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Assessing the Transferability of Peer‐Assisted Ultrasound Training for Medical Students: A Comparative Study Between Two Institutions in Germany and the UK
Get PDFUltrasound (US) is a clinically important imaging modality that can also enhance medical students' understanding of anatomy, physiology, and pathology. However, its integration into preclinical curricula often remains limited due to challenges such as resource constraints and instructor availability. To address these shortcomings, we implemented and evaluated a peer‐assisted learning (PAL)‐based US course—Summer School of Anatomy‐based Sonography Heidelberg (SASH)—with a daughter course at a second institution, the University of Cambridge (Cam‐SASH). Both programs focused on teaching fundamental US techniques through a structured, tutor‐led curriculum including an accompanying course manual. In 2022, we evaluated both programs prospectively, including 36 medical students. Over 1 week, student tutors trained participants in B‐mode abdominal US through lectures, hands‐on practice, and assessments, including Objective Structured Clinical Examinations (OSCEs) and pre‐ and post‐course multiple‐choice tests of anatomical knowledge. Post‐course knowledge levels were comparable between Hei‐SASH and Cam‐SASH participants, with no significant differences observed in multiple‐choice tests or OSCE performance (p ≥ 0.17). Feedback was overwhelmingly positive, with students reporting increased confidence and proficiency in performing US scans and interpreting images. This study highlights the transferability of PAL‐led US courses, with comparable outcomes between institutions. Our findings support the inclusion of such programs in undergraduate medical curricula, as they provide a cost‐effective and scalable solution to resource limitations. By enabling students to gain hands‐on experience with real‐time imaging, these courses bridge the gap between theoretical learning and clinical application, equipping future physicians with essential diagnostic skills
Expression of Properdin, the positive regulator of the Complement Alternative Pathway, at the fetal-maternal interface in Preeclampsia
Get PDFIntroduction: Aberrant complement activation can cause damage to newly formed fetal-derived structures and excessive inflammatory response at the feto-maternal interface, contributing to pregnancy-related complications, including preeclampsia (PE), which is one of the most severe pathologies in new-borns. Properdin is the only known positive regulator of the complement alternative pathway, as it stabilizes the inherently labile C3bBb complex and amplifies its activity. This study describes the presence of properdin in PE and investigates its role in the pathogenesis. Methods: We examined the distribution and expression of properdin at both the transcript and protein levels in term placental tissue, serum, placental syncytiotrophoblast microvesicles (STBMs), and circulating placental exosomes from PE women compared to healthy mothers, using RT-qPCR, western blot, immunohistochemistry, transmission electron microscopy (TEM), and immunofluorescence. To link properdin levels with alternative pathway complement factors, we also assessed the expression of C3 and C5. Results: PE placentae showed significantly higher properdin, C3 and C5 at transcript as well as protein levels compared to healthy placentae. Conversely, properdin levels in serum, STBMs, and circulating placental exosomes were lower in PE compared to healthy pregnancies. Immunohistochemical analysis revealed properdin distribution throughout the PE placentae, with higher concentrations at the syncytial knots containing pyknotic nuclei were observed via TEM, along with elevated levels of cleaved caspase 3. Discussion: Thus, properdin was significantly upregulated in the PE placentae, along with C3 and C5, and might be associated with the apoptotic nuclei inside syncytial knots. This evidence suggests that properdin may trigger complement-mediated damage to the placental barrier, exacerbating the development of PE placentae
JADES: low surface brightness galaxies at 0.4 < z < 0.8 in GOODS-S
Get PDFLow surface brightness galaxies (LSBs) are an important class of galaxies that allow us to broaden our understanding of galaxy formation and test various cosmological models. We present a survey of LSBs at in the Great Observatories Origins Deep Survey-South (GOODS-S) field using JWST Advanced Deep Extragalactic Survey (JADES) data. We model LSB surface brightness profiles, identifying those with mag arcsec in the F200W James Webb Space Telescope/Near-Infrared Camera (JWST/NIRCam) filter. We study the spatial distribution, number density, Sérsic profile parameters, and rest-frame colours of these LSBs. We compare the photometrically derived star formation histories, mass-weighted ages, and dust attenuations of these galaxies with a high surface brightness (HSB) sample at similar redshift and a lower redshift () LSB sample, all of which have stellar masses . We find that all samples have low star formation (SFR). The higher redshift LSBs and HSBs have similar star formation histories which show that the LSBs and HSBs possibly come from the same progenitors at , though the histories are not well constrained for the LSB samples. The LSBs appear to have minimal dust, with most of our LSB samples showing mag. JWST has pushed our understanding of LSBs beyond the local Universe
A supersymmetric AdS 3 duality
Get PDFWe find a dual description of the supersymmetric SL(2, ℂ)/SU(2) WZW model as a super-winding condensate CFT, which follows simply from the bosonic AdS3 duality found in [arXiv:2104.07233]. This duality can be seen as a dimensional uplift of the mirror symmetry between the H3+/U1 supercoset and N=2 super-Liouville theory
Enabling nondestructive observation of electrolyte composition in batteries with ultralow-field nuclear magnetic resonance
Get PDFRechargeable batteries represent a key transformative technology for electric vehicles, portable electronics, and renewable energy. Yet, there are few nondestructive diagnostic techniques compatible with realistic commercial cell enclosures. Many battery failures result from the loss or chemical degradation of the electrolyte. In this work, we present measurements through battery enclosures that allow quantification of electrolyte amount and composition. The study employs instrumentation and techniques developed in the context of zero-to-ultralow-field nuclear magnetic resonance (ZULF NMR), with quantum magnetometers as the detection elements (atomic optically pumped magnetometers, OPMs, and superconducting quantum interference devices, SQUIDs, used in this work). In contrast to conventional NMR methodology, which suffers from skin-depth limitations, the reduced resonance frequencies in ZULF NMR make battery housing and electrodes transparent to the electromagnetic fields involved. As demonstrated here through simulation and experiment, both the solvent and lithium-salt components of the electrolyte (lithium hexafluorophosphate, LiPF6) signature can be quantified using our techniques. Further, we show that the ZULF-NMR apparatus and technique are compatible with measurements of pouch-cell batteries
Spatial transcriptomics reveals a key role of fibroblast-like vascular smooth muscle cells in human atherosclerotic cell crosstalk and stability
Get PDFBackground and Aims: Atherosclerotic plaques are the leading cause of cardiovascular events. Single-cell approaches have identified diverse human plaque cell phenotypes but their spatial distribution and interactions remain unclear. Here, intercellular communication patterns in human plaque microenvironments were mapped to reveal novel targets to prevent atherosclerotic events. Methods: Spatial transcriptomics (Visium, 10x) from 13 carotid plaques, and single-cell transcriptomics (cells = 51 981) were used to analyse cell phenotypes, cell trajectories, and intercellular communications. Cells contributing to plaque stability were explored using deconvolution of plaque bulk RNA-seq data (n = 78), histology, and survival analyses. Key cells and pathways were validated in apolipoprotein E (Apoe)−/− mice and in vitro. Genome-wide association study enrichment analyses were conducted using summary statistics of atherosclerotic diseases. LINCS L1000 data were used to explore drug repurposing. Results: A fibroblast-like vascular smooth muscle cell (VSMC) phenotype associated with extracellular matrix formation pathways (validated in Apoe−/− mice) emerged as a key regulator of intra-plaque ligand-receptor signalling, in particular in the cap region. A higher proportion of fibroblast-like VSMCs was found in asymptomatics, associated with stable plaque features and predicted a lower risk of future events. Genes specific to this VSMC phenotype were enriched in coronary artery disease and myocardial infarction. Finally, compounds, which could induce key marker genes were identified and validated in vitro. Conclusions: This study provides the first comprehensive spatial transcriptomics map of cell communication in human plaque microenvironments. A pivotal role of a fibroblast-like VSMC, orchestrating intraplaque cell signalling and contributing to plaque stability, was identified. Targeting these cells might present promising novel avenues for therapies
Cervical spine chordomas: surgical outcome assessment in a multicenter cohort from the Primary Tumor Research and Outcomes Network
Get PDFObjectiveChordomas are rare, locally aggressive primary neoplasms. Resection with negative margins is the primary recommended therapeutic approach, while adjuvant radiotherapy and chemotherapy can also play a role in their treatment in certain situations, including lesions with positive margins or those that are poorly differentiated or dedifferentiated. Cervical spine chordomas pose significant surgical challenges given their proximity to critical anatomical structures and the mechanical constraints of the cervical spine. In the current case series, authors aimed to explore the clinical and patient-reported outcomes (PROs) of the surgical treatment of cervical chordomas in a large multicenter cohort.MethodsThis multicenter case series analysis utilized data from the prospectively collected Primary Tumor Research and Outcomes Network (PTRON) registry, from its inception (May 16, 2016) to data extraction (February 29, 2024). The study population was restricted to patients with histologically confirmed cervical chordomas involving levels C0-7, who underwent surgical treatment at one of the participating centers, and for whom both the initially planned and postoperatively pathologically confirmed surgical margins were documented. Patient demographics, tumor characteristics, surgical and adjuvant treatments, local recurrence-free survival (LRFS), overall survival (OS), and perioperative adverse events were retrieved. PROs included the Spine Oncology Study Group Outcomes Questionnaire version 2.0 (SOSGOQ2.0), EQ-5D, and SF-36 version 2.0 (SF-36v2).ResultsThirty-eight patients were identified, 12 of whom underwent true en bloc resection (EBR), 18 of whom underwent deliberate intralesional resection, and 8 of whom underwent EBR after intralesional surgery or in whom EBR failed. True EBR led to better LRFS (92% vs 83% vs 63%, respectively) and OS (83% vs 39% vs 50%, respectively). Surgical adverse events within 1 year were more frequent with true EBR (100% vs 39% vs 75%, respectively). EQ-5D, SOSGOQ2.0, and SF-36v2 showed improvement with true EBR, whereas the trends for PROs from the other groups were more variable.ConclusionsThis multicenter case series analysis provides critical insights into the clinical outcomes and PROs in the largest cohort of surgically treated cervical spine chordomas described to date. It underscores the importance and challenges of wide resection for oncological control. It establishes the associated morbidity and provides an overview of PROs following surgery. These findings contribute valuable evidence to inform shared decision-making and optimize patient care
Tissue-specific microbiota dictates the competitive dynamics of listeria species colonization
Get PDFLikelihood of Blood Culture Positivity Using SeptiCyte RAPID
Get PDFBackground: Early diagnosis and identification of causative pathogens using blood culture in patients suspected of blood stream infection (BSI) and sepsis are critical for improving patient outcomes through earlier and more targeted treatment. There is a need for tools that can guide the use of microbiologic diagnostics, especially where resources are limited, such as in lower- and middle-income countries (LMICs), pandemic and mass-casualty scenarios, and prolonged field care settings during military operations. Methods: Post hoc retrospective analysis of individual patient data from three prospective clinical studies, conducted in North America, Europe and Africa, to investigate the association between SeptiCyte RAPID test results (SeptiScores) and blood culture (BC) results. Hypothesis: that a significant correlation exists between elevated SeptiScores and positive blood culture results, and between low SeptiScores and negative blood culture results. Results: The area under the receiver operating characteristic curve (ROC AUC) was 0.91 for 85 BC(+) versus 257 SIRS and was 0.80 for 164 BC(-) versus 257 SIRS. As the SeptiScore increases, the relative probability of a septic patient being BC(+) as opposed to BC(-) also increases. A non-linear positive correlation is observed. Below a crossover point at SeptiScore 10, the ratio of probabilities of BC(+) sepsis/BC(-) sepsis is 1. Thus, septic patients with SeptiScores >10 have a higher probability of being BC(+) compared to BC(-). Conclusions: Elevated SeptiScores, obtained before blood culture results, are indicative of increased blood culture positivity. This may have clinical utility, particularly in resource-limited settings, as an aid for improving the efficiency of blood culture practice, for instance, by informing patient selection and interpretation of blood culture results
Biobanking knowledge and donation willingness among musculoskeletal patients in England: a multisite cross-sectional study
Get PDFObjective: To date, few studies have investigated the factors associated with musculoskeletal patients’ willingness to donate biological samples and their knowledge regarding the use of such samples. We investigated the associations between these distinct knowledge factors, patients’ willingness to donate and socio-demographic factors. Design: Cross-sectional survey. Setting: Musculoskeletal outpatient clinics across four sites in England, representing varied demographic populations. Participants: A total of 469 adult patients attending musculoskeletal appointments were recruited through convenience sampling. Primary and secondary outcome measures: Ordinal regression models were employed to identify socio-demographic and clinical predictors of patients’ willingness to donate biological samples. Other outcome measures specifically in two areas of patient knowledge include: (1) knowledge of sample use and (2) knowledge of surgical waste tissue value and management. Results: Only 37% of participants were aware of the term ‘biobank’. Despite this, participants showed a high level of knowledge regarding both biological sample use and surgical waste tissue management, although their understanding varied considerably by ethnicity and education. Participants with no formal education exhibited a lower level of knowledge in both areas related to sample use and surgical waste tissue management for biomedical research ((OR 0.30, 95% CI 0.14 to 0.61; p=0.001); (OR=0.29, 95% CI 0.16 to 0.52, p<0.001), respectively). Individuals with ≥2 A-levels or equivalent (OR=0.44, 95% CI 0.24 to 0.79, p=0.006) and those identifying as Asian/Asian British (OR=0.51, 95% CI 0.29 to 0.88, p=0.016) also demonstrated a lower understanding of the value and management of surgical waste tissue. Willingness to donate was generally high but was significantly lower among non-Caucasian participants (Black (OR=0.23, 95% CI 0.08 to 0.61, p=0.004); Asian (OR=0.29, 95% CI 0.15 to 0.56, p<0.001)) and those with lower education levels (no formal education (OR=0.40, 95% CI 0.18 to 0.91, p=0.029); preferred not to disclose (OR=0.27, 95% CI 0.13 to 0.57, p<0.001)). Participants from Manchester were 2.18 times more likely to report a higher willingness (OR=2.18, 95% CI 1.09 to 4.33, p=0.027). Finally, participants who were aware of the term “biobank” had 2.16 times the odds of willingness to donate to biobanking initiatives for biomedical research (OR=2.16, 95% CI 1.23 to 3.77, p=0.007). Conclusions: Despite low awareness, musculoskeletal patients showed a high willingness to participate in biobanking. However, significant disparities by ethnicity and education persist. Targeted, inclusive engagement strategies are needed to address under-representation and foster informed, equitable participation of musculoskeletal patients in biomedical research