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Medical personnel need to learn occupational safety knowledge in clinical workplaces, not only to ensure their own safety, but also to further ensure patients safety. Based on Human-centered artificial intelligence (HAI) technology, this study will provide HAI-based occupational safety training system for two training topics, Needle Stick/Sharps Injury (NSSI) prevention and appropriate Clinical Waste Management (CWM). From April 2018 to December 2021, this clinical occupational safety HAI training is used by 342 medical personnel (doctors and non-doctors). This study aims to investigate the learning performance and effectiveness including decreasing anxiety and increasing mastering level of users. This study shows that, for the first-time and feel-friendly users of this HAI training system, not only can they achieve significant learning improvement, but they can also effectively decrease their anxiety and increase their mastery level of clinical work safety knowledge and skill. In terms of learning performance and effectiveness, this study found that doctors are significantly benefited by the HAI training system in contrast to non-doctors.

Metabolic‐associated fatty liver disease (MAFLD) induced‐severe hepatic steatosis poses significant health risks. Early prediction of this condition is crucial for prompt intervention. Short‐chain fatty acids (SCFAs) and tryptophan are gut metabolites correlated with MAFLD pathogenesis in the gut–liver axis. This study aims to construct prediction models for severe hepatic steatosis by including SCFAs and tryptophan metabolites. This study enrolled 83 participants from the outpatient department in 2023. Physical measurements, serum metabolic and inflammatory markers, metabolites of serum SCFAs and tryptophan were collected. Severe hepatic steatosis was diagnosed using vibration‐controlled transient elastography and abdominal sonography. All 40 (48.2%) participants diagnosed with severe hepatic steatosis had MAFLD, while approximately three‐quarters of those without severe hepatic steatosis had MAFLD. In comparison to the non‐severe hepatic steatosis group, individuals with severe hepatic steatosis exhibited higher levels of waist and arm circumference, serum triglyceride (TG), and lower levels of serum high‐density lipoprotein cholesterol (HDL‐C) and AST/ALT ratio. They also had higher serum levels of lipopolysaccharide‐binding protein, isovaleric acid, and propionic acid, and lower levels of 3‐methylvaleric acid, indole‐3‐propionic acid, and indoxyl sulfate. Models incorporating these markers predicted severe hepatic steatosis. One model additionally included waist circumference and triglyceride‐glucose index, while the other incorporated arm circumference and TG/HDL‐C ratio. The area under the curve reached 0.958 and 0.938, respectively (p < 0.001). SCFAs and tryptophan metabolites are valuable in predicting severe hepatic steatosis. Further research is needed to investigate the roles of these metabolites in MAFLD. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsObjective structured clinical examination (OSCE) is used worldwide. This study aims to explore potential alternatives to the OSCE by using entrustable professional activities (EPA)-based assessments in the workplace.This study enrolled 265 six-year undergraduate medical students (UGY) from 2021 to 2023. During their rotations, students were assessed using 13 EPAs, with the grading methods modified to facilitate application. Before graduation, they participated in two mock OSCEs and a National OSCE. We used generalized estimating equations to analyze the associations between the EPA assessments and the OSCE scores, adjusting for age and sex, and developed a prediction model. EPA8 and EPA9, which represent advanced abilities that were not significant in the regression models, were removed from the prediction model.Most EPAs were significantly correlated with OSCE scores across the three cohorts. The prediction model for forecasting passing in the three OSCEs demonstrated fair predictive capacity (area under curve = 0.82, 0.66, and 0.71 for students graduated in 2021, 2022, and 2023, respectively all p < 0.05).The workplace-based assessments (EPA) showed a high correlation with competency-based assessments in simulated settings (OSCE). EPAs may serve as alternative tools to formal OSCE for medical students. [ABSTRACT FROM AUTHOR]

This prospective longitudinal study assessed the effects of the course management system, EDU3, on the effectiveness of the dissemination of holistic health care and evidence-based medicine (EBM) courses. Between January 2014 and December 2021, delinked data (n = 354,229) from EDU3 were analyzed. In addition to analyzing the main educational team or seed teachers responsible for opening the courses, yearly changing trends in the number and teaching styles of courses, main participants, and the diversity of teaching activities were evaluated. EDU3 precisely announced the courses opened by non-doctor major departments, including departments of medical education, nursing, and medical research, for non-doctor medical personnel. Meanwhile, the system smoothly announced doctor major departments which opened courses for doctors. A 2 times/4.5 times parallel increase in holistic health care/EBM courses from institution to department and the yearly increasing trends in the number of these courses indicated the success of this system. This study revealed that centralized training of seed teachers motivated them to open diverse department-oriented teaching activities for holistic health care and EBM. The parallel increasing trends of the number of courses opened by the institution and departments indicated the effective dissemination of holistic health care and EBM from institution to department. [ABSTRACT FROM AUTHOR]

Summary: Transcriptional regulation mechanisms underlying chilling injury (CI) development have been widely investigated in model plants and cold‐sensitive fruits, such as banana (Musa acuminata). However, unlike the well‐known NAC and WRKY transcription factors (TFs), the function and deciphering mechanism of heat shock factors (HSFs) involving in cold response are still fragmented. Here, we showed that hot water treatment (HWT) alleviated CI in harvested banana fruits accomplishing with reduced reactive oxygen species (ROS) accumulation and increased antioxidant enzyme activities. A cold‐inducible but HWT‐inhibited HSF, MaHsf24, was identified. Using DNA affinity purification sequencing (DAP‐seq) combined with RNA‐seq analyses, we found three heat shock protein (HSP) genes (MaHSP23.6, MaHSP70‐1.1 and MaHSP70‐1.2) and three antioxidant enzyme genes (MaAPX1, MaMDAR4 and MaGSTZ1) were the potential targets of MaHsf24. Subsequent electrophoretic mobility shift assay (EMSA), chromatin immunoprecipitation coupled with quantitative PCR (ChIP‐qPCR) and dual‐luciferase reporter (DLR) analyses demonstrated that MaHsf24 repressed the transcription of these six targets via directly binding to their promoters. Moreover, stably overexpressing MaHsf24 in tomatoes increased cold sensitivity by suppressing the expressions of HSPs and antioxidant enzyme genes, while HWT could recover cold tolerance, maintaining higher levels of HSPs and antioxidant enzyme genes, and activities of antioxidant enzymes. In contrast, transiently silencing MaHsf24 by virus‐induced gene silencing (VIGS) in banana peels conferred cold resistance with the upregulation of MaHSPs and antioxidant enzyme genes. Collectively, our findings support the negative role of MaHsf24 in cold tolerance, and unravel a novel regulatory network controlling bananas CI occurrence, concerning MaHsf24‐exerted inhibition of MaHSPs and antioxidant enzyme genes. [ABSTRACT FROM AUTHOR]

ABSTRACT Although the frequency of ancient hybridization across the Tree of Life is greater than previously thought, little work has been devoted to uncovering the extent, timeline, and geographic and ecological context of ancient hybridization. Using an expansive new dataset of nuclear and chloroplast DNA sequences, we conducted a multifaceted phylogenomic investigation to identify ancient reticulation in the early evolution of oaks (Quercus). We document extensive nuclear gene tree and cytonuclear discordance among major lineages of Quercus and relatives in Quercoideae. Our analyses recovered clear signatures of gene flow against a backdrop of rampant incomplete lineage sorting, with gene flow most prevalent among major lineages of Quercus and relatives in Quercoideae during their initial radiation, dated to the Early‐Middle Eocene. Ancestral reconstructions including fossils suggest ancestors of Castanea + Castanopsis, Lithocarpus, and the Old World oak clade probably co‐occurred in North America and Eurasia, while the ancestors of Chrysolepis, Notholithocarpus, and the New World oak clade co‐occurred in North America, offering ample opportunity for hybridization in each region. Our study shows that hybridization—perhaps in the form of ancient syngameons like those seen today—has been a common and important process throughout the evolutionary history of oaks and their relatives. Concomitantly, this study provides a methodological framework for detecting ancient hybridization in other groups. [ABSTRACT FROM AUTHOR]