The presence of fear: How subjective fear, not physiological changes, shapes the experience of presence.

When we become engrossed in novels, films, games, or even our own wandering thoughts, we can feel present in a reality distinct from the real world. Although this subjective sense of presence is, presumably, a ubiquitous aspect of conscious experience, the mechanisms that produce it are unknown. Correlational studies conducted in virtual reality have shown that we feel more present when we are afraid, motivating claims that physiological changes contribute to presence; however, such causal claims remain to be evaluated.

Association of length of hospital stay with delay to surgical fixation of hip fracture.

Background: Previous research has shown increases in length of stay (LOS), morbidity and mortality when the standard for surgical fixation of hip fracture of 48 hours is not met. However, few investigators have analyzed LOS as a primary outcome, and most used time of diagnosis as opposed to time of fracture as the reference point. We examined the effect of time to surgical fixation of hip fracture, measured from time of fracture, on length of hospital stay; the secondary outcome was average 1-year mortality.

Olfaction, cholinergic basal forebrain degeneration, and cognition in early Parkinson disease.

Introduction: Impaired olfaction and reduced cholinergic nucleus 4 (Ch4) volume both predict greater cognitive decline in Parkinson's disease (PD). We examined the relationship between olfaction, longitudinal change in cholinergic basal forebrain nuclei and their target regions, and cognition in early PD.

Methods: We analyzed a cohort of 97 PD participants from the Parkinson's Progression Markers Initiative with brain MRIs at baseline, 1 year, 2 years, and 4 years.

Quality Improvement Focused Morbidity and Mortality Rounds: An Integrative Review.

Morbidity and mortality conference (MMC) is a century-old tradition in medicine that was initially primarily focused on the review of surgical outcomes and errors. In recent years, the value of MMC in quality improvement (QI) and patient safety initiatives has been realized and incorporated into the MMCs of some disciplines and institutions. Despite this, there is a need for a standardized structure of MMC that emphasizes both QI and patient safety.

Proactive Control of Emotional Distraction: Evidence From EEG Alpha Suppression.

Biased attention towards emotional stimuli is adaptive, as it facilitates responses to important threats and rewards. An unfortunate consequence is that emotional stimuli can become potent distractors when they are irrelevant to current goals. How can this distraction be overcome despite the bias to attend to emotional stimuli? Recent studies show that distraction by irrelevant flankers is reduced when distractor frequency is high, even if they are emotional.

A Randomized Feasibility Trial of a Novel, Integrative, and Intensive Virtual Rehabilitation Program for Service Members Post-Acquired Brain Injury.

Introduction: Acquired Brain Injury, whether resulting from Traumatic brain injury (TBI) or Cerebral Vascular Accident (CVA), represent major health concerns for the Department of Defense and the nation. TBI has been referred to as the "signature" injury of recent U.S.

Developing an Undergraduate Ultrasound Curriculum: A Needs Assessment.

Background The introduction of ultrasound into the undergraduate medical school curriculum is gaining momentum in North America. At present, many institutions are teaching ultrasound to undergraduate medical students using a traditional framework designed to instruct practicing clinicians, or have modeled the curriculum on other universities. This approach is not based on educational needs or supported by evidence.

Expression of connexin 26 and connexin 43 is reduced in Hirschsprung's disease.

Background: Despite having an optimal pull-through operation, some children with Hirschsprung's disease (HSCR) continue to experience persistent bowel symptoms. Coordinated colonic electrical activity depends on intercellular communication between the enteric nerves, interstitial cells of Cajal (ICCs), smooth muscle cells, and fibroblast-like (platelet-derived growth factor receptor-alpha-positive) cells. Gap junctions are low-resistance channels composed of connexin (Cx) proteins which couple cells electrically and chemically.

Can We CanMEDS? Intangible Learning Through Tangible Simulation Case Development.

The Royal College CanMEDS framework has become a guide for medical school curricula. This framework aims to improve patient care by identifying and explaining seven key roles that physicians must fulfill in order to deliver high-quality healthcare to their patients. While medical schools incorporate these roles in their teaching processes, students can also apply them outside the classroom.

The Impact of a Concussion-U Educational Program on Knowledge of and Attitudes about Concussion.

Background: The diagnosis of a sports-related concussion is often dependent on the athlete self-reporting their symptoms. It has been suggested that improving youth athlete knowledge and attitudes toward concussion may increase self-reporting behaviour. The objective of this study was to determine if a novel Concussion-U educational program improves knowledge of and attitudes about concussion among a cohort of elite male Bantam and Midget AAA hockey players.

Altered tryptophan hydroxylase 2 expression in enteric serotonergic nerves in Hirschsprung's-associated enterocolitis.

Aim: To determine if expression of colonic tryptophan hydroxylase-2 (TPH2), a surrogate marker of neuronal 5-hydroxytryptamine, is altered in Hirschsprung's-associated enterocolitis.

Methods: Entire resected colonic specimens were collected at the time of pull-through operation in children with Hirschsprung's disease (HSCR, n = 12). Five of these patients had a history of pre-operative Hirschsprung's-associated enterocolitis (HAEC).

Blast From the Past: A Retrospective Analysis of Blast-induced Head Injury.

Because of the sharp increase in the number of military personnel exposed to explosive blasts in combat, research has been dedicated toward understanding the impact of explosions on the brain. It is important to consider that potential injuries that military personnel sustain may be both in the form of physical injury as well as "invisible" neuronal and psychological damage. Since the inception of the study of blast science in the Medieval and Renaissance eras, significant improvements have been made in the historical record keeping and biomedical analysis of blast injuries.

Thermal Burns and Smoke Inhalation: A Simulation Session.

In recent years, simulation-based training has seen increased application in medical education. Emergency medicine simulation uses a variety of educational tools to facilitate trainee acquisition of knowledge and skills in order to help achieve curriculum objectives. In this report, we describe the use of a highly realistic human patient simulator to instruct emergency medicine senior residency trainees on the management of a burn patient.

Neuromuscular fatigue of the knee extensors during repeated maximal intensity intermittent-sprints on a cycle ergometer.

Introduction: We studied the time course of neuromuscular fatigue during maximal intensity intermittent-sprint cycling.

Methods: Eight participants completed 10, 10-s sprints interspersed with 180 s of recovery. The power outputs were recorded for each sprint.

Prepubescent males are less susceptible to neuromuscular fatigue following resistance exercise.

Purpose: To determine if prepubescent and adult males have similar fatigue profiles following high and lower intensity knee extensions.

Methods: Ten male children and ten adults completed two sessions of three sets of high repetition (17 typical muscle endurance training) high repetition (High RM) or low repetition (seven typical strength training) maximum (Low RM) dynamic knee extensions. Voluntary and evoked contractile properties, heart rate (HR), and rating of perceived exertion (RPE) were assessed before and after each knee extension RM.

Aerobic activity before and following short-duration static stretching improves range of motion and performance vs. a traditional warm-up.

Many activities necessitate a high degree of static joint range of motion (ROM) for an extended duration. The objective of this study was to examine whether ROM could be improved with a short duration and volume of static stretching within a warm-up, without negatively impacting performance. Ten male recreationally active participants completed 2 separate protocols to examine changes in ROM and performance, respectively, with different warm-ups.

Direct intracranial extension of malignant eccrine spiradenoma of the face.

Unlabelled: Malignant eccrine spiradenomas are exceedingly rare tumours. They are aggressive tumours normally arising in long-standing benign eccrine spiradenomas. We present a case of malignant eccrine spiradenoma of the right side of the face with direct intracranial extension without distant metastasis.

Vascular endothelial growth factor (VEGF), VEGF receptors expression and microvascular density in benign and malignant thyroid diseases.

Angiogenesis is critical for the growth and metastatic spread of tumours. Vascular endothelial growth factor (VEGF) is the most potent inducer of neovasculature, and its increased expression has been related to a worse clinical outcome in many diseases. The purpose of this study was to evaluate the relation between VEGF, its receptors (VEGFR-1 and VEGFR-2) and microvessel density (MVD) in thyroid diseases.

BRAF mutation is unusual in chronic lymphocytic thyroiditis-associated papillary thyroid carcinomas and absent in non-neoplastic nuclear atypia of thyroiditis.

Chronic lymphocytic thyroiditis (CLT) has an epidemiological relationship to papillary thyroid carcinoma (PTC). The follicular epithelium in CLT can be markedly atypical, with cytologic changes ranging from oncocytic morphology to clearing and overlapping. At the molecular level, the association between CLT and PTC is more controversial.

Microsatellite instability in nasopharyngeal and lymphoepithelial carcinomas of the head and neck.

Lymphoepithelial carcinoma (LEC) is a descriptive diagnosis for an undifferentiated carcinoma that has a typical morphologic appearance of large vesicular cells with prominent nucleoli and infiltrating lymphocytes. Tumors with this histopathologic appearance in the head and neck can be categorized as either those that occur in endemic areas, such as Southeast Asia and are associated with Epstein-Barr virus (EBV) infection, or those that occur in other countries and are less commonly associated with EBV. The molecular changes in endemic EBV-related LEC have been fairly well studied and include both alterations in tumor suppressor genes and 1 report of high levels of microsatellite instability.

NM-23 gene loss of heterozygosity and protein expression in high-stage laryngeal squamous cell carcinomas.

Tumor suppressor genes that reduce metastatic potential have been described in a variety of different tumor types. One of the main tumor metastasis suppressor genes is nm-23, which is a nucleoside diphosphate kinase. Two isotypes, nm-23H1 and nm-23H2, have been cloned and map to chromosome 17q21.