Assessment Tools for Patient Notes in Medical Education: A Scoping Review.

Purpose: Physician proficiency in clinical encounter documentation is a universal expectation of medical education. However, deficiencies in note writing are frequently identified, which have implications for patient safety, health care quality, and cost. This study aimed to create a compendium of tools for educators' practical implementation or future research.

Dysregulated lipid metabolism networks modulate T-cell function in people with relapsing-remitting multiple sclerosis.

Altered cholesterol, oxysterol, sphingolipid, and fatty acid concentrations are reported in blood, cerebrospinal fluid, and brain tissue of people with relapsing-remitting multiple sclerosis (RRMS) and are linked to disease progression and treatment responses. CD4 + T cells are pathogenic in RRMS, and defective T-cell function could be mediated in part by liver X receptors (LXRs)-nuclear receptors that regulate lipid homeostasis and immunity. RNA-sequencing and pathway analysis identified that genes within the 'lipid metabolism' and 'signalling of nuclear receptors' pathways were dysregulated in CD4 + T cells isolated from RRMS patients compared with healthy donors.

Derivation and validation of four patient clusters in Still's disease, results from GIRRCS AOSD-study group and AIDA Network Still Disease Registry.

Background: Different patient clusters were preliminarily suggested to dissect the clinical heterogeneity in Still's disease. Thus, we aimed at deriving and validating disease clusters in a multicentre, observational, prospective study to stratify these patients.

Methods: Patients included in GIRRCS AOSD-study group and AIDA Network Still Disease Registry were assessed if variables for cluster analysis were available (age, systemic score, erythrocyte sedimentation rate (ESR), C reactive protein (CRP) and ferritin).

Faculty and Student Perceptions of Unauthorized Collaborations in the Preclinical Curriculum: Student or System Failure?

Purpose: Unauthorized collaboration among medical students, including the unauthorized provision of assistance and sharing of curricular and assessment materials, is a reported problem. While many faculty view such sharing as academic dishonesty, students do not always perceive these behaviors as problematic. With the trend toward more small-group and team-based learning and the proliferation of resource-sharing and online study aids, collaboration and sharing may have become a student norm.

Impact of Parenteral Prostanoids in Pulmonary Arterial Hypertension: The Relevance of Timing.

Parenteral prostanoids are being recommended in pulmonary arterial hypertension (PAH) treatment, but the prognostic relevance of delayed treatment initiation is still debated. This study assessed the impact of the timing of prostacyclin treatment initiation on reducing PVR and achieving a low-risk profile in PAH patients. The study enrolled 151 patients who started on parenteral prostanoids with different treatment strategies.

Tidal lung hysteresis to interpret PEEP-induced changes in compliance in ARDS patients.

Background: In ARDS, the PEEP level associated with the best respiratory system compliance is often selected; however, intra-tidal recruitment can increase compliance, falsely suggesting improvement in baseline mechanics. Tidal lung hysteresis increases with intra-tidal recruitment and can help interpreting changes in compliance. This study aims to assess tidal recruitment in ARDS patients and to test a combined approach, based on tidal hysteresis and compliance, to interpret decremental PEEP trials.

Comparison of Transforaminal Lumbar Interbody Fusion in the Ambulatory Surgery Center and Traditional Hospital Settings, Part 2: Assessment of Surgical Safety in Medicare Beneficiaries.

(1) Background: The clinical benefits and procedural efficiencies of performing minimally invasive fusion procedures, such as transforaminal lumbar interbody fusion (TLIF), in the ambulatory surgery center (ASC) are becoming increasingly well established. Currently, Medicare does not provide reimbursement for its beneficiaries eligible for TLIF in the ASC due to a lack of evidence regarding procedural safety. However, the initiation of the Hospital Without Walls program allowed for traditional hospital procedures to be relocated to other facilities such as ASCs, providing a unique opportunity to evaluate the utility of TLIF in the ASC in Medicare-age patients.

Activity of fosfomycin/colistin combinations against planktonic and biofilm Gram-negative pathogens.

Objectives: To investigate the in vitro activity of fosfomycin, colistin and combinations thereof against planktonic and biofilm cultures of Gram-negative pathogens, mostly showing MDR phenotypes, at concentrations achievable via inhalation of aerosolized drugs.

Methods: Activity against planktonic cultures was tested by the chequerboard assay with 130 strains, including 52 Pseudomonas aeruginosa, 47 Klebsiella pneumoniae, 19 Escherichia coli, 7 Stenotrophomonas maltophilia and 5 Acinetobacter baumannii. Activity against biofilm cultures was tested by biofilm chequerboard and quantitative antibiofilm assays with a subset of 20 strains.

Porosity of a Fast-Setting Mortar with Crystallization Admixture and Effect of a SA-PA Modification.

Air permeability measurements according to the Hagen-Poiseuille equation, Scanning Electron Microscopy (SEM) and mercury intrusion porosimetry (MIP) tests were conducted on samples of cementitious mortar at different curing times to study the correlation between the increased crystallization and their microstructure. The mortar samples were prepared with a commercial fast-setting premix containing calcium silicates and quartz. The average permeability coefficient (K) was 2.

The P.I.N.K. Study Approach for Supporting Personalized Risk Assessment and Early Diagnosis of Breast Cancer.

Breast cancer is a clear example of excellent survival when it is detected and properly treated in the early stage. Currently, screening of this cancer relies on mammography, which may be integrated by new imaging techniques for more exhaustive evaluation. The Personalized, Integrated, Network, Knowledge (P.

SiGe microelectronic thermoelectric generators with high power and voltage densities.

Microelectronic thermoelectric generators are one potential solution to energizing energy autonomous electronics, such as internet-of-things sensors, that must carry their own power source. However, thermoelectric generators with the mm footprint area necessary for on-chip integration made from high thermoelectric figure-of-merit materials have been unable to produce the voltage and power levels required to run Si electronics using common temperature differences. We present microelectronic thermoelectric generators using SiGe, made by standard Si processing, with high voltage and power generation densities that are comparable to or better than generators using high figure-of-merit materials.

Customized corneal crosslinking for treatment of progressive keratoconus: Clinical and OCT outcomes using a transepithelial approach with supplemental oxygen.

Purpose: To evaluate the outcomes of customized corneal crosslinking (CXL) for treatment of progressive keratoconus (KC) using a transepithelial approach with supplemental oxygen.

Setting: Siena Crosslinking Center, Siena, Italy.

Design: Prospective interventional case series.

New Broad-Spectrum Antibiotics Containing a Pyrrolobenzodiazepine Ring with Activity against Multidrug-Resistant Gram-Negative Bacteria.

It is urgent to find new antibiotic classes with activity against multidrug-resistant (MDR) Gram-negative pathogens as the pipeline of antibiotics is essentially empty. Modified pyrrolobenzodiazepines with a C8-linked aliphatic heterocycle provide a new class of broad-spectrum antibacterial agents with activity against MDR Gram-negative bacteria, including WHO priority pathogens. The structure-activity relationship established that the third ring was particularly important for Gram-negative activity.

A Novel Tool for the Early Identification of Frailty in Elderly People: The Application in Primary Care Settings.

Background: Frailty is a pre-disability condition in older persons providing a challenge to Health-Care Systems. Systematic reviews highlight the absence of a gold-standard for its identification. However, an approach based on initial screening by the General Practitioner (GP) seems particularly useful.

Functional investigation and applications of the acetylesterase activity of the (L.) Osbeck peel.

The hydrolysis of acetyl moieties on a set of commercially relevant substrates was performed by employing the whole tissue of (L.) Osbeck peel as an efficient biocatalyst in mild reaction conditions with high degree of regioselectivity. The reaction is done in aqueous media and the product is easily recovered.

Omeprazole Treatment Enhances Nitrogen Use Efficiency Through Increased Nitrogen Uptake and Assimilation in Corn.

Omeprazole is a selective proton pump inhibitor in humans that inhibits the H/K-ATPase of gastric parietal cells. Omeprazole has been recently shown to act as a plant growth regulator and enhancer of salt stress tolerance. Here, we report that omeprazole treatment in hydroponically grown maize improves nitrogen uptake and assimilation.

Social media in knowledge translation and education for physicians and trainees: a scoping review.

Introduction: The use of social media is rapidly changing how educational content is delivered and knowledge is translated for physicians and trainees. This scoping review aims to aggregate and report trends on how health professions educators harness the power of social media to engage physicians for the purposes of knowledge translation and education.

Methods: A scoping review was conducted by searching four databases (PubMed, Scopus, Embase, and ERIC) for publications emerging between 1990 to March 2018.

Role and Functional Differences of HKT1-Type Transporters in Plants under Salt Stress.

Abiotic stresses generally cause a series of morphological, biochemical and molecular changes that unfavorably affect plant growth and productivity. Among these stresses, soil salinity is a major threat that can seriously impair crop yield. To cope with the effects of high salinity on plants, it is important to understand the mechanisms that plants use to deal with it, including those activated in response to disturbed Na⁺ and K⁺ homeostasis at cellular and molecular levels.

Electronic Knowledge Resources and Point-of-Care Learning: A Scoping Review.

Purpose: The authors sought to summarize quantitative and qualitative research addressing electronic knowledge resources and point-of-care learning in a scoping review.

Method: The authors searched MEDLINE, Embase, PsycINFO, and the Cochrane Database for studies addressing electronic knowledge resources and point-of-care learning. They iteratively revised inclusion criteria and operational definitions of study features and research themes of interest.

Pharmacologic inhibition of protein phosphatase-2A achieves durable immune-mediated antitumor activity when combined with PD-1 blockade.

Mounting evidence suggests that inhibition of protein phosphatase-2A (PP2A), a serine/threonine phosphatase, could enhance anticancer immunity. However, drugs targeting PP2A are not currently available. Here, we report that a PP2A inhibitor, LB-100, when combined with anti-PD-1 (aPD-1) blockade can synergistically elicit a durable immune-mediated antitumor response in a murine CT26 colon cancer model.

A Benzimidazole Proton Pump Inhibitor Increases Growth and Tolerance to Salt Stress in Tomato.

Pre-treatment of tomato plants with micromolar concentrations of omeprazole (OP), a benzimidazole proton pump inhibitor in mammalian systems, improves plant growth in terms of fresh weight of shoot and roots by 49 and 55% and dry weight by 54 and 105% under salt stress conditions (200 mM NaCl), respectively. Assessment of gas exchange, ion distribution, and gene expression profile in different organs strongly indicates that OP interferes with key components of the stress adaptation machinery, including hormonal control of root development (improving length and branching), protection of the photosynthetic system (improving quantum yield of photosystem II) and regulation of ion homeostasis (improving the K:Na ratio in leaves and roots). To our knowledge OP is one of the few known molecules that at micromolar concentrations manifests a dual function as growth enhancer and salt stress protectant.

Clinical phenotypes of US level I trauma centers: use of clustering methodology.

Background: American College of Surgeons Level I Trauma Centers (ACSL1TCs) meet the same personnel and structural requirements but serve different populations. We hypothesized that these nuanced differences may amenable to description through mathematical clustering methodology.

Methods: The National Trauma Data Bank 2014 was used to derive information on ACSL1TCs.

Are You Sure You Want to Do That? Fostering the Responsible Conduct of Medical Education Research.

Engaging in questionable research practices (QRPs) is a noted problem across many disciplines, including medical education. While QRPs are rarely discussed in the context of medical education, that does not mean that medical education researchers are immune. Therefore, the authors seek to raise medical educators' awareness of the responsible conduct of research (RCR) and call the community to action before QRPs negatively affect the field.

Evaluation of a Vibrotactile Simulator for Dental Caries Detection.

Introduction: Developed to educate dental students in caries detection, the VerroTeach simulator allows dental faculty to share, record, and replay the tactile vibrations felt through a dental hand instrument. We assessed this simulation approach by asking experienced dental educators to evaluate the system's real-time and video playback modes.

Methods: VerroTeach uses an accelerometer to sense instrument vibrations and a voice coil actuator to reproduce these vibrations on another tool.