Health care education programs were faced with the need to quickly adapt to a new reality during the coronavirus disease 2019 pandemic. Students were temporarily suspended from campus and clinical ...sites, requiring prompt changes in structure to their didactic and clinical learning. This article describes the rapid adjustments that one midwifery and women's health nurse practitioner education program created using both synchronous and asynchronous simulation experiences to promote student learning and ongoing engagement. Flexibility and reflexivity were needed by faculty and students alike in the face of the multiple changes wrought by the pandemic. Curricular changes were made simultaneously in many courses. Objective structured clinical examinations simulate telehealth experiences that assess knowledge, clinical reasoning, and professional behaviors via a scripted scenario and an actor patient. On‐call simulations mimic telephone triage and provide students the opportunity to build listening, assessment, and management skills for prenatal and intrapartum scenarios. Students are provided equipment and virtual instruction in an intrauterine device insertion session, which promotes skill acquisition and self‐confidence. Trigger films are used to visualize real‐life or scripted clinical encounters, leading to discussion and decision‐making, particularly in the affective domain. Bilateral learning tools, similar to case studies, provide students an opportunity to demonstrate their knowledge and critical thinking with a mechanism for faculty feedback. Web‐based virtual clinical encounter learning tools using patient avatars prompt additional student learning. Suturing skills introduced in live remote group sessions are augmented with video‐guided individual practice. This article describes each of these adapted and innovative simulation methods and shares lessons learned during their development and implementation.
Excitatory amino acid transporters (EAATs) represent a protein family that is an emerging drug target with great therapeutic potential for managing central nervous system disorders characterized by ...dysregulation of glutamatergic neurotransmission. As such, it is of significant interest to discover selective modulators of EAAT2 function. Here, we applied computational methods to identify specific EAAT2 inhibitors. Utilizing a homology model of human EAAT2, we identified a binding pocket at the interface of the transport and trimerization domain. We next conducted a high-throughput virtual screen against this site and identified a selective class of EAAT2 inhibitors that were tested in glutamate uptake and whole-cell electrophysiology assays. These compounds represent potentially useful pharmacological tools suitable for further exploration of the therapeutic potential of EAAT2 and may provide molecular insights into mechanisms of allosteric modulation for glutamate transporters.
Although associated allergies are common and the mechanism may include long-term exposure to allergens, measurement of serum specific IgE levels has not been studied in pediatric eosinophilic ...esophagitis (EE).
To compare the results of serum IgE testing, patch testing, and epicutaneous skin testing to measure allergic sensitization in pediatric patients with EE.
In a cross-sectional study of 53 pediatric patients with EE, relevant history was obtained by questionnaire, and patch testing to foods was performed. Food and inhalant sensitivities were also assessed using skin prick testing and serum specific IgE measurement. Streptavidin CAP was used to measure specific IgE to cross-reactive carbohydrate determinants and Helicobacter pylori.
The overall prevalence of food and inhalant sensitization was 80%, with higher total IgE levels in sensitized vs nonsensitized patients (median, 150 vs 13 IU/mL; P < .001). For foods, serum IgE measurement detected more positive results than did skin prick testing. Specific IgE to milk was most common (43%). Inhalants were implicated as frequently as were foods. In keeping with this, 32% of patients had a cluster of multiple sensitivities that included pollens, soy, grains, peanut, and tree nuts and had higher total IgE levels (P = .001). Patch test results were interpreted as positive in 39% of patients (rye, wheat, and soy were the most common).
Most, but not all, patients with EE are highly atopic individuals with frequent allergic sensitivities. Thus, serum IgE measurement of low-titer IgE antibody may be useful in identifying relevant food sensitivities and in distinguishing subgroups of patients with EE, making a more directed approach to food avoidance possible.
Brown spot, caused by
, is a common foliar disease of soybean (
). Applications of fungicide products that contain quinone outside inhibitor (QoI) active ingredients to soybean fields have ...contributed to the selection and development of QoI-resistant populations of
. We investigated the molecular mechanisms of QoI-resistance in these populations through targeted analysis of the cytochrome
gene. Isolates of
collected from several soybean fields over different seasons varied in sensitivity to QoI fungicides. Characterization of the cytochrome
gene revealed a mutation that changed an amino acid from glycine to alanine at codon 143 - one that is generally associated with QoI fungicide resistances. A PCR assay was developed that allowed successful discrimination of QoI-sensitive and -resistant isolates based on the G143A mutation. Results of this study demonstrated that 47.5% of
isolates tested were resistant to QoI fungicides. Accurate monitoring of this mutation will help slow the spread of QoI resistance and will be important for fungicide resistant management in this pathosystem.
Non-communicable disease rates associated with being overweight or obese are rising. Technologies warrant consideration as weight loss interventions. Cloudtag’s® Onitor® Track, a dual-position ...wearable plus smartphone application, monitors energy expenditure and provides tailored exercise programmes. This research aimed to undertake an experimental study of 20 overweight and obese women using the technology; explore its feasibility and acceptability through interviews; and investigate its behaviour change techniques. The primary outcome was decreased body weight (kg) at 4 weeks. Secondary outcomes were body mass index (kg/m2) and waist circumference (cm) changes. 15 overweight and obese women took part. Results indicated weight loss (median 2.7 kg, p < 0.05) and waist circumference decrease (median 4 cm, p < 0.05), but attrition was high (60%). Users reported dietary changes but few activity adjustments. They valued feedback. 27 behaviour change techniques were identified. The Onitor® Track shows potential for weight loss in overweight and obese women, but further work is needed.
While the diagnostic success of genomic sequencing expands, the complexity of this testing should not be overlooked. Numerous laboratory processes are required to support the identification, ...interpretation, and reporting of clinically significant variants. This study aimed to examine the workflow and reporting procedures among US laboratories to highlight shared practices and identify areas in need of standardization.
Surveys and follow-up interviews were conducted with laboratories offering exome and/or genome sequencing to support a research program or for routine clinical services. The 73-item survey elicited multiple choice and free-text responses that were later clarified with phone interviews.
Twenty-one laboratories participated. Practices highly concordant across all groups included consent documentation, multiperson case review, and enabling patient opt-out of incidental or secondary findings analysis. Noted divergence included use of phenotypic data to inform case analysis and interpretation and reporting of case-specific quality metrics and methods. Few laboratory policies detailed procedures for data reanalysis, data sharing, or patient access to data.
This study provides an overview of practices and policies of experienced exome and genome sequencing laboratories. The results enable broader consideration of which practices are becoming standard approaches, where divergence remains, and areas of development in best practice guidelines that may be helpful.Genet Med advance online publication 03 Novemeber 2016.
Diaporthe seed decay can compromise seed quality in soybean
(L.) Merr. in the warm and humid production areas of the United States during crop maturation. In the current study, 45 isolates of
were ...recovered from seed sampled from soybean fields affected by
-associated diseases in eight U.S. states in 2017. The isolates obtained belonged to 10 species of
based on morphology and phylogenetic analyses of the internal transcribed spacer, partial translation elongation factor 1-α, and β-tubulin gene sequences. The associated species included
,
,
,
,
,
,
, and three novel fungi,
,
, and
. One isolate each of the 10 species was examined for pathogenicity on seed of cultivar Sava under controlled conditions. Seven days postinoculation, significant differences in the percentages of decayed seeds and seedling necrosis were observed among the isolates and the noninoculated control (
< 0.0001). While the isolates of
,
, and
caused a significantly greater percentage of decayed seeds (
< 0.0001), the isolate of
caused the greatest seedling necrosis (
< 0.0001). The observation of new fungi causing Diaporthe seed decay suggests the need for a more comprehensive survey in U.S. soybean producing areas since members of the genus
appear to form a complex that causes seed decay.
Abstract Purpose This study investigated the association between sexual orientation, victimization, and suicide risk-related outcomes among youth attending public high schools in San Francisco. ...Methods Data from the 2009 Youth Risk Behavior Survey were analyzed using bivariate and logistic regression methods for complex samples to examine the relationship between sexual orientation, victimization, and three suicide risk-related outcomes (sadness/depression, suicide planning, and attempting suicide) while controlling for demographics and substance use. Results Lesbian, gay, or bisexual (LGB) youth reported significantly higher rates of substance use, victimization, and suicide risk-related outcomes than heterosexual youth. However, in the controlled regression models, victimization was a significant predictor of sadness/depression and suicide attempts, regardless of sexual orientation. There was a significant interaction effect between sexual orientation and victimization on suicide planning, with heterosexual youth more affected than LGB youth. Conclusions Results underscore the deleterious effect of victimization on suicide risk-related outcomes, regardless of sexual orientation. As LGB youth continue to report higher rates of victimization, effective violence prevention approaches must focus on reducing violence among youth, specifically LGB youth. Additional research should focus on identification of other factors that may help further explain elevated suicide risk among LGB youth.
The composition of plant–pollinator interactions—i.e., who interacts with whom in diverse communities—is highly dynamic, and we have a very limited understanding of how interaction identities change ...in response to perturbations in nature. One prediction from niche and diet theory is that resource niches will broaden to compensate for resource reductions driven by perturbations, yet this has not been empirically tested in plant–pollinator systems in response to real-world perturbations in the field. Here, we use a long-term dataset of floral visitation to
Ipomopsis aggregata
, a montane perennial herb, to test whether the breadth of its floral visitation niche (i.e., flower visitor richness) changed in response to naturally occurring drought perturbations. Fewer floral resources are available in drought years, which could drive pollinators to expand their foraging niches, thereby expanding plants’ floral visitation niches. We compared two drought years to three non-drought years to analyze changes in niche breadth and community composition of floral visitors to
I. aggregata
, predicting broadened niche breadth and distinct visitor community composition in drought years compared to non-drought years. We found statistically significant increases in niche breadth in drought years as compared to non-drought conditions, but no statistically distinguishable changes in community composition of flower visitors. Our findings suggest that plants’ floral visitation niches may exhibit considerable plasticity in response to disturbance. This may have widespread consequences for community-level stability as well as functional consequences if increased niche overlap affects pollination services.
PDF
