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Metal‐free catalytic C−H functionalization is highly desired for the construction of C−C bonds. We herein report a highly chemoselective consecutive C−H [2+3]‐cyclative functionalization for the simultaneous formation of two C−C bonds with construction of polycyclic phenols catalyzed by commercially available and low‐cost B(C6F5)3. This catalytic system tolerates a wide range of substrate scope, providing a series of 2,6,7,8‐tetrahydroacenaphthylen‐3‐ol‐type polycyclic compounds efficiently. Several derivatizations of the catalytic products have also been conducted to show the potential application of this method in synthesis of polycyclic compounds. [ABSTRACT FROM AUTHOR]

Purpose: Measuring patient-reported outcomes (PROs) in clinical practice has been associated with improved survival and quality of life for patients with cancer. However, this application of PROs is relatively new, and little is known about how practices collect PROs, which PROs are measured, and what challenges are met in implementation. Methods: We surveyed Quality Oncology Practice Initiative–registered practices in December 2015 to understand the current state of PROs use and identify areas where implementation support may be needed. PRO collectors were asked to describe their views, practices, and challenges with implementation; noncollectors were asked about their interest in and perceived barriers to collection. Results: Eighty-nine practices (38% of those that viewed the participation request) completed ≥ 50% of the survey and comprised the analytic sample. Most (79%) responders noted that collecting PROs was a high priority; slightly fewer actually collected PROs (69%). Most collectors (79%) were affiliated with hospitals or medical centers, and nearly all (94%) had electronic health records (EHRs). Collectors saw more patients per week than noncollectors (P <.01). The PROs used by collectors addressed several topics, including patient distress (78%), symptoms (76%), and experience or satisfaction (70%). Perceived implementation challenges were similar for collectors and noncollectors: patient unwillingness to complete questionnaires and insufficient staff support; noncollectors additionally cited lack of PRO integration in the electronic health records. Conclusion: Widespread agreement that PRO collection is important has led to early adoption among a sizable minority of Quality Oncology Practice Initiative practices. Reaching consensus regarding which PROs are meaningful and developing and sharing best-practices that overcome implementation barriers could facilitate implementation and maximize PRO utility. [ABSTRACT FROM AUTHOR]

Purpose:Volunteer service learning activities, including Student Run Clinics (SRCs), are becoming an increasingly popular extracurricular component of medical education. While there are reports that student clinicians generally enjoy their educational experiences at SRCs, it is not understood how to optimize and measure student engagement in them. To identify key drivers of student engagement a tool was created to measure volunteer experience at the Crimson Care Collaborative (CCC), a primary care SRC. Methods:CCC volunteers were asked to complete an online engagement survey. Cross-sectional survey data were collected for 149 CCC volunteers (53% response rate). Results:Multivariate linear regression showed that overall ‘likelihood to recommend CCC to a friend’ was significantly associated with students’ perception of the clarity of their role within the clinic, frequency of interprofessional interactions, and overall quality of medical education. Students who volunteer more frequently and for longer periods of time had higher engagement scores. Conclusions:Measuring engagement is feasible in volunteer settings. Engagement appears to be dependent on both structural and experiential components. Easily modifiable components of job design (role definition, expected frequency of volunteering), are key drivers of volunteer engagement. [ABSTRACT FROM AUTHOR]

Objective. To assess the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. Methods. We enrolled 257 men with clinically localized prostate cancer (prostate-specific antigen <20; Gleason score 6 or 7) seen by urologists (primarily residents and fellows) in 4 Veterans Affairs medical centers. We measured patients’ baseline preferences prior to their urology appointments, including initial treatment preference, cancer-related anxiety, and interest in sex. In longitudinal follow-up, we determined which treatment patients received. We used hierarchical logistic regression to determine the factors that predicted treatment received (active treatment v. active surveillance) and urologist recommendations. We also conducted a directed content analysis of recorded clinical encounters to determine if urologists discussed patients’ interest in sex. Results. Patients’ initial treatment preferences did not predict receipt of active treatment versus surveillance, Δχ2(4) = 3.67, P = 0.45. Instead, receipt of active treatment was predicted primarily by urologists’ recommendations, Δχ2(2) = 32.81, P < 0.001. Urologists’ recommendations, in turn, were influenced heavily by medical factors (age and Gleason score) but were unrelated to patient preferences, Δχ2(6) = 0, P = 1. Urologists rarely discussed patients’ interest in sex (<15% of appointments). Conclusions. Patients’ treatment decisions were based largely on urologists’ recommendations, which, in turn, were based on medical factors (age and Gleason score) and not on patients’ personal views of the relative pros and cons of treatment alternatives. [ABSTRACT FROM AUTHOR]

Postcardiac injury syndrome (PCIS) is characterized by the appearance of pericardial, pleural, or pulmonary parenchymal inflammation following a cardiac operation. The autoimmune disorder is characterized by eosinophilia, pleuritic chest pain, pleural, and pericardial effusion. It is a troublesome complication, which may prolong hospital stay and lead to severe and life-threatening conditions. Recently, its incidence appears to be declining, owing to modern immunomodulatory drug therapies. Here we report an uncommon case of PCIS, which occurred following a pulmonary vein isolation for atrial fibrillation. The patient suffered from pulmonary parenchymal inflammation but no pleuropericarditis after the operation. We describe with detailed clinical information, laboratory, and imaging tests, treatment processes, and a favorable prognosis in the content. This case illustrates that even after initially uneventful radiofrequency catheter ablation, careful, long-term follow-up is necessary to recognize the potential development of postcardiac injury syndrome. < Learning objective: Although uncommon, physicians should keep postcardiac injury syndrome in mind following radiofrequency catheter ablation. The pattern does not always resemble the classical picture described by Dressler, but may take many forms and should be sought. Diagnosis is based on the clinical signs and symptoms and is mostly confirmed after excluding other diseases. Prognosis is usually benign, and therapeutic response to anti-inflammatory drugs and corticosteroids can aid in the diagnosis.> [ABSTRACT FROM AUTHOR]