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Systems consolidation (SC) theory proposes that recent, contextually rich memories are stored in the hippocampus (HPC). As these memories become remote, they are believed to rely more heavily on cortical structures within the prefrontal cortex (PFC), where they lose much of their contextual detail and become schematized. Odor is a particularly evocative cue for intense remote memory recall and despite these memories being remote, they are highly contextual. In instances such as posttraumatic stress disorder (PTSD), intense remote memory recall can occur years after trauma, which seemingly contradicts SC. We hypothesized that odor may shift the organization of salient or fearful memories such that when paired with an odor at the time of encoding, they are delayed in the de-contextualization process that occurs across time, and retrieval may still rely on the HPC, where memories are imbued with contextually rich information, even at remote time points. We investigated this by tagging odor- and non-odor-associated fear memories in male c57BL/6 mice and assessed recall and "c-Fos" expression in the dorsal CA1 (dCA1) and prelimbic cortex (PL) 1 or 21 d later. In support of SC, our data showed that recent memories were more dCA1-dependent whereas remote memories were more PL-dependent. However, we also found that odor influenced this temporal dynamic, biasing the memory system from the PL to the dCA1 when odor cues were present. Behaviorally, inhibiting the dCA1 with activity-dependent DREADDs had no effect on recall at 1 d and unexpectedly caused an increase in freezing at 21 d. Together, these findings demonstrate that odor can shift the organization of fear memories at the systems level.

The incorporation of actors as standardized patients (SPs) to help students achieve learning goals across a range of topics has become widespread in medical education. SPs are integrated into formative and summative objective structured clinical examinations by medical educators and by licensing boards for assessment of competence. While SPs are useful for assessment of dynamic skills, they also have significant utility as an engaging instructional method. Few tools in teaching allow for the breadth of instruction, practice, and assessment offered by workshops involving SPs. A simulated encounter with an SP may be a trainee's only opportunity to experience working through a particular clinical scenario in an environment that carries no risk of significant harm. Thus, there is immense potential for educational innovation with SPs. The following Twelve Tips piece provides suggestions for harnessing this potential based on available literature and educational experiences of the authors. [ABSTRACT FROM AUTHOR]

The short stories "Give or Take" and "I'm Letting Myself Go," by Jennifer H. Fortin are presented.

In spite of the value of autopsy in modern medicine, autopsy rates continue to decline. This decline has been especially pronounced for patients who die of acquired immunodeficiency syndrome (AIDS). In this paper, we assess the attitudes of house officers toward the autopsy in AIDS patients. The survey encompassed 112 internal medicine housestaff (IMHS) and 37 pathology housestaff (PHS) at two New York City university hospitals that care for large numbers of AIDS patients. A self-administered questionnaire rated attitudes and practices concerning the autopsy in AIDS patients. Of IMHS, 83%, and of PHS, 89% answered the questionnaire. The vast majority of IMHS felt that the autopsy rate in persons dying of AIDS was too low; only 39% of PHS shared their view. Of the PHS, 36% felt the rate was too high and should be decreased. These PHS felt the autopsy rarely resulted in useful information and unnecessarily exposed the pathologist to human immunodeficiency virus (HIV) infection. The IMHS wanted more formal training in methods of discussing these issues with the patient and family. We conclude that there is a need for postgraduate teaching programs to educate on issues concerning the autopsy. Specifically, the IMHS need instruction on communicating with the family about the autopsy, and the PHS need instruction on the risks of acquiring AIDS from occupational exposure.