Effect of Bimagrumab vs Placebo on Body Fat Mass Among Adults With Type 2 Diabetes and Obesity: A Phase 2 Randomized Clinical Trial.

Importance: Antibody blockade of activin type II receptor (ActRII) signaling stimulates skeletal muscle growth. Previous clinical studies suggest that ActRII inhibition with the monoclonal antibody bimagrumab also promotes excess adipose tissue loss and improves insulin resistance.

Objective: To evaluate the efficacy and safety of bimagrumab on body composition and glycemic control in adults with type 2 diabetes and overweight and obesity.

Impaired lung function following e-cigarette or vaping product use associated lung injury in the first cohort of hospitalized adolescents.

Background: Beginning June 2019, Children's Wisconsin was the first hospital to identify a cohort of adolescent patients hospitalized with symptoms likely associated with e-cigarette use. Our report adds to the growing literature describing the radiographic, gross and cytopathologic bronchoscopic findings, and short-term lung function outcomes in this cohort of adolescents with e-cigarette or vaping product use associated lung injury (EVALI).

Methods: We present 15 adolescents hospitalized from June to September, 2019 with confirmed EVALI.

Novel track morphotypes from new tracksites indicate increased Middle Jurassic dinosaur diversity on the Isle of Skye, Scotland.

Dinosaur fossils from the Middle Jurassic are rare globally, but the Isle of Skye (Scotland, UK) preserves a varied dinosaur record of abundant trace fossils and rare body fossils from this time. Here we describe two new tracksites from Rubha nam Brathairean (Brothers' Point) near where the first dinosaur footprint in Scotland was found in the 1980s. These sites were formed in subaerially exposed mudstones of the Lealt Shale Formation of the Great Estuarine Group and record a dynamic, subtropical, coastal margin.

Lactation Consultation Sustains Breast Milk Intake in Infants With Cystic Fibrosis.

Guidelines recommend breastfeeding in cystic fibrosis (CF) but breastfeeding rates decline rapidly in CF. We initiated a quality improvement project to improve breastfeeding in CF by incorporating International Board-Certified Lactation Consultants (IBCLC) into the initial CF-diagnosis visit to support mothers who were breastfeeding at diagnosis. In the preintervention group, only 8/14 (57%) continued to provide breast milk after the first visit, whereas postintervention, 16/17 (94%) mothers continued to do so (P = 0.

Outcomes of a proficiency-based skills curriculum at the beginning of the fourth year for senior medical students entering surgery.

Introduction: We hypothesized that a proficiency-based curriculum administered early in the fourth year to senior medical students (MS4) would achieve outcomes comparable to a similar program administered during surgical internship.

Methods: MS4 (n = 18) entering any surgical specialty enrolled in a proficiency-based skills curriculum at the beginning of the fourth year that included suturing/knot-tying, on-call problems, laparoscopic, and other skills (urinary catheter, sterile prep/drape, IV placement, informed consent, electrosurgical use). Assessment was at 4-12 weeks after training by a modified Objective Structured Assessment of Technical Skills (OSATS).

Quantifying landscape-level methane fluxes in subarctic Finland using a multiscale approach.

Quantifying landscape-scale methane (CH4 ) fluxes from boreal and arctic regions, and determining how they are controlled, is critical for predicting the magnitude of any CH4 emission feedback to climate change. Furthermore, there remains uncertainty regarding the relative importance of small areas of strong methanogenic activity, vs. larger areas with net CH4 uptake, in controlling landscape-level fluxes.

Elderly surgical patients: are there gaps in residency education?

Background: Geriatric education is essential to ensure the competency of residents caring for the aging population. This study assesses and correlates resident and faculty perceptions of resident geriatric-related competencies to clinical care.

Methods: A survey was sent to 40 general surgery residents and 57 faculty members.

Assessing competency in practice-based learning: a foundation for milestones in learning portfolio entries.

Background: Graduate medical education is undergoing a dramatic shift toward competency-based assessment of learners. Competency assessment requires clear definitions of competency and validated assessment methods. The purpose of this study is to identify criteria used by surgical educators to judge competence in Practice-Based Learning and Improvement (PBL&I) as demonstrated in learning portfolios.

Focused parathyroidectomy with intraoperative parathyroid hormone monitoring in patients with lithium-associated primary hyperparathyroidism.

Background: Lithium-associated hyperparathyroidism has been attributed to multigland hyperplasia requiring bilateral exploration and subtotal parathyroidectomy. Recent studies suggest that some patients may have single gland disease and be eligible for minimally invasive parathyroidectomy.

Methods: We performed a retrospective review of a prospective, single institution parathyroid database of 1,010 patients who underwent parathyroidectomy between December 1999 and October 2010.

Tackling technical skills competency: a surgical skills rating tool.

Background: The Accreditation Council for Graduate Medical Education common program requirements mandate a competency-based assignment of duties. To accomplish this, valid and reliable assessment tools must be developed to evaluate competence. This study evaluated a rating tool to assess competence in basic surgical suturing skills.

Surgical management of normocalcemic primary hyperparathyroidism.

Background: Primary hyperparathyroidism (pHPT), typically defined as elevated serum calcium levels associated with inappropriately elevated parathyroid hormone (PTH) levels, can occur also in patients with normal serum calcium levels. This study investigated the characteristics, workup, and surgical management of patients with normocalcemic pHPT.

Methods: A retrospective chart review of a prospectively collected, single-institution parathyroid database was performed on patients with sporadic pHPT who underwent parathyroidectomy between 12/99 and 12/08.

Nonlocalizing imaging studies for hyperparathyroidism: where to explore first?

Background: For patients with primary hyperparathyroidism (pHPT), imaging studies are obtained to facilitate minimally invasive parathyroidectomy. If imaging studies are nonlocalizing, it is not known if exploration should begin on a particular side or gland location.

Study Design: A retrospective review of a prospective parathyroid database was performed.

Normal PTH levels in primary hyperparathyroidism: still the same disease?

Purpose: Previous studies have suggested that primary hyperparathyroidism (pHPT) with only normal parathyroid hormone (PTH) levels is a milder, less symptomatic form of pHPT. This study investigates symptoms, laboratory values, imaging, and outcomes of sporadic pHPT patients with normal PTH values.

Methods: We reviewed our prospectively collected database of 861 patients with sporadic pHPT who underwent parathyroidectomy between December 1999 and June 2010.