With the regulation for the reorganization of dental education, the legislature restructured dental studies and among other things, called for a strenghtening of interdisciplinary training. This requirement was the basis for the development of an interdisciplinary curriculum in which the topic of "dental traumatology" was to be taught across disciplines. It was investigated whether a measurable increase in learning could be achieved.

The newly designed curriculum was developed on the basis of the National Competence-Based Learning Objectives Catalogue for Dentistry (NKLZ) and was implemented in the summer semester of 2021. Due to the COVID-19 pandemic, the teaching module had to be modified significantly. In order to determine the students learning gains, an examination form was completed online before (T0) and after (T1) the curriculum. The exam paper consisted of knowledge questions and questions on two case vignettes.

The results showed a significant increase in learning in the knowledge questions (p<0.05). The case vignettes presented a heterogeneous picture. In case vignette V₍₁₎, a significant increase in learning was achieved among students in the eighth (p=0.027) and tenth (p=0.022) semesters, but not among those in the sixth semester (p=0.323). In case vignette V₍₂₎, a significant increase in learning was observed in the sixth (p=0.011) and tenth (p=0.003) semesters, but not in the eighth semester (p=0.298). The students evaluated the newly developed curriculum with a good rating.

The interdisciplinary curriculum led to an increase in learning among the students. However, the heterogeneous results of the case vignettes show that even interdisciplinary lectures are not very efficient in acquiring the competence of "transfer thinking". Nevertheless, interdisciplinary teaching formats should shape the future of dental education, but they should be supplemented by interactive elements.

The project Impf-Guides aimed at motivating citizens in selected districts of Munich to get vaccinated against COVID-19 by providing information and advice, thereby increasing the vaccination rate among the population.

The project began in February and ended in December 2022. A total of 31 medical students from LMU Munich were recruited and trained as Impf-Guides. This training included communication and de-escalation techniques. The students conducted consultations, promoted mobile vaccination campaigns and provided on-site support in city districts with defined social challenges. For quality assurance purposes, accompanying evaluations of the vaccinated individuals and the Impf-Guides were carried out.

As part of the mobile vaccination campaigns, 351 people were vaccinated, 18% of whom took part in the evaluation. The majority received their third or fourth vaccination and were satisfied with the consulting activities provided by the Impf-Guides. Of the 31 Impf-Guides, only eight took part in the evaluation. Few students experienced challenging situations (e.g. language barriers) or conflicts (e.g. vaccine hesitancy) during their consultancy work. The students considered the project useful with regard to their future medical practice.

The project mainly reached people who were already willing to be vaccinated. The aim of the project to significantly increase vaccination willingness was ultimately not achieved. The extent to which the Impf-Guides contributed to the health literacy of the population remains speculative. Regardless of vaccination campaigns, consideration should be given to whether trained students could advise the population on general health, prevention and health promotion issues in the future.

Despite significantly improved therapies in recent years, long-term morbidity and mortality in ANCA-associated vasculitis (AAV) remain high. The leading causes of death within the first year after diagnosis are active vasculitis and in subsequent years cardiovascular diseases, malignancies, and infections. Population-based database and cohort analyses suggest an increased risk for major adverse cardiovascular events (MACE) in AAV.

This retrospective cohort study analyzed data samples from an electronic health records database of the US-based TriNetX network. Patients with the diagnostic codes granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) and patients without vasculitis as a matched control cohort (1:1) were included. To optimize between-group comparability, propensity score matching was performed for demographic variables and comorbidity. Hazard ratios (HR) for death and cardiovascular outcomes were calculated using univariate Cox regression after analyzing the matched cohort using the Kaplan-Meier method.

We identified 20, 422 patients with GPA and 5, 907 with MPA. Mortality was more frequent in patients with GPA (17.87%) and MPA (25.85%) than in matched controls (GPA controls: 5.79%; MPA controls: 9.70%), corresponding to an increased hazard of death in both cohorts (GPA: HR 3.01; MPA: HR 3.01). The risk of cardiovascular events was increased in GPA and MPA compared to matched controls, particularly for MACE (GPA: HR: 1.94, MPA: HR: 2.24) and thromboembolic events (deep vein thrombosis: GPA HR: 2.82, MPA HR: 3.33; pulmonary embolism: GPA HR: 3.01, MPA HR: 3.00) and did not differ when adjusted according to sex, disease duration, and age. Compared with GPA patients, MPA patients had a higher risk of MACE (HR: 1.13) and peripheral arterial disease (HR: 1.17).

AAV was associated with an increased risk of death and cardiovascular events. Compared with GPA, MPA was associated with an increased risk for MACE and peripheral arterial disease.

The role of the microbiome in COVID-19 outcomes remains an area of exploration. We comprehensively explored the gut microbiome of Ugandan COVID-19 patients and inferred potential implications.

Stool and demographic data were collected from 100 COVID-19 confirmed cases at the covid isolation and treatment centers in Kampala during the first and second waves of the pandemic in Uganda (2020 and 2021, respectively). 16S rRNA sequencing was performed on the DNA extracted from stool, followed by bioinformatics analysis. Machine-learning techniques were used to determine microbes that were associated with disease severity.

We observed differences in microbial composition between COVID-19 patients and healthy controls. Pathogenic bacteria such as Klebsiella oxytoca, Salmonella enterica and Serratia marcescens had an increased presence in COVID-19 disease states, especially severe cases. Additionally, there was an increase in opportunistic pathogens like Enterococcus species, along with a decrease in beneficial microbes, such as Alphaproteobacteria, when comparing mild and severe cases. Machine-learning identified age and microbes like Ruminococcaceae, Bacilli, Enterobacteriales, porphyromonadaceae and Prevotella copri as predictive of severity.

The microbiome likely plays a role in the dynamics of SARS-CoV-2 infection in Ugandan patients. The shift in abundance of specific microbes can moderately predict severity of COVID-19 in this population.

Not applicable.

Integrating societal considerations into public health research, particularly during crises, can foster public trust, support inclusive policy-making, and enhance technology development. Interdisciplinary collaboration may enhance researchers' capacities to reflect on the societal impacts of scientific advancements as they occur.

This qualitative Socio-Technical Integration Research (STIR) study investigated these claims among four early-career researchers in virology, physics, and engineering, working in a large-scale COVID-19 research project across Germany. The collaboration involved 12 weeks of protocol-based dialogue exercises, pre- and post-study interviews, and participant observation, and was analyzed using the "Midstream modulation" framework.

We found that the exercises documented, and in some cases stimulated, changes in participants' awareness, attitudes, and behaviours regarding their research's broader social context. One participant grew more aware of their work's social impact over time, recognizing stakeholders beyond the laboratory. Another shifted attitudes toward science communication, while a third demonstrated greater empathy for public reactions to scientific advice.

These enhanced capacities for reflexivity suggests potential of STIR for improved communication among scientists, the public, and policymakers, strengthening the science-society interface in COVID-19 and broader health research. Such collaborations can build public trust, inform interventions, and improve the translation of basic research into effective health policies.

Cobalamin C (cblC) deficiency is one of the most common congenital vitamin B12 metabolic abnormalities, and may cause severe neurologic symptoms, gastrointestinal and nephritic symptoms.

A 9-month-old boy presented with a 10-day history of progressive dyspnea and weak cough, accompanied by moaning, perioral cyanosis, and poor feeding. The parents also reported significant developmental regression and delay, characterized by an inability to raise his head, sit independently, or vocalize "dada" and "mama": milestones typically achieved by this age.

The patient was diagnosed with cblCdeficiency, complicated by combined methylmalonic acidemia and homocystinuria, based on clinical manifestations (developmental regression, cyanosis, pulmonary arterial hypertension (PAH)) and confirmatory genetic testing (compound heterozygous variants in the methylmalonic aciduria cobalamin deficiency type C with homocystinuria gene: c.567dupT and c.80A > G).

Following admission, the patient received multifaceted treatment. Metabolic therapy included hydroxocobalamin, folic acid, betaine, and L-carnitine to address the methylmalonic acidemia and homocystinuria. Antibiotic therapy with cefotaxime was administered for concurrent pneumonia. Additionally, bosentan (64 mg/day) was initiated for the management of PAH.

At discharge, the patient exhibited stable vital signs, improved developmental milestones, reduced pulmonary artery systolic pressure, normal renal function, and no evidence of hydrocephalus progression. Genetic analysis revealed a genotype-phenotype correlation: the c.567dupT variant was associated with neurodevelopmental disorders and early-onset severe disease, whereas the c.80A > G variant correlated with PAH and renal dysfunction.

This report highlights the diverse clinical manifestations of cblC deficiency based on specific methylmalonic aciduria cobalamin deficiency type C with homocystinuria mutations. A review of the literature supports these genotype-phenotype associations, aiding in prognostic stratification and targeted management.

Rare earth elements (REEs) are increasingly released into the environment due to intensive mining, industrial processing, and expanding technological applications, resulting in widespread human exposure. Within the respiratory exposome framework, REEs have increasingly been recognized as a potentially important class of airborne contaminants. Fine and ultrafine REE-containing particles can penetrate deeply into the distal lung, where they exhibit high biopersistence and limited clearance. Epidemiological evidence from mining and industrial regions suggests that elevated internal REE burdens may be associated with increased prevalence of respiratory symptoms and chronic lung diseases, including bronchitis and interstitial lung disease. Toxicokinetic and experimental studies provide mechanistic support, demonstrating that inhaled REEs preferentially deposit in the alveolar region, interact with epithelial and immune cells, and may translocate into systemic circulation. At the molecular level, REEs have been shown to induce oxidative stress, immune and inflammatory dysregulation, and calcium homeostasis imbalance in experimental models, thereby promoting tissue injury and remodeling. These processes may contribute to a progressive pathological continuum from persistent inflammation to fibrosis and, potentially, tumorigenesis. Notably, exposure characteristics-including particle physicochemical properties, dose, co-exposure scenarios, and host susceptibility-critically shape health outcomes in real-world settings. Despite accumulating evidence, key uncertainties remain regarding human-relevant exposure thresholds, long-term dose-response relationships, and validated biomarkers of effect. Current knowledge is still largely derived from experimental models, with limited integration into population-based risk assessment. Overall, this review uses a structured literature search and narrative synthesis approach to integrate environmental exposure pathways, toxicokinetic characteristics, and mechanistic evidence within an exposome-oriented framework. It highlights that REEs represent emerging inhalation hazards with the potential to contribute to the burden of chronic respiratory diseases, underscoring the need for improved exposure assessment, biomonitoring strategies, and evidence-based public health interventions.

Hypoxia is a central pathophysiological driver of inflammatory airway diseases, shaping disease progression largely through hypoxia-inducible factor 1α (HIF-1α) signaling. Across these disorders, hypoxia exacerbates airway inflammation through shared mechanisms. As a key signaling hub, HIF-1α disrupts epithelial barrier integrity and initiates inflammatory cascades; reprograms immune responses, promoting the activation and trafficking of eosinophils, T cells, and macrophages while reshaping cytokine profiles, to drive tissue injury; and accelerates airway remodeling, thereby worsening airflow limitation and perpetuating inflammatory cycles. Realizing effective targeted therapies will require rigorous validation of HIF-1α as a therapeutic node and the development of disease-tailored interventions aligned with distinct pathological features. In parallel, strengthened translational and clinical research on hypoxia is essential to build a robust evidence base for practice. This review synthesizes hypoxia-driven mechanisms shared across airway diseases, articulates a unifying framework for HIF-1α signaling across pathological contexts, and highlights the therapeutic implications of fundamental discoveries. By addressing the paucity of cross-disease analyses of hypoxia pathways, it provides both a conceptual foundation and a practical roadmap for developing precise and efficient targeted therapies for inflammatory respiratory diseases.

Unintentional poisoning and exposure to harmful substances involving illicit drugs, medications other than those taken as prescribed, and biological substances have emerged as a leading cause of preventable death in the United States. The increase in drug-specific toxicity, particularly from synthetic opioids, has accelerated during the COVID-19 pandemic, thus highlighting a need for national surveillance to monitor emerging demographic and geographic patterns. The CDC WONDER Multiple Cause of Death database provided mortality data from 1999 to 2023. Deaths with accidental poisoning (International Statistical Classification of Diseases and Health-Related Problems-10th Revision codes X40-X49) coded as the underlying cause and poisoning due to drugs (T36-T50) as multiple causes were considered. Age-adjusted mortality rates were extracted from the SEER database (number of deaths per 100,000 individuals). They were analyzed according to sex, age strata, race/ethnicity, and geographic region via Joinpoint regression for estimation of annual percentage change and average annual percentage change, with statistical significance set at P < .05. From 1999 to 2023, all-ages age-adjusted mortality rates more than sextupled, from 4.8 (95% confidence interval: 4.7-4.9) to 30.8 (95% confidence interval: 30.6-31.0). The consistently higher male mortality culminated in 2022, where men had a crude mortality of 45.3 per million compared with 18.2 per million in women. The largest increase was from 2019 to 2020, after the start of the COVID-19 pandemic. It is most severe among middle-aged adults (ages 45-64) and is characterized by geographic disparities in mortality, with clustering in counties across the Appalachian region and Southern United States. Non-Hispanic Black and American Indian/Alaska Native people experienced the latest spikes in mortality. The ongoing rise in drug-related accidental poisonings indicates a growing, evolving epidemic in the United States. The findings identified a need for focused equity-based interventions targeting substance use treatment, social determinants of health, and enhanced surveillance to address the escalating burden of mortality due to drug toxicity.

This study aimed to evaluate the safety, including blood pressure changes, and medication compliance associated with a generic prolonged-release formulation of mirabegron (Selebeta^® PR Tab. 50 mg) in Korean adults with overactive bladder (OAB) through a large-scale, real-world, multicenter, retrospective observational study.

Patients with OAB who were prescribed Selebeta^® PR once daily for at least 3 months between July 2020 and July 2021 from 95 medical institutions in Korea were included. The primary endpoint was the proportion of patients with an increase in systolic blood pressure (SBP) of ≥10 mmHg after 3 months of treatment. Secondary endpoints included additional thresholds of blood pressure elevation, changes in SBP and diastolic blood pressure (DBP) and pulse rate over time, improvement in OAB symptom, incidence of adverse events, and medication compliance.

A total of 2,091 patients were enrolled in the study. After 3 months of treatment, 8.8% of the patients had an SBP increase of ≥10 mmHg; 3.7%, ≥15 mmHg; and 2.3%, ≥20 mmHg. DBP increased by ≥5 mmHg in 16.8% and by ≥10 mmHg in 6.7% of patients. OAB symptoms also improved significantly in the subgroup with available OAB symptom score data. The overall incidence of adverse events was 2.1%, mostly mild, and mean medication coverage was 73.6%.

This study demonstrated that Selebeta^® PR is an effective and well-tolerated treatment for adults with OAB, with no clinically meaningful increase in blood pressure and a low incidence of adverse events.