Experiences of early graduate medical students working in New York hospitals during the COVID-19 pandemic: a mixed methods study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic presented the world with a sudden need for additional medical professionals. Senior medical students were identified as potential workers and many worldwide graduated early to serve as Junior Physicians in hospitals. The authors sought to identify factors that informed the decision to work, describe experiences in this capacity, and elucidate benefits for trainees. METHODS: The investigators conducted a mixed-methods observational cohort study of early medical graduates eligible to work as Junior Physicians at two New York medical centers in April/May 2020 during an initial surge in COVID-19 hospitalizations. Graduates were surveyed, and a sample of Junior Physicians participated in a focus group. Survey responses of those who worked were compared to those who did not. Focus group responses were transcribed, coded, and thematically analyzed. RESULTS: Fifty-nine graduates completed the study methods and 39 worked as Junior Physicians. Primary reasons for working included duty to help (39 [100%]), financial incentive (32 [82%]), desire to learn about pandemic response (25 [64%]), and educational incentive (24 [62%]). All had direct contact with COVID-19 patients, believed working was beneficial to their medical training, and were glad they worked. None contracted a symptomatic infection while working. Compared with non-Junior Physicians, Junior Physicians reported increased comfort levels in completing medical intern-level actions like transitions of care functions, such as writing transfer notes (P < 0.01), writing discharge orders (P = 0.01), and providing verbal sign out (P = 0.05), and they reported more comfort in managing COVID-19 patients. Sixteen themes emerged from the focus group and were placed into four categories: development of skills, patient care, safety, and wellness. CONCLUSIONS: Senior medical students chose to work as Junior Physicians for both personal and educational reasons. Experiences were beneficial to trainees and can inform future innovations in medical education.

Overcoming racial battle fatigue: The associations between racial microaggressions, coping, and mental health among Chicana/o and Latina/o college students.

OBJECTIVES: The current study tested a conditional process model to determine if (a) different problem-focused coping styles mediated the association between racial microaggressions and mental health, and (b) ethnic identity exploration and commitment moderated these associations. METHOD: Participants were 681 Chicana/o and Latina/o undergraduates matriculating at a public research university in the southwestern United States; 71.7% (n = 488) identified as female and the average age of participants was 20.1 years. Data collected using an online survey were analyzed using structural equation modeling with bootstrapped confidence intervals. RESULTS: Experiencing more racial microaggressions was associated with students' use of more problem-focused coping styles, as well as poorer mental health. All coping styles partially mediated the association between microaggressions and mental health. However, only reflective coping was associated with more positive mental health; reactive and suppressive coping were associated with poorer mental health. These associations were not moderated by ethnic identity. CONCLUSIONS: Consistent with the racial battle fatigue framework, experiencing racial microaggressions in college may contribute to diminished mental well-being for Chicana/o and Latina/o students. Using reflective rather than suppressive or reactive coping styles could facilitate psychological well-being following racial microaggressions among Chicana/o and Latina/o college students. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Using the wax moth larva Galleria mellonella infection model to detect emerging bacterial pathogens.

Climate change, changing farming practices, social and demographic changes and rising levels of antibiotic resistance are likely to lead to future increases in opportunistic bacterial infections that are more difficult to treat. Uncovering the prevalence and identity of pathogenic bacteria in the environment is key to assessing transmission risks. We describe the first use of the Wax moth larva Galleria mellonella, a well-established model for the mammalian innate immune system, to selectively enrich and characterize pathogens from coastal environments in the South West of the UK. Whole-genome sequencing of highly virulent isolates revealed amongst others a Proteus mirabilis strain carrying the Salmonella SGI1 genomic island not reported from the UK before and the recently described species Vibrio injenensis hitherto only reported from human patients in Korea. Our novel method has the power to detect bacterial pathogens in the environment that potentially pose a serious risk to public health.

Impaired hypothalamic-pituitary-testicular axis activity, spermatogenesis, and sperm function promote infertility in males with lead poisoning.

Lead poisoning is a stealthy threat to human physiological systems as chronic exposure can remain asymptomatic for long periods of time before symptoms manifest. We presently review the biophysical mechanisms of lead poisoning that contribute to male infertility. Environmental and occupational exposure of lead may adversely affect the hypothalamic-pituitary-testicular axis, impairing the induction of spermatogenesis. Dysfunction at the reproductive axis, namely testosterone suppression, is most susceptible and irreversible during pubertal development. Lead poisoning also appears to directly impair the process of spermatogenesis itself as well as sperm function. Spermatogenesis issues may manifest as low sperm count and stem from reproductive axis dysfunction or testicular degeneration. Generation of excessive reactive oxygen species due to lead-associated oxidative stress can potentially affect sperm viability, motility, DNA fragmentation, membrane lipid peroxidation, capacitation, hyperactivation, acrosome reaction, and chemotaxis for sperm-oocyte fusion, all of which can contribute to deter fertilization. Reproductive toxicity has been tested through cross-sectional analysis studies in humans as well as in vivo and in vitro studies in animals.

Effects of full-scale beach renovation on fecal indicator levels in shoreline sand and water.

Recolonization of enterococci, at a non-point source beach known to contain high background levels of bacteria, was studied after a full-scale beach renovation project. The renovation involved importation of new exogenous sand, in addition to infrastructure improvements. The study's objectives were to document changes in sand and water quality and to evaluate the relative contribution of different renovation activities towards these changes. These objectives were addressed: by measuring enterococci levels in the sand and fecal indicator bacteria levels (enterococci and fecal coliform) in the water, by documenting sediment characteristics (mineralogy and biofilm levels), and by estimating changes in observable enterococci loads. Analysis of enterococci levels on surface sand and within sediment depth cores were significantly higher prior to beach renovation (6.3-72 CFU/g for each sampling day) when compared to levels during and after beach renovation (0.8-12 CFU/g) (P < 0.01). During the renovation process, sand enterococci levels were frequently below detection limits (<0.1 CFU/g). For water, exceedances in the regulatory thresholds that would trigger a beach advisory decreased by 40% for enterococci and by 90% for fecal coliform. Factors that did not change significantly between pre- and post- renovation included the enterococci loads from animals (approx. 3 × 10(11) CFU per month). Factors that were observed to change between pre- and post- renovation activities included: the composition of the beach sand (64% versus 98% quartz, and a significant decrease in biofilm levels) and loads from direct stormwater inputs (reduction of 3 × 10(11) CFU per month). Overall, this study supports that beach renovation activities contributed to improved sand and water quality resulting in a 50% decrease of observable enterococci loads due to upgrades to the stormwater infrastructure. Of interest was that the change in the sand mineralogy also coincided with changes in biofilm levels. More work is needed to evaluate the relationships between beach sand mineralogy, biofilm characteristics, and the retention of fecal indicator bacteria in sand.

Age-related source memory deficits persist despite superior item memory.

Source and item memory for faces of former United States Presidents were assessed in nondemented older adults over 65 years of age (n = 20) and young adults 18 to 25 years of age (n = 20). During the study phase, a male and a female source each presented pictures of faces to the participant one at a time. To assess source memory, the participant was asked to indicate whether a face from the study phase was presented by the male or female. To assess item memory, a study phase face and distractor face were presented and the participant was asked to indicate which was presented previously. Older adults displayed significantly better item memory for the faces of presidents compared to young adults. However, despite showing superior item memory, source memory still was impaired in older adults compared to young adults. The ability of older adults to efficiently integrate source and item information may be compromised to such a large extent that enhanced item memory does not appear to minimize or negate age-related source memory deficits. The findings demonstrate the robust effects of aging on source memory.

Effect of encoding condition on source memory for odors in healthy young and older adults.

BACKGROUND: Source memory has been shown to be more affected by aging than item memory. Aging also has been shown to result in impairments in odor memory. OBJECTIVE: The aim of the study is to examine the effects of explicit encoding instructions on source memory for olfactory stimuli in healthy older and young adults. METHODS: Source and item memory for odors were assessed in two conditions. In the uninformed condition, young (18-30) and older adults (65+) were presented with 16 odors by two sources (male and female) without instruction at encoding and no warning of a subsequent memory task. In the informed condition, young and older adults were instructed to encode the stimuli and their respective sources. To assess item memory, the participant was presented with an odor from the task and a new odor and was asked to indicate which odor had been presented previously. On source memory trials, the participant was presented with an odor from the task and was asked to indicate whether the male or female presented the odor. RESULTS: A 2 x 2 x 2 analysis of variance revealed that older adults were significantly impaired relative to young adults on the source memory trials in both the uninformed and informed conditions, F(1, 52) = 18.15, p < 0.001. However, older adults matched the performance of young adults on item memory trials, regardless of encoding condition. CONCLUSIONS: Even with conscious effort to encode the sources associated with the odors, older adults show significant source memory impairments. The mnemonic processes used to integrate contextual source information with item memory during encoding may fail to initiate due to the amount of effort required to encode the olfactory stimulus. The difficulty of encoding and subsequently retrieving the source may be increased due to the difficulty of encoding the odors. The results demonstrate the robust effects of aging on source memory for odors.