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ImportanceMost research to understand postacute sequelae of SARS-CoV-2 infection (PASC), or long COVID, has focused on adults, with less known about this complex condition in children. Research is needed to characterize pediatric PASC to enable studies of underlying mechanisms that will guide future treatment.ObjectiveTo identify the most common prolonged symptoms experienced by children (aged 6 to 17 years) after SARS-CoV-2 infection, how these symptoms differ by age (school-age [6-11 years] vs adolescents [12-17 years]), how they cluster into distinct phenotypes, and what symptoms in combination could be used as an empirically derived index to assist researchers to study the likely presence of PASC.Design, setting, and participantsMulticenter longitudinal observational cohort study with participants recruited from more than 60 US health care and community settings between March 2022 and December 2023, including school-age children and adolescents with and without SARS-CoV-2 infection history.ExposureSARS-CoV-2 infection.Main outcomes and measuresPASC and 89 prolonged symptoms across 9 symptom domains.ResultsA total of 898 school-age children (751 with previous SARS-CoV-2 infection [referred to as infected] and 147 without [referred to as uninfected]; mean age, 8.6 years; 49% female; 11% were Black or African American, 34% were Hispanic, Latino, or Spanish, and 60% were White) and 4469 adolescents (3109 infected and 1360 uninfected; mean age, 14.8 years; 48% female; 13% were Black or African American, 21% were Hispanic, Latino, or Spanish, and 73% were White) were included. Median time between first infection and symptom survey was 506 days for school-age children and 556 days for adolescents. In models adjusted for sex and race and ethnicity, 14 symptoms in both school-age children and adolescents were more common in those with SARS-CoV-2 infection history compared with those without infection history, with 4 additional symptoms in school-age children only and 3 in adolescents only. These symptoms affected almost every organ system. Combinations of symptoms most associated with infection history were identified to form a PASC research index for each age group; these indices correlated with poorer overall health and quality of life. The index emphasizes neurocognitive, pain, and gastrointestinal symptoms in school-age children but change or loss in smell or taste, pain, and fatigue/malaise-related symptoms in adolescents. Clustering analyses identified 4 PASC symptom phenotypes in school-age children and 3 in adolescents.Conclusions and relevanceThis study developed research indices for characterizing PASC in children and adolescents. Symptom patterns were similar but distinguishable between the 2 groups, highlighting the importance of characterizing PASC separately for these age ranges.

IMPORTANCE: The prevalence, pathophysiology, and long-term outcomes of COVID-19 (post-acute sequelae of SARS-CoV-2 [PASC] or Long COVID) in children and young adults remain unknown. Studies must address the urgent need to define PASC, its mechanisms, and potential treatment targets in children and young adults. OBSERVATIONS: We describe the protocol for the Pediatric Observational Cohort Study of the NIHs REsearching COVID to Enhance Recovery (RECOVER) Initiative. RECOVER-Pediatrics is an observational meta-cohort study of caregiver-child pairs (birth through 17 years) and young adults (18 through 25 years), recruited from more than 100 sites across the US. This report focuses on two of four cohorts that comprise RECOVER-Pediatrics: 1) a de novo RECOVER prospective cohort of children and young adults with and without previous or current infection; and 2) an extant cohort derived from the Adolescent Brain Cognitive Development (ABCD) study (n = 10,000). The de novo cohort incorporates three tiers of data collection: 1) remote baseline assessments (Tier 1, n = 6000); 2) longitudinal follow-up for up to 4 years (Tier 2, n = 6000); and 3) a subset of participants, primarily the most severely affected by PASC, who will undergo deep phenotyping to explore PASC pathophysiology (Tier 3, n = 600). Youth enrolled in the ABCD study participate in Tier 1. The pediatric protocol was developed as a collaborative partnership of investigators, patients, researchers, clinicians, community partners, and federal partners, intentionally promoting inclusivity and diversity. The protocol is adaptive to facilitate responses to emerging science. CONCLUSIONS AND RELEVANCE: RECOVER-Pediatrics seeks to characterize the clinical course, underlying mechanisms, and long-term effects of PASC from birth through 25 years old. RECOVER-Pediatrics is designed to elucidate the epidemiology, four-year clinical course, and sociodemographic correlates of pediatric PASC. The data and biosamples will allow examination of mechanistic hypotheses and biomarkers, thus providing insights into potential therapeutic interventions. CLINICAL TRIALS.GOV IDENTIFIER: Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT05172011.

The HyFlex learning model has gained popularity in recent years and, with the outbreak of COVID-19, the demand has increased. However, there are challenges associated with the model, especially related to equity and engagement. A HyFlex model known as Interactive Synchronous HyFlex is being developed and practised by the researchers in their introductory design thinking course. The purpose of the paper is to understand the experiences of students using the Interactive Synchronous HyFlex model. A qualitative method in the form of focus group interviews was followed in this study to better understand the student experiences. The focus group interviews were conducted during the beginning, mid and end of the semester. The resulting themes of the study are grouped into two categories: affordances and opportunities. The themes corresponding to affordances are (a) effective model, (b) flexibility, (c) sense of community, (d) ease of communication and (e) help prepare for future jobs. The themes corresponding to opportunities include (a) software learning curve, (b) online non-contributors and (c) inconsiderate face-to-face peers. The results of the study may help faculty and higher education institutions better prepare a version of the HyFlex model taking into consideration the affordances and finding better ways to incorporate opportunities.

Purpose: Drawing on a framework of conservation of resources theory, the purpose of this paper is to explore the relationship between self-perceived academic performance and individual entrepreneurial intention and consider the potential moderating role of (1) participation in serious leisure, (2) perceived stress and/or (3) gender. Design/methodology/approach: A total of 405 UK-based undergraduates completed the questionnaire, with a representative gender split of 57% women and 43% men. Findings: The positive relationship between self-perceived academic performance and individual entrepreneurial intention was moderated by serious leisure (stronger when participation in serious leisure increased) and by perceived stress (stronger when levels of perceived stress were lower). However, contrary to our expectations, gender had no statistically significant moderating role. Practical implications: The practical contribution comes from informing policy for universities and national governments to increase individual entrepreneurial intention in undergraduates. Originality/value: The theoretical contribution comes from advancing conservation of resources theory, specifically the interaction of personal resources, resource caravans and resource passageways.

Introduction: The Visually Enhanced Lesion Scope (VELscope®) is a handheld medical device that can be used to clinically visualise and diagnose oral mucosal lesions. It works by the application of direct fluorescence and the loss of fluorescence in visible and non visible high-risk oral lesions. Numerous publications have offered insights on the possible use of VELscope® for identifying oral mucosal lesions. By analysing patterns in publication outputs, citation metrics and collaborative networks, researchers can gain insights into the development, influence and key contributors in the field of VELscope®, guiding future research directions and policy decisions. Aim: To track down and analyse all studies published on the application of VELscope® in the diagnosis of oral mucosal lesions and to assist future researchers by highlighting the most cited earlier publications. Materials and Methods: This bibliometric analysis was conducted using articles published on the applications of VELscope® in detecting oral mucosal lesions between 2006 and 2022. In December 2023, a comprehensive search was performed on PubMed and Scopus databases using medical subject heading terms like “VELscope®,” “Autofluorescence imaging system,” and “Oral” in several combinations. Bibliographic data regarding the top 100 most cited articles were extracted and collated. Results: The analysis showed that the most contributions came from the journals “Oral Oncology,” “Oral Diseases,” and “Photodiagnosis and Photodynamic Therapy,” with significant contributions from researchers in the USA and India. The highest number of publications occurred in 2015, with a notable peak in the decade 2011-2020. The articles were cumulatively cited 4,559 times. Conclusion: The current bibliographic analysis provided valuable insights into the development and impact of research on the applications of VELscope® in dentistry by highlighting publication trends, influential works, leading authors and collaborative networks. These insights can guide future research directions, inform policy decisions and enhance understanding of the evolution and scholarly influence.

Background: Medical students are vulnerable to sleep disturbances as they navigate life through academic stress, long on-call duties, emotional challenges, and exhaustion. Insufficient sleep negatively affects cognitive functions and fine motor skills, leading to deficiencies in attention, increased drowsiness while driving, propensity for risk-taking behavior, heightened risk of depression, impaired interpersonal relationships, and the potential to impact learning technical aspects of curriculum as well as delivering quality patient care. Objectives: The objective of this study was to measure the sleep quality and its determining factors among undergraduate medical students of a teaching institute in Telangana, South India. Methodology: A cross-sectional study was conducted among 401 undergraduate medical students. A semi-structured questionnaire including the sociodemographic details, medical history, and screen time, followed by the Pittsburgh Sleep Quality Index (PSQI) which assesses the time of quality sleep, frequency of troubled sleep, etc., over the last 1 month was used. The quality of sleep score of >5 indicates poor sleep quality. Results: The mean age was 20.41 years (standard deviation [SD] =2.08). Known comorbidities were present among 17 (4.2%), and 13 (3.2%) had psychiatric conditions. Poor sleep quality was present among 70% of medical undergraduates. The mean global PSQI score was 6.22 (SD = 2.9). The factors found significantly associated with poor sleep quality were academic stress (P = 0.009; odds ratio [OR] = 2.154 [CI = 1.250–3.713]), headache and self-medication (P = 0.008; OR = 1.868 [CI = 1.178–2.964]), and nighttime screen use (P < 0.001; OR = 18.12 [CI = 5.48–59.87]). Conclusion: Sleep deprivation and poor sleep quality is a major concern among medical undergraduates. It is important to have a proper sleep–wake routine and maintain good sleep hygiene. This includes reducing the use of screens before bedtime and addressing any underlying health conditions, including mental health issues, to improve sleep quality and overall well-being.

Active learning strategies engage students and promote student-centered learning environments. Implementing active learning in a HyFlex environment during the Fall of 2020 global pandemic was challenging. We describe the "Interactive Synchronous HyFlex" approach to teaching design thinking at the introductory college level and explore impacts on students' basic psychological needs, including autonomy, competence, and relatedness. Aligned with Self-Determination Theory, active learning has been shown to motivate students and increase performance and retention in science, engineering, and mathematics disciplines, among others (Freeman et al., 2014; Lo & Hew, 2019). In active environments, the predominant mode of instruction is not lecture based and it engages students through student-to-student interactions and student-to-instructor interactions. The flipped classroom is a pedagogical model in which the typical lecture and homework elements of a course are reversed. This model of instruction is ideal for our design thinking course used as a context for this study because students are challenged to learn by doing. In active learning courses, students engage in video-recorded lectures or talks, text-based materials and online quizzes, or other preparation activities before and in preparation for class (Bishop & Verleger, 2013; Lo et al., 2017; O'Flaherty & Phillips, 2015). Scheduled class meeting time is used for engagement and interaction between students informed by a social constructivist learning theory. Students challenge each other to apply what they have learned with guidance and support from the instructor.

With the increasing prevalence of heart failure and end-stage lung disease, there is a sustained interest in expanding the donor pool to alleviate the thoracic organ shortage crisis. Efforts to extend the standard donor criteria and to include donation after circulatory death have been made to increase the availability of suitable organs. Studies have demonstrated that outcomes with extended-criteria donors are comparable to those with standard-criteria donors. Another promising approach to augment the donor pool is the improvement of organ preservation techniques. Both ex vivo lung perfusion (EVLP) for the lungs and the Organ Care System (OCS, TransMedics) for the heart have shown encouraging results in preserving organs and extending ischemia time through the application of normothermic regional perfusion. EVLP has been effective in improving marginal or borderline lungs by preserving and reconditioning them. The use of OCS is associated with excellent short-term outcomes for cardiac allografts and has improved utilization rates of hearts from extended-criteria donors. While both EVLP and OCS have successfully transitioned from research to clinical practice, the costs associated with commercially available systems and consumables must be considered. The ex vivo perfusion platform, which includes both EVLP and OCS, holds the potential for diverse and innovative therapies, thereby transforming the landscape of thoracic organ transplantation.

BACKGROUND: Lymphoblastic lymphomas (LBL) are a rare, aggressive type of non-Hodgkin lymphomas and constitute 2% of all lymphomas. It is classified as T-lymphoblastic lymphoma (T-LBL) and B lymphoblastic lymphoma (B-LBL) and resembles acute lymphoblastic leukemia (ALL), with no or limited bone-marrow involvement. LBL rarely present as soft-tissue swellings. Soft-tissue involvement is more common in B-LBL than in T-LBL. They occur predominantly in adolescents and young adults and have a prognosis similar to ALL. OBJECTIVE: p>The aim was to study the clinical characteristics, treatment response, and survival of patients with lymphoblastic lymphoma presenting with soft-tissue swelling. SETTINGS AND DESIGN: This was a retrospective study of eight adolescent and adult patients with lymphoblastic lymphoma presenting with soft-tissue swelling conducted in the Department of Medical Oncology at a tertiary cancer center in India. STATISTICAL ANALYSIS: The baseline patient characteristics, treatment details, and response assessment were analyzed using descriptive statistics. Overall survival (OS) and progression-free survival were obtained by the Kaplan–Meier method, using the SPSS version. 11. MATERIALS AND METHODS: We present the clinical features, imaging, diagnosis, treatment, and outcome of eight cases of lymphoblastic lymphoma presenting with soft-tissue swellings. Patients above 14 years of age treated over 12 years were included in the study. RESULTS: There were five males and three females. The median age at diagnosis was 24 years. Common presenting complaints were swelling, pain, and paraparesis. The sites of involvement were the epidural mass, thigh, calf, breast, and anterior chest wall. The diagnosis was confirmed by immunohistochemistry. Seven patients were diagnosed with B-LBL and one with T-LBL. They were treated with intensive chemotherapy (six patients with Berlin–Frankfurt–Munster protocol and two with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone). Three patients received consolidation radiotherapy and one received palliative radiotherapy. Seven patients attained remission after induction chemotherapy and four of them are currently alive at a median follow-up of 48 months. The 2-year OS was 71.4%. CONCLUSION: Even though rare, lymphoblastic lymphoma should be considered a differential diagnosis in patients presenting with soft-tissue swelling and should be managed with systemic chemotherapy similar to ALL.

In India, the prevalence of secondhand smoke (SHS) exposure is 29.5% in general and 11.2% at home. The youth may expose themselves to SHS without knowing the risk factors and consequences involved. This study is intended to determine the prevalence of SHS exposure and the measures adopted by the youth to avoid exposure. A cross-sectional study was conducted among 338 youth in an urban area in Hyderabad. A modified Global Youth Tobacco Survey questionnaire was used for data collection on SHS exposure and avoidance. The total prevalence of SHS exposure was 35.21%. The mean days of SHS exposure/week were 1.419 (standard deviation -1.806) days. Belonging to the age group 18–21 years, and male gender were significant predictors of SHS exposure. Education of the head of family was a significant predictor of SHS avoidance behavior. Creating awareness among young adults regarding the deleterious effects and preventive strategies of SHS exposure, thereby making them responsible for the health of their family can be a protective long-term strategy.