Tumor-Infiltrating Immune Cells in Colorectal Cancer.

Colorectal cancer encompasses a heterogeneous group of malignancies that differ in pathophysiological mechanisms, immune response and infiltration, therapeutic response, and clinical prognosis. Numerous studies have highlighted the clinical relevance of tumor-infiltrating immune cells among different types of colorectal tumors yet vary in cell type definitions and cell identification strategies. The distinction of immune signatures is particularly challenging when several immune subtypes are involved but crucial to identify novel intercellular mechanisms within the tumor microenvironment.

Many Paths to the Summit: Survey of Step 1 Study Methods with Pass/Fail Scoring.

Introduction: After the United States Medical Licensing Examination (USMLE) shifted the Step 1 licensure exam to pass/fail, there have been limited studies to analyze changes in student study strategies.

Material And Methods: Surveys were distributed to third- and fourth-year medical students at the University of Michigan Medical School (UMMS). The response rate was 66%.

Automated Spatial Omics Landscape Analysis Approach Reveals Novel Tissue Architectures in Ulcerative Colitis.

The utility of spatial omics in leveraging cellular interactions in normal and diseased states for precision medicine is hampered by a lack of strategies for matching disease states with spatial heterogeneity-guided cellular annotations. Here we use a spatial context-dependent approach that matches spatial pattern detection to cell annotation. Using this approach in existing datasets from ulcerative colitis patient colonic biopsies, we identified architectural complexities and associated difficult-to-detect rare cell types in ulcerative colitis germinal-center B cell follicles.

Certified Nurse-Midwives as Teachers: Expanding Interprofessional Collaboration Learning Opportunities for Medical Students on the Obstetrics and Gynecology Clerkship.

Introduction: Interprofessional experiences provide critical exposure to collaborative health care teams, yet medical students often lack this experience during clinical clerkships. We created a labor and delivery triage rotation exclusively staffed by certified nurse-midwives in the obstetrics and gynecology clerkship to address this gap. We sought to evaluate the clinical learning experiences of medical students rotating on this midwife-supervised collaborative team.

Deploying Machine Learning Based Segmentation for Scientific Imaging Analysis at Synchrotron Facilities.

Scientific user facilities present a unique set of challenges for image processing due to the large volume of data generated from experiments and simulations. Furthermore, developing and implementing algorithms for real-time processing and analysis while correcting for any artifacts or distortions in images remains a complex task, given the computational requirements of the processing algorithms. In a collaborative effort across multiple Department of Energy national laboratories, the "MLExchange" project is focused on addressing these challenges.

MLExchange: A web-based platform enabling exchangeable machine learning workflows for scientific studies.

Machine learning (ML) algorithms are showing a growing trend in helping the scientific communities across different disciplines and institutions to address large and diverse data problems. However, many available ML tools are programmatically demanding and computationally costly. The MLExchange project aims to build a collaborative platform equipped with enabling tools that allow scientists and facility users who do not have a profound ML background to use ML and computational resources in scientific discovery.

Association of a longitudinal, preclinical ultrasound curriculum with medical student performance.

Introduction: Point-of-care ultrasound (US) is used in clinical practice across many specialties. Ultrasound (US) curricula for medical students are increasingly common. Optimal timing, structure, and effect of ultrasound education during medical school remains poorly understood.

COVID-19 and medical education in Africa: a cross sectional analysis of the impact on medical students.

Background: The African continent currently experiences 25% of the global burden of disease with only 1.3% of the world's healthcare workers. The COVID-19 pandemic has caused unprecedented disruption to medical education systems, increasing the strain on already-vulnerable regions.

Concealment of a Sexual Minority Identity in the Workplace: The Role of Workplace Climate and Identity Centrality.

Concealing a sexual minority identity at work has been linked to adverse health and employment outcomes. The authors of this paper examine whether LGBQ employee levels of concealment from coworkers and supervisors are linked to perceived workplace climate and LGBQ-identity centrality. 2010-2011 data were used; N = 319 LGBQ full or part-time employees.

Autonomous adaptive data acquisition for scanning hyperspectral imaging.

Non-invasive and label-free spectral microscopy (spectromicroscopy) techniques can provide quantitative biochemical information complementary to genomic sequencing, transcriptomic profiling, and proteomic analyses. However, spectromicroscopy techniques generate high-dimensional data; acquisition of a single spectral image can range from tens of minutes to hours, depending on the desired spatial resolution and the image size. This substantially limits the timescales of observable transient biological processes.

Creating Supportive Environments for LGBT Older Adults: An Efficacy Evaluation of Staff Training in a Senior Living Facility.

Supportive housing later in life tends to be a key concern for lesbian, gay, bisexual, and transgender (LGBT) elders. Most senior care providers are un(der)prepared to meet the needs of older LGBT adults. This study evaluated the efficacy of a 4 hours, face-to-face, research-based, LGBT-diversity training designed to improve senior housing facility staff's cultural competency regarding the needs of LGBT elders.

Sensitive Detection and Analysis of Neoantigen-Specific T Cell Populations from Tumors and Blood.

Neoantigen-specific T cells are increasingly viewed as important immunotherapy effectors, but physically isolating these rare cell populations is challenging. Here, we describe a sensitive method for the enumeration and isolation of neoantigen-specific CD8+ T cells from small samples of patient tumor or blood. The method relies on magnetic nanoparticles that present neoantigen-loaded major histocompatibility complex (MHC) tetramers at high avidity by barcoded DNA linkers.

Reconsidering the LGBT Climate Inventory: Understanding Support and Hostility for LGBTQ Employees in the Workplace.

Workplace climate matters significantly for lesbian, gay, bisexual, queer, or other sexual minority (LGBQ) employees, given that the presence of workplace hostility or support can affect well-being. The Lesbian, Gay, Bisexual, and Transgender Climate Inventory (LGBTCI) is a measure of workplace climate for LGBQ individuals, intended to capture the full range of workplace climate from hostility to support. The purpose of this article is to provide evidence that the recommended scoring approach of the LGBTCI needs to be reconsidered.

Creating assessments as an active learning strategy: what are students' perceptions? A mixed methods study.

: Teaching students how to create assessments, such as those involving multiple-choice questions (MCQs), has the potential to be a useful active learning strategy. In order to optimize students' learning, it is essential to understand how they engage with such activities. : To explore medical students' perceptions of how completing rigorous MCQ training and subsequently writing MCQs affects their learning.

Identifying Medical Student Mistreatment in the Obstetrics and Gynecology Clerkship.

Objective: To characterize the mistreatment identified within the University of Michigan's Obstetrics and Gynecology (Ob/Gyn) clerkship and compare the rates of mistreatment to that of other clerkships in an effort to improve the learning environment.

Design: This is a retrospective cohort study looking at multiple sources of data from 2015 to 2018 about student mistreatment including end-of-rotation and teaching evaluations completed by students, as well as an online reporting system available to medical students. For evaluations, students were asked to rate their agreement with statements on a 5-point Likert scale (1 = strongly disagree, to 5 = strongly agree).

The effects of minority stressors in the workplace on same-sex relationships: A collective case study of female couples.

The purpose of this study is to explore the relational effects of minority stress processes experienced at work by female sexual minority employees. Lesbians, in particular, warrant attention in the work environment, as their experiences with homophobia may be exacerbated by sexist overtones. While scholars have linked hostility in the work environment to individual health and employment outcomes for LGBQ employees, less attention has been given to the cross-contextual effects from work to family life.

Theoretical Extensions of Minority Stress Theory for Sexual Minority Individuals in the Workplace: A Cross-Contextual Understanding of Minority Stress Processes.

Minority stress theory posits that stress processes specific to a sexual minority orientation can affect the psychological health and well-being of lesbian, gay, bisexual, or queer-identified (LGBQ) individuals. In the workplace, LGBQ employees experiencing minority stress report poor mental health outcomes and decreased job satisfaction and commitment. However, few scholars have examined the cross-contextual effects minority stressors that individuals experience in the workplace may have on couples.

Tolerance Versus Support: Perceptions of Residential Community Climate Among LGB Parents.

Objective: To understand which aspects of residential communities are most salient for determining whether sexual minority parents classify their residential community climates as tolerant versus supportive.

Background: Metropolitan hubs for lesbian, gay, and bisexual (LGB) parents are well established, but less is known about nonmetropolitan community climates for LGB parents. Residential community climate toward nonmetropolitan LGB persons may be particularly important to LGB parents because of the potential influences on child and family well-being.

High pCO-induced exopolysaccharide-rich ballasted aggregates of planktonic cyanobacteria could explain Paleoproterozoic carbon burial.

The contribution of planktonic cyanobacteria to burial of organic carbon in deep-sea sediments before the emergence of eukaryotic predators ~1.5 Ga has been considered negligible owing to the slow sinking speed of their small cells. However, global, highly positive excursion in carbon isotope values of inorganic carbonates ~2.

Palliative Care Matters: Lessons From the Loss of a Facility Dog.

Animal-assisted intervention is gaining attention as a stress reduction modality. Quantitative data demonstrate its effectiveness, as a recent study published in AJHPM supported that a Veterans Affairs (VA) hospital facility dog paired with a palliative care psychologist had a measurable impact on salivary cortisol levels and heart rate in hospitalized veterans. There remains an important role for qualitative insights.

Tracking Student Mistreatment Data to Improve the Emergency Medicine Clerkship Learning Environment.

Introduction: Medical student mistreatment is a prevalent and significant challenge for medical schools across the country, associated with negative emotional and professional consequences for students. The Association of American Medical Colleges and Liaison Committee on Medical Education have increasingly emphasized the issue of mistreatment in recent years, and medical schools are tasked with creating a positive learning climate.

Methods: The authors describe the efforts of an emergency department (ED) to improve its clerkship learning environment, using a multifaceted approach for collecting mistreatment data and relaying them to educators and clerkship leadership.

Effects of VA Facility Dog on Hospitalized Veterans Seen by a Palliative Care Psychologist: An Innovative Approach to Impacting Stress Indicators.

The United States is home to 23 million veterans. In many instances, veterans with serious illness who seek healthcare at the VA receive care from a palliative care service. Animal-assisted intervention (AAI) is gaining attention as a therapeutic stress reducing modality; however, its effects have not been well studied in veterans receiving palliative care in an acute care setting.

Part I--Comparing Noncancer Chronic Human Health Reference Values: An Analysis of Science Policy Choices.

The goal of this study was to systematically evaluate the choices made in deriving a chronic oral noncancer human health reference value (HHRV) for a given chemical by different organizations, specifically those from the U.S. Environmental Protection Agency, Health Canada, RIVM (the Netherlands), and the U.

Part II: Quantitative Evaluation of Choices Used in Setting Noncancer Chronic Human Health Reference Values Across Organizations.

Environmental and public health organizations, including the World Health Organization (WHO) and the U.S. Environmental Protection Agency (USEPA), develop human health reference values (HHRV) that set "safe" levels of exposure to noncarcinogens.