Notes

Performance qualities associated with unsedated ultrathin online video endoscopy inside the assessment from the higher GI tract: methodical review along with meta-analysis.
Data from the present study reveal opportunities and challenges of virtual mentoring and can be used to inform effective research mentoring practices in the future.Learning progressions (LPs) are descriptions of students' growing sophistication in the understanding of a particular construct through a curricular sequence. They are particularly useful for organizing complex constructs for which students do not necessarily connect concepts as taught in different courses. However, they are challenging to construct, because they attempt to linearize students' inherently nonlinear learning. As a result, it is essential to have methods to assess students' arrival at particular steps along the progression. One tool readily available to instructors is concept inventories (CIs). We have mapped published CIs to LPs for acid-base chemistry. The alignment not only provides an assessment that professors can use to pinpoint student learning, but also creates another tool to verify hypothetical LPs. We have compared the types of questions asked on CIs in chemistry, biology, and biochemistry, as well as in some standardized test banks. The mapping of questions from CIs to steps on the LPs allows refinement of the LPs and reveals gaps in assessment tools for sophisticated concepts. This alignment is a novel addition to the cycle of validation of an LP.
Most Veterans Health Administration hospitals do not have radiation oncology (RO) departments on-site. The purpose of this study is to determine the impact of on-site RO on referral patterns and timeliness of palliative radiation therapy (PRT).

A survey was sent to medical directors at 149 Veterans Health Administration centers. Questions evaluated frequency of referral for PRT, timeliness of RO consults and treatment, and barriers to referral for PRT. Chi-square analysis was used to evaluate differences between centers that have on-site RO and centers that refer to outside facilities.

Of 108 respondents, 33 (31%) have on-site RO. Chi-square analysis revealed that RO consult within 1 week is more likely at centers with on-site RO (68%
31%;
= .01). Centers with on-site RO more frequently deliver PRT for spinal cord compression within 24 hours (94%
70%;
= .01). Those without on-site RO were more likely to want increased radiation oncologist involvement (64%
26%;
< .001). Barriers to referral for PRT included patient ability to travel (81%), patient noncompliance (31%), delays in consult and/or treatment (31%), difficulty contacting a radiation oncologist (14%), and concern regarding excessive number of treatments (13%). Respondents with on-site RO less frequently reported delays in consult and/or treatment (6%
41%;
< .0001) and difficulty contacting a radiation oncologist (0%
20%;
= .0056) as barriers.

Respondents with on-site RO reported improved communication with radiation oncologists and more timely consultation and treatment initiation. Methods to improve timeliness of PRT for veterans at centers without on-site RO should be considered.
Respondents with on-site RO reported improved communication with radiation oncologists and more timely consultation and treatment initiation. Methods to improve timeliness of PRT for veterans at centers without on-site RO should be considered.
Tamoxifen prevents breast cancer in high-risk women and reduces mortality in the adjuvant setting. Mammographic density change is a proxy for tamoxifen therapy response. We tested whether lower doses of tamoxifen were noninferior to reduce mammographic density and associated with fewer symptoms.

Women, 40-74 years of age, participating in the Swedish mammography screening program were invited to the 6-month double-blind six-arm randomized placebo-controlled noninferiority dose-determination KARISMA phase II trial stratified by menopausal status (EudraCT 2016-000882-22). In all, 1,439 women were accrued with 1,230 participants accessible for intention-to-treat analysis. WL12 The primary outcome was proportion of women treated with placebo, 1, 2.5, 5, and 10 mg whose mammographic density decreased at least as much as the median reduction in the 20 mg arm. The noninferior margin was 17%. Secondary outcome was reduction of symptoms. Post hoc analyses were performed by menopausal status. Per-protocol population andstudies should test whether 2.5 mg of tamoxifen reduces the risk of primary breast cancer.Purpose To describe the course of posterior subhyaloid precipitates (PSPs) accompanying active retinitis. Methods Retrospective study of three retinitis cases associated with PSPs and literature review. Results Cases 1 and 2 were Toxoplasma retinochoroiditis. Case 3 had bilateral retinitis post-febrile illness. PSPs were yellowish-white spherical lesions seen in the presence of partial posterior hyaloid detachment (PVD) in the retro-hyaloid space lining the inferior PVD margin. In all 3 cases, PSPs resolved during treatment for primary disease. Resolution of PSPs preceded resolution of retinitis. Literature review revealed similar lesions in CMV retinitis and syphilis in addition to Toxoplasma retinochoroiditis. Conclusion PSPs were seen in the presence of active retinitis and partial PVD when inflammatory aggregates gravitate inferiorly in the subhyaloid space. They were observed during active retinitis and their resolution preceded the resolution of retinitis, thus providing a potential marker for disease resolution.The COVID-19 pandemic has precipitated an acute blood shortage for medical transfusions, exacerbating an already tenuous blood supply system in the United States, contributing to the public health crisis, and raising deeper questions regarding emergency preparedness planning for ensuring blood availability. However, these issues around blood availability during the pandemic are related primarily to the decline in supply caused by reduced donations during the pandemic rather than increased demand for transfusion of patients with COVID-19.The challenges to ensure a safe blood supply during the pandemic will continue until a vaccine is developed, effective treatments are available, or the virus goes away. If this virus or a similar virus were capable of transmission through blood, it would have a catastrophic impact on the health care system, causing a future public health emergency that would jeopardize the national blood supply.In this article, we identify the impact of the COVID-19 pandemic on blood supply adequacy, discuss the public health implications, propose recovery strategies, and present recommendations for preparing for the next disruption in blood supply driven by a public health emergency.
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