Virtual delivery: a panacea for the financial and ethical challenges associated with physiology laboratory classes?

There has been a gradual shift in the delivery of physiology laboratory classes over the last 30 years. For many, wet-lab demonstrations using animal tissues have been reduced or replaced with student-led investigations where students are both subjects and researchers. Despite these changes, expectations remain that physiology courses should include a practical component to encourage deeper and higher-order learning. Wet-lab tissue experiments and student-based group research formats can be expensive to run, associated with various ethical constraints, and, as discovered in these times of COVID-19, difficult to operate while adhering to physical distancing. We address the proposition that online and/or remote delivery of laboratory classes using digital technologies may provide a solution to both financial and ethical constraints of on-campus laboratory classes. Our discussions, as an international group of 10 physiologists from the United States, the United Kingdom, Canada, and Australia, revealed that although some of the financial and ethical constraints of using animal tissues and student-led investigations were addressed by the introduction of online alternatives, the construction and maintenance of online delivery modes could also be expensive and ethical issues, not previously considered, included digital equity and student data security. There was also a collective perception that if face-to-face laboratory classes were changed to an entirely virtual mode there was a risk that some intended learning outcomes would not be met. It was concluded that the "ideal" approach is likely a hybrid model whereby student attendance in face-to-face, on-campus classes is supported with interactive digital content either developed in house or obtained through third-party providers.

International educators' attitudes, experiences, and recommendations after an abrupt transition to remote physiology laboratories.

The COVID-19 pandemic triggered university lockdowns, forcing physiology educators to rapidly pivot laboratories into a remote delivery format. This study documents the experiences of an international group of 10 physiology educators surrounding this transition. They wrote reflective narratives, framed by guiding questions, to answer the research question: "What were the changes to physiology laboratories in response to the COVID-19 pandemic?" These narratives probed educators' attitudes toward virtual laboratories before, during, and after the transition to remote delivery. Thematic analysis of the reflections found that before COVID-19 only a few respondents had utilized virtual laboratories and most felt that virtual laboratories could not replace the in-person laboratory experience. In response to university lockdowns, most respondents transitioned from traditional labs to remote formats within a week or less. The most common remote delivery formats were commercially available online physiology laboratories, homemade videos, and sample experimental data. The main challenges associated with the rapid remote transition included workload and expertise constraints, disparities in online access and workspaces, issues with academic integrity, educator and student stress, changes in learning outcomes, and reduced engagement. However, the experience generated opportunities including exploration of unfamiliar technologies, new collaborations, and revisiting the physiology laboratory curriculum and structure. Most of the respondents reported planning on retaining some aspects of the remote laboratories postpandemic, particularly with a blended model of remote and on-campus laboratories. This study concludes with recommendations for physiology educators as to how they can successfully develop and deliver remote laboratories.

Professional skills for physiology majors: defining and refining.

Changing labor markets require a workforce that is broadly trained for a variety of possible careers. Recognizing this, government and industry representatives, along with students and their families, are encouraging universities and colleges to focus more on developing transferable skills to maximize employability of their graduates. In response, academic institutions and professional organizations have begun to develop lists of transferable professional skills that they expect students to have acquired on graduation. At the 2018 Physiology Majors Interest Group (P-MIG) meeting, participants stated that there was a need to define a list of professional skills for undergraduates completing a physiology major. To this end, a professional skills committee was established. Initially members of the committee worked together to develop a draft list of skills. An iterative process of refining the list was then undertaken through presentations/small-group discussions at appropriate international meetings and via an online survey. Over 60 physiology educators, the majority of whom teach in undergraduate programs, provided input. The final list (presented here) consists of 13 skills grouped in four broad categories: think critically, communicate effectively, behave in a socially and scientifically responsible manner, and demonstrate laboratory proficiency. It is anticipated that the list will be used for curriculum mapping and to guide the development of new physiology courses and major programs. The professional skills committee now plans to develop rubrics and tools that will allow for the assessment of these skills.

Physiology educators find community in the Physiology Majors Interest Group.

The Physiology Majors Interest Group (P-MIG) is a grass-roots consortium of physiology educators with the common interest of creating program-level guidelines for undergraduate physiology and related programs. A key component of the consortium's activities are the annual P-MIG conferences that have been held at different universities over the past 3 yr (Michigan State University, 2017; University of Arizona, 2018; and University of Minnesota, 2019). Postconference surveys indicate that the conferences are highly valued by the participants, as they have provided an opportunity to get to know others who are passionate about undergraduate education, to discuss best practices in program and course delivery, and to form working groups with the goal to develop national and international guidelines for physiology program delivery and assessment.

Does Restrictive Lung Function Affect the Exercise Capacity in Patients with Repaired Tetralogy of Fallot?

Patients with repaired Tetralogy of Fallot (rTOF) have decreased exercise capacity (XC) and restrictive lung function (RLF). Our objective was to determine the association between RLF and impaired XC in patients with rTOF. This was a single center retrospective review of patients with rTOF who underwent a cardiopulmonary treadmill exercise testing and spirometry from 2005 to 2015. Patients with a respiratory exchange ratio ≥ 1.05 and peak heart rate > 90% of predicted value were included. Forced vital capacity (FVC) and Forced expiratory volume in 1st second of forceful expiration (FEV1) were used to classify the lung function. Exercise parameters such as peak oxygen uptake (VO2), % of predicted VO2 (%VO2), Metabolic equivalents (METS), and exercise time (ET) were compared between the two groups (i) compared patients with normal lung function (normal FEV1, FVC, and FEV1/FVC > 80%) (ii) RLF (FVC < 80%, normal or increased FEV1/FVC > 80%). In our cohort (n = 151, 52% male, mean age ± SD of 22.3 ± 9.1 years), patients with RLF (n = 73) compared to those with normal lung function (n = 86) had a lower peak VO2 (30.8 ± 8.6 vs. 36.6 ± 9.8 mL/kg/min; p < 0.001) and shorter exercise time (9:23 ± 1:78 vs. 10:23 ± 1:62 min, p < 0.001). On multivariate regression analysis, RLF was independently associated with reduced XC (VO2%) (ß-coefficient - 0.182, p < 0.02) after controlling for age and gender. RLF is common in patients with rTOF and is associated with decreased XC. The contribution of RLF to reduced XC in this population should be considered prior to therapeutic decisions.

Comparative Cardiorespiratory Fitness in Children: Racial Disparity May Begin Early in Childhood.

African American (AA) adults are reported to have lower levels of cardiorespiratory fitness (CRF) as compared to Caucasian adults. CRF is linked to cardiovascular morbidity and mortality. We hypothesized that the disparities start early in childhood. This was a retrospective analysis of the cardiopulmonary exercise test (CPET). We included normal healthy children, ≤ 18 years of age, who had normal electrocardiograms and normal cardiac function. We excluded patients with congenital heart disease, obesity and suboptimal exercise test. The entire cohort was divided into two groups based on race (Caucasian vs. AA) and then further subcategorized by gender. The cohort of 248 patients had a mean ± SD age of 14.4 ± 2.1 years. 158 (60.8%) were males and 158 (60.8%) were Caucasians. Oxygen consumption was higher among Caucasian children when compared to the AA children (48.7 ± 7.9 vs. 45.4 ± 7 mL/kg/min, p = 0.01). This racial disparity continued to persist when comparisons were performed separately for girls and boys. Upon comparing the four groups, the AA females were found to have the lowest values of VO2max, exercise time and METS (p = 0.001). Thus, in conclusion, the AA children have significantly lower level of CRF, as measured by VO2max and exercise time. The racial disparity is independent of gender. African American females show the lowest level of aerobic capacity. The findings of our study suggest that the racial disparity in the CRF levels seen in the adult population may begin early in childhood.

The local regulation of folliculogenesis by members of the transforming growth factor superfamily and its relevance for advanced breeding programmes.

Regulation of the growth and maturation of the ovarian follicle is critical for normal reproductive function. Alterations in this growth can lead to pathological conditions, such as cystic follicles, reduced oocyte quality, or an abnormal endocrine environment leading to poor fertility. Alterations in follicular growth also influence the number of follicles ovulating and thus can change litter size. Both endocrine factors, such as follicle stimulating hormone and luteinizing hormone, as well as local factors, are known to regulate follicular growth and development. This review will focus on the role of local factors in regulation of ovarian follicular growth in ruminants, with a focus on members of the transforming growth factor superfamily. The potential role of these factors in regulating proliferation, apoptosis, steroidogenesis and responsiveness to gonadotrophins will be considered.

Differential expression of CART in ewes with differing ovulation rates.

We hypothesised that cocaine- and amphetamine-regulated transcript (CARTPT) would be differentially expressed in ewes with differing ovulation rates. Expression of mRNA for CARTPT, as well as LHCGR, FSHR, CYP19A1 and CYP17A1 was determined in antral follicles ≥1 mm in diameter collected during the follicular phase in ewes heterozygous for the Booroola and Inverdale genes (I+B+; average ovulation rate 4) and ++ contemporaries (++; average ovulation rate 1.8). In ++ ewes (n = 6), CARTPT was expressed in small follicles (1 to <3 mm diameter), where 18.8 ± 2.5% follicles expressed CARTPT CART peptide was also detected in follicular fluid of some follicles of ++ ewes. In I+B+ ewes, 5/6 ewes did not have any follicles that expressed CARTPT, and no CART peptide was detected in any follicle examined. Expression pattern of CYP19A1 differed between I+B+ and ++ ewes with an increased percentage of small and medium follicles (3 to <4.5 mm diameter) but decreased percentage of large follicles (≥4.5 mm diameter) expressing CYP19A1 in the I+B+ ewes. Many of the large follicles from the I+B+ ewes appeared non-functional and expression of LHCGR, FSHR, CYP17A1 and CYP19A1 was less than that observed in ++ ewes. Expression of FSHR and CYP17A1 was not different between groups in small and medium follicles, but LHCGR expression was approximately double in I+B+ ewes compared to that in ++ ewes. Thus, ewes with high ovulation rates had a distinct pattern of expression of CARTPT mRNA and protein compared to ewes with normal ovulation rates, providing evidence for CART being important in the regulation of ovulation rate.

Prescribing or dispensing medication represents the best opportunity for GPs and pharmacists to engage older people in alcohol-related clinical conversations.

OBJECTIVES: This research aimed to identify older Australian drinkers' knowledge about Australian Alcohol Guidelines and their beliefs about the risks and benefits of alcohol; their recall of alcohol-related issues being raised with them by their community pharmacist and General Practitioner (GP); and their receptiveness to alcohol-related information being provided by either health professional. METHODS: This research was conducted in Perth, Western Australia. Flyers calling for participants were placed in local health and service centres, and advertisements were placed in local media. Participants who met eligibility requirements were posted a survey pack (n = 190) including an information letter, consent form, quantitative survey, and return addressed, postage paid envelope. 188 people aged over 60 years returned completed questionnaires. KEY FINDINGS: Women were more familiar with national alcohol guidelines, and were more conservative about the potential health benefits of alcohol. While 90% of participants were receptive to their GP asking about their alcohol use, only 30% of men and 20% of women recalled their GP raising this issue with them in the prior 12 months. Of these, high-risk drinkers were six times more likely than low-risk drinkers to have been asked by their GP. Likewise, 50% of men and 65% of women were receptive to having alcohol-related health conversations with their community pharmacist, but less than 4% recalled their pharmacist raising this issue. Participants were most receptive to receiving information about alcohol-medication interactions. CONCLUSIONS: This research highlights that prescribing and dispensing medication represents the ideal opportunity for health professionals to deliver alcohol-related information to older people.

Mutations in the leptin receptor gene associated with delayed onset of puberty are also associated with decreased ovulation and lambing rates in prolific Davisdale sheep.

The aim of this study was to determine if single nucleotide polymorphisms (SNPs) in the leptin receptor (LEPR) gene associated with delayed onset of puberty are associated with changes in other reproductive traits in adult ewes. The ovulation rate of ewes homozygous for the SNPs was ~15% lower (PPLEPR SNPs than their wild-type or heterozygous contemporaries. Partial failure of multiple ovulations was also increased (PLEPR had on average 0.2 fewer lambs at mid-pregnancy and at birth compared with the wild-type or heterozygous ewes (PLEPR were strongly associated with poorer reproductive performance in Davisdale ewes, which is likely to be linked to both a reduced number of ova available for fertilisation and an increased number of ewes failing to become pregnant. Increased partial failure of multiple ovulations in ewes with high ovulation rates (i.e. 3 or greater) may also contribute to the poor reproductive performance.

Low-fidelity hybrid sexual assault simulation training's effect on the comfort and competency of resident physicians.

BACKGROUND: Alternative training methods are needed for resident physicians to ensure that care is not compromised should they practice in settings without well-established Sexual Assault Nurse Examiner (SANE) programs. OBJECTIVE: The purpose of this study is to determine the effectiveness of a simulation-based sexual assault response course for resident physicians at an institution without an on-site SANE program. METHODS: Educational intervention study of 12 emergency medicine residents using a low-fidelity hybrid simulation model. The study was comprised of eight male and four female physicians at a military medical center in San Diego, CA. Assessment occurred using three separate metrics. The first was a written knowledge test. The second was a simulated interview and evidentiary examination. These metrics were given 1 month before and 3 months after an 8-h training course. The final metric was Likert-scale questionnaires surveying pre- and post-course feelings of competency and comfort. RESULTS: The emergency medicine residents showed a 13% improvement (95% confidence interval [CI] 7-20%) in written examination scores pre and post intervention. Post-course interview and examinations reflected a 44% improvement (95% CI 24-64%) in critical action completion. Pre-course comfort and competency questionnaires were a median of 2 (interquartile range [IQR] 1-3) on a Likert Scale. Post-course survey responses were a median of 4 (IQR 2-5). CONCLUSIONS: Low-fidelity hybrid simulation is a useful tool to train inexperienced physicians to perform evidentiary examinations and interviews without sacrificing the privacy and direct care of sexual assault victims.

Single-nucleotide polymorphisms in the LEPR gene are associated with divergent phenotypes for age at onset of puberty in Davisdale ewes.

Attainment of puberty is a key developmental event influenced by genetic and environmental factors. In examining age at attainment of puberty, we observed closely related rams from the Davisdale line whose daughters differed in age at which they attained puberty. A candidate gene approach was used to identify mutations that may underlie these observed differences. Four rams with divergent phenotypes for their daughter's age at onset of puberty were selected for whole-genome sequencing. The coding regions of genes with known roles in regulating reproductive function were searched for single-nucleotide polymorphisms (SNPs) that altered the amino acid sequence of the protein. Of interest were three SNPs in the leptin receptor gene (LEPR). A Sequenom assay was developed to determine the genotype of these SNPs in daughters of 17 sons of a founding sire. A higher percentage of ewe lambs homozygous for the LEPR mutations failed to undergo puberty before 1 yr of age, and those that did undergo puberty during the first breeding season on average were approximately 17 days older than homozygous wild-type ewes. Heterozygous ewes were intermediate for both measurements. Given the predicted change in protein function produced by the mutation in LEPR and the strong associations between the genotype and onset of puberty phenotypes, we propose that this mutation in LEPR underlies the observed difference in age at onset of puberty in the Davisdale line. Furthermore, these animals will likely provide a useful model to better understand the role of leptin in the regulation of puberty.

Identification of a line of sheep carrying a putative autosomal gene increasing ovulation rate in sheep that does not appear to interact with mutations in the transforming growth factor beta superfamily.

Sheep lines with mutations in single genes that have major effects on ovulation rate have been very useful in gaining a better understanding of pathways important in controlling follicular development and ovulation rate. To date however, all known mutations are in the transforming growth factor beta (TGFB) superfamily. Ovulation rates were measured in 720 progeny of 20 rams that were descendants of a single prolific ewe. Evaluation of ovulation rates of daughters of closely related sires suggests the presence of a segregating major gene Fecundity Davisdale (FECD) that increases ovulation rate between 0.4 and 0.8 in heterozygous daughters. Key features of mutations in genes of the TGFB superfamily pathway, such as synergistic interactions with other family members, infertility in homozygous carriers, and increased responsiveness to exogenous gonadotropins, were not observed in this line; thus, the mutation does not appear to be acting in the TGFB pathway. Hence, there is likely a novel mutation being carried in this line of sheep that alters ovulation rate. Future identification of the causative mutation may provide new insights into regulation of follicular development and ovulation rate.

Research preparedness paves the way to respond to pandemic H1N1 2009 influenza virus.

The international community has been preparing for an influenza pandemic because of the threat posed by H5N1 avian influenza. Over the past several years, Canada has dedicated funding to boost capacity for research, and public health and health care system readiness and response in the event of a pandemic. The current H1N1/09 influenza pandemic is now testing our readiness. From a research perspective, the present commentary discusses how have we prepared, along with the research gaps. We conclude that: sources of pandemics are not always predictable; investment in the past few years has paid off in a rapid response to pandemic H1N1/09 virus in Canada; and research to meet the challenges of infectious diseases has to be done on an ongoing long-term basis, and its funding has to be flexible, available and predictable to maintain capacity and expertise. In addition, new vaccine technologies are needed to develop and produce vaccines for public health emergencies in a timely fashion.

Patterns of expression of messenger RNAs encoding GDF9, BMP15, TGFBR1, BMPR1B, and BMPR2 during follicular development and characterization of ovarian follicular populations in ewes carrying the Woodlands FecX2W mutation.

Woodlands sheep have a putative genetic mutation (FecX2(W)) that increases ovulation rate. At present, the identity of FecX2(W) is unknown. The trait does not appear to be due to the previously described mutations in bone morphogenetic protein 15 (BMP15), growth differentiation factor 9 (GDF9), or bone morphogenetic protein receptor type 1B (BMPR1B) that affect ovulation rate in sheep. Potentially, FecX2(W) could be an unidentified genetic mutation in BMP15 or in the closely related GDF9, which interacts with BMP15 to control ovarian function. Alternatively, FecX2(W) may affect ovulation rate by changing the expression patterns in the molecular pathways activated by genes known to regulate ovulation rate. The objectives of these experiments were to sequence the complete coding region of the BMP15 and GDF9 genes, determine the patterns of expression of mRNAs encoding GDF9, BMP15, TGFBR1, BMPR1B, and BMPR2 during follicular development, and characterize the follicular populations in ewes heterozygous for the Woodlands mutation and their wild-type contemporaries. No differences in the coding sequences of BMP15 or GDF9 genes were identified that were associated with enhanced ovulation rate. The expression patterns of GDF9 and BMPR2 mRNAs were not different between genotypes. However, expression of BMP15 mRNA was less in oocytes of FecX2(W) ewes in large preantral and antral follicles. Expression of ALK5 mRNA was significantly higher in the oocytes of FecX2(W) ewes, whereas expression of BMPR1B was decreased in both oocytes and granulosa cells of FecX2(W) ewes. FecX2(W) ewes also had increased numbers of antral follicles <1 mm in diameter. These follicles were smaller in average diameter, with the oocytes also being of a smaller mean diameter. Given that a mutation in BMP15 or BMPR1B results in increased ovulation rates in sheep, the differences in expression levels of BMP15 and BMPR1B may play a role in the increase in ovulation rate observed in Woodlands ewes with the FecX2(W) mutation.

PAX genes in development and disease: the role of PAX2 in urogenital tract development.

PAX genes play an important role in fetal development. Moreover, heterozygous mutations in several PAX genes cause human disease. Here we review the role of PAX2 in kidney development, focusing on the morphological effects of PAX2 mutations. We discuss the role of PAX2 in the context of an inhibitory field model of kidney branching morphogenesis and summarize recent progress in this area.

Transgenic expression of numb inhibits notch signaling in immature thymocytes but does not alter T cell fate specification.

The conserved adaptor protein Numb is an intrinsic cell fate determinant that functions by antagonizing Notch-mediated signal transduction. The Notch family of membrane receptors controls cell survival and cell fate determination in a variety of organ systems and species. Recent studies have identified a role for mammalian Notch-1 signals at multiple stages of T lymphocyte development. We have examined the role of mammalian Numb (mNumb) as a Notch regulator and cell fate determinant during T cell development. Transgenic overexpression of mNumb under the control of the Lck proximal promoter reduced expression of several Notch-1 target genes, indicating that mNumb antagonizes Notch-1 signaling in vivo. However, thymocyte development, cell cycle, and survival were unperturbed by mNumb overexpression, even though transgenic Numb was expressed at an early stage in thymocyte development (CD4(-)CD8(-)CD3(-) cells that were CD44(+)CD25(+) or CD44(-)CD25(+); double-negative 2/3). Moreover, bone marrow from mNumb transgenic mice showed no defects in thymopoiesis in competitive repopulation experiments. Our results suggest that mNumb functions as a Notch-1 antagonist in immature thymocytes, but that suppression of Notch-1 signaling at this stage does not alter gammadelta/alphabeta or CD4/CD8 T cell fate specification.