The silver lining of the pandemic in surgical education: virtual surgical education and recommendations for best practices.

Virtual education is an evolving field within the realm of surgical training. Since the onset of the COVID-19 pandemic, the application of virtual technologies in surgical education has undergone significant exploration and advancement. While originally developed to supplement in-person curricula for the development of clinical decision-making, virtual surgical education has expanded into the realms of clinical decision-making, surgical, and non-surgical skills acquisition. This manuscript aims to discuss the various applications of virtual surgical education as well as the advantages and disadvantages associated with each education modality, while offering recommendations on best practices and future directions.

GWAS with principal component analysis identify QTLs associated with main peanut flavor-related traits.

Peanut flavor is a complex and important trait affected by raw material and processing technology owing to its significant impact on consumer preference. In this research, principal component analysis (PCA) on 33 representative traits associated with flavor revealed that total sugars, sucrose, and total tocopherols provided more information related to peanut flavor. Genome-wide association studies (GWAS) using 102 U.S. peanut mini-core accessions were performed to study associations between 12,526 single nucleotide polymorphic (SNP) markers and the three traits. A total of 7 and 22 significant quantitative trait loci (QTLs) were identified to be significantly associated with total sugars and sucrose, respectively. Among these QTLs, four and eight candidate genes for the two traits were mined. In addition, two and five stable QTLs were identified for total sugars and sucrose in both years separately. No significant QTLs were detected for total tocopherols. The results from this research provide useful knowledge about the genetic control of peanut flavor, which will aid in clarifying the molecular mechanisms of flavor research in peanuts.

Spontaneous conus infarction with "snake-eye appearance" on magnetic resonance imaging: A case report and literature review.

BACKGROUND: Infarction of the conus medullaris is a rare form of spinal cord infarction. The first symptom is usually acute non-characteristic lumbar pain, followed by lower limb pain, saddle numbness, fecal incontinence, and sexual dysfunction. Spontaneous conus infarction with "snake-eye appearance" on magnetic resonance imaging has rarely been reported. CASE SUMMARY: We report a 79-year-old male patient with spontaneous conus infarction who had acute lower extremity pain and dysuria as the first symptoms. He did not have any recent history of aortic surgery and trauma. Magnetic resonance imaging revealed a rare "snake-eye appearance." In addition, we reviewed the literature on 23 similar cases and summarized the clinical features and magnetic resonance manifestations of common diseases related to the "snake-eye sign" to explore the etiology, imaging findings, and prognosis of spontaneous conus infarction. CONCLUSION: We conclude that acute onset of conus medullaris syndrome combined with "snake-eye appearance" should be strongly suspected as conus medullaris infarction caused by anterior spinal artery ischemia. This special imaging manifestation is helpful in the early diagnosis and treatment of conus infarction.

Generation of Sesame Mutant Population by Mutagenesis and Identification of High Oleate Mutants by GC Analysis.

Sesame is one of the important oilseed crops in the world. Natural genetic variation exists in the sesame germplasm collection. Mining and utilizing the genetic allele variation from the germplasm collection is an important approach for seed quality improvement. The sesame germplasm accession, PI 263470, which has a significantly higher level of oleic acid (54.0%) than the average (39.5%), was identified by screening the entire USDA germplasm collection. The seeds from this accession were planted in a greenhouse. Leaf tissues and seeds were harvested from individual plants. DNA sequencing of the coding region of the fatty acid desaturase gene (FAD2) confirmed that this accession contained a natural mutation of G425A which may correspond to the deduced amino acid substitution of R142H leading to the high level of oleic acid, but it was a mixed accession with three genotypes (G/G, G/A, and A/A at the position). The genotype with A/A was selected and self-crossed for three generations. The purified seeds were used for EMS-induced mutagenesis to further enhance the level of oleic acid. A total of 635 M2 plants were generated from mutagenesis. Some mutant plants had significant morphological changes including leafy flat stems and others. M3 seeds were used for fatty acid composition analysis by gas chromatography (GC). Several mutant lines were identified with high oleic acid (70%). Six M3 mutant lines plus one control line were advanced to M7 or M8 generations. Their high oleate traits from M7 or M8 seeds harvested from M6 or M7 plants were further confirmed. The level of oleic acid from one mutant line (M7 915-2) was over 75%. The coding region of FAD2 was sequenced from these six mutants, but no mutation was identified. Additional loci may contribute to the high level of oleic acid. The mutants identified in this study can be used as breeding materials for sesame improvement and as genetic materials for forward genetic studies.

Genetic Diversity for Quercetin, Myricetin, Cyanidin, and Delphinidin Concentrations in 38 Blackeye Pea (Vigna unguiculata L. Walp.) Genotypes for Potential Use as a Functional Health Vegetable.

Blackeye peas (Vigna unguiculata L. Walp.) are mainly used as a vegetable throughout the world, however they may contain significant concentrations of quercetin, myricetin, cyanidin, and delphinidin for potential use as a functional vegetable. Thirty-eight blackeye pea genotypes were selected from the core collection in the USDA, ARS, Plant Genetic Resources Conservation Unit's cold storage at 4 °C during 2016. Information regarding concentrations of quercetin, myricetin, cyanidin, delphindin, and correlations among these as well as additional seed traits including seed coat color, seed pattern color, seed pattern, seed texture, and years in storage would add value to the blackeye pea genotypes for use as a functional vegetable. Using high performance liquid chromatography (HPLC), the red seeded accession originating from Mozambique, PI 367927 produced the highest quercetin (469.53 µg/g) and myricetin (212.23 µg/g) concentrations. The black seeded genotype, PI 353236, originating from India, produced the highest cyanidin (1,388.82 µg/g) concentration. However, PI 353236 and the brown seeded genotype, PI 353352 from India produced the highest concentrations of delphinidin (1,343.27 and 1,353.94 µg/g), respectively. Several correlations were observed and interestingly only delphinidin showed a significant negative correlation (r = -0.293*) with years in cold storage indicating that delphinidin declined in the seeds stored the longest (from 4-45 years) at 4 °C. Principal component analysis (PCA) explained how the flavonols, anthocyanidins, and the additional seed traits contributed to the variation of the blackeye pea genotypes. The cluster analysis showed six clusters representing low to high phytochemical concentrations. The genetic parameters including σ2g, σ2p, GCV, PCV, h2h, and GG indicate that improvement in these phytochemical traits is possible through selection. The genotypic and phenotypic correlations showed that improving one phytochemical significantly improved the other except for cyanidin with delphinidin. These results can be used by scientists to develop blackeye pea cultivars with high flavonol and anthocyanidin concentrations.

Valorization of sugarcane bagasse for sugar extraction and residue as an adsorbent for pollutant removal.

Following juice crushing for sugar or bioethanol production from sugarcane, bagasse (SCB) is generated as the main lignocellulosic by-product. This study utilized SCB generated by a hydraulic press as feedstock to evaluate sugar extraction as well as adsorption potential. Total soluble sugar (sucrose, glucose, and fructose) of 0.4 g/g SCB was recovered with H2O extraction in this case. Insoluble sugar, that is, cellulose in SCB, was further hydrolyzed into glucose (2%-31%) with cellulase enzyme, generating a new bagasse residue (SCBE). Persulfate pretreatment of SCB slightly enhanced saccharification. Both SCB and SCBE showed great potential as adsorbents with 98% of methylene blue (MB) removed by SCB or SCBE and 75% of Cu2+ by SCBE and 80% by SCB in 60 min. The maximum adsorption amount (q m) was 85.8 mg/g (MB by SCB), 77.5 mg/g (MB by SCBE), 3.4 mg/g (Cu2+ by SCB), and 1.2 mg/g (Cu2+ by SCBE). The thermodynamics indicated that the adsorption process is spontaneous, endothermic, and more random in nature. The experimental results offer an alternative to better reutilize SCB.

SunUp and Sunset genomes revealed impact of particle bombardment mediated transformation and domestication history in papaya.

Transgenic papaya is widely publicized for controlling papaya ringspot virus. However, the impact of particle bombardment on the genome remains unknown. The transgenic SunUp and its progenitor Sunset genomes were assembled into 351.5 and 350.3 Mb in nine chromosomes, respectively. We identified a 1.64 Mb insertion containing three transgenic insertions in SunUp chromosome 5, consisting of 52 nuclear-plastid, 21 nuclear-mitochondrial and 1 nuclear genomic fragments. A 591.9 kb fragment in chromosome 5 was translocated into the 1.64 Mb insertion. We assembled a gapless 9.8 Mb hermaphrodite-specific region of the Yh chromosome and its 6.0 Mb X counterpart. Resequencing 86 genomes revealed three distinct groups, validating their geographic origin and breeding history. We identified 147 selective sweeps and defined the essential role of zeta-carotene desaturase in carotenoid accumulation during domestication. Our findings elucidated the impact of particle bombardment and improved our understanding of sex chromosomes and domestication to expedite papaya improvement.

Knowledge-based planning using both the predicted DVH of organ-at risk and planning target volume.

PURPOSE: The purpose of this study was to evaluate the performance of a knowledge-based planning (KBP) method in nasopharyngeal cancer radiotherapy using the predicted dose-volume histogram (DVH) of organ-at risk (OAR) and planning target volume (PTV). METHODS AND MATERIALS: A total of 85 patients previously treated for nasopharyngeal cancer using 9-field 6-MV intensity-modulated radiation therapy (IMRT) were identified for training and 30 similar patients were identified for testing. The dosimetric deposition information, individual dose-volume histograms (IDVHs) induced by a series of fields with uniform-intensity irradiation, was used to predict both OAR and PTV DVH. Two KBP methods (KBPOAR and KBPOAR+PTV) were established for plan generation based on the DVH prediction. The KBPOAR method utilized the dose constraints based on the predicted OAR DVH and the PTV dose constraints obtained according to the planning experience, while the KBPOAR+PTV method applied the dose constraints based on the predicted OAR and PTV DVH. For the plan evaluation, the PTV dose coverage was used D98 and D2, and the maximum dose, mean dose or dose-volume parameters were used for the OARs. Statistical differences of the two KBP methods were tested with the Wilcoxon signed rank test. RESULTS: For patients with T3 tumors, there was no significant difference between the KBPOAR and KBPOAR+PTV methods in dosimetric results at most OARs and PTVs. Both KBP methods achieved a similar number of plans meeting the dose requirements. For patients with T4 tumors, KBPOAR+PTV reduced the maximum dose by more than 1 Gy in the body, spinal cord, optic nerve, eye and temporal lobes and reduced the V50 value by more than 3.9% in the larynx and tongue without reducing the PTV dose compared with KBPOAR. The KBPOAR+PTV method increased the plans by more than 14.2% in meeting the maximum dose requirements at the body, optic nerve, mandible and eye and increased the plans by more than 21.4% in meeting the V50 of the larynx and V50 of the tongue when compared with the KBPOAR method. CONCLUSIONS: For patients with T3 tumors, no significant difference was found between the KBPOAR and KBPOAR+PTV methods in dosimetric results at most OARs and PTVs. For patients with T4 tumors, the KBPOAR+PTV method performs better than the KBPOAR method in improving the quality of the plans. Compared with the KBPOAR method, dose sparing of some OARs was achieved without reducing PTV dose coverage and helped to increase the number of plans meeting the dose requirements when the KBPOAR+PTV method was utilized.

Insights into the Genomic Architecture of Seed and Pod Quality Traits in the U.S. Peanut Mini-Core Diversity Panel.

Traits such as seed weight, shelling percent, percent sound mature kernels, and seed dormancy determines the quality of peanut seed. Few QTL (quantitative trait loci) studies using biparental mapping populations have identified QTL for seed dormancy and seed grade traits. Here, we report a genome-wide association study (GWAS) to detect marker-trait associations for seed germination, dormancy, and seed grading traits in peanut. A total of 120 accessions from the U.S. peanut mini-core collection were evaluated for seed quality traits and genotyped using Axiom SNP (single nucleotide polymorphism) array for peanut. We observed significant variation in seed quality traits in different accessions and different botanical varieties. Through GWAS, we were able to identify multiple regions associated with sound mature kernels, seed weight, shelling percent, seed germination, and dormancy. Some of the genomic regions that were SNP associated with these traits aligned with previously known QTLs. For instance, QTL for seed dormancy has been reported on chromosome A05, and we also found SNP on the same chromosome associated with seed dormancy, explaining around 20% of phenotypic variation. In addition, we found novel genomic regions associated with seed grading, seed germination, and dormancy traits. SNP markers associated with seed quality and dormancy identified here can accelerate the selection process. Further, exploring the function of candidate genes identified in the vicinity of the associated marker will assist in understanding the complex genetic network that governs seed quality.

Utilizing CRISPR-Cas in Tropical Crop Improvement: A Decision Process for Fitting Genome Engineering to Your Species.

Adopting modern gene-editing technologies for trait improvement in agriculture requires important workflow developments, yet these developments are not often discussed. Using tropical crop systems as a case study, we describe a workflow broken down into discrete processes with specific steps and decision points that allow for the practical application of the CRISPR-Cas gene editing platform in a crop of interest. While we present the steps of developing genome-edited plants as sequential, in practice parts can be done in parallel, which are discussed in this perspective. The main processes include 1) understanding the genetic basis of the trait along with having the crop's genome sequence, 2) testing and optimization of the editing reagents, development of efficient 3) tissue culture and 4) transformation methods, and 5) screening methods to identify edited events with commercial potential. Our goal in this perspective is to help any lab that wishes to implement this powerful, easy-to-use tool in their pipeline, thus aiming to democratize the technology.

Acute and Sub-chronic Toxicity Study of Recombinant Bovine Interferon Alpha in Rodents.

INTRODUCTION: Recombinant bovine interferon alpha (rBoIFN-α) has been demonstrated to have antiviral activity. However, no conduct of acute or chronic toxicity tests has been reported. MATERIAL AND METHODS: Specific pathogen-free Sprague Dawley rats were administered doses at different concentrations through intraperitoneal or intravenous injection. After the administration (single for an acute toxicity test over 14 days or daily for a sub-chronic toxicity test over 30 days), the rats' behaviour and other indicators and the degree of toxic reaction were continuously monitored. Blood was collected for haematological and serum biochemical examinations. At the end of the experiments, the rats were sacrificed for necropsy and histopathological tissue analysis. RESULTS: The external performance, behaviour characteristics, and changes in body temperature and body weight of the rats in each subgroup were comparable to the normal control subgroup. Except for a few cases, there were no lesions in the viscera's pathological structures, and the blood parameters and biochemical indicators were not noticeably different from those of the control subgroup. CONCLUSION: This study suggests that rBoIFN-α seems to be safe for rats, and its use may foster the development of the cattle industry in China by protecting livestock health.

Teaching Effective Informed Consent Communication Skills in the Virtual Surgical Clerkship.

BACKGROUND: The disruption by the COVID-19 pandemic on undergraduate medical education allowed for assessment of virtual curricular innovations. One of the difficulties encountered in the virtual curriculum is the teaching of clinical competencies that would traditionally require students to undergo in-person simulations and patient encounters. We implemented a novel informed consent activity module, with standardized patients, to improve self-efficacy in communication within our core surgery clerkship. STUDY DESIGN: All medical students who participated in the virtual surgery clerkship were recruited to participate in a retrospective survey study regarding the novel informed consent module. These questions evaluated their perceived competence in 4 domains relating to informed consent: identifying the key elements, describing common challenges, applying the New Mexico Clinical Communication Scale (NMCCS), and documenting. RESULTS: Thirty-four of 90 students participated in the study (38% of the cohort). Respondents to the survey reported that their self-efficacy in communication skills related to informed consent improved as a result of their participation in the activity in each of the 4 domains surveyed (p < 0.01), with the majority of students identifying as satisfactory or above in each domain post-module. Students generally viewed the virtual informed consent activity positively, but noted that it was not the same as an in-person clinical experience. CONCLUSIONS: A virtual module of communication skills training, using standardized patients and faculty, improved students' belief in their self-efficacy in obtaining informed consent. This communication module can be useful in a virtual or mixed curricular structure for both current and future medical students.

Expression, Purification, and Bioactivity of a Soluble Recombinant Ovine Interferon-tau in Escherichia Coli.

INTRODUCTION: Ovine interferon-tau (oIFN-τ) is a newly discovered type I interferon. This study used biochemical techniques to transform the oIFN-τ gene into Escherichia coli to obtain the mass and soluble expression of the recombinant protein. MATERIAL AND METHODS: First, total RNA was extracted from fresh sheep embryonic tissues with TRIzol reagent and then used as a template to reverse transcribe and amplify the mature oIFN-τ gene with RT-PCR. The amplified product was next digested with the HindIII and XhoI restriction enzymes and inserted into the pET-32a(+) vector to construct the prokaryotic expression plasmid. The corrected in-frame recombinant plasmid, pET-32a(+)-oIFN-τ, was transformed into E. coli Rosetta (DE3) competent cells. After induction with isopropyl-beta-D-thiogalactopyranoside (IPTG), the recombinant protein was detected in bacteria. Finally, the bacteria were lysed by sonication, and the recombinant protein was purified by nickel affinity chromatography and DEAE anion exchange chromatography. RESULTS: The protein was confirmed to be oIFN-τ, which mainly existed in the soluble lysate fraction, as proven by SDS-PAGE and Western blot assays. CONCLUSION: Purified IFN-τ exists mostly in a soluble form, and its anti-vesicular stomatitis virus (VSV) activity reached 7.08×10(6)IU/mL.

Evaluation of dose-volume histogram prediction for organ-at risk and planning target volume based on machine learning.

The purpose of this work is to evaluate the performance of applying patient dosimetric information induced by individual uniform-intensity radiation fields in organ-at risk (OAR) dose-volume histogram (DVH) prediction, and extend to DVH prediction of planning target volume (PTV). Ninety nasopharyngeal cancer intensity-modulated radiation therapy (IMRT) plans and 60 rectal cancer volumetric modulated arc therapy (VMAT) plans were employed in this study. Of these, 20 nasopharyngeal cancer cases and 15 rectal cancer cases were randomly selected as the testing data. The DVH prediction was performed using two methods. One method applied the individual dose-volume histograms (IDVHs) induced by a series of fields with uniform-intensity irradiation and the other method applied the distance-to-target histogram and the conformal-plan-dose-volume histogram (DTH + CPDVH). The determination coefficient R2 and mean absolute error (MAE) were used to evaluate DVH prediction accuracy. The PTV DVH prediction was performed using the IDVHs. The PTV dose coverage was evaluated using D98, D95, D1 and uniformity index (UI). The OAR dose was compared using the maximum dose, V30 and V40. The significance of the results was examined with the Wilcoxon signed rank test. For PTV DVH prediction using IDVHs, the clinical plan and IDVHs prediction method achieved mean UI values of 1.07 and 1.06 for nasopharyngeal cancer, and 1.04 and 1.05 for rectal cancer, respectively. No significant difference was found between the clinical plan results and predicted results using the IDVHs method in achieving PTV dose coverage (D98, D95, D1 and UI) for both nasopharyngeal cancer and rectal cancer (p-values ≥ 0.052). For OAR DVH prediction, no significant difference was found between the IDVHs and DTH + CPDVH methods for the R2, MAE, the maximum dose, V30 and V40 (p-values ≥ 0.087 for all OARs). This work evaluates the performance of dosimetric information of several individual fields with uniform-intensity radiation for DVH prediction, and extends its application to PTV DVH prediction. The results indicated that the IDVHs method is comparable to the DTH + CPDVH method in accurately predicting the OAR DVH. The IDVHs method quantified the input features of the PTV and showed reliable PTV DVH prediction, which is helpful for plan quality evaluation and plan generation.

Decreased LF/HF ratio is associated with worse outcomes in patients who received mechanical thrombectomy under general anesthesia for emergent large vessel occlusion: a retrospective study.

BACKGROUND AND PURPOSE: We aimed to determine whether heart rate variability (HRV) was correlated to long-term outcome in patients who received mechanical thrombectomy (MT) under general anesthesia for emergent large vessel occlusion (ELVO). METHODS: Data from 106 patients receiving MT under general anesthesia to treat ELVO between January 1, 2017 and December 31, 2019 were collected in a multicenter chart review. Univariate analysis, Chi-square test, and bivariate logistic regression were performed to assess the correlations between preoperative risk factors such as HRV and long-term outcome (as indicated by the modified Rankin score [mRS] at 90 days after MT). RESULTS: Bivariate logistic regression revealed that decreased LF/HF (low frequency/high frequency in HRV) ratio was correlated with unfavorable functional outcome as indicated by mRS ≥ 2 (odds ratio [OR], 0.650; 95% confidence interval [CI], 0.157-0.839; p = 0.018), and functionally dependent outcome as indicated by mRS ≥ 3 (OR, 0.704; 95% CI, 0.360-0.914; p = 0.021). It was also found that ELVO in the right anterior circulation was correlated with lower LF/HF ratio, as compared with ELVO in the contralateral side (p < 0.05). CONCLUSION: Our retrospective study demonstrated that worse outcome in patients with ELVO who received MT under general anesthesia induced autonomic changes and that decreased LF/HF ratio.

Inhibitory effects of recombinant porcine interferon-α on porcine transmissible gastroenteritis virus infections in TGEV-seronegative piglets.

Our previous research obtained purified recombinant porcine interferon-α (rPoIFN-α) containing thioredoxin (Trx) fusion tag in E. coli Rosetta (DE3). Here, we evaluate the efficacy of this rPoIFN-α to prevent piglets from the infection of the transmissible gastroenteritis virus (TGEV) attack. In this experiment, twenty-five TGEV-seronegative piglets were randomly divided into five groups. Group 1 was positive control and only challenged with TGEV; Pigs in groups 2-4 were pretreated with 2 × 10(7)IU/pig, 2 × 10(6)IU/pig, and 2 × 10(5)IU/pig rPoIFN-α before TGEV challenge. The fifth group is a negative control group. The animals of this group are pretreated only with Trx protein-containing PBS solution without TGEV challenge. After 48 h of rPoIFN-α pretreatment, the pigs in groups 1-4 were challenged by TGEV, and the pigs in group 5 were administered with PBS. The surveillance results show that Pigs pre-treated with 2 × 10 (7) IU/pig rPoIFN-α are fully aligned with the violent TGEV attack. Pigs pretreated with 2 × 10 (6) IU/pig rPoIFN-α are partially aligned with the violent TGEV attack. Though piglets pretreated with 2 × 10(6) IU/pig or 2 × 10(5)IU/pig rPoIFN-α cannot be adapted to the challenge of TGEV. However, the use of this dose of rPoIFN-α could put off the clinical signs of pigs than the positive control group of the above. These results indicate that rPoIFN-α can protect pigs from the infection of potential TGEV or delay the appearance of clinical symptoms, and its effect is dose-dependent.

Selection of GmSWEET39 for oil and protein improvement in soybean.

Soybean [Glycine max (L.) Merr.] was domesticated from wild soybean (G. soja Sieb. and Zucc.) and has been further improved as a dual-use seed crop to provide highly valuable oil and protein for food, feed, and industrial applications. However, the underlying genetic and molecular basis remains less understood. Having combined high-confidence bi-parental linkage mapping with high-resolution association analysis based on 631 whole sequenced genomes, we mapped major soybean protein and oil QTLs on chromosome15 to a sugar transporter gene (GmSWEET39). A two-nucleotide CC deletion truncating C-terminus of GmSWEET39 was strongly associated with high seed oil and low seed protein, suggesting its pleiotropic effect on protein and oil content. GmSWEET39 was predominantly expressed in parenchyma and integument of the seed coat, and likely regulates oil and protein accumulation by affecting sugar delivery from maternal seed coat to the filial embryo. We demonstrated that GmSWEET39 has a dual function for both oil and protein improvement and undergoes two different paths of artificial selection. A CC deletion (CC-) haplotype H1 has been intensively selected during domestication and extensively used in soybean improvement worldwide. H1 is fixed in North American soybean cultivars. The protein-favored (CC+) haplotype H3 still undergoes ongoing selection, reflecting its sustainable role for soybean protein improvement. The comprehensive knowledge on the molecular basis underlying the major QTL and GmSWEET39 haplotypes associated with soybean improvement would be valuable to design new strategies for soybean seed quality improvement using molecular breeding and biotechnological approaches.

More Than Aligning Perception: Impact of an Educational Intervention on Medical Student Mistreatment Reporting.

BACKGROUND: Despite decades of reporting, rates of medical student mistreatment on the surgical clerkship remains a national issue. To understand whether misaligned perceptions about what constitutes mistreatment were leading to the high rates of reported mistreatment at our institution, we implemented an intervention designed to educate students about the unique challenges of the surgical environment and to build consensus around the definition of mistreatment. STUDY DESIGN: Medical students were recruited from the surgery clerkship to participate in a video vignette-based curriculum accompanied by a facilitated discussion. Participants completed a survey before and after the educational intervention to assess their understanding of mistreatment and their perceptions of the surgical learning environment. At the end of each clerkship block students who participated in the intervention, as well as students who did not participate, were asked to complete a questionnaire about their experiences during the clerkship. RESULTS: During 6 clerkship blocks, 53 students participated in the intervention (51% of the third-year student cohort). Students who participated in the intervention were more likely to report experiencing mistreatment or witnessing mistreatment during the clerkship. Students who participated in the intervention also reported experiencing neglect more frequently than students who did not participate. CONCLUSIONS: We found that using an educational intervention designed to align perceptions of what constitutes mistreatment in the surgical learning environment did not decrease rates of mistreatment reporting on the surgical clerkship at our institution. Students who participated in the intervention reported increased confidence in their ability to define and recognize mistreatment after the intervention, as well as increased comfort reporting mistreatment and turning to faculty with concerns about mistreatment.

Identification of QTLs for resistance to leaf spots in cultivated peanut (Arachis hypogaea L.) through GWAS analysis.

KEY MESSAGE: Two QTLs on ChrB09 significantly associated with both early and late leaf spots were identified by genome-wide association study in the US peanut mini-core collection. Early leaf spot (ELS) and late leaf spot (LLS) are two serious peanut diseases in the USA, causing tens of millions of dollars of annual economic losses. However, the genetic factors underlying resistance to those diseases in peanuts have not been well-studied. We conducted a genome-wide association study for the two peanut diseases using Affymetrix version 2.0 SNP array with 120 genotypes mainly coming from the US peanut mini-core collection. A total of 46 quantitative trait loci (QTLs) were identified with phenotypic variation explained (PVE) from 10.19 to 24.11%, in which eighteen QTLs are for resistance to ELS and 28 QTLs for LLS. Among the 46 QTLs, there were four and two major QTLs with PVE higher than 16.99% for resistance ELS and LLS, respectively. Of the six major QTLs, five were located on the B sub-genome and only one was on the A sub-genome, which suggested that the B sub-genome has more potential resistance genomic regions than the A sub-genome. In addition, two genomic regions on chromosome B09 were found to provide significant resistance to both ELS and LLS. A total of 74 non-redundant genes were identified as resistance genes, among which, twelve candidate genes were in significant genomic regions including two candidate genes for both ELS and LLS, and other ten candidate genes for ELS. The QTLs and candidate genes obtained from this study will be useful to breed peanuts for resistances to the diseases.

Granulocyte colony-stimulating factor and stromal cell-derived factor-1 combination therapy: A more effective treatment for cerebral ischemic stroke.

BACKGROUND: Drugs that promote angiogenesis include statins, recombinant human granulocyte colony-stimulating factor, and stromal cell-derived factor-1. Low doses of atorvastatin could significantly increase the vascular expressions of endothelial growth factor, and the number of peripheral blood endothelial progenitor cells (EPCs), thus improving angiogenesis and local blood flow. G-CSF is an EPC-mobilization agent used in ischemia studies for targeting angiogenesis after cerebral ischemia via EPCs. In previous clinical trials, consistent conclusions have not been reached about the effectiveness of G-CSF on ischemic stroke. Therefore, the therapeutic effect of G-CSF and its combination with other medicines need further experimental verification. It is known that atorvastatin, rhG-CSF, and SDF-1 are considered the most promising neuroprotective candidates, but a comprehensive comparison of their effects is lacking. AIMS: To compare the effects of atorvastatin, stromal cell-derived factor-1, and recombinant human granulocyte colony-stimulating factor on ischemic stroke. METHODS: Adult male Sprague-Dawley rats were randomly allocated to three groups: normal, sham-operated, and middle cerebral artery occlusion operated. Middle cerebral artery occlusion operated rats were further allocated into saline, atorvastatin, recombinant human granulocyte colony-stimulating factor, and recombinant human granulocyte colony-stimulating factor + stromal cell-derived factor-1 groups. Neurological function evaluation, cerebral infarction and the blood-brain barrier integrity analysis, identification of angiogenic factors, assessment of angiogenesis, expression of growth-associated protein-43, neuroglobin, glial cell-derived neurotrophic factor, and cleaved caspase 3, were performed. RESULTS: Compared with atorvastatin or recombinant human granulocyte colony-stimulating factor alone, recombinant human granulocyte colony-stimulating factor + stromal cell-derived factor-1 treatment improved neurological performance, reduced cerebral infarction and blood-brain barrier disruption after stroke, and increased the content of stromal cell-derived factor-1, vascular endothelial growth factor, monocyte chemotactic protein 1, and basic fibroblast growth factor in peripheral blood. In addition, recombinant human granulocyte colony-stimulating factor + stromal cell-derived factor-1 promoted greater angiogenesis than atorvastatin or recombinant human granulocyte colony-stimulating factor alone and increased the expression of growth-associated protein-43, neuroglobin, and glial cell-derived neurotrophic factor, while decreasing the levels of cleaved caspase 3 in the brain after ischemic stroke. CONCLUSIONS: Combination therapy with recombinant human granulocyte colony-stimulating factor and stromal cell-derived factor-1 is more effective than atorvastatin or recombinant human granulocyte colony-stimulating factor alone in protecting against stroke-induced damage and could be an optimal therapeutic strategy for stroke.