noecker10 1Grippo Glaucoma and Cataract Center, Buenos Aires, Argentina; 2Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA; 3Cook County Health, Chicago, IL, USA; 4Department of Ophthalmology, Doheny and Stein Eye Institutes, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA; 5University Eye Clinic, Maastricht University Medical Centre, Maastricht, the Netherlands; 6Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN, USA; 7Sacramento Eye Consultants, Sacramento, CA, USA; 8Department of Ophthalmology, Wilmer Eye Institute, John Hopkins School of Medicine, Bethesda, MD, USA; 9Glaucoma Department, New York Eye and Ear Infirmary, New York, NY, USA; 10Ophthalmic Consultants of Connecticut, Fairfield, CT, USACorrespondence: Tomas M Grippo, Grippo Glaucoma and Cataract Center, 250 Luis Maria Campos, 1st Floor, Suite O, Capital Federal, 1426, Argentina, Tel +54-11-4-774-2930, Email tomasgrippo@yahoo.comPurpose: To provide expert consensus and evidence-based current guidelines on treatment technique, postoperative care, expected outcomes and retreatment for MicroPulse Transscleral Laser Treatment (TLT).Methods: A comprehensive search of PubMed led to the identification and analysis of 61 studies on MicroPulse TLT. To provide guidance in areas where there was not enough available literature, a three-round Delphi method was conducted involving 10 international experts in MicroPulse TLT.Results: The response rate was 70% in the first round, 70% in the second round, and 80% in the third round of the Delphi method. Once all responses were aggregated, a live meeting was held with 90% attendance, and consensus was achieved on each of the findings detailed in this manuscript.Conclusion: Used within appropriate treatment parameters, with proper technique and patient selection, MicroPulse TLT is a safe and effective treatment for many types and severities of glaucoma. MicroPulse TLT represents a useful addition to the glaucoma armamentarium.Keywords: glaucoma, MicroPulse, transscleral laser treatment

Professional development of scientists is enhanced by training students in responsible conduct of research earlier in their careers. One aspect of responsible conduct of research is authorship ethics, which concerns granting of credit to those who make intellectual contributions to the research. The activity discussed in this article emphasizes how authorship ethics can be integrated with Course-based Undergraduate Research Experience (CURE) and includes an adaption that could also be used for independent research students. The activity allows students to reflect upon inequalities and problems seen in scientific authorship, including gender bias, failure to credit effort (ghostwriters), and inclusion of authors that did not meaningfully contribute to the work (honorary/gift authorship). Themes seen in student reflections on how they could demonstrate ethics in authorship included: determining authorship by contribution, appropriate attributions on curriculum vitas (CV) and posters, different credit levels, understanding authorship criteria, and tracking contributions. Themes seen in student reflections on the importance of authorship were proper authorship credit distribution, authorship impacting career opportunities, and accountability in research. In the activity, students also created attributions for a poster to be presented from their research. We found that most students were able to create attributions that were correctly formatted, included the same authors, and positioned authors in the same order as other group members, matching what was presented on the finalized poster. We found that students' reflection on authorship and this professionalization of their activities in their CURE led to modest increases in their view of themselves as scientists.

Winogradsky columns were invented by Sergei Winogradsky in the 1880s and have commonly been used as a microbiology classroom learning tool in K-12 and collegiate education. However, they can be challenging to examine with microscopy. We scaled down Winogradsky columns into nuclear magnetic resonance (NMR) tubes and replaced the natural sediment with a transparent soil substitute toward the goal of observing the microbial growth under a bright-field microscope without column disassembly. Using this "Mini Winnie" approach, students can practice their microscopy skills while observing microbial growth inside the column after only days of incubation on the laboratory windowsill. Overall, we believe that the Mini Winnies provide a simple method for maximizing student engagement while giving them a greater understanding of how microorganisms interact in the environment.

The complexity of modern biology poses challenges in fostering interdisciplinary understanding, particularly between practicing scientists and the public. Furthermore, scientists often lack formal training in science communication, despite various motivations to engage the public. The science literacy of the public in the biological sciences can also vary across socio-economic and cultural backgrounds. Leveraging popular culture and informal learning practices to promote active learning offers promising avenues to enhance public understanding of biological systems. Organized sports hold collective recognition across various communities and cultures, serving as a means to bring people together. Notably, the NCAA March Madness event holds widespread national and international popularity, presenting an opportunity to laterally apply this concept to promote science communication within STEM and biology education. An educational social media and web-based contest tool was developed integrating NCAA-inspired brackets with animal biological systems concepts. The tool featured tournament-style matchups based on animal biological systems, interesting animal facts, and a voting system, all housed within a user-friendly interface. To encourage regular user access to the tool, graphic designs were developed for all social media posts to aid in visual recruitment to the voting website. Based on online metrics, the use of social media garnered repeat users across both the public and educators. The latter noted the tool's simplicity and informative content. Application of this social media and web-based bracket contest tool, which leverages informal settings for active learning for use in biology education, can foster science communication to engage audiences, improve comprehension, and promote interdisciplinary biology education.

The challenge of creating reliable technology-based resources for science learning is a perennial challenge in Philippine education, with limited learning materials accessible to all learners. This study is about the development of a videocast embedded with physics education technology (PhET) simulation that served as supplementary learning material for grade 9 science in response to the scarcity of dependable visualization materials. The study employed the developmental research design with analysisdesign-development-implementation-evaluation (ADDIE) model as the developmental framework. The vodcast evaluation tool, achievement test questionnaire, and vodcast perception survey questionnaire for students and teachers were used in the data collection, while the Kendall's W statistic, mean, percentage, and gain score were used in the data interpretation. The teacher respondents (N=64) have moderate agreement on the ranking of topic difficulty, with Kendall's W of 0.45. The researcher-made vodcast attained an overall rating of 4.78 from experts, which implies that the vodcast can be very good material for classroom implementation. The developed achievement test has acceptable difficulty and discrimination indices. The implementation stage yielded a low normalized gain, which can be accounted for by unfocused attention during the pandemic. Nevertheless, the voicecasts were found very useful in learning projectile motion, as perceived by both students and teacher-observers.

How do teachers perceive and experience the impact of evaluation feedback across various domains of their work? This study investigates whether there are qualitatively distinct groups of teachers in the United States based on teacher perceived impact of evaluation feedback using the 2013 Teaching and Learning International Survey (TALIS 2013). Applying latent class analysis to the U.S. sample of lower-secondary school teachers (n=1,824), we find that there are four distinctive groups of teachers: Receptive (25%), Compliant (15%), Motivated (27%), and Indifferent (33%). Our analysis shows feedback sources and teacher beliefs about the evaluation's purpose are significant predictors of teacher class assignment. Finally, controlling for various individual and school-level characteristics, these teacher groups vary significantly in their intention to change school.

Simon Fraser University in Vancouver, Canada offers two introductory calculus courses designed for students enrolled in science and engineering programs. Students identified as needing additional support based on their admission grades take the version of the course where students meet weekly for four hours instead of three. A new approach for the fourth hour was introduced in Fall 2019 splitting the class into smaller sections of 20-40 students to work in small groups on vertical whiteboards under the supervision of the instructor, complemented by peer tutors. This format introduces an active learning element that improves student performance and attitude. The project was first implemented in Fall 2019, although interrupted due to COVID-19. After returning to the in-person classroom, the whiteboard seminar program was reinstated. In Fall 2022 and Spring 2023, survey feedback was collected from both students and peer tutors for a more holistic perspective on the program. In this study, the results of these surveys are analyzed, focussing on four areas of measurement: students' satisfaction, learning calculus concepts and problem-solving techniques, the contribution of the instructor, and the contribution of the peer tutors. Exploratory factor analysis revealed three latent variables underlying student survey responses. The survey results suggest that interactions with the instructor, peer tutors, and active learning activities all contributed to students' enjoyment of the course and their perceptions of their own learning. We compared students' final course grades from Fall 2018, where the fourth hour was devoted to lecture before the program was implemented, to Fall 2019 and 2022. The data shows a decrease in the percentage of students failing the course and an increase in those earning A's and B's since the program's implementation. Additionally, survey results show that replacing a typical lecture-style hour with a whiteboard seminar improved students' attitudes and perceptions of the course.

The researchers examined the relationship between informal digital gameplay and learner profiles in two Japanese private universities. Seventy-eight participants responded to 59 items on a digital questionnaire that consisted of four sections: 1) Learner Profiles, 2) Digital Game Usage, 3) Open-Responses, and 4) Demographics. The results of the study demonstrated that students positively identified with the learner profiles featured on the questionnaire (M = 3.80). The highest mean values were associated with the profiles of Digital Citizen (M = 4.30) and Knowledge Constructor (M = 4.15). It was discovered that participants engaged in digital gameplay most often with smartphones (M = 3.64) and game consoles (M = 2.79). Simulation (M = 2.81) and real-time strategy (M = 2.66) games were the most frequently played. The results of a Pearson Product Moment Correlation showed that there was no significant relationship between informal digital gameplay and learner profiles. Furthermore, self-identified gamers and non-gamers did not significantly differ on the Learner Profile Total Scale or subscales.

In this randomized control study, we evaluated science teachers' pedagogical practices via classroom observations following ongoing, intensive, and structured instructional support sessions. These sessions included virtual professional development (VPD) and virtual mentoring and coaching (VMC) that accompanied a literacy-infused science curriculum. Using a low-inference observational instrument, we explored the direct impact of VPD and VMC on fifth-grade science teachers' observed time allocation in a randomized controlled trial (RCT) validation study. The observations were collected three times during science instruction from 121 teachers in 68 schools from 35 public school districts in the U.S. state of Texas, during the 2017-2018 school year. Preliminary findings revealed pedagogical differences in time allocation among teachers between treatment and control classrooms. We identified improved instructional practices within treatment classrooms, which suggests the intervention had a positive effect by enhancing the quality of pedagogy as well as the content-area instruction in science.

Ping Liu,1,2 Jing An,2 Huizhen Wu1,2 1Graduate School of Hebei Medical University, Shijiazhuang, People’s Republic of China; 2National Clinical Drug Monitoring Center, Department of Pharmacy, Hebei General Hospital, Shijiazhuang, People’s Republic of ChinaCorrespondence: Huizhen Wu, National Clinical Drug Monitoring Center, Department of Pharmacy, Hebei General Hospital, No. 348, West Heping Road, Shijiazhuang, 050051, People’s Republic of China, Email 13582005982@163.comPurpose: The present study aimed to establish and validate an isotope-dilution-UHPLC-MS/MS method for the determination of perampanel (PER) concentration and investigate the effect of eslicarbazepine acetate (ESL) on the pharmacokinetics of PER in rats.Methods: The rats were randomly divided into the control (0.5% CMC-Na) and experimental groups (ESL, 72 mg/kg), with six rats in each group. A single dose of PER (1 mg/kg) was administered after a week of repetitive 0.5% CMC-Na or ESL dosing (72 mg/kg); then, plasma samples were collected. Perampanel-d5 (PER-d5) was used as the internal standard (IS), liquid-liquid extraction of plasma samples was carried out using ethyl acetate, and chromatographic separation was carried out on a Titank C18 column (2.1 mm × 50 mm, 3.0 μm) using a gradient mobile phase consisting of 0.1% formic acid and acetonitrile at a flow rate of 0.3 mL/min.Results: PER had good linearity (0.3– 600 ng/mL, r > 0.999), and the accuracy, precision, recovery rate, and matrix effects (ME) met the Food and Drug Administration (FDA) guidelines. Compared to the control group, the area under the curve AUC0→t, AUC0→∞, and Cmax of PER in the experimental group decreased by 30.28%, 30.34%, and 46.94%, respectively, and CL increased by 32.08%.Conclusion: ESL could induce the metabolism of PER in rats and decreases plasma exposure to PER. Thus, the concomitant treatment with ESL may require a high dose of PER to achieve the same efficacy.Keywords: perampanel, eslicarbazepine acetate, pharmacokinetics, UHPLC-MS/MS, drug-drug interactions, Sprague–Dawley rats

Hailan Shen,1,&ast; Ye Lu,2,&ast; Ruide Su,1 Kai Wang,1 Wenrong Wang,1 Jian An2 1Department of Family Planning, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, People’s Republic of China; 2Department of Gynecology, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenrong Wang, Department of Family Planning, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, 361000, People’s Republic of China, Email wwr1293@163.com Jian An, Department of Gynecology, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, 361000, People’s Republic of China, Email anjian1994@foxmail.comPurpose: To investigate the clinical value of hysteroscopy with chromopertubation (HSC) in infertile patients with hysterosalpingography (HSG) evidence of abnormal tubal patency.Methods: The study consisted of 296 patients. HSG was performed as a preliminary test for the evaluation of fallopian tube status. Patients who desired to conceive naturally were treated with HSC in the next month or followed-up without additional treatment. The primary outcome was natural clinical pregnancy within 12 months after the procedure.Results: In total, the number of clinical pregnancies was estimated to be 70 of 143 (48.95%) clinical pregnancies with management by HSC and 65 of 153 (42.48%) pregnancies with management comprising follow-up without additional treatment, and this was not significantly different (Log rank test, P = 0.516). Subgroup analysis showed that among women with bilateral abnormalities by HSG, patients receiving management with HSC tended to have a higher probability of pregnancy throughout the follow-up period than women without HSG (Log rank test, P = 0.005). No corresponding significant difference was found for women with a unilateral abnormality (P = 0.674).Conclusion: HSC shows potential fertility improvement value for infertile patients with tubal factors. HSC may be complementary to HSG and could be incorporated as a modality of the fertility work-up.Keywords: hysteroscopy, chromopertubation, hysterosalpingography, pregnancy, tubal patency

Xuejie Fu,1,&ast; Shuangjian He,2,&ast; Liang Wang,2 Yangyang Xue,2 Shigang Qiao,1 Jianzhong An,1 Tingting Xia1 1Institute of Clinical Medicine Research, Suzhou Science & Technology Town Hospital, Suzhou, JiangSu, People’s Republic of China; 2Department of Orthopedics, Suzhou Science & Technology Town Hospital, Suzhou, JiangSu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Tingting Xia, Institute of Clinical Medicine Research, Suzhou Science & Technology Town Hospital, Suzhou, 215153, JiangSu, People’s Republic of China, Tel +86 18523986726, Email xtt_92@126.comPurpose: Osteoarthritis (OA) places a significant burden on society and finance, and there is presently no effective treatment besides late replacement surgery and symptomatic relief. The therapy of OA requires additional research. Madecassic acid (MA) is the first native triterpenoid compound extracted from Centella asiatica, which has a variety of anti-inflammatory effects. However, the role of MA in OA therapy has not been reported. This study aimed to explore whether MA could suppress the inflammatory response, preserve and restore chondrocyte functions, and ameliorate the progression of OA in vitro and in vivo.Methods: Rat primary chondrocytes were treated with IL-1β to simulate inflammatory environmental conditions and OA in vitro. We examined the effects of MA at concentrations ranging from 0 to 200 μM on the viability of rat chondrocytes and selected 10 μM for further study. Using qRT-PCR, immunofluorescent, immunocytochemistry, and Western blotting techniques, we identified the potential molecular mechanisms and signaling pathways that are responsible for these effects. We established an OA rat model by anterior cruciate ligament transection (ACLT). The animals were then periodically injected with MA into the knee articular cavity.Results: We found that MA could down-regulate the IL-1β-induced up-regulation of COX-2, iNOS and IL-6 and restore the cytoskeletal integrity of chondrocytes treated with IL-1β. Moreover, MA protects chondrocytes from IL-1β-induced ECM degradation by upregulating ECM synthesis related protein expression, including collagen-II and ACAN, and further down-regulating ECM catabolic related protein expression, including MMP-3 and MMP-13. Furthermore, we found that NF-κB/IκBα and PI3K/AKT signaling pathways were involved in the regulatory effects of MA on the inflammation inhibition and promotion of ECM anabolism on IL-1β-induced chondrocytes.Conclusion: These findings suggest that MA appears to be a potentially small molecular drug for rat OA.Keywords: osteoarthritis, madecassic acid, inflammatory responses, cartilage degradation

Pingping Su,1 Jian An,1,2 Lirui Yu,1 Huifang Lei,1 Lixiang Huang,1 Xiaodan Mao,1,3 Pengming Sun1,3 1Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, 350001, People’s Republic of China; 2Department of Gynecology, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, People’s Republic of China; 3Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, 350001, People’s Republic of ChinaCorrespondence: Pengming Sun; Xiaodan Mao, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350001, People’s Republic of China, Tel +86-591-87558732, Fax +86-591-87551247, Email fmsun1975@fjmu.edu.cn; maodan1985@yeah.netPurpose: This study aimed to explore lymphocyte subsets for the personalized prediction of endometrioid endometrial cancer (EEC) risk and evaluated the correlation between immune cells and International Federation of Gynecology and Obstetrics (FIGO) staging in patients with EEC.Patients and Methods: A case-control study was conducted to analyze the clinical data of 421 patients admitted to Fujian Maternity and Child Health Hospital from October 2017 to December 2021. t-tests or Mann–Whitney U-tests were used to analyze the percentages and absolute counts of peripheral blood lymphocyte subsets in patients with EEC and patients without cancer. The independent risk factors for ECC and FIGO stage were analyzed via multivariate binary logistic regression. The receiver operating characteristic curve was calculated to evaluate the prediction efficacy of risk factors on ECC.Results: The CD4+ T% in the 121 patients with EEC was lower than in the 300 patients without cancer (P = 0.013). The absolute counts of peripheral CD4+ T (P = 0.002) and T cells (P = 0.007) in 37 patients with EEC were lower than in 51 patients without cancer. Multivariate binary logistic regression analysis showed that CD4+ T% and natural killer cell (NK)% were independent risk factors for FIGO staging in patients with EEC. NK% was significantly higher in patients with advanced stage (FIGO III and IV) than those with early EEC (FIGO I and II) (P = 0.004). To determine the early and advance FIGO stage of EEC, the cutoff value of NK% was calculated as 19.94%.Conclusion: With the decrease of CD4+ T counts, the immune status of patients with EEC is impaired. NK cells may help in the evaluation of the prognosis of patients with EEC and are likely to be an independent risk factor for FIGO staging in patients with EEC.Keywords: CD4+ T lymphocyte, NK cells, endometrioid endometrial cancer, lymphocyte subsets, immune

Tomas M Grippo,1 Ronald MPC de Crom,2 Michael Giovingo,3 Marc Töteberg-Harms,4 Brian A Francis,5 Brian Jerkins,6 Jacob W Brubaker,7 Nathan Radcliffe,8 Jella An,9 Robert Noecker10 1Department of Ophthalmology, Hospital Aleman, Buenos Aires, Argentina; 2University Eye Clinic, Maastricht University Medical Centre, Maastricht, the Netherlands; 3Department of Ophthalmology, Cook County Health, Chicago, Illinois, USA; 4Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA; 5Department of Ophthalmology, Doheny and Stein Eye Institutes, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA; 6Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN, USA; 7Sacramento Eye Consultants, Sacramento, CA, USA; 8New York Eye and Ear Infirmary, New York, NY, USA; 9Department of Ophthalmology, Wilmer Eye Institute, John Hopkins School of Medicine, Bethesda, MD, USA; 10Department of Ophthalmology, School of Medicine, Yale University, New Haven, CT, USACorrespondence: Tomas M Grippo, 250 Luis Maria Campos, 1st Floor, Suite O, Capital Federal, Buenos Aires, 1426, Argentina, Tel +54-11-4-774-2930, Email tomasgrippo@yahoo.comPurpose: To provide consensus-based current guidelines on optimal dosimetry and patient selection for MicroPulse Transscleral Laser Therapy (TLT) based on a review of the literature and a Delphi method.Methods: A comprehensive search of Pub Med led to the identification and analysis of 61 studies on MicroPulse TLT that contained information on laser settings and patient selection. To determine consensus in areas where there was not enough available literature, a three-round Delphi method was conducted.Results: The response rate was 90% in the first round, 90% in the second round, and 80% in the third round of the Delphi technique. Once all responses were aggregated, a live meeting was held with 80% attendance, and consensus was achieved on each of the findings detailed in this manuscript.Conclusion: Micropulse TLT is a useful addition to the glaucoma armamentarium. When used with proper surgical technique at energy settings within the boundaries described in this manuscript, MicroPulse TLT is a safe and effective treatment for many types and stages of glaucoma. Based on current knowledge and experience, the consensus recommendation of this expert panel is that the standard MicroPulse TLT settings using the revised MicroPulse P3 Probe should be 2500 mW, 31.3% duty cycle, and 4 sweeps at a sweep velocity of 20 seconds each per hemisphere. Both hemispheres avoiding the 3 and 9 clock hours should be treated. The panel also reached consensus on patient selection for MicroPulse TLT providing guidance for the use of the procedure.Keywords: glaucoma, MicroPulse, transscleral laser therapy