Proton Treatment Suppresses Exosome Production in Head and Neck Squamous Cell Carcinoma.

Proton therapy (PT) is emerging as an effective and less toxic alternative to conventional X-ray-based photon therapy (XRT) for patients with advanced head and neck squamous cell carcinomas (HNSCCs) owing to its clustered dose deposition dosimetric characteristics. For optimal efficacy, cancer therapies, including PT, must elicit a robust anti-tumor response by effector and cytotoxic immune cells in the tumor microenvironment (TME). While tumor-derived exosomes contribute to immune cell suppression in the TME, information on the effects of PT on exosomes and anti-tumor immune responses in HNSCC is not known.

Accuracy of Entrustment-Based Assessment: Implications for Programs and Patients.

Although entrustment-supervision ratings are more intuitive compared to other rating scales, it is not known whether their use accurately assesses the appropriateness of care provided by a resident. To determine the frequency of incorrect entrustment ratings assigned by faculty and whether accuracy of an entrustment-supervision scale differed by resident performance when the scripted resident performance level is known. Faculty participants rated standardized residents in 10 videos using a 4-point entrustment-supervision scale.

Gender Differences in Work-Based Assessment Scores and Narrative Comments After Direct Observation.

Background: While some prior studies of work-based assessment (WBA) numeric ratings have not shown gender differences, they have been unable to account for the true performance of the resident or explore narrative differences by gender.

Objective: To explore gender differences in WBA ratings as well as narrative comments (when scripted performance was known).

Design: Secondary analysis of WBAs obtained from a randomized controlled trial of a longitudinal rater training intervention in 2018-2019.

Immune and ionic mechanisms mediating the effect of dexamethasone in severe COVID-19.

Introduction: Severe COVID-19 is characterized by cytokine storm, an excessive production of proinflammatory cytokines that contributes to acute lung damage and death. Dexamethasone is routinely used to treat severe COVID-19 and has been shown to reduce patient mortality. However, the mechanisms underlying the beneficial effects of dexamethasone are poorly understood.

Faculty Perceptions of Frame of Reference Training to Improve Workplace-Based Assessment.

Background: Workplace-based assessment (WBA) is a key assessment strategy in competency-based medical education. However, its full potential has not been actualized secondary to concerns with reliability, validity, and accuracy. Frame of reference training (FORT), a rater training technique that helps assessors distinguish between learner performance levels, can improve the accuracy and reliability of WBA, but the effect size is variable.