Proximity to Practice: The Role of Technology in the Next Era of Assessment.

The integration of technology into health professions assessment has created multiple possibilities. In this paper, we focus on the challenges and opportunities of integrating technologies that are used during clinical activities or that are completed by raters after a clinical encounter. In focusing on technologies that are more proximal to practice, we identify tradeoffs with different data collection approaches.

Diversity-Related, Student-Led National Medical Organizations: Leadership Opportunities for Learners.

Introduction: In light of the lack of diversity in academic medicine leadership, diversity-related, student-led national medical organizations (NMOs) provide a space for solace and reprieve among common peers while providing an opportunity to develop leadership competencies in a supportive environment. Despite the impact NMOs have had on cultivating generations of leaders in medicine, trainees may not identify opportunities for leadership development that are transferable to future careers in academic medicine.

Methods: We designed and implemented a dynamic 60-minute workshop with an interactive PowerPoint presentation, author-owned video testimonials (from past student leaders of NMOs), two case presentations, and reflection exercises.

Revisiting Injectable Estrogen Dosing Recommendations for Gender-Affirming Hormone Therapy.

Injectable estrogens are options for gender-affirming hormone therapy per guidelines, which suggest intramuscular dosages of 5-30 mg every 2 weeks or 2-10 mg weekly with estradiol cypionate or valerate interchangeably. Data among transgender and gender-diverse patients are limited due to local unavailability and concerns around laboratory assay variability and estradiol (E2) level fluctuation. We note a concerning trend where patients are prescribed high-dose injections based on the guidelines leading to serum E2 levels well above the range recommended in the same guidelines.

Semaglutide-Associated Gastric Pneumatosis.

Semaglutide, a glucagon-like peptide-1 receptor agonist, used for Type 2 diabetes mellitus and more recently for weight loss, often causes gastrointestinal adverse effects such as delayed gastric emptying and abdominal discomfort. Current literature has not described an associated case of gastric pneumatosis with semaglutide use. We report a 61-year-old man on semaglutide for 9 months with gastric pneumatosis.

Pediatric Transplant and Cellular Therapy Consortium RESILIENT Conference on Pediatric Chronic Graft-Versus-Host Disease Survivorship After Hematopoietic Cell Transplantation: Part IV. Patient Important Outcomes.

Chronic graft versus host disease (cGVHD), occurs in approximately one in five pediatric allogeneic HCT patients and is a leading cause of late morbidity and mortality. Late effects of HCT may lead to long-term chronic health conditions and shortened life expectancy. In addition to direct physiological challenges from cGVHD and other late-effects, numerous patient-important outcomes impact the quality of life (QOL) of patients and their families.

The Impact of Interactions with Nonsurgical Staff on the Surgical Resident Experience in the Nonoperative Clinical Learning Environment: A Qualitative Study.

Objective: Residents interact, collaborate with, and learn from nurses, advanced practice providers, and physicians in multiple specialties. Both positive and negative experiences in the clinical workspace can affect residents' well-being, their ability to learn, and their development into effective, independent physicians. The aim of this study is to evaluate the general surgery resident experience in the nonsurgical clinical learning environment to identify how interactions outside of the operating room affect resident well-being and their ability to learn.

Comparative survival of sleeve gastrectomy versus Roux-en-Y gastric bypass in adults with obesity: a systematic review and meta-analysis.

Background: The difference in survival between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) remains controversial.

Objective: To investigate the comparative survival difference between SG and RYGB in adults with morbid obesity.

Setting: A meta-analysis.

Plasma phosphorylated tau and neuropsychiatric symptoms in dementia with Lewy bodies.

Introduction: Neuropsychiatric symptoms (NPSs) are common in dementia with Lewy bodies (DLB) but their neurobiological mechanisms are poorly understood.

Methods: NPSs and cognition were assessed annually in participants (DLB n = 222; Alzheimer's disease [AD] n = 125) from the European DLB (E-DLB) Consortium, and plasma phosphorylated tau-181 (p-tau181) and p-tau231 concentrations were measured at baseline.

Results: Hallucinations, delusions, and depression were more common in DLB than in AD and, in a subgroup with longitudinal follow-up, persistent hallucinations and NPSs were associated with lower p-tau181 and p-tau231 in DLB.

A descriptive examination of rurality in the Environmental influences on Child Health Outcomes Cohort: Implications, illustrations, and future directions.

Purpose: The Environmental influences on Child Health Outcomes (ECHO) Cohort has enrolled over 60,000 children to examine how early environmental factors (broadly defined) are associated with key child health outcomes. The ECHO Cohort may be well-positioned to contribute to our understanding of rural environments and contexts, which has implications for rural health disparities research. The present study examined the outcome of child obesity to not only illustrate the suitability of ECHO Cohort data for these purposes but also determine how various definitions of rural and urban populations impact the presentation of findings and their interpretation.

Epidermal Collagen Reduction Drives Selective Aspects of Aging in Sensory Neurons.

Despite advances in understanding molecular and cellular changes in the aging nervous system, the upstream drivers of these changes remain poorly defined. Here, we investigate the roles of non-neural tissues in neuronal aging, using the cutaneous PVD polymodal sensory neuron in Caenorhabditis elegans as a model. We demonstrate that during normal aging, PVD neurons progressively develop excessive dendritic branching, functionally correlated with age-related proprioceptive deficits.

Association between triglyceride to high-density lipoprotein cholesterol ratio and microalbuminuria in the Chinese population.

The evidence for the association between the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-c) ratio and the risk of developing microalbuminuria is still limited in the Chinese population. Therefore, our research will endeavor to explore the relationship between the two. The cross-sectional survey enrolled 32,877 general population from eight regional centers in China.

Emergency department utilization patterns for pediatric urinary stone patients in the United States.

Background: The prevalence of pediatric urolithiasis has increased rapidly, leading to more emergency department (ED) visits across the United States.

Objective: The purpose of this study was to determine emergency care practices for children and adolescents with urinary stones and characteristics associated with management.

Methods: We performed a cross-sectional study of the 2021 Nationwide Emergency Department Sample to identify pediatric patients (≤21 years) presenting to an ED in the United States with a primary diagnosis of urinary stone disease.

Impact of same-day sleeve gastrectomy surgery on postoperative emergency department visits: analysis from the Michigan Bariatric Surgery Collaborative.

Background: Same-day discharge after sleeve gastrectomy (SDDSG) is being performed in select patient populations with increased regularity since 2020.

Objectives: To evaluate the impact of SDDSG on emergency department (ED) visits.

Setting: Academic and private practice bariatric surgery programs participating in a statewide quality improvement collaborative.

Development and implementation of a 3d-HDR brachytherapy program for cervical cancer in a sub-Saharan African centre.

Background: Cervical cancer is the second most common cancer among women in Nigeria where, the gap between need for, and access to, radiation therapy including brachytherapy is significant. This report documents the implementation of the first three-dimensional high-dose-rate (3D-HDR) brachytherapy service for cervical cancer in Nigeria.

Purpose: This report details the steps taken to implement the 3D-HDR brachytherapy program, the challenges faced, and the adaptive strategies employed to overcome them.

Intraoperative Factors Affecting Pain Management and Postoperative Narcotic Use in Cranial Vault Remodeling: A Retrospective Review.

Perioperative pain control in open cranial vault reconstruction (CVR) poses significant challenges. Narcotic use may confound signs of neurological deterioration and cause medication-induced complications. Previous studies have shown improved health outcomes in CVR with reduced narcotic use.

Optimizing Ewing Sarcoma and Osteosarcoma Biopsy Acquisition: A Children's Oncology Group Bone Tumor Committee Consensus Statement.

Trends in diagnostic biopsy sample collection approaches for primary bone sarcomas have shifted in the past 2 decades. Although open/incisional biopsies used to be the predominant approach to obtain diagnostic material for Ewing sarcoma and osteosarcoma, image-guided core needle biopsies have increased in frequency and are safe for patients. These procedures are less invasive and reduce recovery times but have potential limitations.

Estimated Vaccine Effectiveness for Pediatric Patients With Severe Influenza, 2015-2020.

Importance: Increasing the understanding of vaccine effectiveness (VE) against levels of severe influenza in children could help increase uptake of influenza vaccination and strengthen vaccine policies globally.

Objective: To investigate VE in children by severity of influenza illness.

Design, Setting, And Participants: This case-control study with a test-negative design used data from 8 participating medical centers located in geographically different US states in the New Vaccine Surveillance Network from November 6, 2015, through April 8, 2020.

Acute Responses of Low-Load Resistance Exercise with Blood Flow Restriction.

Blood flow restriction (BFR) is a popular resistance exercise technique purported to increase metabolic stress and augment training adaptations over time. However, short-term use may lead to acute neuromuscular fatigue and higher exertion ratings. The purpose of the current study was to examine acute physiological responses to low-load resistance exercise utilizing BFR compared to higher-load, non-BFR resistance exercise.

Quantitative MRI Assessment of Post-Surgical Spinal Cord Injury Through Radiomic Analysis.

This study investigates radiomic efficacy in post-surgical traumatic spinal cord injury (SCI), overcoming MRI limitations from metal artifacts to enhance diagnosis, severity assessment, and lesion characterization or prognosis and therapy guidance. Traumatic spinal cord injury (SCI) causes severe neurological deficits. While MRI allows qualitative injury evaluation, standard imaging alone has limitations for precise SCI diagnosis, severity stratification, and pathology characterization, which are needed to guide prognosis and therapy.

Elucidating Early Radiation-Induced Cardiotoxicity Markers in Preclinical Genetic Models Through Advanced Machine Learning and Cardiac MRI.

Radiation therapy (RT) is widely used to treat thoracic cancers but carries a risk of radiation-induced heart disease (RIHD). This study aimed to detect early markers of RIHD using machine learning (ML) techniques and cardiac MRI in a rat model. SS.

Genetics and Genomics of Gastroschisis, Elucidating a Potential Genetic Etiology for the Most Common Abdominal Defect: A Systematic Review.

(1) Background: The exact etiology for gastroschisis, the most common abdominal defect, is yet to be known, despite the rising prevalence of this condition. The leading theory suggests an increased familial risk, indicating a possible genetic component possibly in the context of environmental risk factors. This systematic review aims to summarize the studies focused on the identification of a potential genetic etiology for gastroschisis to elucidate the status of the field.

Amygdala-centered emotional processing in Prolonged Grief Disorder: Relationship with clinical symptomatology.

Background: Prolonged Grief Disorder is a multidimensional condition with adverse health consequences. We hypothesized that enhanced negative emotional bias characterizes this disorder and underlies its key clinical symptoms.

Methods: In a cross-sectional design, chronically grieving older adults (61.