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Background Invasive procedures are a core aspect of pulmonary and critical care practice. Procedures performed in the intensive care unit can be divided into high-risk, low-volume (HRLV) procedures and low-risk, high-volume (LRHV) procedures. HRLV procedures include cricothyroidotomy, pericardiocentesis, Blakemore tube placement, and bronchial blocker placement. LRHV procedures include arterial line placement, central venous catheter placement, thoracentesis, and flexible bronchoscopy. Despite the frequency and importance of procedures in critical care medicine, little is known about the similarities and differences in procedural training between different Pulmonary and Critical Care Medicine (PCCM) and Critical Care Medicine (CCM) training programs. Furthermore, differences in procedural training practices for HRLV and LRHV procedures have not previously been described.Objective To assess procedural training practices in PCCM and CCM fellowship programs in the United States, and compare differences in traini.7% of the time versus 3.9% for HRLV procedures (P = 0.004). Program directors’ confidence in their ability to determine fellows’ competence in performing procedures was significantly lower for HRLV versus LRHV versus HRLV procedures (P  less then  0.001).Conclusion Significant differences exist in procedural training education for PCCM and CCM fellows for LRHV versus HRLV procedures, and awareness of this discrepancy presents an opportunity to address this educational gap in PCCM and CCM fellowship training.Background Social media is ubiquitous as a tool for collaboration, networking, and dissemination. However, little is known about use of social media platforms by pulmonary and critical care medicine fellowship programs.Objective We identify and characterize pulmonary and critical care fellowship programs using Twitter and Instagram, as well as the posting behaviors of their social media accounts.Methods We identified all adult and pediatric pulmonary, critical care medicine (CCM), and combined pulmonary and critical care medicine (PCCM) programs in the United States using the Electronic Residency Application Service. We searched for Twitter profiles for each program between January 1, 2018, and September 30, 2018. Tweets and Twitter interactions were classified into the following three types social, clinical, or medical education (MedEd) related. We collected data about content enhancements of tweets, including the use of pictures, graphics interchange format or videos, hashtags, links, and tagging other accotent enhancements (pictures, graphics interchange format/videos, links, and tagging) were associated with a higher number of followers, except for hashtags.Conclusion Despite the steadily increasing use of social media in medicine, only 10% of the pulmonary and critical care fellowship programs in the United States have Twitter accounts. Social and clinical content appears to gain traction online; however, additional evaluation is needed on how to effectively engage audiences with MedEd content.Black physicians remain severely underrepresented in academic medicine despite the documented benefits of a diverse medical faculty. Only 3.6% of academic medical faculty self-report as Black or African American. Efforts to improve faculty diversity at academic medical institutions nationwide have not made meaningful impacts. Sustained improvements in faculty diversity cannot be achieved without an actively antiracist approach, including the intentional transformation of policies, practices, and systems that persistently produce worse outcomes for Black medical students, trainees, and faculty.The spread of coronavirus disease (COVID-19) infection across the world accelerated the adoption of social media as the platform of choice for real-time dissemination of medical information. Though this allowed useful clinical anecdotes and links to the latest articles related to COVID-19 to quickly circulate, the broad use of social media also highlighted the power of platforms such as Twitter to spread misinformation. Trainees in medicine have important perspectives to share on social media but may be reluctant to do so for a variety of reasons. There is a need to provide guidance on how to safely engage with social media as well as move the conversation forward in a meaningful way. In this manuscript, we suggest a stepwise approach for trainee social media engagement that integrates the modified Bloom’s Taxonomy for social media with Aristotle’s principles of rhetoric. This provides trainees with guidance on making ethical, logical, and persuasive cases on social media when creating, consuming, promoting, and discussing content produced by themselves or others.Qualitative research methods are important and have become increasingly prominent in medical education and research. The reason is simple many pressing questions in these fields require qualitative approaches to elicit nuanced insights and additional meaning beyond standard quantitative measurements in surveys or observatons. Among the most common qualitative data collection methods are structured or semistructured in-person interviews and focus groups, in which participants describe their experiences relevant to the research question at hand. In the era of physical and social distancing because of the novel coronavirus disease (COVID-19) pandemic, little guidance exists for strategies for conducting focus groups or semistructured interviews. Here we describe our experience with, and recommendations for, conducting remote focus groups and/or interviews in the era of social distancing. Specifically, we discuss best practice recommendations for researchers using video teleconferencing programs to continue qualitative research during the COVID-19 pandemic.A colloid cyst is a malformation composed of an amorphous, gelatinous material surrounded by epithelial and connective tissue. It is typically located in the third ventricle, leading to signs of increased intracranial pressure and hydrocephalus. In this case report, we discuss a classic presentation of a patient presenting with a colloid cyst of the third ventricle. This includes the patient’s symptoms before arriving at the emergency department and presentation upon arrival and during their hospital stay. We also discuss the diagnostic approach to colloid cysts, providing radiographic imaging to support the diagnosis. Finally, we discuss the approach to treatment of a colloid cyst, including temporizing measures to relieve symptoms and definitive measures for removal of the colloid cyst. The overall approach from diagnosis to management to definitive treatment of a colloid cyst requires an interdisciplinary approach but prompt recognition of the signs and symptoms in the ED can decrease both morbidity and mortality associated with this potentially fatal diagnosis.Maternal immune activation (MIA) in midpregnancy is a risk factor for neurodevelopmental disorders. Improper brain development may cause malformations of the brain; maldevelopment induced by MIA may lead to a pathology-related phenotype. In this study, a single intraperitoneal injection of 20 mg/kg polyriboinosinic-polyribocytidylic acid [poly(IC)] was administered to C57BL/6J mice on embryonic day (E) 12.5 to mimic maternal viral infection. Histopathological analysis of neurogenesis was performed using markers for Pax6, Tbr2, and Tbr1. In these fetuses, significant increases were observed in the proportion of Pax6-positive neural progenitor cells and Pax6/Tbr2 double-positive cells 24 h after poly(IC) injection. There were no differences in the proportion of Tbr1-positive postmitotic neurons 48 h after poly(IC) injection. At E18.5, there were more Pax6-positive and Tbr2-positive neural progenitor cells in the poly(IC)-injected group than in the saline-injected group. Gene ontology enrichment analysis of poly(IC)-induced differentially expressed genes in the fetal brain at E12.5 demonstrated that these genes were enriched in terms including response to cytokine, response to decreased oxygen levels in the category of biological process. At E13.5, activating transcription factor 4 (Atf4), which is an effector of integrated stress response, was significantly upregulated in the fetal brain. Our results show that poly(IC)-induced MIA at E12.5 leads to dysregulated neurogenesis and upregulates Atf4 in the fetal brain. These findings provide a new insight in the mechanism of MIA causing improper brain development and subsequent neurodevelopmental disorders.Recent evidence shows a greater facilitating effect of beta-adrenergic receptors (β-ARs) on long-term synaptic plasticity in the ventral versus the dorsal hippocampus. Here, using field potentials from the CA1 area and a ten-pulse stimulation train of varying frequency we show that activation of β-ARs by isoproterenol preferentially facilitates the output from the dorsal hippocampus at the frequency range of 3-40 Hz without affecting short-term synaptic plasticity. Furthermore, isoproterenol increases basal synaptic transmission in the dorsal hippocampus only and enhances basal neuronal excitation more in the dorsal than the ventral hippocampus. These results suggest that β-AR-modulation of short-term neuronal dynamics differs along the longitudinal axis of the hippocampus, thereby contributing to functional specialization along the same axis.

We studied lab-confirmed COVID-19 infection (LCCI) testing, incidence, and severity.

We included all Manitoba residents and limited our severity analysis to LCCI patients. We calculated testing, incidence and vaccination rates between March 8, 2020 and June 1, 2021. We estimated the association between patient characteristics and testing (rate ratio [RR]; Poisson regression), including the reason for testing (screening, symptomatic, contact/outbreak asymptomatic), incidence (hazard ratio [HR]; Cox regression), and severity (prevalence ratio [PR], Cox regression).

The overall testing rate during the second/third wave was 570/1,000 person-years, with an LCCI rate of 50/1,000 person-years. The secondary attack rate during the second/third wave was 16%. Across regions, young children (<10) had the lowest positivity for symptomatic testing, the highest positivity for asymptomatic testing, and the highest risk of LCCI as asymptomatic contact. People in the lowest income quintile had the highest risk of LCCI, 1.3-6x the hazard of those in the highest income quintile. Long-term care (LTC) residents were particularly affected in the second wave with HRs>10 for asymptomatic residents.

Although the severity of LCCI in children was low, they have a high risk of asymptomatic positivity. The groups most vulnerable to LCCI, who should remain a focus of public health, were residents of Manitoba’s North, LTC facilities, and low-income neighbourhoods.

Canada Research Chair Program.

Canada Research Chair Program.

Liver transplant recipients are at lifelong risk of immunosuppression-related cutaneous complications, such as malignancy and infection.

Our study aims to assess the epidemiology of dermatologic conditions among liver transplant recipients in an academic medical center in Singapore.

Medical records of liver transplant recipients on follow-up with gastroenterology and dermatology departments at the Singapore General Hospital between 2006 and 2021 were retrospectively reviewed. A literature review was subsequently performed on the keywords “liver transplant” and “dermatology.”

A total of 99 liver transplant recipients were identified in this study. Sixty-nine patients (70%) had at least 1 dermatologic condition. FB23-2 cell line Inflammatory skin conditions were the most common (53%), followed by cutaneous infection (36%) and benign cutaneous tumors (30%). Malignant and premalignant lesions were the least common skin conditions reported (10%). Our study results concurred with many other studies reported worldwide, demonstrating a low cutaneous malignancy burden after liver transplantation.