Lymphocyte subset analysis was performed on 114 healthy children and 84 healthy adults. Samples were prepared by a whole blood lysis technique and analyzed by flow cytometry. The percentage and total number of CD3+, CD4+, CD8+, and CD19+ lymphocytes were calculated for each of six age groups. A direct correlation with age was seen in the percentages of CD3+, CD4+, and CD8+ lymphocytes. The absolute number and percentage of total lymphocytes, the percentage and absolute number of CD19+ lymphocytes, and the absolute number of CD3+ lymphocytes decreased with age. No significant correlation with age was observed for white blood cells, the absolute number of CD4+ and CD8+ lymphocytes, and the CD4+/CD8+ ratio.

Nanomedicines can be taken up by cells via nonspecific and dynamin-dependent (energy-dependent) clathrin and caveolae-mediated endocytosis. While significant effort has focused on targeting pathway-specific transporters, the role of nanobiophysics in the cell lipid bilayer nanoparticle uptake pathway remains largely unexplored. In this study, it is demonstrated that stiffness of lipid bilayer is a key determinant of uptake of liposomes by mammalian cells. Dynamin-mediated endocytosis (DME) of liposomes is found to correlate with its phase behavior, with transition toward solid phase promoting DME, and transition toward fluidic phase resulting in dynamin-independent endocytosis. Since liposomes can transfer lipids to cell membrane, it is sought to engineer the biophysical properties of the membrane of breast epithelial tumor cells (MD-MBA-231) by treatment with phosphatidylcholine liposomes, and elucidate its effect on the uptake of polymeric nanoparticles. Analysis of the giant plasma membrane vesicles derived from treated cells using flicker spectroscopy reveals that liposome treatment alters membrane stiffness and DME of nanoparticles. Since liposomes have a history of use in drug delivery, localized priming of tumors with liposomes may present a hitherto unexploited means of targeting tumors based on biophysical interactions.

Innovation Concept: The Orange Book (OB) identifies drugs approved on the basis of safety and effectiveness by the FDA and serves as the gold standard reference for correct pharmacological therapies. It ties in closely with Choosing Wisely Canada (CWC) modelling good stewardship in antimicrobial prescriptions. The book focuses on passive didactic learning instead of active learning, which was shown to have a greater influence on prescribing behaviour. Educational video games, a form of active learning, have been shown to improve clinical skills in medical training. Contagion is a role-playing video game providing an active way of teaching antimicrobial components of the OB and CWC guidelines. Method: Phase I of Contagion was qualitatively tested on students and physicians at McMaster University for teaching effectiveness, applicability to real-life scenarios, and enjoyability. Post-game play 12 participants scored different aspects of the game on a Likert scale. Curriculum, Tool, or Material: The player is a rural physician treating infections in various communities. Each round, the player is given a crate of antibiotics. As communities are infected, the player is provided with clinical symptoms the patients present with. The player must identify the pathology and then correctly treat the communities. The player can treat empirically or order tests to identify the infectious organism. The player strategically navigates which communities to treat as there are limited actions per turn and the player must prevent communities from dying or infecting neighboring regions. Communities tend to build antibiotic resistance over time making first-line treatments unviable, thus careful strategizing and stewardship is essential. Active learning will occur when players are tasked with finding the correct answer to different presentations. After each turn, players will learn about the infecting organism, its phenotypes, and common infectious symptoms. This is considered passive learning. Conclusion: Contagion was well-received by physicians and medical students as an active learning tool to teach the OB and CWC guidelines. On preliminary user testing Contagion scored 5 in effectiveness in teaching treatments and 4.6 in teaching stewardship. An objective of this project is to perform large scale testing across schools to demonstrate the effectiveness of the learning components of the game. We hope to eventually create a tool that can be incorporated in continuing medical education for physicians.

BackgroundThe COVID-19 pandemic has restricted in-person clinical training for medical students. Simulation-based teaching is a promising tool to introduce learners to the clinical environment. MacSim is a student-led simulation workshop for learners to develop clinical competencies. The objective of this study was to assess the impacts of MacSim and participants’ perspectives regarding simulation-based teaching.MethodsA comprehensive simulation, representative of a virtual care scenario, was delivered to 42 pre-clerkship medical students via video conferencing. In pairs, participants obtained histories and carried out management plans for simulated patients. Participants were surveyed and interviewed. Survey data were analyzed using the Wilcoxon signed-ranks test. Interview transcript data were thematically analyzed.ResultsPost-simulation, participants (n=24) felt more prepared to make clinical decisions, collaborate, and communicate in a virtual setting. 92% of respondents agreed MacSim was a valuable learning experience and 96% agreed more simulation-based learning should be integrated into curricula. Emergent themes from interviews (n=12) included: 1) value of simulation fidelity, 2) value of physician feedback, and 3) effectiveness of MacSim in improving virtual clinical skills.ConclusionSimulation-based teaching is of importance and educational value to medical students. It may play an increasingly prevalent role in education as virtual care is likely to become more prevalent.