Overcome the 60% passing score and improve the quality of assessment.

It is not unusual for institutions around the world to have fixed standards (e.g., 60%) for all of their examinations.

Consensus Guidelines for Practical Competencies in Anatomic Pathology and Laboratory Medicine for the Undifferentiated Graduating Medical Student.

The practice of pathology is not generally addressed in the undergraduate medical school curriculum. It is desirable to develop practical pathology competencies in the fields of anatomic pathology and laboratory medicine for every graduating medical student to facilitate (1) instruction in effective utilization of these services for optimal patient care, (2) recognition of the role of pathologists and laboratory scientists as consultants, and (3) exposure to the field of pathology as a possible career choice. A national committee was formed, including experts in anatomic pathology and/or laboratory medicine and in medical education.

Awareness and Use of Dissolvable Tobacco Products in the United States.

Introduction: Little is known about dissolvable tobacco products (DTPs) compared with other alternative tobacco products (ATPs) like e-cigarettes and snus. We sought to understand US adults' awareness and use of DTPs.

Methods: A nationally representative sample of US adults (age ≥ 18 years, N = 17 522) completed an online survey in March 2013 assessing their awareness and use of DTPs.

Trail Making Test Elucidates Neural Substrates of Specific Poststroke Executive Dysfunctions.

Background And Purpose: Poststroke cognitive impairment is typified by prominent deficits in processing speed and executive function. However, the underlying neuroanatomical substrates of executive deficits are not well understood, and further elucidation is needed. There may be utility in fractionating executive functions to delineate neural substrates.

Late Post-Conditioning with Sevoflurane after Cardiac Surgery--Are Surrogate Markers Associated with Clinical Outcome?

Introduction: In a recent randomized controlled trial our group has demonstrated in 102 patients that late post-conditioning with sevoflurane performed in the intensive care unit after surgery involving extracorporeal circulation reduced damage to cardiomyocytes exposed to ischemia reperfusion injury. On the first post-operative day the sevoflurane patients presented with lower troponin T values when compared with those undergoing propofol sedation. In order to assess possible clinical relevant long-term implications in patients enrolled in this study, we performed the current retrospective analysis focusing on cardiac and non-cardiac events during the first 6 months after surgery.

The Tortoise Transformation as a Prospect for Life Extension.

The value of extending the human lifespan remains a key philosophical debate in bioethics. In building a case against the extension of the species-typical human life, Nicolas Agar considers the prospect of transforming human beings near the end of their lives into Galapagos tortoises, which would then live on decades longer. A central question at stake in this transformation is the persistence of human consciousness as a condition of the value of the transformation.

Residents' Perspectives on Rewards and Challenges of Caring for Ambulatory Care Patients Living With Chronic Illness: Findings From Three Academic Health Centers.

Purpose: To elicit residents' perspectives on rewards and challenges of caring for ambulatory patients with chronic illness and ways to improve their education in caring for these patients.

Method: The authors conducted a qualitative study with internal medicine residents during ambulatory medicine block rotations at three academic health centers from October 2011 through February 2012. Focus group questions covered rewards and challenges of caring for patients with chronic illness and strengths and weaknesses of residency education therein, and the Chronic Care Model provided a framework for interpretation.

Labor patterns in women attempting vaginal birth after cesarean with normal neonatal outcomes.

Objective: We sought to describe labor patterns in women with a trial of labor after cesarean (TOLAC) with normal neonatal outcomes.

Study Design: In a retrospective observational study at 12 US centers (2002 through 2008), we examined time interval for each centimeter of cervical dilation and compared labor progression stratified by spontaneous or induced labor in 2892 multiparous women with TOLAC (second delivery) and 56,301 nulliparous women at 37 0/7 to 41 6/7 weeks of gestation. Analyses were performed including women with intrapartum cesarean delivery, and also limiting only to women who delivered vaginally.

Urinary metabolic signatures of human adiposity.

Obesity is a major public health problem worldwide. We used 24-hour urinary metabolic profiling by proton ((1)H) nuclear magnetic resonance (NMR) spectroscopy and ion exchange chromatography to characterize the metabolic signatures of adiposity in the U.S.

Recognition of elevated blood pressure in an outpatient pediatric tertiary care setting.

Objective: To assess the prevalence of elevated blood pressure (BP) and its identification among outpatients at a pediatric tertiary care hospital and to assess clinician attitudes towards BP management.

Study Design: A retrospective review was undertaken of electronic medical record data of visits over the course of 1 year to 10 subspecialty divisions and 3 primary care services at an urban tertiary care hospital. Interviews of division/service representatives and a clinician survey on perceived role on BP care, practices, and protocols related to BP management were conducted.

Do shared barriers when reporting to work during an influenza pandemic influence hospital workers' willingness to work? A multilevel framework.

Objective: Characteristics associated with interventions and barriers that influence health care workers' willingness to report for duty during an influenza pandemic were identified. Additionally, this study examined whether workers who live in proximal geographic regions shared the same barriers and would respond to the same interventions.

Methods: Hospital employees (n=2965) recorded changes in willingness to work during an influenza pandemic on the basis of interventions aimed at mitigating barriers.

Presentation of glaucoma in the greater Accra metropolitan area of Ghana.

Background: This study addresses the prevalence and clinical presentation of patients with primary open angle glaucoma (POAG) in the greater Accra metropolitan area.

Methods: This is a retrospective case series of 455 patients (813 eyes) at the Emmanuel Eye Clinic. Patients were diagnosed from May 2008 to Nov 2011.

Virtual reality cerebral aneurysm clipping simulation with real-time haptic feedback.

Background: With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping.

Objective: To develop and evaluate the usefulness of a new haptic-based virtual reality simulator in the training of neurosurgical residents.

Methods: A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the ImmersiveTouch platform.

CRIM1 haploinsufficiency causes defects in eye development in human and mouse.

Colobomatous macrophthalmia with microcornea syndrome (MACOM, Online Mendelian Inheritance in Man (OMIM) 602499) is an autosomal dominantly inherited malformation of the eye, which is characterized by microcornea with increased axial length, coloboma of the iris and of the optic disc, and severe myopia. We performed whole-exome sequencing (WES) in two affected individuals from the 2p23-p16-linked MACOM family, which includes 13 affected individuals in 3 generations. As no shared novel variation was found on the linked haplotype, we performed copy number variation (CNV) analysis by comparing the coverage of all exons in the WES data sets of the 2 patients with the coverage of 26 control exomes.

A multicolor panel of TALE-KRAB based transcriptional repressor vectors enabling knockdown of multiple gene targets.

Stable and efficient knockdown of multiple gene targets is highly desirable for dissection of molecular pathways. Because it allows sequence-specific DNA binding, transcription activator-like effector (TALE) offers a new genetic perturbation technique that allows for gene-specific repression. Here, we constructed a multicolor lentiviral TALE-Kruppel-associated box (KRAB) expression vector platform that enables knockdown of multiple gene targets.

Comparison of primary open angle glaucoma patients in rural and urban Ghana.

Purpose: To compare the clinical features of glaucoma patients who present at a rural hospital in North Eastern Ghana and an urban hospital in the capital city of Accra.

Methods: This is a multi-center retrospective case series involving records of newly diagnosed glaucoma patients with emphasis on primary open angle glaucoma (POAG). Information collected included basic demographic data, intraocular pressures and optic disc measurements.

Harnessing the hidden curriculum: a four-step approach to developing and reinforcing reflective competencies in medical clinical clerkship.

Changing the culture of medicine through the education of medical students has been proposed as a solution to the intractable problems of our profession. Yet few have explored the issues associated with making students partners in this change. There is a powerful hidden curriculum that perpetuates not only desired attitudes and behaviors but also those that are less than desirable.

Plummer-Vinson syndrome following gastric bypass surgery.

Plummer-Vinson syndrome (PVS) is the combination of dysphagia, angular cheilitis, atrophic glossitis, and esophageal webbing in the setting of iron deficiency anemia. Although it is relatively uncommon, this condition is important to recognize because it is a source of dysphagia and it confers an increased risk for hypopharyngeal cancer. Cases of PVS associated with gastrointestinal conditions such as celiac disease and gastric cancer have been previously reported in the literature, but as far as we know, no case of PVS associated with bariatric surgery has been previously reported.

Initial steps for quality improvement of obesity care across divisions at a tertiary care pediatric hospital.

Background: Pediatric subspecialists can participate in the care of obese children.

Objective: To describe steps to help subspecialty providers initiate quality improvement efforts in obesity care.

Methods: An anonymous patient data download, provider surveys and interviews assessed subspecialty providers' identification and perspectives of childhood obesity and gathered information on perceived roles and care strategies.

Apolipoprotein L1 gene variants associate with prevalent kidney but not prevalent cardiovascular disease in the Systolic Blood Pressure Intervention Trial.

Apolipoprotein L1 gene (APOL1) G1 and G2 coding variants are strongly associated with chronic kidney disease (CKD) in African Americans (AAs). Here APOL1 association was tested with baseline estimated glomerular filtration rate (eGFR), urine albumin:creatinine ratio (UACR), and prevalent cardiovascular disease (CVD) in 2571 AAs from the Systolic Blood Pressure Intervention Trial (SPRINT), a trial assessing effects of systolic blood pressure reduction on renal and CVD outcomes. Logistic regression models that adjusted for potentially important confounders tested for association between APOL1 risk variants and baseline clinical CVD (myocardial infarction, coronary, or carotid artery revascularization) and CKD (eGFR under 60 ml/min per 1.

miR-let-7f-1 regulates SPARC mediated cisplatin resistance in medulloblastoma cells.

Our previous studies indicate that Secreted Protein Acidic and Rich in Cysteine (SPARC) expression suppressed medulloblastoma tumor growth in vitro and in vivo. Here we sought to determine the effect of SPARC expression in medulloblastoma cells to chemotherapeutic agents. In this study, we show that SPARC expression induces cisplatin resistance in medulloblastoma cells.

A case of acute psychosis in an adolescent male.

Primary hyperparathyroidism (PHPT) is a disorder of calcium homeostasis. We report the case of a 17-year-old adolescent male, who presented with an acute psychosis coinciding with severe hypercalcemia and markedly elevated intact parathyroid hormone (iPTH) level and low vitamin D level. A Sestamibi scan showed a positive signal inferior to the left lobe of the thyroid gland.

Janus kinase inhibitors and allogeneic stem cell transplantation for myelofibrosis.

Myelofibrosis (MF) is a manifestation of several disorders of hematopoiesis, collectively referred to as myeloproliferative neoplasms. Allogeneic hematopoietic stem cell transplantation (ASCT) is the only therapy with proven curative potential. However, most patients with MF are in their 6th or 7th decade of life, and only some of these patients have been considered suitable transplantation candidates.