Tools for Medical Education Scholarship: From Curricular Development to Educational Research.

The development of successful educational scholarship, either curricula or medical education research, is vital in ensuring that the field of medical education continues to evolve. Fostering the skills of medical educators in conducting high-quality educational research is essential to this process because publishing such research helps to disseminate best educational practices to the medical community at large. Unfortunately, developing rigorous medical education research can be challenging for pediatric hospitalists within busy clinical settings.

Medical Student H&Ps: Do You Have to Observe Them All At Once?

Objectives: Direct observation of medical students' history and physical examination (H&P) skills by attendings is essential in ensuring trainees' competence. This study compared whether partial observations by multiple pediatric attendings across various clinical encounters versus a full observation by one attending affected students' performance on the pediatric Objective Structured Clinical Examination (OSCE) and the Year 3 Clinical Performance Examination (CPX3).

Methods: For the 2013-2014 and 2014-2015 academic years, 323 medical students submitted either H&P checklists completed by one attending observing an entire H&P (full observations) versus multiple attendings observing portions of the H&P (partial observations).

4-D ICE: A 2-D Array Transducer With Integrated ASIC in a 10-Fr Catheter for Real-Time 3-D Intracardiac Echocardiography.

We developed a 2.5 ×6.6 mm 2 -D array transducer with integrated transmit/receive application-specific integrated circuit (ASIC) for real-time 3-D intracardiac echocardiography (4-D ICE) applications.

Toward Quantitative Assessment of Rheumatoid Arthritis Using Volumetric Ultrasound.

Goal: Rheumatoid arthritis (RA) is characterized by inflammation within the joint space as well as erosion or destruction of the bone surface. We believe that volumetric (3-D) ultrasound imaging of the joints in conjunction with automated image-analysis tools for segmenting and quantifying the regions of interest can lead to improved RA assessment.

Methods: In this paper, we describe our proposed algorithms for segmenting 1) the 3 -D bone surface and 2) the 3-D joint capsule region.

4-D spatiotemporal analysis of ultrasound contrast agent dispersion for prostate cancer localization: a feasibility study.

Currently, nonradical treatment for prostate cancer is hampered by the lack of reliable diagnostics. Contrastultrasound dispersion imaging (CUDI) has recently shown great potential as a prostate cancer imaging technique. CUDI estimates the local dispersion of intravenously injected contrast agents, imaged by transrectal dynamic contrast-enhanced ultrasound (DCE-US), to detect angiogenic processes related to tumor growth.

Packaging and modular assembly of large-area and fine-pitch 2-D ultrasonic transducer arrays.

A promising transducer architecture for largearea arrays employs 2-D capacitive micromachined ultrasound transducer (CMUT) devices with backside trench-frame pillar interconnects. Reconfigurable array (RA) application-specified integrated circuits (ASICs) can provide efficient interfacing between these high-element-count transducer arrays and standard ultrasound systems. Standard electronic assembly techniques such as flip-chip and ball grid array (BGA) attachment, along with organic laminate substrate carriers, can be leveraged to create large-area arrays composed of tiled modules of CMUT chips and interface ASICs.

Simulation training as a mechanism for procedural and resuscitation education for pediatric residents: a systematic review.

Background: Pediatric residents often finish their training lacking sufficient procedural proficiency and resuscitation experience in the care of critically ill children. Simulation is gaining favor in pediatric residency programs as a modality for procedural and resuscitation education. We reviewed the literature assessing simulation and its role in pediatric resident training.

High-fidelity simulation enhances pediatric residents' retention, knowledge, procedural proficiency, group resuscitation performance, and experience in pediatric resuscitation.

Objective: The goal of this study was to assess the effect of high-fidelity simulation (HFS) pediatric resuscitation training on resident performance and self-reported experience compared with historical controls.

Methods: In this case-control study, pediatric residents at a tertiary academic children's hospital participated in a 16-hour HFS resuscitation curriculum. Primary outcome measures included cognitive knowledge, procedural proficiency, retention, and self-reported comfort and procedural experience.

Pilot randomized trial on mindfulness training for smokers in young adult binge drinkers.

Background: We report results of a pilot study designed to test a novel smoking cessation intervention, Mindfulness Training for Smokers (MTS), in smokers age 18-29 years with regular episodes of binge drinking. Mindfulness is a cognitive skill of applying close moment-to-moment attention to experience with a mental posture of acceptance and non-reactivity. The MTS intervention consisted of six weekly classes that provided instruction on how to use mindfulness to manage known precursors of smoking relapse including smoking triggers, strong emotions, stressful situations, addictive thoughts, urges, and withdrawal symptoms.

Volumetric ultrasound and computer-assisted analysis at the point-of-care: a musculoskeletal exemplar.

In this paper we motivate the hypothesis that the use of volumetric ultrasound imaging and automated image analysis tools would improve clinical workflows as well as outcomes at the point-of-care. To make our case, this paper presents results from a rheumatoid arthritis (RA) study where several image analysis techniques have been applied to volumetric ultrasound, highlighting anatomy of interest to better understand disease progression. Pathologies related to RA in joints, manifest themselves commonly as changes in the bone (e.

Intra-urban societal vulnerability to extreme heat: the role of heat exposure and the built environment, socioeconomics, and neighborhood stability.

Extreme heat is an important weather hazard associated with excess mortality and morbidity. We determine the relative importance of heat exposure and the built environment, socioeconomic vulnerability, and neighborhood stability for heat mortality (Philadelphia, PA, USA) or heat distress (Phoenix, AZ, USA), using an ecologic study design. We use spatial Generalized Linear and Mixed Models to account for non-independence (spatial autocorrelation) between neighboring census block groups.

Coordinate suppression of B cell lymphoma by PTEN and SHIP phosphatases.

The inositol phosphatases phosphatase and tensin homologue (PTEN) and Src homology 2 domain-containing inositol phosphatase (SHIP) negatively regulate phosphatidylinositol-3-kinase (PI3K)-mediated growth, survival, and proliferation of hematopoietic cells. Although deletion of PTEN in mouse T cells results in lethal T cell lymphomas, we find that animals lacking PTEN or SHIP in B cells show no evidence of malignancy. However, concomitant deletion of PTEN and SHIP (bPTEN/SHIP(-/-)) results in spontaneous and lethal mature B cell neoplasms consistent with marginal zone lymphoma or, less frequently, follicular or centroblastic lymphoma.

Central lower eyelid thinning with trichiasis: characterization and management of a unique subset of entropion in elderly patients.

Purpose: To characterize the clinical and pathologic features of central lower eyelid thinning with trichiasis and discuss the management of this unique subset of entropion in elderly patients.

Methods: Retrospective study of patients with central lower eyelid thinning with trichiasis who presented between July 1996 and March 2006. Evaluation of management, including surgical intervention, using a modified Quickert "4-snip" block excision combined with lower eyelid retractor plication.

Ocular manifestations of long-term mascara use.

Mascara, a widely used cosmetic, is associated with eye pathology. The authors report 3 cases of eye problems secondary to long-term mascara use. Two patients had multiple pigmented conjunctival lesions; one of these had a history of melanoma of the hand.

Wideband energy reflectance measurements of ossicular chain discontinuity and repair in human temporal bone.

Objective: Recent studies have suggested the potential of wideband energy reflectance (ER) for the assessment of middle ear disorders. The purpose of this study was to examine the use of wideband ER in the evaluation of an ossicular discontinuity and its repair in human cadaver temporal bones.

Design: ER measurements at ambient pressure were made on five human cadaver ears in three conditions: (1) baseline with intact ossicular chain, (2) with the ossicular chain cut using an argon laser, and (3) with the ossicular chain repaired.

Climate change, extreme weather events, and us health impacts: what can we say?

Objective: Address how climate change impacts on a group of extreme weather events could affect US public health.

Methods: A literature review summarizes arguments for, and evidence of, a climate change signal in select extreme weather event categories, projections for future events, and potential trends in adaptive capacity and vulnerability in the United States.

Results: Western US wildfires already exhibit a climate change signal.

Posttraumatic cellulitis and ulcerative conjunctivitis caused by Yersinia enterocolitica O:8.

A 55-year-old white man presented with orbital cellulitis and suspicion of an intraorbital foreign body after ocular trauma. He underwent orbital exploration, but no intraorbital foreign bodies were identified. Intraoperative orbital and conjunctival cultures grew Yersinia enterocolitica O:8.

Cell-type specific and cytoplasmic targeting of PEGylated carbon nanotube-based nanoassemblies.

In this paper we report the fabrication of a multivalent, cell-type specific and cytoplasmic delivery system based on single-walled carbon nanotubes. The latter were functionalized through adsorption of phospholipids terminated by biotinylated PEG chains functionalized with fluorochrome-coupled neutravidin, and subsequently with antibodies (anti-CD3epsilon and anti-CD28) for T cell receptor post-signaling endocytosis and a synthetic fusogenic polymer for disruption of lysosomal compartments. The biomimetic nanoassemblies were composed by PEGylated individual/very small bundles of carbon nanotubes having an average length and a standard deviation of 176 nm and 77 nm, respectively.

Sneezing reflex associated with intravenous sedation and periocular anesthetic injection.

Purpose: To assess and compare the frequency of reflex sneezing occurring during periocular anesthetic injections with and without intravenous sedation.

Design: Retrospective, comparative case series.

Methods: Seven hundred and twenty-two patients undergoing oculoplastic surgical procedures were included in this study.

Evaluation of cochlear hearing disorders: normative distortion product otoacoustic emission measurements.

Objective: The overall objective was to begin the investigation, in humans, of distortion product otoacoustic emission measurements, which are intended to be part of a diagnostic protocol being developed. This protocol, designed to distinguish among different cochlear hearing disorders, has been tested to date only through lesion studies in the gerbil (Mills, Ear and Hearing, 27, 508-525, 2006). To be applied successfully to human subjects, it was required that parameters and procedures for emission measurements be found, which resulted in sufficiently small intersubject variability in normal subjects, among other requirements.

Developing standards for distortion product otoacoustic emission measurements.

Characteristics of distortion product otoacoustic emission (DPOAE) measurements were investigated by comparing responses from two different emission measurement systems in 40 volunteers (78 ears) and making test-retest measurements of each system in 20 ears. For transformation of results between systems, it was shown that the minimum data set consisted of input-output (growth) functions obtained by stepping stimulus levels across a wide range, for each set of stimulus frequencies (1-8 kHz). Linear transformations were considered which involved either recalibration of the emission amplitude (vertical transformation) or of the stimulus levels (horizontal transformation).

The microbiologic spectrum of dacryocystitis: a national study of acute versus chronic infection.

Purpose: To examine the microbiologic spectrum of dacryocystitis, specifically characterizing differences between acute and chronic infection.

Methods: National multicenter prospective study of the microbiologic spectrum of acute and chronic dacryocystitis based on culture results reported between March 2005 and March 2006. Chi-square analysis was used to compare differences between groups.

Floppy eyelid syndrome: quantifying the effect of horizontal tightening on upper eyelid position.

Purpose: To evaluate the change in upper eyelid position after horizontal surgical tightening in patients with floppy eyelid syndrome.

Design: Prospective, noncomparative, interventional case series.

Participants: Eighteen patients with a clinical diagnosis of floppy eyelid syndrome.

Luminescent silica nanobeads: characterization and evaluation as efficient cytoplasmatic transporters for T-lymphocytes.

We report the fabrication and characterization of neutravidin-conjugated silica nanobeads doped with a ruthenium-complex luminophore and functionalized with antihuman CD3, antihuman CD28, and an acid-sensitive polymer. We observed that the nanobeads were readily delivered into Jurkat T leukemia cells by endocytosis, transported into lysosomes and subsequently into the cytoplasm as revealed by pH-sensitive luminescence. Since signs of cytotoxicity were not observed, the reported nanobeads could be an excellent and nontoxic building block for efficient intracellular transporters.