Fully online OSCEs: A large cohort case study.

This article was migrated. The article was marked as recommended. Objective Structured Clinical Examinations (OSCEs) are extensively used for clinical assessment in the health professions.

Bilateral Atypical Femur Fractures Complicated by Carbon Fiber Cephalomedullary Nail Fracture: A Case Report.

Case: A 69-year-old woman with a history of breast cancer, on long-term antiresorptive medications, was treated with carbon fiber cephalomedullary nails for bilateral atypical femur fractures. Her thigh pain was presumed to be from metastatic lesions and was treated with radiation without standard imaging. The index procedure was complicated by a left nail fracture.

ITGB2 (Integrin β2) Immunomodulatory Gene Variants in Premature Infants With Necrotizing Enterocolitis.

Aberrant toll-like receptor (TLR) activation is central to necrotizing enterocolitis (NEC) pathogenesis. β2 integrins regulate TLR signaling, and integrin β2 (ITGB2) deficiency causes TLR hyperresponsiveness. To test the hypothesis that ITGB2 genetic variants modulate NEC susceptibility, we sequenced the exonic ITGB2 locus to compare the prevalence of deleterious variants among 221 preterm infants with and without NEC.

A first for forensic genetics in Africa: successful identification of skeletal remains from the marine environment using massively parallel sequencing.

In unrelated circumstances, two young adult males allegedly went missing off the coast of Cape Town, South Africa, within two months of each other. Weeks after the second disappearance, a decomposed human lower limb was recovered from a beach in Cape Town, followed by a washed-up decomposed hand three days later. An item of female clothing was found with the remains, and preliminary analysis of the skeleton indicated a female, leading to confusion regarding the possible identity of the decedent.

Left atrium perforation with lung injury after catheter ablation.

Left atrial perforation is a known complication following pulmonary vein catheter ablation. Our case of a 62-year-old female underwent urgent surgery for repair of left atrium perforation with left pleural effusion as a late complication after multiple transcatheter radiofrequency pulmonary vein ablations for persistent atrial fibrillation.

The association between social emotional development and symptom presentation in autism spectrum disorder.

Understanding differences in social-emotional behavior can help identify atypical development. This study examined the differences in social-emotional development in children at increased risk of an autism spectrum disorder (ASD) diagnosis (infant siblings of children diagnosed with the disorder). Parents completed the Brief Infant-Toddler Social-Emotional Assessment (BITSEA) to determine its ability to flag children with later-diagnosed ASD in a high-risk (HR) sibling population.

Infective endocarditis is associated with worse outcomes in stroke: A Thailand National Database Study.

Background: There is lack of data on the association between infective endocarditis (IE) and outcomes of mortality and complications in stroke. We aimed to compare characteristics and outcomes of stroke patients with and without IE.

Methods: We retrospectively examined the above association using data obtained from an insurance database which covers ~75% of the Thai population.

VOICES: South Island pilot survey of bereaved people.

Aims: To test the feasibility of surveying bereaved next-of-kin in the South Island about their perceptions of end-of-life care for people over 18 years of age; to report results; and to identify issues for future research.

Method: The study used the VOICES (Views of Informal Carers Evaluation of Services) questionnaire from the UK, adapted for use in Aotearoa New Zealand. Identification of next-of-kin for all South Island deaths September-November 2017 was undertaken by a commercial firm specialising in such work.

Tumor Microenvironment Composition and Severe Cytokine Release Syndrome (CRS) Influence Toxicity in Patients with Large B-Cell Lymphoma Treated with Axicabtagene Ciloleucel.

Purpose: One of the challenges of adoptive T-cell therapy is the development of immune-mediated toxicities including cytokine release syndrome (CRS) and neurotoxicity (NT). We aimed to identify factors that place patients at high risk of severe toxicity or treatment-related death in a cohort of 75 patients with large B-cell lymphoma treated with a standard of care CD19 targeted CAR T-cell product (axicabtagene ciloleucel).

Experimental Design: Serum cytokine and catecholamine levels were measured prior to lymphodepleting chemotherapy, on the day of CAR T infusion and daily thereafter while patients remained hospitalized.

Bodies without names: A retrospective review of unidentified decedents at Salt River Mortuary, Cape Town, South Africa, 2010 - 2017.

Background: Decedents who remain unidentified and/or unclaimed following postmortem investigations are an international occurrence. Salt River Mortuary (SRM), one of the largest and busiest mortuaries in Cape Town, South Africa, also experiences this burden; however, little is known about the nature of these cases.

Objectives: To review all cases admitted to SRM between 1 January 2010 and 31 December 2017 (n=26 960), with the objectives of quantifying the number of decedents who remained unidentified, and to better understand circumstances surrounding death and the identification methods that were attempted.

Water-mediated biomolecular dynamics and allostery.

Dynamic coupling with water contributes to regulating the functional dynamics of a biomolecule. We discuss protein-water dynamics, with emphasis on water that is partially confined, and the role of protein-confined water dynamics in allosteric regulation. These properties are illustrated with two systems, a homodimeric hemoglobin from Scapharca inaequivalvis (HbI) and an A adenosine receptor (AAR).

Weight change among repeat participants of an Aboriginal community-based weight loss program.

Background: Community-based weight loss programs may have potential to address overweight and obesity at the population level. However, participation patterns and individual outcomes from these programs are understudied. This study examined repeat participation patterns and participant weight change between contests over seven years of an Aboriginal Australian team-based program in order to identify (1) predictors of repeat participation and (2) associations with weight change between contests.

Roundtable: arguments in support of using multi-parametric prostate MRI protocol.

There is increasing evidence to suggest the value of bi-parametric prostate MRI to replace multi-parametric MRI, which includes the dynamic contrast enhancement (DCE) sequence. In this review, we discuss the value of DCE in select scenarios, specifically in resolving equivocal cases, improving the diagnostic accuracy in the inexperienced reader, rescuing exams in the settings of failed T2W and DWI, detecting biochemical recurrence, while imposing minimal to no risk to the patient with respect to IV gadolinium use, specifically group II agents.

Translation of the Frailty Paradigm from Older Adults to Children with Cardiac Disease.

Children and adolescents with cardiac disease (CCD) have significant morbidity and lower quality of life. However, there are no broadly applicable tools similar to the frailty score as described in the elderly, to define functional phenotype in terms of physical capability and psychosocial wellbeing in CCD. The purpose of this study is to investigate the domains of the frailty in CCD.

Florida neighborhood analysis of social determinants and their relationship to life expectancy.

Background: Social determinants of health (SDOH) contribute to unequal life expectancy (LE). Only a handful of papers have analyzed these relationships at the neighborhood level as opposed to the county level. This study draws on both the SDOH and social vulnerability literature to identify relevant factors affecting LE.

Effect of indium alloying on the charge carrier dynamics of thick-shell InP/ZnSe quantum dots.

Thick-shell InP/ZnSe III-V/II-VI quantum dots (QDs) were synthesized with two distinct interfaces between the InP core and ZnSe shell: alloy and core/shell. Despite sharing similar optical properties in the spectral domain, these two QD systems have differing amounts of indium incorporation in the shell as determined by high-resolution energy-dispersive x-ray spectroscopy scanning transmission electron microscopy. Ultrafast fluorescence upconversion spectroscopy was used to probe the charge carrier dynamics of these two systems and shows substantial charge carrier trapping in both systems that prevents radiative recombination and reduces the photoluminescence quantum yield.

Factors Disrupting Melatonin Secretion Rhythms During Critical Illness.

Objectives: The circadian system modulates many important physiologic processes, synchronizing tissue-specific functions throughout the body. We sought to characterize acute alterations of circadian rhythms in critically ill patients and to evaluate associations between brain dysfunction, systemic multiple organ dysfunction, environmental stimuli that entrain the circadian rhythm (zeitgebers), rest-activity rhythms, and the central circadian rhythm-controlled melatonin secretion profile.

Design: Prospective study observing a cohort for 24-48 hours beginning within the first day of ICU admission.

Stress-Induced Behavioral Quiescence and Abnormal Rest-Activity Rhythms During Critical Illness.

Objectives: To characterize acute alterations of circadian and ultradian rest-activity rhythms in critically ill patients and their association with brain dysfunction, systemic multiple organ dysfunction, and melatonin rhythms.

Design: Prospective study observing a cohort for 48 hours beginning within the first day of ICU admission.

Setting: ICUs within an academic medical center.

Restoration-mediated secondary contact leads to introgression of alewife ecotypes separated by a colonial-era dam.

Secondary contact may have important implications for ecological and evolutionary processes; however, few studies have tracked the outcomes of secondary contact from its onset in natural ecosystems. We evaluated an anadromous alewife ( reintroduction project in Rogers Lake (Connecticut, USA), which contains a landlocked alewife population that was isolated as a result of colonial-era damming. After access to the ocean was restored, adult anadromous alewife were stocked into the lake.

Circulating Interleukin-6 Is Associated with Skeletal Muscle Strength, Quality, and Functional Adaptation with Exercise Training in Mobility-Limited Older Adults.

Background: Human aging is characterized by a chronic, low-grade inflammation suspected to contribute to reductions in skeletal muscle size, strength, and function. Inflammatory cytokines, such as interleukin-6 (IL-6), may play a role in the reduced skeletal muscle adaptive response seen in older individuals.

Objectives: To investigate relationships between circulating IL-6, skeletal muscle health and exercise adaptation in mobility-limited older adults.

Predicting No Show in Voice therapy: Avoiding the Missed Appointment Cycle.

Introduction: Voice therapy plays a critical role in the treatment of voice disorders. Despite positive outcomes in patients who attend voice therapy, otolaryngologists, and speech-language pathologists continue to struggle with patient compliance. Previous studies evaluating the multidisciplinary clinic model have shown better completion, VHI-10 scores, and fewer cancelation and no-shows (NS).

Feasibility and Preliminary Efficacy of a Bright Light Intervention in Ovarian and Endometrial Cancer Survivors.

Background: Cancer-related sleep disturbance is common and can adversely affect physical and mental health. Bright light (BL) therapy is a novel intervention that targets sleep by promoting circadian regulation. Emerging evidence suggests BL can improve sleep disturbance, symptom burden, and health-related quality of life in cancer and other populations; however, this research is limited.

Patient-specific reference values for objective physical function tests: data from the Osteoarthritis Initiative.

Introduction/objective: We aimed to establish sex-specific reference values of objective physical function tests among individuals with or at risk for knee osteoarthritis (KOA) across subsets of age, radiographic KOA severity, and body mass index (BMI).

Method: We included Osteoarthritis Initiative participants with data for objective physical function tests, sex, age, BMI, and radiographic KOA severity (Kellgren-Lawrence [KL] grade) at baseline. Objective physical function was quantified with 20-m walk speed, chair-stand speed, 400-m walk time, and knee extension and flexion strength.