Why Wait? The Ethics of Disclosing HIV Screening Results.

Counseling patients on their HIV test results is an important part of undergraduate and graduate medical education. However, many trainees and physicians feel ill prepared to counsel patients on potentially distressing results. We present a case involving early disclosure of a false-positive HIV screening test result to a patient and the downstream effects of this premature disclosure.

Positive Deep Initial Incision Margin Affects Outcomes in TORS for HPV+ Oropharynx Cancer.

Objective: Evaluate the effect of initial incision margins (IIM) on clinical outcomes after transoral robotic surgery (TORS) for human papillomavirus positive (HPV+) squamous cell cancers of the oropharynx (OPSCC).

Methods: Retrospective chart review of patients undergoing TORS for HPV+ OPSCC from 2007 to 2015 was performed. Overall survival (OS), disease-specific survival (DSS), recurrence, and metastases were evaluated in the context of pathology, IIM, final margins, adjuvant therapy, and patient characteristics.

Development of a Multicomponent Intervention to Decrease Racial Bias Among Healthcare Staff.

Background: Real or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from non-physician and non-nursing (non-MD/RN) staff members (e.g.

DMEK with endophotocoagulation and cyst wall removal for corneal endothelial decompensation due to iris cyst.

Purpose: Iris cysts may arise secondary to surgical or nonsurgical trauma, potentially leading to corneal decompensation via mechanical injury to the adjacent endothelium. However, no well-established protocol exists for the treatment for corneal edema arising therefrom.

Observations: A 58-year-old white male presented with an iris mass of his left eye; it occupied 1/3rd the anterior chamber volume and directly contacted the corneal endothelium.

A Legacy of Scientific Racism: William Osler's "An Alabama Student".

William Osler's essay "An Alabama Student" made John Young Bassett (1804-1851) a widely admired avatar of idealism in medicine. However, Bassett fiercely attacked the idea that all humans are members of the same species (known as ) and asserted that Black inferiority was a justification for slavery. Antebellum physician-anthropologists bequeathed a legacy of scientific racism that in subtler forms still runs deep in American society, including in the field of medicine.

Inhaled gene therapy of preclinical muco-obstructive lung diseases by nanoparticles capable of breaching the airway mucus barrier.

Introduction: Inhaled gene therapy of muco-obstructive lung diseases requires a strategy to achieve therapeutically relevant gene transfer to airway epithelium covered by particularly dehydrated and condensed mucus gel layer. Here, we introduce a synthetic DNA-loaded mucus-penetrating particle (DNA-MPP) capable of providing safe, widespread and robust transgene expression in in vivo and in vitro models of muco-obstructive lung diseases.

Methods: We investigated the ability of DNA-MPP to mediate reporter and/or therapeutic transgene expression in lung airways of a transgenic mouse model of muco-obstructive lung diseases (ie, -Tg) and in air-liquid interface cultures of primary human bronchial epithelial cells harvested from an individual with cystic fibrosis.

Influence of Spirituality, HIV Stigma and Education on HIV Knowledge in Rural African American Congregants in the Deep South: Additional Findings from Project FAITHH.

HIV incidence has shifted racially and geographically in the United States and now represents higher proportions of African Americans living in the Rural South. Lower levels of HIV knowledge may be the culprit behind the increasing HIV rates observed in the Rural South. The purpose of this study was to investigate the individual and joint correlates of HIV knowledge in a sample of rural African Americans.

Descriptive Epidemiology of Pediatric Drowning Patients Presenting to a Large Southern US Children's Hospital.

Objectives: Drowning is the leading cause of death for children ages 1 to 4, and it is among the leading causes of death for children of all ages. National data show disparities in drowning risk for certain racial groups. This study aimed to describe characteristics of patients presenting after a drowning event to guide focused drowning prevention outreach efforts.

Cocaine-Specific Effects on Exosome Biogenesis in Microglial Cells.

Cocaine is a highly addictive stimulant and a well-known drug, with multiple effects on physiology. Cocaine can have direct effects on all cell types in the brain, including microglia. Microglia can be activated by other conditions, such as infection, inflammation, or injury.

Effects of Cocaine on Human Glial-Derived Extracellular Vesicles.

Background: Microglia are important myeloid cells present in the brain parenchyma that serve a surveillance function in the central nervous system. Microglial cell activation results in neuroinflammation that, when prolonged, can disrupt immune homeostasis and neurogenesis. Activated microglia-derived extracellular vesicles (EVs) may be involved in the propagation of inflammatory responses and modulation of cell-to-cell communication.

Examining the Correlation between Altmetric Score and Citations in the Plastic Surgery Literature.

Background: Social media are transforming the dissemination of published research. This influence brought the advent of a new metric, altmetrics, which seeks to quantify the influence of research in real time based on an article's attention online. This study aims to determine the correlation between altmetrics ratings for articles with traditional bibliometrics of impact factor and citation rate.

Recurrent Pneumonia? A Case of Availability Bias and Anchoring.

Invasive mucinous adenocarcinoma is a multi-centric adenocarcinoma that accounts for less than 5% of all lung cancer diagnoses. The most common presenting symptoms (cough, sputum production, and chest pain) in conjunction with its radiographic findings (patchy, multi-lobar infiltrates) make invasive mucinous adenocarcinoma challenging to distinguish from both infectious and inflammatory pneumonia. However, due to its aggressive nature, invasive mucinous adenocarcinoma should be considered if a presumed case of pneumonia lacks symptoms of infection (e.

Association of State Legislation and Industry Compensation to Orthopaedic Residents: A 3-Year Review of the Centers for Medicare and Medicaid Services Open Payments Database.

Background: The Sunshine Act aims to increase the transparency of physicians receiving compensation from pharmaceutical and medical device companies. Nine states have supplementary legislation in addition to the Federal Sunshine Act. The purpose of this study is to assess the characteristics of financial compensation to orthopaedic residents on the Centers for Medicare and Medicaid Services (CMS) Open Payments Database in states with more restrictive regulations compared with those without additional restrictions.

Design and implementation of a molecular imaging elective for third-year pharmacy students.

Objective: To design, implement, and evaluate a molecular imaging elective course that would expose Doctor of Pharmacy (PharmD) students to fundamentals of various imaging modalities and their pre-clinical and clinical applications.

Methods: The "Surveys of Multi-Modality Imaging" course is a two-credit hour elective course offered to third-year PharmD and doctoral students. Experiential learning methods including active learning application-based exercises were used to supplement didactic lectures in the form of field trips (with follow-up debriefings), small group team-based tasks, hands-on demonstrations, visual modelling, gamification with problem sets, concept maps regarding given modalities, and concluding with written summary reports and formal in-class group presentations.

Correction to: Association of CMV genomic mutations with symptomatic infection and hearing loss in congenital CMV infection.

After publication of the original article [1], we were notified that Fig. 3 has "Fig. 1" posted on the top of it and Figs.

Utilization of a Co-enrolled Course Structure for Point-of-Care Ultrasound Training in the Undergraduate Medical Education Setting.

With continuing advancements in software, electronics, and miniaturization, ultrasound (US) is quickly becoming an everyday tool of numerous medical specialties. With the advent of new handheld and other small-scale units, physicians have a tool to obtain on demand imaging without exposing the patient to ionizing radiation in the pocket of their white coat. As such, the need for competency in US is increasing.

Association of CMV genomic mutations with symptomatic infection and hearing loss in congenital CMV infection.

Background: Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and a leading cause of long-term neurological and sensory sequelae, the most common being sensorineural hearing loss (SNHL). Despite extensive research, clinical or laboratory markers to identify CMV infected children with increased risk for disease have not been identified. This study utilizes viral whole-genome next generation-sequencing (NGS) of specimens from congenitally infected infants to explore viral diversity and specific viral variants that may be associated with symptomatic infection and SNHL.

Use of the Montreal Cognitive Assessment (MoCA) in a Rural Outreach Program for Military Veterans.

The Montreal Cognitive Assessment (MoCA) is a free, easily accessible screener ideal for rural areas where resources are limited. We examined administration and scoring by Veteran Community Outreach Health Workers (VCOHWs); compared positive screening rates using two cutoff scores; and examined predictors of education-adjusted scores in N = 168 rural military Veterans from the Alabama Veteran Rural Health Initiative. Accuracy of administration (95 percent) and scoring (68 percent) was calculated and recommendations are offered.

Teen Driving Education in a Pediatric Emergency Department: Effectiveness of a Toolkit.

Objectives: In the United States, the leading cause of death for adolescents aged 16 to 24 years is motor vehicle crashes, with Alabama ranked as the second-worst state in the nation for teen driving deaths. We sought to determine the efficacy of teenage driving education within the setting of the pediatric emergency department and to assess the driving habits of teenagers and their parents and their understanding of the Alabama Graduated Driver's License (GDL) law.

Methods: Surveys were administered to noncritically ill teenagers aged 13 to 19 years and their parents who presented to the children's emergency department.

What Defines an Honors Student? Survey of Pediatric and Internal Medicine Faculty Perspectives.

Objective: Although considerable emphasis is placed on the attainment of honors in core medical school clerkships, little is known about what student characteristics are used by attending physicians to earn this designation. The purpose of this study was to evaluate what values and characteristics that attending physicians consider important in the evaluation of Pediatrics and Internal Medicine clerkship students for clinical honors designation.

Methods: This cross-sectional survey study was framed around Accreditation Council for Graduate Medical Education (ACGME) competencies.

Effect of Levocarnitine vs Placebo as an Adjunctive Treatment for Septic Shock: The Rapid Administration of Carnitine in Sepsis (RACE) Randomized Clinical Trial.

Importance: Sepsis induces profound metabolic derangements, while exogenous levocarnitine mitigates metabolic dysfunction by enhancing glucose and lactate oxidation and increasing fatty acid shuttling. Previous trials in sepsis suggest beneficial effects of levocarnitine on patient-centered outcomes.

Objectives: To test the hypothesis that levocarnitine reduces cumulative organ failure in patients with septic shock at 48 hours and, if present, to estimate the probability that the most efficacious dose will decrease 28-day mortality in a pivotal phase 3 clinical trial.