Citations

Hematopoietic and stromal cells within the bone marrow (BM) provide membrane-bound and/or soluble factors that are vital for the survival of plasma cells (PCs). Recent reports in murine BM demonstrated the dynamic formation and dispersion of PC clusters. To date, PC clustering in normal human BM has yet to be thoroughly examined. The goal of this study was to determine whether PC clusters are present in human BM and whether clustering changes as a function of age. Quantification of PCs and clustering in BM sections across six different age groups revealed that fewer PCs and PC clusters were observed in the youngest and oldest age groups. PC clustering increased with age until the sixth decade and then began to decrease. A positive correlation between the number of PCs and PC clusters was observed across all age groups. PC clusters were typically heterogeneous for immunoglobulin heavy- and light-chain expression. Taken together, these data demonstrate that PC clusters are present in human BM and that PC clustering increases until middle adulthood and then begins to diminish. These results suggest the spatial distribution of BM PC-supportive stromal cells changes with age:

OBJECTIVE Determine if a longitudinal point-of-care ultrasonography (POCUS) elective for medical students is effective in improving POCUS knowledge. METHODS We share the format of our longitudinal POCUS elective for medical students. To evaluate the efficacy of our longitudinal elective, we compare the difference between pre-elective and post-elective scores on a POCUS test using a paired t-test with threshold of statistical significance of p ≤ .05. We also share the results of a post-elective survey evaluating the effectiveness and quality of the longitudinal POCUS elective. RESULTS Pretest mean score was 56.3% (σ = 13.6), while posttest mean score was 73.3% (σ = 9.4), with an average score improvement of 17.0% (95% CI 9.9-24.0%, p < .0001). All students strongly or moderately agreed that they would recommend the elective to future medical students, that they were more confident with their POCUS skills after completing the elective, that the time commitment of the elective was appropriate, and that they felt they had the time to fit the elective into their schedule as a medical school student. Most students (56.7%) strongly or moderately agreed that the knowledge gained from the POCUS elective had helped them in their clinical rotations. CONCLUSIONS Our longitudinal POCUS curriculum subjectively and objectively improves medical students’ POCUS knowledge while remaining accessible to students. We share our unique longitudinal POCUS elective curriculum, the format of which and its benefits are transferable to other medical schools. Through this, we hope to provide others with ideas on how they may implement a longitudinal POCUS elective.

Background Quadricuspid aortic valve (QAV) is an exceedingly rare congenital heart defect (CHD) which has not been well-defined in a pediatric population. Methods The Mayo Clinic echocardiography database was retrospectively analyzed to identify patients ≤18 years diagnosed with QAV from January 1990 to December 2023. Patients with truncus arteriosus were excluded. All images were independently reviewed to define morphology of the QAV by using the Hurwitz and Roberts classification. Results Fourteen patients with QAV were identified with a median age at time of diagnosis being 10.5 years (interquartile range [IQR] 6-14 years). Male-to-female ratio was 3:1. Associated CHDs were present in 50% (n = 7) patients. The most common morphological subtypes of QAV were Type D in 43% (n = 6) and Type B in 29% (n = 4). Aortic regurgitation was the most frequently associated valvular abnormality affecting 86% (n = 12) cases, with greater than moderate regurgitation in only two patients. Aortic valve stenosis was observed in 14% (n = 2) patients. Ascending aortic dilatation was present in 21% (3/14) of the cohort, but only 14% (1/7) of isolated QAV patients. At a mean follow up of 11 ± 6.6 years and a median follow-up age of 22 years (IQR 14-27 years), survival was 100% with no primary interventions on the aortic valve or aorta. However, four patients required surgical interventions for associated CHDs. Conclusion Among children with QAV, almost half of the patients had additional CHD. Aortic regurgitation was the predominant hemodynamic abnormality. Long-term survival was excellent with minimal progression during childhood and adolescence.

Background Before the COVID-19 pandemic began, medical staff and academic department workers reported increasing levels of stress and burnout because of strain on the health care system. The COVID-19 pandemic exacerbated this strain and introduced several novel stressors, which included transitioning to remote work. Safe and scalable strategies are needed to help health care workers cope with these stressors. Aromatherapy may help address this need. Objectives To assess the effect of 2 aromatherapy interventions (essential oil blends termed STILL and FOCUS) on perceived mental/psychological health parameters for academic department workers working from home during the COVID-19 pandemic. Methods Participants were advised to use STILL for 5 days (Monday through Friday). After a 2-day washout period (Saturday and Sunday), participants were instructed to use FOCUS for 5 days (Monday through Friday). Participants completed a visual analog scale survey evaluating restlessness, fatigue, anxiety, stress, happiness, energy, relaxation, calmness, and well-being before and after each of the 2 intervention periods. Results Twenty academic department remote workers participated in the study. Mental/psychological health surveys were completed by 6 participants before and after using STILL and by 10 before and after using FOCUS. Five participants answered all survey questions before and after both interventions. Although mean (SD) perceived stress scores improved after both the STILL (4.3 [2.3] vs 1.8 [1.7], P = .03) and FOCUS (2.9 [2.3] vs 1.5 [1.4], P = .02) interventions, this improvement was not statistically significant after Bonferroni correction (adjusted α = .006). Most participants (73.3%) reported that participating in the study was worthwhile, and 81.3% indicated that they would recommend aromatherapy to others. Conclusions The STILL and FOCUS aromatherapy interventions did not significantly improve mental/psychological health parameters for remote academic department workers, although perceived stress was marginally improved and participants reported a perceived benefit from using aromatherapy.

The heterogeneity of diaphragm muscle (DIAm) activity in awake animals reflects real motor behavior diversity but makes assessments of eupneic breathing challenging. The present article uses an unsupervised machine learning model to identify eupneic breathing amidst a deluge of different DIAm electromyography (EMG) burst patterns in awake rats. This technique offers a scalable and reliable tool that improves efficiency of DIAm EMG analysis and minimizes potential sources of bias.