Spatial molecular profiling: platforms, applications and analysis tools.

Molecular profiling technologies, such as genome sequencing and proteomics, have transformed biomedical research, but most such technologies require tissue dissociation, which leads to loss of tissue morphology and spatial information. Recent developments in spatial molecular profiling technologies have enabled the comprehensive molecular characterization of cells while keeping their spatial and morphological contexts intact. Molecular profiling data generate deep characterizations of the genetic, transcriptional and proteomic events of cells, while tissue images capture the spatial locations, organizations and interactions of the cells together with their morphology features.

Consecutive 265 Profunda Artery Perforator Flaps: Refinements, Satisfaction, and Functional Outcomes.

Introduction: The ideal form of breast reconstruction provides total permanent restoration of the breast mound. When a deep inferior epigastric (DIEP) flap is not an option or does not provide significant volume, a secondary source must be considered. In our practice, the profunda artery perforator (PAP flap) from the thigh has emerged as a second choice.

Adolescent and Parent Perceptions about Participation in Biomedical Sexual Health Trials.

Given the burden of HIV and other sexually transmitted infections among adolescents who are legal minors, it is critical that they be included in biomedical sexual health trials to ensure that new prevention and treatment interventions are safe, effective, and acceptable for their use. However, adolescents are often not well represented in clinical trials. We provide an overview of the available evidence regarding adolescent and parent willingness for adolescents to participate in biomedical sexual health trials, parental involvement in the permission-consent process, management of differences and discord among adolescents and parents, and parental involvement throughout the study period.

Gonorrhea-positive sinus cultures in a 15-year-old with allergic fungal sinusitis.

This article describes a patient with gonorrhea in sinus cultures and allergic fungal sinusitis. A multidisciplinary team was assembled to deliver the results to the minor patient and her family and provide support and resources for long-term care.

Prostate brachytherapy procedural training: incorporation of related procedures in resident training and competency assessment.

Purpose: Inadequate procedural training is of increasing concern in resident training, especially in prostate brachytherapy (PB). Transperineal rectal spacer placement (TRSP) requires many of the same proficiencies as PB. This work describes the assessment of teaching techniques focusing on developing critical competencies for PB using related clinical procedures (TRSP).

Validation of the Timberlawn Couple and Family Evaluation Scales-Self-Report in Veterans with PTSD.

A modified version of the the Timberlawn Couple and Family Evaluation Scales was validated to assess intimate partner relationship functioning among veterans who suffer from PTSD.

Cardiac auscultation: Using physiologic maneuvers to further identify heart murmurs.

Auscultation of heart sounds and murmurs often is taught in a simulated environment with optimal listening conditions. Clinicians' auscultation skills can wither if they do not have contact with patients with valvular heart disease during clinical practice, or if they rely on handheld ultrasound devices or echocardiography. This article reviews heart murmurs and how to use physiologic maneuvers during the cardiac examination to assist in identifying murmurs.

Hypertension management in patients with chronic kidney disease.

Managing hypertension, especially when accompanied by chronic kidney disease, is challenging. These different but related conditions are complicated by differing guidelines. NPs can safely prescribe antihypertensive treatments, which reduce hypertension and the risk of associated comorbidities, such as kidney failure, stroke, myocardial infarction, and vascular disease.

Changing equipoise in the landscape of radiation for oligometastatic lung cancer.

There is growing interest in exploring use of local therapies in the management of oligometastatic non-small cell lung cancer (NSCLC) to provide durable local and distant disease control. Prospective phase II studies have incorporated local therapy (predominantly stereotactic ablative radiotherapy or SABR) to both primary and metastatic sites. For patients who received these treatments, median progression-free survival (PFS) and overall survival (OS) exceeded that of historical controls treated with systemic therapy alone (9.

PAEA End of Rotation™ Exams Accurately Identify Students at Risk of Physician Assistant National Certifying Exam Failure.

Purpose: Physician Assistant Education Association (PAEA) End of Rotation™ exams are used by programs across the country. However, little information exists on the predictive ability of the exams' scale scores and Physician Assistant National Certifying Exam (PANCE) performance. The purpose of this study was to evaluate End of Rotation exam scores and their relationship with poor PANCE performance (PPP).

Minority Physician Assistant Faculty: A Phenomenological Assessment of Factors Leading to Retention in the Faculty Role.

Improving racial and ethnic diversity in the physician assistant (PA) profession is important to providing better care for underserved communities. The recruitment and retention of minority PA faculty is one aspect of helping to attract and retain a more diverse student body. Previous research has indicated that minority status is associated with the increased attrition of PA faculty but has not provided insight into the specific factors involved in the retention or attrition of minority PA faculty.

A Decision Algorithm Is Not Superior to Clinician Judgment to Determine Need for Peripheral vs Central Venous Catheterization.

Background: Venous access, via a midline peripheral catheter (midline) or a peripherally inserted central catheter, is used regularly in the neurointensive care unit as a means for prolonged infusion of drugs or medications. There is little research on how to choose the appropriate access device to use in this setting. The aim of this study is to trial an algorithm to assist clinicians in determining which device to use, as a way to reduce patient complications such as central line-associated bloodstream infection and deep vein thrombosis.

Symbrachydactyly: Finger nubbins are not always amniotic band disruption sequence.

Although congenital hand anomalies associated with finger nubbins may be produced by amniotic band disruption sequence (ABDS), symbrachydactyly should be considered in the differential diagnosis. ABDS usually affects more than one limb but symbrachydactyly largely is limited to one upper extremity, and has five distinct clinical presentations: short-fingered, atypical cleft, monodactylous, peromelic, and a forearm proximal transverse deficiency. This article discusses the diagnosis of symbrachydactyly compared with ABDS and outlines plans for managing patients with symbrachydactyly.

Restless Legs Syndrome Among Veterans With Spinal Cord Lesions.

Researchers developed a restless legs syndrome questionnaire using diagnostic criteria to assess its prevalence among veterans with spinal cord injuries and disorders.

Sleep hygiene in patients with chronic respiratory disease.

Purpose: This study assessed the effectiveness of patient-directed interventions for improving sleep quality in patients with cystic fibrosis and pulmonary hypertension.

Methods: A nonrandomized, prospective pilot study was used to monitor the effectiveness of patient-initiated sleep preferences in 15 hospitalized patients.

Results: During their stay, 53.

Astronaut Cardiovascular Health and Risk Modification (Astro-CHARM) Coronary Calcium Atherosclerotic Cardiovascular Disease Risk Calculator.

Background: Coronary artery calcium (CAC) is a powerful novel risk indicator for atherosclerotic cardiovascular disease (ASCVD). Currently, there is no available ASCVD risk prediction tool that integrates traditional risk factors and CAC.

Methods: To develop a CAC ASCVD risk tool for younger individuals in the general population, subjects aged 40 to 65 without prior cardiovascular disease from 3 population-based cohorts were included.

What Is New in Morbidly Adherent Placenta?: Best Articles From the Past Year.

This month we focus on current research in morbidly adherent placenta. Dr. Dashe discusses five recent publications, which are concluded with a "bottom line" that is a take-home message.

Effect of Epidural Volume Extension on Quality of Combined Spinal-Epidural Anesthesia for Cesarean Delivery: A Systematic Review and Meta-Analysis.

In nonobstetric procedures, epidural volume extension (EVE) has been suggested to lower intraoperative opioid requirements while improving motor recovery when added to spinal anesthesia. This systematic review with meta-analysis was performed to evaluate the efficacy of EVE in elective cesarean delivery. We searched PubMed, Embase, and The Cochrane Review Database for randomized controlled trials evaluating EVE compared with single shot spinal and/ or combined spinal/epidural anesthesia.

Parent Mentoring Program Increases Coverage Rates For Uninsured Latino Children.

Latinos have the highest US childhood uninsurance rate of any race/ethnicity, but little is known about effective ways to eliminate this disparity. We evaluated the effects of parent mentors-Latino parents with children covered by Medicaid or the Children's Health Insurance Program-on insuring Latino children in a randomized, controlled, community-based trial of 155 uninsured children conducted in the period 2011-15. Parent mentors were trained to assist families in getting insurance coverage, accessing health care, and addressing social determinants of health.

Similarities and Differences Between Physician Assistant Program and Medical School Mission Statement Themes.

Purpose: The purpose of this study was to examine the concordance of US physician assistant (PA) program mission statements with those of US public- and private-sponsored medical schools. With the exception of a broader medical school focus on research, the authors hypothesized that little difference in mission statement congruence would be found in a comparison of medical schools and PA programs.

Methods: Mission statements of 209 of the 210 accredited US PA programs as of May 2016 were obtained and analyzed.