2004 Freshwater Mussel Survey of the Big Piney River and Roubidoux Creek, Pulaski County, Missouri

Native freshwater mussels are an ecologically important group of aquatic mollusks. This group is of particular concern to conservation biologists because many species are classified as species of conservation concern (SCC). The freshwater mussel community of the Big Piney River and Roubidoux Creek, on and in the vicinity of Fort Leonard Wood, was previously surveyed by Sternburg et al. (1998). The present project was a resurvey of the area to determine the current status of the mussel community, so that appropriate measures can be taken to preserve and protect that community

Inflammatory Phenotype of Intrahepatic Sulfatide-Reactive Type II NKT Cells in Humans With Autoimmune Hepatitis

Background: Natural Killer T (NKT) cells are CD1d-restricted innate-like T cells that can rapidly release stored cytokines upon recognition of lipid antigens. In mice, type I NKT cells seem to promote liver inflammation, whereas type II NKT cells seem to restrict hepatitis. Here, we aimed at characterizing the role of human type I and type II NKT in patients with autoimmune hepatitis (AIH).Methods: NKT cells were analyzed by flow cytometry in peripheral blood and liver of AIH patients and control groups. α-galactosylceramide-loaded or sulfatide-loaded tetramers were used to detect type I or II NKT cells, respectively. Hepatic CD1d was stained by in situ-hybridization of liver biopsies.Results and Conclusions: Type II NKT cells were more prevalent in human peripheral blood and liver than type I NKT cells. In AIH patients, the frequency of sulfatide-reactive type II NKT cells was significantly increased in peripheral blood (0.11% of peripheral blood leukocytes) and liver (3.78% of intrahepatic leukocytes) compared to healthy individuals (0.05% and 1.82%) and patients with drug-induced liver injury (0.06% and 2.03%; p < 0.05). Intrahepatic type II NKT cells of AIH patients had a different cytokine profile than healthy subjects with an increased frequency of TNFα (77.8% vs. 59.1%, p < 0.05), decreased IFNγ (32.7% vs. 63.0%, p < 0.05) and a complete lack of IL-4 expressing cells (0% vs. 2.1%, p < 0.05). T cells in portal tracts expressed significantly more CD1d-RNA in AIH livers compared to controls. This study supports that in contrast to their assumed protective role in mice, human intrahepatic, sulfatide-reactive type II NKT cells displayed a proinflammatory cytokine profile in patients with AIH. Infiltrating T cells in portal areas of AIH patients overexpressed CD1d and could thereby activate type II NKT cells

Assessing Virtual Versus In-Person Experiential Learning in Medical Student Pediatric Clerkship Training

Assessing Virtual Versus In-Person Experiential Learning in Medical Student Pediatric Clerkship Training Andrew Berry, Andrew Wigger, Karilynn Craig, Dr. Brock Blankenship, Dr. Jennifer Gibson, Center for Experiential Learning, Quillen College of Medicine, East Tennessee State University, Johnson City, TN. Simulation and experiential training have been incorporated into medical school training for decades. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience. As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, our research team was interested in understanding students’ perceptions of virtual and in-person experiential learning activities. The primary goal of this study is to compare medical students’ perceptions of the quality and value of in-person versus virtual experiential learning during their pediatric clerkship. Secondary measures of this study examine the differences regarding the retention of case information presented, the clinical relevance of the pediatric cases discussed, and the likelihood that students will attend similar future sessions. Our team hypothesized that students would perceive in-person sessions as more valuable and meaningful to their medical education. One academic year of medical students who participated in two experiential learning encounters during their pediatric clerkship was assessed. Each encounter involved a series of approximately ten patient cases over two hours; one encounter was done in person, and the other was done virtually. Each case was then discussed using a Socratic format; faculty would ask questions and engage students individually, assessing their decision-making capability (including differential diagnosis, treatment plans, and dispositions). Data was collected by a survey administered after both encounters, each with the same questions. Students generally felt the virtual format for this type of training was as well received as the in-person format (56% vs. 52.2% for excellent value ratings, respectively). Similarly, 43.5% of students reported that the in-person cases greatly improved their retention, while 40% said the virtual cases improved their retention of educational material to the same degree. The in-person experiences were reported as being extremely clinically relevant by 56.5% of students, while the virtual cases were perceived as extremely relevant by 48% of respondents. Lastly, survey data showed that 47.8% of respondents said they would very likely attend similar future in-person sessions (compared to 44% for similar virtual events). Our team feels that the results of this study demonstrate that utilizing a Socratic Model of teaching in experiential learning has excellent value, and high-quality training can be accomplished virtually, even during times of potential virtual fatigue. These findings are important as our results show that experiential learning can be adapted, yet still beneficial, when in-person activities cannot take place, such as what we encountered during the COVID-19 pandemic

Auto-aggressive CXCR6+ CD8 T cells cause liver immune pathology in NASH.

Nonalcoholic steatohepatitis (NASH) is a manifestation of systemic metabolic disease related to obesity, and causes liver disease and cancer1,2. The accumulation of metabolites leads to cell stress and inflammation in the liver3, but mechanistic understandings of liver damage in NASH are incomplete. Here, using a preclinical mouse model that displays key features of human NASH (hereafter, NASH mice), we found an indispensable role for T cells in liver immunopathology. We detected the hepatic accumulation of CD8 T cells with phenotypes that combined tissue residency (CXCR6) with effector (granzyme) and exhaustion (PD1) characteristics. Liver CXCR6+ CD8 T cells were characterized by low activity of the FOXO1 transcription factor, and were abundant in NASH mice and in patients with NASH. Mechanistically, IL-15 induced FOXO1 downregulation and CXCR6 upregulation, which together rendered liver-resident CXCR6+ CD8 T cells susceptible to metabolic stimuli (including acetate and extracellular ATP) and collectively triggered auto-aggression. CXCR6+ CD8 T cells from the livers of NASH mice or of patients with NASH had similar transcriptional signatures, and showed auto-aggressive killing of cells in an MHC-class-I-independent fashion after signalling through P2X7 purinergic receptors. This killing by auto-aggressive CD8 T cells fundamentally differed from that by antigen-specific cells, which mechanistically distinguishes auto-aggressive and protective T cell immunity