Effects of a Gender-Balancing Strategy on Resident Panels in a Primary Care Setting.

Background: Patients often prefer gender concordance when choosing a primary care practitioner. In a trainee setting, this may lead to unequal training opportunities for male and female resident physicians. Residency leadership may be interested in ways to promote balance in patient empanelment.

Update in Outpatient General Internal Medicine: Practice-Changing Evidence Published in 2023.

The expansive scope of internal medicine can make it challenging for clinicians to stay informed about new literature that changes practice. Guideline updates and synthesis of relevant evidence can facilitate incorporation of advancements into clinical practice. The titles and abstracts from the seven general medicine journals with highest impact factors and relevance to outpatient internal medicine were reviewed by six internal medicine physicians.

A zero-valent palladium cluster-organic framework.

Acquiring spatial control of nanoscopic metal clusters is central to their function as efficient multi-electron catalysts. However, dispersing metal clusters on surfaces or in porous hosts is accompanied by an intrinsic heterogeneity that hampers detailed understanding of the chemical structure and its relation to reactivities. Tethering pre-assembled molecular metal clusters into polymeric, crystalline 2D or 3D networks constitutes an unproven approach to realizing ordered arrays of chemically well-defined metal clusters.

Fitting In While Standing Out: Professional Identity Formation, Imposter Syndrome, and Burnout in Early-Career Faculty Physicians.

Purpose: Professional identity formation (PIF) is a dynamic process by which an individual internalizes the core values and beliefs of a specific profession. Within medical education, PIF begins in medical school and continues throughout training and practice. Transitions affect PIF, with a critical transition occurring between medical training and unsupervised practice.

Palpebral Fissure Response to Phenylephrine Indicates Autonomic Dysfunction in Patients With Type 1 Diabetes and Polyneuropathy.

Purpose: The superior and inferior tarsal muscles are sympathetically innervated smooth muscles. Long-term diabetes often leads to microvascular complications, such as, retinopathy and autonomic neuropathy. We hypothesized that diabetes induces (1) sympathetic paresis in the superior and inferior tarsal muscles and that this measure is associated with (2) the severity of diabetic retinopathy, (3) the duration of diabetes, and (4) autonomic function.

Macular oedema and changes in macular thickness in multiple sclerosis patients treated with fingolimod.

Macular oedema is a known side effect to fingolimod, but changes in specific areas of the retina are only sparsely described. Our aim was to investigate the prevalence of macular oedema and characterize macular changes after initiation of fingolimod based on routine ophthalmological examinations in all consecutive patients treated at our hospital. We evaluated macular thickness change from baseline to 3-4 months after initiation of treatment.

Brain spectroscopy reveals that N-acetylaspartate is associated to peripheral sensorimotor neuropathy in type 1 diabetes.

Aims: Emerging evidence shows, that distal symmetric peripheral neuropathy (DSPN) also involves alterations in the central nervous system. Hence, the aims were to investigate brain metabolites in white matter of adults with diabetes and DSPN, and to compare any cerebral disparities with peripheral nerve characteristics.

Methods: In type 1 diabetes, brain metabolites of 47 adults with confirmed DSPN were compared with 28 matched healthy controls using proton magnetic resonance spectroscopy (H-MRS) in the parietal region including the sensorimotor fiber tracts.

Increased Mortality and Comorbidity Associated With Leber's Hereditary Optic Neuropathy: A Nationwide Cohort Study.

Purpose: Leber's hereditary optic neuropathy (LHON) is a mitochondrial genetic disease in which optic neuropathy is considered a key feature. Several other manifestations of LHON have been reported; however, only little is known of their incidence and the life expectancy in LHON patients.

Methods: This study, based on Danish nationwide health registries, included 141 patients diagnosed with LHON and 297 unaffected family members in the maternal line.

Lesson of the month 1: Lobar pulmonary consolidation in an immunocompromised host.

A 19-year-old male with a history of idiopathic panuveitis, currently taking methotrexate and infliximab, presented to our institution with 6 weeks of cough, dyspnoea and fevers. He had failed outpatient antimicrobial therapy. Computerised tomography (CT) of the chest revealed the presence of a lobar pneumonia and he was treated with broad spectrum antibiotics, which did not improve his symptoms.

The effects of napping on the risk of hypertension: a systematic review and meta-analysis.

Objective: The risk of hypertension in adults who regularly take a nap is controversial. The objective of this meta-analysis was to assess the associations between napping and hypertension.

Methods: A literature search was performed using MEDLINE, EMbase and The Cochrane Database of Systematic Reviews from inception through October, 2015.

Cataract surgery education in member countries of the European Board of Ophthalmology.

Purpose: To address the use of and knowledge about skills assessment and competency-based training in cataract surgery in European Board of Ophthalmology (EBO) member countries.

Methods: A survey was emailed directly to all directors of the European societies in ophthalmology. The survey included queries about criteria to undergo training in cataract surgery, regulation of education in cataract surgery, and skills assessment and training methods.

[A varix of the vortex vein ampulla is a rare differential diagnosis of malignant melanoma of the choroid].

Melanoma of the choroid is the most frequent primary intra-ocular malignancy whereas a varix of the vortex vein ampulla is a benign, rare and asymptomatic condition requiring no treatment. A varix of the vortex vein ampulla is usually found accidentally and can easily be mistaken for a choroidal melanoma, a naevus or a haemorrhage. We present a case of a varix of the vortex vein ampulla, which can be distinguished from other more serious conditions by using simple clinical methods.

Safety effects of wider edge lines on rural, two-lane highways.

Although it is generally expected that wider lines will have a positive effect on vehicle safety, there have not been any convincing evidence based on the crash data analysis, partly because of the lack of relevant data. In this paper, the safety effect of wider edge lines was examined by analyzing crash frequency data for road segments with and without wider edge lines. The data from three states, Kansas, Michigan, and Illinois, have been analyzed.

Arabidopsis homologs of the petunia hairy meristem gene are required for maintenance of shoot and root indeterminacy.

Maintenance of indeterminacy is fundamental to the generation of plant architecture and a central component of the plant life strategy. Indeterminacy in plants is a characteristic of shoot and root meristems, which must balance maintenance of indeterminacy with organogenesis. The Petunia hybrida HAIRY MERISTEM (HAM) gene, a member of the GRAS family of transcriptional regulators, promotes shoot indeterminacy by an undefined non-cell-autonomous signaling mechanism(s).

[Photographic screening for diabetic retinopathy in the county of North Jutland. The first fully digitalized telemedicine-screening clinic].

Screening for diabetic retinopathy was introduced in Denmark in 1988. At present, screening is carried out in four of the 14 counties, thus being available to a minority of diabetic subjects. According to the WHO but also the National Board of Health, all diabetic patients should undergo screening for diabetic retinopathy.