1. Scientific communication: posters and presentations Scott K. Heysell MD, MPH Infectious Diseases and International Health University of Virginia

2. All scientific communication is (polite) argument ▪ Grant ▪ Manuscript ▪ Meeting presentation/poster ▪ Editorial/ letter to the editor ▪ Peer review of another’s manuscript ▪ Letter of recommendation Why did you perform the experiment? Why are your results important? How does your work impact your field of study?

3. Know your audience and the context ▪ Peers ▪ Colleagues familiar with your work ▪ Experts in your field ▪ Experts in a separate but related field ▪ Non-scientific or non-medical community Stairwell conversation Tea time conversation Your thesis dissertation

4. Stairwell conversation “Tuberculosis treatment outcomes are poor, we think in part because of inadequate drug combinations and dosages. We designed a test to see how well a TB patient’s plasma kills their own TB. We hope to use the test to optimize the drug regimen.” “Looking forward to your lecture this week!”

5. Tea time conversation “We believe TB drug regimens can be optimized to improve treatment outcomes. Low circulating drug levels are common but require a lot of resources and expense to measure and their clinical significance remains unclear. We developed a test to measure the killing of a patient’s own plasma while on TB treatment that could be performed in any lab with a MGIT machine. We found the assay correlated well drug levels, particularly for isoniazid and rifampin, the two most important drugs in first-line regimen. In Tanzania, patients had low drug levels and poor plasma killing.” “Can you please pass the sugar?”

6. Thesis dissertation “TB drug regimens can be optimized to improve treatment outcomes, but are dependent upon both achievable drug level and M. tuberculosis MIC. In our study of the TB drug activity assay (TDA) where we co-cultured plasma from TB patients with their own M. tb isolate, we found a better correlation with TDA and drug level/ MIC, than to drug level alone. This occurred despite low drug levels that were still well above the MIC. Not only can TDA serve as an estimate of drug levels in settings without access to HPLC, we think it should be studied in the context of optimizing Cmax/ MIC for key drugs within both a drug-susceptible and a MDR-TB regimen.” “Would you like to fund my grant?”

7. Components of a scientific poster A descriptive title in large font, often referencing the study design Authors names and institutions Abstract Optional to include Background Methods Results Dataxy 147 258 369 ResultsConclusions Implications Support/ Contact Photo People read here

8. Now some examples of my own posters for you to criticize ( load other powerpoint slides)

9. Someone stops at your poster: Introduce yourself  Proceed with the “stairwell” conversation If they appear interested: Offer to walk them through the key results  Proceed with the “tea time” conversation If they are still listening, asking questions: Emphasize the conclusions/implications  Proceed with the “thesis dissertation”

10. Components of a 10 minute oral presentation for scientific meeting Title page  1 slide  30 seconds Background  1 (maybe 2) slides  1-2 minutes Methods  2-3 slides  2-3 minutes Results  3-4 slides (figures/ tables)  4-5 minutes Conclusions  1 slide  1 minute Implications  1 slide  1 minute Acknowledgements  only if not in title page  1 slide < 30 seconds (Leaving 3-5 minutes for questions) Not much time, use wisely

11. Choose the right color font/ background Or else you will lose your audience (this font is too small) Black font / white background Yellow font/ blue background Black font/ yellow background 24 point font is the smallest to use (practice projecting presentation with a colleague before)

12. Choose the right color font/ background Or else you will lose your audience (this font is too small) Black font / white background Yellow font/ blue background Black font/ yellow background 24 point font is the smallest to use (practice projecting presentation with a colleague before)

13. Choose the right color font/ background Or else you will lose your audience (this font is too small) Black font / white background Yellow font/ blue background Black font/ yellow background 24 point font is the smallest to use (practice projecting presentation with a colleague before)

14. Choose the right color font/ background Or else you will lose your audience (this font is too small) Black font / white background Yellow font/ blue background Black font/ yellow background 24 point font is the smallest to use (practice projecting presentation with a colleague before) (An example of what not to choose)

15. Keep powerpoint art to a minimum But it is acceptable to use a header line that does not distract and is kept throughout Header font and text font should be kept the same size throughout Small icons of university or affiliation are common in bottom or top corners, particularly for title page

16. Example of Title and Background slides

17. Blood Cultures for the Diagnosis of Drug-resistant TB in Rural South Africa ASTMH Annual Meeting, 2009 Scott K. Heysell MD, MPH Infectious Diseases and International Health University of Virginia Tugela Ferry Care and Research Collaboration on behalf of: Tania A. Thomas, Neel R. Gandhi, Anthony P. Moll, François Eksteen, Yacoob Coovadia, Lynne Roux, Palav Babaria, Umesh Lalloo, Gerald Friedland and N. Sarita Shah TF CARES Tugela Ferry Care and Research Collaboration

18. Tugela Ferry, KwaZulu-Natal, South Africa Tugela Ferry South Africa TB incidence: 948/100,000 South Africa TB pts co-infected with HIV: 44% Tugela Ferry ~80-90% 2006-2008 >650 cases of MDR and XDR-TB from Tugela Ferry Tugela Ferry TB mortality*: MDR-TB 71% XDR-TB 83% *Gandhi, AJRCCM 2010.

19. Drug-resistant TB Multi-drug resistant (MDR)-TB= resistant to isoniazid and rifampicin Extensively drug-resistant (XDR)-TB= MDR plus resistance to at least one fluoroquinolone and one second-line injectable agent (capreomycin, kanamycin, amikacin)

20. Examples of a Results slide

21. Majority of slow responders in Virginia had low C 2hr levels of isoniazid (INH) and rifampin (RMP) 39 patients had testing to both INH and RMP: 32 (82%) had low levels to either medication

22. static killing †p=0.008 *p=0.07 MIC: [INH <0.03, RMP 0.25] Increasing RMP or INH concentration results in greater TB drug activity

23. Example of Conclusions/ Implications slides

24. ▪ PZA is not inhibitory. EMB may have modest inhibitory effect against some susceptible isolates, but is not additionally inhibitory in combination with INH or RMP (data not shown) or against MDR-TB. TDA is largely a measure of INH and RMP activity Conclusions ▪ At clinically relevant combinations of INH and RMP, TDA reflects measurable additive effect for each drug, particularly when the MIC is low. ▪ As a measure of C max /MIC, TDA may add information beyond conventional drug susceptibility testing or drug levels alone. Summary of results in written form

25. ▪ TDA can be used as estimate of drug activity in resource- limited settings that do not have access to individual drug level measurement (HPLC). Implications ▪ TDA may be used for optimization of drug regimens in patients at risk of poor response to TB treatment. ▪ TDA warrants further study in larger cohorts and in multi- drug resistant TB where other medications are used. Why is the study important, how does it change the field

26. Summary All scientific communication is (polite) argument Remember the audience/context: stairwell conversation, tea time conversation, and thesis dissertation Posters: ▪ leave plenty of blank space ▪ less words and more figures/tables ▪ highlight the top right corner for results and conclusions Presentations: ▪ practice timing, remember to leave 3-5 minutes for questions ▪ project presentation and stand at the back of room to see if all slides are readable Practice, Practice, Practice