Utilizing a medical school outreach program to help high school students explore the impact of food security and ultraprocessed foods on health risks.

We offered an enrichment program for high school students with the theme, "The Environment, Health, and You" during the Summer of 2022 and the Spring of 2023. We developed several educational modules for high school students that provided them with an opportunity to learn and explore the foundations of physiological systems, nutrient needs to maintain health, and the impact that environmental factors can have on them. The modules included videos, discussion boards, games, readings, and labs. These modules were integrated into the first session: Your Body and Health. On day 1, the first module explored the basic physiology and anatomy of the body with respect to the organization of cells into organ systems. Additionally, the educational content included information on macro- and micronutrients and their impact on body development, nutrition, and metabolism. The nutrition module explored nutrition concepts and various factors that can impact healthy eating patterns, such as food insecurity issues and the consumption of ultraprocessed foods. A lab activity on label reading was included to help empower students to make healthy choices. A total of 43 high school students participated in the program. Overall, the quality of the educational content in the modules was rated highly by the students, and they indicated that the educational experience inspired them to learn more about the physiology and nutrition concepts associated with human metabolism, and the importance of healthy food choices to maintain health.NEW & NOTEWORTHY We describe how we integrated guided learning teaching modules in an enrichment program for high school students with the aim of enhancing their knowledge and skills to empower them to take charge of their own health risks and well-being.

Treatment of established TH2 cells with 4µ8c, an inhibitor of IRE1α, blocks IL-5 but not IL-4 secretion.

BACKGROUND: T cell activation induces ER stress and upregulates Inositol Requiring Enzyme 1 alpha (IRE1α), an activator of the unfolded protein response (UPR) pathway. Inhibition of IRE1α RNase activity in activated CD4+ splenocytes from naïve mice, via treatment of the cells with the commercially available drug 4µ8c upon activation, results in the reduction of the secretion of proteins IL-5, IL-4, and IL-13. Prior to this work, it was unknown if 4µ8c could inhibit TH2 cytokines in established TH2 cells, cells that are crucial in promoting disease in severe asthma. RESULTS: Treatment of a mouse T helper (TH)2 cell line and differentiated human TH2 cells with 4µ8c resulted in inhibition of IL-5, but not IL-4, as measured by ELISA. The reduced cytokine expression was not due to differences in mRNA stability or mRNA levels; it appears to be due to a defect in secretion, as the cells produce cytokines IL-5 as measured by flow cytometry and western blot. CONCLUSION: These data suggest that the inhibition of IL-5 was due to post-translational processes. IL-5 promotes chronic, inflammatory asthma, and 4µ8c blocks its expression in T cells in vitro. Future studies will determine if 4µ8c treatment can ameliorate the effects of the cytokine IL-5 in a disease model.

Stressed: The Unfolded Protein Response in T Cell Development, Activation, and Function.

The unfolded protein response (UPR) is a highly conserved pathway that allows cells to respond to stress in the endoplasmic reticulum caused by an accumulation of misfolded and unfolded protein. This is of great importance to secretory cells because, in order for proteins to traffic from the endoplasmic reticulum (ER), they need to be folded appropriately. While a wealth of literature has implicated UPR in immune responses, less attention has been given to the role of UPR in T cell development and function. This review discusses the importance of UPR in T cell development, homeostasis, activation, and effector functions. We also speculate about how UPR may be manipulated in T cells to ameliorate pathologies.

Analysis of sirtuin 1 expression reveals a molecular explanation of IL-2-mediated reversal of T-cell tolerance.

The type III histone deacetylase sirtuin 1 (Sirt1) is a suppressor of both innate and adoptive immune responses. We have recently found that Sirt1 expression is highly induced in anergic T cells. However, the transcriptional program to regulate Sirt1 expression in T cells remains uncharacterized. Here we report that the early responsive genes 2 and 3, which can be up-regulated by T-cell receptor-mediated activation of nuclear factor of activated T-cell transcription factors and are involved in peripheral T-cell tolerance, bind to the sirt1 promoter to transcript sirt1 mRNA. In addition, the forkhead transcription factor, FoxO3a, interacts with early responsive genes 2/3 on the sirt1 promoter to synergistically regulate Sirt1 expression. Interestingly, IL-2, a cytokine that can reverse T-cell anergy, suppresses sirt1 transcription by sequestering FoxO3a to the cytoplasm through activating the PI3K-AKT pathway. Expression of the constitutively active form of FoxO3a blocks IL-2-mediated reversal of T-cell tolerance by retaining sirt1 expression. Our findings here provide a molecular explanation of IL-2-mediated reversion of T-cell anergy.

The serine-threonine kinase inositol-requiring enzyme 1α (IRE1α) promotes IL-4 production in T helper cells.

The inositol-requiring enzyme 1α (IRE1α) is a serine-threonine kinase that plays crucial roles in activating the unfolded protein response. Studies suggest that IRE1α is activated during thymic T cell development and in effector CD8(+) T cells. However, its role in regulating T helper cell differentiation remains unknown. We find that IRE1α is up-regulated and activated upon CD4(+) T cell activation and plays an important role in promoting cytokine IL-4 production. CD4(+) T cells from IRE1α KO mice have reduced IL-4 protein expression, and this impaired IL-4 production is not due to the altered expression of Th2 lineage-specific transcription factors, such as GATA3. Instead, IL-4 mRNA stability is reduced in IRE1α KO T cells. Furthermore, treatment of T cells with an IRE1α-specific inhibitor, 4µ8C, leads to a block in IL-4, IL-5, and IL-13 production, confirming the role of IRE1α in the regulation of IL-4. This study identifies a regulatory function for IRE1α in the promotion of IL-4 in T cells.

White Blood Cell and C-Reactive Protein Levels Are Similar in Obese Hispanic White Women Reporting Adherence to a Healthy Plant, Unhealthy Plant, or Animal-Based Diet, unlike in Obese Non-Hispanic White Women.

While modifying dietary patterns can reduce the effects of inflammation in obesity, less is known about the impact of dietary patterns on inflammation levels in women of different ethnicities. This study investigated the link between dietary patterns and mediators associated with inflammation, such as C-reactive protein (CRP) and white blood cells (WBCs), among obese Hispanic and Non-Hispanic White women. CRP and WBC counts were extracted from the National Health and Nutrition Examination Survey conducted between 2003 and 2010. Based on their recorded responses to two 24 h recall interviews, individuals were grouped into one of three dietary patterns: healthy plant-based, less healthy plant-based, or animal-based. Comparisons were run between obese Hispanic and Non-Hispanic women assigned to the same dietary pattern groups and between dietary pattern groups within ethnic groups. CRP and WBCs increased in obese Non-Hispanics as dietary patterns moved from healthy plant-based to animal-based (pCRP = 0.002 and pWBC = 0.017). Regardless of the dietary pattern, CRP and WBC expression were similar in Hispanic women. In addition, WBCs were higher in Hispanics compared to Non-Hispanics when both populations adhered to healthy plant and less healthy plant dietary patterns. The results indicate that dietary patterns may influence Hispanics' inflammation differently than Non-Hispanics.

Self-directed learning assessment practices in undergraduate health professions education: a systematic review.

PURPOSE: The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education. METHODS: Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes. RESULTS: Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001). CONCLUSIONS: The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.

Lck mediates Th2 differentiation through effects on T-bet and GATA-3.

The Src family kinase Lck has been shown to be crucial in T cell signaling and development. However, its role in Th effector functions is not well understood. Lck has previously been shown to play a role in the cytokine expression of Th2 cells, but the mechanism by which Lck influences Th2 effector functions is unknown. Using a mouse model, we report that Lck is important in regulating the expression of IL-4 in Th2 skewed cells but is not as necessary for the expression of Th2 cytokines IL-5, IL-10, and IL-13. Furthermore, in the absence of Lck, T-bet and GATA-3 expression is aberrant. Moreover, this atypical expression pattern of T-bet and GATA-3 correlates with increased histone 3 acetylation at the Ifng locus and production of the Th1 cytokine IFN-gamma. We find overexpression of GATA-3 restores IL-4 expression in lck(-/-) Th2 cells; this indicates that the decreased IL-4 expression is due in part to reduced amounts of GATA-3. Taken together, these data imply that Lck mediates Th2 differentiation through effects on T-bet and GATA-3.

Exploration of a Collaborative Self-Directed Learning Model in Medical Education.

PURPOSE: One of the aims of medical education is to generate lifelong learners, leading to the identification of self-directed learning (SDL) as an essential component of medical education. While SDL is focused on an individual learner, collaboration is critically important in medicine. We developed an online course using the collaborative SDL (CSDL) framework. A goal for the course was for students to gain a better appreciation for the SDL process by exploring the COVID-19 pandemic. METHODS: We utilized CSDL to implement a 2-week elective attended by fifteen M3 and M4 medical students. Students submitted short videos reflecting on their course experience and the relevance of the material to their future training. Qualitative analysis of reflections was conducted to determine the effectiveness of the CSDL framework, and an assessment of the course evaluations was performed to explore student perceptions of the course and its effectiveness at preparing them for practice. A survey regarding student perceptions of SDL was offered to M3 and M4 students in order to explore their experiences with SDL and perceptions of its importance in the context of the school curriculum. RESULTS: The CSDL framework was effective in making students aware of the importance of SDL in medical practice. Students gained basic and clinical knowledge about the subject, experienced increased confidence, and appreciated collaborating with their peers. The survey offered to the general student body reflected that all students perceived that they employed SDL in their time as medical students. However, many students indicated that they had not utilized components of SDL beyond synthesizing and assessing their learning needs. CONCLUSION: CSDL is an effective method for promoting self-directed learning. Undergraduate medical course constructs utilizing CSDL will benefit students as they continue their career development. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01493-7.

Lck regulates IL-10 expression in memory-like Th1 cells.

The Src family kinase Lck is thought to facilitate Th2 differentiation; however, its role in Th1 cells has not been well explored. Using mice that lack Lck in mature T cells, we find that lck(-/-) Th1 skewed cells have normal expression of T-bet and produce IFN-γ at WT levels. However, there is a 3-fold increase in IL-10 producing cells in the mutant cultures. These cells do not have elevated levels of IL-4, GATA3, IL-17 or Foxp3, indicating that they are not Th2, Th17, or Foxp3(+) T regulatory cells (Treg). Nor do these cells behave in a similar manner as the type 1 Treg. Most of the IL-10 in the lck(-/-) Th1 cultures is derived from the memory/activated subset, as the cytokine profile from Th1 cultures established from purified CD62L(+) (naïve) cells are similar to WT cells. Furthermore, this IL-10 expression appears to be dependent on IL-12 and correlates with elevated c-Maf. These data highlight a previously unappreciated role for Lck in regulating IL-10 in Th1 cells.

Test Corrections Appear To Benefit Lower-Achieving Students in an Introduction to Biology Major Course: Results of a Single-Site, One-Semester Study.

Student-performed assessment correction is a well-established practice in the field of teaching and learning. This practice engages students in the feedback process and promotes active learning, which may be particularly important when serving underrepresented minority students. There is a dearth of research into the role of assessment correction in student learning outcomes (SLOs) in science courses, particularly at minority-serving institutions. Students at a Native American-serving, primarily undergraduate rural institution were allowed to perform test corrections for each of the three exams given during the term in an undergraduate introductory biology course. Students received the graded test back and were given 1 week to answer the following questions: what was your original answer, why did you choose that answer/what were you thinking at the time, why is the answer wrong, what is the correct answer, why is it the correct answer, and what is your source of reference if different from the textbook? The students were administered a comprehensive final exam at the end of the course that determined the number of SLOs passed. A Pearson correlation and a bivariate regression analysis were performed to determine if the number of test corrections performed (TC) during the term influenced the number of SLOs passed for all students, lower-achieving students, and higher-achieving students in the study. The TC correlated with, and could predict, SLOs passed for lower-achieving students only. This preliminary analysis suggests that performing test corrections may benefit lower-achieving students.

Using What's at Hand: The Creation of an Online Microbiology Outreach Program.

Outreach programs lead to increased student interest to pursue careers in science fields. However, hosting existing programs during a pandemic has proven difficult. We used "The Seven Principles of Good Practice," which emphasizes interactions between the instructor and students, feedback, and peer interactions, to design an online microbiology program for high school students. Moreover, we incorporated diverse learning techniques to reach learners at disparate levels. While our program was primarily asynchronous, to accommodate for the schedules of our student population, synchronous sessions were held each morning to answer questions, ensure clarity of instructions, and encourage students to benefit from the content expertise of the multidisciplinary faculty. Student and faculty assessment indicated that the program was a success. Our online microbiology precollege outreach program demonstrated an effective way to expose students to infectious disease concepts and information literacy. In this paper, we describe some tips and tools from lessons learned in our outreach program for high school students that was offered online on the topic of microbiology and antimicrobial resistance.