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The COVID-19 pandemic required adjustments and limitations in university teaching, thereby challenging teaching concepts in anatomy requiring in-person contact, including the gross anatomy course. Therefore, the present study investigates the impact of COVID-19-associated adjustments on students' perception of the gross anatomy course's importance and quality, students' preferred learning setting and outcome, and their motivation to involve themselves in academic activities, including becoming a future peer-teacher of the course. Using paper-based questionnaires in Ulm, Germany, 397 (response rate: 82.3%) students of the winter term of 2020/2021 were surveyed using quantitative and qualitative items, which were compared with cohorts prior to the pandemic. Students reported a higher global rating on course quality during COVID-19 (pre-COVID-19: 5.3 ± 0.9, during-COVID-19: 5.6 ± 0.7, p < 0.001; 1 = very bad, 6 = very good). Students' perceived importance of the gross anatomy course showed a small but significant increase (pre-COVID-19: 4.2 ± 0.6, during-COVID-19: 4.3 ± 0.6, p < 0.001; 1 = strongly disagree, 6 = strongly agree). Students' motivation to apply as a peer-teacher remained stable, nevertheless, they reported less interest in transferring their knowledge to junior students. Finally, students reported that they spent significantly more learning time alone and their examination grades remained unchanged during the pandemic. Astonishingly, despite radical changes of the teaching environment due to COVID-19, students appreciate the offered teaching and highly valued the gross anatomy course.

Eosinophilic fasciitis (EF) and generalized morphea (GM) are rare and difficult-to-treat sclerosing skin diseases which may occur in association with hematologic disorders. We present a 66-year-old man with EF and associated Waldenström macroglobulinemia who received combination therapy with rituximab (375mg/m2 every other week, gradually extended to every eight weeks), prednisolone (1.25-30mg/d), and methotrexate (7.5-15mg/w). Three months after rituximab initiation, his skin condition improved steadily accompanied by a significant improvement in joint mobility with only mild and transitory flares (observation period: 59 months under treatment with rituximab). To date, there are five case reports on rituximab treatment of EF/GM with an association to hypergammaglobulinemia in three of those cases. Therapy effected significant improvement in four patients. Our case adds to the hitherto limited evidence that rituximab may be a promising therapeutic strategy for EF/GM in association with hypergammaglobulinemia.

Scientific competencies, as defined in the German competency framework, describe the ability to think independently and act scientifically which is a central component of medical education. This report describes integration of scientific competencies into anatomical teaching. Based on findings seen in two consecutive years of dissection courses, students worked on either a case report (n = 70) or an original research study (n = 6) in the format of a scientific poster while learning to use primary literature. Posters were evaluated by juror teams using standardized evaluation criteria. Student perception of the project was assessed by quantitative and qualitative data obtained from the faculty's course evaluation and an online-survey. Overall, students worked collaboratively and invested extra-time (median 3.0 hours) in poster creation. Primary literature was integrated in 90.8% of the posters. Overall poster quality was satisfactory (46.3 ± 8.5 [mean ± standard deviation] out of 72 points), but several insufficiencies were identified. Students integrated information gained from the donor's death certificate, post-mortem full-body computed tomography (CT) scan (22.4%), and histopathological workup (31.6%) in their case reports. Students responded positively about learning new scientific skills (median 4.0 on a six-point Likert scale), but free-text answers revealed that some students experienced the project as an extra burden in a demanding gross anatomy course. In summary, it was feasible to introduce students to scientific skills during the dissection course and to increase interest in science in approximately a third of the survey respondents. Further adjustments to ensure the posters' scientific quality might be necessary for the future.

Background: Activation of protease-activated receptor-2 (PAR2) has been implicated in inflammation, pruritus, and skin barrier regulation, all characteristics of atopic dermatitis (AD), as well as Netherton syndrome which has similar characteristics. However, understanding the precise role of PAR2 on neuro-immune communication in AD has been hampered by the lack of appropriate animal models. Methods: We used a recently established mouse model with epidermal overexpression of PAR2 (PAR2OE) and littermate WT mice to study the impact of increased PAR2 expression in epidermal cells on spontaneous and house dust mite (HDM)-induced skin inflammation, itch, and barrier dysfunction in AD, in vivo and ex vivo. Results: PAR2OE newborns displayed no overt abnormalities, but spontaneously developed dry skin, severe pruritus, and eczema. Dermatological, neurophysiological, and immunological analyses revealed the hallmarks of AD-like skin disease. Skin barrier defects were observed before onset of skin lesions. Application of HDM onto PAR2OE mice triggered pruritus and the skin phenotype. PAR2OE mice displayed an increased density of nerve fibers, increased nerve growth factor and endothelin-1 expression levels, alloknesis, enhanced scratching (hyperknesis), and responses of dorsal root ganglion cells to non-histaminergic pruritogens. Conclusion: PAR2 in keratinocytes, activated by exogenous and endogenous proteases, is sufficient to drive barrier dysfunction, inflammation, and pruritus and sensitize skin to the effects of HDM in a mouse model that mimics human AD. PAR2 signaling in keratinocytes appears to be sufficient to drive several levels of neuro-epidermal communication, another feature of human AD.

Background: The subcellular distribution of CD30 on mast cells and the presence of eosinophils in cutaneous mastocytosis require further investigation, especially as the cell surface expression of CD30 is critical for the therapeutic response of systemic mastocytosis to brentuximab vedotin. Objective: Investigation of 147 biopsy specimens from 143 patients with cutaneous mastocytosis for mast cell density and distribution, frequency of CD30 expression, CD30 staining patterns, and presence and distribution of eosinophils. Correlation with clinical patterns. Methods: Retrospective multicenter immunohistochemical study of CD30 expression, eosinophils and basic clinical data in cutaneous mastocytosis. Results: CD30 expression was found in all samples (cut‐off: ≥1%), whereby the staining was predominantly cytoplasmic in 99% of the samples. Additional membrane staining was detected in 62% of the samples. Surface expression of CD30 was more common in biopsy specimens with a high mast cell burden and in biopsy specimens with a higher CD30 expression rate. Eosinophils were admixed in 58% of the samples. Females and older patients showed a trend of a lower mast cell burden. Limitations: Retrospective study on formalin‐fixed and paraffin‐embedded tissue without functional analysis. Conclusion: Most cases of cutaneous mastocytosis show cell surface expression of CD30 expression and is, therefore, in principle, accessible for therapy with antibodies against CD30, provided the overall situation of the patient warrants. [ABSTRACT FROM AUTHOR]

The study explores the relationship between anti-rubella IgG serum levels and the risk of SARS-CoV-2 breakthrough infections. Lower anti-rubella IgG levels were associated with an increased risk of breakthrough infections, indicating a potential predictive value for identifying individuals at risk. These findings suggest that assessing anti-rubella IgG levels could help determine the need for additional SARS-CoV-2 vaccinations and may serve as an indicator of vaccine efficacy beyond SARS-CoV-2. The study was conducted with a diverse group of participants and adhered to ethical guidelines, providing valuable insights for personalized prevention strategies. [Extracted from the article]

Despite recent advances in prophylactic vaccination, SARS‐CoV‐2 infections continue to cause significant morbidity. A better understanding of immune response differences between vaccinated individuals with and without later SARS‐CoV‐2 breakthrough infection is urgently needed. CoV‐ADAPT is a prospective long‐term study comparing humoral (anti‐spike‐RBD‐IgG, neutralization capacity, avidity) and cellular (spike‐induced T‐cell interferon‐γ [IFN‐γ] release) immune responses in individuals vaccinated against SARS‐CoV‐2 at four different time points (three before and one after third vaccination). In this cohort study, 62 fully vaccinated individuals presented with SARS‐CoV‐2 breakthrough infections vs 151 without infection 3–7 months following third vaccination. Breakthrough infections significantly increased anti‐spike‐RBD‐IgG (p < 0.01), but not spike‐directed T‐cell IFN‐γ release (TC) or antibody avidity. Despite comparable surrogate neutralization indices, the functional neutralization capacity against SARS‐CoV‐2—assessed via a tissue culture‐based assay—was significantly higher following breakthrough vs no breakthrough infection. Anti‐spike‐RBD‐IgG and antibody avidity decreased with age (p < 0.01) and females showed higher anti‐spike‐RBD‐IgG (p < 0.01), and a tendency towards higher antibody avidity (p = 0.051). The association between humoral and cellular immune responses previously reported at various time points was lost in subjects after breakthrough infections (p = 0.807). Finally, a machine‐learning approach based on our large immunological dataset (a total of 49 variables) from different time points was unable to predict breakthrough infections (area under the curve: 0.55). In conclusion, distinct differences in humoral vs cellular immune responses in fully vaccinated individuals with or without breakthrough infection could be demonstrated. Breakthrough infections predominantly drive the humoral response without boosting the cellular component. Breakthrough infections could not be predicted based on immunological data, which indicates a superior role of environmental factors (e.g., virus exposure) in individualized risk assessment. [ABSTRACT FROM AUTHOR]