From wild-type to Omicron: changes in SARS-CoV-2 hospital cluster dynamics. Observations from a German tertiary care hospital.

Aim: SARS-CoV-2 hospital clusters are a challenge for healthcare systems. There is an increased risk of infection for both healthcare workers (HCWs) and patients; cluster countermeasures are also a drain on resources for the wards affected. We analysed to which extent characteristics and dynamics of SARS-CoV-2 clusters varied throughout the pandemic at a German university hospital. Methods: Patient and/or HCW clusters from 10/2020 to 04/2022 were included in the study and grouped by virus variant into i.) clusters comprised of the presumably predominant wild-type, Alpha or Delta (WAD) SARS-COV-2 variants, and ii.) clusters comprised predominantly of Omicron subtype cases. The two groups were compared for specific characteristics and dynamics. Results: Forty-two SARS-CoV-2 clusters and 528 cases were analysed. Twenty-one clusters and 297 cases were attributed to the WAD and 21 clusters and 231 cases to the Omicron group. There were no significant differences in median size (8 vs. 8 cases, p=0.94) or median duration (14 vs. 12 days; p=0.48), nor in the percentage of HCWs involved (46.8% vs. 50.2%; p=0.48). Patients in the WAD group were older (median 75 vs. 68 years of age; p≤0.05). The median time from cluster onset to case onset was significantly shorter for the Omicron group (median 6 vs. 11 days; p≤0.05). Conclusions: Omicron clusters exhibited a more rapid dynamic, forcing all parties involved to adapt to the increased workload. Compared to excessive community case counts, constant Omicron cluster-affiliated case counts and stable cluster characteristics suggest an improved compliance with IPC countermeasures.

Teaching prudent antibiotic use on the go: a descriptive report on development, utilization and listener satisfaction of an educational podcast format for medical students and young professionals.

BACKGROUND: An important component in fostering the responsible use of antibiotics is training of new and future prescribers in this interdisciplinary topic. Because podcasts are playing an increasing role in medical education, we aimed to develop and evaluate a podcast format with practice and guideline-oriented learning content on antibiotic therapy for medical students and young medical professionals. METHODS: We developed the concept for the podcast with the direct involvement of medical students and medical experts with teaching experience. We used video conferencing when recording the episodes in order to have quick, easy, and nationwide access to the experts involved. We released an episode every 2 to 4 weeks on the popular podcast platforms. The podcast was promoted through mailing lists, social and print media, and at conferences. The evaluation of episodes was based on user data provided by the platforms and an anonymous feedback questionnaire linked to each episode in the podcast notes. RESULTS: Between December 2021 and December 2022 19 episodes of InfectEd: der Antibiotika-Podcast were released. The mean duration of an episode was 91 min. By March 9, 2023, a total of 38,829 downloads and streams had been recorded. The majority of users listened to the podcast on a mobile device. The average playing time per episode was 65%. The feedback questionnaire was completed 135 times. 60.7% of respondents were female, 38.5% male. The majority of respondents were in their twenties and thirties (66.7%). 31.1% were medical students, 25.9% were residents, and 25.2% were specialists. Listeners were asked to rate episodes on a scale from 1 to 6, where 1 was "very good" and 6 was "insufficient." Ratings did not differ significantly between female and male respondents or between medical students and others. 118 respondents (87.4%) reported an increase in knowledge. Free-text feedback frequently emphasized clinical and also exam relevance. CONCLUSION: Our podcast format, developed with a user-centered approach, was broadly distributed and has been well accepted by both medical students and physicians alike. It provides a large number of learners with low-threshold access to current, guideline-orientated content and could be a useful supplement to conventional teaching formats.

The Role of the Human Cerebellum for Learning from and Processing of External Feedback in Non-Motor Learning: A Systematic Review.

This review aimed to systematically identify and comprehensively review the role of the cerebellum in performance monitoring, focusing on learning from and on processing of external feedback in non-motor learning. While 1078 articles were screened for eligibility, ultimately 36 studies were included in which external feedback was delivered in cognitive tasks and which referenced the cerebellum. These included studies in patient populations with cerebellar damage and studies in healthy subjects applying neuroimaging. Learning performance in patients with different cerebellar diseases was heterogeneous, with only about half of all patients showing alterations. One patient study using EEG demonstrated that damage to the cerebellum was associated with altered neural processing of external feedback. Studies assessing brain activity with task-based fMRI or PET and one resting-state functional imaging study that investigated connectivity changes following feedback-based learning in healthy participants revealed involvement particularly of lateral and posterior cerebellar regions in processing of and learning from external feedback. Cerebellar involvement was found at different stages, e.g., during feedback anticipation and following the onset of the feedback stimuli, substantiating the cerebellum's relevance for different aspects of performance monitoring such as feedback prediction. Future research will need to further elucidate precisely how, where, and when the cerebellum modulates the prediction and processing of external feedback information, which cerebellar subregions are particularly relevant, and to what extent cerebellar diseases alter these processes.

Mental Health Monitoring: Design Concept of a Smartphone Application.

Mental health (MH) has become a global issue. Digital phenotyping in mental healthcare provides a highly effective, scaled, cost-effective approach to handling global MH problems. We propose an MH monitoring application. The application monitors overall MH based on mood, stress, behavior, and personality. Further, it proposes objective MH assessment from smartphone data and subjective screening of MH via periodic, short, self-report standardized questionnaires.

Influence of titanium nanotubular surfaces, produced by anodization, on the behavior of osteogenic cells: in vitro evaluation / Influência da superfície nanotubular do titânio, produzido por anodização, no comportamento de células osteogênicas: avaliação in vitro

Objective: The objective of this study was to evaluate in vitro the influence of the anodized surface of Ti35Nb7Zr alloy on the behavior of osteogenic cells, for future application in biomedical implants. Material and Methods: For the development of this research, samples of commercially pure titanium (TiCp) and samples of Ti35Nb7Zr alloy were anodized, both were characterized by scanning electron microscopy (SEM) and were plated afterwards with human osteoblast-like cells (MG63 line) (2 x 104). Cell adhesion, cytotoxicity test, formation of mineralization nodules and a comet assay were also performed in different periods. The bottom of the plate was used as a control, without a sample. Results: SEM analysis showed that the topography of both samples presented surfaces covered by nanotubes. Cellular morphology exhibited spreading in both samples proposing an intimate cell- material liaison. After 3 days, the Ti35Nb7Zr group exhibited greater cell viability than the TiCp group (p<0.01). Regarding calcium content, there was no statistical difference between the anodized groups, but there was a difference between the experimental groups and the control group (p<0.01). In the comet assay, the percentage of DNA in the comet tail did not exhibit any significant difference (p>0.05) among the groups in the evaluated periods. Conclusion: It was concluded that this process of anodization was efficient to form nanotubes, as well as promote a positive influence on the behavior of osteogenic cells without promoting cell damage. (AU)

Objetivo: O objetivo deste estudo foi avaliar in vitro a influência da superfície anodizada da liga Ti35Nb7Zr no comportamento de células osteogênicas, para futura aplicação em implantes biomédicos. Material e Métodos: Para o desenvolvimento desta pesquisa, amostras de titânio comercialmente puro (TiCp) e amostras da liga Ti35Nb7Zr foram anodizadas, ambas foram caracterizadas por microscopia eletrônica de varredura (MEV) e posteriormente plaqueadas com células semelhantes a osteoblastos humanos (linha MG63) (2 x 104). Foram realizados em diferentes períodos a adesão celular, teste de citotoxicidade, formação de nódulos de mineralização e ensaio do cometa. O fundo da placa foi usado como controle, sem amostra. Resultados: A análise em MEV mostrou que a topografia de ambas as amostras apresentava superfícies cobertas por nanotubos. A morfologia celular exibiu espalhamento em ambas as amostras, propondo uma ligação íntima célula-material. Após 3 dias, o grupo Ti35Nb7Zr exibiu maior viabilidade celular do que o grupo TiCp (p<0.01). Em relação ao teor de cálcio, não houve diferença estatística entre os grupos anodizados, mas houve diferença entre os grupos experimentais e o grupo controle (p<0.01). No ensaio do cometa, a porcentagem de DNA na cauda do cometa não apresentou diferença significativa (p> 0.05) entre os grupos nos períodos avaliados. Conclusão:Concluiu-se que esse processo de anodização foi eficiente para formar nanotubos, além de promover uma influência positiva no comportamento das células osteogênicas sem promover dano celular. (AU)