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Responses to COVID-19 within medical education prompted significant changes to the surgical clerkship. We analyzed the changes in medical student end of course feedback before and after the COVID-19 outbreak. Postclerkship surveys from 2017 to 2022 were analyzed including both Likert scale data and free text, excluding the COVID outbreak year 2019-2020. Likert scale questions were compared between pre-COVID (2017-2019) and COVID-era cohorts (2020-2022) with the Mann–Whitney U -test. Free-text comments were analyzed using both thematic analysis and natural language processing including sentiment, word and phrase frequency, and topic modeling. Of the 483 medical students surveyed from 2017 to 2022, 297 responded (61% response rate) to the included end of clerkship surveys. Most medical students rated the clerkship above average or excellent with no significant difference between the pre-COVID and COVID-era cohorts (70.4% Versus 64.8%, P = 0.35). Perception of grading expectations did significantly differ, 51% of pre-COVID students reported clerkship grading standards were almost always clear compared to 27.5% of COVID-era students (P = 0.01). Pre-COVID cohorts more frequently mentioned learning and feedback while COVID-era cohorts more frequently mentioned case, attending, and expectation. Natural language processing topic modeling and formal thematic analysis identified similar themes: team, time, autonomy, and expectations. COVID-19 presented many challenges to undergraduate medical education. Despite many changes, there was no significant difference in clerkship satisfaction ratings. Unexpectedly, the greater freedom and autonomy of asynchronous lectures and choice of cases became a highlight of the new curriculum. Future research should investigate if there are similar associations nationally with a multi-institutional study. [ABSTRACT FROM AUTHOR]

The surgical clerkship is a formative experience in the medical school curriculum and can leave a lasting impression on students' perception of surgery. Given the historical negative stereotypes of surgeons, the clerkship represents an opportunity to impact students in a meaningful way. Our institution developed a program in which research residents can serve as junior clerkship coordinators and educators; working closely with medical students on their surgery clerkship. At the end of their clerkship, students were administered a survey with Likert-scale and free text responses regarding satisfaction with the rotation, lectures, feedback, and value of the clerkship. Student survey results were compared before (2015-2016) and after (2017-2019) the implementation of the scholar program with nonparametric statistical analysis and qualitative text analysis. A total of 413 students responded to the survey with no significant difference in response rate by term (P = 0.88). We found no statistical difference with respect to overall course perception (92.3% versus 91.2%, P = 0.84), but a statistically significant difference was noted for the clarity of the provided written clerkship materials (80.3% versus 91.3%, P = 0.02) and usefulness of the feedback (57.5% versus 78.7%, P = 0.01). Qualitative analysis demonstrated an overall positive shift in perception of the clerkship, improvement in the course materials, and organization. The scholar program was overall well received by the students with improvements in certain aspects of the clerkship: organization, feedback, and course materials. This program represents a potential strategy to improve certain portions of the medical school clerkship experience. [ABSTRACT FROM AUTHOR]

Ischemic stroke induces a debilitating neurological insult, where inflammatory processes contribute greatly to the expansion and growth of the injury. Receptor-interacting protein kinase 2 (RIPK2) is most well-known for its role as the obligate kinase for NOD1/2 pattern recognition receptor signaling and is implicated in the pathology of various inflammatory conditions. Compared to a sham-operated control, ischemic stroke resulted in a dramatic increase in the active, phosphorylated form of RIPK2, indicating that RIPK2 may be implicated in the response to stroke injury. Here, we assessed the effects of pharmacological inhibition of RIPK2 to improve post-stroke outcomes in mice subjected to experimental ischemic stroke. We found that treatment at the onset of reperfusion with a RIPK2 inhibitor, which inhibits the phosphorylation and activation of RIPK2, resulted in marked improvements in post-stroke behavioral outcomes compared to the vehicle-administered group assessed 24 h after stroke. RIPK2 inhibitor-treated mice exhibited dramatic reductions in infarct volume, concurrent with reduced damage to the blood-brain barrier, as evidenced by reduced levels of active matrix metalloproteinase-9 (MMP-9) and leakage of blood-borne albumin in the ipsilateral cortex. To explore the protective mechanism of RIPK2 inhibition, we next pretreated mice with RIPK2 inhibitor or vehicle and examined transcriptomic alterations occurring in the ischemic brain 6 h after stroke. We observed a dramatic reduction in neuroinflammatory markers in the ipsilateral cortex of the inhibitor-treated group while also attaining a comprehensive view of the vast transcriptomic alterations occurring in the brain with inhibitor treatment through bulk RNA-sequencing of the injured cortex. Overall, we provide significant novel evidence that RIPK2 may represent a viable target for post-stroke pharmacotherapy and potentially other neuroinflammatory conditions. [Display omitted] • Stroke induces a significant increase in phosphorylated RIPK2 levels in the lesioned brain. • Inhibition of RIPK2 elicits dramatic neuroprotection and improves functional outcomes in experimental ischemic stroke. • RIPK2 inhibition dampens the neuroinflammatory response to stroke injury and preserves blood-brain barrier function. • RIPK2 inhibition evokes profound transcriptional alterations in the lesioned brain in response to stroke injury. [ABSTRACT FROM AUTHOR]

Fast-rotating asteroids (FRAs) are considered to be small bodies having a rotation period (P) faster than the spin barrier of about 2.3 h, starting at diameters of less than 300 m. We selected the 20 fastest Arecibo radar-observed targets, with P < 0. 13 h (∼ 8 min). Some key measurements and calculations obtained from radar observations include: the Doppler bandwidth, the circular polarization ratio, radar astrometry, and (with enough signal-to-noise ratio) delay-Doppler images of the object. Rotation period data available from the Light Curve Database for the selected objects combined with the radar observations allow us to constrain the possible diameters and confirm the periods. Of the objects in this sample, the median absolute magnitude (H) is 24.9, and the median calculated diameter is 32 meters. The apparent rotation period indicated by the bandwidth can appear slower than the object's true rotation, but not faster, providing an upper limit to the true rotation period. Asteroid cohesion required to prevent rotational disruption depends on rotation rate, density, and diameter; we performed calculations for the minimum values for cohesion via the Drucker–Prager (D–P) cohesion criterion. Most of these objects need a few to a few hundred pascals of cohesion; however four cases stand out: 2014 TV, 2015 RF 36 , 2015 GS 2 and 2017 EK, needing a minimum cohesion on the order of a few kilopascals. These are comparable to very weak Earth rocks, and are larger than previously reported values for NEAs. • Analysis of fastest-rotating near-Earth asteroids observed from Arecibo Observatory. • Comparing radar- and lightcurve-derived rotation period, diameter, and cohesion. • We show the orbit determination for small NEAs is significantly improved when radar observations are available. • A few objects need cohesion on the order of a few kilopascals to prevent disruption. [ABSTRACT FROM AUTHOR]