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Background and objectives: According to the World Health Organization, climate change constitutes the single greatest threat to human health. However, the health care system contributes to climate change worldwide through its high CO emissions. In order to make future physicians more aware of this issue and to expand medical education to include climate-related aspects, the mandatory 28 academic hours elective “Climate Change and Health” for students of human medicine in the preclinical study stage was implemented at the Medical Faculty of Ulm in the 2020/21 winter semester. Our accompanying study investigated 1. in what form the topic of climate change can be successfully integrated into the study of human medicine in a manner that includes student opinions and2. whether being required to take an elective on the topic led to changes in student environmental knowledge and awareness. Methodology: Personal individual interviews were conducted with all =11 students after the course in a pilot that was carried out in the 2020/21 winter semester to determine course feasibility and student acceptance. The students were also able to evaluate the course using an evaluation form and were asked to complete a questionnaire on their environmental knowledge and awareness before and after the course. The course was revised on the basis of the results and offered again in the 2021 summer semester with an intervention group (=16, participation in the mandatory elective) and a comparison group (=25, no participation in the mandatory elective). The intervention group was asked to evaluate the course on the evaluation form. Both groups completed the environmental questionnaire at the same time. Results: The positive feedback from students for both semesters indicates a good feasibility and acceptance of the course. Student environmental knowledge was increased in both semesters. However, there were only few observable changes in student environmental awareness. Conclusion: This paper illustrates how the topic of climate change and health can be embedded into medical studies. The students considered climate change an important topic and drew added value from the course for their future work in healthcare. The study shows that knowledge transfer at the university level is an effective way to educate the young generation on climate change and its impacts.

Objective: Climate change constitutes a major challenge. The higher education sector plays an important role in regard to climate change and the adaptation to its consequences. Various approaches toward the integration of environmental subject areas to higher education teaching have already been described in other studies, but there is a lack of data supporting the effectiveness of these approaches in changing not only the environmental knowledge of students, but also their awareness. To address this, the present study tracked whether student attitudes about the environment could be changed by implicitly addressing medically relevant environmental topics as part of an online seminar.Methods: Second semester students of molecular medicine attending a mandatory 14-hour online seminar, which was required to obtain additive key qualifications and which consisted of independent study phases as well as online class meetings, were divided into two groups: the intervention group (IG, n=27, thereof 20 in the pretest and 21 in the posttest) was exposed to medically relevant environmental topics, while the comparison group (CG, n=26, thereof 22 in the pretest and 21 in the posttest) was exposed to general, non-environmental medical topics. Surveys were conducted with standardized questionnaires before and after the seminar in order to study the influence on the students’ environmental knowledge, awareness and other personal attitudes.Results: While the seminar did not significantly change the environmental awareness in either group, the environmental knowledge of the IG was significantly increased by the group’s exposure to environmental topics. In addition, the IG assessed its own environmental awareness regarding sustainable working methods in a laboratory as significantly higher after the seminar than the CG did, and some students of the IG had become more interested in issues relating to sustainability.Conclusion: The approach used to communicate environmental content mainly increased the environmental knowledge of students and piqued the interest of some students in climate-related and environmental topics. However, it was not possible to change deeper personal attitudes about environmental awareness, especially everyday behavior.

Background: Although the majority of medical students in Germany pursue a doctorate, only a portion of them receive a standardized scientific training, which is reflected in the quality issues seen in medical doctoral theses. The course Medical Dissertation Basics was conceptualized and scientifically monitored in order to support medical doctoral students on the one hand and to improve the quality of their scientific work on the other.Methodology: The course consists of three modules. Module I, which is an introductory module, covers time and writing management and addresses how to approach literature and the principles of scientific work as well as the chapters required in a dissertation and the dissertation presentation and defense. In the practical module II, doctoral students write sections of their dissertation chapters and receive feedback via peer and expert reviews. Module III includes training on dissertation presentations and their defense. For objective analysis purposes, a multiple-choice test was administered before and after module I. Medical students from semesters 2 to 6 served as a control group.Questionnaires were used to subjectively analyze the training and support functions of modules I-III. Results: High participation rates and the fact that the modules were taught numerous times show that doctoral students accept the courses. The objective analysis of module I showed a highly significant knowledge acquisition of the course group (N=55) in contrast to the control group (N=34). The doctoral students rated the course modules I-III with grades between 1.0 and 1.25 (grade A+/A; N=20-65 SD=0-0.44), felt well supported and estimated their learning success as high. Conclusion: The study indicates knowledge acquisition in module I and a high doctoral student satisfaction with all modules. For an objective analysis of modules II-III, a comparison of completed doctoral theses (course participants vs. non-participants) would be appropriate but would only make sense in a few years. Based on the results of our study, we recommend that other faculties implement similar courses.

Objective: The Master Plan for Medical Studies 2020 places additional emphasis on curricular development processes. In addition, institutes may recognize a need to optimize their courses, for example because of poor evaluations. Frequently, however, the resources required for comprehensive optimizations are not available. In the present study, we aimed to use the example of a biochemistry seminar that takes place in the preclinical part of the medical degree at Ulm University Medical School to show how a course can be successfully optimized in small steps and evaluation results can be used for quality assurance.Methods: Similar to a continuous improvement process (CIP), over the course of five years a biochemistry seminar was gradually optimized in three steps. This process used structural, methodological, and content components, such as vertical integration, the inverted classroom method, and competence orientation. For quality assurance, we analyzed the official, standardized evaluation sheets from a total of n=1248 students. We evaluated the optimization process on the basis of We then determined the usefulness of the students’ evaluation results for evaluating the optimization process.Results: Each developmental step resulted in a significantly more positive overall evaluation of the seminar by the students. This result was independent of whether the development was on a structural or methodological/content-related level. In addition, the evaluations of the categories that were optimized were significantly better. For example, the vertical integration and introduction of the inverted classroom method were accompanied by a better evaluation of the “quality of teaching” and a change in the structure led to a higher score in the category “organization, structure, implementation.” A comparison with the free text evaluation sheets and the results of the pilot study supports the results.Conclusion: Although optimization of a curriculum or course is a major task, it can also be successfully completed in small steps. With this approach, new learning goals, for example as required in the Master Plan for Medical Studies 2020, can be continuously integrated and student satisfaction with a course can be increased. Student evaluation results can represent a kind of quality assurance in this process and can provide important impulses for optimization.

Background: Medical students often have a problem recognising the relevance of basic science subjects for their later professional work in the pre-clinical stage of their studies. This can lead to a lower motivation to learn biochemical content and dissatisfaction in the courses amongst the students. Alternative teaching methods such as the Inverted Classroom (IC) method can address this deficiency. The goal of this study was: We also investigated how a biochemistry course in the pre-clinical stage of a human medicine course of studies can be successfully organised according to the IC method. Furthermore, we examined the benefits of the IC method over conventional teaching formats. Method: The IC method was implemented in accordance with the guidelines of the GMA committee “New Media” in a biochemistry seminar for two student IC intervention groups with 42 students. A part of the factual knowledge from the on-site phase in the form of teaching videos together with self-learning control tasks were provided online before the seminar for both IC intervention groups. Exporting content to the self-learning phase creates new free time in the on-site phase, during which the content can be critically considered and processed and additional competency-based learning objectives can be taught. Identical biochemistry teaching content was taught in parallel control groups (14 student groups with n=299 students), but no material was handed out beforehand for a self-learning phase. These students only received the materials after the on-site phase. Motivation and satisfaction as well as the acceptance for the teaching methods were recorded by questionnaires, the acquisition of knowledge by MC exams.Results: On a Likert scale from 1 (strongly disagree) to 6 (strongly agree), the students in the IC intervention groups could be seen to be much more motivated (5.53) than students in the control group (4.01). Students in the IC intervention groups also recognised the relevance of the learning content much more clearly (5.44) than students in the control group (4.01). Furthermore, the IC group also observed that additional competencies were trained in addition to the biochemistry content. In addition, the IC intervention group award the event a school grade of 1.53, the traditional control group a grade of 2.96. The teaching videos were rated very positively by both groups with an average school grade of 1.3 in each case. A qualitative analysis showed that the motivation and a positive attitude of the lecturers played a decisive role in the successful implementation of the IC method.Discussion and conclusion: Pre-clinical students display a high acceptance of the e-learning-based IC method. Teaching communication competencies in a biochemistry seminar was also rated very positively by the students. The quality of the teaching video and the motivation of the lecturers were shown to be a critical parameter for the successful performance of the IC method. What’s more, the IC method can contribute to implementing a competence orientation in medical studies.

Pigments homologous to the green fluorescent protein (GFP) have been proposed to fine-tune the internal light microclimate of corals, facilitating photoacclimation of photosynthetic coral symbionts (Symbiodiniaceae) to life in different reef habitats and environmental conditions. However, direct measurements of the in vivo light conditions inside the coral tissue supporting this conclusion are lacking. Here, we quantified the intra-tissue spectral light environment of corals expressing GFP-like proteins from widely different light regimes. We focus on: (1) photoconvertible red fluorescent proteins (pcRFPs), thought to enhance photosynthesis in mesophotic habitats via wavelength conversion, and (2) chromoproteins (CPs), which provide photoprotection to the symbionts in shallow water via light absorption. Optical microsensor measurements indicated that both pigment groups strongly alter the coral intra-tissue light environment. Estimates derived from light spectra measured in pcRFP-containing corals showed that fluorescence emission can contribute to >50% of orange-red light available to the photosynthetic symbionts at mesophotic depths. We further show that upregulation of pink CPs in shallow-water corals during bleaching leads to a reduction of orange light by 10-20% compared to low-CP tissue. Thus, screening by CPs has an important role in mitigating the light-enhancing effect of coral tissue scattering and skeletal reflection during bleaching. Our results provide the first experimental quantification of the importance of GFP-like proteins in fine-tuning the light microclimate of corals during photoacclimation.

On-site teaching at Ulm University was restricted in the summer semester (SS) 2020 due to the Corona pandemic. The biochemistry seminar "From gene to protein" in the 2nd preclinical semester, which had been successfully conducted as an Inverted Classroom (IC), had to be changed to an online concept. The aim of this study was to analyze the concept conversion in terms of students' satisfaction and knowledge acquisition. In the seminar, human medical students of the 2nd semester acquired biochemical and competency-oriented learning content. In SS2019, the course was taught using the IC concept. For the conversion to the online format in the SS2020, alternative teaching materials were developed and used. Students' satisfaction was assessed by an evaluation questionnaire and knowledge acquisition was tested by a written biochemistry exam. For both teaching concepts a high level of satisfaction was detected. Individual evaluation criteria were evaluated similarly by the students for both concepts. The online concept led up to significantly higher biochemistry exam scores. Due to the high levels of students' satisfaction in both concepts and the results of the biochemistry exam, it can be concluded that online teaching offers a suitable substitute. Based on these results, it is worth to undertake further research on digitization of studies.

Rapid progress in algal biotechnology has triggered a growing interest in hydrogel-encapsulated microalgal cultivation, especially for the engineering of functional photosynthetic materials and biomass production. An overlooked characteristic of gel-encapsulated cultures is the emergence of cell aggregates, which are the result of the mechanical confinement of the cells. Such aggregates have a dramatic effect on the light management of gel-encapsulated photobioreactors and hence strongly affect the photosynthetic outcome. To evaluate such an effect, we experimentally studied the optical response of hydrogels containing algal aggregates and developed optical simulations to study the resultant light intensity profiles. The simulations are validated experimentally via transmittance measurements using an integrating sphere and aggregate volume analysis with confocal microscopy. Specifically, the heterogeneous distribution of cell aggregates in a hydrogel matrix can increase light penetration while alleviating photoinhibition more effectively than in a flat biofilm. Finally, we demonstrate that light harvesting efficiency can be further enhanced with the introduction of scattering particles within the hydrogel matrix, leading to a fourfold increase in biomass growth. Our study, therefore, highlights a strategy for the design of spatially efficient photosynthetic living materials that have important implications for the engineering of future algal cultivation systems. [ABSTRACT FROM AUTHOR]

Iron (Fe) plays a fundamental role in coral symbiosis, supporting photosynthesis, respiration, and many important enzymatic reactions. However, the extent to which corals are limited by Fe and their metabolic responses to inorganic Fe enrichment remains to be understood. We used respirometry, variable chlorophyll fluorescence, and O2 microsensors to investigate the impact of increasing Fe(III) concentrations (20, 50, and 100 nM) on the photosynthetic capacity of two Mediterranean coral species, Cladocora caespitosa and Oculina patagonica. While the bioavailability of inorganic Fe can rapidly decrease, we nevertheless observed significant physiological effects at all Fe concentrations. In C. caespitosa, exposure to 50 nM Fe(III) increased rates of respiration and photosynthesis, while the relative electron transport rate (rETR(II)) decreased at higher Fe(III) exposure (100 nM). In contrast, O. patagonica reduced respiration, photosynthesis rates, and maximum PSII quantum yield (Fv/Fm) across all iron enrichments. Both corals exhibited increased hypoxia (<50 µmmol O2 L-1) within their gastric cavity at night when exposed to 50 and 100 nM Fe(III), leading to increased polyp contraction time and reduced O2 exchange with the surrounding water. Our results indicate that C. caespitosa, but not O. patagonica, might be limited in Fe for achieving maximal photosynthetic efficiency. Understanding the multifaceted role of iron in corals' health and their response to environmental change is crucial for effective coral conservation. [ABSTRACT FROM AUTHOR]

Cell-fate decisions and pluripotency are dependent on networks of key transcriptional regulators. Recent reports demonstrated additional functions of pluripotency-associated factors during early lineage commitment. The T-box transcription factor TBX3 has been implicated in regulating embryonic stem cell self-renewal and cardiogenesis. Here, we show that TBX3 is dynamically expressed during specification of the mesendoderm lineages in differentiating embryonic stem cells (ESCs) in vitro and in developing mouse and Xenopus embryos in vivo. Forced TBX3 expression in ESCs promotes mesendoderm specification by directly activating key lineage specification factors and indirectly by enhancing paracrine Nodal/Smad2 signaling. TBX3 loss-of-function analyses in the Xenopus underline its requirement for mesendoderm lineage commitment. Moreover, we uncovered a functional redundancy between TBX3 and Tbx2 during Xenopus gastrulation. Taken together, we define further facets of TBX3 actions and map TBX3 as an upstream regulator of the mesendoderm transcriptional program during gastrulation.