Background: The larynx is important in breathing, swallowing, and speech production. The closure and opening of the space between the vocal folds (“glottis”), allows the larynx to fulfill its functions. The larynx is a symmetric organ. To move all parts of the larynx appropriately and achieve glottal sufficiency, symmetry is beneficial. Previous studies have reported on various forms of shape asymmetry and their consequence for function. Asymmetry in how the larynx is positioned within the neck has not been investigated before but could play a critical role in the development of shape asymmetry and thereby influence larynx functions. 
Methods: We investigated a stratified sample of 210 human subjects (105 females, 105 males) for positional asymmetry. Positional asymmetry was defined as the angle between the mid-sagittal organ plane and the mid-sagittal body plane. The larger the angle between the two, the greater the positional asymmetry. Positional asymmetry was measured in all subjects. With the help of regression models, the relationships between positional asymmetry and body size, larynx organ size, and larynx shape were explored. 
Results: Positional asymmetry ranged between 0 and 18°. It was larger in males (4.71°±3.05; mean±stdev) than in females (3.49°±3.11) (t-test, T105,105 = -2.85; p < 0.01). Larynx midsagittal plane was deflected either to the left or the right side. In females, the distribution was almost even (51.43%) but it was biased towards the right side in males (62.86%). Positional asymmetry was associated with larynx overall shape (females: R2= 0.05, P= 0.017; males: R2= 0.09, P= 0.002), and shape asymmetry (female: R2 = 0.059; p< 0.01, male: R2= 0.21; p<0.001), with larynx size in females (females: R2= 0.042, P= 0.036; males: R2= 0.003, P= 0.609), with age in females (females: R2 = 0.467; p= 0.027; males: R2 = 0.0232; p= 0.12), but not with body height (males: R2= 0.0082; P= 0.357 ; females: R2= 0.0061; P= 0.43) or with BMI (Body Mass Index) (female: R2 = 0.018; p= 0.169, males: R2= 0; p= 0.97). 
Conclusions: Our data highlight the value and challenges of investigating human phenotypic variation. Positional asymmetry of the larynx was associated with the shape and size variation of the vocal organ as well as with a person’s age.

Assessing Positional Asymmetry of the Larynx

Various growth factors have been shown to affect the proliferation, migration, and adhesion of keratinocytes in the face of wound healing. The expression of wound repair genes is suspected to be regulated by circadian rhythm. How wound repair functions over the course of a circadian rhythm has yet to be fully described. Moreover, much is unknown about the impact of bacteria on the circadian expression of wound healing genes. Here, we intend to use periodontal disease as a model to describe the effect of a septic environment on expression of wound healing genes by epithelial cells. Furthermore, we aim to demonstrate that stimulation of epithelial cells with pathogenic bacteria alters the circadian patterns of wound repair gene expression. In the experiment, OKF4 cells were seeded, and artificial wounds were created in each well. The cells were challenged with pathogenic oral bacteria, and cell lysates were collected at T=0, T=8, and T=22 hours. PCR quantified gene expression levels. Microscopically, increased cell spreading was observed after T=22 hours in the wounded cells. Impaired cell spreading was observed in the wells challenged with pathogenic bacteria. The expression of EGF and FGF-7 appeared to follow a circadian rhythm. The presence of pathogenic bacteria downregulated the expression of genes involved in keratinocyte migration. These findings support the hypothesis that genes involved in wound healing follow a circadian rhythm and are altered in the face of infection. Continued research into this topic can lead to the development of therapies targeted towards restoring the expression of genes that aid in wound repair complicated by a septic environment or overlying infection. Further elucidating the circadian pattern of expression of these genes can also result in optimization of the timing that therapies are administered to maximize their therapeutic effect thereby improving patient outcomes. 


Altered Wound Healing Response after Challenge with Pathogenic Bacterium

**Scoring is only possible in the semifinals hall**

**Abstract:**



The role of the triglyceride-glucose index (TyG) in obesity and its progression to Type 2 diabetes

Background: Neuroinflammation has been implicated in the development and progression of numerous neurodegenerative disorders and studies suggest systemic inflammation may precede central inflammation. Chronic low-grade systemic inflammation is a hallmark of metabolic disorders like Type II diabetes mellitus (T2DM), which is a risk factor for cognitive dysfunction. In fact, researchers have proposed the term “Type III diabetes” for Alzheimer’s disease due to the shared molecular and cellular mechanisms among diabetes and cognitive decline. For both of these pathologies, diet has been recognized as a modifiable risk factor, yet the specific impact of diet on neuroinflammation remains poorly understood. Current literature suggests that a high intake of saturated fats and processed foods may promote neuroinflammation and worsen neurodegeneration, while a ketogenic diet has been linked to cognitive improvement in dementia via regulation of neuroinflammatory pathways. This ongoing work seeks to uncover how diet composition influences neuroinflammation, specifically how diet modulates the activity of the NLRP3-inflammasome.

Methods: To address this question, we utilized a novel biosensor mouse developed in our laboratory that allows us to measure caspase-1/NLRP3-inflammasome activity in vivo. Due to the strong association of dementia and T2DM, and the established abnormalities in blood glucose levels in T2DM, this study focuses on high glycemic index (HGD) and ketogenic (KD) diets. These diets will allow us to determine whether rapid spikes in blood sugar seen with the HGD increase NLRP3-inflammasome neuroinflammation, potentially contributing to neurodegeneration, and if the extremely low carbohydrate load in the KD has the opposite effect.

Results: Long term administration of a KD promotes glucose intolerance but does not increase neuroinflammation, which a HGD increases NLRP3-inflammasome-dependent neuroinflammation without altering glucose regulation in wild-type male mice.

Conclusion: We found that the ketogenic diet impairs glucose metabolism, but does not lead to increased neuroinflammation, while the HGD showed the opposite phenotype. Future experiments will assess inflammatory cytokines systemically and centrally, determine levels of pro-inflammatory transcripts and cleaved caspase-1 protein levels in the brain, and evaluate behavior deficits to probe at the mechanism behind these unexpected results.


The Impact of Diet on Neuroinflammation

Biomass is an organic material that normally comes from plants or animals. The discovery of converting biomass wastes into graphene is a successful route for recovering sources because it is sustainable, renewable, and abundant. For both basic research and practical applications, finding a novel way to produce graphene with a high yield and excellent crystalline structure is critical. For this research, waste disposable paper-cups will be used for the formation of graphene sheets by using KOH activation while using FeCl3 as a catalyst. The chemical activation of carbon-rich materials using KOH as the activating agent is a ground-breaking technique because of its lower activation temperature and higher yield [1]. Also, the obtained graphene will have a well-defined micropore size distribution and extremely high surface area. The graphene nanostructure can be used as a filler for thermoplastic polymers since it provides polymers of several functional characteristics, which are not accessible by using other types of fillers. For this research, the extracted graphene nanoparticles will be used as a filler in polypropylene to enhance its morphological, mechanical, and thermal properties. Thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) tests will be used to determine the thermal properties of the graphene reinforced polymer composites. Also, X-ray diffraction (XRD), FTIR, SEM, TEM, and tensile tests will be used to determine the mechanical, microscopic, and morphological property.es of GRPC. The results obtained from this research indicates that high yield and high-quality graphene materials can be synthesized by using biomass resources rather than conventional methods and can be used as a filler in polymers that could improve the mechanical and thermal performance when dispersed uniformly.

Morphological, Mechanical, and Thermal Properties of Polypropylene Reinforced with Graphene Nanoparticles Extracted from Paper Cups.

Languages exhibit a tremendous amount of variation in how they organise and order morphemes within words; however, regularities are also found. For example, gender and number inflectional morphology tend to appear together within a single affix, and when they appear in two separate affixes, gender marking tends to be placed closer to the stem than number. Formal theories of gender and number have been designed (in part) to explain these tendencies. However, determining whether the abstract representations hypothesised by these theories indeed drive the patterns we find cross-linguistically is difficult, if not impossible, based on the natural language data alone. In this study we use an artificial language learning paradigm to test whether the inferences learners make about the order of gender and number affixes—in the absence of any explicit information in the input—accord with formal theories of how they are represented. We test two different populations, English and Italian speakers, with substantially differ- ent gender systems in their first language. Our results suggest a clear preference for placing gender closest to the noun across these populations, across different types of gender systems, and across prefixing and suffixing morphology. These results expand the range of behavioural evidence for the role of cognitive representations in determining morpheme order.


Speakers' cognitive representations of gender and number morphology shape cross-linguistic tendencies in morpheme order

The Phrase-as-Lemma construction

For the motion

Against the motion

Background: There is a paucity of research regarding the perceptions and potential behavioral changes of the medical students that will be taking the USMLE as a pass/fail examination. We sought to assess medical student perceptions of the USMLE Step 1 transition to pass/fail and evaluate differences in extracurricular participation between pass/fail Step 1 students and scored Step 1 students.

Methods: Sixty-eight US medical schools were invited to participate in an anonymous survey. Self-reported extracurricular activities during the first year of medical school were compared between Step 1 pass/fail students (S1PF) and Step 1 scored students (S1S) with a chi square test.

Results: Between 8/25/2021-11/16/2021, 341 students started the survey and 277 (81.2%) completed the survey. One hundred two (36.8%) were S1S and 175 (63.2%) were S1PF, of which 87 (49.7%) had completed at least one year of medical school. We found mixed results on whether students would prefer Step 1 to be pass/fail or scored. The majority felt the transition would disadvantage students from “lower ranking” medical schools. Regarding the transition, the majority of S1PF reported more anxiety related to Step 2, extracurricular activities, and the
residency application process. There were no significant differences between S1S and S1PF students for participation in volunteering, teaching, and research, but a significant increase was observed in how many leadership positions S1PF students applied to and obtained during their first year of medical school (p < 0.001 and p = 0.011, respectively).

Conclusion: To our knowledge, this is the first study analyzing the perceptions and possible behavioral changes of medical students who will be taking Step 1 as a pass/fail examination. The reported increase in anxiety among pass/fail students should be addressed by medical education professionals and merits discussion of curricular remodeling. The transition creates an opportunity to redefine the residency application process allowing holistic evaluation of students which can confer advantage to those from “lower ranking” schools.

Medical Student Perceptions of the USMLE Step 1 Transition to Pass/FailScoring

Abstract Title:
Image Quality Assessment in Point of Care Ultrasound Education
Background
Our aim was to provide a high-quality POCUS education program for hospitalists at the Jesse Brown VA hospital. That entailed providing a valid and consistent way of tracking the progress of our learners throughout the program, for which image quality assessment was one of the main metrics. Literature review demonstrated a gap in evidence-based methods for doing so, which is why we believe our findings are invaluable for the advancement of POCUS education.
Methods
A group of 25 ultrasound images was shared with our 3 educators for quality measurement on a numerical scale. First, each educator independently scored the images based on clinical gestalt. A second round of image scoring was done where the educators were provided a rubric to independently score images based on orientation, gain, plane, depth, and visible structures. A debriefing session was then done to clarify how each of the educators perceived and utilized the rubric after which a third and final round of image scoring was done. The educators were blinded to their colleagues’ grading submissions until the end of the 3 rounds.
Results
The intraclass correlation coefficient (ICC) was 0.589 for the first round of scoring. After adding the rubric, the ICC rose to 0.752 (28% increase). The ICC further increased to 0.862 after the debriefing session was done on using the rubric. The calculated Conbrach’s alpha for internal consistency was 0.811.

Conclusion
There is a significant improvement in the ICC after implementing the rubric, and again after the debriefing session was conducted. This implies a higher consistency in the feedback learners receive on their images from the different educators when using an agreed-upon rubric to track their progress. 
The rubric was also successful in grounding the educators to focus on the innate image quality attributes first, and then to provide feedback on the clinical utility of the entire study of images a learner has submitted for a given patient. We were thus able to independently score technical skills for image acquisition while fostering the learner’s clinical skills of interpreting such images to guide their use of ultrasonography in clinical practice.

Image Quality Assessment in Point of Care Ultrasound Education

Native Hawaiian and Pacific Islanders Fail to Match Previous 15-Years of Underrepresented in Medicine Growth in Graduate Medical Education Residency Training Programs

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