Implementing Core Entrustable Professional Activities in Undergraduate Medical Education: A Psychometric Study.

Purpose: This study examines the feasibility and psychometric results of an assessment of entrustable professional activities (EPAs) as a core component of the clinical program of assessment in undergraduate medical education, assesses the learning curves for each EPA, explores the time to entrustment, and investigates the dependability of the EPA data based on generalizability theory (G theory) analysis.

Method: Third-year medical students from the University of Minnesota Medical School in 7 required clerkships from May 2022 through April 2023 were assessed. Students were required to obtain at least 4 EPA assessments per week on average from clinical faculty, residents supervising the students, or assessment and coaching experts.

Plant-derived compounds normalize platelet bioenergetics and function in hyperglycemia.

Background: Polyphenols have been shown to decrease oxidative stress and modulate glycemic response. Nevertheless, their effect on platelet bioenergetics and clot structure in diabetes and hyperglycemia is unknown.

Objectives: To investigate the effect of polyphenols on human platelet bioenergetics and its subsequent effect on clot structure in normoglycemia vs acute hyperglycemia .

Affimer reagents as tool molecules to modulate platelet GPVI-ligand interactions and specifically bind GPVI dimer.

Glycoprotein VI (GPVI) plays a key role in collagen-induced platelet aggregation. Affimers are engineered binding protein alternatives to antibodies. We screened and characterized GPVI-binding Affimers as novel tools to probe GPVI function.

[Influence of overtones and undertones on melody recognition with a cochlear implant with SSD].

Many cochlear implant (CI) users have difficulties recognising pitches and melodies because pitch transmission is blurred and shifted. This study investigates whether postlingually deafened adult CI users recognize melodies better when overtones are removed or undertones are added.Fifteen unilaterally postlingually deafened CI users (single sided deafness = SSD) were included aged 22 to 73 years (MW 52, SD 11.

Novel therapeutics and emerging technology in haemostasis and thrombosis: highlights from the British society for haemostasis and thrombosis annual meeting.

The 2023 annual meeting of the British Society for Haemostasis and Thrombosis (BSHT) was held in Birmingham, United Kingdom. The theme of this year's meeting was novel therapeutics and emerging technology. Here, the exciting research presented at the meeting is discussed.

Race and Gender Bias in Clerkship Grading.

Existing literature, as well as anecdotal evidence, suggests that tiered clinical grading systems may display systematic demographic biases. This study aimed to investigate these potential inequities in-depth. Specifically, this study attempted to address the following gaps in the literature: (1) studying grades actually assigned to students (as opposed to self-reported ones), (2) using longitudinal data over an 8-year period, providing stability of data, (3) analyzing three important, potentially confounding covariates, (4) using a comprehensive multivariate statistical design, and (5) investigating not just the main effects of gender and race, but also their potential interaction.

Factors Associated With Health Care Professionals' Choice to Practice in Rural Minnesota.

Importance: Rural health inequities are due in part to a shortage of health care professionals in these areas.

Objective: To determine the factors associated with health care professionals' decisions about where to practice.

Design, Setting, And Participants: This prospective, cross-sectional survey study of health care professionals in Minnesota was administered by the Minnesota Department of Health from October 18, 2021, to July 25, 2022.

A subjective evaluation of different music preprocessing approaches in cochlear implant listeners.

Cochlear implants (CIs) can partially restore speech perception to relatively high levels in listeners with moderate to profound hearing loss. However, for most CI listeners, the perception and enjoyment of music remains notably poor. Since a number of technical and physiological restrictions of current implant designs cannot be easily overcome, a number of preprocessing methods for music signals have been proposed recently.

Fibrin-glycoprotein VI interaction increases platelet procoagulant activity and impacts clot structure.

Background: The glycoprotein VI (GPVI) signaling pathway was previously reported to direct procoagulant platelet activity through collagen binding. However, the impact of GPVI-fibrin interaction on procoagulant platelet development and how it modulates the clot structure are unknown.

Objectives: To determine the effect of GPVI-fibrin interaction on the platelet phenotype and its impact on the clot structure.

Platelet-Neutrophil Interaction and Thromboinflammation in Diabetes: Considerations for Novel Therapeutic Approaches.

Thromboinflammation has become a topic of key interest in cardiovascular disease and the prevention of diabetes complications because of the interplay between thrombosis and inflammation in diabetes. Specifically, the significant risk of vascular thrombotic disease in diabetes highlights the need for new and better therapeutic targets to help manage and prevent vascular thrombo-occlusive disease in this condition. Similarly, the prominent role of inflammation in diabetes has sparked interest in anti-inflammatory agents to better prevent and control vascular disease.

A versatile deep-neural-network-based music preprocessing and remixing scheme for cochlear implant listeners.

While cochlear implants (CIs) have proven to restore speech perception to a remarkable extent, access to music remains difficult for most CI users. In this work, a methodology for the design of deep learning-based signal preprocessing strategies that simplify music signals and emphasize rhythmic information is proposed. It combines harmonic/percussive source separation and deep neural network (DNN) based source separation in a versatile source mixture model.

A Comparative Assessment Study of Known Small-molecule GPVI Modulators.

The GPVI platelet receptor was recently validated as a safe antiplatelet target for the treatment of thrombosis using several peptidic modulators. In contrast, few weakly potent small-molecule GPVI antagonists have been reported. Those that have been published often lack evidence for target engagement, and their biological efficacy cannot be compared because of the natural donor variability associated with the assays implemented.

Does an endocrinology subspecialty residency rotation enhance resident endocrine clinical knowledge?

Background: Internal Medicine (IM) programs offer elective subspecialty rotations in which residents may enroll to supplement the experience and knowledge obtained during general inpatient and outpatient rotations. Objective evidence that these rotations provide enhanced subspecialty specific knowledge is lacking. The purpose of this study was to determine whether exposure to an endocrinology subspecialty rotation enhanced a resident's endocrinology-specific knowledge beyond that otherwise acquired during IM residency.

Impact of the Rural Physician Associate Program on Workforce Outcomes.

Background And Objectives: The Rural Physician Associate Program (RPAP) at the University of Minnesota Medical School (UMMS) is a 9-month rural longitudinal integrated clerkship (LIC) for third-year medical students built on a foundation of family medicine. The purpose of this study was to examine the relationships between participation in the RPAP program and the desired workforce outcomes of practice in Minnesota, primary care specialty (particularly family medicine), and rural practice.

Methods: We analyzed workforce outcomes for UMMS graduates who completed postgraduate training between 1975 and 2017, comparing RPAP participants (n=1,217) to noparticipants (n=7,928).

GPVI (Glycoprotein VI) Interaction With Fibrinogen Is Mediated by Avidity and the Fibrinogen αC-Region.

Objective: GPVI (glycoprotein VI) is a key molecular player in collagen-induced platelet signaling and aggregation. Recent evidence indicates that it also plays important role in platelet aggregation and thrombus growth through interaction with fibrin(ogen). However, there are discrepancies in the literature regarding whether the monomeric or dimeric form of GPVI binds to fibrinogen at high affinity.

Neutrophils can promote clotting via FXI and impact clot structure via neutrophil extracellular traps in a distinctive manner in vitro.

Neutrophils and neutrophil extracellular traps (NETs) have been shown to be involved in coagulation. However, the interactions between neutrophils or NETs and fibrin(ogen) in clots, and the mechanisms behind these interactions are not yet fully understood. In this in vitro study, the role of neutrophils or NETs on clot structure, formation and dissolution was studied with a combination of confocal microscopy, turbidity and permeation experiments.

Effect of anticoagulants on fibrin clot structure: A comparison between vitamin K antagonists and factor Xa inhibitors.

Background: Abnormal clot structure has been identified in patients with thrombotic disorders. Anticoagulant therapy offers clear benefits for thrombosis prevention and treatment by reducing blood clot formation and size; nevertheless, there are limited data on the effects of different anticoagulants, where clotting is initiated with different triggers, on clot structure.

Objectives: Our aim was to investigate the effects of vitamin K antagonists and factor Xa inhibitors on clot structure.

Dynamic human MutSα-MutLα complexes compact mismatched DNA.

DNA mismatch repair (MMR) corrects errors that occur during DNA replication. In humans, mutations in the proteins MutSα and MutLα that initiate MMR cause Lynch syndrome, the most common hereditary cancer. MutSα surveilles the DNA, and upon recognition of a replication error it undergoes adenosine triphosphate-dependent conformational changes and recruits MutLα.

Fibrinogen αC-regions are not directly involved in fibrin polymerization as evidenced by a "Double-Detroit" recombinant fibrinogen mutant and knobs-mimic peptides.

Background: Fibrin polymerization, following fibrinopeptides A and B (FpA, FpB) cleavage, relies on newly exposed α- and β-chains N-termini (GPR, GHR; A-, B-knobs, respectively) engaging preexistent a and b pockets in other fibrin(ogen) molecules' γ- and (B)β-chains C-terminal regions. A role for mostly disordered (A)α-chains C-terminal regions "bridging" between fibrin molecules/fibrils has been proposed.

Objectives: Fibrinogen Detroit is a clinically observed mutation (AαR19 → S) with nonengaging GPS A-knobs.

Interactive Evaluation of a Music Preprocessing Scheme for Cochlear Implants Based on Spectral Complexity Reduction.

Music is difficult to access for the majority of CI users as the reduced dynamic range and poor spectral resolution in cochlear implants (CI), amongst others constraints, severely impair their auditory perception. The reduction of spectral complexity is therefore a promising means to facilitate music enjoyment for CI listeners. We evaluate a spectral complexity reduction method for music signals based on principal component analysis that enforces spectral sparsity, emphasizes the melody contour and attenuates interfering accompanying voices.

A Study of the Validity of the New MCAT Exam.

Purpose: To conduct a study of the validity of the new Medical College Admission Test (MCAT).

Method: Deidentified data for first- and second-year medical students (185 women, 54.3%; 156 men, 45.

Building a Medical Education Outcomes Center: Development Study.

Background: Medical education outcomes and clinical data exist in multiple unconnected databases, resulting in 3 problems: (1) it is difficult to connect learner outcomes with patient outcomes, (2) learners cannot be easily tracked over time through the education-training-practice continuum, and (3) no standard methodology ensures quality and privacy of the data.

Objective: The purpose of this study was to develop a Medical Education Outcomes Center (MEOC) to integrate education data and to build a framework to standardize the intake and processing of requests for using these data.

Methods: An inventory of over 100 data sources owned or utilized by the medical school was conducted, and nearly 2 dozen of these data sources have been vetted and integrated into the MEOC.

Treating and teaching: using publicly available data to explore the relationship between student and patient evaluations of teaching hospitals.

Treating patients and teaching medical students are parallel activities that occur at teaching hospitals. However, the relationship between these activities is poorly understood. There have been multiple calls for assessing the quality of medical education by examining publicly available clinical data but there is minimal evidence linking these variables.

The association between United States Medical Licensing Examination scores and clinical performance in medical students.

United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores are frequently used to evaluate applicants to residency programs. Recent literature questions the value of USMLE scores for evaluation of residency applicants, in part due to a lack of evidence supporting a relationship with clinical performance. This study explored the relationship between USMLE scores and medical students' clinical performance, as measured by the count of honors grades received in core clinical clerkships.

Effect of the flavonoid hesperidin on glucose and fructose transport, sucrase activity and glycaemic response to orange juice in a crossover trial on healthy volunteers.

Although polyphenols inhibit glucose absorption and transport in vitro, it is uncertain whether this activity is sufficient to attenuate glycaemic response in vivo. We examined this using orange juice, which contains high levels of hesperidin. We first used a combination of in vitro assays to evaluate the potential effect of hesperidin and other orange juice components on intestinal sugar absorption and then tested whether this translated to an effect in healthy volunteers.