i capitalized “Woman” and it hasn’t killed us yet

Prose by Megan Cooper

Analysis of Gut Microbiota from Aedes albopictus Mosquitoes Collected in Central Illinois

Aedes albopictus, Asian tiger mosquitoes, are vectors of a wide number of human viral diseases including, West Nile virus, Dengue virus, Chikungunya virus and (recently) Zika virus. A large body of evidence has suggested that microbiomes of mosquito midguts are closely associated with specific mosquito life processes such as nutrition, reproduction, aggregation and defense against toxins. In this study we characterize the bacterial flora of the midguts of adult female Ae. albopictus collected from woodlots and residential areas in Champaign and Coles Counties of Central Illinois (40 samples in each category). After extraction of DNA from dissected midguts, we used next generation sequencing (Mi Seq V3) to obtain sequences spanning the V4 hypervariable region of the 16S rRNA gene. The bacterial sequences were analyzed with QIIME. After quality filtering and rarefying, we identified 551 operational taxonomic units (OTUs) from 114 samples. Of the top 30 most abundant OTUs, 31 genera were discovered in 22 families. According to an indicator species analysis, in Champaign County Pseudomonas (50%) and Sediminibacterium (63.5%) characterized the midguts of Ae. albopictus collected from residential areas and woodlots, respectively. For Coles County, the midguts of Ae. albopictus from residential area were well characterized by the OTU for Bradyrhizobiaceae (49.3%), and by Janthinobacterium (51.2%) for woodlots. In general, the composition of bacterial communities differed between both trapping locations and land use types, with some overlap occurring in the residential sectors. In contrast, alpha-diversity measures were largely similar across locality, but differed between land use types, with greater species richness (Chao1), heterogeneity (Shannon Index) and equitability in the midguts of mosquitoes collected from wooded areas. In conclusion, the midgut bacterial community composition and diversity of Ae. albopictus varies by land use and location. Further studies on whether and how such differences in midgut biota influence variation in vectorial capacity traits are warranted

Failure of an Educational Intervention to Improve Consultation and Implications for Healthcare Consultation.

INTRODUCTION: Consultation of another physician for his or her specialized expertise regarding a patient's care is a common occurrence in most physicians' daily practice, especially in the emergency department (ED). Therefore, the ability to communicate effectively with another physician during a patient consultation is an essential skill. However, there has been limited research on a standardized method for a physician to physician consultation with little guidance on teaching consultations to physicians in training. The objective of our study was to measure the effect of a structured consultation intervention on both content standardization and quality of medical student consultations. METHODS: Senior medical students were assessed on a required emergency medicine rotation with a physician phone consultation during a standardized, simulated chest pain case. The intervention groups received a standard consult checklist as part of their orientation to the rotation, followed by a video recording of a good consult call and a bad consult call with commentary from an emergency physician. The intervention was given to students every other month, alternating with a control group who received no additional education. Recordings were reviewed by three second-year internal medicine residents pursuing a fellowship in cardiology. Each recording was evaluated by two of the three reviewers and scored using a standardized checklist. RESULTS: Providing a standardized consultation intervention did not improve students' ability to communicate with consultants. In addition, there was variability between evaluators in regards to how they received the same information and how they perceived the quality of the same recorded consultation calls. Evaluator inter-rater reliability (IRR) was poor on the questions of 1) would you have any other questions of the student calling the consult and 2) did the student calling the consult provide an accurate account of information and case detail. The IRR was also poor on objective data such as whether the student stated their name. CONCLUSIONS: A brief intervention may not be enough to change complex behavior such as a physician to physician consultant communication. Importantly, despite consultants listening to the same audio recordings, the information was processed differently. Future investigations should focus on both those delivering as well as those receiving a consultation

Factors that Contribute to Resident Teaching Effectiveness

Background One of the key components of residency training is to become an educator. Resident physicians teach students, advanced practice providers, nurses, and even faculty on a daily basis. Objective The goal of this study was to identify the objective characteristics of residents, which correlate with perceived overall teaching effectiveness. Methods We conducted a one-year, retrospective study to identify factors that were associated with higher resident teaching evaluations. Senior emergency medicine (EM) teaching residents are evaluated by medical students following clinical teaching shifts. Eighteen factors pertaining to resident teaching effectiveness were chosen. Two items from the medical students' evaluations were analyzed against each factor: teaching effectiveness was measured on a five-point Likert scale and an overall teaching score (1-75). Results A total of 46 EM residents and 843 medical student evaluations were analyzed. The ACGME milestones for systems-based practice (p = 0.02) and accountability (p = 0.05) showed a statistically significant association with a rating of "five" on the Likert scale for teaching effectiveness. Three other ACGME milestones, systems-based practice (p = 0.01), task switching (p = 0.04), and team management (p = 0.03) also showed a statically significant association of receiving a score of 70 or greater on the overall teaching score. Conclusion Residents with higher performance associated with system management and accountability were perceived as highly effective teachers. USMLE and in-service exams were not predictive of higher teaching evaluations. Our data also suggest that effective teachers are working in both academic and community settings, providing a potential resource to academic departments and institutions

Mechanism-based strategies for the management of autoimmunity and immune dysregulation in primary immunodeficiencies

A broad spectrum of autoimmunity is now well described in patients with primary immunodeficiencies (PIDs). Management of autoimmune disease in the background of PID is particularly challenging given the seemingly discordant goals of immune support and immune suppression. Our growing ability to define the molecular underpinnings of immune dysregulation has facilitated novel targeted therapeutics. This review focuses on mechanism-based treatment strategies for the most common autoimmune and inflammatory complications of PID including autoimmune cytopenias, rheumatologic disease, and gastrointestinal disease. We aim to provide guidance regarding the rational use of these agents in the complex PID patient population

Heart and Ventilatory Measures in Crayfish During Copulation

Monitoring heart rate (HR) and ventilatory rate (VR) during defined sensory stimuli and during aggressive and submissive social interactions has provided additional information of a crayfish\u27s physiological state which is not achieved by behavioral observations. In this study, the HR and VR of crayfish were monitored before, during and after the act of copulation in both heterosexual partners. The female crayfish abruptly reduces HR and VR during copulation but the male maintains HR and VR. After separation from copulation the female HR and VR are elevated, potentially paying back the O2 debt. The tight relationship with HR and VR in direction of change indicates a potential neural coupling. These physiological changes in cardiac and respiratory systems suggest an autonomic-like regulation of HR and VR. How these neuronal functions are driven and regulated remains to be determined. Olfactory cues from the female to the male during copulation may be reduced by the reduction in VR in the female. These studies offer experimental paradigms for future neuronal and pharmacological investigations into autonomic regulation of HR and VR as well as the neural circuitry involved

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from Dialogues in Art and Design: Promoting and sharing ExcellenceUo

Toll-like receptor signaling in the establishment and function of the immune system

Toll-like receptors (TLRs) are pattern recognition receptors that play a central role in the development and function of the immune system. TLR signaling promotes the earliest emergence of hematopoietic cells during development, and thereafter influences the fate and function of both primitive and effector immune cell types. Aberrant TLR signaling is associated with hematopoietic and immune system dysfunction, and both loss- and gain-of- function variants in TLR signaling-associated genes have been linked to specific infection susceptibilities and immune defects. Herein, we will review the role of TLR signaling in immune system development and the growing number of heritable defects in TLR signaling that lead to inborn errors of immunity