A Longitudinal Evaluation of a Multimodal POCUS Curriculum in Pediatric Residents.

Pediatric residency programs often do not include a point of care ultrasound (POCUS) curriculum. We analyzed a novel POCUS curriculum for pediatric residents that incorporated an online question bank (QB), in addition to a traditional teaching model of didactic instruction and hands-on learning experience. Four high-yield POCUS topics were chosen: Focused Assessment by Sonography for Trauma (FAST), soft tissue, lung, and cardiac Residents completed online multiple-choice quizzes before and after each of four in-person learning sessions, taught by ultrasound faculty and fellows.

Nasal Ventilation Mask for Prevention of Upper Airway Obstruction in Patients With Obesity or Obstructive Sleep Apnea.

This project aimed to develop and implement a nasal ventilation mask (NVM) guideline to reduce the incidence of airway obstruction in outpatients undergoing endoscopy procedures. An observational design was used to evaluate implementation of an NVM guideline as the oxygen delivery method for this patient population. An evidence-based guideline for NVM use was developed for patients with obstructive sleep apnea (OSA) and/or an elevated body mass index (BMI) above 35 kg/m² undergoing esophagogastroduodenoscopy and/or colonoscopy procedures at an outpatient endoscopy clinic.

Novel Cellulose-Halloysite Hemostatic Nanocomposite Fibers with a Dramatic Reduction in Human Plasma Coagulation Time.

High-performance cellulose-halloysite hemostatic nanocomposite fibers (CHNFs) are fabricated using a one-step wet-wet electrospinning process and evaluated for human plasma coagulation by activated partial thromboplastin time. These novel biocompatible CHNFs exhibit 2.4 times faster plasma coagulation time compared with the industry gold standard QuikClot Combat Gauze (QCG).

Remodeling of Glycosaminoglycans During Differentiation of Adult Human Bone Mesenchymal Stromal Cells Toward Hepatocytes.

There is a critical need to generate functional hepatocytes to aid in liver repair and regeneration upon availability of a renewable, and potentially personalized, source of human hepatocytes (hHEP). Currently, the vast majority of primary hHEP are obtained from human tissue through cadavers. Recent advances in stem cell differentiation have opened up the possibility to obtain fully functional hepatocytes from embryonic or induced pluripotent stem cells, or adult stem cells.

Preoperative anatomical road mapping reduces variability of operating time, estimated blood loss, and lymph node yield in right colectomy with extended D3 mesenterectomy for cancer.

Objective: To assess the impact of individual patient anatomy on operating time, estimated blood loss (EBL), and lymph node yield in right colectomy with extended D3 mesenterectomy, where surgeons have access to a preoperative 3-D reconstruction of the vascular anatomy of patients before surgery. Data on the impact of individual patient vascular anatomy when surgeons have an anatomical road map as a guide at surgery is still missing in the literature.

Method: Consecutive patients enrolled in an ongoing trial were classified into 4 groups and 2 subgroups using a 3-D vascular anatomy reconstruction derived from the staging CT.

Abbreviated dignity therapy for adults with advanced-stage cancer and their family caregivers: Qualitative analysis of a pilot study.

Objective: Dignity therapy (DT) is designed to address psychological and existential challenges that terminally ill individuals face. DT guides patients in developing a written legacy project in which they record and share important memories and messages with those they will leave behind. DT has been demonstrated to ease existential concerns for adults with advanced-stage cancer; however, lack of institutional resources limits wide implementation of DT in clinical practice.

Abnormal synaptic Ca(2+) homeostasis and morphology in cortical neurons of familial hemiplegic migraine type 1 mutant mice.

Objective: Migraine is among the most common and debilitating neurological conditions. Familial hemiplegic migraine type 1 (FHM1), a monogenic migraine subtype, is caused by gain-of-function of voltage-gated CaV 2.1 calcium channels.

The prevalence of torture and associated symptoms in United States Iraqi refugees.

Iraqi refugees face difficulties resettling in the US, which may be partially due to high rates of torture. This study determines the rates of torture experience, primary and secondary, among Iraqi refugees in the US; and the association to physical and mental health symptoms on arrival. A retrospective review was conducted in 2011 on the post-arrival health screens of Iraqi refugees resettled in Utah in 2008 and 2009.

Early CT for suspected occult scaphoid fractures.

In this study, the use of computed tomography (CT) early in the management of suspected occult scaphoid fractures was evaluated. We retrospectively reviewed the notes and radiology of patients who had scaphoid CT scans over the preceding 3 years. Eighty-four patients that had CT scans within 14 days from injury were identified.

The clinical scaphoid fracture: early computed tomography as a practical approach.

Introduction: Up to 40% of scaphoid fractures are missed at initial presentation as clinical examination and plain radiographs are poor at identifying scaphoid fractures immediately after the injury. Avoiding a delay in diagnosis is essential to prevent the risk of non-union and early wrist arthritis. We demonstrate the use of CT scanning for the early confirmation of a scaphoid fracture.

A study to explore the patient's experience of peritoneal surface malignancies: pseudomyxoma peritonei.

Pseudomyxoma peritonei (PMP) is a rare tumour originating from the appendix and producing extensive mucus accumulation within the abdomen and pelvis. Since UK government policy reinforces the importance of involving patients in the delivery of healthcare, it is essential to explore patients views so that service development can be fully responsive to the patients need. The primary objective of this study was to explore the impact of PMP on the lives of patients.

Meeting the ongoing needs of survivors of rarer cancer.

With more treatment options for people with cancer long-term survivorship is increasing. Physical and psycho-social needs have been identified in survivors of common cancers but very little has been written about the needs of patients with rarer cancers. Patients treated for rarer cancer are discharged to the primary health care team (PHCT), yet little is known about the assessment, management and support of these patients.

Importance of N-linked glycosylation in the functional expression of murine CD1d1.

The mouse CD1d1 glycoprotein is specialized in presenting lipid antigens to a novel class of T cells called natural killer T (NKT) cells. CD1d1 is predicted to contain five potential N-linked glycosylation sites (asparagine residues at positions 25, 38, 60, 128, and 183). Glycosylation has been shown to invariably affect the molecular and functional properties of various glycoproteins, and in the current report it was found that a conservative change of the individual endogenous asparagine residues in CD1d1 to glutamine differentially affected its functional expression.

Protein kinase C delta is a critical regulator of CD1d-mediated antigen presentation.

We have recently demonstrated that the p38 and ERK1/2 MAP kinases play reciprocal roles in the control of CD1d-mediated antigen presentation. Although the use of specific inhibitors for these pathways clearly had an effect, the effects were not complete, leading to speculations that additional pathways were involved. Here, we show that inhibiting protein kinase C delta (PKCdelta) substantially impairs antigen presentation by murine CD1d1 to NKT cells.

Working with the team: strategies employed by hospital cancer nurse specialists to implement their role.

Aim: This paper describes the strategies used by cancer nurse specialists in the UK to implement their role within the multiprofessional team.

Background: The prevalence of cancer increasingly preoccupies the developed world causing concern about the effective use of healthcare resources. The demand to contain healthcare costs and meet the complex needs of patients has led to the development of new and different types of nurse specialist roles.

Challenges to end of life care in the acute hospital setting.

Background: Research exploring patients' care and treatment preferences at the end of life (EOL) suggests they prefer comfort more than life-extension, wish to participate in decision-making, and wish to die at home. Despite these preferences, the place of death for many patients is the acute hospital, where EOL interventions are reported to be inappropriately invasive and aggressive.

Aim: This paper discusses the challenges to appropriate EOL care in acute hospitals in the UK, highlighting how this setting contributes to the patients' and families' care and treatment requirements being excluded from decision-making.

Supportive care in the cancer setting: rhetoric or reality?

Background: Since 1995, UK cancer policy has been directed at organizational changes to secure improvements in treatment outcomes and quality of supportive care for cancer patients. The substantial increase in hospital-based specialist cancer nurses (SCNs) during this time suggests they have a major role to play in the delivery of supportive care.

Aim: To explore how SCNs implemented their role in the context of organizational change and newly-formed multidisciplinary teams.

Oncocytic mucoepidermoid carcinoma of parotid gland origin.

This article reports 3 cases of oncocytic mucoepidermoid carcinoma of the parotid gland and compares them with 9 cases from the literature with emphasis on clinical behavior, treatment, and recurrence rate. The tumor occurs most often in the middle-aged to elderly, with a decided predilection for the parotid gland. All three oncocytic mucoepidermoid carcinomas from the Armed Forces Institute of Pathology series were low grade with extensive oncocytic change.

Migrating third molar: a report of a case.

Pathologic migration is an abnormal change in the position of a tooth within the dental arch. There are many etiologic factors associated with this phenomenon, but the exact cause is often difficult to diagnose. The following is a report of a 42-year-old man exhibiting a unique form of bilateral migration of his mandibular third molars.

Allergic fungal sinusitis: report of 3 cases and review of the literature.

Allergic fungal sinusitis is a form of noninvasive fungal disease resulting from an IgE-mediated hypersensitivity reaction in atopic individuals. Allergic fungal sinusitis can present with a continuum of symptoms. Accumulation of allergic inspissated mucin may cause simple nasal obstruction or progress to facial deformity with osteolytic destruction and intracranial extension.

A rare case of a sebaceous nevus in the external auditory canal.

We report the case of a patient who came to us for evaluation of a progressive unilateral hearing loss and who was found to have a sebaceous nevus in an unusual location: the external auditory canal. A sebaceous nevus is a congenital organoid mass that occurs primarily on the face, scalp, and periauricular regions. Despite the predilection of sebaceous nevi for the head and neck, reports of this lesion rarely appear in the otolaryngology literature.

Differential kinetics and specificity of EBV-specific CD4+ and CD8+ T cells during primary infection.

The generation and maintenance of virus-specific CD4(+) T cells in humans are not well understood. We used short in vitro stimulation assays followed by intracellular cytokine staining to characterize the timing, magnitude, and Ag specificity of CD4(+) T cells over the course of primary EBV infection. Lytic and latent protein-specific CD4(+) T cells were readily detected at presentation with acute infectious mononucleosis and declined rapidly thereafter.