Background: Case-based learning (CBL) and lecture-based learning (LBL) are two well-established instructional approaches in education. CBL emphasizes active participation, critical thinking, and problem-solving skills, while LBL relies primarily on lectures for knowledge transfer. The effectiveness of these methods has been a subject of ongoing research and discussion due to their respective strengths and limitations. Understanding the advantages and drawbacks of CBL and LBL is crucial in determining the most suitable approach for specific educational contexts and desired learning outcomes. Aim: This study aims to conduct a systematic review and meta-analysis to assess the effectiveness of case-based learning compared to traditional lecture-based learning in medical education. Methods: A comprehensive search was conducted using various databases, including PubMed, Google Scholar, African Journals OnLine, Scopus, Web of Science, Embase, and Wiley Online Library. The screening and selection process adhered to predetermined eligibility criteria using RAYYAN software. A mean difference metaanalysis was performed employing random-effects models and the DerSimonian Laird method to generate forest plots, evaluate heterogeneity, and assess publication bias. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the analysis was performed using STATA Version 18 software. Results: Seventeen studies meeting the inclusion criteria were analyzed, involving a total of 1,937 participants. Among them, 977 medical students were assigned to the case-based learning group, while 960 medical students were assigned to the lecture based learning group. The meta-analysis showed a pooled mean difference of 0.84 (95% CI: 0.54, 1.13), favoring the effectiveness of case-based learning over traditional lecture-based learning in medical education with significant heterogeneity (I2 > 89.05%, P < 0.001 and the H2 = 9.13) and no evidence of publication bias (Egger 0.1323 and Begg's P= 0.638). Conclusions: Our findings suggest that case-based learning is a more effective instructional method than lecture-based learning for medical students, leading to improved performance and case analysis abilities.

Introduction: Skin and soft tissue infections (SSTIs) are commonly encountered in clinical practice and mainly caused by gram-positive cocci such as S.aureus and β-hemolytic streptococci. Complicated SSTIs involving deeper tissues often necessitate surgical intervention and occur in patients with significant comorbidities such as diabetes or immunocom-promising conditions. Methods: In this study, we retrospectively reviewed the epidemiology, clinical characteristics, microbiology, and treatment of patients admitted with SSTI during a five-year period in the Internal Medicine Department of a tertiary hospital. Results: During the study period, 317 patients were recorded, with a mean age of 72.1 years. The most common underlying medical conditions were diabetes mellitus, chronic kidney disease, and heart failure. Cultures were positive in 23.3 % of cases, 62.2 % of which were polymicrobial. The most frequently isolated microorganisms were Enterococci, Escherichia coli, and Pseudomonas aeruginosa. Significant antimicrobial resistance rates were noted, in particular for gram-negative microorganisms. Mortality was higher than described in the literature and associated with age, comorbidities, and infection by gram-negative microorganisms. Conclusion: This study denotes the role of gram-negative bacteria in SSTI epidemiology. Therapeutic protocols regarding the empiric treatment of SSTIs should necessarily take into account the local epidemiology of isolated pathogens and antimicrobial resistance.

Normal aging results in subtle changes both in ACTH and cortisol secretion. Most notable is the general increase in mean daily serum cortisol levels in the elderly, without a noteworthy alteration in the normal circadian rhythm pattern. Glucocorticoid excess seen in the elderly population can have serious consequences in both the structural and functional integrity of various key areas in the brain, including the hippocampus, amygdala, prefrontal cortex, with consequent impairment in normal memory, cognitive function, and sleep cycles. The chronically elevated glucocorticoid levels also impinge on the normal stress response in the elderly, leading to an impaired ability to recover from stressful stimuli. In addition to the effects on the brain, glucocorticoid excess is associated with other age-related changes, including loss of muscle mass, hypertension, osteopenia, visceral obesity, and diabetes, among others. In contrast to the increase in glucocorticoid levels, other adrenocortical hormones, particularly serum aldosterone and DHEA (the precursor to androgens and estrogens) show significant decreases in the elderly. The underlying mechanisms for their decrease remain unclear. While the adrenomedullary hormone, norephinephrine, shows an increase in plasma levels, associated with a decrease in clearance, no notable changes observed in plasma epinephrine levels in the elderly. The multiplicity and complexity of the adrenal hormone changes observed throughout the normal aging process, suggests that age-related alterations in cellular growth, differentiation, and senescence specific to the adrenal gland must also be considered.

Objective The main objective of the study was to investigate major differences among European countries in implementing infection prevention and control (IPC) measures and reasons for reduced compliance. Design An online survey including experts in IPC and a gap analysis were conducted to identify major limitations in implementing IPC guidelines. Setting Europe. Main outcome measures Four areas were targeted: (1) healthcare structure, (2) finances, (3) culture and (4) education and awareness. Perceived compliance to IPC measures was classified as low (<50%), medium (50% to 80%) and high (>80%). Countries were classified in three regions: North-Western Europe (NWE), Eastern Europe (EE) and Southern Europe (SE). Results In total, 482 respondents from 34 out of 44 (77.3%) European countries participated. Respondents reported availability of national guidelines to control multidrug-resistant Gram-negatives (MDR-GN) in 20 countries (58.0%). According to participants, compliance with IPC measures ranged from 17.8% (screening at discharge) to 96.0% (contact precautions). Overall, three areas were identified as critical for the compliance rate: (1) number of infection control staff, (2) IPC dedicated educational programmes and (3) number of clinical staff. Analysis of reasons for low compliance showed high heterogeneity among countries: participants from NWE and SE deemed the lack of educational programmes as the most important, while those from EE considered structural reasons, such as insufficient single bed rooms or lacking materials for isolation, as main contributors to the low compliance. Conclusions Although national guidelines to reduce the spread of MDR-GN are reported in the majority of the European countries, low compliance with IPC measures was commonly reported. Reasons for the low compliance are multifactorial and vary from region to region. Cross-country actions to reduce the spread of MDR-GN have to consider structural and cultural differences in countries. Locally calibrated interventions may be fruitful in the future.

Dr. Loucas Louca is an Associate Professor of Science Education at the European University Cyprus. His research interests focus on student abilities for inquiry in science, on modeling-based learning in scinece and on teachers’ instructional strategies for promoting student inquiry in science. He has also a longstanding interest in supporting professional teacher development in science education. He has been involved in several nationally and EU funded projects focusing on student inquiry in science, teacher professional development, professional learning communities, development of curriculum materials, promoting opportunities for gender balance in science education, STEM education, and promoting inquiry-based teaching and learning in science. He has also experiences in the development and enactment of afternoon clubs for young children in Science, and he also has designed various out-of-school STEM activities for students.

The Mediterranean and Black Sea region is an international centre of economic and commercial development and transactions. At the same time, though, it is characterised by a very volatile and dynamically changing security environment that poses severe threats and challenges on the societies and their prosperity. MEDEA aspires to contribute to the establishment of safer and more secure societies throughout the Mediterranean and Black Sea region using research and innovation as a catalyst to promote collaboration between practitioners from diverse disciplines and countries. The MEDEA project, during its 60 months of implementation aims to: Establish and Operate the MEDEA network. A multi-disciplinary network of security practitioners, with active links to policy makers and users/providers of security innovations across the M&BS countries focusing on Border Protection and other Security- and Disaster-Related tasks. All MEDEA members will engage in activities towards maintaining its sustainability and longevity even after the end of the project. Engage participants in anticipatory governance on emerging security challenges that the Mediterranean and Black Sea regions would face in the coming years (present until +10 years), based on a threefold structure that forms the backbone of the project: i) understanding the unsatisfactory state of play, ii) design the desirable future and iii) define a resilient pathway on how to achieve this. Push for the “co-creation” of security technology and capabilities innovations between practitioners and innovation. Their evaluation and prioritization will be based on a multi-criteria analysis (technology, operational, cost-benefit, etc.) and it will be linked to Human Development, Policy Making and Organizational Improvements in-terms of facilitating their use by the practitioners. Establish and annually update the Mediterranean Security Research and Innovation Agenda (MSRIA), that identifies areas where security & defence research is needed (including the research needs that are not covered by civilian research) and establishes recommendations for European Security & Defence technology investments. It will constitute the common position of the Mediterranean practitioners’ for future call for proposals from European and National funding mechanisms.

GRACE aims to equip European law enforcement agencies with advanced analytical and investigative capabilities to respond to the spread of online child sexual exploitation material. The growth in online child sexual exploitation and abuse material is a significant challenge for European law enforcement agencies. Referrals of CSEM exceed the capacity of LEAs to respond in a practical and timely manner. To safeguard victims, prosecute offenders and limit the spread of CSEM, LEAs need a next-generation AI-powered investigative platform. Background The sexual exploitation and abuse of children, the production of CSEM and subsequent distribution of this material via the internet is a shocking crime. Referrals from Online Service Providers (OSPs) are crucial to fighting CSE. Growth in the number of referrals of CSEM to LEAs is driven both by increased availability and distribution of online CSEM and improved detection and reporting processes. The extent of referrals is affecting LEAs' capacity to respond promptly, leading to an inability to prevent harm to infants and children, rescue those in immediate danger, and investigate and prosecute perpetrators. Core concepts Recent improvements to the referral process have improved LEAs capabilities. However, the sheer volume of data obtained in CSE cases stretches human resources, the limits of manual analysis beyond most LEAs reach. Given there has been a 4,000% increase in referrals since 2014, a new approach to managing, processing and analysing this content is necessary. At the heart of the project, GRACE has three core concepts. Adress the volume and analyse the content of online CSEM through technological innovations; Provide genuine operational value to LEAs in their investigation of online CSEM; and Impact at the strategic and policy level in the harmonisation of EU-wide responses to CSE.

Flipped classroom (FC) is a pedagogical approach in which the conventional notion of classroom-based learning is inverted, so that students are introduced to the learning material before class, with classroom time then being used to deepen understanding through discussion with peers and problem-solving activities facilitated by teachers. Although using FC methods has multiple benefits and is growing popularity, researchers and practitioners indicate that among impediments of widespread usage of FC methods are the additional time and technological support in relation to development of flipped learning activities. The flipped approach often involves the investment of significant time and energy on the part of instructors (e.g., recording video lectures; designing additional in-class activities). It is therefore recommended for teachers flipping their courses in team. By working in team, teachers can share their experiences of implementing flipped classrooms as well as their teaching resources The “Developing Flipped Methods for Teaching” project aims at developing all the necessary flipped learning pedagogical material (out-of-class tasks, pre-assessment tools, in-class activities) for teaching a discipline (psychology) covering a whole academic year course. The project aims at overcoming the difficulties of elaborating multiple materials for teaching with flipped classroom design. By collaboration of six education institutions an entire discipline will be covered with FC materials in seven languages (English, Romanian, Hungarian, Portuguese, Bulgarian, Slovak and Greek), tackling a gap between educational research and practice. One of the project partners, The Mihai Eminescu National Pedagogical High School (Romania) is a secondary-level educational institute. Due to the particularities of the Romanian education system they offer teacher and kindergarten teacher training program, whereby graduates receive a teacher-kindergarten teacher degree. In Romania psychology is part of the secondary-level school curricula, so high schools can also benefit from educational materials translated to Romanian. Their main role in the project is to translate the developed educational methods by the higher education institutes from the partnership, to test and adapt it to the Romanian requirements. The partnership is composed from other six Higher Education Institutes with Teacher Training Faculties, who have important experience as partners or leaders Strategic Partnership projects and educational innovation. The main intellectual output of the project are the pedagogical materials for teaching an entire course of psychology with flipped classroom (FC) methods (materials for 30 courses), available in seven languages. Each pedagogical material is composed of instructional video, out-of-class work plans (online activities) associated with Low-stakes, formative assignments as well as in-class activities and assessment tools.