Utilizing a Web-Based Program for Educational Material Distribution in an OBGYN Residency Program

Background: Online modules and assignments are commonly used for continuing education among residents. Ensuring ease of distribution and access to learning modules, assignments and simulations allows for the efficient completion of these tasks. Objective: The purpose of this quality improvement project is to propose a new method for distribution of educational material and assignments to improve resident satisfaction and ease of completion as well as tracking completion by the program manager. Methods: A survey was sent to the 2020-21 academic year OBGYN residents regarding the current in-hospital folder-based distribution of resources. Based on the survey feedback, a checklist was designed in a web-based program (New Innovations). A repeat survey was sent out to current OBGYN residents in the 2021-22 academic year to assess resident satisfaction with the new distribution system. Results: The checklist-based system proposed in this project utilizing a web-based system resulted in improved resident satisfaction and reported ease of use compared to the in-hospital folder-based computer system, with 86% preferring the web-based checklist

Evaluating the Effect of Neuraxial Analgesia on External Cephalic Version Success

Abstract Background: External cephalic version (ECV) can be a helpful procedure in attempts to decrease the overall cesarean section rate. ECV involves the application of external pressure to the pregnant woman’s abdomen in attempts to turn the fetus to a vertex presentation and allow for subsequent vaginal delivery. Tocolytics are routinely used to increase ECV success rates, and neuraxial analgesia has been presented as another adjunct to increase overall success. The purpose of this quality improvement project is to evaluate the effect neuraxial analgesia may have on ECV success rates. Methods: Patients scheduled for ECV between the dates of January 2020 and September 2021 were reviewed. Data collected includes patient age, BMI, gestational age, success of ECV and use of neuraxial analgesia (epidural anesthesia). Results: Of the 21 patients, 6 (29%) were found to be vertex on their scheduled ECV date. Six (29%) patients who did not have an epidural failed ECV. Four (19%) patients who had an epidural failed ECV. Five (24%) patients who had an epidural had a successful ECV. Interestingly, no patients had a successful ECV without an epidural. Conclusion: No attempts at ECV were successful without an epidural in the 21 patient charts reviewed. Further evaluation through expanded chart review to increase the sample size would allow for meaningful statistical evaluation of this salient finding

Supercharged Models of Intrinsically Disordered Proteins and Their Utility in Sensing

In this thesis I show that greatly increasing the magnitude of a protein’s net charge using surface supercharging transforms that protein into a ligand-gated or counterion-gated conformational molecular switch. To demonstrate this I first modified the designed helical bundle hemoprotein H4 using simple molecular modeling, creating a highly charged protein which both unfolds reversibly at low ionic strength and undergoes the ligand-induced folding transition commonly observed in signal transduction by intrinsically disordered proteins in biology. Due to the high surface charge density, ligand binding to this protein is allosterically activated by low concentrations of divalent cations and the polyamine spermine. To demonstrate this process further using a natural protein, I similarly modified E. coli cytochrome b562 and the resulting protein behaves in a like manner. These simple model systems allow us to derive and then experimentally validate a mass-action model for coupled folding and binding behavior of ligand-gated conformational switches, establishing a set of general engineering principles which can be used to convert natural and designed proteins into allosteric molecular switches useful in biodesign, synthetic biology, and sensing

Sulfation and amidinohydrolysis in the biosynthesis of giant linear polyenes.

Clethramycin from Streptomyces malaysiensis DSM4137, and mediomycins (produced together with clethramycin from Streptomyces mediocidicus), are near-identical giant linear polyenes apparently constructed from, respectively, a 4-guanidinobutanoate or 4-aminobutanoate starter unit and 27 polyketide extender units, and bearing a specific O-sulfonate modification at the C-29 hydroxy group. We show here that mediomycins are actually biosynthesised not by use of a different starter unit but by direct late-stage deamidination of (desulfo)clethramycin. A gene (slf) encoding a candidate sulfotransferase has been located in both gene clusters. Deletion of this gene in DSM4137 led to accumulation of desulfoclethramycin only, instead of a mixture of desulfoclethramycin and clethramycin. The mediomycin gene cluster does not encode an amidinohydrolase, but when three candidate amidinohydrolase genes from elsewhere in the S. mediocidicus genome were individually expressed in Escherichia coli and assayed, only one of them (medi4948), located 670 kbp away from the mediomycin gene cluster on the chromosome, catalysed the removal of the amidino group from desulfoclethramycin. Subsequent cloning of medi4948 into DSM4137 caused mediomycins A and B to accumulate at the expense of clethramycin and desulfoclethramycin, respectively, a rare case where an essential biosynthetic gene is not co-located with other pathway genes. Clearly, both desulfoclethramycin and clethramycin are substrates for this amidinohydrolase. Also, purified recombinant sulfotransferase from DSM4137, in the presence of 3'-phosphoadenosine-5'-phosphosulfate as donor, efficiently converted mediomycin B to mediomycin A in vitro. Thus, in the final steps of mediomycin A biosynthesis deamidination and sulfotransfer can take place in either order

A Survey Evaluating Extent of Undergraduate Medical Education Regarding Sex-Based Differences in Pathophysiology

Introduction A historical gap in research on sex differences in health outcomes has led to a lack of education on sex-based differences in pathophysiology. The primary objective of this research study was to survey pathophysiology professors of medical schools in the United States (US) to understand the current extent to which the impact of sex on disease is included in the pre-clinical curricula of undergraduate medical institutions in the US. Methods A survey tool was created via literature review to assess the extent of education on sex-based differences in pathophysiology. This survey was distributed using the Qualtrics electronic platform to the head professor of pathophysiology at each of the 141 Liaison Committee on Medical Education (LCME) accredited medical schools in the United States. Results The survey response rate was 14.9%. The most taught topics were epidemiology of most common cancers affecting each sex and risk factors for development of osteoporosis between different sexes. Sex-based differences in zolpidem dosing, smoking cessation, and the physiologic mechanism of narcotic addiction had the least curricular coverage. 28.57% of faculty and 38.10% of faculty agree and somewhat agree, respectively, their institution provides faculty development for teaching about topics relating to sex differences in pathophysiology. Medical students are primarily evaluated on their knowledge of sex pathophysiology in the form of written examination, followed by evaluation by standardized patients, and lastly faculty observed patient interactions. Discussion Curricular topics relating to sex-based differences in pathophysiology are taught to varying degrees in medical school preclinical curricula. Improved efforts can be made to increase instruction on specific topics and to support faculty development in teaching about sex-based differences in disease evaluation and management, enhancing the education of the next generation of physicians and facilitating better care for patients

Vitamin D heritability and effect of pregnancy status in Vervet monkeys ( Chlorocebus aethiops sabaeus ) under conditions of modest and high dietary supplementation: Vitamin D, Pregnancy, Diet Interaction in Vervets

The two objectives of the current study were to: 1) investigate the genetic contributions to variations in serum vitamin D concentrations under two dietary conditions (a standard monkey biscuit diet vs. a diet designed to model typical American consumption) and; 2) explore the interaction of vitamin D with pregnancy status using a cohort of pedigreed female vervet/African green monkeys

Cold atoms in space: community workshop summary and proposed road-map

We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies.publishedVersio

Cold atoms in space: community workshop summary and proposed road-map

We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies

Cold atoms in space: community workshop summary and proposed road-map

We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies