Clinical teaching is a cornerstone of health sciences education; it is also the most challenging aspect. The University of Pittsburgh Schools of Dental Medicine, Nursing, and Pharmacy developed a new evidence-based interprofessional course framed as a faculty learning community (FLC) around the principles of learning in a clinical environment. The aim of this study was to assess the overall effectiveness of this two-semester FLC at four health professions schools in academic year 2014-15. The assessment included anonymous participant surveys in each session and an anonymous end-of-course survey. Thirty-five faculty members from dental, health and rehabilitation sciences, nursing, and pharmacy enrolled in the FLC, with six to 32 enrollees attending each session. All attendees at each session completed the session evaluation surveys, but the attendance rate at each session ranged from 17.1% to 91.4%. Sixteen participants (46%) completed the end-of-course survey. The results showed overall positive responses to the FLC and changes in the participants’ self-reported knowledge. Session surveys showed that the participants found the FLC topics helpful and appreciated the opportunity to learn from each other and the interprofessional nature of the FLC. Responses to the end-of-course survey were in alignment with the individual session surveys and cited specific benefits as being the content, teaching materials, and structured discussions. In additional feedback, participants reported interest to continue as a cohort and to extend the peer-support system beyond the FLC. This outcomes assessment of the first round of the FLC confirmed that this cohort-based faculty development in an interprofessional setting was well received by its participants. Their feedback provided valuable insights for changes to future offerings.

ABSTRACT

Physical distancing imposed by the COVID-19 pandemic has led to alterations in routines and new responsibilities for much of the research community. We provide some tips for how research teams can cope with physical distancing, some of which require a change in how we define productivity. Importantly, we need to maintain and strengthen social connections in this time when we can’t be physically together.

Background

Transient loss of consciousness (TLOC) is a common reason for presentation to primary/emergency care; over 90% are because of epilepsy, syncope, or psychogenic non-epileptic seizures (PNES). Misdiagnoses are common, and there are currently no validated decision rules to aid diagnosis and management. We seek to explore the utility of machine-learning techniques to develop a short diagnostic instrument by extracting features with optimal discriminatory values from responses to detailed questionnaires about TLOC manifestations and comorbidities (86 questions to patients, 31 to TLOC witnesses).

There is increasing interest in developing diagnostics that discriminate individual mutagenic mechanisms in a range of applications that include identifying population-specific mutagenesis and resolving distinct mutation signatures in cancer samples. Analyses for these applications assume that mutagenic mechanisms have a distinct relationship with neighboring bases that allows them to be distinguished. Direct support for this assumption is limited to a small number of simple cases, e.g., CpG hypermutability. We have evaluated whether the mechanistic origin of a point mutation can be resolved using only sequence context for a more complicated case. We contrasted single nucleotide variants originating from the multitude of mutagenic processes that normally operate in the mouse germline with those induced by the potent mutagen N-ethyl-N-nitrosourea (ENU). The considerable overlap in the mutation spectra of these two samples make this a challenging problem. Employing a new, robust log-linear modeling method, we demonstrate that neighboring bases contain information regarding point mutation direction that differs between the ENU-induced and spontaneous mutation variant classes. A logistic regression classifier exhibited strong performance at discriminating between the different mutation classes. Concordance between the feature set of the best classifier and information content analyses suggest our results can be generalized to other mutation classification problems. We conclude that machine learning can be used to build a practical classification tool to identify the mutation mechanism for individual genetic variants. Software implementing our approach is freely available under an open-source license.

Andre J. Riveros, Anne S. Leonard, Wulfila Gronenberg, and Daniel R. Papaj

Similar to animal communication displays, flowers emit complex signals that attract pollinators. Signal complexity could lead to higher cognitive load, impairing performance, or might benefit pollinators by facilitating learning, memory and decision-making. Here, we evaluate learning and memory in foragers of the bumble bee Bombus impatiens trained to simple (unimodal) vs. complex signals (bimodal) under restrained conditions. Use of a proboscis extension response protocol enabled us to control the timing and duration of stimuli presented during absolute and differential learning tasks. Overall, we observed broad variation in the performance under the two conditions, with bees trained to compound bimodal signals learning and remembering as well as, better, or more poorly than bees trained to unimodal signals. Interestingly, the outcome of training was affected by the specific colour-odour combination. Among unimodal stimuli, the performance with odour stimuli was higher than with colour stimuli, suggesting that olfactory signals played a more significant role in the compound bimodal condition. This was supported by the fact that after 24 h, most bimodal-treatment bees responded to odour but not visual stimuli. We did not observe differences in latency of response, suggesting that signal composition affected decision accuracy, not speed. We conclude that restrained bumble bee workers exhibit broad variation of responses to bimodal stimuli and that components of the bimodal signal may not be used equivalently. The analysis of bee performance under restrained conditions enables accurately control the multimodal stimuli provided to individuals and to study the interaction of individual components within a compound.

In the olfactory bulb, a cAMP/PKA/CREB-dependent form of learning occurs in the first week of life that provides a unique mammalian model for defining the epigenetic role of this evolutionarily ancient plasticity cascade. Odor preference learning in the week-old rat pup is rapidly induced by a 10-min pairing of odor and stroking. Memory is demonstrable at 24 h, but not 48 h, posttraining. Using this paradigm, pups that showed peppermint preference 30 min posttraining were sacrificed 20 min later for laser microdissection of odor-encoding mitral cells. Controls were given odor only. Microarray analysis revealed that 13 nonprotein-coding mRNAs linked to mRNA translation and splicing and 11 protein-coding mRNAs linked to transcription differed with odor preference training. MicroRNA23b, a translation inhibitor of multiple plasticity-related mRNAs, was down-regulated. Protein-coding transcription was up-regulated for Sec23b, Clic2, Rpp14, Dcbld1, Magee2, Mstn, Fam229b, RGD1566265, and Mgst2. Gng12 and Srcg1 mRNAs were down-regulated. Increases in Sec23b, Clic2, and Dcbld1 proteins were confirmed in mitral cells in situ at the same time point following training. The protein-coding changes are consistent with extracellular matrix remodeling and ryanodine receptor involvement in odor preference learning. A role for CREB and AP1 as triggers of memory-related mRNA regulation is supported. The small number of gene changes identified in the mitral cell input/output link for 24 h memory will facilitate investigation of the nature, and reversibility, of changes supporting temporally restricted long-term memory.

Background:

Relatives of patients with bladder cancer have been shown to be at increased risk for kidney, lung, thyroid, and cervical cancer after correcting for smoking-related behaviors that may concentrate in some families. We demonstrate a novel approach to simultaneously assess risks for multiple cancers to identify distinct multicancer configurations (multiple different cancer types that cluster in relatives) surrounding patients with familial bladder cancer.

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Smart Education And Learning Market Size, Share & Trends Analysis Report By Age, By Component (Hardware, Software, Service), By Learning Mode, By End User, By Region, And Segment Forecasts, 2020 - 2027Read the full report: https://www.reportlinker.com/p05891723/?utm_source=PRN The global smart education and learning market size is expected to reach USD 680.1 billion by 2027. The market is anticipated to witness a CAGR of 17.9% from 2020 to 2027. Demand for smart education and learning solutions is increasing among the growing population in corporate and academic sectors, owing to benefits such as improved education quality and easy access to educational content. Increasing adoption of consumer electronics, such as smartphones, e-readers, laptops, and e-learning applications, has altered conventional education methodology and has enhanced the efficiency of an individual to learn. Additionally, there are enormous opportunities for advancements in the market, owing to improved internet accessibility.Also, the COVID - 19 outbreak has emerged an opportunity for the market with an increasing number of states and countries closing educational institutes. For instance, over 90.0% of the world's students are not attending their schools due to this pandemic, as mentioned by UNESCO (The United Nations Educational, Scientific, and Cultural Organization). Commonwealth of Learning (COL), an intergovernmental organization of The Commonwealth (Canada), has supported educational institutions and governments in building robust distance education solutions for quality e-learning practices. However, lack of awareness among end-users about the latest technologies and inadequate amount of resources for delivering quality education in developing regions is anticipated to hinder market growth.The simulation-based learning segment is anticipated to exhibit the highest CAGR because this mode enables corporate professional and educational institutions to create a realistic experience in a controlled environment.It also allows professionals and learners to practice, navigate, explore, and obtain more information through a virtual medium before they start working on real-life tasks.Growing awareness among people and the rising popularity of smart education are encouraging solution providers to invest in research and development for creating more reliable, better, and cost-effective solutions. Manufacturers are making substantial investments in developing new products for enhancing the user experience.Smart education and learning market report highlights:• Growing demand for smart educational practices can be accredited to factors, such as reducing expenses of online training, curbing geographic challenges in physically attending classes, and time constraints faced by aspirants• Increasing penetration of the Internet of Things (IoT), enhanced internet accessibility, and rapid adoption of mobile technology have encouraged users to adopt smart education and learning solutions• Innovative techniques, such as gamification, Massive Open Online Courses (MOOCs), microlearning, and adaptive learning, which improve the overall educational process, are expected to drive the market over the projected period• North America accounted for the largest market share in 2019 owing to its large consumer base for e-learning methodsRead the full report: https://www.reportlinker.com/p05891723/?utm_source=PRN About Reportlinker ReportLinker is an award-winning market research solution. Reportlinker finds and organizes the latest industry data so you get all the market research you need - instantly, in one place. __________________________ Contact Clare: clare@reportlinker.com US: (339)-368-6001 Intl: +1 339-368-6001

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I’m no stranger to forced isolation. For the better part of my 20s, I served as a nuclear submarine officer running secret missions for the United States Navy. I deployed across the vast Pacific Ocean with a hundred other sailors on the USS Connecticut, a Seawolf-class ship engineered in the bygone Cold War era to be one of the fastest, quietest, and deepest-diving submersibles ever constructed. The advanced reactor was loaded with decades of enriched uranium fuel that made steam for propulsion and electrical power so we could disappear under the waves indefinitely without returning to port. My longest stint was for two months, when I traveled under the polar ice cap to the North Pole with a team of scientists studying the Arctic environment and testing high frequency sonar and acoustic communications for under-ice operations. During deployments, critical-life events occur without you: holidays with loved ones, the birth of a child, or in my case, the New York Giants 2011-2012 playoff run to beat Tom Brady’s Patriots in the Super Bowl for the second time. On the bright side, being cut off from the outside world was a great first job for an introvert.

It’s been a month since COVID-19 involuntarily drafted me into another period of isolation far away from home. I’m in Turkey, where a two-week trip with my partner to meet her family has been extended indefinitely. There were no reported cases here and only a few in California in early March when we left San Francisco, where I run a business design studio. I had a lot of anticipation about Turkey because I’d never been here. Now I’m sheltering in a coastal town outside of Izmir with my partner, her parents, their seven cats, and a new puppy.

Shuttered in a house on foreign soil where I don’t speak the language, I have found myself snapping back into submarine deployment mode. Each day I dutifully monitor online dashboards of data and report the status of the spread at the breakfast table to no one in particular. I stay in touch with friends and family all over the world who tell me they’re going stir crazy and their homes are getting claustrophobic. But if there is one thing my experience as a submarine officer taught me, it’s that you get comfortable being uncomfortable.

My training began with psychological testing, although it may not be what you think. Evaluating mental readiness for underwater isolation isn’t conducted in a laboratory by clipboard-toting, spectacled scientists. The process to select officers was created by Admiral Hyman Rickover—the engineering visionary and noted madman who put the first nuclear reactor in a submarine—to assess both technical acumen and composure under stress. For three decades as the director of the Navy’s nuclear propulsion program, Rickover tediously interviewed every officer, and the recruiting folklore is a true HR nightmare: locking candidates in closets for hours, asking obtuse questions such as “Do something to make me mad,” and sawing down chair legs to literally keep one off balance.

Rickover retired from the Navy as its longest-serving officer and his successors carried on the tradition of screening each officer candidate, but with a slightly more dignified approach. Rickover’s ghost, though, seemed to preside over my interview process when I applied to be a submariner as a junior at the U.S. Naval Academy in Annapolis, Maryland. I was warned by other midshipmen that I would fail on the spot if I initiated a handshake. So, dressed in my formal navy blue uniform and doing my best to avoid tripping into accidental human contact, I rigidly marched into the Admiral’s office, staring straight ahead while barking my resume. When I took a seat on the unaltered and perfectly level chair in front of his desk, the Admiral asked me bluntly why I took so many philosophy classes and if I thought I could handle the technical rigors of nuclear power school. My response was a rote quip from John Paul Jones’ “Qualifications of a Naval Officer.” “Admiral, an officer should be a gentleman of liberal education, refined manners, punctilious courtesy, and the nicest sense of personal honor.” My future boss looked at me, shook his head like he thought I’d be a handful, and told me I got the job.

Confinement opened something up in my psyche and I gave myself permission to let go of my anxieties.

Nuclear power training is an academic kick in the face every day for over a year. The curriculum is highly technical and the pedagogy resembles a cyborg assembly-line without even a hint of the Socratic method. Our grades were conspicuously posted on the classroom wall and a line was drawn between those who passed and those who failed. I was below the line enough to earn the distinguished dishonor of 25 additional study hours each week, which meant I was at school at 5 a.m. and every weekend. This is how the Nuclear Navy builds the appropriate level of knowledge and right temperament to deal with shipboard reactor operations.

I finally sat down for a formal psychological evaluation a few months before my first deployment. I was ushered into a room no bigger than a broom closet and instructed to click through a computer-based questionnaire with multiple-choice questions about my emotions. I never did  learn the results, so I assume my responses didn’t raise too many red flags.

During my first year onboard, I spent all my waking hours either supervising reactor operations or learning the intricacies of every inch of the 350-foot tube and the science behind how it all worked. The electrolysis machine that split water molecules to generate oxygen was almost always out of commission, so instead we burned chlorate candles that produced breathable air. Seawater was distilled each day for drinking and shower water. Our satellite communications link had less bandwidth than my dial-up modem in the 1990s and we were permitted to send text-only emails to friends and family at certain times and in certain locations so as not to risk being detected. I took tests every month to demonstrate proficiency in nuclear engineering, navigation, and the battle capabilities of the ship. When I earned my submarine warfare qualification, the Captain pinned the gold dolphins insignia on my uniform and gave me the proverbial keys to the $4 billion warship. At that point, I was responsible for coordinating missions and navigating the ship as the Officer of the Deck.

Modern submarines are hydrodynamically shaped to have the most efficient laminar flow underwater, so that’s where we operated 99 percent of the time. The rare exception to being submerged is when we’d go in and out of port. The most unfortunate times were long transits tossing about in heavy swells, which made for a particularly nauseated cruise. To this day, conjuring the memory of some such sails causes a reflux flashback. A submariner’s true comfort zone is beneath the waves so as soon as we broke ties with the pier we navigated toward water that was deep enough for us to dive.

It’s unnatural to stuff humans, torpedoes, and a nuclear reactor into a steel boat that’s intentionally meant to sink. This engineering marvel ranks among the most complex, and before we’d proceed below and subject the ship and its inhabitants to extreme sea pressures, the officers would visually inspect thousands of valves to verify the proper lineup of systems that would propel us to the surface if we started flooding uncontrollably and sinking—a no-mistakes procedure called rigging for dive. Once we’d slip beneath the waves, the entire crew would walk around to check for leaks before we’d settle into a rotation of standing watch, practicing our casualty drills, engineering training, eating, showering (sometimes), and sleeping (rarely). The full cycle was 18 hours, which meant the timing of our circadian cycles were constantly changing. Regardless of the amount of government-issued Folger’s coffee I’d pour down my throat, I’d pass out upon immediate contact with my rack (the colloquialism for a submarine bunk in which your modicum of privacy was symbolized by a cloth curtain).

As an officer, I lived luxuriously with only two other grown men in a stateroom no bigger than a walk-in closet. Most of the crew slept stacked like lumber in an 18-person bunk room and they all took turns in the rack. This alternative lifestyle is known as hot-racking, because of the sensation you get when you crawl into bedding that’s been recently occupied. The bunk rooms are sanctuaries where silence is observed with monastic intensity. Slamming the door or setting an alarm clock was a cardinal sin so wakeups were conducted by a junior sailor who gently coaxed you awake when it was time to stand watch. Lieutenant Weiner, it’s time to wake up. You’ve got the midnight watch, sir. Words that haunt my dreams.

The electrolysis machine was out of commission, so we burned chlorate candles that produced breathable air.

I maintained some semblance of sanity and physical fitness by sneaking a workout on a rowing erg in the engine room or a stationary bike squeezed between electronics cabinets. The rhythmic beating of footsteps on a treadmill was a noise offender—the sound could be detected on sonar from miles away—so we shut it off unless we were in friendly waters where we weren’t concerned with counter-detection.

Like a heavily watered-down version of a Buddhist monk taking solitary retreat in a cave, my extended submarine confinements opened something up in my psyche and I gave myself permission to let go of my anxieties. Transiting underneath a vast ocean in a vessel with a few inches of steel preventing us from drowning helps put things into perspective. Now that I’m out of the Navy, I have more appreciation for the freedoms of personal choice, a fresh piece of fruit, and 24 hours in a day. My only regrets are not keeping a journal or having the wherewithal to discover the practice of meditation under the sea.

Today, I’m learning Turkish so I can understand more about what’s happening around me. I’m doing Kundalini yoga (a moving meditation that focuses on breathwork) and running on the treadmill (since I’m no longer concerned about my footsteps being detected on sonar). On my submarine, I looked at photos to stay connected to the world I left behind, knowing that I’d return soon enough. Now our friend who is isolating in our apartment in San Francisco sends us pictures of our cat and gives us reports about how the neighborhood has changed.

It’s hard to imagine that we’ll resume our lifestyles exactly as they were. But the submariner in me is optimistic that we have it in us to adapt to whatever conditions are waiting for us when it’s safe to ascend from the depths and return to the surface.

Steve Weiner is the founder of Very Scarce, a business design studio. He used to lead portfolio companies at Expa and drive nuclear submarines in the U.S. Navy. He has an MBA from The Wharton School and a BS from the U.S. Naval Academy. Instagram: @steve Twitter: @weenpeace

Lead image: Mike H. / Shutterstock

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