Does self-modulated learning vs. algorithm-regulated learning of dermatology morphology affect learning efficiency of medical students?

Background: Deliberate practice is an important method of skill acquisition and is under-utilized in dermatology training. We delivered a dermatologic morphology training module with immediate feedback for first year medical students. Our goal was to determine whether there are differences in accuracy and learning efficiency between self-regulated and algorithm-regulated groups. Methods: First year medical students at the University of Calgary completed a dermatologic morphology module. We randomly assigned them to either a self-regulated arm (students removed cases from the practice pool at their discretion) or an algorithm-regulated arm (an algorithm determined when a case would be removed). We then administered a pre-survey, pre-test, post-test, and post-survey. Data collected included mean diagnostic accuracy of the practice sessions and tests, and the time spent practicing. The surveys assessed demographic data and student satisfaction. Results: Students in the algorithm-regulated arm completed more cases than the self-regulated arm (52.9 vs. 29.3, p<0.001) and spent twice as much time completing the module than the self-regulated participants (34.3 vs. 17.0 min., p<0.001). Mean scores were equivalent between the algorithm- and self-regulated groups for the pre-test (63% vs. 66%, n = 54) and post-test (90% vs. 86%, n = 10), respectively. Both arms demonstrated statistically significant improvement in the post-test. Conclusion: Both the self-regulated and algorithm-regulated arms improved at post-test. Students spent significantly less time practicing in the self-directed arm, suggesting it was more efficient

Influence of Translocations on Eastern Wild Turkey Population Genetics in Texas

Between 1979 and 2006, over 7,000 eastern wild turkeys (Meleagris gallopavo silvestris) from 16 states were translocated to east Texas in an attempt to restore a stable, huntable population. Although current populations are stable in some areas and a spring male-only hunting season was opened in 1995, turkey density in the region remains low and large areas of apparently suitable habitat are not occupied. The longterm effects of the extensive translocations and current levels of connectivity among various populations are unknown. We used microsatellite DNA analysis to assess the influence of translocations on current genetic structure and gene flow in eastern wild turkeys. The influence of translocations was clearly evident and reflected historical contributions from the Midwest and southeastern United States. The east Texas population consisted of 3 distinct genetic clusters. Despite a lack of clear geographic barriers and nearly contiguous forest cover in much of the east Texas landscape, regional gene flow among clusters appeared to be limited. Diversity in the regional population remains high, but we recommend that regulations reflect the current population structure and that long-term efforts should be made to increase connectivity among wild turkeys in the region

The GlueX DIRC Project

The GlueX experiment was designed to search for and study the pattern of gluonic excitations in the meson spectrum produced through photoproduction reactions at a new tagged photon beam facility in Hall D at Jefferson Laboratory. The particle identification capabilities of the GlueX experiment will be enhanced by constructing a DIRC (Detection of Internally Reflected Cherenkov light) detector, utilizing components of the decommissioned BaBar DIRC. The DIRC will allow systematic studies of kaon final states that are essential for inferring the quark flavor content of both hybrid and conventional mesons. The design for the GlueX DIRC is presented, including the new expansion volumes that are currently under development.Comment: 8 pages, 6 figure

RioGrande Wild Turkey Life History and Management Calendar

4 pp., 3 color photosThis calendar is for landowners and managers who want to manage and improve their wild turkey habitat. The calendar is in easy-to-follow chart form and shows important annual events pertaining to wild turkey life history, habitat management, and population monitoring

Nucleotide modification at the γ-phosphate leads to the improved fidelity of HIV-1 reverse transcriptase

The mechanism by which HIV-1 reverse transcriptase (HIV-RT) discriminates between the correct and incorrect nucleotide is not clearly understood. Chemically modified nucleotides containing 1-aminonaphthalene-5-sulfonate (ANS) attached to their γ-phosphate were synthesized and used to probe nucleotide selection by this error prone polymerase. Primer extension reactions provide direct evidence that the polymerase is able to incorporate the gamma-modified nucleotides. Forward mutation assays reveal a 6-fold reduction in the mutational frequency with the modified nucleotides, and specific base substitutions are dramatically reduced or eliminated. Molecular modeling illustrates potential interactions between critical residues within the polymerase active site and the modified nucleotides. Our data demonstrate that the fidelity of reverse transcriptase is improved using modified nucleotides, and we suggest that specific modifications to the γ-phosphate may be useful in designing new antiviral therapeutics or, more generally, as a tool for defining the structural role that the polymerase active site has on nucleotide selectivity

Impacts of Invasive, Exotic Grasses on Quail of Southwestern Rangelands: A Decade of Progress?

Exotic grass invasions are a serious concern for State and Federal agencies, non-government organizations, and private landowners engaged in quail conservation and management. Quail biologists recognized the potential negative impacts of exotic grass invasion on North American quail populations 2 decades ago. This issue was addressed in a review paper published in the Proceedings of the 5th National Quail Symposium in 2002. That paper reported the state of our knowledge on impacts of exotic grass invasions on 5 quail species inhabiting southwestern rangelands. Our objective is to update the progress of exotic grass-quail research on southwestern rangelands during the past decade by reviewing studies that provide specific results about the impacts of exotic grass invasions on southwestern quail populations. Results of studies that have quantified the impacts of exotic grass on quail habitat use are summarized and discussed along with studies that describe how exotic grasses impact important components of quail habitat such as diversity and abundance native herbaceous plants and arthropods. Management of exotic grasses is also discussed

Effect of a Virtual Patient Navigation Program on Behavioral Health Admissions in the Emergency Department: A Randomized Clinical Trial

This randomized clinical trial assesses whether the availability of a 45-day behavioral health-virtual patient navigation program decreases hospitalization among adult patients presenting to the emergency department with a behavioral health crisis or need. Importance The number of patients presenting to emergency departments (EDs) for psychiatric care continues to increase. Psychiatrists often make a conservative recommendation to admit patients because robust outpatient services for close follow-up are lacking. Objective To assess whether the availability of a 45-day behavioral health-virtual patient navigation program decreases hospitalization among patients presenting to the ED with a behavioral health crisis or need. Design, Setting, and Participants This randomized clinical trial enrolled 637 patients who presented to 6 EDs spanning urban and suburban locations within a large integrated health care system in North Carolina from June 12, 2017, through February 14, 2018; patients were followed up for up to 45 days. Eligible patients were aged 18 years or older, with a behavioral health crisis and a completed telepsychiatric ED consultation. The availability of the behavioral health-virtual patient navigation intervention was randomly allocated to specific days (Monday through Friday from 7 am to 7 pm) so that, in a 2-week block, there were 5 intervention days and 5 usual care days; 323 patients presented on days when the program was offered, and 314 presented on usual care days. Data analysis was performed from March 7 through June 13, 2018, using an intention-to-treat approach. Interventions The behavioral health-virtual patient navigation program included video contact with a patient while in the ED and telephonic outreach 24 to 72 hours after discharge and then at least weekly for up to 45 days. Main Outcomes and Measures The primary outcome was the conversion of an ED encounter to hospital admission. Secondary outcomes included 45-day follow-up encounters with a self-harm diagnosis and postdischarge acute care use. Results Among 637 participants, 358 (56.2%) were men, and the mean (SD) age was 39.7 (16.6) years. The conversion rates were 55.1% (178 of 323) in the intervention group vs 63.1% (198 of 314) in the usual care group (odds ratio, 0.74; 95% CI, 0.54-1.02; P = .06). The percentage of patient encounters with follow-up encounters having a self-harm diagnosis was significantly lower in the intervention group compared with the usual care group (36.8% [119 of 323] vs 45.5% [143 of 314]; P = .03). Conclusions and Relevance Although the primary result did not reach statistical significance, there is a strong signal of potential positive benefit in an area that lacks evidence, suggesting that there should be additional investment and inquiry into virtual behavioral health programs. Question Does offering virtual patient navigation reduce admission rates for patients presenting to the emergency department with a behavioral health crisis? Findings In this randomized clinical trial, there were fewer admissions on days when the navigation program was available (55.1%) vs on days with usual care (63.1%), although the difference was not statistically significant. Significantly fewer patients who used the navigation program had a follow-up encounter involving a self-harm diagnosis within 45 days compared with patients who received usual care (36.8% vs 45.5%). Meaning Although the primary result did not reach statistical significance, there is a strong signal of potential positive benefit in an area that lacks evidence, suggesting that there should be additional investment and inquiry into this area.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Long-Chain n-3 Fatty Acids Attenuate Oncogenic KRas-Driven Proliferation by Altering Plasma Membrane Nanoscale Proteolipid Composition

Ras signaling originates from transient nanoscale compartmentalized regions of the plasma membrane composed of specific proteins and lipids. The highly specific lipid composition of these nanodomains, termed nanoclusters, facilitates effector recruitment and therefore influences signal transduction. This suggests that Ras nanocluster proteolipid composition could represent a novel target for future chemoprevention interventions. There is evidence that consumption of fish oil containing long-chain n-3 polyunsaturated fatty acids (n-3 PUFA) such as eicosapentaenoic acid (EPA, 20:5Δ5,8,11,14,17) and docosahexaenoic acid (DHA, 22:6Δ4,7,10,13,16,19) may reduce colon cancer risk in humans, yet the mechanism underlying this effect is unknown. Here, we demonstrate that dietary n-3 PUFA reduce the lateral segregation of cholesterol-dependent and -independent nanoclusters, suppressing phosphatidic acid-dependent oncogenic KRas effector interactions, via their physical incorporation into plasma membrane phospholipids. This results in attenuation of oncogenic Ras-driven colonic hyperproliferation in both Drosophila and murine models. These findings demonstrate the unique properties of dietary n-3 PUFA in the shaping of Ras nanoscale proteolipid complexes and support the emerging role of plasma membrane-targeted therapies. Significance: The influence of dietary long chain n-3 polyunsaturated fatty acids on plasma membrane protein nanoscale organization and KRas signaling supports development of plasma membrane-targeted therapies in colon cancer