The Senior Mentoring Program at VCU’s School of Medicine

Educational Objectives 1. To demonstrate the value of senior mentoring in geriatrics education for medical students. 2. To provide a framework for positively influencing student attitudes toward older adults. 3. To describe the underlying human relationships that contribute to patient-centered care. 4. To describe effective verbal and non-verbal skills to establish and build relationships

PEARLS: A Potentially Isolated Quiescent Dwarf Galaxy with a TRGB Distance of 31 Mpc

A wealth of observations have long suggested that the vast majority of isolated classical dwarf galaxies ($M_*=10^7$-$10^9$ M$_\odot$) are currently star-forming. However, recent observations of the large abundance of "Ultra-Diffuse Galaxies" beyond the reach of previous large spectroscopic surveys suggest that our understanding of the dwarf galaxy population may be incomplete. Here we report the serendipitous discovery of an isolated quiescent dwarf galaxy in the nearby Universe, which was imaged as part of the PEARLS GTO program. Remarkably, individual red-giant branch stars are visible in this near-IR imaging, suggesting a distance of $31$ Mpc, and a wealth of archival photometry point to an sSFR of $2\times10^{-12}$ yr$^{-1}$. Spectra obtained with the Lowell Discovery Telescope find a recessional velocity consistent with the Hubble Flow and ${>}1500$ km/s separated from the nearest massive galaxy in SDSS, suggesting that this galaxy was either quenched from internal mechanisms or had a very high-velocity interaction with a nearby massive galaxy in the past. This analysis highlights the possibility that many nearby quiescent dwarf galaxies are waiting to be discovered and that JWST has the potential to identify them.Comment: Submitted to ApJ Letters. Comments welcome

PEARLS: A potentially isolated quiescent dwarf galaxy with a tip of the red giant branch distance of 30 Mpc

A wealth of observations have long suggested that the vast majority of isolated classical dwarf galaxies (M* = 107–109M⊙) are currently star forming. However, recent observations of the large abundance of "ultra-diffuse galaxies" beyond the reach of previous large spectroscopic surveys suggest that our understanding of the dwarf galaxy population may be incomplete. Here we report the serendipitous discovery of an isolated quiescent dwarf galaxy in the nearby Universe, which was imaged as part of the JWST PEARLS Guaranteed Time Observation program. Remarkably, individual red-giant branch stars are visible in this near-IR imaging, suggesting a distance of 30 ± 4 Mpc, and a wealth of archival photometry point to an sSFR of 2 × 10−11 yr−1 and star formation rate of 4 × 10−4M⊙ yr−1. Spectra obtained with the Lowell Discovery Telescope find a recessional velocity consistent with the Hubble Flow and >1500 km s−1 separated from the nearest massive galaxy in Sloan Digital Sky Survey suggesting that this galaxy was either quenched from internal mechanisms or had a very high-velocity (≳1000 km s−1) interaction with a nearby massive galaxy in the past. This analysis highlights the possibility that many nearby quiescent dwarf galaxies are waiting to be discovered and that JWST has the potential to resolve them.T.M.C. is grateful for support from the Beus Center for Cosmic Foundations. R.A.W., S.H.C., and R.A.J. acknowledge support from NASA JWST Interdisciplinary Scientist grants NAG5-12460, NNX14AN10G and 80NSSC18K0200 from GSFC. J.M.D. acknowledges the support of project PGC2018-101814-B-100 (MCIU/AEI/MINECO/FEDER, UE) Ministerio de Ciencia, Investigación y Universidades. This project was funded by the Agencia Estatal de Investigación, Unidad de Excelencia María de Maeztu, ref. MDM-2017-0765. C.C. is supported by the National Natural Science Foundation of China, Nos. 11803044, 11933003, 12173045. This work is sponsored (in part) by the Chinese Academy of Sciences (CAS), through a grant to the CAS South America Center for Astronomy (CASSACA). We acknowledge the science research grants from the China Manned Space Project with No. CMS-CSST-2021-A05. R.A.B. gratefully acknowledges support from the European Space Agency (ESA) Research Fellowship. C.J.C. acknowledges support from the European Research Council (ERC) Advanced Investigator Grant EPOCHS (788113). C.N.A.W. acknowledges funding from the JWST/NIRCam contract NASS-0215 to the University of Arizona. M.A.M. acknowledges the support of a National Research Council of Canada Plaskett Fellowship, and the Australian Research Council Centre of Excellence for All Sky Astrophysics in 3 Dimensions (ASTRO 3D), through project number CE17010001.Peer reviewe

Modeling oxythermal stress for cool-water fishes in lakes using a cumulative dosage approach

Lake warming can negatively impact cool-water fishes through both temperature and oxygen stress. We modeled the joint dynamics of water column temperature and oxygen to quantify oxythermal habitat for yellow perch (Perca flavescens) in Fish Lake, Wisconsin, USA. To estimate annual oxythermal stress, we developed a novel metric (Cumulative Oxythermal Stress Dosage; COSD), that integrates both stress duration and stress magnitude. We find that COSD better predicts observed perch declines than the published TDO3 metric (temperature at depth where dissolved oxygen is 3 mg L-1), which was developed for cold-water fish. Simulations show increases in COSD between 1911-2014, punctuated by a sharp rise since 1989. Extreme COSD years result from the intersection of high maximum daily dosage and prolonged duration exceeding the tolerance threshold. Temperature perturbation experiments to explore future climate scenarios reveal that COSD would increase greatly if the atmosphere warms by >3째C. Applying the COSD metric broadly to temperate lakes could help direct management efforts toward the ecosystems most likely to serve as climate refugia for cold- and cool-water fishes in the future.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Creating Interprofessional Readiness to Advance Age-Friendly U.S. Healthcare

A successful interprofessional faculty development program was transformed into a more clinically focused professional development opportunity for both faculty and clinicians. Discipline-specific geriatric competencies and the Interprofessional Education Collaborative (IPEC) competencies were aligned to the 4Ms framework. The goal of the resulting program, Creating Interprofessional Readiness for Complex and Aging Adults (CIRCAA), was to advance an age-friendly practice using evidence-based strategies to support wellness and improve health outcomes while also addressing the social determinants of health (SDOH). An interprofessional team employed a multidimensional approach to create age-friendly, person-centered practitioners. In this mixed methods study, questionnaires were disseminated and focus groups were conducted with two cohorts of CIRCAA scholars to determine their ability to incorporate learned evidence-based strategies into their own practice environments. Themes and patterns were identified among transcribed interview recordings. Multiple coders were used to identify themes and patterns and inter-coder reliability was assessed. The findings indicate that participants successfully incorporated age-friendly principles and best practices into their own work environments and escaped the silos of their disciplines through the implementation of their capstone projects. Quantitative data supported qualitative themes and revealed gains in knowledge of critical components of age-friendly healthcare and perceptions of interprofessional collaborative care. These results are discussed within a new conceptual framework for studying the multidimensional complexity of what it means to be age-friendly. Our findings suggest that programs such as CIRCAA have the potential to improve older adults’ health by addressing SDOH, advancing age-friendly and patient-centered care, and promoting an interprofessional model of evidence-based practice

A Phase II, Open-Label Clinical Trial of Intranasal Ketamine for Depression in Patients with Cancer Receiving Palliative Care (INKeD-PC Study)

Antidepressants require several weeks for the onset of action, a lag time that may exceed life expectancy in palliative care. Ketamine has demonstrated rapid antidepressant effects, but has been minimally studied in cancer and palliative care populations. Herein, the objective was to determine the feasibility, safety, tolerability and preliminary efficacy of intranasal racemic ketamine for major depressive disorder (MDD) in patients with advanced cancer. We conducted a single-arm, open-label phase II trial at the Princess Margaret Cancer Centre in Toronto, ON, Canada. Participants with advanced cancer with moderate to severe MDD received three flexible doses of intranasal (IN) ketamine (50–150 mg) over a one-week period. The primary efficacy outcome was an antidepressant response and remission rates as determined by the Montgomery–Åsberg Depression Rating Scale (MADRS) from baseline to the Day 8 primary endpoint. Twenty participants were enrolled in the trial, receiving at least one dose of IN ketamine, with fifteen participants receiving all three doses. The Day 8 antidepressant response (MADRS decreased by >50%) and remission (MADRS p < 0.001). Antidepressant effects were partially sustained in the second week in the absence of additional ketamine doses, with a Day 14 mean MADRS score of 14 +/− 9.9. Common adverse effects included fatigue, dissociation, nausea, dysgeusia and headaches; almost all adverse effects were mild and transient, resolving within 2 h of each ketamine dose with one dropout related to adverse effects (negative dissociative episode). Given these promising findings, larger, controlled trials are merited