Implementation and Evaluation of an Academic Development Rotation for Surgery Residents.

OBJECTIVE: To describe the design, implementation, and evaluation of a two-week rotation intended to enhance junior surgical residents' preparation for their dedicated professional development time (PDT) and academic careers. DESIGN: As part of a multifaceted effort to promote residents' academic development, we designed a two-week, nonclinical "Academic Development Block" (ADB) rotation for postgraduate year (PGY)-2 and -3 residents. During this rotation, residents meet with clinical, research, and peer mentors and work on academic activities, with relevant deliverables specific to each class year. We analyzed feedback from postrotation surveys and interviews, which were inductively coded and thematically analyzed, and data on resident grant applications and earnings before and after implementation. SETTING: The general surgery residency program at a major urban, university-affiliated academic medical center. ADBs were first implemented in 2021. PARTICIPANTS: A total of 39 PGY-2 and PGY-3 residents rotated through the program with 51 ADBs over the first two years of implementation. RESULTS: Surveys indicated overwhelmingly positive perceptions on the value of ADBs, including the amount of structure and resources available. Free-response and interview themes indicated appreciation for time to meet with mentors, develop ideas, and complete academic work. Residents believed the ADB rotation accelerated their transition into PDT and was a marker of institutional commitment. Areas for improvement pertained to the timing of ADBs and pairing of mentors. Both cohorts who participated in at least 1 ADB had higher proportions of residents who successfully applied for grants and a greater amount of total funding awarded compared to all 4 of the most recent cohorts prior to implementation. CONCLUSIONS: A short academic development rotation protected from clinical responsibilities is a well-regarded intervention to help residents refine their career goals and prepare for their PDT. Similar initiatives may be of interest to residency programs seeking to foster their residents' academic career development.

Implicit Race Bias in Pediatric Patients: Understanding Patient Perspectives.

INTRODUCTION: Implicit racial bias has been well studied in adults, including among orthopaedic surgeons, through the Implicit Association Test (IAT). Recent studies suggest implicit race bias is also present among children. Explicit racial preference has been studied in children through The Clark Doll Test since the 1930s. The purpose of this study was to determine whether implicit and explicit racial biases are present among pediatric orthopaedic patients. METHODS: A prospective, cross-sectional survey was administered to pediatric orthopaedic patients aged 7 to 18 years at clinics in a tertiary pediatric hospital setting. The survey included a Clark Doll Test to determine whether pediatric patients expressed explicit bias, followed by a race IAT to determine whether pediatric patients expressed implicit bias. Preference and magnitude of implicit bias as demonstrated on the IAT was calculated using standard D-scores. RESULTS: A total of 96 patients were consented and included in this study. Overall, pediatric patients demonstrated a slight pro-White implicit bias (M = 0.22) on IAT testing. Pediatric patients who identified as White or European American and Hispanic or Latinx both had the strongest pro-White implicit bias (M = 0.35). Patients who identified as Black or African American demonstrated no implicit racial bias (M = -0.13) on IAT testing. No notable explicit bias was observed in participants of any racial background. DISCUSSION: This study contributes evidence that pediatric orthopaedic patients express implicit racial bias on IAT testing, with an overall slight pro-White bias. It also provides insight into the dissociation of implicit and explicit racial bias in childhood and adolescence. CONCLUSION: We encourage future research on implicit bias among pediatric patients in the orthopaedic community to provide a better understanding and possible solutions to bias-related challenges in health care.

Forensic intelligence in Australia and New Zealand: Status and future directions.

Forensic science is underutilised. Operating models restricted to the support of court outcomes do not address core requirements of contemporary policing and public security, which are to disrupt criminal activity and prevent crime. Forensic intelligence (FORINT) is a principal means of enhancing the role of forensic science, emphasising proactivity and cross-case, cross-crime domain insights. To catalyse implementation, a FORINT Specialist Advisory Group (SAG) has been established under the Australia & New Zealand Policing Advisory Agency (ANZPAA) National Institute of Forensic Science (NIFS). The SAG has established a concept of operations with four lines of effort - namely, to (i) promote awareness and consistency, (ii) shape the workforce, (iii) develop information management frameworks and (iv) guide operational implementation. This aims to shift Australia & New Zealand from its present state (of substantial interagency variability) to a state of widespread, consistent and effective FORINT delivery in terms of: (a) culture, (b) information management, (c) education & training, and (d) organisation & operating environment. There are risks to implementing FORINT, in terms of privacy/confidentiality, bias/misinterpretation, and resource impost. However, these are not necessarily FORINT-specific, and solutions or mitigations exist. Moreover, these issues are outweighed by the risks of not implementing FORINT - such as a failure to reveal threats, missed opportunities, and poor resource efficiency. This paper is a call to arms. For policing and laboratories - now is the time to implement and entrench FORINT. For academia - now is the time to build foundations for this future. For supporting industries - now is the time to develop partnerships and facilitate delivery.

Firefighter- and fire department-level barriers and promoters of physical activity and fitness among volunteer firefighters: a qualitative study using semi-structured interviews.

OBJECTIVE: To describe volunteer firefighters' perspectives on how firefighter- and fire department-level factors influence their physical activity and fitness. METHODS: Firefighters (n = 28) were interviewed, stratified by their years of firefighting, using an interview guide. Thematic analysis and systematic coding were employed to analyze the interview transcripts. RESULTS: Five themes were identified: (1) health and firefighting performance; (2) firefighter time and availability; (3) responsibility of the fire department to support volunteer members' physical fitness; (4) fire training drills as a form of functional physical activity, and (5) fitness initiatives at the department. Interviewing by years of experience showed varied perspectives which converged towards similar conclusions. CONCLUSIONS: Incorporating fitness discussions into department meetings and trainings, and identifying fitness advocates within the department, may contribute to overcoming barriers to physical fitness among volunteer firefighters.

Charting Diagnostic Safety: Exploring Patient-Provider Discordance in Medical Record Documentation.

BACKGROUND: The 21st Century Cures Act enables patients to access their medical records, thus providing a unique opportunity to engage patients in their diagnostic journey. OBJECTIVE: To explore the concordance between patients' self-reported diagnostic concerns and clinician-interpreted information in their electronic health records. DESIGN: We conducted a mixed-methods analysis of a cohort of 467 patients who completed a structured data collection instrument (the Safer Dx Patient) to identify diagnostic concerns while reviewing their clinician's notes. We conducted a qualitative content analysis of open-ended responses on both the tools and the case summaries. Two clinical chart reviewers, blinded to patient-reported diagnostic concerns, independently conducted chart reviews using a different structured instrument (the Revised Safer Dx Instrument) to identify diagnostic concerns and generate case summaries. The primary outcome variable was chart review-identified diagnostic concerns. Multivariate logistic regression tested whether the primary outcome was concordant with patient-reported diagnostic concerns. SETTING: Geisinger, a large integrated healthcare organization in rural and semi-urban Pennsylvania. PARTICIPANTS: Cohort of adult patients actively using patient portals and identified as "at-risk" for diagnostic concerns using an electronic trigger algorithm based on unexpected visit patterns in a primary care setting. RESULTS: In 467 cohort patients, chart review identified 31 (6.4%) diagnostic concerns, of which only 11 (21.5%) overlapped with 51 patient-reported diagnostic concerns. Content analysis revealed several areas of discordant understanding of the diagnostic process between clinicians and patients. Multivariate logistic regression analysis showed that clinician-identified diagnostic concerns were associated with patients who self-reported "I feel I was incorrectly diagnosed during my visit" (odds ratio 1.65, 95% CI 1.17-2.3, p < 0.05). CONCLUSION: Patients and clinicians appear to have certain differences in their mental models of what is considered a diagnostic concern. Efforts to integrate patient perspectives and experiences with the diagnostic process can lead to better measurement of diagnostic safety.

Quantitative susceptibility and T1 ρ mapping of knee articular cartilage at 3T.

T1 ρ and Quantitative Susceptibility Mapping (QSM) are evolving as substrates for quantifying the progressive nature of knee osteoarthritis. Objective: To evaluate the effects of spin lock time combinations on depth-dependent T1 ρ estimation, in adjunct to QSM, and characterize the degree of shared variance in QSM and T1 ρ for the quantitative measurement of articular cartilage. Design: Twenty healthy participants (10 â€‹M/10F, 22.2 â€‹± â€‹3.4 years) underwent bilateral knee MRI using T1 ρ MAPPS sequences with varying TSLs ([0-120] ms), along with a 3D spoiled gradient echo for QSM. Five total TSL combinations were used for T1 ρ computation, and direct depth-based comparison. Depth-wide variance was assessed in comparison to QSM as a basis to assess for depth-specific variation in T1 ρ computations across healthy cartilage. Results: Longer T1 ρ relaxation times were observed for TSL combinations with higher spin lock times. Depth-specific differences were documented for both QSM and T1 ρ , with most change found at ∼60% depth of the cartilage, relative to the surface. Direct squared linear correlation revealed that most T1 ρ TSL combinations can explain over 30% of the variability in QSM, suggesting inherent shared sensitivity to cartilage microstructure. Conclusions: T1 ρ mapping is subjective to the spin lock time combinations used for computation of relaxation times. When paired with QSM, both similarities and differences in signal sensitivity may be complementary to capture depth-wide changes in articular cartilage.

CelltypeR: A flow cytometry pipeline to characterize single cells from brain organoids.

Motivated by the cellular heterogeneity in complex tissues, particularly in brain and induced pluripotent stem cell (iPSC)-derived brain models, we developed a complete workflow to reproducibly characterize cell types in complex tissues. Our approach combines a flow cytometry (FC) antibody panel with our computational pipeline CelltypeR, enabling dataset aligning, unsupervised clustering optimization, cell type annotating, and statistical comparisons. Applied to human iPSC derived midbrain organoids, it successfully identified the major brain cell types. We performed fluorescence-activated cell sorting of CelltypeR-defined astrocytes, radial glia, and neurons, exploring transcriptional states by single-cell RNA sequencing. Among the sorted neurons, we identified subgroups of dopamine neurons: one reminiscent of substantia nigra cells most vulnerable in Parkinson's disease. Finally, we used our workflow to track cell types across a time course of organoid differentiation. Overall, our adaptable analysis framework provides a generalizable method for reproducibly identifying cell types across FC datasets in complex tissues.

Electrostatic Dissipation in 3D-Printable Silicone.

In this report, we describe the incorporation of single-walled carbon nanotubes (CNTs) into 3D printable siloxane elastomers for electrostatic dissipation. The composite was characterized, focusing on how rheological and mechanical properties of the siloxane are affected at various CNT loading levels. Electrical properties were also characterized to develop materials with effective electrostatic dissipation. We demonstrate that low loadings (<1 wt %) of CNTs can be sufficiently dispersed into silicone resins that can be 3D printed, and the resulting material shows a significant improvement in electrostatic dissipation through the reduction in electrical resistivity with minimal effect on its mechanical properties.

Hidden genomic diversity drives niche partitioning in a cosmopolitan eukaryotic picophytoplankton.

Marine eukaryotic phytoplankton are fundamental to the marine food web, yet the lack of reference genomes or just a single genome representing a taxon has led to an underestimation of their taxonomic, adaptive, and functional diversity. Here, we integrated strain isolation with metagenomic binning to recover genomes from the cosmopolitan picophytoplankton genus Bathycoccus, traditionally considered monospecific. Our recovery and analysis of 37 Bathycoccus genomes delineated their global genomic diversity and established four evolutionary clades (BI, BII, BIII, BIV). Our metagenomic abundance survey revealed well-differentiated ecological niches and distinct biogeographic distributions for each clade, predominantly shaped by temperature, salinity, and nutrient availability. Comparative genomics analyses further revealed clade-specific genomic traits that underpin niche adaptation and contribute to the global prevalence of Bathycoccus. Our findings underscore temperature as a major driver of genome diversification in this genus, with clade divergences coinciding with major paleoclimatic events that influenced their contemporary thermal niches. Moreover, the unique enrichment of C2H2 zinc finger and ankyrin repeat gene families in polar-adapted clades suggests previously unrecognized cold-adaptation mechanisms in marine eukaryotic phytoplankton. Our study offers a comprehensive genomic landscape of this crucial eukaryotic picophytoplankton, providing insights into their microdiversity and adaptive evolution in response to changing environments.

Bacteroides ovatus alleviates dysbiotic microbiota-induced graft-versus-host disease.

Acute lower gastrointestinal GVHD (aLGI-GVHD) is a serious complication of allogeneic hematopoietic stem cell transplantation. Although the intestinal microbiota is associated with the incidence of aLGI-GVHD, how the intestinal microbiota impacts treatment responses in aLGI-GVHD has not been thoroughly studied. In a cohort of patients with aLGI-GVHD (n = 37), we found that non-response to standard therapy with corticosteroids was associated with prior treatment with carbapenem antibiotics and a disrupted fecal microbiome characterized by reduced abundances of Bacteroides ovatus. In a murine GVHD model aggravated by carbapenem antibiotics, introducing B. ovatus reduced GVHD severity and improved survival. These beneficial effects of Bacteroides ovatus were linked to its ability to metabolize dietary polysaccharides into monosaccharides, which suppressed the mucus-degrading capabilities of colonic mucus degraders such as Bacteroides thetaiotaomicron and Akkermansia muciniphila, thus reducing GVHD-related mortality. Collectively, these findings reveal the importance of microbiota in aLGI-GVHD and therapeutic potential of B. ovatus.

Fluorescence labeling strategies for cell surface expression of TRPV1.

Regulation of ion channel expression on the plasma membrane is a major determinant of neuronal excitability, and identifying the underlying mechanisms of this expression is critical to our understanding of neurons. Here, we present two orthogonal strategies to label extracellular sites of the ion channel TRPV1 that minimally perturb its function. We use the amber codon suppression technique to introduce a non-canonical amino acid (ncAA) with tetrazine click chemistry, compatible with a trans-cyclooctene coupled fluorescent dye. Additionally, by inserting the circularly permutated HaloTag (cpHaloTag) in an extracellular loop of TRPV1, we can incorporate a fluorescent dye of our choosing. Optimization of ncAA insertion sites was accomplished by screening residue positions between the S1 and S2 transmembrane domains with elevated missense variants in the human population. We identified T468 as a rapid labeling site (∼5 min) based on functional and biochemical assays in HEK293T/17 cells. Through adapting linker lengths and backbone placement of cpHaloTag on the extracellular side of TRPV1, we generated a fully functional channel construct, TRPV1exCellHalo, with intact wild-type gating properties. We used TRPV1exCellHalo in a single molecule experiment to track TRPV1 on the cell surface and validate studies that show decreased mobility of the channel upon activation. The application of these extracellular label TRPV1 (exCellTRPV1) constructs to track surface localization of the channel will shed significant light on the mechanisms regulating its expression and provide a general scheme to introduce similar modifications to other cell surface receptors.

Evaluation of Rhode Island's Early Geographic COVID-19 Vaccine Prioritization Policy.

Objectives. To determine whether geographic prioritization of limited COVID-19 vaccine supply was effective for reducing geographic disparities in case rates. Methods. Rhode Island allocated a portion of the initial COVID-19 vaccine supply to residents of Central Falls, a community already affected by structural policies and inadequate systems that perpetuate health inequities and experiencing disproportionately high COVID-19 morbidity and mortality. The policy was implemented with a culturally and linguistically appropriate community engagement plan and was intended to reduce observed disparities. Using a Bayesian causal analysis with population surveillance data, we evaluated the impact of this prioritization policy on recorded cases over the subsequent 16 weeks. Results. Early geographic prioritization of Central Falls accelerated vaccine uptake, averting an estimated 520 cases (95% confidence interval = 22, 1418) over 16 weeks and reducing cases by approximately 34% during this period (520 averted vs 1519 expected without early prioritization). Conclusions. Early geographic prioritization increased vaccine uptake and reduced cases in Central Falls, thereby reducing geographic disparities. Public Health Implications. Public health institutions should consider geographic prioritization of limited vaccine supply to reduce geographic disparities in case rates. (Am J Public Health. 2024;114(S7):S580-S589. https://doi.org/10.2105/AJPH.2024.307741).

Review and statistical analysis of activity values reported for coastal sands worldwide.

The activity of natural radionuclides is unevenly distributed across the Earth's crust, with certain areas exhibiting significantly higher levels than others, known as High Background Radiation Areas (HBRAs). This study presents a statistical analysis of reported activity values for coastal sands globally. Through this statistical analysis, costal sands were classified into four categories based on their activity levels, providing a standardized framework to compare the natural radioactivity of these sands. This classification is a valuable tool for identifying populations exposed to different radiation levels, which is essential for the study of stochastic effects. The study proposes thresholds to define HBRAs as regions with activity values exceeding 203 Bq/kg for 238U, 517 Bq/kg for 232Th, or 960 Bq/kg for 40K. Regions with lower values are classified as NonHBRAs. Further subdivision of these categories resulted in four distinct regions: NonHBRA-, NonHBRA+, HBRA-, and HBRA+. The activity values for these subdivisions are 92 Bq/kg and 2,903 Bq/kg for 238U, 94 Bq/kg and 7,230 Bq/kg for 232Th, and 901 Bq/kg and 2,298 Bq/kg for 40K. By calculating the external dose rates from the reported activity data, a threshold of 357 nGy/h was identified as the dose boundary separating NonHBRAs from HBRAs. The values for the subdivisions resulted 101 nGy/h and 3,867 nGy/h. The study also explores the content of these natural radionuclides in relation to their bearing minerals and discusses correlations between the reported activity values and the characteristics of the sands. Additionally, the activity of the anthropogenic radionuclide 137Cs (reported values ranging from the detection limit to 63 Bq/kg) is examined.

Associations Between Brain Metabolites Measured With MR Spectroscopy and Head Impacts in High School American Football Athletes.

BACKGROUND: While changes in brain metabolites after injury have been reported, relationships between metabolite changes and head impacts are less characterized. PURPOSE: To investigate alterations in neurochemistry in high school athletes as a function of head impacts, concussion, and the use of a jugular vein compression (JVC) collar. STUDY TYPE: Prospective controlled trial. SUBJECTS: A total of 284 male American football players, divided into JVC collar and noncollar groups; 215 included in final analysis (age = 15.9 ± 1.0 years; 114 in collar group). FIELD STRENGTH/SEQUENCE: 3 Tesla/T1-weighted gradient echo, 1H point resolved spectroscopy, acquired between August and November 2018. ASSESSMENT: Head impacts were quantified using accelerometers. Concussion was diagnosed by medical professionals for each team. Pre- to postseason differences in total N-acetylaspartate (tNAA), total choline (tCho), myo-inositol (myoI), and glutamate + glutamine (Glx), in primary motor cortex (M1) and anterior cingulate cortex (ACC), relative to total creatine (tCr), were determined. STATISTICAL TESTS: Group-wise comparisons were performed using Wilcoxon signed-rank, Friedman's, and Mann-Whitney U tests. Relationships between ∆metabolite/tCr and mean g-force were analyzed using linear regressions accounting for concussion and JVC collar. Significance was set at P ≤ 0.05. RESULTS: In participants without concussion, a significant decrease in tCho/tCr (0.233 ± 1.40 × 10-3 to 0.227 ± 1.47 × 10-7) and increase in Glx/tCr (1.60 ± 8.75 × 10-3 to 1.63 ± 1.08 × 10-2) in ACC were observed pre- to postseason. The relationship between ∆tCho/tCr in M1 and ACC and mean g-force from >80 g to >140 g differed significantly between participants with and without concussion (M1 ß ranged from 3.9 × 10-3 to 2.1 × 10-3; ACC ß ranged from 2.7 × 10-3 to 2.1 × 10-3). Posthoc analyses revealed increased tCho/tCr in M1 was positively associated with mean g-force >100 g (ß = 3.6 × 10-3) and >110 g (ß = 2.9 × 10-3) in participants with concussion. Significant associations between ∆ myoI / tCr $$ \Delta \mathrm{myoI}/\mathrm{tCr} $$ in ACC and mean g-force >110 g (ß = -1.1 × 10-3) and >120 g (ß = -1.1 × 10-3) were observed in the collar group only. DATA CONCLUSION: Diagnosed concussion and the use of a JVC collar result in distinct neurochemical trends after repeated head impacts. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.

An observational cross-sectional study of pharmaceutical waste disposal practices in Australian medical imaging departments: A comparison of community versus hospital practice.

INTRODUCTION: Pharmaceuticals are used widely in radiography practice but pose an environmental risk. This study explored Australian radiographers' environmental attitude, pharmaceutical waste disposal practices, and knowledge and concern regarding the environmental impact of these pharmaceuticals. METHODS: This study utilised an anonymous, online questionnaire developed from two validated questionnaires. Participants (n = 150) held current registration with the Medical Radiation Practice Board of Australia and were working eight or more hours per week in a medical imaging practice (public or private). RESULTS: Participants did not answer all questions, hence percentages reported reflect the number of counts for each question. Most participants (71.4%; 105/147) disposed of contaminated pharmaceutical waste in clinical waste bins with 17.1% (15/146) disposing of it down drains. More hospital radiographers 13.54% (13/96) reported this disposal compared with 2.08% (1/48) of community-based radiographers (Fisher's Exact Test, p = 0.035). There was no difference in disposal of non-contaminated waste between practice settings - general waste bin (68.5%; 100/150), recycling bin (28.8%; 42/146), and clinical waste bin (41.8%; 61/146). Participants lacked knowledge of impacts on the food chain and the health of humans and wildlife. Only 34.7% (48/138) of participants expressed concern regarding the impacts of human excreted pharmaceuticals on the environment compared with 65.8% (98/149) regarding impacts from incorrect disposal. Many (18.4%; 25/136) reported having received no information on correct disposal of pharmaceutical waste. CONCLUSION: This study highlighted participants' lack of knowledge on how pharmaceuticals enter the natural environment and the subsequent impacts on the environment and on the health of humans, and flora and fauna. They lacked knowledge of correct pharmaceutical waste disposal methods, but most agreed it was their professional responsibility to dispose of waste correctly. IMPLICATIONS FOR PRACTICE: Improving radiographers' pharmaceutical waste disposal practices through education and professional support will reduce environmental impacts and also provide financial co-benefits if non-contaminated waste is recycled where possible and not incinerated.

A Faculty-Centered Career Consultation Service in an Academic Health Sciences Center: Five Years of Presenting Problems, Demographics, and Recommendations.

Psychologists in faculty affairs/faculty development (FAFD) roles can contribute to faculty vitality in academic health centers (AHCs) and mitigate barriers to advancement and retention. We describe a novel psychologist-led consultation service within an Office for Faculty Success (OFS) to support faculty across their career trajectories. We used 5 years of consultation data including faculty demographics, presenting concerns, and post-consultation evaluation data on consultation satisfaction and perceived benefits to examine trends and demographic group differences in consultation frequency, presenting concerns, and perceived benefits. From 2018 to 2023, 434 individuals presented for 683 consultations. Promotion in rank was the most frequent presenting concern. Women and racially/ethically minoritized faculty were found to present more frequently for repeat consultations, for concerns related to careers negotiation and advancement, and for intersectionality issues specific to gender and/or racial minority identities. From years one to five, there was a 93% increase in number of annual consultations performed and users were highly satisfied with the service (3.86/4). The consultation service is a unique, highly acceptable addition to interventions focused on career satisfaction and retention for AHC faculty, especially for women, early career, and minoritized faculty, and can serve as a model for other institutions.

Associations between 1930s HOLC grades and estimated population burden of cardiovascular disease risk factors in 2020.

Studies have recently begun to explore the potential long-term health impacts of homeownership policies implemented in the New Deal era. We investigated the association between assigned grades of lending risk by the Home Owners' Load Corporation (HOLC) maps from the 1930s and present-day prevalence of three cardiovascular risk factors (diabetes and obesity in 2020, and hypertension in 2019), estimated at the census tract level in the United States. To minimize potential confounding, we adjusted for sociodemographic data from the time period when HOLC maps were made. We calculated propensity scores (predicted probability of receiving a HOLC grade) and created a pseudo-population using inverse probability weighting. We then employed marginal structural models to estimate prevalence differences comparing A vs. B, B vs. C, and C vs. D HOLC grades. Adjusting only for regions, a less desirable HOLC grade was associated with higher estimated prevalence rates of present-day cardiovascular risk factors; however, most differences were no longer significant after applying propensity score methods. The one exception was that the prevalence of diabetes, hypertension, and obesity were all higher in C vs. B graded census tracts, while no differences were observed for C and D and A and B comparisons. These results contribute to a small body of evidence that suggests historical "yellowlining" (as C grade was in color yellow) may have had persistent impacts on neighborhood-level cardiovascular risk factors 80 years later.

Fragment-Based Screen of SARS-CoV-2 Papain-like Protease (PLpro).

Coronaviruses have been responsible for numerous viral outbreaks in the past two decades due to the high transmission rate of this family of viruses. The deadliest outbreak is the recent Covid-19 pandemic, which resulted in over 7 million deaths worldwide. SARS-CoV-2 papain-like protease (PLPro) plays a key role in both viral replication and host immune suppression and is highly conserved across the coronavirus family, making it an ideal drug target. Herein we describe a fragment-based screen against PLPro using protein-observed NMR experiments, identifying 77 hit fragments. Analyses of NMR perturbation patterns and X-ray cocrystallized structures reveal fragments bind to two distinct regions of the protein. Importantly none of the fragments identified belong to the same chemical class as the few reported inhibitors, allowing for the discovery of a novel class of PLPro inhibitors.

Walk with a Future Doc program allows Canadian medical students to promote physical activity and health education in local communities.

Medical student-led walk and talk programs, such as Walk with a Future Doc (WWAFD), provide a means for the medical community and community at-large to interact in a non-clinical setting. This environment can increase attendance accountability, enhance patient-provider relationships, and allow medical professionals to be leading examples of healthy, active living. We demonstrate the positive interest for this program, rationale of participants for joining, and the feasibility of its setup. As one of the only WWAFD programs in Canada, we encourage other medical schools to implement this program to promote continuity of hands-on, community-engaged learning amongst their students.

Les programmes de marche et de discussion menés par les étudiants en médecine, tels que Walk with a Future Doc (WWAFD), permettent à la communauté médicale et à la communauté dans son ensemble d'interagir dans un cadre non clinique. Cet environnement peut accroître la responsabilité face à l'assiduité, améliorer les relations patient-fournisseur et permettre aux professionnels de la santé d'être des exemples de vie saine et active. Nous démontrons l'intérêt positif de ce programme, les raisons pour lesquelles les participants y adhèrent et la faisabilité de sa mise en place. Comme il s'agit de l'un des seuls programmes WWAFD au Canada, nous encourageons les autres facultés de médecine à mettre en œuvre ce programme pour promouvoir la continuité de l'apprentissage pratique et engagé au sein de la communauté parmi leurs étudiants.