Use of Mobile Learning by Resident Physicians in Botswana

With the growth of mobile health in recent years, learning through the use of mobile devices (mobile learning [mLearning]) has gained recognition as a potential method for increasing healthcare providers\u27 access to medical information and resources in resource-limited settings. In partnership with the University of Botswana School of Medicine (SOM), we have been exploring the role of smartphone-based mLearning with resident (physicians in specialty training) education. The SOM, which admitted its first class of medical students and residents in 2009, is committed to providing high-level on-site educational resources for resident physicians, even when practicing in remote locations. Seven residents were trained to use an Android-based myTouch 3G smartphone equipped with data-enabled subscriber identity module (SIM) cards and built-in camera. Phones contained locally loaded point-of-care and drug information applications, a telemedicine application that allows for the submission of cases to local mentors, and e-mail/Web access. Surveys were administered at 4 weeks and 8 weeks following distribution of phones. We found that smartphones loaded with point-of-care tools are effectively utilized by resident physicians in resource-limited settings, both for accessing point-of-care medical information at the bedside and engaging in self-directed learning at home

NK cell–activating receptors require PKC-θ for sustained signaling, transcriptional activation, and IFN-γ secretion

Natural killer (NK) cell sense virally infected cells and tumor cells through multiple cell surface receptors. Many NK cell–activating receptors signal through immunoreceptor tyrosine–based activation motif (ITAM)–containing adapters, which trigger both cytotoxicy and secretion of interferon-gamma (IFN-γ). Within the ITAM pathway, distinct signaling intermediates are variably involved in cytotoxicity and/or IFN-γ secretion. In this study, we have evaluated the role of protein kinase C-θ (PKC-θ) in NK-cell secretion of lytic mediators and IFN-γ. We found that engagement of NK-cell receptors that signal through ITAMs results in prompt activation of PKC-θ. Analyses of NK cells from PKC-θ–deficient mice indicated that PKC-θ is absolutely required for ITAM-mediated IFN-γ secretion, whereas it has no marked influence on the release of cytolytic mediators. Moreover, we found that PKC-θ deficiency preferentially impairs sustained extracellular-regulated kinase signaling as well as activation of c-Jun N-terminal kinase and the transcription factors AP-1 and NFAT but does not affect activation of NF-κB. These results indicate that NK cell–activating receptors require PKC-θ to generate sustained intracellular signals that reach the nucleus and promote transcriptional activation, ultimately inducing IFN-γ production