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Robin Lüchinger,1 Matteo Coen,1,2 Anne-Claire Bréchet Bachmann,2 Sara de Oliveira,3 Hélène Richard-Lepouriel,4 Noëlle Junod Perron1,5 1Unit of Research and Development in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland; 2Department of Primary Care Medicine, University Hospitals of Geneva, Geneva, Switzerland; 3Department of Paediatrics, Gynaecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland; 4Department of Psychiatry, University Hospitals of Geneva, Geneva, Switzerland; 5Medical Directorate, University Hospitals of Geneva, Geneva, SwitzerlandCorrespondence: Robin Lüchinger, Unit of Research and Development in Medical Education, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, Geneva, 1205, Switzerland, Tel +41 22 379 59 44, Email Robin.luechinger@unige.chPurpose: How to give feedback is widely taught and assessed during Faculty Development programs. As part of such programs, clinical teachers can attend objective structured teaching sessions (OSTEs), during which they are asked to give feedback to simulated residents on different tasks. Study aimed at: -analysing the feedback content provided during these OSTEs; -evaluating the impact of the training phase, medical discipline, or observed task; -assessing the alignment between feedback content addressed by clinical teachers and content identified as essential by experts.Methods: We conducted a multimethod study. Clinical teachers (N=89) from five departments were trained to give feedback to residents in a six-month training program. Before and after training, they completed three OSTE stations which focused on tasks involving communication, interprofessional, physical exam or procedural skills. We analysed feedback content descriptively. ANOVA test was applied to evaluate feedback contents’ influencing factors (ie participants’ training phase, medical discipline, type of task addressed). For each OSTE, we analysed the percentage of items identified as essential by 3 experts that were addressed by clinical teachers during the feedback.Results: We analysed 317 feedback sessions and coded 5388 occurrences. Feedback content distribution was: targeted content (73%), other clinical content (20%), learning strategies (4%), and self-management/other (3%). Feedback was often negative (73%). The training phase did not influence the content addressed while the topic of the observed task and clinical teachers’ specialization slightly did. Alignment between content identified by experts and addressed by clinical teachers during OSTEs was low (3– 38%).Conclusion: Clinical teachers give mostly negative and targeted feedback according to the task. The poor alignment in selecting key content to be addressed is striking and should be further explored since clinical teachers may address elements of competence more according to their personal preferences than to residents’ needs and context priorities.Keywords: OSTEs, feedback content, clinical teacher, simulation, chief residents, fellow

Edward R Kastenhuber,1,2 John Craig,3 Jon Ramsey,4 Kevin M Sullivan,5 Julien Sage,6,7 Sofia de Oliveira,8 Kimberly J Riehle,5 John D Scott,5 John D Gordan,9 Nabeel Bardeesy,10,11 Ghassan K Abou-Alfa1,12 1Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA; 2Louis V. Gerstner Jr. Graduate School of Biomedical Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA; 3Fibrolamellar Cancer Foundation, Greenwich, CT, USA; 4Department of Biochemistry, University of Vermont Cancer Center, Burlington, VT, USA; 5Northwest Liver Research Program, University of Washington, Seattle, WA, USA; 6Department of Pediatrics, Stanford University, Stanford, CA, USA; 7Department of Genetics, Stanford University, Stanford, CA, USA; 8Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, WI, USA; 9Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; 10Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA; 11Department of Medicine, Harvard Medical School, Boston, MA, USA; 12Department of Medicine, Weill Cornell School of Medicine, New York, NY, USA Abstract: Fibrolamellar carcinoma is a rare liver cancer, which primarily afflicts adolescents and young adults worldwide and is frequently lethal. Given the rarity of this disease, patient recruitment for clinical trials remains a challenge. In November 2017, the Second Fibrolamellar Cancer Foundation Scientific Summit (Stamford, CT, USA) provided an opportunity for investigators to discuss recent advances in the characterization of the disease and its surrounding liver and immune context. The Fibrolamellar Cancer Foundation has thus set out a road map to identify and test therapeutic targets in the most efficient possible manner. Keywords: fibrolamellar carcinoma, liver cancer, adolescent, young adult, fusion oncogene, cyclic AMP-dependent protein kinase catalytic subunit, heat shock protein 40

The hybrid material was obtained from the synthesis of graphene oxide (GO) followed by GO chemical reduction with L‐ascorbic acid. Then hydrothermal synthesis was carried out to form and grow carbon dots (CDs) on the surface of reduced graphene oxide (rGO). The material obtained, CD@rGO, was characterized by transmission electron microscopy (TEM), the infrared (FTIR), Raman and UV‐visible (UV‐Vis) spectroscopy, in addition to X‐ray diffractometry (XRD), spectroscopy and electrochemical methods. The results indicated the formation of carbon dots on the surface of rGO. The study of the voltammetric determination of hydroxychloroquine (HCQ) was performed using adsorptive stripping voltammetry (AdSV) and employing a modified electrode with CD@rGO (ECR). Optimizations were kept in the electrolytic environment and AdSV technique parameters, making it possible to obtain a LOD and LOQ of 2.40 and 7.99 pmol L−1, respectively. The evaluation of the ECR electrochemical stability, repeatability and reproducibility tests were performed with maximum variations of up to 2.79 and 2.03 %, respectively. Determinations in commercial samples of HCQ (tablets) and synthetic urine, recovery in the range of 101.55–106.83 % were obtained. [ABSTRACT FROM AUTHOR]

Summary: The breadth‐first search procedure is an algorithm that traverses the vertices of a graph, determining the distance from each vertex to the initial vertex. The distance is infinite for a non‐reachable vertex from the starting vertex. Despite having an efficient serial version, this important algorithm is irregular, making its effective parallel implementation a daunting task. This paper shows the results of an OpenMP‐based implementation of the breadth‐first search procedure using the bag data structure. Furthermore, the code relied on the C++ programming language. This paper reimplements an existing proposal coded using the Cilk++ programming language. The experiments relied on 32 strongly connected graphs and 31 disconnected graphs in executions performed on two machines. The first machine contained 28 cores and two threads per core. The second machine comprised 48 processing cores, with hyperthreading disabled. Regarding the serial version, the parallel implementation yielded a speedup of up to 20× when using 28 processing cores and up to 25× when using 56 threads in tests performed on a machine with the first generation of Intel® Xeon® Scalable processors. Furthermore, the new parallel implementation yielded speedups of up to 45× when using 48 cores in experiments performed on a machine with the second generation of Intel® Xeon® Scalable processors. [ABSTRACT FROM AUTHOR]

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Management of patients with central nervous system tumors relies largely on magnetic resonance imaging scans to document disease progression or recurrence. The finding of new lesions always presents the challenge of differentiating between post-surgical changes, radiation necrosis, gliosis, and tumor, submitting these patients to more aggressive therapy and more toxicity. We reviewed the medical records of three patients with primary central nervous system tumors treated at the Children’s Hospital Los Angeles who had new false-positive magnetic resonance imaging findings suggestive of tumor recurrence. All of them had complete total resection of primary tumor, had received involved-field radiation therapy, had biopsies confirming absence of viable tumor, and all three patients are long-term survivors. These cases exemplify that not everything that enhances on brain or spine magnetic resonance imaging is viable tumor, and a biopsy should always be considered in the decision-making process in evaluation of potentially recurrent central nervous system tumors in pediatric patients. A step-wise approach for such challenging cases is presented in this article.

BACKGROUNDIn previous clinical trials involving children with X-linked severe combined immunodeficiency (SCID-X1), a Moloney murine leukemia virus–based γ-retrovirus vector expressing interleukin-2 receptor γ-chain (γc) complementary DNA successfully restored immunity in most patients but resulted in vector-induced leukemia through enhancer-mediated mutagenesis in 25% of patients. We assessed the efficacy and safety of a self-inactivating retrovirus for the treatment of SCID-X1.METHODSWe enrolled nine boys with SCID-X1 in parallel trials in Europe and the United States to evaluate treatment with a self-inactivating (SIN) γ-retrovirus vector containing deletions in viral enhancer sequences expressing γc (SIN-γc).RESULTSAll patients received bone marrow–derived CD34+ cells transduced with the SIN-γc vector, without preparative conditioning. After 12.1 to 38.7 months of follow-up, eight of the nine children were still alive. One patient died from an overwhelming adenoviral infection before reconstitution with genetically modified T cells. Of the remaining eight patients, seven had recovery of peripheral-blood T cells that were functional and led to resolution of infections. The patients remained healthy thereafter. The kinetics of CD3+ T-cell recovery was not significantly different from that observed in previous trials. Assessment of insertion sites in peripheral blood from patients in the current trial as compared with those in previous trials revealed significantly less clustering of insertion sites within LMO2 , MECOM, and other lymphoid proto-oncogenes in our patients.CONCLUSIONSThis modified γ-retrovirus vector was found to retain efficacy in the treatment of SCID-X1. The long-term effect of this therapy on leukemogenesis remains unknown. (Funded by the National Institutes of Health and others; ClinicalTrials.gov numbers, NCT01410019, NCT01175239, and NCT01129544.)