Cephalic and ocular manifestations of EBV-associated plasmablastic lymphoma: Clinical and radiological response to bortezomib, EPOCH, and intrathecal methotrexate.

Plasmablastic lymphoma (PBL) is a rare and aggressive type of lymphoma, particularly affecting HIV-positive and immunocompromised individuals, with a median diagnosis age of 49 years. Cases of this malignancy in HIV-negative individuals are less common and rarely involve the bone marrow. While traditional chemotherapy regimens such as cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) were previously utilized in the management of such malignancy, the National Comprehensive Cancer Network currently recommends more intensive approaches. We present a rare stage IV Epstein-Barr virus (EBV)-positive PBL with a nasal cavity tumor extending into the left orbital sinus and encapsulating segments of the optic nerve in a 38-year-old young immunocompetent adult, without a significant past medical history. Treatment consisted of 6 cycles of Bortezomib in combination with dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) and intrathecal methotrexate which exhibited significant clinical and radiological improvement suggesting the potential efficacy of this regimen. Vision returned to baseline, the mass size reduced significantly, and headaches improved. Given this outcome, it is highly encouraged to emphasize the need for further exploration of this treatment in larger clinical trials.

Toll-like receptor 21 in Labeo rohita recognizes double-stranded RNA and lipopolysaccharides by engaging the critical motifs in the LRR domain and gets activated against bacterial assaults.

TLR (Toll-like receptor)-21 is a non-mammalian TLR and exhibits a unique function within the innate immune systems of fishes, birds, and amphibians. Despite its important role as PRR (pattern recognition receptor), research on TLR21 in many fish species, as well as in rohu (Labeo rohita), remains relatively limited. This article describes the molecular cloning of LrTLR21 (TLR21 in L. rohita), 3D (3-dimensional) modelling of its LRR (leucine-rich repeat)-regions, prediction of LRR18 to LRR20 as the LPS (lipopolysaccharide)-binding site, and LRR1 to LRR5 and LRR21 to LRR23 as the poly I:C (polyinosinic-polycytidylic acid) binding sites. It also describes the response of LrTLR21 in response to Aeromonas hydrophila and Edwardsiella tarda infections and PAMPs (pathogen-associated molecular patterns) (LPS and poly I:C)-stimulations. The ORF (open reading frame) of the LrTLR21 comprises 2955 nucleotides, encoding 984 aa (amino acid) residues with molecular weight and isoelectric point of 113.791 kDa and ∼8.79, respectively. Domain analysis of the deduced LrTLR21 displayed the existence of a signal peptide (residues 1-24), 26 LRR regions (residues 61-685), a TM (transmembrane) domain (residues 736-758), and a TIR (Toll/interleukin-1 receptor) domain (residues 790-937). The 3D model of LrTLR21-LRR regions has parallel ß-sheets and few α-helices. Phylogenetically, LrTLR21 is closely related to the Onychostoma macrolepis and Carassius gibelio TLR21, and during ontogenesis, it is expressed in most of the developmental stages. In rohu fingerlings, it is consistently expressed in all examined tissues viz., skin, liver, heart, blood, eye, muscle, kidney, intestine, brain, gill, and spleen. Upon exposure to E. tarda and A. hydrophila infections, as well as LPS and poly I:C stimulations, the expression of LrTLR21 is significantly (p < 0.05) increased in the blood, kidney, liver, and gill. In the RBCs (red blood cells), PBLs (peripheral blood leukocytes), and kidney macrophages, LrTLR21 is also significantly induced following in-vivo and in-vitro LPS and poly I: C-stimulations. These findings on LrTLR21 are the first ones showing its structural insights and PAMPs binding motifs and its key role in recognizing pathogens and their PAMPs in RBCs, PBLs, and macrophages.

Fine-tuning of the dual-role transcription factor WRKY8 via differential phosphorylation for robust broad-spectrum plant immunity.

Plants utilize plasma membrane-localized pattern recognition receptors (PRRs) to perceive pathogen-associated molecular patterns (PAMPs) to activate broad-spectrum pattern-triggered immunity (PTI). However, the regulatory mechanism ensuring robust broad-spectrum plant immunity remains largely unknown. Here, we reveal the dual roles of the transcription factor WRKY8 in transcriptional regulation of PRR genes: repressing the nlp20/nlp24 receptor gene RLP23 whereas promoting the chitin receptor gene CERK1. Remarkably, SsNLP1 and SsNLP2, two nlp24 type PAMPs in the destructive fungal pathogen Sclerotinia sclerotiorum, activate two calcium-elicited kinases, CPK4 and CPK11 to phosphorylate WRKY8 and consequently release its inhibition on RLP23 expression to accumulate RLP23. Meanwhile, SsNLPs activate a RLCK type kinase, PBL19 to phosphorylate WRKY8 and consequently enhance the accumulation of CERK1. Intriguingly, RLP23 is repressed at late stage by PBL19-mediated phosphorylation of WRKY8, to avoid excessive immunity for normal growth. Our findings unveil a "killing two birds with one stone" strategy employed by plants to elicit robust broad-spectrum immunity, which is based on PAMP-triggered fine-tuning of a dual-role transcription factor to simultaneously amplify two PRRs recognizing PAMPs well conserved in a wide range of pathogens. Moreover, our results reveal a novel plant strategy based on fine-tuning of multiple PRR gene expression to balance the trade-off between growth and immunity.

Studying the effectiveness of self-directed education in learning and teaching the otolaryngology module in an integrated-based curriculum.

Introduction: Self-learning is a learning process in which students harvest the enterprise, to express their learning goals, choose assets for learning, practice learning strategies, and assess the outcomes achieved. Many forms of self-learning were introduced in integrative medical curricula such as Team-based learning (TBL) and Problem-based learning (PBL). This study aims to evaluate self-learning in the otolaryngology module and determine the type of self-learning that students prefer and which of these types has a stronger impact on achieving the educational objectives of the module. Material and methods: A cross-sectional study was done on the 270 students of studied the otolaryngology module in three consecutive years representing the whole class of the fifth-year medical students along three consecutive years. A Likert scale questionnaire was distributed to measure the students' satisfaction with the current teaching and learning. Results: The obtained results revealed higher students 'satisfaction with TBL than other modalities supported by high achievement in TBL-related questions. In addition, there is a significant difference between TBL and PBL (p = .00044). No significant differences were obtained either between TBL and CBL (p = .16570) or between TBL and Seminar presentation (p = .16570). In addition, no significant correlations were obtained between PBL and CBL (p = .34677), between PBL and seminar presentation (p = .46496), and between CBL and seminar (p = .99967). Conclusion: The results showed that the highest students' satisfaction was towards TBL compared to other educational methods. These results encourage clinical educators to insert and implement TBL in most of the integrative curriculum modules, especially that of the clinical years.

The implementation of a diversified teaching model can enhance the quality and efficacy of dental materials science.

OBJECTIVE: Dental materials science is one of the fundamental disciplines in stomatology, encompassing clinical areas such as orthodontics, prosthodontics, and endodontics. Due to its extensive knowledge base, strong professional nature, and wide scope, teaching dental materials science presents a challenge. This study aimed to enhance the application of dental materials science in oral teaching by comparing the effectiveness of different teaching methods. METHODS: This research project was evaluated by the Xi'an Jiaotong University Committee on Human Subjects Research and approved as exempt research. A total of 56 clinical stomatology students from the first year and second year cohorts at the Stomatology Hospital of Xi'an Jiaotong University were selected for the study. The first year cohort served as the nonteaching reform class, while the second year cohort formed the teaching reform class. The impact of the teaching reform was assessed through a questionnaire survey and final examination results. RESULTS: The questionnaire survey of students in the teaching reform class indicated a significant improvement in their interest in professional courses and overall satisfaction with the teaching. Additionally, the final examination results revealed a significantly greater rate of excellence among students in the teaching reform class than among those in the nonteaching reform class, with no students failing. CONCLUSION: The use of diverse teaching modes can enhance the quality and effectiveness of dental materials science instruction, offering a new approach for improving teaching in this discipline.

Application of data-driven blended online-offline teaching in medicinal chemistry for pharmacy students: a randomized comparison.

BACKGROUND: The purpose of this study was to evaluate the effectiveness and efficiency of implementing a data-driven blended online-offline (DDBOO) teaching approach in the medicinal chemistry course. METHODS: A total of 118 third-year students majoring in pharmacy were enrolled from September 2021 to January 2022. The participants were randomly assigned to either the DDBOO teaching group or the traditional lecture-based learning (LBL) group for medicinal chemistry. Pre- and post-class quizzes were administered, along with an anonymous questionnaire distributed to both groups to assess students' perceptions and experiences. RESULTS: There was no significant difference in the pre-class quiz scores between the DDBOO and LBL groups (T=-0.637, P = 0.822). However, after class, the mean quiz score of the DDBOO group was significantly higher than that of the LBL group (T = 3.742, P < 0.001). Furthermore, the scores for learning interest, learning motivation, self-learning skill, mastery of basic knowledge, teamwork skills, problem-solving ability, innovation ability, and satisfaction, as measured by the questionnaire, were significantly higher in the DDBOO group than in the traditional group (all P < 0.05). CONCLUSION: The DDBOO teaching method effectively enhances students' academic performance and satisfaction. Further research and promotion of this approach are warranted.

Reform of teaching and practice of the integrated teaching method BOPPPS-PBL in the course "clinical haematological test technique".

BACKGROUND: In order to meet the demand for laboratory talents in the clinical laboratory industry and address the current curriculum characteristics and shortcomings of the teaching mode of "Clinical Hematology Laboratory Technology", we investigated the effectiveness of the bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary model combined with problem-based learning (BOPPPS-PBL) in undergraduate teaching of this course. METHOD: Seventy students majoring in Medical Laboratory Technology from the Army Medical University in the past 5 years have been selected and divided into two groups with the same teaching content and time. The control group (2015 and 2016 grades) used traditional teaching methods, while the experimental group (2017, 2018 and 2019 grades) used the BOPPPS-PBL model. After class, diverse evaluation methods were used to analyze the formative and summative exam scores of the two groups of students. RESULTS: After the reform, students performed significantly better in exams than before. In addition, the new teaching methods have had a positive impact, with students demonstrating high motivation for self-directed learning and problem-solving abilities. CONCLUSION: Compared to traditional teaching methods. The BOPPPS-PBL integrated case study education model is a relatively effective teaching method to improve students' problem-solving ability and comprehensive practical ability.

Problem-Based Learning for Interprofessional Education: A Review of the Concept and Its Application in a Geriatric Team.

The global population is aging, with those aged 65 years or over increasing in number and accounting for a growing share of the population. There are increasing demands for geriatric care which makes the development and delivery of effective geriatric team training a priority. Training in geriatrics is complex because of the multiplicity of medical, psychosocial, and functional issues in elderly individuals which need to be addressed by a multidisciplinary approach using interprofessional education (IPE). Problem-based learning, a student-centered educational model that brings several natural strengths to IPE, is a unique curriculum replacing the traditional lecture-based learning model. This model enhances physician competency after graduation, mainly in psychosocial and teamwork issues that are fundamentally essential for geriatrics. IPE has been shown to have a substantial positive impact on team collaboration, individual development, and healthcare improvement. In this paper, we summarize the current findings from recent studies on training professionals from different healthcare disciplines to deliver care for the elderly in collaborative practice. We also discuss if an interprofessional problem-based geriatric team program in geriatrics is a promising solution to enhance professional collaboration and quality of patient care.

Enhancing Engagement and Achievement in Nursing Education: The Effect of Combining Online PBL and Design Thinking on Student Motivation and Satisfaction - A Qualitative Analysis.

This study explores the integration of design thinking into online problem-based learning (PBL) within the context of nursing education, leveraging Google Jamboard as a facilitative interactive tool. By prioritizing creativity, empathy, and iteration, this innovative approach seeks to bolster student motivation and satisfaction. Employing a quasi-experimental design, the research involved third-year nursing students and compared the efficacy of traditional PBL methods against a hybrid model that integrates design thinking principles. Notably, the experimental group's interaction with Google Jamboard significantly enhanced their engagement, resulting in notable improvements in both motivation and satisfaction. The findings underscore the benefits of merging online PBL with design thinking, particularly when supported by digital tools, in creating a more vibrant and effective learning environment. This methodology not only stimulates active learning but also fosters vital competencies such as critical thinking and collaboration, which are crucial in the nursing profession. The results of this study advocate for the implementation of cutting-edge teaching methodologies in nursing education and pave the way for further investigation into the enduring impacts of this educational amalgamation.

Problem-Based Learning - An Overview.

The main objective of Problem-Based Learning (PBL) is to develop problem-solving skills, collaborative learning skills, self-directed learning skills, communication skills, deeper learning skills, lifelong learning skills, and better retention in the students to equip them better in their professional careers. Unlike the traditional curriculum which is mainly based on didactic lectures, PBL is based on a group of students working on a problem and solving it. PBL is a promising teaching and learning tool that can be adopted in all fields, especially in Medical and Dental curricula.

Exploring the Effectiveness of Problem-Based Learning in an International Undergraduate Program in Veterinary Sciences: Students' Satisfaction, Experience and Learning.

The systematic evaluation of the integration of problem-based learning (PBL) into educational programs in Italy is scarce and there are no published reports of its use in an Italian Bachelor of Veterinary Science degree program. This paper aims to assess the satisfaction of second-year students on an international Bachelor of Veterinary Science degree program after implementing two weeks of PBL with a multidisciplinary approach. Moreover, the impact of this methodological approach on the students' performance and their perceptions concerning their learning experience was investigated. The results showed that students expressed a high level of satisfaction and a positive attitude towards learning through PBL. A significant increase in the perception of students' soft skills was also found, based on self-evaluation. Moreover, a significant improvement was seen in the students' perception of their learning and teaching experiences and general life competencies, assessed using the validated questionnaire HowULearn. Negative effects were also identified, requiring further design modification of the tutors' feedback and pedagogical orchestration. Based on our findings, when planning bachelor's degree programs in veterinary science, PBL modules or activities should be considered to promote active learning, engagement among students, and the improvement of problem-solving and team-working skills.

Sociocultural factors affecting first-year medical students' adjustment to a PBL program at an African medical school.

BACKGROUND: Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students' experiences during the first semester of an undergraduate problem-based learning medical program at an African medical school. METHOD: We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. RESULTS: Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. CONCLUSIONS: Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self-direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research-informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem-based learning process.

Use of problem-based learning in orthopaedics education: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Currently, problem-based learning (PBL) has been widely used in many disciplines, but no systematic review has explored the advantages and disadvantages of PBL in orthopaedics education. METHODS: We searched the PubMed, Cochrane Library, Embase, Web of Science, Scopus, Chongqing VIP Database (VIP), Chinese National Knowledge Infrastructure (CNKI), and Wanfang databases up to April 2023 to identify for relevant studies. Relevant studies were identified by using specific eligibility criteria, and data were extracted. RESULTS: A total of 51 randomized controlled trials with 4268 patients were included. Compared with traditional education, PBL teaching yielded significantly higher knowledge scores (SMD=1.10, 95% CI: 0.78~1.41, P<0.00001), procedural skill scores and clinical skill scores than traditional teaching (SMD=2.07, 95% CI: 1.61~2.53, P<0.00001; SMD=1.20, 95% CI: 0.88~1.52, P<0.00001). Moreover, the total scores were higher in the PBL teaching group than in the traditional teaching group (MD=5.69, 95% CI: 5.11~6.26, P<0.00001). Students also expressed higher levels of interest and satisfaction in the PBL teaching group than in the traditional teaching group (OR=4.70, 95% CI: 3.20~6.93, P<0.00001; OR=5.43, 95% CI: 3.83~7.69, P<0.00001). However, there was less learning time and higher levels of learning pressure in the PBL teaching group (OR=0.12, 95% CI: 0.06~0.24, P<0.00001; OR=5.95, 95% CI: 3.16~11.23, P<0.00001). CONCLUSION: Current evidence indicates that PBL teaching can increase knowledge scores, procedural skill scores, and clinical skill scores. Students have higher levels of interest in teaching and higher levels of teaching satisfaction in the PBL group. However, students can feel higher levels of study pressure and experience less study time. The findings of the current study need to be further verified in multicentre, double-blind and large-sample RCTs.

Enhancing Medical Education: A Pathway to Nurturing Future Healthcare Professionals.

Introduction As medical knowledge, technology, and healthcare delivery continue to evolve, it is critical that upcoming healthcare workers possess the skills and information needed to ensure optimal patient care. Numerous studies indicate that students achieve better learning outcomes through active practice rather than solely relying on theoretical knowledge. The average human attention span is only 8.25 seconds, so an effective teaching program should employ various modes and techniques to ensure that students remain involved and interested. Aims and objectives The aim is to identify the primary areas where medical students need teaching and guidance and form the basis of a new teaching program to meet those needs. Materials and methods An anonymous online questionnaire, designed by the author was distributed to medical students who came for their clinical rotations at Basildon University Hospital, Mid and South Essex NHS Foundation Trust, United Kingdom, and that laid the foundations for introducing a new teaching program at the education department of the hospital in April 2023. The progress of the teaching program was evaluated by a second questionnaire-based survey conducted after six months, in October 2023. The teaching program we designed employed various modes and techniques including simulation, flip classroom, graded quizzes, and constructive feedback. The technique we used for giving feedback to students was the "star star wish" to encourage growth and further participation. The teaching program also made use of Lev Vygotsky's "Learning zone model" to ensure optimum learning. Results and discussion The program received immensely positive feedback from the students, and they felt that it catered perfectly to their requirements. Twenty-three students took part in this study and the results showed that 39% of the students felt adequately prepared for ward rounds in October 2023 in contrast to only 17% in April 2023. The mean score, on a scale of 1-10 on how comfortable the students felt in discussing patient care plans and management with the rest of the team rose from 2.78 in April 2023 to 4.26 in October 2023. When asked to score how confident the students felt in performing bedside examinations in wards, 26% scored 5 or above (on a scale of 1-10) in April 2023 as compared to 62% scoring 5 or above in October 2023. The students were then asked how confident they felt in using their theoretical knowledge in practical situations and the majority scored 2 or 3 (on a scale of 1-10) in April 2023 whereas in October, the majority scored 4 or above. Conclusions A significant number of medical students were satisfied with the teaching program and demanded more frequent sessions. The results of this study showed that in order to foster increased student engagement and effective participation, it is essential for teaching to incorporate diverse techniques and approaches.

Anaplastic lymphoma kinase-positive anaplastic large-cell lymphoma with primary bone involvement: a case report.

Background: Lymphomas originating in bone but not involving visceral or regional lymph nodes are diagnosed as primary bone lymphoma (PBL). Few case reports of anaplastic large-cell lymphoma (ALCL) originating in bone have been reported. The purpose of this report is to describe the difficulty in diagnosing and complete treatment process of this rare type of bone lymphoma. Case Description: We describe a case of anaplastic lymphoma kinase positive (ALK+) ALCL patient with primary multiple bone lesions. The patient was initially in the local hospital due to lumbosacral pain and was diagnosed with multiple myeloma. However, after receiving two cycles of bortezomib, lenalidomide and dexamethasone (VRD) chemotherapy, the patient's pain increased. After discussion with the patient and his family, the patient finally agreed to accept the biopsy of the T10 and L2 vertebral bodies and diagnosed as ALK+ ALCL stage IV with primary bone involvement. After receiving multiple cycles of chemotherapy, local bone radiotherapy and denosumab treatment, the patient's bone pain and osteolytic lesions were improved. Regular follow-up shows that the patient's bone pain has been controlled and he is generally in good condition. Conclusions: ALK+ ALCL originating primarily in the bone may be easily misdiagnosed and hence require appropriate evaluation in the upfront setting. In consideration of the lack of relevant experience due to the rarity of the disease, choosing a suitable treatment regimen requires comprehensive consideration. In the next clinical work, we must observe relevant cases to summarize the treatment experience better.

Efficacy and safety of pembrolizumab combined with albumin-bound paclitaxel and nedaplatin for advanced esophageal squamous cell carcinoma.

Objective: This research aimed to assess the efficacy and safety of pembrolizumab (PBL) combined with albumin-bound paclitaxel (ab-Pac) and nedaplatin (NDP) for advanced esophageal squamous cell carcinoma (ESCC). Methods: A total of 47 ESCC patients were administered PBL or NDP on day 1 and ab-Pac on days 1 and 8, every 21 days for one cycle. Tumor and toxicities were evaluated every two cycles and every cycle, respectively. Results: The objective response rate was 68.1% and the disease control rate was 100%. The median follow-up was 16.7 months; median progression-free and overall survival were 12.6 and 19.9 months, respectively. Conclusion: The combination of PBL with ab-Pac and NDP proved to be an effective and safe treatment regimen for advanced ESCC.

Relationship of human cytomegalovirus-infected endothelial cells and circulating leukocytes in the pathogenesis of disseminated human cytomegalovirus infection: A narrative review.

Among the leucocyte subpopulations circulating in peripheral blood of immune-compromised patients with disseminated Human cytomegalovirus (HCMV) infection, polymorphonuclear leuckocytes (PMNL) and M/M may carry infectious virus. While only in PMNL early HCMV replicative events do occur, monocytes are susceptible to complete virus replication when they enter human organs, where as macrophages become a site of active complete virus replication. In vivo leucocytes and endothelial cells interact continuously, as suggested by several in vitro experimental findings showing the bidirectional HCMV transmission from leucocytes to and from endothelial cells with the critical aid of adhesion molecules. Recently, the neutralising antibody response in sera from subjects with primary HCMV infection was reported to be much higher and earlier than in human embryonic lung fibroblasts (HELF) cells when measured in endothelial cells and epithelial cells, where virus entry is mediated mostly by the pentamer complex gH/gL/pUL128/pUL130/pUL131, whereas it was much lower and delayed when determined in HELF, where virus entry is mediated mostly by the trimer complex gH/gL/gO. Thus, these results suggested that products of UL128L were the molecules primary responsible for the differential neutralising antibody response. This conclusion was confirmed by a series of polyclonal and monoclonal antibodies directed to the components of pUL128L. Very recently, based on two sets of experiments including inhibition and immunoblotting assays, the pentamer complex/trimer complex ratio has been finally identified as the main factor of the neutralising antibody response. This ratio may change with the virus suspension producer and target cell system as well as number of cell culture passages.

Primary bone diffuse large B-cell lymphoma (PB-DLBCL): a distinct extranodal lymphoma of germinal centre origin, with a common EZB-like mutational profile and good prognosis.

AIMS: Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is not recognized as a separate entity by the current classification systems. Here we define and highlight its distinctive clinical presentation, morphology, phenotype, gene expression profile (GEP), and molecular genetics. METHODS: We collected 27 respective cases and investigated their phenotype, performed gDNA panel sequencing covering 172 genes, and carried out fluorescence in situ hybridization to evaluate MYC, BCL2, and BCL6 translocations. We attempted to genetically subclassify cases using the Two-step classifier and performed GEP for cell-of-origin subtyping and in silico comparison to uncover up- and downregulated genes as opposed to other DLBCL. RESULTS: Most cases (n = 22) were germinal centre B-cell-like (GCB) by immunohistochemistry and all by GEP. Additionally, PB-DLBCL had a mutational profile similar to follicular lymphoma and nodal GCB-DLBCL, with the exception of more frequent TP53 and B2M mutations. The GEP of PB-DLBCL was unique, and the frequency of BCL2 rearrangements was lower compared to nodal GCB-DLBCL. The Two-step classifier categorized eight of the cases as EZB, three as ST2, and one as MCD. CONCLUSION: This study comprehensively characterizes PB-DLBCL as a separate entity with distinct clinical and morpho-molecular features. These insights may aid in developing tailored therapeutic strategies and shed light on its pathogenesis.

The tools of the future are the challenges of today: The use of ChatGPT in problem-based learning medical education.

What is the educational challenge?Incorporation of large language model (LLM) or generative artificial intelligence (AI) software poses a challenge to various areas of medical education, including problem-based learning (PBL). LLMs, such as ChatGPT, have incredible potential to transform educational systems and enhance student learning outcomes when used responsibly.What are the proposed solutions?ChatGPT can provide several ways to support students and assist facilitators with course responsibilities. Here we address factors of implementation and describe how ChatGPT can be responsibly utilized to support key elements of PBL.How was the solution implemented?Providing reasonable access is an essential element of novel software implementation. Additionally, training for both faculty and staff is vital to foster responsible usage, provide base-line proficiency, and guide users to critically evaluate the quality of output.What lessons were learned that are relevant to a wider audience?The use of LLMs or other generative AI is dramatically rising in the world. Appropriate and conscientious incorporation of AI into educational programs can foster responsible use and potentially enhance student learning.What are the next steps?Assessment of learning outcomes, student self-efficacy, group dynamics, and stakeholder feedback are required to measure the effects of ChatGPT in the PBL curriculum. Additionally, software programs competitive with ChatGPT are currently under development and will also need to be investigated for their potential role in education.