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0001). Qreflux was not significantly different between different cuff inflation pressures. RV and EV were statistically different at different cuff pressure settings (analysis of variance, P  less then .0001). The IR was almost identical at different pressure settings (0.43 ± 0.23 at 60 mm Hg, 0.43 ± 0.20 at 90 mm Hg, and 0.42 ± 0.19 at 120 mm Hg). CONCLUSIONS The amount of reflux is primarily determined by the value of EV in a distal cuff compression-decompression maneuver. Both the ratio RV/EV (IR) and RV were related to the severity of the disease, more severe forms having larger IR and RV values. BACKGROUND The cyanoacrylate closure (CAC) procedure is a safe and effective modality for the treatment of an incompetent saphenous vein. Thrombus extension into the deep vein, known as endovenous glue-induced thrombosis (EGIT), may be a worrisome complication of the procedure. However, the incidence, classification, and risk factors of EGIT have not been elucidated. We report, herein, the incidence, classification, and risk factors of EGIT following the CAC procedure for an incompetent saphenous vein. METHODS A retrospective review was performed of prospectively collected data of CAC patients. Preoperatively, the diameter, reflux time, and peak reflux velocity of the saphenous vein were measured. The CAC procedure was performed as per the instructions for use. Postoperative follow-up was conducted at 1 week, 3 months, 6 months, and 1 year after the procedure. Postoperative duplex scanning was performed to evaluate the occlusion of the target vein and presence of EGIT. Demographic data, risk factors, procedurUSIONS EGIT is not an uncommon complication of CAC. A small diameter of the saphenous vein ( less then 5 mm) is a risk factor for the development of EGIT. A classification system and treatment protocol for EGIT based on the area of thrombus extension into the deep vein is proposed for managing patients. Besides typical sexually transmitted microbes, even environmental, opportunistic microbes have been found in copulatory organs of insects and even humans. To date, only one study has experimentally investigated the sexual transmission of opportunistic microbes from male to female insects, whereas nothing is known about the transmission from females to males. Even if opportunistic microbes do not cause infection upon transmission, they might eventually become harmful if they multiply inside the female. While the immune system of females is often assumed to target sexually transmitted microbes, most studies ignore the role of mating-associated opportunistic microbes. Variation in immunity between populations has been linked to parasite or bacteria prevalence but no study has ever addressed between-population differences in immune responses to sexually transmitted opportunistic microbes. We here show that bacteria applied to the copulatory organs of common bedbugs, Cimex lectularius, are sexually transmitted to populations. BACKGROUND Immunosuppressive therapy (IST) yields durable hematologic improvement (HI) in a subset of patients with lower-risk myelodysplastic syndrome (MDS). Age, human leukocyte antigen (HLA)-DR15 positivity, and duration of transfusion dependence are putative clinical variables predictive for response. selleck chemicals We investigated the effect of somatic gene mutations on response to IST in lower-risk MDS. PATIENTS AND METHODS Forty of 66 patients who received antithymocyte globulin with or without cyclosporine A identified at the Moffitt Cancer Center were molecularly profiled using a 49-gene myeloid panel. All patients profiled received antithymocyte globulin, and cyclosporine A was provided to 60% of patients. RESULTS The overall frequency of HI was 42%. Presence of a large granular lymphocytic clone, hypocellular bone marrow, HLA-DR15 positivity, trisomy 8, and age had no influence on response to IST. Among 40 patients evaluated by next-generation sequencing, the presence of an SF3B1 mutation (MT) was significantly associated with IST nonresponse (1 of 9 SF3B1 MT, 11% vs. 21 of 31 wild type, 68%; P = .002). All patients with SF3B1 MT had ring sideroblasts > 15% (RS) by morphology; the corresponding HI rate was 20% among patients with RS versus 50% for those without RS (P = .09). CONCLUSION These findings support the clinical implementation of genomics in MDS. The presence of an SF3B1 mutation adversely influences response to IST and should be incorporated into treatment decisions upon validation of these findings. OBJECTIVE To1 describe the development and evaluate the feasibility of a surgical objective structured clinical examination (OSCE) for the purpose of competency assessment based on the Royal College of Canada's CanMEDS framework. DESIGN A unique surgical OSCE was developed to evaluate the clinical and surgical management of common orthopaedic problems using simulated patients and cadaveric specimens. Cases were graded by degree of difficulty (less complex, complex, more complex) Developing an assessment tool with significant resource utilization and good correlation with traditional methods is challenging. The feasibility of an OSCE that evaluates independent clinical and surgical decision making was evaluated. In addition, as part of establishing construct validity, correlation of OSCE scores with previously validated O-scores was performed. SETTING A tertiary level academic teaching hospital. PARTICIPANTS Thirty-four Postgraduate year 3-5 trainees of a 5-year Canadian orthopedic residency program creating 96 operative case performances available for final review. RESULTS The development of the OSCE cases involved a multistep process with attending surgeons, residents and a surgical education consultant. There were 4 different OSCE days, over a 3 year period (2016-2018) encompassing a variety of less complex and more complex procedures. Performance on the OSCE correlated strongly with the (O-SCORE, 0.89) and a linear regression analysis correlated moderately with year of training (r2 = 0.5737). The feasibility analysis demonstrated good financial practicality with solid programmatic integration. CONCLUSIONS The unique surgical OSCE scores correlate strongly with an established entrustability scale. Administering this OSCE to evaluate preoperative and intraoperative decision making to complement other forms of assessment is feasible. The financial burden to training programs is modest in comparison to the insight gained by both residents and faculty.