Measuring biodiversity from DNA in the air.

The crisis of declining biodiversity1 exceeds our current ability to monitor changes in ecosystems. Rapid terrestrial biomonitoring approaches are essential to quantify the causes and consequences of global change. Environmental DNA2 has revolutionized aquatic ecology,3 permitting population monitoring4 and remote diversity assessments matching or outperforming conventional methods of community sampling.3-5 Despite this model, similar methods have not been widely adopted in terrestrial ecosystems. Here, we demonstrate that DNA from terrestrial animals can be filtered, amplified, and then sequenced from air samples collected in natural settings representing a powerful tool for terrestrial ecology. We collected air samples at a zoological park, where spatially confined non-native species allowed us to track DNA sources. We show that DNA can be collected from air and used to identify species and their ecological interactions. Air samples contained DNA from 25 species of mammals and birds, including 17 known terrestrial resident zoo species. We also identified food items from air sampled in enclosures and detected taxa native to the local area, including the Eurasian hedgehog, endangered in the United Kingdom. Our data demonstrate that airborne eDNA concentrates around recently inhabited areas but disperses away from sources, suggesting an ecology to airborne eDNA and the potential for sampling at a distance. Our findings demonstrate the profound potential of air as a source of DNA for global terrestrial biomonitoring.

Frequency of specific osteopathic manipulative treatment modalities used by candidates while taking COMLEX-USA Level 2-PE.

CONTEXT: As one of the key measures of clinical skills assessment, the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) is used to rate candidates' performance of osteopathic manipulative treatment (OMT). OBJECTIVE: To evaluate the frequency of specific OMT modalities used by COMLEX-USA Level 2-PE candidates and to report frequent use on the basis of clinical presentation. METHODS: With enhanced scoring procedures in place, OMT physician-examiners identified and documented specific OMT techniques that were performed by candidates at the 28 colleges of osteopathic medicine and branch campuses that had eligible students at that time. A frequency analysis for OMT techniques, according to clinical content axis, was applied to all candidates (N=4757) for the 2010-2011 testing cycle. RESULTS: Students used a wide range of specific OMT techniques. Candidates performed 24,202 instances of specific OMT techniques, including 10,471 myofascial/soft tissue (43.3%), 3942 muscle energy (16.3%), 1676 sinus drainage (6.9%), 1476 inhibition (6.1%), 1221 fascial release (5.0%), 1171 rib raising (4.8%), 918 lymphatic (3.8%), and 866 counterstrain (3.6%). A few students (<0.01%) used high-velocity, low-amplitude (HVLA), a technique that is prohibited from use on the COMLEX-USA Level 2-PE because of the potential hazard of repeatedly treating a standardized patient with thrust technique to the same segment in a given day. Additional techniques included functional, facilitated positional release, balanced ligamentous tension, and visceral. Use of techniques also varied according to the clinical presentation of the standardized patient (ie, cardiovascular, respiratory, neuromusculoskeletal, gastrointestinal, or other) and chronicity (ie, acute or chronic). CONCLUSION: Findings contributed to a better understanding of the types of OMT techniques being used by candidates taking COMLEX-USA Level 2-PE. Frequency of use of specific OMT modalities varied according to clinical case presentation.

Relationship between standardized patient checklist item accuracy and performing arts experience.

INTRODUCTION: : It is not known whether a Standardized Patient's (SP's) performing arts background could affect his or her accuracy in recording candidate performance on a high-stakes clinical skills examination, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2 Performance Evaluation. The purpose of this study is to investigate the differences in recording accuracy of history and physical checklist items between SPs who identify themselves as performing artists and SPs with no performance arts experience. METHODS: : Forty SPs identified themselves as being performing artists or nonperforming artists. A sample of SP live examination ratings were compared with a second set of ratings obtained after video review (N = 1972 SP encounters) over 40 cases from the 2008-2009 testing cycle. Differences in SP checklist recording accuracy were tested as a function of performing arts experience. RESULTS: : Mean overall agreement rates, both uncorrected and corrected for chance agreement, were very high (0.94 and 0.79, respectively, at the overall examination level). There was no statistically significant difference between the two groups with respect to any of the mean accuracy measures: history taking (z = -0.422, P = 0.678), physical examination (z = -1.453, P = 0.072), and overall data gathering (z = -0.812, P = 0.417) checklist items. CONCLUSION: : Results suggest that SPs with or without a performing arts background complete history taking and physical examination checklist items with high levels of precision. Therefore, SPs with and without performing arts experience can be recruited for high-stakes SP-based clinical skills examinations without sacrificing examination integrity or scoring accuracy.

Five-year summary of COMLEX-USA level 2-PE examinee performance and survey data.

The authors present data on examination format and examinee demographics, performance, and survey results for the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) from the first five testing cycles (2004-2005 to 2008-2009). First-time examinees in the 2004-2005 testing cycle had a pass rate of 96.1%, compared with a pass rate of 94.7% for first-time examinees in the 2008-2009 testing cycle. Pass rates were fairly consistent across all testing cycles. Based on postexamination survey results from all testing cycles, the majority of examinees reported that the cases in COMLEX-USA Level 2-PE represented appropriate challenges for fourth-year osteopathic medical students. The majority of examinees also reported that comprehensive standardized patient-based examinations and exercises were administered through their colleges of osteopathic medicine. In addition, survey results indicated overall satisfaction among examinees with the administration of COMLEX-USA Level 2-PE.