Curriculum Changes and Trends 2010-2020: A Focused National Review Using the AAMC Curriculum Inventory and the LCME Annual Medical School Questionnaire Part II.

Medical school curricula have evolved from 2010 to 2020. Numerous pressures and influences affect medical school curricula, including those from external sources, academic medical institutions, clinical teaching faculty, and undergraduate medical students. Using data from the AAMC Curriculum Inventory and the LCME Annual Medical School Questionnaire Part II, the nature of curriculum change is illuminated. Most medical schools are undertaking curriculum change, both in small cycles of continuous quality improvement and through significant change to curricular structure and content. Four topic areas are explored: cost consciousness, guns and firearms, nutrition, and opioids and addiction medicine. The authors examine how these topic areas are taught and assessed, where in the curriculum they are located, and how much time is dedicated to them in relation to the curriculum as a whole. When examining instructional methods overall, notable findings include (1) the decrease of lecture, although lecture remains the most used instructional method, (2) the increase of collaborative instructional methods, (3) the decrease of laboratory, and (4) the prevalence of clinical instructional methods in academic levels 3 and 4. Regarding assessment methods overall, notable findings include (1) the recent change of the USMLE Step 1 examination to a pass/fail reporting system, (2) a modest increase in narrative assessment, (3) the decline of practical labs, and (4) the predominance of institutionally developed written/computer-based examinations and participation. Among instructional and assessment methods, the most used methods tend to cluster by academic level. It is critical that faculty development evolves alongside curricula. Continued diversity in the use of instructional and assessment methods is necessary to adequately prepare tomorrow's physicians. Future research into the life cycle of a curriculum, as well optional curriculum content, is warranted.

Honey bee colony performance and health are enhanced by apiary proximity to US Conservation Reserve Program (CRP) lands.

Honey bee colony performance and health are intimately linked to the foraging environment. Recent evidence suggests that the US Conservation Reserve Program (CRP) has a positive impact on environmental suitability for supporting honey bee apiaries. However, relatively little is known about the influence of habitat conservation efforts on honey bee colony health. Identifying specific factors that influence bee health at the colony level incorporates longitudinal monitoring of physiology across diverse environments. Using a pooled-sampling method to overcome individual variation, we monitored colony-level molecular biomarkers during critical pre- and post-winter time points. Major categories of colony health (nutrition, oxidative stress resistance, and immunity) were impacted by apiary site. In general, apiaries within foraging distance of CRP lands showed improved performance and higher gene expression of vitellogenin (vg), a nutritionally regulated protein with central storage and regulatory functions. Mirroring vg levels, gene transcripts encoding antioxidant enzymes and immune-related proteins were typically higher in colonies exposed to CRP environments. Our study highlights the potential of CRP lands to improve pollinator health and the utility of colony-level molecular diagnostics to assess environmental suitability for honey bees.

The impact of pollen consumption on honey bee (Apis mellifera) digestive physiology and carbohydrate metabolism.

Carbohydrate-active enzymes play an important role in the honey bee (Apis mellifera) due to its dietary specialization on plant-based nutrition. Secretory glycoside hydrolases (GHs) produced in worker head glands aid in the processing of floral nectar into honey and are expressed in accordance with age-based division of labor. Pollen utilization by the honey bee has been investigated in considerable detail, but little is known about the metabolic fate of indigestible carbohydrates and glycosides in pollen biomass. Here, we demonstrate that pollen consumption stimulates the hydrolysis of sugars that are toxic to the bee (xylose, arabinose, mannose). GHs produced in the head accumulate in the midgut and persist in the hindgut that harbors a core microbial community composed of approximately 108 bacterial cells. Pollen consumption significantly impacted total and specific bacterial abundance in the digestive tract. Bacterial isolates representing major fermentative gut phylotypes exhibited primarily membrane-bound GH activities that may function in tandem with soluble host enzymes retained in the hindgut. Additionally, we found that plant-originating ß-galactosidase activity in pollen may be sufficient, in some cases, for probable physiological activity in the gut. These findings emphasize the potential relative contributions of host, bacteria, and pollen enzyme activities to carbohydrate breakdown, which may be tied to gut microbiome dynamics and associated host nutrition.

Draft genome sequences of two Bifidobacterium sp. from the honey bee (Apis mellifera).

BACKGROUND: Widely considered probiotic organisms, Bifidobacteria are common inhabitants of the alimentary tract of animals including insects. Bifidobacteria identified from the honey bee are found in larval guts and throughout the alimentary tract, but attain their greatest abundance in the adult hind gut. To further understand the role of Bifidobacteria in honey bees, we sequenced two strains of Bifidobacterium cultured from different alimentary tract environments and life stages. RESULTS: Reflecting an oxygen-rich niche, both strains possessed catalase, peroxidase, superoxide-dismutase and respiratory chain enzymes indicative of oxidative metabolism. The strains show markedly different carbohydrate processing capabilities, with one possessing auxiliary and key enzymes of the Entner-Doudoroff pathway. CONCLUSIONS: As a result of long term co-evolution, honey bee associated Bifidobacterium may harbor considerable strain diversity reflecting adaptation to a variety of different honey bee microenvironments and hive-mediated vertical transmission between generations.