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BackgroundSince the emergence of COVID-19, health care workers and first responders have been at a high risk for mental health symptoms owing to their exposure to the virus and increased work stress during the pandemic. Although interventions exist to address mental health issues following exposure to disasters, emergencies, and humanitarian crises, considerably less is known about web-based unguided interventions to help mitigate the negative impacts of such events. Additionally, in contexts in which emergencies reduce access to in-person care, remote forms of support are critical, yet there are limited studies on the use of such interventions. Evidence-based, easy-to-use, scalable interventions are direly needed for this population. ObjectiveThis study aimed to develop and test the feasibility of an unguided electronic mental health program, COVID-19 Anxiety and Stress Resilience Training (COAST), tailored to first responders and health care personnel, based on scientific evidence and empirically based techniques. MethodsWe developed COVID-19–specific training modules focusing on several domains that are previously reported as key to resilience and stress recovery: self-efficacy, mindfulness, sleep quality, and positive thinking. The program was made available to 702 first responders between May and August 2020, during the COVID-19 pandemic. Sociodemographic, work-, and COVID-19–related information was collected, and psychometric questionnaires were completed. We examined user acceptance and user activity, including module choice and participant feedback. ResultsIn total, 52 of 702 (7%) first responders to whom we reached out used the program at least once. COAST use was independent of age, sex, or baseline levels of self-efficacy, mindful awareness, sleep quality, and positive thinking (for all, P>.39). First responders who had tested positive and those who had been quarantined were more likely to engage in the program. A click count analysis per module showed that participants used the self-efficacy and mindfulness modules most often, with 382 and 122 clicks, respectively, over 15 weeks. Overall, first responders expressed satisfaction with the program. ConclusionsEngagement of first responders in the multimodule web-based COAST program was feasible and the first responder cohort expressed overall satisfaction with the program. Those in more difficult circumstances, including those in quarantine and those who tested positive, may be more likely to engage in such programs. Further controlled studies could pave the way for efficacy studies and the development of additional modules, including just-in-time interventions or blended interventions combining individual use of an unguided self-help intervention, such as COAST, with subsequent individual psychotherapy for those who continue to experience stress and psychological symptoms.

Due to the COVID-19 pandemic, digital teaching approaches should be used wherever possible. In this article we report on our project for digital teaching and learning of surgical skills.The compulsory elective “Intensivkurs Chirurgische Techniken” for medical students starting with semester 5 was designed as a blended learning course. One week before the face-to-face class, the students receive the learning and teaching material online in a Moodle course. In the face-to-face class, live demos of procedures (e.g. performing skin and intestinal sutures) are presented by the teachers. The learners then perform the practical procedures and record themselves with the camera of an iPad. They publish their videos in the Moodle course via an Opencast plugin. The implementation of an annotation tool enables everyone in the Moodle course to add free-text comments to selected parts of the videos (video-assisted feedback and coaching).As a result of the pandemic, the face-to-face class is being moved to a digital learning environment. For this purpose, we are extending the existing system with a web conference tool (BigBlueButton).

Objective: The objective structured clinical examination (OSCE) has become widely accepted as a form of assessment in medical education. At the same time, the more traditional multiple choice question (MCQ) examinations remain a central modality of student assessment. This pilot survey aimed to investigate students’ perceptions about the benefits of the OSCE and MCQs to yield data supporting the implementation of this assessment strategy into the national medical licensing examination in Germany.Methods: A questionnaire was delivered electronically to 34 German medical schools. Students in years 3-6 were invited to rate 11 items about objectives of good medical assessment. All items were presented for both the OSCE and MCQs using a 5-point Likert Scale (1=strongly disagree to 5=strongly agree). Factor analysis was used to identify underlying components in the ratings. Average scores of items that belonged to a component were computed.Results: Data analysis included 1,082 students from 32 medical schools. For the OSCE, factor analysis revealed two components, which were labelled “educational impact” and “development of clinical competence”. The average scores of items were 3.37 and 3.55, respectively. For the MCQ modality, also two components emerged. These were labelled “perceived weaknesses of MCQs” and “perceived strengths of MCQs” (consisting of items such as “promotes my theoretical knowledge”). The average scores for these components were 1.85 and 3.62.Conclusion: The results of this pilot survey indicate that students consider both OSCE and MCQs as useful assessments for the purposes for which they were designed. The assessment strategy thus appears appropriate and it should be used in the national licensing examination.

Lectures and seminars increasingly strive for continuous interactions between learners and the instructor. I study whether the communication program Slack contributes to these goals by analyzing daily activity statistics in methodological and project-based postgraduate courses at an Irish university. Both semester-long courses were taught online during the coronavirus pandemic (COVID-19) and in person. The quantitative analysis reveals three insights. First, students are active on Slack throughout the term. Second, students post messages in public channels and extensively use private channels and direct messages. Third, many students follow the conversations, ensuring transparent and fair communication between students and instructors. Open-ended responses suggest that Slack created "team spirit." I conclude with five recommendations: students should sign up in the first week of term; create channels for different aspects of the module; explain when students can expect a response; encourage private conversations between students; and monitor activities regularly.

Background: The highly vascular nature of renal carcinoma cells suggests that inhibition of angiogenesis may be beneficial in this disease. Thalidomide has been described as inhibitor of the fibroblast growth factor (FGF) and the vascular endothelial growth factor (VEGF). Therefore and in consideration of the promising response rates of the combination of IL-2, IFN-alpha and 5-FU [1] in metastatic renal cancer, we found it reasonable to test the combination of 5-FU and thalidomide. Thus, we conducted a phase I trial to determine safety, side effects and responses to such a treatment. Methods: Patients with metastasized renal cell cancer after nephrectomy and progress after IL-2 and interferon treatment, received oral 5-FU at a dose of 1250 mg/qm2 twice a day for two weeks, then after pausing a week, the oral application was restarted. In addition, oral thalidomide was applied constantly at a maximum dose of 400 mg/d. The combined therapy was given for three months. The primary endpoint was duration until disease progression, the secondary endpoint the response to treatment. Response was determined by CT scans three months after the end of treatment. Results: In total, 12 male patients participated in the trial and received the combined oral therapy. Concerning clinical response, one mixed response (8%), a stable disease in 4/12 patients (33%) and progression was seen in 7 patients (58%). The survival from the start of the therapy showed a median of 21 months with three patients being alive. At present, the longest survival after the therapy is 51 months. Conclusions: The combination of oral 5-FU and thalidomide showed clinical response with tolerable side effects. Further studies will be required to assess the outcome of this treatment regimen.

Objective: Therapeutic vaccination with dendritic cells (DC) showed promising results in first clinical trials in cases of metastatic renal cell carcinoma (RCC). Human telomerase reverse transcriptase (hTERT) could be a potential target because it is detectable in more than 85% of human tumors including RCC. Design: 10 patients with progressive metastatic RCC were enrolled in a clinical phase I/II trial using DC pulsed with hTERT-peptide. Beside toxicity and feasibility aspects, a complex immune monitoring including in vitro data were evaluated. In addition to detection of tumor-specific effector cells we investigated their functionality like IFN-γ secretion and cytotoxic activity against tumor cells. Results: The vaccine was well tolerated. Two patients showed a mixed response (MR) and one patient a stable disease (SD). Interestingly, responders showed cytotoxic activity already before start of therapy and there was a significant increase in cytotoxic activity of effector cells from all responders (SD and MR patients) after the first vaccination. In contrast non-responders showed no cytotoxic activity before and during treatment. Therefore, cytotoxic activity might be used as a predictive marker in the future. Tetramer staining detected higher amounts of tumor-specific cytotoxic cells in responding patients compared to non-responders. Also, responders possessed increasing amounts of IFN-γ producing immunological effector cells. Conclusion: Telomerase-pulsed DC could enhance a tumor-specific immune response against RCC.

Traditional research on political parties pays little attention to the temporal focus of communication. It usually concentrates on promises, issue attention, and policy positions. This lack of scholarly attention is surprising, given that voters respond to nostalgic rhetoric and may even adjust issue positions when policy is framed in nostalgic terms. This article presents a novel dataset, PolNos, which contains six text-based measures of nostalgic rhetoric in 1,648 party manifestos across 24 European democracies from 1946 to 2018. The measures combine dictionaries, word embeddings, sentiment approaches, and supervised machine learning. Our analysis yields a consistent result: nostalgia is most prevalent in manifestos of culturally conservative parties, notably Christian democratic, nationalist, and radical right parties. However, substantial variation remains regarding regional differences and whether nostalgia concerns the economy or culture. We discuss the implications and use of our dataset for studying political parties, party competition, and elections. [ABSTRACT FROM AUTHOR]

Reductions in greenhouse gas emissions are necessary to slow global warming and decrease the likelihood of irreversible climate scenarios. There is thus an urgent need for low‐emissions fuels. This study conducted a techno‐economic analysis of two different industrial plant concepts for producing hydrogen from woody biomass. One was a large‐scale centralized 60 MWH2 option using dual fluidized bed gasification with CO2 removal. The other was a small‐scale decentralized 1 MWH2 option using fixed‐bed gasification without CO2 removal. Mass and energy balances were calculated by the process simulation software IPSEpro. Key performance indicators, including technical, economic, and environmental parameters, were derived. Overall energy efficiencies of 64.2 and 59.5% and hydrogen yields of 87 and 68 gH2 kg−1BM.db were determined for hydrogen production by dual fluidized bed and fixed‐bed gasification, respectively. The levelized costs of hydrogen amounted to 5.6 and 15.0 €2022 kg−1H2 and agreed quite well with values from the literature. Flexible and decentralized heat, electricity, and hydrogen production based on fixed‐bed gasification within a multiproduct plant were also evaluated. The results show that the multiproduct plant could be economically feasible if at least 63% of the annual operating hours were dedicated to hydrogen production, and assuming a hydrogen selling price of 17.5 €2022 kg−1H2 in Austria. In conclusion, both of the processes that were evaluated are conceivable technologies for the transition of the energy system towards renewable energy sources from a technical and economic point of view, although small‐scale hydrogen production is considerably more expensive. [ABSTRACT FROM AUTHOR]

Introduction: Acute myeloid leukemia (AML) is a cancer of the hematopoietic system characterized by hyperproliferation of undifferentiated cells of the myeloid lineage. While most of AML therapies are focused toward tumor debulking, all-trans retinoic acid (ATRA) induces neutrophil differentiation in the AML subtype acute promyelocytic leukemia (APL). Macroautophagy has been extensively investigated in the context of various cancers and is often dysregulated in AML where it can have context-dependent pro- or anti-leukemogenic effects. On the contrary, the implications of chaperone-mediated autophagy (CMA) on the pathophysiology of diseases are still being explored and its role in AML remains elusive. Methods: We took advantage of human AML primary samples and databases to analyze CMA gene expression and activity. Furthermore, we used ATRA-sensitive (NB4) and -resistant (NB4-R1) APL cells to further dissect a potential function for CMA in ATRA-mediated neutrophil differentiation. NB4-R1 cells are unique in that they do respond to retinoic acid transcriptionally but do not mature in response to retinoid signaling alone unless maturation is triggered by adding cyclic adenosine monophosphate. Results: Here, we report that CMA-related mRNA transcripts are significantly higher expressed in immature hematopoietic cells as compared to neutrophils, contrasting the macroautophagy gene expression patterns. Accordingly, lysosomal degradation of an mCherry-KFERQ CMA reporter decreases during ATRA-induced differentiation of APL cells. On the other hand, using NB4-R1 cells we found that macroautophagy flux primed ATRA-resistant NB4-R1 cells to differentiate upon ATRA treatment but reduced the association of lysosome-associated membrane protein type 2A (LAMP-2A) and heat shock protein family A (Hsp70) member 8 (HSPA8), necessary for complete neutrophil maturation. Accordingly, depletion of HSPA8 attenuated CMA activity and facilitated APL cell differentiation. In contrast, maintaining high CMA activity by ectopic expression of LAMP-2A impeded APL differentiation. Conclusion: Overall, our findings suggest that APL neutrophil differentiation requires CMA inactivation and that this pathway predominantly depends on HSPA8 and is possibly assisted by other co-chaperones. [ABSTRACT FROM AUTHOR]

Do private interests predict politicians' rhetoric? Focusing on housing policy, we compare issue emphasis and positions of landlord politicians and politicians who do not own multiple properties. Ireland provides a unique opportunity to study legislating landlords' behavior as housing has become one of the most important political issues. We construct a novel dataset of politicians' homeownership status between 2013 and 2022, a period characterized by rising rent and property prices. We fine‐tune a transformer‐based machine learning model and apply text scaling and sentiment analysis to identify issue salience and positions on housing in over 870,000 tweets and parliamentary questions. Contrary to our expectations, landlord politicians do not avoid the topic of housing, nor do they take different positions. We also find that government status does not influence this relationship. The results imply that private financial interests do not influence rhetoric on housing policy. [ABSTRACT FROM AUTHOR]