Highlights d Sex differences in phenotype and gene expression depend upon genetic background d The gene Lypla1 impacts obesity in a sex-specific manner d Functional analyses reveal sex differences for adipose tissue beiging d Adipose mitochondrial function depends upon gene-by-sex interactions

Elevated hepatic ceramide levels have been implicated in both insulin resistance (IR) and hepatic steatosis. To understand the factors contributing to hepatic ceramide levels in mice of both sexes, we have quantitated ceramides in a reference population of mice, the Hybrid Mouse Diversity Panel that has been previously characterized for a variety of metabolic syndrome traits. We observed significant positive correlations between Cer(d18:1/16:0) and IR/hepatic steatosis, consistent with previous findings, although the relationship broke down between sexes, as females were less insulin resistant, but had higher Cer(d18:1/16:0) levels than males. The sex difference was due in part to testosterone-mediated repression of ceramide synthase 6. One ceramide species, Cer(d18:1/20:0), was present at higher levels in males and was associated with IR only in males. Clear evidence of gene-by-sex and gene-by-diet interactions was observed, including sex-specific genome-wide association study results. Thus, our studies show clear differences in how hepatic ceramides are regulated between the sexes, which again suggests that the physiological roles of certain hepatic ceramides differ between the sexes.

person during low technology reproductive-health education sessions at community centers. CONCLUSION:The refugee women in this study were interested in using contraceptives to limit family size due to economic strain. Participants reported concerns about side effects that impacted their current contraception use. The women preferred contraceptive education in their community centers.

INTRODUCTION:Among third-year medical students at a community-based medical school, students report feeling less prepared at the start of an obstetrics and gynecology clerkship compared to other clerkships. We sought to determine if a student-led curriculum is an effective resource for third-year clerkship preparation and how this curriculum affects student interest in obstetrics and gynecology, perceptions of the obstetrician-gynecologist attending lifestyle, comfort with obtaining a specialty-specific history and physical (H&P), and obstetric ultrasound techniques.METHODS:Fourth-year medical students pursuing obstetrics and gynecology designed clerkship-specific curricula and administered a lecture to third-year medical students via Zoom. This lecture focused on obtaining obstetrics and gynecology-specific H&P, interpreting tests of fetal well-being, labor and delivery (L&D) triage cases, and obstetric ultrasound techniques. An eight-question pre and postlecture survey using a Likert scale was distributed to all attendees.RESULTS:The pre and post lecture survey had 26 and 22 respondents, respectively. Attendees reported increased comfort with obstetrics and gynecology-specific patient presentations (P<.001), taking obstetric and gynecologic histories (P<0.001, P<.001), performing a pelvic exam (P<.001), and performing obstetric ultrasound (P<.001) after attending the lecture. Respondents overall felt more prepared for the obstetrics and gynecology clerkship relative to Family Medicine (P<.001). In terms of career guidance, students believed obstetrics and gynecology to be less demanding post-lecture (P<.03); however, student interest in the specialty did not significantly change.CONCLUSION:This study suggests that a single, remotely conducted, upperclassmen-led lecture centered on applied clinical knowledge in obstetrics and gynecology significantly improves third-year medical student comfort with performing specialty-specific history and physical exams, obstetric ultrasound techniques, and perception of attending lifestyle. It also confirms that student-led curriculum is an effective resource for third-year clerkship preparation.

Background: Throughout medical school students are exposed to a variety of fields within medicine, but structured leadership and teaching opportunities are limited. There is a need for more training to prepare students of all backgrounds to be future leaders in all healthcare realms, especially critical care medicine, in order to address the lack of diversity seen in leadership positions. Methods: Implemented entirely by students with faculty guidance, the Kern model was applied to develop a student-run longitudinal Designated Emphasis in Healthcare Leadership. This program was implemented at a medical school leading the nation in creating opportunities for diverse and underrepresented groups in medicine. Students are involved in structured leadership lectures, projects, and mentorship, and there is an emphasis on learning by doing. A survey was sent out to all present and past student participants to assess its acceptability and effectiveness. Results: A post-participation survey found that a total of 96% of participants identified themselves as healthcare leaders, felt confident leading a team, and felt comfortable working with a diverse team. Further, 96% of participants agreed or strongly agreed they would recommend the program to other medical students. Qualitative feedback revealed that participants felt they learned how to “apply leadership skills to the healthcare setting” and were provided an “environment to grow and practice vital leadership skills that will help [them] be effective clinicians.” Conclusions: Our initial research shows that introducing a longitudinal leadership program into Medical Education may allow participants to start developing personal and professional leadership qualities. The program is well-received by the students and preliminary data shows that there may be increase in leadership capabilities when participating in this program. Such a program can enable future healthcare providers to become leaders in their own fields, so that they can hone interpersonal communication skills, bridge the gap of representation in leadership positions, and lead teams effectively.