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Association of missense variant DCLRE1B rs3761936 with breast and cervical cancer risk—A case-control study

Background Overexpression of rs3761936 of DCLRE1B gene has been observed in both breast cancer and cervical cancer patients. To justify the association of this polymorphism with these cancers, we performed this case-control study. Method A total of 245 cancer patients and 108 healthy controls participated in the research. An efficient T-ARMS PCR method was used for genotyping. Results The cancer patients showed higher mutant allele frequency compared to the controls. Mutant allele carrier breast cancer patients showed significantly increased risk in four genetic models, including additive model 1 (TC vs. TT: OR=2.31, 95% CI = 1.33–3.99, p-value = 0.0028), additive model 2 (CC vs. TT: OR=3.93, 95% CI = 1.36–11.38, p-value = 0.0116), dominant model (TC + CC vs. TT: OR=2.52, 95% CI = 1.50–4.25, p-value = 0.0005), and over-dominant model (TC vs. TT + CC: OR=1.93, 95% CI = 1.13–3.28, p-value = 0.0152). The allele frequency analysis showed that mutant allele C carriers among breast cancer patients had a significantly higher risk than the wild type T allele carriers (C vs. T: OR=2.15, 95% CI = 1.41–3.26, p-value = 0.0003). Likewise, the cervical cancer patients showed significant risk in three genetic models, including additive model 1 (TC vs. TT: OR=1.80, 95% CI = 1.01–3.20, p-value = 0.0444), additive model 2 (CC vs. TT: OR=3.17, 95% CI = 1.05–9.55, p-value = 0.0403), and dominant model (TC + CC vs. TT: OR=1.98, 95% CI = 1.15–3.41, p-value = 0.0138). The mutant allele C carriers had a significantly higher risk than the wild-type T allele carriers (C vs. T: OR=1.84, 95% CI = 1.19–2.85, p-value = 0.0065). Conclusion DCLRE1B rs3761936 is strongly associated with breast cancer and cervical cancer risk in Bangladeshi women.

A systematic review using a multi-layered criteria framework for assessing the validity and reliability of velocity monitoring devices in resistance training

Background Velocity-Based Training (VBT) is an emerging method in resistance training for objectively prescribing and monitoring training intensity and neuromuscular function. Given its growing popularity, assessing the validity and reliability of VBT devices is critical for strength and conditioning coaches. Objective The primary purpose of this review was twofold: (1) to identify and address methodological gaps in current assessments of VBT device validity and reliability, and (2) to propose and apply a novel, multi-layered, criterion-based framework—developed in collaboration with statisticians and domain experts—for evaluating these devices. Methods A systematic search was conducted in PubMed, Scopus, and SPORTDiscus following PRISMA guidelines, focusing on original research studies published before February 2024 that assessed VBT device validity or reliability. Out of 568 studies identified, 75 met the inclusion criteria. Results Among the included studies, 66 investigated device validity and 56 examined reliability, with some studies addressing both aspects. Notably, only 5 of the 66 validity studies met all of the proposed criteria, while just 16 of the 56 reliability investigations satisfied the required statistical thresholds defined by our framework. These findings highlight significant methodological variability and underscore the need for more standardized evaluation practices. Conclusions This review systematically evaluated the validity and reliability of various VBT devices and introduced a robust, multi-layered framework for their assessment. By integrating statistician-led and domain expert-led criteria, the framework offers a standardized approach that enhances the precision of device evaluation. Promising tools identified include the GymAware LPT, Perch Motion Capture Single Camera System, Flex optical device, and VmaxPro. Future research should build upon and refine this methodology to further standardize study designs, improve data reporting, and ultimately support more informed decision-making in sports technology and training practice.

Optimizing recombinant mini proinsulin production via response surface method and microbioreactor screening

The increasing demand for efficient recombinant insulin production necessitates the development of scalable, high-yield, and cost-effective bioprocesses. In this study, we engineered a novel mini-proinsulin (nMPI) with enhanced expression properties by shortening the C-peptide and incorporating specific residue substitutions to eliminate the need for enzymatic cleavage. To optimize its production, we applied a hybrid approach combining microscale high-throughput cultivation using the BioLector microbioreactor and statistical modeling via response surface methodology (RSM). Critical medium components were first screened using Plackett–Burman Design (PBD) and refined through Central Composite Design (CDD), identifying glycerol as the most influential factor for yield. Among the four statistically derived formulations, Scenario III demonstrated the highest productivity in the microscale platform (13.00 g/L) and maintained strong performance upon scale-up to a 3-L bioreactor (11.5 g/L). The optimized medium balanced carbon and nitrogen sources to enhance cell viability and maximize protein expression. This study not only confirms the predictive accuracy and scalability of the hybrid optimization system but also introduces a robust production platform for nMPI that can be translated into industrial settings. The workflow presented here can serve as a model for the development of efficient expression systems for complex recombinant proteins in E. coli.

‘Communities already have the solutions’: why I advocate for Indigenous knowledge

3-O-acetylrubiarbonol B preferentially targets EGFR and MET over rubiarbonol B to inhibit NSCLC cell growth

Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related deaths, remaining a significant challenge in terms of early detection, effective treatment, and improving patient survival rates. In this study, we investigated the anticancer mechanism of rubiarbonol B (Ru-B) and its derivative 3-O-acetylrubiarbonol B (ARu-B), a pentacyclic terpenoid in gefitinib (GEF)-sensitive and -resistant NSCLC HCC827 cells. Concentration- and time-dependent cytotoxicity was observed for both Ru-B and ARu-B. The in vitro kinase assay showed that ARu-B treatment inhibited epidermal growth factor receptor (EGFR), mesenchymal-epithelial transition (MET), and AKT1, and their phosphorylation in HCC827 cells. A molecular docking model suggested that ARu-B could interact with EGFR and MET in different ways, either by binding to the ATP pocket or the substrate pocket. ARu-B induced reactive oxygen species (ROS) generation and cell cycle arrest. The induction of apoptosis through caspase activation was confirmed by preventing cytotoxicity with Z-VAD-FMK pretreatment. Taken together, ARu-B inhibited the growth of both GEF-sensitive and GEF-resistant NSCLC cells by targeting EGFR, MET, and AKT and inducing ROS generation and caspase activation. Further studies on ARu-B can improve the treatment of chemotherapy-resistant NSCLC through the development of effective ARu-B-based anticancer agents.

The Dino Study: Rationale and protocol for a randomized controlled trial of the Incredible Years Dinosaur Program with daily assessments

Background Children with conduct problems vary considerably in how they respond to behavioral interventions. Although group-based, child-focused programs are increasingly implemented, research still relies on retrospective parent or teacher reports and group-level outcomes. These traditional approaches often obscure individual differences in treatment response and reduce the potential for individualized behavioral support tailored to each child’s unique profile. The Dino Study—Daily Intervention-based research on Nurturing Opportunities—introduces the Incredible Years Dinosaur Program in the Netherlands for children aged 4–8 with conduct problems. This evidence-based program, grounded in cognitive-behavioral principles, aims to strengthen children’s emotional regulation, social skills, and problem-solving through structured, play-based group sessions. However, little is known about mechanisms of change in children’s daily life, particularly how emotional and behavioral improvements unfold within and across individual children during intervention. This study evaluates the program’s effectiveness in reducing externalizing behavior and promoting cognitive and prosocial functioning, and explores daily variability in children’s emotional and behavioral responses using a daily diary design. Methods This protocol outlines a randomized controlled trial with a waitlist control condition. A total of 120 children will be randomly assigned (1:1) to the intervention or waitlist group. Participants will be recruited via professional institutions and primary schools in both preventive and clinical contexts. In addition to pre- and post-assessments, Intensive Longitudinal Data (ILD) will be collected to capture daily fluctuations in mood, behavior, and family interactions before, during, and after the intervention. This design enables analysis of group-level effects as well as intra-individual change patterns. Expected outcomes Findings will offer novel insights into how children respond individually to structured interventions in real-life settings and inform more personalized, ecologically valid approaches to early behavioral support. Trial registration ClinicalTrials.gov ( NCT07051642 ).

Unraveling the functional landscape of ATRA- and DMSO-differentiated HL-60 cells

The short lifespan of polymorphonuclear neutrophils (PMNs) in vitro poses challenges, as their limited viability restricts functional assays and experimental manipulations. The HL-60 cell line serves as a valuable model for neutrophil-like differentiation, yet the functional relevance of ATRA- and DMSO-induced differentiation remains incompletely understood. In the present study, we aimed to characterize the differentiation potential of all-trans retinoic acid (ATRA) and dimethyl sulfoxide (DMSO) on HL-60 cells and compare their functionality with primary PMNs. Besides that, we performed profound immunophenotypes of the cells with multicolor cytometry, and evaluated their antitumor capabilities. Our findings indicate that both differentiation conditions yield cells resembling immature neutrophils, exhibiting promyelocyte-like morphology, lacking key maturity markers. However, ATRA-differentiated cells exhibit a more mature phenotype, with higher expression of C/EBPα and reduced proliferation rates, indicating advanced differentiation. Functionally, ATRA-dHL-60 cells displayed limited immune responses, showing minimal phagocytic activity, low ROS production, and a reduced response to LPS. In contrast, DMSO-dHL-60 cells, despite their less mature phenotype, showed enhanced NET formation, and tumor-promoting potential. Additionally, DMSO-dHL-60 cells demonstrated superior adhesion and migration abilities, likely due to increased expression of CD18 and CD31. Overall, different differentiation conditions shape the functional specialization of HL-60 cells, with ATRA promoting a more neutrophil-like maturation and moderate activation, while DMSO results in a more immature phenotype with enhanced NET formation. These distinct properties suggest that ATRA-dHL-60 cells may better model neutrophils in chronic inflammation, whereas DMSO-dHL-60 cells could be more suitable for studying NETosis-driven autoimmune, thrombotic disorders and cancer.

Artificial intelligence-based CT histogram parameters differentiating bronchiolar adenoma and lung adenocarcinomas: A two-center study

Purpose Bronchiolar adenoma (BA) is a rare benign pulmonary neoplasm originating from the bronchial mucosal epithelium and mimics lung adenocarcinoma (LAC) both radiographically and microscopically. This study aimed to develop a nomogram for distinguishing BA from LAC by integrating clinical characteristics and artificial intelligence (AI)-derived histogram parameters across two medical centers. Methods This retrospective study included 215 patients with diagnoses confirmed by postoperative pathology from two medical centers. Medical center 1 provided 151 patients (68 BA and 83 LAC nodules) as the training cohort, while medical center 2 contributed 64 patients (28 BA and 36 LAC nodules) as the external validation cohort. Risk predictors and the nomogram were developed using clinical characteristics and AI-derived histogram parameters. Results Nodule density (solid, ground glass, and subsolid) exhibited a statistically significant difference between the BA and LAC groups (p < 0.01). The following parameters were significantly higher in the LAC group compared to the BA group (all p < 0.05): 2D long diameter, 2D short diameter, 2D average diameter, 2D maximum surface area, 3D long diameter, 3D surface area, 3D volume, and entropy. In contrast, CT value variance was significantly lower in the LAC group than in the BA group (p < 0.01). A nomogram was constructed incorporating density, 2D short diameter, and CT value variance. The area under the curve (AUC) of the nomogram in the training and validation cohorts were 0.821, 0.811. Conclusion The AI-based nomogram, as a non-invasive preoperative tool, had the potential to enhance diagnostic accuracy for distinguishing BA from LAC.

Examining models of telemedicine use among U.S. physicians during the COVID-19 pandemic

The purpose of this study is to apply the theory of reasoned action (TRA) and technology acceptance model (TAM) to U.S. physicians’ adoption of telemedicine during the COVID-19 pandemic. A total of 230 physicians licensed in the U.S. completed a cross-sectional survey during the COVID-19 pandemic assessing telemedicine use and components of the TRA and TAM. Path models representing the TRA, TAM, and a trimmed version of the TAM were tested. The TRA was an adequate to poor fit for modeling physicians’ decisions concerning telemedicine use. The TAM demonstrated better fit, although a trimmed TAM was ultimately retained for parsimony with mostly good or adequate fit indices. Subjective norms, perceived usefulness, and attitude toward telemedicine may be important targets for trainings and advocacy efforts to facilitate and sustain telemedicine use in a post-pandemic context.

Multi-modal virtual reality system for tinnitus treatment methods and validation

Virtual reality (VR) has been utilized in clinical treatment because it can efficiently simulate situations that are difficult to control in the real world. In this study, we evaluated the efficacy of VR in patients with chronic subjective tinnitus. We assessed the clinical effectiveness based on electroencephalogram (EEG) analysis and questionnaire responses after patients participated in a 6–8-week VR-based tinnitus relief program. The intervention involved removing tinnitus avatars in the VR, through which we expected the patients to experience subjective tinnitus control. Standardized low-resolution brain electromagnetic tomography was used to analyze changes in source activity in prefrontal regions associated with tinnitus. The study included patients aged 27–68 years with chronic non-pulsatile tinnitus lasting ≥3 months. Patients completed VR sessions, neurological EEGs, and questionnaires. Statistically significant differences were observed in the tinnitus handicap questionnaire total scores immediately after treatment (p = 0.002) and 1-month post-treatment (p = 0.001) compared to those before treatment. Significant changes were also found in the visual numeric scale and profile of mood states scores 1-month post-treatment. Additionally, significant changes were observed in sensor-level and source-level power spectrum criteria immediately following the VR experiment, suggesting that similar to some forms of cognitive behavioral therapy, VR-based programs may help alleviate tinnitus-related distress in patients with chronic subjective tinnitus.

“Colorectal Cancer Care Quality in a Developing Country: Insights from a Comparison of Teaching and Non-teaching Hospitals in Iran”

Background Our study represents the first effort in the Eastern Mediterranean Region to identify disparities in the quality of colorectal cancer (CRC) care in Iran. Methods We established a collaborative registry program for non-metastatic CRC patients to evaluate survival rates between teaching cancer centers (TCCs) and a high-volume, non-teaching, non-cancer center (NTNC). The study included a diverse patient population and considered various factors such as cancer stage, margin involvement, adherence to guidelines for adjuvant and neoadjuvant treatments, emergency surgeries, socioeconomic status, and risk of surgery. We utilized a multivariate Cox regression model and the targeted maximum likelihood estimator (TMLE) to analyze survival disparities in colorectal cancer between TCCs and the NTNC. Results We recruited 668 CRC patients, including 320 with colon cancer and 298 with rectal cancer. Patients who underwent surgery at teaching cancer centers (TCCs) displayed significantly higher quality of care and better outcomes than those treated at the non-teaching, non-cancer center (NTNC). The adjusted hazard ratios (HR) were 1.97 (95% CI 1.21–3.21) for colon cancer and 1.54 (95% CI 1.01–2.55) for rectal cancer. Additionally, we observed significant causal mortality risk ratios (RR) based on hospital type for overall colorectal cancer (RR = 1.42, 95% CI 1.12–1.81) and specifically for colon (RR = 1.48, 95% CI 1.04–2.11) and rectum cancer (RR = 1.39, 95% CI 1.01–2.02). Conclusion The survival disparities in colon and rectal cancers between TCCs and NTNCs highlight a significant gap in CRC care in Iran. It is essential to expand this study nationally and implement the knowledge and experiences from TCCs in other hospitals to improve the quality of care and enhance patient outcomes.

Antibodies raised against a structurally defined Aβ oligomer mimic protect human iPSC neurons from Aβ toxicity at sub-stoichiometric concentrations

Anti-Aβ antibodies are important tools for identifying structural features of aggregates of the Aβ peptide and are used in many aspects of Alzheimer’s disease (AD) research. Our laboratory recently reported the generation of a polyclonal antibody, pAb2AT-L, that is moderately selective for oligomeric Aβ over monomeric and fibrillar Aβ and recognizes the diffuse peripheries of Aβ plaques in AD brain tissue but does not recognize the dense fibrillar plaque cores. This antibody was generated against 2AT-L, a structurally defined Aβ oligomer mimic composed of three Aβ-derived β-hairpins arranged in a triangular fashion and covalently stabilized with three disulfide bonds. In the current study, we set out to determine if pAb2AT-L is neuroprotective against toxic aggregates of Aβ and found that pAb2AT-L protects human iPSC-derived neurons from Aβ42-mediated toxicity at molar ratios as low as 1:100 antibody to Aβ42, with a ratio of 1:25 almost completely rescuing cell viability. Few other antibodies have been reported to exhibit neuroprotective effects at such low ratios of antibody to Aβ. ThT and TEM studies indicate that pAb2AT-L delays but does not completely inhibit Aβ42 fibrillization at sub-stoichiometric ratios. The ability of pAb2AT-L to inhibit Aβ42 toxicity and aggregation at sub-stoichiometric ratios suggests that pAb2AT-L binds toxic Aβ42 oligomers and does not simply sequester monomeric Aβ42. These results further suggest that toxic oligomers of Aβ42 share significant structural similarities with 2AT-L.

Formation of actin mesh structures and alpha-smooth muscle actin dynamics in fibroblasts contribute to dermal regeneration in mouse fetus

In adult mammals and other highly developed animals, incomplete wound healing, scar formation, and fibrosis occur. No treatment for complete tissue regeneration is currently available. However, in mice, at up to 13 days of gestation, early embryonic wounds regenerate without visible scarring. In mouse fetuses, actin cable formation at the epidermal wound margin contributes to regeneration after wounding; however, the relationship between actin behavior and dermal regeneration or scar formation by myofibroblasts is unknown. In the present study, we observed actin dynamics in the wound dermis of mouse fetuses and investigated fibroblast and alpha-smooth muscle actin (α-SMA) properties involved in the switch between regeneration and scar formation in the dermis. In the wound healing process of mouse fetuses, actomyosin bundles develop and contract in a mesh-like pattern in different parts depending on the developmental stage, i.e., in the dermis of E13 (regeneration) and in the fascia of E15 and later (scar formation). Furthermore, in E13 dermal fibroblasts, α-SMA is present in the cytoplasm independently of actin, but in E15 and later myofibroblasts, TGFβ-1 stimulation causes the distribution of α-SMA and actin to coincide, and in E17, when dermal scarring occurs, α-SMA is expressed particularly in the nucleus. The results indicate that reticular contraction by actomyosin is involved in dermal regeneration, and that the discrepancy in the localization of actin and α-SMA in fibroblasts is necessary. The findings may contribute to effective wound regeneration therapy.

Effect of C-reactive protein and serum amyloid A point-of-care testing on antibiotic prescribing for acute respiratory-tract infections at village clinics in China: A study protocol for a cluster randomised controlled trial

Background Antimicrobial resistance is a globally recognised public health threat. In rural China, antibiotic use is common for acute respiratory infections (ARIs), which include symptoms such as coughing and fever that are most likely viral infections but with a small proportion as bacterial infections. This study aims to evaluate the effectiveness of a comprehensive intervention based on C-reactive protein and serum amyloid A point-of-care testing (CRP&SAA POCT) in reducing the inappropriate use of antibiotics for ARIs in Chinese village clinics. Methods This is a pragmatic, parallel-group, controlled, cluster-randomised, superiority trial featuring blinded outcome evaluation and data analysis, along with unblinded treatment. This study will be conducted over a period of six months across 40 village clinics in Hubei, China. CRP&SAA POCT will be implemented in 20 village clinics within the intervention arm. This will include additional training for village doctors on the operations of CRP&SAA POCT, which encompasses centralised training, the distribution of training manuals, and desk reminders. Patient education materials will be provided to assist patients in understanding how CRP&SAA POCT can aid in their diagnosis and treatment. The control arm will not receive any intervention except the usual care. The primary outcome is the proportion of patients of all age groups who are diagnosed with ARIs and prescribed antibiotics during their initial visit in both study arms. All analyses will be conducted using the intention-to-treat approach. Discussion Our study is one of the first trials utilizing CRP&SAA POCT to address the inappropriate prescription of antibiotics for ARIs in village clinics in China. We will also evaluate the implementation process to inform future scale-up in similar resource constrained settings. Trial registration ClinicalTrials.gov Identifier - NCT06568432.

Assessment of community livelihood vulnerability to climate change in Vietnam: A case study of ethnic groups in Northern Upland Region

This study aims to assess the livelihood vulnerability to climate change of ethnic minority communities in Yen Bai province, a typical mountainous region in northern Vietnam. Utilizing the Livelihood Vulnerability Index (LVI) framework developed by Hahn et al. (2009), in combination with the IPCC vulnerability structure, the research analyzes eight components related to household characteristics, health, food, water, housing and productive land, social and financial networks, livelihood strategies, and exposure to climate shocks. Data were collected through a combination of desk study and survey with 480 households from two major ethnic groups: Tay and Thai.The results indicate that the Thai group has a higher overall LVI score (0.43) compared to the Tay group (0.37), reflecting greater livelihood vulnerability. The main factors contributing to this difference are limited livelihood diversification, lower educational attainment, weaker access to healthcare, and higher dependency on climate-sensitive resources. Although both groups are highly exposed to climate-related hazards such as flash floods, landslides, and droughts, the Thai group demonstrates greater sensitivity and lower adaptive capacity. This research contributes theoretically by adapting and refining the LVI framework to suit the context of upland ethnic communities, and practically by providing empirical evidence to inform climate adaptation policies. The study highlights the need for differentiated and context-specific strategies that prioritize ethnic minority communities with high vulnerability, focusing on improving education, livelihood diversification, healthcare access, and institutional support mechanisms.

Exploring extreme environments in Türkiye for novel P450s through metagenomic analysis

Cytochrome P450 enzymes (P450s), particularly those of microbial origin, are highly versatile biocatalysts capable of catalyzing a broad range of regio- and stere-oselective reactions. P450s derived from extremophiles are of particular interest due to their potential tolerance to high temperature, salinity, and acidity. This study aimed to identify and classify novel microbial P450 enzymes from extreme environments across Türkiye, including hydrothermal springs, hypersaline lakes, and an acid-mine drainage site. The focus of this study was on classifying the sequence diversity of P450 enzymes in these sites. To that end, shotgun metagenomic analysis of six sites, using de novo binning, phylogenetic analysis, and functional gene annotation, was used to discover 311 putative P450 sequences, assigned to 87 families and 158 subfamilies, including 8 novel families and 49 new subfamilies. Of these, 237 were in 138 metagenomic bins, including 45 high-quality metagenome-assembled genomes. The distribution of P450 families varied across sites, reflecting distinct environmental conditions and microbial community compositions. These findings highlight the untapped potential of Türkiye’s extreme habitats as a source of novel biocatalysts. Beyond their industrial relevance, extremophile-derived P450s may also play key roles in enabling microbial adaptation to harsh environmental conditions, through their involvement in stress-responsive metabolic pathways and structurally resilient enzyme forms. This work provides a foundation for future studies into both their biotechnological applications and ecological functions.

Echocardiographic findings in young adults with primary hypertension: A scoping review protocol

Echocardiography is the primary imaging tool for evaluating cardiac structure and function in patients with primary hypertension. A significant limitation of the current literature is that most studies focus on older adults, leaving a significant gap in understanding the cardiac effects of primary hypertension in young adults. This scoping review protocol aims to assess conventional echocardiographic parameters, left ventricular geometric patterns, and advanced echocardiographic findings for the early detection of cardiac changes in young adults aged 18–39 with primary hypertension. A systematic literature search will be conducted across the MEDLINE, EMBASE, Web of Science, Scopus, and Cochrane Central databases. This involves systematically reviewing existing literature to outline the reported echocardiographic findings, the parameters analysed, and the abnormalities identified within this population. It will establish the foundation for future reviews and primary research, supporting the evaluation of the diagnostic and prognostic significance of these findings for early detection and risk assessment, ranging from standard conventional measures to more advanced methods.

Correction: Distribution of Anopheles stephensi bioforms in selected districts of Rajasthan, India

The impact of driving versus undistracted listening on podcast knowledge acquisition and retention using a driving simulator: A randomized, cross-over trial

Introduction Research on listening to podcasts while driving suggested no significant difference compared to undistracted listening. However, these studies were conducted in non-controlled driving environments, limiting the evaluation of the environment’s impact. This study aimed to compare knowledge acquisition and retention among resident physicians and undergraduate students while listening to medical education podcasts in a controlled, simulator-based, driving environment versus an undistracted listening condition. Methods A randomized, crossover trial involved 19 residents and 22 undergraduate students from McMaster university and McMaster hospital. Participants listened to podcasts while driving in an immersive, high-fidelity motion simulator that mimics different driving environments: a high-distraction city environment and a low-distraction country environment. In the undistracted listening condition, participants listened to podcasts while being seated at a desk. Immediate and delayed recall tests after a month were administered, and data were analyzed using a 2x2 mixed ANOVA. Results There were no significant differences in knowledge acquisition (e.g., accuracy) between the undistracted, city driving, and country driving conditions (p > 0.05, η2 = 0.011). However, the country driving condition demonstrated slightly higher accuracy compared to the city driving condition in the immediate assessment condition (p < 0.05, η2 = 0.018). Medical expertise level (i.e., resident vs student) did not affect knowledge acquisition across different listening conditions (p > 0.05, η2 = 0.007). Conclusion In a simulated environment, knowledge acquisition from a podcast is not compromised by the attention needed for driving a vehicle. The two distraction levels used in this experiment showed no significant interference with knowledge acquisition. This holds true regardless of participants’ medical expertise. This study highlights the potential of incorporating podcasts into daily commuting to support ongoing education without requiring dedicated study time, enhancing both flexibility and efficiency in professional development.

Rapid response to hemorrhagic fever emergence in Guinea: community-based systems can enhance engagement and sustainability

Since the 2013–2014 Ebola virus disease outbreak, Guinea has faced recurrent epidemics of viral hemorrhagic fevers. Although the country has learned from these epidemics by improving its disease surveillance and investigation capacities, local authorities and stakeholders, including community actors, are not sufficiently involved in the disease-emergence response. As a result, measures are not fully understood and have failed to engage local stakeholders. However, recent research has shown community-based response measures to be effective. For this study, we used a qualitative participatory research approach to (i) describe and analyze the health signals that alert local stakeholders to a problem, (ii) describe the outbreak response measures implemented in Guinée Forestière from local to national levels, and (iii) identify obstacles and levers for implementing responses adapted to the local sociocultural context. Local stakeholders receive a variety of health, environmental, and sociopolitical signals. When dealing with health signals, their next step should be to follow a flowchart developed using a top-down approach and disseminated by national stakeholders. However, our interviews revealed that local stakeholders found this official flowchart difficult to understand. To address this issue, we used a bottom-up approach to co-construct with local stakeholders a response flowchart based on their perceptions and experiences. The resulting diagram opens the door to the development of a community-based response. We then identified six main obstacle categories from the interviews, including insufficient logistical and financial resources, lack of legitimacy of community workers, and inadequate coordination. Based on these obstacles, we suggest ways to develop a response to emerging zoonotic diseases that would enable local stakeholders to better understand their roles and responsibilities and improve their commitment to the outbreak response. Ultimately, this study should help to build an integrated, community-based early warning and response system in Guinée Forestière.