This study sought to evaluate the expression of previously identified microRNAs known to regulate neuronal differentiation in mesenchymal stem cells (MSCs), including miR-27, miR-125, miR-128, miR-135, miR-140, miR-145, miR-218 and miR-410, among dental pulp stem cells (DPSCs) under conditions demonstrated to induce neuronal differentiation. Using an approved protocol, n = 12 DPSCs were identified from an existing biorepository and treated with basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF), which were previously demonstrated to induce neural differentiation markers including Sox1, Pax6 and NFM among these DPSCs. This study revealed that some microRNAs involved in the neuronal differentiation of MSCs were also differentially expressed among the DPSCs, including miR-27 and miR-145. In addition, this study also revealed that administration of bFGF and EGF was sufficient to modulate miR-27 and miR-145 expression in all of the stimulus-responsive DPSCs but not among all of the non-responsive DPSCs—suggesting that further investigation of the downstream targets of these microRNAs may be needed to fully evaluate and understand these observations.

Background: Compassion is recognized as a key component of high-quality healthcare. The literature shows that compassion is essential to improving patient-reported outcomes and fostering health care professionals’ (HCPs) response and resilience to burnout. However, compassion is inherently difficult to define, and a validated tool to reliably quantify and measure patients’ experience of compassion in healthcare settings did not exist until recently. The Sinclair Compassion Questionnaire (SCQ) was compared to six similar tools in 2022 and emerged as the most reliable tool to assess compassion. The purpose of our study was to validate the SCQ in an English-speaking U.S. population. Methods: A total of 272 patients completed our survey, which included the SCQ and 17 demographic-related questions. A confirmatory factor analysis (CFA) was conducted to establish the construct validity of the SCQ and also the five-item version, the SCQ Short Form (SCQ-SF). Results: The CFA confirmed a good model fit, with factor loadings ranging from 0.81 to 0.93. Further analysis showed strong reliability, ranging from 0.866 to 0.957, and with an overall Cronbach’s alpha = 0.96. Conclusions: This study validates the SCQ and SCQ-SF in an English-speaking U.S. population and provides researchers and HCPs with a reliable psychometric tool to measure compassion across healthcare settings.

Case: Bean bag projectiles (BBPs) are less lethal munition composed of a cloth bag filled with lead pellets and marking powder housed in a plastic casing fired from a 12-gauge shot gun. Two patients sustained penetrating BBP injuries that resulted in open fractures and retained BBP. Patient clothing and all BBP components were found deep in the wounds with marking powder surrounding fracture edges. Both patients healed without infection. Conclusion: Surgical exploration of penetrating BBP injuries is recommended to remove marking powder, fabric, plastic, and potentially other forms of contamination. Fracture stabilization should adhere to existing guidelines pertaining to open contaminated wound conditions.

Background: Burnout is increasingly recognized as a critical concern in medical education due to its associations with reduced professional performance, decreased empathy, and increased risk of medical errors. With growing evidence that medical students commonly experience burnout and its associated health consequences (eg, depression and suicide), it is essential to explore factors that may protect against its harmful effects on student well-being. Although spirituality is often considered a potential factor supporting mental health and resilience, its role in buffering burnout among medical students has not been comprehensively reviewed. Objective: This scoping review seeks to map the extent, range, and characteristics of the literature examining the relationship between spirituality and burnout and defined forms of stress among medical students. Specifically, the review will (1) describe the nature and direction of reported associations and (2) identify gaps to inform priorities for future research. Methods: This scoping review followed PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines to ensure a systematic and transparent process. Studies that examined the relationship between spirituality and burnout or related outcomes and correlates, such as anxiety, depression, stress, or suicidality, among undergraduate medical students were eligible. Only studies that focused specifically on medical students rather than other health care professionals or professional students were eligible. Eligible articles were peer-reviewed and published in English. MEDLINE (PubMed), APA PsycInfo, Scopus, and Embase databases were searched. Two reviewers independently screened titles and abstracts, followed by full-text review to determine final inclusion. Discrepancies were resolved through discussion with a third reviewer until consensus was reached. Extracted data were descriptively analyzed and summarized in charts and tables and synthesized narratively according to the review questions. Results: The database searches were completed in July 2025 and yielded 1788 records. Screening was conducted from September 2025 through January 2026. Of the database records 39 (2.2%) peer-reviewed studies met the inclusion criteria. During full-text screening, articles were most frequently excluded because they did not explicitly evaluate the association between spirituality and burnout, represented an ineligible publication type, or included populations beyond undergraduate medical students without reporting separate results for medical students. Data extraction was completed in April 2026. The manuscript reporting results was completed in May 2026 and is under review as of September 2026. Conclusions: This review will provide a comprehensive overview of how spirituality and religious practices have been examined in relation to burnout and stress among undergraduate medical students. By mapping conceptualizations and experiences of spirituality within medical training, as well as varying patterns in how these practices relate to student well-being, this review highlights key gaps in the evidence and directions for future research on factors that may support medical student mental health. Trial Registration: OSF Registries osf.io/tqwsk; https://osf.io/tqwsk International Registered Report Identifier (IRRID): DERR1-10.2196/88915

BACKGROUND Burnout is highly prevalent among undergraduate medical students and is associated with adverse outcomes including depression, anxiety, psychological distress, and suicidal ideation. Spirituality and religiosity are increasingly recognized as potential coping resources that may limit burnout and improve well-being among medical students. However, existing studies vary substantially in how spirituality and burnout are defined and measured. OBJECTIVE The goal of this scoping review was to synthesize evidence on the relationship between spirituality and burnout-related outcomes, including psychological distress and well-being, among undergraduate medical students. METHODS A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, Web of Science, and PsycINFO were searched. Two independent reviewers screened studies and extracted data, with disagreements resolved by a third reviewer. Extracted data included study characteristics, measurement instruments, and key findings related to spirituality and burnout-related outcomes. RESULTS Thirty-nine studies published from 2007 to 2025 across nineteen countries met inclusion criteria. Most were single site, cross sectional surveys with convenience samples. Sample sizes ranged from about 16 to 1,417. About half used validated spirituality measures (e.g., FACIT-Sp, SWBS, DUREL or Brief COPE); others used single item indicators. Burnout itself was measured less often than stress or mood symptoms. Overall, higher spirituality or intrinsic religiosity was frequently associated with lower burnout stress, anxiety, depressive symptoms, and suicidal ideation, and higher resilience, empathy, life satisfaction, and quality of life. Qualitative work found that spirituality provided meaning, comfort, belonging, and moral grounding during training. A smaller set of studies reported null or mixed findings, often when spirituality was measured with single items or in universities with low religious participation and limited formal support for spiritual practice. CONCLUSIONS Across diverse settings, spirituality is commonly used by medical students and is frequently linked with better mental health. Measurement diversity and the dominance of cross-sectional designs limit causal inference. Future work should use clearer constructs, common validated tools, and prospective or interventional designs. These findings may help inform the development of more holistic and inclusive wellness initiatives within medical education that recognize the potential role of spirituality in supporting student mental health and resilience. CLINICALTRIAL This protocol is registered on the Open Science Framework: https://doi.org/10.17605/OSF.IO/TQWSK

BACKGROUND Burnout is increasingly recognized as a critical concern in medical education due to its associations with reduced professional performance, decreased empathy, and increased risk of medical errors. With growing evidence that medical students commonly experience burnout and its associated health consequences (eg, depression and suicide), it is essential to explore factors that may protect against its harmful effects on student well-being. Although spirituality is often considered a potential factor supporting mental health and resilience, its role in buffering burnout among medical students has not been comprehensively reviewed. OBJECTIVE This scoping review seeks to map the extent, range, and characteristics of the literature examining the relationship between spirituality and burnout and defined forms of stress among medical students. Specifically, the review will (1) describe the nature and direction of reported associations and (2) identify gaps to inform priorities for future research. METHODS This scoping review followed PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines to ensure a systematic and transparent process. Studies that examined the relationship between spirituality and burnout or related outcomes and correlates, such as anxiety, depression, stress, or suicidality, among undergraduate medical students were eligible. Only studies that focused specifically on medical students rather than other health care professionals or professional students were eligible. Eligible articles were peer-reviewed and published in English. MEDLINE (PubMed), APA PsycInfo, Scopus, and Embase databases were searched. Two reviewers independently screened titles and abstracts, followed by full-text review to determine final inclusion. Discrepancies were resolved through discussion with a third reviewer until consensus was reached. Extracted data were descriptively analyzed and summarized in charts and tables and synthesized narratively according to the review questions. RESULTS The database searches were completed in July 2025 and yielded 1788 records. Screening was conducted from September 2025 through January 2026. Of the database records 39 (2.2%) peer-reviewed studies met the inclusion criteria. During full-text screening, articles were most frequently excluded because they did not explicitly evaluate the association between spirituality and burnout, represented an ineligible publication type, or included populations beyond undergraduate medical students without reporting separate results for medical students. Data extraction was completed in April 2026. The manuscript reporting results was completed in May 2026 and is under review as of September 2026. CONCLUSIONS This review will provide a comprehensive overview of how spirituality and religious practices have been examined in relation to burnout and stress among undergraduate medical students. By mapping conceptualizations and experiences of spirituality within medical training, as well as varying patterns in how these practices relate to student well-being, this review highlights key gaps in the evidence and directions for future research on factors that may support medical student mental health. CLINICALTRIAL OSF Registries osf.io/tqwsk; https://osf.io/tqwsk INTERNATIONAL REGISTERED REPORT DERR1-10.2196/88915