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We present the complete chloroplast genome sequence of an endophytic Ostreobium sp. isolated from a 19th-century coralline red algal specimen from St. Croix, U.S. Virgin Islands. The chloroplast genome is 84,848 bp in length, contains 114 genes, and has a high level of gene synteny to other Ostreobiaceae.

Non-melanoma skin cancer (NMSC) is the most common cancer in the world. Environmental exposure to carcinogens is one of the major causes of NMSC initiation and progression. In the current study, we utilized a two-stage skin carcinogenesis mouse model generated by sequential exposure to cancer-initiating agent benzo[a]pyrene (BaP) and promoting agent 12-O-tetradecanoylphorbol-13-acetate (TPA), to study epigenetic, transcriptomic and metabolic changes at different stages during the development of NMSC. BaP/TPA caused significant alterations in DNA methylation and gene expression profiles in skin carcinogenesis, as evidenced by DNA-seq and RNA-seq analysis. Correlation analysis between differentially expressed genes and differentially methylated regions found that the mRNA expression of oncogenes leucine rich repeat LGI family member 2 (Lgi2), kallikrein-related peptidase 13 (Klk13) and SRY-Box transcription factor (Sox5) are correlated with the promoter CpG methylation status, indicating BaP/TPA regulates these oncogenes through regulating their promoter methylation at different stages of NMSC. Pathway analysis identified that the modulation of macrophage-stimulating protein-recepteur d’origine nantais and high-mobility group box 1 signaling pathways, superpathway of melatonin degradation, melatonin degradation 1, sirtuin signaling and actin cytoskeleton signaling pathways are associated with the development of NMSC. The metabolomic study showed BaP/TPA regulated cancer-associated metabolisms like pyrimidine and amino acid metabolisms/metabolites and epigenetic-associated metabolites, such as S-adenosylmethionine, methionine and 5-methylcytosine, indicating a critical role in carcinogen-mediated metabolic reprogramming and its consequences on cancer development. Altogether, this study provides novel insights integrating methylomic, transcriptomic and metabolic-signaling pathways that could benefit future skin cancer treatment and interception studies.

The patient is a 35-year-old Filipino man, diagnosed with Hemophilia A since birth, who presented with an enlarged right thigh with multiple masses. This paper will discuss the following issues: 1) how to differentiate pseudotumor from primary bone malignancy and 2) to describe how patients with hemophilia should be prepared for surgery.

The 2019 novel coronavirus pandemic has tremendously affected health-seeking behaviors. Fear of contracting the disease has been a major factor keeping patients from presenting to hospitals, even when urgent or emergent medical attention is needed. Hospitals limiting staff exposure and capacity to accommodate patients also limits opportunities to seek care. Although physical distancing is encouraged to curb infections, this call needs to be tempered with public health education for what constitutes emergencies and urgent medical conditions needing face-to-face attention. Measures to assuage fears among patients and their caregivers to ensure their safety in the hospital or health care setting need to be communicated and executed effectively. Epidermolysis bullosa is an inherited mechanobullous disorder that is usually stable, but in some patients with underlying comorbidities, close monitoring or face-to-face management is required . We present our experience and provide recommendations pertinent to epidermolysis bullosa patients of all subtypes during the coronavirus crisis.

Posttraumatic growth (PTG) represents positive changes following a trauma, crisis, and/or psychologically distressing event. Experiencing cancer can serve as a traumatic event for patients, resulting in life changes among survivors. Various PTG measures have been used to assess post-cancer change among childhood cancer survivors (CCS), but few have been evaluated for use in this population. This study examined the factor structure of an adapted, 11-item version of the Posttraumatic Growth Inventory (PTGI) among CCS. A randomly selected subgroup of participants ( N = 332) was selected from the Los Angeles Cancer Surveillance Program (mean age of 26.5 years at time of survey, mean age at diagnosis of 12 years, primarily male [53.6%], and Hispanic [51.5%]). Participants indicated the degree to which they experienced positive, negative, or no change in their life because of their cancer experience. An exploratory factor analysis (EFA) identified two factors: Appreciation of New Possibilities and Spiritual Change. The adapted, 11-item PTGI was deemed appropriate for use among CCS. Additional research is needed to confirm the use of the two-factor model with confirmatory factor analysis in an independent sample. Future research on PTG among CCS can consider spiritual change as a potential independent factor.

Less than 1% of children in the United States concurrently meet guidelines for fruit/vegetable intake, physical activity, screen time, and sugar-sweetened beverages. Prior evidence suggests that parents of this 1% potentially cope with stress differently. This qualitative study used a positive deviance-based approach to locate mothers whose children avoided negative feeding outcomes despite being ‘high-risk’ for obesity. Semi-structured interviews were conducted in Spanish for two groups: low-income, Hispanic mothers whose children were normal weight and met recommendations for fruits/vegetables and physical activity (n = 5); and a comparison group whose children had obesity and did not meet guidelines (n = 8). Topics included weight-related parenting practices, attitudes toward health, and stress management. Interviews were transcribed, translated, and coded using NVivo for theoretically driven thematic analysis. Results suggested that mothers viewed stress differently. Mothers of healthy weight children believed stress could be prevented, such as by paying children more attention or directing one’s attention away from stressors; comparison group mothers tended to report stress about managing their child’s eating and about financial worries. Future research is needed to understand the underlying sources of these differences (e.g. personality traits, coping practices) and test whether stress prevention interventions can promote healthy parental feeding practices.

Sulforaphane (SFN), a potent antioxidant and antiinflammatory agent, has been shown to protect against cancers especially at early stages. However, how SFN affects UVB-mediated epigenome/DNA methylome and transcriptome changes in skin photodamage has not been fully assessed. Herein, we investigated the transcriptomic and DNA methylomic changes during tumor initiation, promotion, and progression and its impact and reversal by SFN using next-generation sequencing (NGS) technology. The results show that SFN reduced tumor incidence and tumor number. SFN's protective effects were more dramatic in the early stages than with later stages. Bioinformatic analysis of RNA sequencing (RNA-seq) data shows differential expressed genes and identifies the top canonical pathways related to SFN treatment of UVB-induced different stages of epidermal carcinogenesis. These pathways include p53 signaling, cell cycle: G2–M DNA damage checkpoint regulation, Th1, and Th2 activation pathway, and PTEN signaling pathways. The top upstream regulators related to UVB and SFN treatment as time progressed include dextran sulfate, TP53, NFE2L2 (Nrf2), IFNB1, and IL10RA. Bioinformatic analysis of Methyl-seq data shows several differential methylation regions induced by UVB were attenuated by SFN. These include Notch1, Smad6, Gnai3, and Apc2. Integrative analysis of RNA-seq and DNA-seq/CpG methylome yields a subgroup of genes associated with ultraviolet B (UVB) and SFN treatment. The changes in gene expression were inversely correlated with promoter CpG methylation status. These genes include Pik3cd, Matk, and Adm2. In conclusion, our study provides novel insights on the impact of SFN on the transcriptomic and DNA methylomic of UVB-induced different stages of skin cancer in mice.

Nonmelanoma skin cancer (NMSC) is the most common skin cancer burden on the U.S. population. Environmental exposure to chemical carcinogens is one of the major causes of NMSC initiation, promotion, and progression. Ursolic acid (UA) is a naturally abundant pentacyclic triterpenoid showing anticancer potentials against diverse cancers. In the current study, we developed a two-stage skin carcinogenesis model in SKH1 hairless mice by administering cancer-initiating agent benzo[a]pyrene (B[a]P) and promoting agent 12-O-tetra-decanoylphorbol-13-acetate to study the epigenetic, transcriptomic, and metabolic changes at different stages (5, 20, and 26 weeks) during the development of NMSC, and investigated how UA regulates B[a]P-mediated alterations for NMSC interception. We found that UA protects against B[a]P-induced tumorigenesis at different phases of NMSC. Epigenetic CpG methyl-seq showed UA abrogated B[a]P-mediated alterations in differentially methylated regions (DMRs) profiles. Transcriptomic RNA-seq data exhibited UA reversed the differentially expressed genes (DEGs) of several inflammatory genes, such as chemokine ligand 8 (Ccl8) and interleukin 17F (Il17f), and epigenetic genes, such as DNA-methyltransferase 3-like (Dnmt3l) and protein-l-isoaspartate O-methyltransferase domain-containing protein 1 (Pcmtd1) during different stages of NMSC. Association study between DEGs and DMRs showed that B[a]P promoted transcription of kallikrein-related peptidase 13 (Klk13) by promoter demethylation, while UA suppressed Klk13 expression through hypermethylation in the promoter during the initiation stage, indicating the early intervention of UA. Ingenuity pathway analysis further showed significant upregulation of macrophage-stimulating protein-recepteur d'origine nantais (MSP-RON) signaling pathway by B[a]P during the initiation stage while suppressed by UA treatment. The metabolomic study revealed UA modulated cancer-associated changes in metabolisms, including the TCA cycle and pyruvate metabolism/metabolites during the promotion phase, indicating UA plays a critical role in regulating B[a]P-regulated metabolic changes and intercepting NMSC progression. In summary, UA protects against the environmental carcinogen B[a]P-driven epigenetic, transcriptomic, and metabolic changes during the initiation, promotion, and progression of NMSC, potentially contributing to the anticancer effects of UA. (Supported by NIH R01 CA200129 to A.N.K) Citation Format: Md. Shahid Sarwar, Christina N. Ramirez, Hsiao-Chen Dina Kuo, Pochung Chou, Renyi Wu, Davit Sargsyan, Ahmad Shannar, Rebecca Mary Peter, Ran Yin, Yujue Wang, Xiaoyang Su, Ah-Ng Kong. Metabolic rewiring and epigenetic reprogramming by the environmental carcinogen benzo[a]pyrene in a two-stage skin carcinogenesis mouse model and cancer interception by triterpenoid ursolic acid. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5266.

FoxP3 is an essential transcription factor (TF) for immunologic homeostasis, but how it utilizes the common forkhead DNA-binding domain (DBD) to perform its unique function remains poorly understood. We here demonstrate that, unlike other known forkhead TFs, FoxP3 forms a head-to-head dimer using a unique linker (Runx1-binding region, RBR) preceding the forkhead domain. Head-to-head dimerization confers distinct DNA-binding specificity and creates a docking site for the cofactor Runx1. RBR is also important for proper folding of the forkhead domain, as truncation of RBR induces domain-swap dimerization of forkhead, which was previously considered the physiological form of FoxP3. Rather, swap-dimerization impairs FoxP3 function, as demonstrated with the disease-causing mutation R337Q, while a swap-suppressive mutation largely rescues R337Q-mediated functional impairment. Altogether, our findings suggest that FoxP3 can fold into two distinct dimerization states: head-to-head dimerization representing functional specialization of an ancient DBD and swap-dimerization with impaired functions.

Children with autism spectrum disorders often display dysregulated immune responses and related gastrointestinal symptoms. However, the underlying mechanisms leading to the development of both phenotypes have not been elucidated. Here, we showed that mouse offspring exhibiting autism-like phenotypes due to prenatal exposure to maternal inflammation were more susceptible to developing intestinal inflammation following challenges later in life. In contrast to its prenatal role in neurodevelopmental phenotypes, interleukin-17A (IL-17A) generated immune-primed phenotypes in offspring through changes in the maternal gut microbiota that led to postnatal alterations in the chromatin landscape of naïve CD4(+) T cells. The transfer of stool samples from pregnant mice with enhanced IL-17A responses into germ-free dams produced immune-primed phenotypes in offspring. Our study provides mechanistic insights into why children exposed to heightened inflammation in the womb might have an increased risk of developing inflammatory diseases in addition to neurodevelopmental disorders.

This research study was designed to analyze the impact of an evidence-based charge nurse (CN) education program on novice and experienced CNs' self-confidence and satisfaction with the role, skill competencies, and nursing metrics.Charge nurses are critical to effective daily unit operations. However, executive nursing leadership found that unit performance varied by CN despite experience.University faculty partnering with nurse leaders developed an evidence-based CN education program including a series of classes, coaching in skills and role responsibilities by nurse leaders, and evaluation of skills competencies before and after the CN education program.The CN program was associated with significant positive changes in CN performance, nurse-specific metrics, hospital-acquired events, and patient satisfaction.Interventions targeting frontline leaders positively impact CN performance.

OBJECTIVE This research study was designed to analyze the impact of an evidence-based charge nurse (CN) education program on novice and experienced CNs' self-confidence and satisfaction with the role, skill competencies, and nursing metrics. BACKGROUND Charge nurses are critical to effective daily unit operations. However, executive nursing leadership found that unit performance varied by CN despite experience. METHODS University faculty partnering with nurse leaders developed an evidence-based CN education program including a series of classes, coaching in skills and role responsibilities by nurse leaders, and evaluation of skills competencies before and after the CN education program. RESULTS The CN program was associated with significant positive changes in CN performance, nurse-specific metrics, hospital-acquired events, and patient satisfaction. CONCLUSIONS Interventions targeting frontline leaders positively impact CN performance.

Background. The genus Metarhizium is integrated of various species, they have a wide geographic distribution and are considered one of the best biological control agents for pests insect. Objective. To determine the genetic diversity of Metarhizium strains isolated from different insects and agroecosystems using RAPD markers. Methodology. Soil was collected from different agroecosystems (Mexican lemon, grapefruit, sugar cane, mango), insects Diatraea saccharalis (Lepidoptera: Crambidae), Diatraea magnifactella (Lepidoptera: Crambidae), Schistocerca piceifrons piceifrons (Orthoptera: Acridylus), Macrodactylus murinus (Coleoptera: Scarabaeidae), Spodoptera frugiperda (Lepidoptera: Noctuidae) and the mite Boophilus microplus (Acari: Ixodidae) to isolate Metarhizium strains, the isolates were analyzed through random amplified polymorphic DNA (RAPD) markers. Results. The RAPD markers were highly informative and polymorphic. The generated dendrogram was made up of four clusters (A-D); cluster A consisted of 11 soil isolates, one from D. magnifactella and two from D. saccharalis. In cluster B one of D. saccharalis and one of soil. On the other hand, in cluster C were that B. microplus and one of soil. While cluster D was integrated by the S. frugiperda, M. murinus and S. piceifrons isolates. Implications. The determination of the genetic diversity between Metarhizium isolates obtained from insects and agroecosystems, generates a contribution on the habitat that will allow the development of strategies to carry out an adequate biological control of pest insects. Conclusion. The analyzes using the RAPD markers indicated that there is a genetic diversity among the Metarhizium isolates collected from different insects and agroecosystems.

There is significant interest in the use of terbium radioisotopes for applications in cancer therapy and diagnosis. Of these

Pemphigus vulgaris is an autoimmune bullous dermatosis presenting with flaccid blisters and erosions. The morphology of pemphigus reflects the more superficial intraepidermal level of split seen histologically in contrast with pemphigoid, where the level of split is deep below the epidermis. This is a case of a 58-year-old male clinically presenting with arcuate tense bullae, which are more characteristic of the pemphigoid group of disorders, which revealed an intraepidermal split and tombstoning pattern of the basal epidermis on histopathology. Direct immunofluorescence revealed intercellular IgG and C3 distribution. Although this patient presented clinically with tense bullae, the histopathology and direct immunofluorescence results were consistent with pemphigus vulgaris. © 2021 University of the Philippines Manila. All rights reserved.

Hailey-Hailey disease (HHD) is an uncommon acantholytic disorder of the skin. This is a case of a 64-year-old Filipino female with a chronic history of painful and malodorous intertriginous plaques. Histopathologic evaluation showed overlapping features of pemphigus vulgaris and Hailey-Hailey disease. A negative direct immunofluorescence test clinched the diagnosis of Hailey-Hailey disease. The patient was advised regarding preventive measures and treated with topical antibiotics and corticosteroids with improvement of her lesions.

Background. Leprosy, a chronic granulomatous disease affecting mainly the skin and peripheral nerves, has widely recognized ocular complications. It is a significant cause of visual impairment in countries where it is still prevalent, including the Philippines. Methods. This was a cross-sectional study that determined the clinical profile and distribution of ocular pathology among Filipino patients with leprosy seen at a tertiary institution in the Philippines. Results. A total of 67 patients consented to be included in the study and were evaluated by an ophthalmologist. Thirty-seven out of the 67 patients diagnosed with leprosy had reported ocular findings. The average age was 41.2 ± 13.1 years and the majority of patients were men (78%). Thirty-six patients were multibacillary cases, 10 (27%) had a lepra reaction, and 24 (65%) were undergoing multi-drug therapy. Three patients had varying degrees of visual acuity impairment (one was visually impaired with visual acuity [VA] 6/24-6/60, one with VA 3/60-5/60, and one with VA

BackgroundChildhood cancer survivors (CCS) face increased risk of morbidity and are recommended to receive lifelong cancer-related follow-up care. Identifying factors associated with follow-up care can inform efforts to support the long-term health of CCS.MethodsEligible CCS (diagnosed between 1996 and 2010) identified through the Los Angeles County Cancer Surveillance Program responded to a self-report survey that assessed demographic, clinical, health-care engagement, and psychosocial risk and protective factors of recent (prior 2 years) cancer-related follow-up care. Weighted multivariable logistic regression was conducted to identify correlates of care. All statistical tests were 2-sided.ResultsThe overall response rate was 44.9%, with an analytical sample of n = 1106 (54.2% Hispanic; mean [SD] ages at survey, diagnosis, and years since diagnosis were 26.2 [4.9], 11.6 [5.4], and 14.5 [4.4] years, respectively). Fifty-seven percent reported a recent cancer-related visit, with lower rates reported among older survivors. Having insurance, more late effects, receipt of a written treatment summary, discussing long-term care needs with treating physician, knowledge of the need for long-term care, having a regular source of care, and higher health-care self-efficacy were statistically significantly associated with greater odds of recent follow-up care, whereas older age, Hispanic or Other ethnicity (vs non-Hispanic White), and years since diagnosis were associated with lower odds of recent care (all Ps < .05).ConclusionsAge and ethnic disparities are observed in receipt of follow-up care among young adult CCS. Potential intervention targets include comprehensive, ongoing patient education; provision of written treatment summaries; and culturally tailored support to ensure equitable access to and the utilization of care.

FoxP3 is an essential transcription factor (TF) for immunologic homeostasis, but how it utilizes the common forkhead DNA-binding domain (DBD) to perform its unique function remains poorly understood. We here demonstrated that unlike other known forkhead TFs, FoxP3 formed a head-to-head dimer using a unique linker (Runx1-binding region [RBR]) preceding the forkhead domain. Head-to-head dimerization conferred distinct DNA-binding specificity and created a docking site for the cofactor Runx1. RBR was also important for proper folding of the forkhead domain, as truncation of RBR induced domain-swap dimerization of forkhead, which was previously considered the physiological form of FoxP3. Rather, swap-dimerization impaired FoxP3 function, as demonstrated with the disease-causing mutation R337Q, whereas a swap-suppressive mutation largely rescued R337Q-mediated functional impairment. Altogether, our findings suggest that FoxP3 can fold into two distinct dimerization states: head-to-head dimerization representing functional specialization of an ancient DBD and swap dimerization associated with impaired functions.

The ketogenic diet (KD) has gained immense popularity during the last decade, primarily because of its successful short-term effect on weight loss. In the United States, KD is utilized in a variety of patient populations for weight management, despite limited evidence regarding its efficacy and risks. This literature review provides an evaluation of data on the benefits and risks associated with the chronic use of KD, including its metabolic, endocrinological, and cardiovascular effects.

SummaryWhole-body regeneration requires the re-establishment of body axes for appropriate patterning of new and old tissue. Wnt signaling has been utilized to correctly regenerate tissues along the primary axis in many animals. However, the causal molecular mechanisms that first launch Wnt signaling during regeneration are poorly characterized. We used the acoel wormHofstenia miamiato identify processes that initiate Wnt signaling. Transcriptome profiling,in situhybridization, and functional studies revealed a Wnt ligand,wnt-3, as an early wound-induced gene specifically activated in posterior-facing wound sites and was required for establishing posterior identity during regeneration.wnt-3was upregulated upon amputation in stem cells, and its inhibition affected stem cell proliferation. Ectopic expression of anterior markers inwnt-3RNAi head fragments was stem cell dependent. Chromatin accessibility data revealed thatwnt-3activation during regeneration required input from the general wound response. Additionally, the expression of a different Wnt ligand,wnt-1, prior to amputation was required for activation of wound-inducedwnt-3expression. Our study establishes a gene regulatory network for initiating Wnt signaling in posterior tissues in a bilaterian.

Ethnic and sex variations in depressive symptoms and quality of life (QOL) among adolescent and young adult (AYA) childhood cancer survivors were explored among a sample of Latino and non-Latino childhood cancer survivors (CCSs) (n = 194) treated at hospitals in Los Angeles County. Latinos scored higher in depressive symptoms and lower in QOL when compared with non-Latinos. Males had higher depressive symptoms. Among Latinos, higher levels of acculturation were associated with depression and a poorer QOL, and we found that more acculturated Latino males were more likely to have meaningful levels of depression than less acculturated males or females. Interventions addressing depressive symptoms may be most needed for Hispanic male CCSs.

Myeloid-derived suppressor cells (MDSCs) and dendritic cells (DCs) arise from common progenitors. Tumor-derived factors redirect differentiation from immune-promoting DCs to tolerogenic MDSCs, an immunological hallmark of cancer. Indeed, in vitro differentiation of DCs from human primary monocytes results in the generation of MDSCs under tumor-associated conditions (PGE2 or tumor cell-conditioned media). Comparison of MDSC and DC DNA methylomes now reveals extensive demethylation with specific gains of DNA methylation and repression of immunogenic-associated genes occurring in MDSCs specifically, concomitant with increased DNA methyltransferase 3A (DNMT3A) levels. DNMT3A downregulation erases MDSC-specific hypermethylation, and it abolishes their immunosuppressive capacity. Primary MDSCs isolated from ovarian cancer patients display a similar hypermethylation signature in connection with PGE2-dependent DNMT3A overexpression. Our study links PGE2- and DNMT3A-dependent hypermethylation with immunosuppressive MDSC functions, providing a promising target for therapeutic intervention., This work was supported by grants SAF2014-55942-R and PI16/00132 from Instituto de Salud Carlos III, organisms ascribed to the Ministerio de Economía y Competitividad and cofunded by FEDER funds/European Regional Development Fund (ERDF) - a way to build Europe. The study was also supported by NCI/NIH/HHS (United States) grant P50 CA159981 (RPCI-UPCI Ovarian Cancer SPORE) (to N.O., R.P.E., and P.K.).

Iron aluminides form an interesting class of materials which combine excellent corrosion and oxidation resistance with good mechanical properties at moderate to high temperature (up to 500 °C). These materials, however, suffer from low room-temperature ductility (under 5% elongation in tension), which is mostly due to environmental effects. Casting is a processing route traditionally applied to brittle alloys (e.g., gray cast irons), but to cast a part without defects, several thermochemical properties are needed, as well as information on the tendency of the alloy to form foundry defects (e.g., shrinkage voids, pores). The present work aims to provide this information using parts produced on laboratory scale. In particular, the solidification contraction and the efficiency of TiB2 as inoculant are investigated. Three alloys with nominal composition (in at.%) Fe28Al, Fe28Al6Cr, and Fe28Al6Cr1Ti (about 1.5 kg for each melt) were melted in an induction furnace under argon flux protection using conventional raw materials (carbon steel, commercial aluminum, metallic chromium, and commercial ferrotitanium). The resulting melts were treated by adding Al-TiB2 master alloy used in the aluminum industry and poured into “staircase” molds, designed to investigate feeding distance effects in complex parts. Characterization of the microstructure of the alloys revealed that alloys Fe28Al and Fe28Al6Cr showed κ-carbide precipitation, while alloy Fe28Al6Cr additionally showed chromium carbides at dendritic boundaries. Addition of 1 wt.% Ti in alloy Fe28Al6Cr1Ti changed the solidification microstructure, refining the dendrite morphology and forming TiC-containing eutectic in interdendritic spaces.

BACKGROUND Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. METHODS In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores. RESULTS Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (P

The environmental quality differences between two groups of reefs in the Veracruz Reef System were evaluated. The North group of reefs is very close to Veracruz, an urban and port zone, whereas the South group is more isolated, with minor anthropogenic disturbances. To prove the hypothesis that the North group is more affected by anthropogenic activities, the concentrations of hydrocarbons in liver, metals and metalloids such as Se, As, Ba, Cd, Hg and V in muscle, and PAH metabolites in bile were evaluated, and related to biomarkers (transcript abundance of cytochrome P4501A, Vitellogenin, and Glutathione-S-transferase) in two species of fish: Haemulon aurolineatum and Ocyurus chysurus. H. aurolineatum presents the highest concentrations for many pollutants, but O. chysurus shows the most significant differences in pollutant concentrations and biomarkers between the two reef groups, suggesting that this species could be used as a sentinel in future studies in the Gulf of Mexico.

Purpose The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a tool used to standardize and objectify the pre-transplant evaluation. We sought to assess whether the SIPAT score is associated with outcomes of acute cellular rejection (ACR), graft failure (GF) and survival. Methods Retrospective study in HTx recipients between 01/2008 and 05/2019 at a single institution. Post-transplant outcomes included: incidence of ACR, GF, and death, comparing HTx recipients with a SIPAT score Results Overall 393 HTx recipients had a SIPAT evaluation. Patients included were more likely Caucasian (55.5%) and male (70.2%), with a median age of 55.2 (46-61.7) years. The median (IQR) SIPAT score was 14 (10-19) and 68 patients (17.2%) had a SIPAT score ≥ 21. Women were more likely to have a low (acceptable) SIPAT score (33% vs. 16%, p-value = 0.008). Recipients with a SIPAT score ≥21 were not at higher risk for ACR (p= 0.99) (Figure 1A), when adjusted for recipients’ demographics. Between-group differences in survival and graft failure were not statistically significant (5-year survival: ≤21 vs. >21, 84.5% [79.3%, 88.5%] vs. 81.6% [65.0%, 90.8%], p= 0.74; 5-year GF CIF: ≤21 vs. >21, 6.5% [3.9%, 10.9%] vs. 10.2% [3.7%, 28.2%], p= 0.65 [GF]). Conclusion The study did not show evidence that minimally acceptable recipients, according to psychosocial criteria, experienced an increased risk of rejection, graft failure or death. While the SIPAT tool has become an integral tool for heart transplant evaluation, a high SIPAT score alone may not be sufficient to risk stratify candidates.

Data from the US Census Bureau, the Accreditation Council for Graduate Medical Education, and the American Academy of Orthopaedic Surgeons reveal that orthopedic surgery is the least diverse of any surgical specialty and that diversity within orthopedics is not improving. Considerable data from both medicine and business suggest that improving diversity within the orthopedic surgery specialty would be of significant benefit to the orthopedic surgery profession and to patients. Multiple avenues for increasing diversity exist, including large-scale pipeline programs as well as personal and institutional efforts examining biases and decision-making processes.