Entrustable professional activities for residency in general internal medicine: a systematic review.

Entrustable Professional Activities (EPAs) are observable tasks that are regular parts of a physician's daily clinical work. Before being permitted to accomplish these tasks independently, trainees must gain their supervisors' trust. Defining the list of EPAs that should be mastered by the end of a residency is critical to setting clear expectations about autonomous practice. To collect all the lists of EPAs defined for residencies in general internal medicine and synthesise them into a reference work useful for developing new lists of EPAs or improving existing ones. This systematic review searched five databases and relevant grey literature using keywords related to EPAs and postgraduate education, from 2005, when the first article on EPAs was published, to April 2022. Inclusion criteria were the availability of an EPAs list and a focus on general internal medicine. Two reviewers independently selected the studies, extracted data and performed a quality assessment using QATSDD and AACODS tools. Mean values and inter-rater reliability were calculated. The review yielded 3292 records, with 16 articles meeting the inclusion criteria, mostly from North America. Synthesising their 16 lists generated 395 EPAs. The reviewers then inductively categoried those EPAs, 308 of which fell into 6 domains, 14 themes and 24 subthemes. The domains were: (1) care and management of the general adult population (n = 103 EPAs); (2) care and management of patients with specific needs (n = 67); (3) care coordination and communication (n = 52); (4) management and leadership (N = 21); (5) healthcare quality, education, and research (n = 41); and (6) miscellaneous (n = 24). The remaining 87 EPAs were disease-specific and did not fit into this categorisation. Categorising EPAs created a unique synthesis of the existing lists of EPAs for educating residents in general internal medicine. This synthesis could be used as a reference for anyone tasked with developing new lists of EPAs or improving existing ones

An Electrochemical Platform for the Carbon Dioxide Capture and Conversion to Syngas

We report on a simple electrochemical system able to capture gaseous carbon dioxide from a gas mixture and convert it into syngas. The capture/release module is implemented via regeneration of NaOH and acidification of NaHCO3 inside a four-chamber electrochemical flow cell employing Pt foils as catalysts, while the conversion is carried out by a coupled reactor that performs electrochemical reduction of carbon dioxide using ZnO as a catalyst and KHCO3 as an electrolyte. The capture module is optimized such that, powered by a current density of 100 mA/cm2 , from a mixture of the CO2–N2 gas stream, a pure and stable CO2 outlet flow of 4–5 mL/min is obtained. The conversion module is able to convert the carbon dioxide into a mixture of gaseous CO and H2 (syngas) with a selectivity for the carbon monoxide of 56%. This represents the first all-electrochemical system for carbon dioxide capture and conversion

Mammalian sialidase Neu3 overexpression in Cos-7 cells causes a drastic decrease of ndv-cell fusion and virus infectivity

The paramyxovirus Newcastle Disease Virus (NDV) binds to sialic acid-containing glycoconjugates, sialoglycoproteins and sialoglycolipids (gangliosides) of host cell plasma membrane through its hemagglutinin-neuraminidase (sialidase) HN glycoprotein. We hypothesized that the modifications of the cell surface ganglioside pattern determined by over-expression of the mammalian plasma-membrane associated, ganglioside specific, sialidase NEU3 would affect the virus-host cell interactions. Using COS7 cells as a model system, we observed that over-expression of the murine MmNEU3 did not affect NDV binding but caused a marked reduction in NDV infection and virus propagation through cell-cell fusion. Moreover, since GD1a was greatly reduced in COS7 cells following NEU3-over-expression, we added [(3)H]-labelled GD1a to COS7 cells under conditions that block intralysosomal metabolic processing, and we observed a marked increase of GD1a cleavage to GM1 during NDV infection, indicating a direct involvement of the virus sialidase and host cell GD1a in NDV infectivity. Therefore, the decrease of GD1a in COS7 cell membrane upon MmNEU3 over-expression is likely to be instrumental to NDV reduced infection. Evidence was also provided for the preferential association of NDV-HN at 4 degrees C to detergent resistant microdomains (DRMs) of COS7 cells plasma membranes

A Peer-reviewed Newspaper About_ Machine Research

About research on machines, research with machines, and research as a machine. Publication resulting from research workshop at Brussels World Trade Center, organised in collaboration with Constant, Association for Arts and Media, Brussels, and transmediale festival for art and digital culture, Berlin

Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery.

In these times of COVID-19 pandemic, concern has been raised about the potential effects of SARS-CoV-2 infection on immunocompromised patients, particularly on those receiving B-cell depleting agents and having therefore a severely depressed humoral response. Convalescent plasma can be a therapeutic option for these patients. Understanding the underlying mechanisms of convalescent plasma is crucial to optimize such therapeutic approach. Here, we describe a COVID-19 patient who was deeply immunosuppressed following rituximab (anti-CD20 monoclonal antibody) and concomitant chemotherapy for chronic lymphoid leukemia. His long-term severe T and B cell lymphopenia allowed to evaluate the treatment effects of convalescent plasma. Therapeutic outcome was monitored at the clinical, biological and radiological level. Moreover, anti-SARS-CoV-2 antibody titers (IgM, IgG and IgA) and neutralizing activity were assessed over time before and after plasma transfusions, alongside to SARS-CoV-2 RNA quantification and virus isolation from the upper respiratory tract. Already after the first cycle of plasma transfusion, the patient experienced rapid improvement of pneumonia, inflammation and blood cell counts, which may be related to the immunomodulatory properties of plasma. Subsequently, the cumulative increase in anti-SARS-CoV-2 neutralizing antibodies due to the three additional plasma transfusions was associated with progressive and finally complete viral clearance, resulting in full clinical recovery. In this case-report, administration of convalescent plasma revealed a stepwise effect with an initial and rapid anti-inflammatory activity followed by the progressive SARS-CoV-2 clearance. These data have potential implications for a more extended use of convalescent plasma and future monoclonal antibodies in the treatment of immunosuppressed COVID-19 patients

Providing alcohol-related screening and brief interventions to adolescents through health care systems: Obstacles and solutions

Duncan Clark and Howard Moss identify obstacles to alcohol-related screening and treatment for adolescents and propose policy solutions

Functional Brain Imaging in the Clinical Assessment of Consciousness

Recent findings suggest that functional brain imaging might be used to identify consciousness in patients diagnosed with persistent vegetative state and minimally conscious state. Michael Rafii and James Brewer discuss the potential for fMRI's wider implementation in clinical practice, and associated caveats

A Synergistic Use of a High-Resolution Numerical Weather Prediction Model and High-Resolution Earth Observation Products to Improve Precipitation Forecast

open20siThe Mediterranean region is frequently struck by severe rainfall events causing numerous casualties and several million euros of damages every year. Thus, improving the forecast accuracy is a fundamental goal to limit social and economic damages. Numerical Weather Prediction (NWP) models are currently able to produce forecasts at the km scale grid spacing but unreliable surface information and a poor knowledge of the initial state of the atmosphere may produce inaccurate simulations of weather phenomena. The STEAM (SaTellite Earth observation for Atmospheric Modelling) project aims to investigate whether Sentinel satellites constellation weather observation data, in combination with Global Navigation Satellite System (GNSS) observations, can be used to better understand and predict with a higher spatio-temporal resolution the atmospheric phenomena resulting in severe weather events. Two heavy rainfall events that occurred in Italy in the autumn of 2017 are studied—a localized and short-lived event and a long-lived one. By assimilating a wide range of Sentinel and GNSS observations in a state-of-the-art NWP model, it is found that the forecasts benefit the most when the model is provided with information on the wind field and/or the water vapor content.openLagasio, Martina; Parodi, Antonio; Pulvirenti, Luca; Meroni, Agostino N.; Boni, Giorgio; Pierdicca, Nazzareno; Marzano, Frank S.; Luini, Lorenzo; Venuti, Giovanna; Realini, Eugenio; Gatti, Andrea; Tagliaferro, Giulio; Barindelli, Stefano; Monti Guarnieri, Andrea; Goga, Klodiana; Terzo, Olivier; Rucci, Alessio; Passera, Emanuele; Kranzlmueller, Dieter; Rommen, BjornLagasio, Martina; Parodi, Antonio; Pulvirenti, Luca; Meroni, Agostino N.; Boni, Giorgio; Pierdicca, Nazzareno; Marzano, Frank S.; Luini, Lorenzo; Venuti, Giovanna; Realini, Eugenio; Gatti, Andrea; Tagliaferro, Giulio; Barindelli, Stefano; Monti Guarnieri, Andrea; Goga, Klodiana; Terzo, Olivier; Rucci, Alessio; Passera, Emanuele; Kranzlmueller, Dieter; Rommen, Bjor

Mechanisms underlying disorders of consciousness: Bridging gaps to move toward an integrated translational science

AIM: In order to successfully detect, classify, prognosticate, and develop targeted therapies for patients with disorders of consciousness (DOC), it is crucial to improve our mechanistic understanding of how severe brain injuries result in these disorders. METHODS: To address this need, the Curing Coma Campaign convened a Mechanisms Sub-Group of the Coma Science Work Group (CSWG), aiming to identify the most pressing knowledge gaps and the most promising approaches to bridge them. RESULTS: We identified a key conceptual gap in the need to differentiate the neural mechanisms of consciousness per se, from those underpinning connectedness to the environment and behavioral responsiveness. Further, we characterised three fundamental gaps in DOC research: (1) a lack of mechanistic integration between structural brain damage and abnormal brain function in DOC; (2) a lack of translational bridges between micro- and macro-scale neural phenomena; and (3) an incomplete exploration of possible synergies between data-driven and theory-driven approaches. CONCLUSION: In this white paper, we discuss research priorities that would enable us to begin to close these knowledge gaps. We propose that a fundamental step towards this goal will be to combine translational, multi-scale, and multimodal data, with new biomarkers, theory-driven approaches, and computational models, to produce an integrated account of neural mechanisms in DOC. Importantly, we envision that reciprocal interaction between domains will establish a virtuous cycle, leading towards a critical vantage point of integrated knowledge that will enable the advancement of the scientific understanding of DOC and consequently, an improvement of clinical practice

Prototype ATLAS IBL Modules using the FE-I4A Front-End Readout Chip

The ATLAS Collaboration will upgrade its semiconductor pixel tracking detector with a new Insertable B-layer (IBL) between the existing pixel detector and the vacuum pipe of the Large Hadron Collider. The extreme operating conditions at this location have necessitated the development of new radiation hard pixel sensor technologies and a new front-end readout chip, called the FE-I4. Planar pixel sensors and 3D pixel sensors have been investigated to equip this new pixel layer, and prototype modules using the FE-I4A have been fabricated and characterized using 120 GeV pions at the CERN SPS and 4 GeV positrons at DESY, before and after module irradiation. Beam test results are presented, including charge collection efficiency, tracking efficiency and charge sharing.Comment: 45 pages, 30 figures, submitted to JINS