Training in Neurology: Resident Perception of the Utility and Applicability of Global Neurology Morning Reports.

Interest in global health is increasing among neurology residents. However, funding, time, and, recently, COVID-19 travel restrictions remain barriers to widespread participation. To meet this need, we instituted virtual global neurology morning reports with the objectives of (1) improving knowledge about neurologic diseases common in sub-Saharan Africa and (2) developing clinical reasoning skills through consideration of diagnostic and therapeutic limitations in resource-limited settings. Interactive case-based sessions were presented from Zambia via videoconference by a Johns Hopkins faculty member or Zambian neurology trainee. An anonymous cross-sectional survey was conducted among Johns Hopkins neurology residents. Of eligible participants, 69% (n = 30) completed the survey, 66% of whom were female, and 33% reported prior in-person global health experience. Although most participants did not anticipate a career in global health, the majority (85%) reported that exposure to global health was important. All but 1 participant (96%) reported satisfaction with the global neurology morning reports, with 100% reporting that they were useful to their clinical knowledge and 86% reporting that they were useful to their clinical practice. All respondents felt that morning reports should continue, and 69% ranked the educational value of the experience in the top quartile of the residency curriculum. Resident satisfaction with and perceived utility of global neurology morning reports were high, although the majority did not plan to pursue global neurology opportunities as part of their career. Remote learning opportunities may increase interest in global health among neurology residents.

Effects of oxytocin on background anxiety in rats with high or low baseline startle.

RATIONALE: Oxytocin has antianxiety properties in humans and rodents. However, the antianxiety effects have been variable. OBJECTIVES: To reduce variability and to strengthen the antianxiety effect of oxytocin in fear-potentiated startle, two experiments were performed. First, different amounts of light-shock pairings were given to determine the optimal levels of cue-specific fear conditioning and non-predictable startle (background anxiety). Second, the antianxiety effects of oxytocin were examined in rats with high and low pre-fear conditioning baseline startle to determine if oxytocin differentially affects high and low trait anxiety rats. METHODS: Baseline pre-fear conditioning startle responses were first measured. Rats then received 1, 5, or 10 light-shock pairings. Fear-potentiated startle was then tested with two trial types: light-cued startle and non-cued startle trials. In the second experiment, rats fear conditioned with 10 light-shock pairings were administered either saline or oxytocin before a fear-potentiated startle test. Rats were categorized as low or high startlers by their pre-fear conditioning startle amplitude. RESULTS: Ten shock pairings produced the largest non-cued startle responses (background anxiety), without increasing cue-specific fear-potentiated startle compared to one and five light-shock pairings. Cue-specific fear-potentiated startle was unaffected by oxytocin. Oxytocin reduced background anxiety only in rats with low pre-fear startle responses. CONCLUSIONS: Oxytocin has population selective antianxiety effects on non-cued unpredictable threat, but only in rats with low pre-fear baseline startle responses. The low startle responses are reminiscent of humans with low startle responses and high trait anxiety.