Progression of anal intraepithelial neoplasia in HIV-positive individuals: predisposing factors.

Background: The aim of the present study was to evaluate patient factors that affect the progression of anal dysplasia in human immunodeficiency virus (HIV)-positive individuals.

Methods: A retrospective cohort study of HIV-positive adults with human papilloma virus related anal lesions was performed from 2012 to 2017. All patients underwent surgical excision or biopsy and fulguration of lesions in the operating room without using high resolution anoscopy.

Examining persistence of acute environmental enrichment-induced anti-sucrose craving effects in rats.

A single, overnight (acute) environmental enrichment (EE; a large environment with conspecifics and novel objects) experience robustly decreases sucrose consumption (taking) and responsiveness to sucrose-paired cues (seeking) in rats. Persisting effects of acute EE on sucrose seeking and taking have not yet been identified. In the present study, rats were trained to self-administer a 10% sucrose solution paired with a compound tone + light stimulus for 10 days in 2-h sessions.

Assessment of Radiation Safety Knowledge Among Urology Residents in the United States.

Urologists are increasingly exposed to fluoroscopy, which can cause cellular damage. Appropriate awareness and safety precautions concerning fluoroscopy are necessary and likely should be a focus during training. We sought to assess radiation safety knowledge among Urology residents in the United States.

Can smartphone vibration provide a valid alternative to tuning forks for use on the ENT ward round?

Background: All patients undergoing tympanomastoid surgery should be assessed post-operatively for a 'dead ear'; however, tuning forks are frequently inaccessible.

Objective: To demonstrate that smartphone-based vibration applications provide equivalent accuracy to tuning forks when performing Weber's test.

Methods: Data were collected on lay participants with no underlying hearing loss.

Does Pre-clerkship Medical Humanities Curriculum Support Professional Identity Formation? Early Insights from a Qualitative Study.

There is a lack of consensus about the outcomes of medical humanities training. In this qualitative study, the authors analyzed pre-clerkship small group discussions to assess the nature of learning in medical humanities. Twenty-two medical students (12 females and 10 males) in three humanities small groups consented to participate.

Continental drift? Do European clinical genetic testing laboratories have a patent problem?

Recent US Supreme Court decisions have invalidated patent claims on isolated genomic DNA, and testing methods that applied medical correlations using conventional techniques. As a consequence, US genetic testing laboratories have a relatively low risk of infringing patents on naturally occurring DNA or methods for detecting genomic variants. In Europe, however, such claims remain patentable, and European laboratories risk infringing them.

Performance based situation awareness observations in a simulated clinical scenario pre and post an educational intervention.

This study compared final year nursing students' error rate and use of strategies to maintain SA when undertaking specific nursing care in a simulated clinical environment pre and 10 weeks post a planned SA education intervention. Students were observed using a Performance Based Situation Awareness Observation Schedule (PBSAOS) undertaking two tasks in a simulated clinical environment pre and post the SA education. For task 1, post educational intervention, there was no significant increase in the error rate for any performance measures, and there were significant decreases in the error rates for three performance measures.

Assessment of Radiation Safety Knowledge among House Staff Exposed to Fluoroscopic Radiation.

Introduction: Urologists are increasingly exposed to fluoroscopy as minimally invasive techniques continue to proliferate. Fluoroscopy, or electromagnetic radiation, can cause cellular damage. Appropriate knowledge of safety precautions for fluoroscopy are necessary and ideally should be taught to physicians in training.

Substance Use, Demographic and Socioeconomic Factors Are Independently Associated With Postpartum HIV Care Engagement in the Southern United States, 1999-2016.

Background: Retention in care (RIC) and viral suppression (VS) are associated with reduced HIV transmission and mortality. Studies addressing postpartum engagement in HIV care have been limited by small sample size, short follow-up, and a lack of data from the Southeast United States.

Methods: HIV-positive adult women with ≥1 prenatal visit at the Vanderbilt Obstetrics Comprehensive Care Clinic from 1999 to 2015 were included.

Metabolic adaptations during negative energy balance and their potential impact on appetite and food intake.

This review examines the metabolic adaptations that occur in response to negative energy balance and their potential putative or functional impact on appetite and food intake. Sustained negative energy balance will result in weight loss, with body composition changes similar for different dietary interventions if total energy and protein intake are equated. During periods of underfeeding, compensatory metabolic and behavioural responses occur that attenuate the prescribed energy deficit.

Are prediction models for vaginal birth after cesarean accurate?

Background: The use of trial of labor after cesarean delivery calculators in the prediction of successful vaginal birth after cesarean delivery gives physicians an evidence-based tool to assist with patient counseling and risk stratification. Before deployment of prediction models for routine care at an institutional level, it is recommended to test their performance initially in the institution's target population. This allows the institution to understand not only the overall accuracy of the model for the intended population but also to comprehend where the accuracy of the model is most limited when predicting across the range of predictions (calibration).

CDK1-CCNB1 creates a spindle checkpoint-permissive state by enabling MPS1 kinetochore localization.

Spindle checkpoint signaling is initiated by recruitment of the kinase MPS1 to unattached kinetochores during mitosis. We show that CDK1-CCNB1 and a counteracting phosphatase PP2A-B55 regulate the engagement of human MPS1 with unattached kinetochores by controlling the phosphorylation status of S281 in the kinetochore-binding domain. This regulation is essential for checkpoint signaling, since MPS1 is not recruited to unattached kinetochores and fails to support the recruitment of other checkpoint proteins.

Activity energy expenditure is an independent predictor of energy intake in humans.

Background: There is evidence that the energetic demand of metabolically active tissue is associated with day-to-day food intake (EI). However, the extent to which behavioural components of total daily energy expenditure (EE) such as activity energy expenditure (AEE) are also associated with EI is unknown. Therefore, the present study examined the cross-sectional associations between body composition, resting metabolic rate (RMR), AEE and EI.

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis.

Objective: Despite a recent surge in literature identifying professional identity formation (PIF) as a key process in physician development, the empiric study of PIF in medicine remains in its infancy. To gain insight about PIF, the authors examined the medical literature and that of two other helping professions.

Methods: The authors conducted a scoping review and qualitative metasynthesis of PIF in medicine, nursing and counselling/psychology.

Understanding surgical education needs in Zambian residency programs from a Resident's perspective.

Introduction: Approximately 100 surgeons in Zambia serve a population of 16 million, a severe shortage in basic surgical care. Surgical education in Zambia and other low-middle income countries has not been well characterized. The aim of this study was to evaluate surgical training resources from a resident perspective.

A new family of dissimilarity metrics for discrete character matrices that include inapplicable characters and its importance for disparity studies.

The use of discrete character data for disparity analyses has become more popular, partially due to the recognition that character data describe variation at large taxonomic scales, as well as the increasing availability of both character matrices co-opted from phylogenetic analysis and software tools. As taxonomic scope increases, the need to describe variation leads to some characters that may describe traits not found across all the taxa. In such situations, it is common practice to treat inapplicable characters as missing data when calculating dissimilarity matrices for disparity studies.

Code Generation in Computational Neuroscience: A Review of Tools and Techniques.

Advances in experimental techniques and computational power allowing researchers to gather anatomical and electrophysiological data at unprecedented levels of detail have fostered the development of increasingly complex models in computational neuroscience. Large-scale, biophysically detailed cell models pose a particular set of computational challenges, and this has led to the development of a number of domain-specific simulators. At the other level of detail, the ever growing variety of point neuron models increases the implementation barrier even for those based on the relatively simple integrate-and-fire neuron model.

Panel Size, Clinician Time in Clinic, and Access to Appointments.

Large panel sizes are often held responsible for worse access to appointments in primary care. We evaluated the relationship between appointment backlog, panel size, and primary care clinician time in clinic, using Spearman correlation and multiple regression in a retrospective analysis. We found no independent association between panel size and days until third next available appointment, but larger panel size adjusted for clinician time in clinic was associated with worse access.

Ketorolac Use and Anastomotic Leak in Elective Colorectal Surgery: A Detailed Analysis.

Background: Recent population-level analyses have linked ketorolac use to adverse outcomes. However, its use is also associated with decreased opioids and faster return of bowel function.

Objective: This study aims to assess the association between ketorolac and anastomotic leak.

An enhanced recovery program in colorectal surgery is associated with decreased organ level rates of complications: a difference-in-differences analysis.

Background: Perioperative care has lacked coordination and standardization. Enhanced recovery programs (ERPs) have been shown to decrease aggregate complications across surgical specialties. We hypothesize that the sustained implementation of an ERP will be associated with a decrease in a broad range of complications at the organ system level.

Point-of-Care Screening for a Current Hepatitis C Virus Infection: Influence on Uptake of a Concomitant Offer of HIV Screening.

Eliminating hepatitis C as a public health threat requires an improved understanding of how to increase testing uptake. We piloted point-of-care testing (POCT) for a current HCV infection in an inner-city Emergency Department (ED) and assessed the influence on uptake of offering concomitant screening for HIV. Over four months, all adults attending ED with minor injuries were first invited to complete an anonymous questionnaire then invited to test in alternating cycles offering HCV POCT or HCV+HIV POCT.

Outpatient Surgical Management for Acquired Buried Penis.

Objective: To demonstrate the safety and feasibility of outpatient surgical management for patients with acquired buried penis (ABP).

Methods: We conducted an Institutional Review Board approved review of patients who underwent surgical repair of ABP at a single institution from September 2014 to August 2017. Patient characteristics, operative details, and 30- and 90-day complications were assessed.

Induction of Labor versus Scheduled Cesarean in Morbidly Obese Women: A Cost-Effectiveness Analysis.

Objective: To assess the costs, complication rates, and harm-benefit tradeoffs of induction of labor (IOL) compared to scheduled cesarean delivery (CD) in women with class III obesity.

Study Design: We conducted a cost analysis of IOL versus scheduled CD in nulliparous morbidly obese women. Primary outcomes were surgical site infection (SSI), chorioamnionitis, venous thromboembolism, blood transfusion, and readmission.

Mechanisms responsible for homeostatic appetite control: theoretical advances and practical implications.

Homeostatic appetite control is part of a psychobiological system that has evolved to maintain an adequate supply of nutrients for growth and maintenance. The system links the physiological needs for energy with the behaviour that satisfies these needs (feeding), and is shaped by excitatory and inhibitory signals. Owing to rapid shifts in the food environment, homeostatic appetite control is not well adapted for modern-day human functioning.

Visible-Light, Iodine-Promoted Formation of -Sulfonyl Imines and -Alkylsulfonamides from Aldehydes and Hypervalent Iodine Reagents.

Alternative synthetic methodology for the direct installation of sulfonamide functionality is a highly desirable goal within the domain of drug discovery and development. The formation of synthetically valuable -sulfonyl imines from a range of aldehydes, sulfonamides, and PhI(OAc)₂ under practical and mild reaction conditions has been developed. According to mechanistic studies described within, the reaction proceeds through an initial step involving a radical initiator (generated either by visible-light or heat) to activate the reacting substrates.