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• There are no publications on the use of educational escape room (EER) in an accelerated nursing program • The (EER) is an interactive learning activity to evaluate learning outcomes • The activity is low-cost and feasible to implement in other accelerated nursing programs An educational escape room (EER) was developed as an innovative strategy for summative evaluation at the end of the first semester in a medical/surgical course within an accelerated nursing program. Learning outcomes were focused on recognizing abnormal vital signs of a decompensating patient, prioritizing nursing interventions, role-playing as a rapid response nurse, collaborating with peers to complete each puzzle, interpreting findings, and discovering medication errors. Debriefing allowed faculty to provide feedback on the achievement of the learning outcomes. Most students agreed that the EER allowed them to meet each learning outcome. This project supported the usefulness of EERs for the evaluation of student learning outcomes in a fast-paced program that may be similar to the speed at which associate degree programs prepare students. [ABSTRACT FROM AUTHOR]

A 15-year-old neutered male mixed breed Domestic Shorthair cat was presented for a rapidly growing, intraoral soft gingival mass on the left mandibular region. The neoplastic tissue consisted histologically of two distinct malignant cell populations: spindle cells arranged in bands and epithelioid cells arranged in cords. A few multinucleated giant cells were scattered among the neoplastic cells. Spindle cells and multinucleated giant cells strongly expressed vimentin while epithelial cells strongly expressed pancytokeratins. On the basis of the histological and immunohistochemical results, a diagnosis of oral carcinosarcoma was made. After 2 months, due to the extent of disease and poor prognosis, the cat was euthanized. Necropsy revealed a markedly enlarged, multilobulated white–pink neoplastic mass that had originated from the left side of the sublingual region and involved the coronoid process of the left mandibular bone. The cut surface of the enlarged left submandibular lymph node was glistening, whitish–tan in colour with a multinodular appearance, suggestive of metastasis and confirmed by histological examination. Oral carcinosarcoma is uncommonly recorded in humans and dogs and, to the best of our knowledge, this is the first reported case in a cat. [ABSTRACT FROM AUTHOR]

Long-term spatial studies are crucial for understanding how the Earth's surface has changed. Before satellite imagery, landscapes were monitored using black and white (B&W) aerial photographs. However, surveys were infrequent and image analysis was a manual process that was both time-consuming and costly. In this study, we created a composite of high spatial resolution (0.5–0.75 m) B&W aerial images from 1939–1944, covering about 91% of Kruger National Park (KNP)'s nearly 2 million ha. We used this to produce the first historical woody cover (tall trees and shrubs) map of KNP, which until now was only partially understood through fragmented descriptions in period literature and small-area case studies. We established a supervised learning workflow using Google Earth Engine (GEE) which included performing an Object-based Image Analysis (OBIA) with a Random Forest classifier. This approach, enhanced by integrating texture, shape, neighboring features, and spectral variables into the training/validation dataset, enabled the identification of woody vegetation from B&W landscape objects. To enhance accuracy, we guided our sampling method using vegetation types with comparable woody cover and species composition. Initially, we tested our method on a smaller set of images (25 km2), and after confirming its effectiveness, we then expanded the approach to cover all available historical aerial imagery. Our results show that in 1939–1944, 26% of KNP was covered in woody vegetation (overall accuracy of 89%, producer's accuracy (non-woody = 88%, woody = 90%), and user's accuracy (non-woody = 90%, woody = 87%)). The importance of geological substrate in driving vegetation pattern is reflected in a higher woody cover percentage on granite (28%) than on basalt (21%) soils, with the lowest woody cover on northern basalts (11%) and the highest on north-central granites (32%). This study highlights the potential of GEE and OBIA for analyzing large-area, high spatial resolution B&W aerial photographs in a systematic and efficient manner and the importance of creating large-scale historical land cover baselines to support environmental planning and landscape management. • Historical aerial images provide valuable insight into long-term ecosystem changes. • First historical woody cover map of Kruger National Park, South Africa (1939–1944). • Object-based image analysis applied to large-area black-and-white aerial images. • Supervised learning workflow using open-source geospatial platform Google Earth Engine. • Applications for large-area land cover assessments and environmental planning. [ABSTRACT FROM AUTHOR]

Ancylostoma caninum is the most prevalent nematode parasite of dogs. We confirmed multiple-drug resistance (MDR) in several A. caninum isolates to all anthelmintic drug classes approved for the treatment of hookworms in dogs in the USA. Cases of MDR hookworms appear to be highly overrepresented in greyhounds. The aims of this study were to evaluate the drug-resistant phenotypes and genotypes of the A. caninum infecting greyhounds. Fecal samples from greyhounds of the USA were acquired from two greyhound adoption kennels, one active greyhound racing kennel, and three veterinary practices. Fecal egg counts (FECs) were performed on fecal samples from 219 greyhounds, and despite treatment with anthelmintics, the mean FEC was 822.4 eggs per gram (EPG). Resistance to benzimidazoles and macrocyclic lactones were measured using the egg hatch assay (EHA) and the larval development assay (LDA), respectively. We performed 23 EHA and 22 LDA on either individual or pooled feces, representing 54 animals. Mean and median IC 50 and IC 95 values for the EHA were 5.3 μM, 3.6 μM, and 24.5 μM, 23.4 μM, respectively. For the LDA, the median IC 50 value was >1000 nM. These values ranged 62–81 times higher than our susceptible laboratory isolate. Only post-treatment samples were available. For samples collected <10 days post-treatment with albendazole, moxidectin, or a combination of febantel-pyrantel-moxidectin, the mean FEC were 349, 333, and 835 EPG, respectively. We obtained DNA from hookworm eggs isolated from 70 fecal samples, comprised of 60 individual dogs and 10 pools. Deep sequencing of the isotype 1 β-tubulin gene only revealed the presence of the F167Y (TTC>TAC) resistance polymorphism in 99% of these samples. These clinical, in vitro, and genetic data provide strong evidence that greyhound dogs in the USA are infected with MDR A. caninum at very high levels in prevalence and infection intensity. [Display omitted] • Conclusive evidence that most racing greyhounds in the USA are infected with MDR A. caninum. • 79% of the samples from racing or retired greyhounds were positive. • IC 50 values for BZs and MLs were 62–81 times higher in greyhounds. • The F167Y SNP was detected in 99% of samples, and in more than 2/3 the frequency was ≥ 75%. [ABSTRACT FROM AUTHOR]

• Algorithm and Field or grid size are predictive of OF calculation accuracy in TPS. • Modern TPSs slightly overestimate the calculated small fields OFs. • For Monte Carlo and AAA algorithms, a grid resolution of 1 mm is recommended. The influence of basic plan parameters such as slice thickness, grid resolution, algorithm type and field size on calculated small field output factors (OFs) was evaluated in a multicentric study. Three computational homogeneous water phantoms with slice thicknesses (ST) 1, 2 and 3 mm were shared among twenty-one centers to calculate OFs for 1x1, 2x2 and 3x3 cm2 field sizes (FSs) (normalized to 10x10 cm2 FS), with their own treatment planning system (TPS) and the energy clinically used for stereotactic body radiation therapy delivery. OFs were calculated for each combination of grid resolution (GR) (1, 2 and 3 mm) and ST and finally compared with the OFs measured for the TPS commissioning. A multivariate analysis was performed to test the effect of basic plan parameters on calculated OFs. A total of 509 data points were collected. Calculated OFs are slightly higher than measured ones. The multivariate analysis showed that Center, GR, algorithm type, and FS are predictive variables of the difference between calculated and measured OFs (p < 0.001). As FS decreases, the spread in the difference between calculated and measured OFs became larger when increasing the GR. Monte Carlo and Analytical Anisotropic Algorithms, presented a dependence on GR (p < 0.01), while Collapsed Cone Convolution and Acuros did not. The effect of the ST was found to be negligible. Modern TPSs slightly overestimate the calculated small field OFs compared with measured ones. Grid resolution, algorithm, center number and field size influence the calculation of small field OFs. [ABSTRACT FROM AUTHOR]

• Eight institutions set KB models for tangential fields of left-breast irradiation. • Good transferability for 7 out of 8 models was found. • Inter-institution variability of DVH ipsilateral OARs prediction was less than 2%. • Results suggest the feasibility of building a benchmark model. Within a multi-institutional project, we aimed to assess the transferability of knowledge-based (KB) plan prediction models in the case of whole breast irradiation (WBI) for left-side breast irradiation with tangential fields (TF). Eight institutions set KB models, following previously shared common criteria. Plan prediction performance was tested on 16 new patients (2 pts per centre) extracting dose-volume-histogram (DVH) prediction bands of heart, ipsilateral lung, contralateral lung and breast. The inter-institutional variability was quantified by the standard deviations (SDint) of predicted DVHs and mean-dose (Dmean). The transferability of models, for the heart and the ipsilateral lung, was evaluated by the range of geometric Principal Component (PC1) applicability of a model to test patients of the other 7 institutions. SDint of the DVH was 1.8 % and 1.6 % for the ipsilateral lung and the heart, respectively (20 %-80 % dose range); concerning Dmean, SDint was 0.9 Gy and 0.6 Gy for the ipsilateral lung and the heart, respectively (<0.2 Gy for contralateral organs). Mean predicted doses ranged between 4.3 and 5.9 Gy for the ipsilateral lung and 1.1–2.3 Gy for the heart. PC1 analysis suggested no relevant differences among models, except for one centre showing a systematic larger sparing of the heart, concomitant to a worse PTV coverage, due to high priority in sparing the left anterior descending coronary artery. Results showed high transferability among models and low inter-institutional variability of 2% for plan prediction. These findings encourage the building of benchmark models in the case of TF-WBI. [ABSTRACT FROM AUTHOR]

Abstract Metals, whether essential (Cu, Zn, Cr, Fe, Mn) or non-essential (Al, As, Cd, Ni, Pb, Hg) for organism metabolism, occur naturally in the marine environment and their abundance can increase due to the presence of human activities. In this study, fish were used as bio-indicators, to determine a correlation between the bio-accumulation of metals in muscle and gill tissues and the health status of fish. The study area was the Gulf of Tigullio (north-western Italy), which is impacted by various sources of metal contamination. Histopathology served as a significant tool to investigate possible alterations in gills, one of the main organs involved in fish physiology. Results highlighted some correlations between certain metals (e.g. Pb, Ni) and gill alterations (e.g. epithelial hyperplasia, epithelial lifting), providing baseline data from a pool of different fish species, which can be used for comparison purposes in further studies. Highlights • A pool of different sea fish species was used as bio-indicators for metal pollution. • High metal concentrations in gills showed correlation with some gill alterations. • Histopathology is a useful monitoring tool to investigate alterations in gills. • Cd, Hg and Pb values in muscle tissue were often higher than legislation limits. [ABSTRACT FROM AUTHOR]

Abstract This paper presents the results of a combined experimental and analytical/computational study of viscoelastic cell deformation and detachment from poly-di-methyl-siloxane (PDMS) surfaces. Fluid mechanics and fracture mechanics concepts are used to model the detachment of biological cells observed under shear assay conditions. The analytical and computational models are used to compute crack driving forces, which are then related to crack extension during the detachment of normal breast cells and breast cancer cells from PDMS surfaces that are relevant to biomedical implants. The interactions between cells and the extracellular matrix, or the extracellular matrix and the PDMS substrate, are then characterized using force microscopy measurements of the pull-off forces that are used to determine the adhesion energies. Finally, fluorescence microscopy staining of the cytosketelal structures (actin, micro-tubulin and cyto-keratin), transmembrane proteins (vimentin) and the ECM structures (Arginin Glycine Aspartate – RGD) is used to show that the detachment of cells during the shear assay experiments occurs via interfacial cracking between (between the ECM and the cell membranes) with a high incidence of crack bridging by transmembrane vinculin structures that undergo pull-out until they detach from the actin cytoskeletal structure. The implications of the results are discussed for the design of interfaces that are relevant to implantable biomedical devices and normal/cancer tissue. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare the accuracy of a smartphone application and a mechanical pedometer for step counting at different walking speeds and mobile phone locations in a laboratory context. Methods: Seventeen adults wore an iPphone6© with Runtastic Pedometer© application (RUN), at 3 different locations (belt, arm, jacket) and a pedometer (YAM) at the waist. They were asked to walk on an instrumented treadmill (reference) at various speeds (2, 4 and 6 km/h). Results: RUN was more accurate than YAM at 2 km/h (p < 0.05) and at 4 km/h (p = 0.03). At 6 km/h the two devices were equally accurate. The precision of YAM increased with speed (p < 0.05), while for RUN, the results were not significant but showed a trend (p = 0.051). Surprisingly, YAM underestimates the number of step by 60.5% at 2 km/h. The best accurate step counting (0.7% mean error) was observed when RUN is attached to the arm and at the highest speed. Conclusions: RUN pedometer application could be recommended mainly for walking sessions even for low walking speed. Moreover, our results confirm that the smartphone should be strapped close to the body to discriminate steps from noise by the accelerometers (particularly at low speed). [ABSTRACT FROM AUTHOR]

In protected areas of the African savanna tree cover, structure and species composition are influenced by a combination of many different variables. These include complex and multi-scaled interplay of environmental factors such as water and nutrient availability, fire, herbivory and, when occurring, direct human disturbance. In this study, we conducted a comprehensive and comparative analysis of the spatial variability of tree cover and density in three neighboring Southern African National Parks (Kruger, Limpopo, and Gonarezhou) characterized by similar environmental conditions but different management plans. We sampled 3382 plots of 0.5 ha across the three parks using an innovative methodology defined as augmented visual interpretation, based on a free and open source software. This software, named Collect Earth, allows access to very high spatial and temporal resolution imagery archives. Spatial variability of tree cover and density was analyzed comparing the three parks and the two bioclimatic regions (semiarid and dry subhumid) characterizing them. The effect of relevant environmental variables such as edaphic factors, precipitation and fire frequency was also assessed. Kruger National Park is characterized by the lowest values of tree cover and density among the three Parks. Contrary to what was expected and the general trend of Southern Africa, the dry subhumid zone showed lower values of tree cover and density than the semiarid zone. Such variability is hypothesized to be related to the different managements of the three parks within the general environmental template characterizing the African savanna as well as differences in tree species composition between the two climatic zones. [ABSTRACT FROM AUTHOR]

The understanding of adhesive interaction at the nanoscale between functionalized nanoparticles and biological cells is of great importance to develop effective theranostic nanocarriers for targeted cancer therapy. Here, we report a combination of experimental and computational approaches to evaluate the adhesion between Triptorelin (a Luteinizing Hormone-Releasing Hormone (LHRH) agonist)-conjugated poly-(ethylene glycol) (PEG)-coated magnetite nanoparticles (Triptorelin-MNPs) and breast cells. The adhesion forces between Triptorelin-MNPs and normal/cancerous breast cells are obtained using atomic force microscopy. The corresponding work of adhesion is then estimated using Johnson-Kendall-Roberts model. Our results demonstrate that Triptorelin-MNPs have a fourteen-fold greater work of adhesion to breast cancer cells than to normal breast cells. In addition, the work of adhesion between Triptorelin-MNPs and breast cancer cells is found to be three times more than that between unmodified MNPs and breast cancer cells. Hence, the experimental observation indicates that Triptorelin ligands facilitate the specific targeting of breast cancer cells. Furthermore, molecular dynamics simulations are performed to investigate the molecular origins of the adhesive interactions. The simulations reveal that the interactions between molecules (e.g. Triptorelin and PEG) and LHRH receptors are dominated by van der Waals energies, while the interactions of these molecules with cell membrane are dominated by electrostatic interactions. Moreover, both experimental and computational results reveal that PEG serves as an effective coating that enhances adhesive interactions to breast cancer cells that over-express LHRH receptors, while reduces the adhesion to normal breast cells. Our results highlight the potential to develop Triptorelin-MNPs into tumor-specific MRI contrast agents and drug carriers. Statement of Significance Systematic investigation of adhesive interactions between functionalized nanoparticles and cancer cells is of great importance in developing effective theranostic nanocarriers for targeted cancer therapy. Herein, we use a combination of atomic force microscopy technique and molecular dynamics simulations approach to explore the adhesive interactions at the nanoscale between Triptorelin-conjugated polyethylene glycol (PEG)-coated magnetite nanoparticles and normal/cancerous breast cells. This study characterizes and quantifies the work of adhesion, as well as adhesion forces, at the nanocarrier/cell interfaces, unravels the molecular origins of adhesive interactions and highlights the effectiveness of PEG coatings and Triptorelin ligands in the specific targeting of breast cancer cells. Our findings expand the fundamental understanding of nanoparticle/cell adhesion and provide guidelines for the design of more rational nanocarriers. [ABSTRACT FROM AUTHOR]

Peatlands in Indonesia are of global significance for biodiversity conservation and climate regulation, as well as of national and local significance for water management and livelihood support. Despite their importance, in tropics these ecosystems remain among the least investigated and monitored and are increasingly threatened by anthropogenic activities. To support the ongoing formulation, refinement and implementation of peatland restoration and conservation activities in Indonesia, we developed a methodology based on land cover and land productivity analysis, which will help prioritize interventions in Sumatra, Kalimantan and Papua. Results showed that of the analysed peatland area, approximately 45.5% should be conserved, 28.7% should be restored and 16.2% should be subjected to sustainable agricultural practices. Furthermore, the analysis showed that only 15.6% of the peatlands in need of conservation measures are currently protected, resulting in a necessary expansion of protected areas of about 84%. This study is intended as a tool for policy makers to guide future action, emphasising that conservation and restoration efforts in Indonesian peatlands should be increased, and providing spatial guidance for their implementation. [ABSTRACT FROM AUTHOR]

Purpose/Objective(s) Board certified radiation oncologists and medical physicists are required to earn self-assessment module (SAM) continuing medical education (CME) credit, which may require travel costs or usage fees. Data indicate that faculty participation in resident teaching activities is beneficial to resident education. Our hypothesis was that providing the opportunity to earn SAM credit in resident didactics would increase faculty participation in and improve resident education. Methods and materials SAM applications, comprising CME certified category 1 resident didactic lectures and faculty-generated questions with respective answers, rationales, and references, were submitted to the American Board of Radiology for formal review. Surveys were distributed to assess main academic campus physician, affiliate campus physician, physicist, and radiation oncology resident impressions regarding the quality of the lectures. Survey responses were designed in Likert-scale format. Sign-test was performed with P < .05 considered statistically different from neutral. Results First submission SAM approval was obtained for 9 of 9 lectures to date. A total of 52 SAM credits have been awarded to 4 physicists and 7 attending physicians. Main academic campus physician and affiliate campus physician attendance increased from 20% and 0%, respectively, over the 12 months preceding CME/SAM lectures, to 55.6% and 20%, respectively. Survey results indicated that the change to SAM lectures increased the quality of resident lectures ( P = .001), attending physician participation in resident education ( P < .0001), physicist involvement in medical resident education ( P = .0006), and faculty motivation to attend resident didactics ( P = .004). Residents reported an increased amount of time required to prepare lectures ( P = .008). Conclusions We are the first department, to our knowledge, to offer SAM credit to clinical faculty for participation in resident-generated didactics. Offering SAM credit at resident lectures is a cost-effective alternative to purchasing SAM resources, increases faculty attendance, and may improve the quality of radiation oncology resident education. [ABSTRACT FROM AUTHOR]

This paper presents the results of an experimental study of the adhesion forces between components of model conjugated magnetite nanoparticle systems for improved selectivity in the specific targeting of triple negative breast cancer. Adhesion forces between chemically synthesized magnetite nanoparticles (CMNPs), biosynthesized magnetite nanoparticles (BMNPs), as well as their conjugated systems and triple negative breast cancer cells (MDA-MB-231) or normal breast cells (MCF 10A) are elucidated at a nanoscale. In all cases, the BMNPs had higher adhesion forces (to breast cancer cells and normal breast cells) than CMNPs. The adhesion of LHRH-conjugated BMNPs or BSA-conjugated BMNPs to cancer cells is shown to be about 6 times to that of normal breast cells. The increase in adhesion forces between luteinizing hormone-releasing hormone, LHRH- or EphA2, a breast specific antibody(BSA)-conjugated BMNPs to breast cancer cells is attributed to van der Waals interactions between the peptides/antibodies from the conjugated nanoparticles and the over-expressed receptors (revealed using immunofluorescence staining) on the surfaces of the breast cancer. The implications of the results are discussed for the selectivity and specificity of breast cancer targeting by ligand-conjugated BMNPs. [ABSTRACT FROM AUTHOR]

Few studies have examined the progression of symptom dimensions in schizophrenia patients over the course of the illness. The objective of this study was to investigate whether clinical and psychopathological differences exist between first-episode schizophrenia (FES) and multiple-episode patients in an inpatient setting. Patients (N = 203) were evaluated using the Positive and Negative Syndrome Scale (PANSS) over time. Five different generalized estimating equations were built for the PANSS factors using the following as covariates: sex, patient's age, assessment time point (i.e., moment of patient's evaluation, with a minimum of two and a maximum of four assessments throughout the study timeframe). The FES group was used as the reference to which the groups with up to five years of illness and more than five years of illness were compared. Remission rates and treatment resistance (TRS) rates were also compared. Generalized estimating equations were used to allow for different numbers of assessments over the study period. Patients with FES showed significantly milder severity in positive, disorganized, and hostility factors. Also, FES patients were more likely to achieve remission ( P = 0.002) and had lower rates of TRS ( P = 0.001). First-episode schizophrenia seems to be the critical period to improve outcome, as multiple-episode patients were similar in clinical characteristics regardless of illness duration. [ABSTRACT FROM AUTHOR]

In a context of drug repurposing, pentamidine (PTM), an FDA-approved antiparasitic drug, has been proposed to reverse the splicing defects associated in myotonic dystrophy type 1 (DM1). However, clinical use of PTM is hinder by substantial toxicity, leading to find alternative delivery strategies. In this work we proposed hyaluronic acid-based nanoparticles as a novel encapsulation strategy to efficiently deliver PTM to skeletal muscles cells. In vitro studies on C2C12 myoblasts and myotubes showed an efficient nanoparticles' internalization with minimal toxicity. More interestingly, our findings evidenced for the first time the endosomal escape of hyaluronic acid-based nanocarriers. Ex vivo studies showed an efficient nanoparticles' internalization within skeletal muscle fibers. Finally, the therapeutic efficacy of PTM-loaded nanosystems to reduce the number of nuclear foci has been demonstrated in a novel DM1 in vitro model. So far, current data demonstrated the potency of hyaluronic acid-based nanosystems as efficient nanocarrier for delivering PTM into skeletal muscle and mitigate DM1 pathology. Illustration of hyaluronic acid-based nanoparticles to deliver pentamidine in C2C12 skeletal muscle myoblasts and myotubes and in explanted skeletal murine muscle to treat DM1 pathology. [Display omitted] • Hyaluronic acid-based nanoparticles were efficiently internalized into muscle cells both in vitro and ex vivo. • CD44 receptors play a key role in the uptake of hyaluronic acid-based nanoparticles. • Novel established DM1 cell model accurately represents theDM1 pathological phenotype. • Pentamidine loaded into nanoparticles highly decreased the number of DM1 nuclear foci. • Pentamidine loaded hyaluronic acid-based nanoparticles offer an innovative strategy for DM1 treatment. [ABSTRACT FROM AUTHOR]

Purpose The Next Accreditation System (NAS) requires radiation oncology residents to do a formal quality improvement project during their residency. The American Board of Radiology (ABR) Maintenance of Certification (MOC) program requires certified physicians to complete a Practice Quality Improvement (PQI) project approximately every 3 years. The purpose of our project was to develop a clinical transition of care policy via a process that resulted in quality improvement project credit for residents and PQI credit for participating faculty. Methods and materials Approval for project implementation was obtained from the ABR MOC committee. The PQI project consisted of an initial survey to assess resident perception on resident transition of care in our department, formal sign-out training, and 2 postintervention surveys after 1 and 11 months. The primary endpoint was the percentage of questions with ≤ 1 unfavorable responses. Sign-test was used to determine response difference from neutral. Results One hundred percent of surveyed residents completed the preintervention (n = 6), postintervention 1 (n = 7), and postintervention 2 (n = 8) surveys. In the preintervention, postintervention 1, and postintervention 2 surveys, 71.4%, 57.1%, and 57.1% of questions were answered with ≤ 1 unfavorable response, respectively. The number of questions with ≥ 75% favorable response was 7 (50%), 7 (50%), and 11 (78.5%) in the preintervention, postintervention 1, and postintervention 2 surveys, respectively ( P = .13). A written sign-out template and monthly protected sign-out meetings were instituted. One resident and 3 attending physicians received credit for Accreditation Council of Graduate Medical Education NAS quality improvement and ABR MOC PQI projects, respectively. Conclusions This project shows the feasibility of a combined attending and resident physician effort to improve patient care and fulfill his or her respective ABR MOC PQI and Accreditation Council of Graduate Medical Education NAS requirements. Attending and resident physicians can tailor collaborative projects to fulfill MOC and NAS requirements unique to their subspecialty. Written sign-out templates and protected sign-out time may improve transition of care. [ABSTRACT FROM AUTHOR]

The development of residential automation and energy management systems have aimed to achieve energy reduction within the home. These systems have been developed to compliment human behaviour and potentially impart change in the way people consume energy. The development of energy efficient buildings has been considered a sustainable approach to better manage or optimise energy consumption and generation within a building however, multiple studies have demonstrated some limitations to these buildings and systems. The advancement of the home system of practice using the basis of Social Practice Theory has demonstrated a new focus for the design methodology of these systems. The home system of practice outlines the routines and repetitive nature of individual lifestyles, and these routines result in the temporal characteristic of energy consumption. This study monitored an Australian home that consisted of renewable energy systems, smart technology and automated systems designed to reduce the use of grid electricity. The aim was to understand the performance of the automation systems and interaction with the occupants and their routines. The paper discusses the effectiveness of incorporating social theories and the home system of practice into the design of energy efficient buildings and energy management systems. The methodology utilised machine learning techniques to identify patterns in energy consumption data and related these patterns to the routines and lifestyles of the home occupants. These patterns aimed to describe why the automation system incorporated into the study home did not operate as intended and how design changes can increase effectiveness and performance. • Assessed the performance of low-carbon systems and technologies, and the impact of occupancy on this performance. • Provide insight into how social theories and the home system of practice can be incorporated into the design of net zero buildings. • Utilised a K-Means machine learning approach to assess the routines of the occupants. • Occupant's routines can impact the performance of automation systems and net-zero developments. [ABSTRACT FROM AUTHOR]

Summary: A 7-year-old female Shih-tzu dog was presented with severe dyspnoea. A large mass was palpated in the left cranial neck. Cytological examination of an aspirate sample revealed cells with marked anisokaryosis, giant elements and many bare nuclei. Scattered intact giant cells showed scant, granular cytoplasm and intranuclear inclusions. Histologically, neoplastic cells were subdivided into lobules by fine collagenous trabeculae. Numerous pleomorphic giant, or ‘monster’, cells were observed, showing a highly indented nuclear envelope, intranuclear cytoplasmic pseudoinclusions (ICPs) and ‘ground-glass’ nuclear appearance. Neoplastic emboli were present, but no distant metastases were detected grossly. Immunohistochemically, the neoplastic cells expressed synaptophysin and had variable expression of neuron-specific enolase and vimentin. The cells were negative for pan-cytokeratin, CAM 5.2, glial fibrillary acidic protein and S100. Nuclear abnormalities and cytoplasmic neurosecretory granules were noted ultrastructurally. These features were consistent with a diagnosis of carotid body carcinoma (chemodectoma). Monster cells with ICPs have not been documented previously in canine chemodectoma. [ABSTRACT FROM AUTHOR]

Summary: Abnormal expression of heat shock proteins (HSPs) has been observed in many human neoplasms and such expression has prognostic, predictive and therapeutic implications. The aim of this study was to evaluate immunohistochemically the expression of HSP 27, HSP 32 and HSP 90 in normal canine peripheral nerves and in four benign and 15 malignant canine peripheral nerve sheath tumours (PNSTs). In normal nerve, all of the HSPs were detected in axons, epineurial fibroblasts and scattered Schwann cell bodies. Cytoplasmic expression of HSP 27 was more widespread and intense in benign PNSTs compared with malignant PNSTs (P <0.05). Widespread and intense nuclear expression of HSP 32 was also associated with benign tumours (P <0.01), while high HSP 90 immunoreactivity was detected in all tumours, suggesting that HSP 90 might represent a new therapeutic target. [Copyright &y& Elsevier]

Summary: In normal adult skin, β-catenin is a structural component of the intercellular junction and the Wnt/β-catenin pathway plays a key role in the regulation of cutaneous homeostasis, particularly in the maintenance of hair follicle stem cells. No data are available on the expression pattern of β-catenin in normal canine skin and in canine cutaneous epidermal and follicular tumours. The present study used immunohistochemistry to determine β-catenin expression in four samples of normal canine skin and 62 cutaneous epithelial tumours (14 epidermal, 30 follicular and 18 glandular). β-catenin expression was localized to the nucleus of matrical and dermal papilla cells in anagen hair follicles and was also found in scattered cells of the outer root sheath, suggesting that these follicular epithelial cells may have a high proliferative potential. Nuclear labelling, considered a hallmark of activation of the Wnt/β-catenin signalling pathway, was observed in canine follicular tumours with matrical differentiation (100% of cases of trichoepithelioma and pilomatricoma), suggesting that a possible mutation of the canine CTNBB1 gene may underlie these tumours. In contrast, malignant tumours (squamous cell carcinoma, basal cell carcinoma, sebaceous and apocrine gland carcinoma and epithelioma) were characterized by reduction/loss of β-catenin membrane labelling compared with normal cutaneous epithelial cells and benign tumours, suggesting that reduction/loss of β-catenin expression is important in the acquisition of the malignant phenotype and may have a role in the infiltration and metastasis of these tumours. [Copyright &y& Elsevier]

Abstract: The present study aimed to examine the effects of a prior 1-hour continuous exercise bout (CONT) at an intensity (Fatmax) that elicits the maximal fat oxidation (MFO) on the fat oxidation kinetics during a subsequent submaximal incremental test (IncrC). Twenty moderately trained subjects (9 men and 11 women) performed a graded test on a treadmill (Incr), with 3-minute stages and 1-km·h−1 increments. Fat oxidation was measured using indirect calorimetry and plotted as a function of exercise intensity. A mathematical model (SIN) including 3 independent variables (dilatation, symmetry, and translation) was used to characterize the shape of fat oxidation kinetics and to determine Fatmax and MFO. On a second visit, the subjects performed CONT at Fatmax followed by IncrC. After CONT performed at 57% ± 3% (means ± SE) maximal oxygen uptake (V̇o2max), the respiratory exchange ratio during IncrC was lower at every stage compared with Incr (P < .05). Fatmax (56.4% ± 2.3% vs 51.5% ± 2.4% V̇o2max, P = .013), MFO (0.50 ± 0.03 vs 0.40 ± 0.03 g·min−1, P < .001), and fat oxidation rates from 35% to 70% V̇o2max (P < .05) were significantly greater during IncrC compared with Incr. However, dilatation and translation were not significantly different (P > .05), whereas symmetry tended to be greater in IncrC (P = .096). This study showed that the prior 1-hour continuous moderate-intensity exercise bout increased Fatmax, MFO, and fat oxidation rates over a wide range of intensities during the postexercise incremental test. Moreover, the shape of the postexercise fat oxidation kinetics tended to have a rightward asymmetry. [Copyright &y& Elsevier]

Perichromatin fibrils represent the morphological expression of transcription and co-transcriptional processing of pre-mRNA. They can be considered, hence, an example of work in progress. High resolution techniques such as electron microscopy demonstrate that perichromatin fibrils play a role as early markers of transcriptional alterations. In this paper, we review some experimental and physiological conditions impairing or modulating transcription as well as their effects on perichromatin fibrils. In all the situations reported, perichromatin fibrils show modifications in their amount and/or their associated proteins. Their movements are also affected, as well as their export or their intra-nuclear storage forms. Perichromatin fibrils therefore represent highly sensitive markers not only for monitoring transcriptional and processing rate but also for identifying the maturation level of pre-mRNA/mRNA occurring in the cell nucleus and the functional correlation with the cellular metabolic state. [ABSTRACT FROM AUTHOR]

Abstract: EBT radiochromic films were used to determine skin-dose maps for patients undergone Total Skin Electron Therapy (TSET). Gafchromic EBT radiochromic film is one of the newest radiation-induced auto-developing photon and electron-beam analysis films available for therapeutic radiation dosimetry in radiotherapy applications. EBT films can be particularly useful in TSET; due to patient morphology, underdosed regions typically occur, and the radiochromic film represents a suitable candidate for monitoring them. In this study, TSET was applied to treat cutaneous T-cell lymphoma. The technique for TSET was implemented by using an electron beam with a nominal energy of 6MeV. The patient was treated in a standing position using dual angled fields in order to obtain the greatest dose uniformity along the patient''s longitudinal axis. The electron beam energy was degraded by a PMMA filter. The in vivo dose distribution was determined through the use of EBT films, as well as of thermoluminescent dosimeters for comparison (TLDs). EBT results showed a reasonable agreement with TLDs data. [Copyright &y& Elsevier]

Abstract: The Gafchromic XR type R film is a suitable dosimeter to determine the map of the skin dose in patients undergone complex interventional radiological procedures, such as cardiology ones. The need of preventing or locating possible skin injuries due to high doses administered to patients—as recommended by international organizations—wants the introduction in patient dosimetry of a dosimeter easy to handle, with low dependence of the response on energy in the typical radiological range, and extended measurable dose range. XR type R films fulfil all these requirements and moreover may be quickly analyzed by cheap commercial scanners. In order to determine skin-dose values by XR-R, a film calibration curve is required. In this work, validation of the XR-R dosimetry has been performed for the determination of the skin dose: maximum skin-dose values in 14 patients undergone radiofrequency ablation and pacemaker implant procedures have been determined by XR-R calibrated films. A comparison between skin-dose values determined by XR-R films and retrospective ionometric measurements has pointed out some discrepancies in the results, due to difficulties in retrospectively reproducing the real procedure settings, where XR-R film dosimetry is related to the specific patient procedure, even, in very complex interventional settings. [ABSTRACT FROM AUTHOR]

Unverricht-Lundborg disease (ULD) is an inherited form of progressive myoclonus epilepsy caused by mutations in the gene encoding Cystatin B (CSTB), an inhibitor of lysosomal proteases. The most common mutation described in ULD patients is an unstable expansion of a dodecamer sequence located in the CSTB gene promoter. This expansion is causative of the downregulation of CSTB gene expression and, consequently, of its inhibitory activity. Here we report the generation of induced pluripotent stem cell (iPSC) lines from two Italian siblings having a family history of ULD and affected by different clinical and pathological phenotypes of the disease. [ABSTRACT FROM AUTHOR]

Here, we described the generation of human induced pluripotent stem cell lines (hiPSCs) from fibroblasts isolated by punch biopsies of two siblings carrying inherited mutation (c.434 T > C) in the SCN1A gene, encoding for the neuronal voltage gated sodium channel Na V 1.1. The mutation leads to the substitution of a highly conserved methionine with a threonine (M145T) in the protein sequence, leading to infant febrile seizures (FS). The older brother, affected by complex FS, also developed temporal lobe epilepsy (TLE) during adolescence. [ABSTRACT FROM AUTHOR]

The vast majority of women (60-90%) hold infants on their left side. Such a population-level lateral bias has been shown to improve the processing of socio-emotional stimuli in both the woman and the baby. Recently, some studies related cradling lateralization and Autism Spectrum Disorders (which entail socio-communicative deficits and a reduction of the typical lateralization of brain functions), raising the possibility that the asymmetrical cradling behavior experienced during infanthood might be related to the infant's neurodevelopment. Any progress made towards earlier diagnoses could significantly increase the chance of successful intervention for these patients. We here suggest that a wide retrospective investigation on family photo albums and home movies of children diagnosed with Autism might provide useful data about early behavioral signs of this condition. We hypothesize that an atypical trajectory in maternal cradling might be one of the early signs of interference in dyadic socio-emotional communication, and thus of potential neurodevelopmental dysfunctions. [ABSTRACT FROM AUTHOR]

Purpose The management of patients with CIED receiving radiotherapy (RT) is challenging and requires a structured multidisciplinary approach. In order to stratify the risk of patients and approaching RT sessions appropriately, a consensus document from Associazione Italiana Aritmologia e Cardiostimolazione (AIAC), Associazione Italiana Radioterapia Oncologica (AIRO), Associazione Italiana Fisica Medica (AIFM) has been published on the International Journal of Cardiology in 2018. Along this line, the AIFM working group is promoting specific measurements to better investigate the role of RT on CIED. Methods In Consensus document potential radiation interactions on CIED such as recommendations for the estimation of the dose to the device are described and a multidisciplinary review of in vivo and in vitro data is presented. Further, a multi-center study to evaluate IGRT dose, neutron contamination assessment, and photon out-of-field dose are still being performed. To measure out-of-field dose to CIEDs two phantoms were created and sent to centers working with different treatment planning systems (TPS). Results Preliminary results show that the use of daily CBCT can add a considerable contribution to CIED dose up to 50 cGy like lung 4D protocol. Neutron contamination of photon and electron beams of energies ranging from 6 to 18 MV measured with REM counters show that neutron production for 10 MV photon beam is not negligible. It confirms that neutron produced by electron beam has to be taken into account for beam energy higher than 15 MeV. Comparisons between calculated and measured out-of-filed dose along with examining the behavior of different dosimeters are being studied. Working group is performing measurement to confirm that, in absence of out-of-field TPS commissioning, in vivo dosimetry is still recommended in the case of short distance CIED-field edge or dose close to 2 Gy. Conclusions A detailed approach for safe management of RT patients with CIEDs is now available with important implications for clinical practice. Only a multidisciplinary approach between medical physicists, radiation oncologists and electrophysiologists can really reduce the risk of malfunctions in patient with CIED undergoing RT. Results of the AIFM working group try to provide valuable support and further indications in this regard. [ABSTRACT FROM AUTHOR]