Influx of zwitterionic buffer after intracytoplasmic sperm injection (ICSI) membrane piercing alters the transcriptome of human oocytes.

Purpose/study Question: Does piercing oocyte membranes during ICSI allow the influx of surrounding zwitterionic buffer into human oocytes and result in altered developmental competence?

Methods: Human oocytes directed to IRB-approved research were used to determine the unrestricted influx of surrounding buffer into the oocyte after piercing of membranes via confocal fluorescence microscopy (n = 80 human MII oocytes) and the influence of the select buffer influx of HEPES, MOPS, and bicarbonate buffer on the oocyte transcriptome using ultra-low input RNA sequencing (n = 40 human MII oocytes).

Results: Piercing membranes of human MII oocytes during sham-ICSI resulted in the unrestricted influx of surrounding culture buffer into the oocyte that was beyond technician control. Transcriptome analysis revealed statistically significant decreased cytoskeletal transcripts in the pierced buffer cohorts, higher levels of embryo competency transcripts (IGF2 and G6PD) in the bicarbonate buffer cohort, higher levels of stress-induced transcriptional repressor transcripts (MAF1) in the HEPES and MOPS cohorts, and decreased levels of numerous chromosomal maintenance transcripts (SMC3) in the HEPES buffer cohort.

SilverCloud mental health feasibility study: who will it benefit the most?

Introduction: This study examines the feasibility of SilverCloud therapy for anxiety and/or depression. Findings may help determine SilverCloud effectiveness based on patients' profiles.

Methods: Participants were randomly assigned to the immediate or later therapy groups.

Measuring vaping-related expectancies in young adults: Psychometric evaluation of the Electronic Nicotine Vaping Outcomes (ENVO) scale.

Objective: Electronic cigarettes are the most commonly used tobacco products by young adults. Measures of beliefs about outcomes of use (i.e.

Single dose topical inserts containing tenofovir alafenamide fumarate and elvitegravir provide pre- and post-exposure protection against vaginal SHIV infection in macaques.

Background: Vaginal products for HIV prevention that can be used on-demand before or after sex may be a preferable option for women with low frequency or unplanned sexual activity or who prefer not to use daily or long-acting pre-exposure prophylaxis (PrEP). We performed dose ranging pharmacokinetics (PK) and efficacy studies of a vaginally applied insert containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) in macaques under PrEP or post-exposure prophylaxis (PEP) modalities.

Methods: PK studies were performed in 3 groups of pigtailed macaques receiving inserts with different fixed-dose combinations of TAF and EVG (10/8, 20/16 and 40/24 mg).

Parent's Hesitation with COVID-19 Vaccinations in Infants and Children Aged 6 Months to 5 Years.

We implemented an in-person survey of parents/guardians concerning COVID-19 vaccine for a predominantly African-American Medicaid pediatric patient population between the ages of 6-59 months at a Children's Hospital General Pediatric Clinic in Norfolk, VA. Vaccine hesitancy was predominantly based on concerns surrounding safety and overall need for the vaccine.

Association of U.S. birth, duration of residence in the U.S., and atherosclerotic cardiovascular disease risk factors among Asian adults.

Introduction: Prior studies have shown a direct association between U.S. birth and duration of residence with atherosclerotic cardiovascular disease (ASCVD) though, few have specifically focused on Asian Americans.

Prevalence and Predictors of Premature Coronary Heart Disease Among Asians in the United States: A National Health Interview Survey Study.

Identifying Asian subgroups with higher risk of premature coronary heart disease (CHD) can help implement targeted strategies to prevent future CHD events. We conducted this National Health Interview Survey study from 2006 to 2015 among participants with history of CHD to compare the risk of premature CHD (<65 for women and <55 years old for men) across Whites, Chinese, Asian Indians, Filipinos, and "other Asians" (Japanese, Korean, and Vietnamese individuals) using univariate and multi-variable logistic regression models. A total of 17,266 participants with history of CHD (mean age, 66.

Reassessing career pathways of surgical leaders: An examination of surgical leaders' early accomplishments.

Background: The American College of Surgeon (ACS), American Surgical Association (ASA), Association of Women Surgeons (AWS), and Society of Black Academic Surgeons (SBAS) partnered to gain insight into whether inequities found in surgical society presidents may be present earlier.

Methods: ACS, ASA, AWS, and SBAS presidents' CVs were assessed for demographics and scholastic achievements at the time of first faculty appointment. Regression analyses controlling for age were performed to determine relative differences across societies.

Low-Frequency Transcranial Magnetic Stimulation (LF-TMS) in Treating Depression in Patients With Impaired Cognitive Functioning.

Objective: Common methodologies for treating depressive symptoms have demonstrated decreased efficacy among individuals with impaired cognitive functioning. While transcranial magnetic stimulation (TMS) has been approved to treat major depressive disorder, few studies have analyzed the ability of TMS to treat depressive symptoms among individuals with cognitive impairments. The present study had two objectives: to determine whether low-frequency TMS (LF-TMS) might demonstrate efficacy in treating depressive symptoms among individuals with impaired cognitive functioning; and to determine whether LF-TMS might improve neurocognitive functioning above and beyond depressive symptom improvements.

Benchmarking Accomplishments of Leaders in American Surgery and Justification for Enhancing Diversity and Inclusion.

Objective: To comprehensively assess the level of achievement and demographics of national surgical society presidents.

Background: Data on the accomplishments needed to rise to positions of national surgical leadership is scarce and merit alone does not always yield such opportunities. Recognizing the shortcomings of sex and ethnic diversity within academic surgical leadership, the American College of Surgeon (ACS), American Surgical Association (ASA), Association of Women Surgeons (AWS), and the Society of Black Academic Surgeons (SBAS) partnered to address these challenges by performing a comprehensive assessment of their presidents over the last 16 years.

2017 Bangladesh landslides: physical rehabilitation perspective.

Purpose: This report describes the general impact and direct health effects including death and traumatic injuries on populations impacted by the 2017 landslides in the affected hilly and coastal districts in southeastern Bangladesh. The medical response including emergency treatment and rehabilitation provided at pre-hospital and hospital care sites is also described.

Materials And Methods: An electronic literature search of appropriate databases was performed to identify relevant articles on landslides in Bangladesh, Southeast Asia, and other developing countries from 1990-2017.

Applications of Future Technologies to Detect Skill Decay and Improve Procedural Performance.

Medical simulation training has progressed in its use of incorporating various technologies to provide quality training interfaces from novices to experts. The purpose of this paper is to explore modeling, simulation and visualization training technology interfaces to improve precision learning, rigorous, objective assessment, and performance improvement feedback for clinical procedural skill training and sustainment. Technologies to include augmented reality (AR), haptic technology and computer vision will be defined and clarified.

Emerging Roles of Virtual Patients in the Age of AI.

Today's web-enabled and virtual approach to medical education is different from the 20th century's Flexner-dominated approach. Now, lectures get less emphasis and more emphasis is placed on learning via early clinical exposure, standardized patients, and other simulations. This article reviews literature on virtual patients (VPs) and their underlying virtual reality technology, examines VPs' potential through the example of psychiatric intake teaching, and identifies promises and perils posed by VP use in medical education.

Reimagining Medical Education in the Age of AI.

Available medical knowledge exceeds the organizing capacity of the human mind, yet medical education remains based on information acquisition and application. Complicating this information overload crisis among learners is the fact that physicians' skill sets now must include collaborating with and managing artificial intelligence (AI) applications that aggregate big data, generate diagnostic and treatment recommendations, and assign confidence ratings to those recommendations. Thus, an overhaul of medical school curricula is due and should focus on knowledge management (rather than information acquisition), effective use of AI, improved communication, and empathy cultivation.

Pain Management: Time to Minimize Variations in Practice.

There continue to be great variations in the management of pain in palliative care. Efforts need to be made within the field develop strategies to address this to avoid undue distress in patients.

Augmented perineal urethrostomy using a dorsal buccal mucosal graft, bi-institutional study.

Purpose: To present our technique and outcomes for perineal urethrostomy augmented with a dorsal onlay buccal mucosa graft (BMG). Results from initial series and collaboration from an international center are included.

Methods: A retrospective chart review of all adult patients who underwent urethral reconstruction with perineal urethrostomy utilizing a buccal mucosal graft between January 1, 2002 and January 1, 2013 was performed.

Pulmonary function in pectus excavatum patients before repair with the Nuss procedure.

Objectives: Whether the origin of symptoms in pectus excavatum patients (Pex) is related to reduced pulmonary function or impaired cardiovascular performance is debatable. However, pulmonary function testing (PFT) is still part of the evaluation prior to surgical repair in Pex. The purpose of this study was to corroborate our hypothesis that the majority of Pex that qualified for surgery present preoperatively with normal or close to normal PFT.

The role of aldo-keto reductase 1C3 (AKR1C3)-mediated prostaglandin D2 (PGD2) metabolism in keloids.

Keloids are progressively expanding scars, mostly prevalent in individuals of African descent. Previous data identified increased mast cell number and activation state in keloids suggesting a role in disease progression. The major eicosanoid secreted by mast cells is prostaglandin D2 (PGD2), a relatively unstable pro-inflammatory mediator which can be spontaneously converted to 15-deoxy-(Delta12,14)-prostaglandin J2(15d-PGJ2) or enzymatically metabolized to 9α,11β-PGF2 by aldo-keto reductase 1C3 (AKR1C3).

A Pilot Study Measuring the Distribution and Permeability of a Vaginal HIV Microbicide Gel Vehicle Using Magnetic Resonance Imaging, Single Photon Emission Computed Tomography/Computed Tomography, and a Radiolabeled Small Molecule.

Vaginal microbicide gels containing tenofovir have proven effective in HIV prevention, offering the advantage of reduced systemic toxicity. We studied the vaginal distribution and effect on mucosal permeability of a gel vehicle. Six premenopausal women were enrolled.

AAOA allergy primer: history and physical examination.

Background: Allergic disease is very common in the general population and makes a significant impact on the quality of life of patients. Immunoglobulin E (IgE)-mediated allergic disease manifests throughout the body, but many signs and symptoms of inhalant allergy are centered in the head and neck region.

Methods: A thorough yet focused history of allergic symptoms and potential physical examination findings of inhalant allergy are described.

Does tenofovir gel or do other microbicide products affect detection of biomarkers of semen exposure in vitro?

Objectives: There is currently no information on whether products evaluated in HIV microbicide trials affect the detection of the semen biomarkers prostate-specific antigen (PSA) or Y chromosome DNA.

Study Design: We tested (in vitro) dilutions of tenofovir (TFV), UC781 and the hydroxyethylcellulose (HEC) placebo gels using the Abacus ABAcard and the quantitative (Abbott Architect total PSA) assays for PSA and Y chromosome DNA by real-time polymerase chain reaction.

Results: TFV gel and the HEC placebo adversely affected PSA detection using the ABAcard but not the Abbott Architect total PSA assay.