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The purpose of this commentary is to describe the Johns Hopkins Home Care Group's (JHHCG) Community-based Pharmacy Residency Medication Therapy Management (MTM) rotation, summarize adjustments made to the rotation after the onset of the coronavirus disease 2019 (COVID-19) pandemic, describe key learnings from the adjustments, and provide a call to action for other residency programs seeking to improve their rotations amidst pandemic restrictions. MTM clinical pharmacists at JHHCG collaborate with patients to identify barriers to adherence, review medications, and develop plans for improvement. Through improved medication adherence, the goals for this program are to reduce adverse effects, patient cost, and medical visits or hospital admissions. Central to this practice is the belief that strong patient relationships are necessary to uncover the root cause of medication nonadherence. In Postgraduate Year-1 (PGY-1) community-based pharmacy residency training, new pharmacists learn the value of building relationships with patients and working through complex problems during this clinical experience. By assisting patients with complex medical conditions and social situations, new pharmacists gain skills in patient care, pharmacy operations, and medication access challenges. As the COVID-19 pandemic forced the discontinuation of face-to-face interactions in this setting, rotation experiences for residents were adapted with the goal of continuing high-impact patient interactions and keeping everyone involved safe. Although considerable changes were made to the MTM rotation because of the COVID-19 pandemic, residents were still able to provide meaningful clinical care telephonically and continued to learn valuable patient care skills. Most importantly, high quality care was still delivered to the patients despite considerable challenges. The major challenge for the residents' clinical experiences as a result of the adjustments has been finding an impactful volume of complex patients to enhance their skills. Other residency programs are encouraged to consider three recommendations to improve their rotations moving forward., (Published by Elsevier Inc.)

Dynein light chains are required for the assembly of axonemal dyneins into cilia and flagella. Most organisms express a single p28 dynein light chain and four to nine one-headed inner arm dynein heavy chains. In contrast, Tetrahymena encodes three p28 dynein light chain genes (p28A, p28B, and p28C) and 18 one-headed inner arm dynein heavy chains. In this article it is shown that mutations in p28A and p28B affected both beat frequency and waveform of cilia, while mutations in p28C affected only ciliary beat frequency. A similar set of dynein heavy chains were affected in both p28AKO and p28BKO, but a distinct set of heavy chains was affected in p28CKO. The results suggested that the p28s have non-redundant functions in Tetrahymena and that p28C was associated with a different set of dynein heavy chains than were p28A and p28B., (© 2016 Wiley Periodicals, Inc.)

How microtubule-associated motor proteins are regulated is not well understood. A potential mechanism for spatial regulation of motor proteins is provided by posttranslational modifications of tubulin subunits that form patterns on microtubules. Glutamylation is a conserved tubulin modification [1] that is enriched in axonemes. The enzymes responsible for this posttranslational modification, glutamic acid ligases (E-ligases), belong to a family of proteins with a tubulin tyrosine ligase (TTL) homology domain (TTL-like or TTLL proteins) [2]. We show that in cilia of Tetrahymena, TTLL6 E-ligases generate glutamylation mainly on the B-tubule of outer doublet microtubules, the site of force production by ciliary dynein. Deletion of two TTLL6 paralogs caused severe deficiency in ciliary motility associated with abnormal waveform and reduced beat frequency. In isolated axonemes with a normal dynein arm composition, TTLL6 deficiency did not affect the rate of ATP-induced doublet microtubule sliding. Unexpectedly, the same TTLL6 deficiency increased the velocity of microtubule sliding in axonemes that also lack outer dynein arms, in which forces are generated by inner dynein arms. We conclude that tubulin glutamylation on the B-tubule inhibits the net force imposed on sliding doublet microtubules by inner dynein arms.

Sorption of commonly used herbicides by wetland sediment can provide important information for herbicide fate modeling. The influence of sediment properties on herbicide sorption as a result of different land uses in the wetland catchment is unclear. We examined the effects of land use on the physiochemical properties of wetland sediments and the associations between these sediment properties and herbicide sorption characteristics. Bottom sediments were sampled in 0- to 5- and 5- to 10-cm sections from 17 wetlands under five different land use classes: (i) ephemeral wetlands with no riparian vegetation in a cultivated catchment (ECNR), (ii) ephemeral wetlands with riparian vegetation in a cultivated catchment (ECR), (iii) ephemeral wetlands in a grassland catchment established 4 yr ago (E4G), (iv) ephemeral wetlands in a brome grass catchment established 20 yr ago (E20G), and (v) semi-permanent (SP) wetlands in a multiple-land-use catchment. Sediments were analyzed for total organic carbon (TOC), total inorganic carbon (TIC), pH, electrical conductivity, exchangeable cations (EXCAT), total cation exchangeable capacity (CEC), and percent clay (%clay). Sediment herbicide sorption partition coefficient (Kd) was measured for trifluralin, atrazine, 2,4-D, and glyphosate. The sorption of the herbicides in the sediment increased in the order of 2,4-D < atrazine < glyphosate < trifluralin. The sorption of 2,4-D, atrazine, and trifluralin was positively correlated to TOC, EXCAT, and CEC but negatively correlated to %clay. Glyphosate sorption was negatively correlated to pH, TIC, EXCAT, and %clay. Overall, wetland sediments that were recently cultivated (ECNR and E4G) had lower TOC, TIC, EC, EXCAT, CEC, and Kd values (2,4-D, trifluralin, and atrazine) than sediments that had not been recently cultivated (ECR, E20G, and SP). The ECR wetland sediments had the largest Kd for all four herbicides, suggesting that land use and riparian vegetation have a significant impact on herbicide sorption.

Cilia and flagella contain at least eight different types of dynein arms. It is not entirely clear how the different types of arms are organized along the axoneme. In addition, the role each different type of dynein plays in ciliary or flagellar motility is not known. To initiate studies of dynein organization and function in cilia, we have introduced a mutation into one dynein heavy chain gene (DYH6) in Tetrahymena themophila by targeted gene knockout. We have generated mutant cells that lack wild-type copies of the DYH6 gene. We have shown that the DYH6 gene encodes one heavy chain (HC2) of Tetrahymena 18S dynein and that 18S dynein occupies the I1 position in the ciliary axoneme. We have also shown that Tetrahymena I1 is required for normal motility, normal feeding and normal doubling rate.

The dynein ATPases are a family of motor enzymes that drive microtubule sliding in cilia and flagella and contribute to microtubule-based transport inside cells. The multi-dynein hypothesis makes two predictions: 1) Axonemes contain multiple dynein heavy chain (DHC) isoforms, each encoded by a different gene; 2) Each isoform performs a specific role in ciliary beating. We used PCR-based techniques to clone thirteen different DHC sequences from Tetrahymena genomic DNA. All thirteen genes appeared to be expressed in growing cells. Comparisons of the deduced amino acid sequences of the thirteen DHCs with other known DHCs suggested that we have cloned three outer arm DHCs, two cytoplasmic DHCs, and eight inner arm DHCs.

A combinatorial, phage-display library of human Fab antibody fragments was generated from IgG heavy chain (HC) and light chain (LC) genes cloned from the lymphocytes of a vaccinia virus (VACV)-immune donor. To ascertain the complexity of the library, nucleotide sequences of the variable regions of the HC and LC genes were determined. Fourteen distinct HC and 18 distinct LC (7 kappa and 11 lambda) that formed a combinatorial library of 22 Fabs were identified. Immune-precipitation of radiolabeled VACV revealed that at least six different VACV proteins were recognized by the antibodies. Plaque-reduction neutralization demonstrated that six of the Fabs neutralized VACV in the presence of anti-human antibody. ELISA studies indicated that 15 of the Fabs were cross-reactive with monkeypox virus.

Two dyneins can be extracted from Tetrahymena ciliary axonemes. The 22S dynein contains three heavy chains (HC), sediments at 22S in a sucrose gradient, and makes up the outer arms. The 14S dynein contains two to six HCs, sediments at 14S, and is thought to contribute to formation of the inner arms. We have identified two large proteins that are extracted from Tetrahymena axonemes with high salt and that sediment together at approximately 18S. The two large proteins cleave when subjected to UV light in the presence of ATP and vanadate, suggesting both proteins are dynein HC. Antibodies against one of the 18S HCs do not recognize 22S dynein HCs. Antibodies to 22S dynein HC do not bind appreciably to 18S dynein photocleavage fragments. Taken together, these results indicate that the large proteins that sediment at 18S are axonemal dynein heavy chains.

To identify proteins in Tetrahymena thermophila which were phosphorylated during ciliary assembly, the antiphosphoprotein antibody MPM-2 was used to probe blots of total ciliary protein or axonemal and ciliary membrane/matrix fractions from full-length cilia, regenerating cilia, or cilia that had grown to full-length following deciliation. A 70 kD protein was recognized by MPM-2 only in blots of total ciliary protein from regenerating cilia and of the membrane/matrix fraction from regenerating cilia. MPM-2 did not recognize this protein in blots of axonemal fractions of regenerating cilia or in blots of either axonemal or membrane/matrix fractions of full-length cilia. The results indicate that the 70 kD ciliary membrane protein was phosphorylated only in ciliary membranes or matrices of growing cilia. After the cilia reached full-length the membrane/matrix protein was either dephosphorylated or removed from the cilia. These observations support the hypothesis that the 70 kD membrane/matrix protein functions primarily during ciliary assembly.

Tetrahymena thermophila mutants homozygous for the oad mutation become nonmotile when grown at the restrictive temperature of 39 degrees C. Axonemes isolated from nonmotile oad mutants (oad 39 degrees C axonemes) lack approximately 90% of their outer dynein arms and are deficient in 22S dynein. Here we report that oad 39 degrees C axonemes contain 40% of the 22S dynein heavy chains that wild-type axonemes contain and that oad axonemes do not undergo ATP-induced microtubule sliding in vitro. Wild-type 22S dynein will bind to the outer arm position in oad axonemes and restore ATP-induced microtubule sliding in those axonemes. Unlike wild-type 22S dynein, oad 22S dynein does not bind to the outer arm position in oad axonemes. These data indicate that the oad mutation affects some component of the outer arm dynein itself rather than the outer arm dynein binding site. These data also indicate that oad axonemes can be used to assay outer dynein arm function.

We have used the anti-phosphoprotein antibody MPM-2 to examine changes in phosphorylation of cortical proteins during cilia regeneration in Tetrahymena thermophila. Although numerous cortical proteins are phosphorylated in both nondeciliated and deciliated cells, deciliation induces a dramatic increase in the phosphorylation of a 90-kDa cortical protein. The 90-kDa protein remained phosphorylated during cilia regeneration and then gradually became dephosphorylated. The 90-kDa protein was phosphorylated and dephosphorylated normally in Tetrahymena mutants that assemble short cilia, suggesting that achievement of full length is not the signal that triggers dephosphorylation of the 90-kDa protein. When initiation of cilia assembly is blocked, the 90-kDa protein becomes phosphorylated and remains phosphorylated for an extended period of time, suggesting that initiation of cilia elongation triggers eventual dephosphorylation of the 90-kDa protein, regardless of how long the cilia actually become.

The formation of Hantaan (HTN) virus nucleocapsid-like structures (NLS) or virus-like particles (VLP) from expressed gene products was investigated in two eukaryotic systems. Baculovirus expression of the HTN virus small segment (S), which encodes the viral nucleocapsid protein, resulted in assembly of NLS inside infected insect cells. The NLS and authentic ribonucleocapsids, prepared by detergent disruption of HTN virions, had similar sedimentation characteristics and morphologies, and were recognized by HTN virus N-specific antibodies. Co-expression of S and the medium segment (M), which encodes the two viral envelope glycoproteins (G1 and G2), did not efficiently generate VLP in the baculovirus-insect cell system, but VLP were observed in lysates and supernatants of cells infected with a recombinant vaccinia virus co-expressing HTN virus M and S. The VLP sedimented in sucrose to densities consistent with HTN virions, and some of them bore a striking resemblance to Hantaan virions when examined by immunoelectron microscopy.

In Tetrahymena, at least 17 distinct microtubule structures are assembled from a single primary sequence type of alpha- and beta-tubulin heterodimer, precluding distinctions among microtubular systems based on tubulin primary sequence isotypes. Tetrahymena tubulins also are modified by several types of posttranslational reactions including acetylation of alpha-tubulin at lysine 40, a modification found in most eukaryotes. In Tetrahymena, axonemal alpha-tubulin and numerous other microtubules are acetylated. We completely replaced the single type of alpha-tubulin gene in the macronucleus with a version encoding arginine instead of lysine 40 and therefore cannot be acetylated at this position. No acetylated tubulin was detectable in these transformants using a monoclonal antibody specific for acetylated lysine 40. Surprisingly, mutants lacking detectable acetylated tubulin are indistinguishable from wild-type cells. Thus, acetylation of alpha-tubulin at lysine 40 is non-essential in Tetrahymena. In addition, isoelectric focusing gel analysis of axonemal tubulin from cells unable to acetylate alpha-tubulin leads us to conclude that: (a) most or all ciliary alpha-tubulin is acetylated, (b) other lysines cannot be acetylated to compensate for loss of acetylation at lysine 40, and (c) acetylated alpha-tubulin molecules in wild-type cells contain one or more additional charge-altering modifications.

Epitopes recognized by three G1-specific and two G2-specific neutralizing monoclonal antibodies to Hantaan virus were mapped by sequence analyses of the complete M genome segments of neutralization escape variant viruses. For each variant, we detected nucleotide sequence substitutions which resulted in a single amino acid change in either the G1 or G2 protein. Serological properties of the variant viruses correlated with changes identified by nucleotide sequence analyses. To map epitopes recognized by three G1-specific and six G2-specific, non-neutralizing monoclonal antibodies, we prepared genes, truncated at the carboxy terminal coding regions of G1 or G2, and expressed them with baculovirus recombinants or transiently in a vaccinia/T7 RNA polymerase system. Reactivities of the monoclonal antibodies with the truncated proteins were monitored by immune precipitation of the radiolabeled, truncated glycoproteins. We determined that all three of the G1-specific antibodies reacted with truncated proteins, which retained the amino terminal one-third of G1, but lost reactivity with shorter G1 proteins. The G2-specific antibodies only recognized G2 proteins, which retained approximately 80% of the G2 gene.

Tetrahymena thermophila mutants homozygous for the oad mutation become nonmotile when grown at the restrictive temperature, and axonemes isolated from nonmotile mutants lack approximately 90% of their outer dynein arms. Electrophoretic analyses of axonemes isolated from nonmotile mutants (oad axonemes) indicate they contain significantly fewer of the 22 S dynein heavy chains that axonemes isolated from wild-type cells (wild-type axonemes) contain. The 22 S dynein heavy chains that remain in axonemes isolated from nonmotile, oad mutants are assembled into 22 S dynein particles that exhibit wild-type levels of ATPase activity. Two-dimensional gel electrophoresis of oad axonemes show that they are deficient in no proteins other than those proteins thought to be components of 22 S dynein. This report is the first formal proof that outer dynein arms in Tetrahymena cilia are composed of 22 S dynein.

We have characterized ciliogenesis in a mutant Tetrahymena thermophila that both fails to regain motility following deciliation and that fails to complete cytokinesis. Scanning electron microscopic (SEM) observations revealed that starved deciliated cells regenerated fewer, shorter cilia at the restrictive temperature than similarly treated cells incubated at the permissive temperature. Transmission electron microscopic evaluation of isolated, regenerated cilia revealed no structural abnormalities. Incorporation of S-35 methionine was similar during ciliary regeneration at both the restrictive and permissive temperatures, indicating the mutant phenotype was not due to a simple failure in translation or transcription. Mutant cells incubated in growth medium at the restrictive temperature arrested in cytokinesis and assembled a large number of abnormally short cilia. These cells also developed irregular surface projections that were not visible on wild-type cells. These observations suggest that ciliogenesis can be initiated in growing cells as well as in starved deciliated cells but that elongation is inhibited before cilia reach full length. The mutation was named dcc for defective in ciliogenesis and cytokinesis.

We have characterized a novel, temperature-sensitive mutation affecting motility in Tetrahymena thermophila. Mutants grew and divided normally at the restrictive temperature (38 degrees C), but became nonmotile. Scanning electron microscopic analysis indicated that nonmotile mutants contained the normal number of cilia and that the cilia were of normal length. Transmission electron microscopic analysis indicated that axonemes isolated from nonmotile mutants lacked outer dynein arms, so the mutation was named oad 1 (outer arm deficient). Motile mutants shifted to 38 degrees C under conditions that prevent cell growth and division (starvation) remained motile suggesting that once assembled into axonemes at the permissive temperature (28 degrees C) the outer arm dyneins remain functional at 38 degrees C. Starved, deciliated mutants regenerated a full complement of functional cilia at 38 degrees C, indicating that the mechanism that incorporates the outer arm dynein into developing axonemes is not affected by the oad 1 mutation. Starved, nonmotile mutants regained motility when shifted back to 28 degrees C, but not when incubated with cycloheximide. We interpret these results to rule out the hypothesis that the oad 1 mutation affects the site on the microtubules to which the outer arm dyneins bind. Axonemes isolated from mutants grown for one generation at 38 degrees C had a mean of 6.0 outer arm dyneins, and axonemes isolated from mutants grown for two generations at 38 degrees C had a mean of 3.2 outer arm dyneins. Taken together, these results indicate that the oad 1 mutation affects the synthesis of outer arm dyneins in Tetrahymena.

Previous work suggests that changes in the phosphorylation state of some centrosomal proteins regulate centrosomal activity. The hypothesis that changes in the phosphorylation state of one or more basal body microtubule organizing centre (MTOC) components regulate its ability to nucleate cilia assembly in Tetrahymena thermophila was tested. The MPM-2 antibody, which recognizes phosphorylated epitopes in MTOCs in a variety of organisms, was used to probe immunoblots of cytoskeletal frameworks prepared from starved Tetrahymena, from starved deciliated Tetrahymena, and from a starved deciliated mutant Tetrahymena which failed to initiate ciliogenesis following deciliation. The MPM-2 antibody recognized an identical array of proteins in all blots. These results suggest that, unlike centrosomes, basal body MTOC activity is not regulated by changes in the phosphorylation state of component proteins.

The use of the artificially-produced radioactive isotope Cesium-137 for the measurement of soil erosion is examined in this article as an example of the development of a chemical indicator of a specific environmental stress. The theoretical and methodological bases of the technique ar examined in the context of seven criteria developed to assess the suitability of a technique as a chemical indicator. The type of results available from the application of the technique are demonstrated for research in agricultural ecosystems in Saskatchewan, Canada. The research indicates that mean soil losses within agricultural fields are 2 to 3 times higher than the tolerable soil losses for the area and that net soil export from fields is a poor indicator of the intensity of erosion within the field. The major remaining constraint to the use of the technique is the lack of a standardized sampling and analytical framework for researchers using the procedure.

A temperature-sensitive mutation was isolated that blocks cilia regeneration and arrests growth in Tetrahymena thermophila. Protein and RNA synthesis and ATP production appeared to be largely unaffected at the restrictive temperature, suggesting that the mutation is specific for cilia regeneration and growth. At the restrictive temperature, mutant cells arrested at a specific point in the cell cycle, after macronuclear S phase and shortly before micronuclear mitosis. Arrested cells did not undergo nuclear divisions, DNA replication, or cytokinesis, so the mutation appears to cause true cell cycle arrest. Surprisingly, the mutation does not appear to affect micronuclear mitosis directly but rather some event(s) prior to micronuclear mitosis that must be completed before cells can complete the cell cycle. The cell cycle arrest was transiently complemented by wild-type cytoplasm exchanged during conjugation with a wild-type cell. Each starved, wild-type cell apparently contained enough rescuing factor to support an average of six cell divisions. Thus, this mutation affects assembly and/or function of at least one but not all of the microtubule-based structures in T. thermophila.

The role of Tc in the suppression of immunity has not been widely evaluated although this antibiotic is often prescribed as a long-term therapy [1]. Sporadic reports have indicated that Tc suppresses cellular immunity [2]. However, no data are available concerning the effects of Tc on lymphokine production, especially in human subjects. Peripheral blood mononuclear cells (2 X 10(6)/ml) were obtained from seven normal volunteers and pulsed with 150 micrograms of con A/ml of medium for 3 hr at 37 C. The procedure was carried out in the presence or absence of Tc in RPMI medium under an atmosphere of 5% CO2. The cells were then pelleted, washed, and resuspended in RPMI medium with or without similar concentrations of Tc. Following incubation for 48 hr, the cells were removed and the supernatant was assayed for MIF activities with the use of guinea pig peritoneal macrophages as indicator cells. A change of greater than or equal to 20% in migration was considered significant [3]. Remarkable inhibition of MIF production was noted in cells obtained from five of seven volunteers in the presence of 3 micrograms and 100 micrograms of Tc/ml. ConA-induced inhibition of migration was almost abolished in cell cultures in the presence of 3 micrograms of Tc/ml. Negative inhibition (accelerated migration) was observed in the presence of 100 micrograms of Tc/ml. Macrophage migration in the presence of 100 micrograms of Tc/ml was greater than the migration of control cells. Thus, it appeared that Tc not only interfered with MIF production but also modulated factors involved in the control of normal cell migration.(ABSTRACT TRUNCATED AT 250 WORDS)

This study was designed to examine the effects of tetracycline on DNA and protein synthesis by human lymphocytes treated with Con A. The effects of the drug were also assessed in terms of the in vitro production of the lymphokine, migration inhibitory factor (MIF). The results indicate that marked suppression of protein synthesis occurred in presence of tetracycline at all concentrations including clinically achievable doses. The group mean values of DNA synthesis did not show significant inhibition with lower concentrations of the drug. The marked decline in protein synthesis in tetracycline treated cultures was accompanied by a significant suppression of MIF production. Accelerated migration of macrophages was observed when the lymphocyte supernatant was produced in presence of the higher concentrations of tetracycline (75-100 microliter/ml). These observations suggest that tetracycline interfered with the in vitro correlates of cellular immunity in humans. This raises a possibility that indiscriminate use of the drug might compromise host defenses especially where long-term therapy is prescribed.

We have assayed a series of linker scanner mutants which cover the Xenopus laevis ribosomal gene promoter at approximately ten base pair intervals. All of these mutations adversely affect promoter activity with the exception of one mutation which stimulates activity. Thus, none are neutral. We show that most of the mutations can be partially rescued by ligating a block of enhancer elements upstream of the promoter. In addition, we have made extracts from liver nuclei which produce DNaseI protection footprints over the promoter. Analysis of both strands reveals a prominent footprinting domain from about -5 to -30. However, lesser changes in the digestion pattern are detected over most of the promoter. Previously published analyses have suggested that this promoter might be composed of three functional domains. The experiments presented here suggest that either 1) the three putative domains are so closely arranged that the boundaries are difficult to discern, or 2) the situation is more complex.

Nineteen mutants that are conditional for both the ability to regain motility following deciliation and the ability to grow were isolated. The mutations causing slow growth were placed into five complementation groups. None of the mutations appears to affect energy production as all mutants remained motile at the restrictive temperature. In three complementation groups protein synthesis and the levels of mRNA encoding alpha-tubulin or actin were largely unaffected at the restrictive temperature, consistent with the hypothesis that mutations in these three groups directly affect the assembly of functional cilia and growth. Complementation group 1 was chosen for further characterization. Both phenotypes were shown to be linked, suggesting they are caused by a single mutation. Group 1 mutants regenerated cilia at the restrictive temperature, but the cilia were nonmotile. This mutation also caused a block in cytokinesis at the restrictive temperature but did not affect nuclear divisions or DNA synthesis. The block in cell division was transiently rescued by wild-type cytoplasm exchanged when mutants were paired with wild-type cells during conjugation (round 1 of genomic exclusion). Thus, at least one mutation has been isolated that affects assembly of some microtubule-based structures in Tetrahymena (cilia during regeneration) but not others (nuclei divide at 38 degrees), and the product of this gene is likely to play a role in both ciliary function and in cytokinesis.

The effect of methylation of X. laevis rDNA on its transcription was tested by methylating all of the HpaII sites in a series of rDNA plasmids and injecting the methylated rDNA into X. borealis oocytes. Analysis of RNA transcribed from the injected plasmids showed that methylation of rDNA in vitro does not affect transcription of X. laevis ribosomal genes. This result suggests that despite the observed correlation between demethylation of rDNA and synthesis of ribosomal RNA in X. laevis embryos (1), methylation of rDNA does not regulate transcription of the gene.