The purpose of this study was to evaluate baseline best corrected visual acuity (BCVA), full-field electroretinography (ERG), full-field stimulus thresholds (FST), and their relationship with baseline demographic and clinical characteristics in the Rate of Progression in Usher syndrome type 2 (

)-related Retinal Degeneration (RUSH2A) multicenter study.

Participants had Usher syndrome type 2 (USH2,

= 80) or autosomal recessive nonsyndromic retinitis pigmentosa (ARRP,

=47) associated with biallelic variants in the

gene. Associations of demographic and clinical characteristics with BCVA, ERG, and FST were assessed with regression models.

In comparison to ARRP, USH2 had worse BCVA (median 79 vs. 82 letters;

< 0.001 adjusted for age), lower rod-mediated ERG b-wave amplitudes (median 0.0 vs. 6.6µV;

< 0.001) and 30 Hz flicker cone-mediated ERG amplitudes (median 1.5 vs. 3.1 µV;

=0.001), and higher (white, blue, and red) FST thresholds (means [-26, -31, -23dB] vs. [-39, -45, -28dB];

&lts with USH2A mutations.

Choroidal thickness (ChT) and choroidal vascularity index (CVI) represent two important metrics in health-, disease-, and myopia-related studies. Wide-field swept-source optical coherence tomography (OCT) provides improved and extended imaging and extraction of choroidal variables. This study characterizes the topography and repeatability of these parameters in healthy eyes.

Swept-source OCT volume scans were obtained on 14 young adult patients on three separate days. ChT and CVI were automatically corrected for image magnification and extracted for different enface regions within an extended ETDRS grid of 10mm diameter. Topographical distribution, correlation to ocular length, and intersession repeatability of both choroidal parameters were assessed.

CVI showed little fluctuation between subfields, unlike ChT, which demonstrated thinning toward the peripheral choroid (coefficients of variation 5.92 vs. 0.89). ChT showed a consistent negative correlation with axial length (ρ=-0.05 to -0.61), although this was only statistically significant in the inner superior subfield (

=0.02). There was no consistent or significant relationship between CVI and axial length or between CVI and ChT. The repeatability of CVI measurements (3.90%-5.51%) was more consistent between scan regions than ChT measurements (10.37-20.33µm).

CVI values were consistent across the central 10mm of the retina, while ChT reduced with eccentricity. The repeatability of both parameters is similar to the effect size reported in many studies using the choroid as a biomarker, which should be considered in the interpretation of findings.

This study provided normative as well as metrological information for the clinical interpretation of ChT and CVI in health and disease.

This study provided normative as well as metrological information for the clinical interpretation of ChT and CVI in health and disease.

This review examines the role of education and relaying findings to non-dermatologist colleagues when performing inpatient dermatology consults. We highlight best practices for communication and education.

Non-dermatologists receive minimal training on the diagnosis and the management of skin conditions. learn more Efforts to teach dermatology in the inpatient setting via traditional didactics have been met with limited success, and hospitalists have indicated a desire to learn from specialists. Incorporating education into standard consultation practices including the note, one-on-one communication, and bedside rounds can efficiently improve teaching and patient care.

Our key principles of consultation emphasize communication, use of pre-existing components of a consultation to teach, and close follow-up. Inpatient dermatologists can implement these simple but effective measures to encourage education and communication with primary teams for both in-person and telehealth consults.

Our key principles of consultation emphasize communication, use of pre-existing components of a consultation to teach, and close follow-up. Inpatient dermatologists can implement these simple but effective measures to encourage education and communication with primary teams for both in-person and telehealth consults.The outcomes model most applied in continuing education for the health professions evaluation is Moore and colleagues’ conceptual framework. Examination of how the levels interact and the role of confidence and intention to change can help outcomes professionals understand better how to impact clinician practice and conductand report outcomes studies. The current study examined the relationships among knowledge and competence change, confidence change, and intention to change across 57 online oncology certified education programmes published from 2018 to 2020 on Medscape.org. Findings indicate that not only improvement in knowledge and competence but also reinforcement of knowledge and competence are significant predictors of changes in confidence. They also indicate that knowledge and competence influence intention to change through confidence.

A 51-year-old man with essential tremor (ET) had bilateral ventralis intermedius nucleus deep brain stimulation (VIM-DBS) placed to address refractory tremor. Despite well-placed DBS leads and adequate tremor response, he subsequently experienced worsening. Re-programming of the device and reconfirming the electrical thresholds for benefits and side effects were both performed. Six years following DBS implantation, repeat imaging revealed brain atrophy and a measured lead position change with a coincident change in clinical response.

What do we know about brain atrophy affecting lead placement and long-term DBS effectiveness? What are the potential strategies to combat narrowed therapeutic thresholds and to maximize DBS therapeutic benefit?

Decreasing the electrical field of stimulation and programming in a bipolar configuration are strategies to provide symptomatic tremor control and to minimize stimulation-induced side effects.

Currently, effects of brain atrophy, and factors underpinning emergence of side effects and/or loss of benefit in chronic VIM-DBS remain largely unexplored.