This work dramatically improves our understanding of the assembly of the outermost layer of the B. anthracis spore, the exosporium, a layer that encases spores from many bacterial species and likely plays important roles in the spore’s interactions with the environment, including host tissues. Nonetheless, the mechanisms directing exosporium assembly into a shell surrounding the spore are still very poorly understood. In this study, we clarify these mechanisms by the identification of a novel protein interaction network that directs assembly to initiate at a specific subcellular location in the developing cell. Our results further suggest that the presence or absence of an exosporium has a major impact on the assembly of other more interior spore layers, thereby potentially explaining long-noted differences in spore assembly between B. anthracis and the model organism B. subtilis.
Following the efforts of Disability-Justice advocates who have fought for decades for the representation of people with disabilities in matters that impact them, this paper considers the importance of centering people with lived experience of homelessness and housing insecurity in efforts to end and prevent homelessness. This paper has three interrelated goals: situating the work being done by activists with lived experience of homelessness within broader homelessness prevention and housing rights advocacy in Canada; outlining the importance of centering voices of lived experience in research and advocacy contexts, focusing on both ‘naming’ power and privilege in advocacy work, and navigating embodied knowledge and epistemic authority; and highlighting the ethics of ‘care’ (as theorized by disability and feminist scholars) as fundamental to the process of doing radical and justice-oriented work. To accomplish this, this paper examines two oppositional faces of ‘care’–anonymous care, structured by the demands of neoliberal capitalism, and a potential antidote, revolutionary care. The paper draws on ethnographic fieldwork conducted in 2017 in Whitehorse, Yukon Territory to contextualize lived experience self-advocacy. Additional examples are drawn from the new Canadian Lived Experience Leadership Network, as well as the author’s lived experience of homelessness and activist work in the context of homelessness prevention. Ultimately, this paper offers a critique of efforts to include lived experts in the fight to end and prevent homelessness that, despite good intentions, often reproduce power imbalances–suggesting mutual, reciprocal, revolutionary care as one possible path forward. Power operates in subtle ways in advocacy contexts as an unintended driver of exclusion and discrimination: recognizing and disrupting this dynamic is integral to the goals of ending and preventing homelessness and achieving housing justice in Canada.
BackgroundPoint-of-care ultrasound (POCUS) has become a useful diagnostic tool across multiple specialties. However, no standardized curriculum is currently in place for Canadian Internal Medicine (IM) residency programs. This report aims to describe the development of a longitudinal POCUS curriculum at Dalhousie University and reports on resident knowledge, confidence, and perceived clinical utility of POCUS also.MethodsResidents in the core IM program were invited to complete a POCUS survey and knowledge test in December 2019. The survey evaluated self-reported confidence in acquired POCUS skills and clinical use in practice, whereas the knowledge test evaluated image interpretation skills.ResultsA total of 34/45 (75.6%) residents participated, who agreed that POCUS training should be a formal component of residency (4.56 ± 0.56). Scores on the knowledge test improved based on time spent in the curriculum, with postgraduate year (PGY) 1s scoring an average of 70.0% (21/30) and PGY3s 82.8% (24.9/30; P = 0.02). Residents reported the strongest confidence in lung imaging for detecting A and B lines (4.10 ± 0.79), pleural effusions (3.92 ± 0.90), and lung sliding (3.89 ± 0.92).ConclusionDalhousie University is among the first IM programs in Canada to implement a formal longitudinal POCUS curriculum, which has enabled the incremental acquisition of POCUS knowledge, confidence, and clinical utility amongst residents. RésuméContexteL’échographie au point d’intervention (POCUS) est devenue un outil de diagnostic utile dans de multiples spécialités. Toutefois, aucun programme normalisé n’est en place actuellement dans les programmes de résidence en médecine interne au Canada. Ce rapport vise à décrire l’élaboration d’un programme longitudinal sur la POCUS à l’Université Dalhousie et rend compte des connaissances et de l’assurance des résidents relatives à la POCUS et de leur perception quant à son utilité clinique.MéthodologieDes résidents du programme de médecine interne tronc commun ont été invités à répondre à un sondage sur la POCUS et à effectuer un test de connaissances en décembre 2019. Le sondage a évalué le degré d’assurance quant aux compétences acquises sur la POCUS et à son utilisation clinique dans la pratique, tandis que le test de connaissances a évalué les compétences en matière d’interprétation des images. RésultatsAu total, 34 des 45 résidents ayant participé au sondage (75,6 %) sont d’avis que la formation sur la POCUS devrait être une composante officielle de la résidence (4,56 ± 0,56). Les scores du test de connaissances s’améliorent en fonction du temps passé dans le programme, le score des résidents de première année d’études postdoctorales (PGY-1) étant de 70,0 % (21/30) en moyenne et celui des résidents de troisième année (PGY-3) de 82,8 % (24,9/30; P = 0,02). Les résidents mentionnent faire preuve de la meilleure assurance en matière d’imagerie pulmonaire dans la détection des lignes A et B (4,10 ± 0,79), des épanchements pleuraux (3,92 ± 0,90) et des glissements pulmonaires (3,89 ± 0,92). ConclusionL’Université Dalhousie figure parmi les premiers programmes de médecine interne au Canada à mettre en œuvre un programme longitudinal officiel sur la POCUS, ce qui a permis l’acquisition progressive parmi les résidents des connaissances et de l’assurance relatives à la POCUS et de l’utilité clinique de cet outil de diagnostic.
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