Responding to Interprofessional Microaggressions: Bystander Training-A Virtual Simulation Curriculum for Internal Medicine Residents.

Introduction: Literature demonstrates the detrimental impact of discrimination and microaggressions at personal and institutional levels in the health care workplace. Residents in our program requested curricula to help with addressing manifestations of bias. In response, we designed and implemented an adaptable and reproducible 4-hour virtual simulation session aimed at helping residents identify and constructively respond to microaggressions.

Optimizing leaf nutrient status, growth, and yield parameters in high-density apple orchards (cv. Super chief) via integrated drip irrigation and fertigation techniques.

Nutrients and water are important ecophysiological components for apples' development and productivity. The combination of high-density plantation, drip irrigation, and weekly fertigation not only conserves irrigation water, but also reduces cultivation costs compared to conventional methods. Leaf nutrient analysis provides insight into nutrient levels and assists in determining irrigation and fertigation schedules.

Sleep hygiene a neglected paediatric identity - A cross-sectional study.

Background: Sleep is the physiological need of any human being; its role in paediatric mental and physical development is irreplaceable. However, in recent days, the rising trend of childhood obesity makes it essential to assess the sleep hygiene of the children to know if there is any adjacent association.

Objectives: 1.

More specific feedback: why "confidence" in feedback is too ambiguous.

High quality feedback should be delivered in a timely manner, based on specific direct observation, and formulated to be actionable on the part of the trainee. Utilizing "confidence" as a point of feedback does not meet these criteria given the ambiguity and lack of actionable steps towards improvement. "Confidence"-based feedback makes a judgment about the trainee's internal state leading to potentially gender or culturally biased feedback.

Physiological and perceptual auditory consequences of hunting-related recreational firearm noise exposure in young adults with normal hearing sensitivity.

Purpose: The objective of the current study was to describe outcomes on physiological and perceptual measures of auditory function in human listeners with and without a history of recreational firearm noise exposure related to hunting.

Design: This study assessed the effects of hunting-related recreational firearm noise exposure on audiometric thresholds, oto-acoustic emissions (OAEs), brainstem neural representation of fundamental frequency (F0) in frequency following responses (FFRs), tonal middle-ear muscle reflex (MEMR) thresholds, and behavioral tests of auditory processing in 20 young adults with normal hearing sensitivity.

Results: Performance on both physiological (FFR, MEMR) and perceptual (behavioral auditory processing tests) measures of auditory function were largely similar across participants, regardless of hunting-related recreational noise exposure.

A Comparison of Self-Reported Nonoccupational Noise Exposure in a Large Cohort of Listeners.

Objective: A variety of questionnaires have been developed to describe and quantify occupational and nonoccupational noise exposure, which are associated with hearing loss and tinnitus. The main aim of this study was to compare and contrast three commonly used nonoccupational noise exposure measurement questionnaires in a group of young adults.

Materials And Methods: A total of 197 participants were recruited for this study.

Statins Induce Locomotion and Muscular Phenotypes in That Are Reminiscent of Human Myopathy: Evidence for the Role of the Chloride Channel Inhibition in the Muscular Phenotypes.

The underlying mechanisms for statin-induced myopathy (SIM) are still equivocal. In this study, we employ to dissect possible underlying mechanisms for SIM. We observe that chronic fluvastatin treatment causes reduced general locomotion activity and climbing ability.

Effects of Temporal Envelope Cutoff Frequency, Number of Channels, and Carrier Type on Brainstem Neural Representation of Pitch in Vocoded Speech.

Purpose: The objective of this study was to determine if and how the subcortical neural representation of pitch cues in listeners with normal hearing is affected by systematic manipulation of vocoder parameters.

Method: This study assessed the effects of temporal envelope cutoff frequency (50 and 500 Hz), number of channels (1-32), and carrier type (sine-wave and noise-band) on brainstem neural representation of fundamental frequency ( ) in frequency-following responses (FFRs) to vocoded vowels of 15 young adult listeners with normal hearing.

Results: Results showed that FFR strength (quantified as absolute magnitude divided by noise floor [NF] magnitude) significantly improved with 500-Hz vs.

Diabetes Physical Examination.

The physical examination of the patient with diabetes may have revealed findings that confirm the diagnosis, classify the type of diabetes, and begin to evaluate for the macro- and microvascular complications of diabetes and significant comorbid conditions. While screening for the diagnosis of diabetes occurs with assessment for abnormal blood glucose, given the high rates of morbidity and mortality associated with diabetes, utilization of the physical examination plays a key role in identifying patients at risk for the complications of diabetes. The discussion of elements of the physical examination relevant to the patient with diabetes, both type 1 and type 2, will be discussed in this article.

Pattern and Profile of Co-Sleeping in School-Aged Children.

This cross-sectional study was conducted among parents of children aged 5-12 years to determine the prevalence and pattern of co-sleeping among children,and sleep problems associated with it. Out of 275 children, 269 (97.8%) co-slept.

A scalable, secure, and interoperable platform for deep data-driven health management.

The large amount of biomedical data derived from wearable sensors, electronic health records, and molecular profiling (e.g., genomics data) is rapidly transforming our healthcare systems.

Effectiveness of Simulation Training on Graduate Audiology Students' Auditory Brainstem Response Testing Skills.

Purpose Simulation is a tool commonly used in the clinical training of students within the health professions fields, such as medicine and nursing. The effectiveness of simulation as a teaching technique has been extensively documented in numerous health care professions; however, little is known about the effectiveness of simulation techniques in audiology education. This study assesses the effectiveness of a simulation activity focused on auditory brainstem response (ABR) testing conducted with students of an applied doctoral program in audiology.

An Evaluation of Simulation Techniques in Audiology and Allied Health Professions.

Purpose This study aims to investigate the experiences and opinions of clinical educators from various allied health care fields, including audiology, related to the use of simulation as a teaching technique and determine the status of clinical simulation techniques in training audiology graduate students nationwide. Method An interview was conducted with nine faculty members in the College of Health Professions at Towson University to discuss advantages and challenges of incorporating clinical simulation techniques into student learning. A thematic analysis was used to analyze the interview responses.

Can You Hear Me Now? Helping Faculty Improve Feedback Exchange for Internal Medicine Subspecialty Fellows.

Introduction: Feedback is an important tool that describes an individual's performance in a specific activity. Trainees at all levels grow from feedback exchanges to develop knowledge, skills, and attitudes in their specialty. However, there is a dearth of faculty development on providing advanced trainees feedback effectively.

Human Frequency Following Responses to Filtered Speech.

Objectives: There is increasing interest in using the frequency following response (FFR) to describe the effects of varying different aspects of hearing aid signal processing on brainstem neural representation of speech. To this end, recent studies have examined the effects of filtering on brainstem neural representation of the speech fundamental frequency (f0) in listeners with normal hearing sensitivity by measuring FFRs to low- and high-pass filtered signals. However, the stimuli used in these studies do not reflect the entire range of typical cutoff frequencies used in frequency-specific gain adjustments during hearing aid fitting.

How to select the appropriate method(s) of cytotoxicity analysis of mammalian cells at biointerfaces: A tutorial.

Many individuals perform cell viability assays as a measure of biocompatibility whether the focus of their research is on novel drug discovery, development of novel biomedical devices, or the study of biointerfacial phenomena. In this tutorial paper, the most commonly used methods available to users to perform biocompatibility testing are discussed. This includes a brief introduction into the benefits and drawbacks of the techniques, including which are best used as screening assays, which are better suited to experienced users, the relative cost of the assays per unit, and what detection techniques are most appropriate for use in conjunction with the assays.

The use of vitamin D in preventing post-thyroidectomy hypocalcemia: An endocrinologist survey study.

Objective: To evaluate the use of preoperative vitamin D levels and postoperative vitamin D supplementation among endocrinologists for the prevention of post-thyroidectomy hypocalcaemia.

Methods: Endocrinologist members of the American Thyroid Association (ATA) were contacted via email to complete a 21-question survey, which included both questions about demographic information, and preventing and managing postoperative hypocalcaemia after thyroidectomy. Univariate and multivariate analysis was performed to determine the respondents' use of preoperative vitamin D levels, dose and duration of preoperative vitamin D repletion, decision to delay surgery for low vitamin D levels in the case of a benign or malignant disease, and routine prescription of postoperative calcium or vitamin D supplementation.

Gestational diabetes insipidus: Diagnosis and management.

In the pregnant patient, hypotonic polyuria in the setting of elevated serum osmolality and polydipsia should narrow the differential to causes related to diabetes insipidus (DI). Gestational DI, also called transient DI of pregnancy, is a distinct entity, unique from central DI or nephrogenic DI which may both become exacerbated during pregnancy. These three different processes relate to vasopressin, where increased metabolism, decreased production or altered renal sensitivity to this neuropeptide should be considered.

Frequency Following Response and Speech Recognition Benefit for Combining a Cochlear Implant and Contralateral Hearing Aid.

Multiple studies have shown significant speech recognition benefit when acoustic hearing is combined with a cochlear implant (CI) for a bimodal hearing configuration. However, this benefit varies greatly between individuals. There are few clinical measures correlated with bimodal benefit and those correlations are driven by extreme values prohibiting data-driven, clinical counseling.

Human frequency following responses to iterated rippled noise with positive and negative gain: Differential sensitivity to waveform envelope and temporal fine-structure.

The perceived pitch of iterated rippled noise (IRN) with negative gain (IRNn) is an octave lower than that of IRN with positive gain (IRNp). IRNp and IRNn have identical waveform envelopes (ENV), but differing stimulus waveform fine structure (TFS), which likely accounts for this perceived pitch difference. Here, we examine whether differences in the temporal pattern of phase-locked activity reflected in the human brainstem Frequency Following Response (FFR) elicited by IRNp and IRNn can account for the differences in perceived pitch for the two stimuli.

SWI/SNF and RSC cooperate to reposition and evict promoter nucleosomes at highly expressed genes in yeast.

The nucleosome remodeling complex RSC functions throughout the yeast genome to set the positions of -1 and +1 nucleosomes and thereby determines the widths of nucleosome-depleted regions (NDRs). The related complex SWI/SNF participates in nucleosome remodeling/eviction and promoter activation at certain yeast genes, including those activated by transcription factor Gcn4, but did not appear to function broadly in establishing NDRs. By analyzing the large cohort of Gcn4-induced genes in mutants lacking the catalytic subunits of SWI/SNF or RSC, we uncovered cooperation between these remodelers in evicting nucleosomes from different locations in the promoter and repositioning the +1 nucleosome downstream to produce wider NDRs-highly depleted of nucleosomes-during transcriptional activation.

Acetylation-Dependent Recruitment of the FACT Complex and Its Role in Regulating Pol II Occupancy Genome-Wide in .

Histone chaperones, chromatin remodelers, and histone modifying complexes play a critical role in alleviating the nucleosomal barrier for DNA-dependent processes. Here, we have examined the role of two highly conserved yeast () histone chaperones, facilitates chromatin transcription (FACT) and Spt6, in regulating transcription. We show that the H3 tail contributes to the recruitment of FACT to coding sequences in a manner dependent on acetylation.

Proteinuria, Hypoalbuminemia, and Chronic Lymphocytic Leukemia: An Unusual Trio.

Chronic lymphocytic leukemia (CLL) is a chronic, progressive lymphoproliferative disorder characterized by a monoclonal population of functionally incompetent lymphocytes. Renal involvement is rare and poorly described. A 57-year-old male with no prior medical history was diagnosed with CLL and followed with a watch and wait approach.

Predictors of Severity in Pediatric Scrub Typhus.

Objective: To identify the factors that can predict the severity of scrub typhus in children.

Methods: This prospective study was conducted at a tertiary care teaching hospital between November 2014 to October 2016. All children <12y of age admitted with fever for more than 7d and positive IgM ELISA for scrub typhus were included in the study.

Clinical Profile of Scrub Typhus Meningoencephalitis among South Indian Children.

Re-emerging scrub typhus is gaining recognition as an important cause of paediatric meningoencephalitis in tropics. We studied the clinical profile of scrub typhus meningoencephalitis (STME) in children <12 years. Of 270 serology-confirmed cases of scrub typhus, 14 (5%) had features consistent with STME and 9 (64%) of these children were between 5 and 12 years of age; 12 (85%) children presented to the hospital during the second week of illness.