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Experts perceive and evaluate domain-specific visual information with high accuracy. In doing so, they exhibit eye movements referred to as "expert gaze" to rapidly focus on task-relevant areas. Using eye tracking, it is possible to record these implicit gaze patterns and present them to histology novice learners during training. This article presents a comprehensive evaluation of such "expert gaze cueing" on pattern recognition of medical students in histology. For this purpose, 53 students were randomized into two groups over eight histology sessions. The control group was presented with an instructional histology video featuring voice commentary. The gaze cueing group was presented the same video, but with an additional overlay of a live recording of the expert's eye movements. Afterward, students' pattern recognition was assessed through 20 image-based tasks (5 retention, 15 transfer) and their cognitive load with the Paas scale. Results showed that gaze cueing significantly outperformed the control group (p = 0.007; d = 0.40). This effect was evident for both, retention (p = 0.003) and transfer tasks (p = 0.046), and generalized across different histological contexts. The cognitive load was similar in both groups. In conclusion, gaze cueing helps histology novice learners to develop their pattern recognition skills, offering a promising method for histology education. Histology educators could benefit from this instructional strategy to provide new forms of attentional guidance to learners in visually complex learning environments.

ABSTRACT The spread of antimicrobial resistance among bacteria by horizontal plasmid transmissions poses a major challenge for clinical microbiology. Here, we evaluate a new real-time plasmid transmission detection pipeline implemented in the SeqSphere+ (Ridom GmbH, Münster, Germany) software. Within the pipeline, a local Mash plasmid database is created, and Mash searches with a distance threshold of 0.001 are used to trigger plasmid transmission early warning alerts (EWAs). Clonal transmissions are detected using core-genome multi-locus sequence typing allelic differences. The tools MOB-suite, NCBI AMRFinderPlus, CGE MobileElementFinder, pyGenomeViz, and MUMmer, integrated in SeqSphere+, are used to characterize plasmids and for visual pairwise plasmid comparisons, respectively. We evaluated the pipeline using published hybrid assemblies (Oxford Nanopore Technology/Illumina) of a surveillance and outbreak data set with plasmid transmissions. To emulate prospective usage, samples were imported in chronological order of sampling date. Different combinations of the user-adjustable parameters sketch size (1,000 vs 10,000) and plasmid size correction were tested, and discrepancies between resulting clusters were analyzed with Quast. When using a sketch size of 1,000 with size correction turned on, the SeqSphere+ pipeline agreed with the published data and produced the same clonal and carbapenemase-carrying plasmid clusters. EWAs were in the correct chronological order. In summary, the developed pipeline presented here is suitable for integration into clinical microbiology settings with limited bioinformatics knowledge due to its automated analyses and alert system, which are combined with the GUI-based SeqSphere+ platform. Thus, with its integrated sample database, (near) real-time plasmid transmission detection is within reach in bacterial routine-diagnostic settings when long-read sequencing is employed.IMPORTANCEPlasmid-mediated spread of antimicrobial resistance is a major challenge for clinical microbiology, and monitoring of potential plasmid transmissions is essential to combat further dissemination. Whole-genome sequencing is often used to surveil nosocomial transmissions but usually limited to the detection of clonal transmissions (based on chromosomal markers). Recent advances in long-read sequencing technologies enable full reconstruction of plasmids and the detection of very similar plasmids, but so far, easy-to-use bioinformatic tools for this purpose have been missing. Here, we present an evaluation of an innovative real-time plasmid transmission detection pipeline. It is integrated into the GUI-based SeqSphere+ software, which already offers core-genome multi-locus sequence typing-based pathogen outbreak detection. It requires very limited bioinformatics knowledge, and its database, automated analyses, and alert system make it well suited for prospective clinical application.

Objectives: Teaching of ECG interpretation frequently relies on visual schemas. However, subsequent student ECG interpretation skills are often poor. Expertise research shows that expert looking patterns frequently deviate from the steps taught in schema learning. The present study made a cardiology expert’s gaze interpreting ECGs visible – through eye-tracking videos with cued retrospective reporting (CRR) – and investigated the potential as an additional expert-driven route to improve medical students’ ECG interpretation skills.Methods: =91 Medical students participated in the RCT of an ECG e-learning session aimed at medical students’ ECG interpretation skills gain, either receiving the newly developed eye-tracking video with CRR audio commentary materials (=47) or studying via four clinical cases only (=44). Three outcome scores relating to different aspects of ECG interpretation skills were derived from pre-post MCQ ECG tests. The effect of the EYE-ECG training and additional characteristics (e.g., prior experience, interest) on student ECG interpretation skills were evaluated using t-tests and multivariate linear regression.Results: A small, non-significant advantage of the EYE-ECG training signifying a tendency for greater knowledge gain was observed, compared to training as usual. In multivariate regression models, the predictive value of clinical case 1 was an unexpected finding warranting further exploration.Conclusion: Additional gains after an only 9-minute intervention using videos of expert’s real-time gaze pattern in combination with hearing their thought processes during ECG interpretation is a promising finding. Furthermore, a number of specific performance characteristics enabling students to best benefit from ECG training were identified and possible modifications to the learning intervention suggested.

Harrison: I don't really understand why this book was banned. I think what it is a really powerful portrait not only of deeply flawed parents, but also of you know, [...]

Purpose BioMD-Y is a comprehensive biobank study of children and adolescents with major depression (MD) and their healthy peers in Germany, collecting a host of both biological and psychosocial information from the participants and their parents with the aim of exploring genetic and environmental risk and protective factors for MD in children and adolescents.Participants Children and adolescents aged 8–18 years are recruited to either the clinical case group (MD, diagnosis of MD disorder) or the typically developing control group (absence of any psychiatric condition).Findings to date To date, four publications on both genetic and environmental risk and resilience factors (including FKBP5, glucocorticoid receptor activation, polygenic risk scores, psychosocial and sociodemographic risk and resilience factors) have been published based on the BioMD-Y sample.Future plans Data collection is currently scheduled to continue into 2026. Research questions will be further addressed using available measures.

As educators and members of the NCTE Secondary Section Steering Committee, we were struck by Burke, Hendrix-Soto, and Stewart's call for manuscripts for this issue, particularly that they requested articles [...]

IntroductionThe emergence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is an urgent and alarming One Health problem. This study aimed to investigate duplications of plasmid-encoded ESBL genes and their impact on antimicrobial resistance (AMR) phenotypes in clinical and screening isolates.MethodsMulti-drug-resistant bacteria from hospitalized patients were collected during routine clinical surveillance from January 2022 to June 2023, and their antimicrobial susceptibility patterns were determined. Genotypes were extracted from long-read whole-genome sequencing data. Furthermore, plasmids and other mobile genetic elements associated with ESBL genes were characterized, and the ESBL genes were correlated to ceftazidime minimal inhibitory concentration (MIC).ResultsIn total, we identified four cases of plasmid-encoded ESBL gene duplications that match four genetically similar plasmids during the 18-month surveillance period: five Escherichia coli and three Klebsiella pneumoniae isolates. As the ESBL genes were part of transposable elements, the surrounding sequence regions were duplicated as well. In-depth analysis revealed insertion sequence (IS)-mediated transposition mechanisms. Isolates with duplicated ESBL genes exhibited a higher MIC for ceftazidime in comparison to isolates with a single gene copy (3–256 vs. 1.5–32 mg/L, respectively).ConclusionESBL gene duplications led to an increased phenotypic resistance against ceftazidime. Our data suggest that ESBL gene duplications by an IS-mediated transposition are a relevant mechanism for how AMR develops in the clinical setting and is part of the microevolution of plasmids.

Regular inspection and maintenance of infrastructure facilities are crucial to ensure their functionality and safety for users. However, current inspection methods are labor-intensive and can vary depending on the inspector. To improve this process, modern sensor systems and machine learning algorithms can be deployed to detect defects based on rapidly acquired data, resulting in lower downtime. A quality-controlled processing chain allows to provide hence informed uncertainty assessments to inspection operators. In this study, we present several Deeplab V3+ models optimized to predict corroded segments of the quay wall at JadeWeserPort, Germany, which is a dataset from the 3D HydroMapper research project. Our models achieve generally high accuracy in detecting this damage type. Therefore, we examine the use of a Region Growing-based weakly supervised approach to efficiently extend our model to other common types in the future. This approach achieves about 90 % of the results compared to corresponding fully supervised networks, of which a ResNet-50 variant peaks at 55.6 % Intersection-over-Union regarding the test set’s corrosion class.

IntroductionHorse clinics are hotspots for the accumulation and spread of clinically relevant and zoonotic multidrug-resistant bacteria, including extended-spectrum β-lactamase producing (ESBL) Enterobacterales. Although median laparotomy in cases of acute equine colic is a frequently performed surgical intervention, knowledge about the effects of peri-operative antibiotic prophylaxis (PAP) based on a combination of penicillin and gentamicin on the gut microbiota is limited.MethodsWe collected fecal samples of horses from a non-hospitalized control group (CG) and from horses receiving either a pre-surgical single-shot (SSG) or a peri-operative 5-day (5DG) course of PAP. To assess differences between the two PAP regimens and the CG, all samples obtained at hospital admission (t0), on days three (t1) and 10 (t2) after surgery, were screened for ESBL-producing Enterobacterales and subjected to 16S rRNA V1–V2 gene sequencing.ResultsWe included 48 samples in the SSG (n = 16 horses), 45 in the 5DG (n = 15), and 20 in the CG (for t0 and t1, n = 10). Two samples of equine patients receiving antibiotic prophylaxis (6.5%) were positive for ESBL-producing Enterobacterales at t0, while this rate increased to 67% at t1 and decreased only slightly at t2 (61%). Shannon diversity index (SDI) was used to evaluate alpha-diversity changes, revealing there was no significant difference between horses suffering from acute colic (5DG, SDImean of 5.90, SSG, SDImean of 6.17) when compared to the CG (SDImean of 6.53) at t0. Alpha-diversity decreased significantly in both PAP groups at t1, while at t2 the onset of microbiome recovery was noticed. Although we did not identify a significant SDImean difference with respect to PAP duration, the community structure (beta-diversity) was considerably restricted in samples of the 5DG at t1, most likely due to the ongoing administration of antibiotics. An increased abundance of Enterobacteriaceae, especially Escherichia, was noted for both study groups at t1.ConclusionColic surgery and PAP drive the equine gut microbiome towards dysbiosis and reduced biodiversity that is accompanied by an increase of samples positive for ESBL-producing Enterobacterales. Further studies are needed to reveal important factors promoting the increase and residency of ESBL-producing Enterobacterales among hospitalized horses.

When I started teaching English in 1996, I enjoyed teaching essay writing. However, as time went on, as my students' discomfort with and outward disdain for the practice grew, my [...]

Abstract Nations and companies are forced to reduce CO2 emissions and decelerate global warming. In this development, the transition of the heating sector is still in its infancy despite the relatively large share of thermal energy in the total energy consumption. Industrial companies can contribute significantly to reduce CO2 emissions by using waste heat through connecting their industrial energy supply system (IESS) to a district heating system (DHS). This paper focuses on emission reduction potential of an (industrial) heat transfer station (HTS) regarding energy flexibility and sector coupling required for the successful integration of industrial waste heat. To optimize the operating behaviour of the HTS, a data and optimization model is integrated into a digital twin (DT) based on reference architecture model for industry 4.0 (RAMI4.0). Within the DT, the information, functional and business layer are modeled. The effects of operating the HTS supported by central modules of the DT are evaluated on one year’s data of an IESS of a real industrial site. The results show a potential operating cost reduction by 6 % for the IESS and increases in profits of 1.3 % for the DHS. Scope 2 emissions can be reduced by 25 % for the IESS and 180 % for the DHS respectively, strongly depending on emission factors and allocation methods.

In 2011, in Germany, Escherichia coli O104:H4 caused the enterohemorrhagic E coli (EHEC) outbreak with the highest incidence rate of hemolytic uremic syndrome. This pathogen carries an exceptionally potent combination of EHEC- and enteroaggregative E coli (EAEC)–specific virulence factors. Here, we identified an E coli O104:H4 isolate that carried a single-nucleotide polymorphism (SNP) in the start codon (ATG > ATA) of rpoS , encoding the alternative sigma factor S. The rpoS ATG > ATA SNP was associated with enhanced EAEC-specific virulence gene expression. Deletion of rpoS in E coli O104:H4 Δ stx2 and typical EAEC resulted in a similar effect. Both rpoS ATG > ATA and Δ rpoS strains exhibited stronger virulence-related phenotypes in comparison to wild type. Using promoter-reporter gene fusions, we demonstrated that wild-type RpoS repressed aggR , encoding the main regulator of EAEC virulence. In summary, our work demonstrates that RpoS acts as a global repressor of E coli O104:H4 virulence, primarily through an AggR-dependent mechanism. [ABSTRACT FROM AUTHOR]

Experts perceive and evaluate domain‐specific visual information with high accuracy. In doing so, they exhibit eye movements referred to as "expert gaze" to rapidly focus on task‐relevant areas. Using eye tracking, it is possible to record these implicit gaze patterns and present them to histology novice learners during training. This article presents a comprehensive evaluation of such expert gaze cueing on pattern recognition of medical students in histology. For this purpose, 53 students were randomized into two groups over eight histology sessions. The control group was presented with an instructional histology video featuring voice commentary. The gaze cueing group was presented the same video, but with an additional overlay of a live recording of the expert's eye movements. Afterward, students' pattern recognition was assessed through 20 image‐based tasks (5 retention, 15 transfer) and their cognitive load with the Paas scale. Results showed that gaze cueing significantly outperformed the control group (p = 0.007; d = 0.40). This effect was evident for both, retention (p = 0.003) and transfer tasks (p = 0.046), and generalized across different histological contexts. The cognitive load was similar in both groups. In conclusion, gaze cueing helps histology novice learners to develop their pattern recognition skills, offering a promising method for histology education. Histology educators could benefit from this instructional strategy to provide new forms of attentional guidance to learners in visually complex learning environments. [ABSTRACT FROM AUTHOR]

Rudine Sims Bishop's influential essay 'Mirrors, Windows, and Sliding Glass Doors' is foundational to English language arts pedagogy. It provides a framework that supports the incorporation of inclusive texts. Bishop [...]

Despite good intentions and extensive planning by teacher education and/or induction programs, novice teachers frequently cite the first years as unsupported and lonely. Feelings of isolation and being overwhelmed help contribute to the large numbers of teachers leaving the profession. In fact, nearly 50 percent of all teachers will quit within the first five years, dissatisfied because of low salaries, student discipline problems, lack of support, working conditions, inadequate preparation, and little opportunity to participate in decision making. One approach to combating stress and fostering encouragement among teachers is offered by membership in support groups. Research shows that support groups reduce stress and feelings of isolation while cultivating enthusiasm, competency, and reflection. The collaborative study the authors offer in this article was an attempt for each of them, individually and collectively, to understand what they experienced as new teachers in order to improve their practice as educators and make sense of the complexity of teaching. (Contains 2 notes.)

Background: Joint range of motion based on the neutral null method, muscle strength based on manual muscle testing, and selective voluntary motor control based on selective control assessment of the lower extremity are standard parameters of a pediatric three-dimensional clinical gait analysis. Lower-limb reference data of children are necessary to identify and quantify abnormalities, but these are limited and when present restricted to specific joints or muscles. Methods: This is the first study that encompasses the aforementioned parameters from a single group of 34 typically developing children aged 5–17 years. Left and right values were averaged for each participant, and then the mean and standard deviation calculated for the entire sample. The data set was tested for statistical significance (p < 0.05). Results: Joint angle reference values are mostly consistent with previously published standards, although there is a large variability in the existing literature. All muscle strength distributions, except for M. quadriceps femoris, differ significantly from the maximum value of 5. The mean number of repetitions of heel-rise test is 12 ± 5. Selective voluntary motor control shows that all distributions, except for M. quadriceps femoris, differ significantly from the maximum value of 2. Conclusion: Since typically developing children do not match expectations and reference values from the available literature and clinical use, this study emphasizes the importance of normative data. Excessively high expectations lead to typically developing children being falsely underestimated and affected children being rated too low. This is of great relevance for therapists and clinicians. Level of evidence: 3. [ABSTRACT FROM AUTHOR]