However, memory performance was impaired when distractor objects were presented, and this effect was exacerbated under apprehension particularly for high trait anxious individuals. CONCLUSIONS Results suggest that induced apprehension and trait anxiety have little influence on visual working memory capacity, instead primarily disrupting distractor filtering efficiency.Interdisciplinary rounding has been shown to improve patient safety and provider engagement. Many models for interdisciplinary rounding have been proposed but few focus on preserving bedside medical education. The authors changed the interdisciplinary bedside rounding model to accommodate more time for medical education. The objective was to assess perceptions of communication, care coordination, and teamwork surrounding this change. Resident and attending physicians and unit-based nursing staff completed an anonymous online survey prior to and following the rounding intervention. Length of stay on medical units also was monitored prior to and following the rounding intervention. Following the intervention, there were perceived improvements in interdisciplinary communication, care coordination, and teamwork, and there were no significant changes in length of stay.BACKGROUND In Canada, cardiovascular disease is the second most common cause of death. Akt inhibitor A subset of these patients will require a cardiovascular implantable electronic device (CIED). An estimated 200 000 Canadians are living with a CIED. CIEDs can improve life and prevent premature death. However, when patients reach the end of their lives, they can pose a challenge. An example of which is a painful shock delivered from an implantable cardioverter defibrillator (ICD) for an arrhythmia in a dying patient. Receiving a shock at the end of life (EOL) is unacceptable in an age when we aim to ease the suffering of the dying and allow for a comfortable death. METHODS As a quality standard of practice, all clinicians are expected to engage in EOL conversations in patients requiring CIED deactivation. Due to the potential discomfort of an ICD shock, specific conversations about deactivation of an ICD are encouraged. A process improvement approach was developed by our hospital that included an advance care planning simulation lab, electronic documentation and a standardized comfort measures order set that includes addressing the need for ICD deactivation at EOL. RESULTS EOL conversations are complex. Health care providers have been equally challenged to have conversations about ICD deactivation. Standardization of the process of ICD deactivation ensures an approach to EOL which respects the individuality of patients and promotes quality dying. CONCLUSION Our hospital is committed to assisting clinicians to provide quality care by improving conversations about EOL care. On the basis of a synthesis of existing literature, we describe the importance of and the ideal process for having EOL conversations in patients about ICD deactivation at the EOL.Tanzania has recently adapted World Health Organization antiretroviral guidelines that include integrase strand transfer inhibitor (INSTIs) in the first-line regimen. However, evidence lack on integrase (IN) gene polymorphisms in viral strains circulating in Tanzania. Here, we characterise IN gene polymorphisms in viral strains circulating in Dar es Salaam, Tanzania prior to introduction of INSTIs. Plasma viral RNAs were prepared from 158 HIV-1-infected subjects, including 111 treated but viremic (INSTIs naïve) subjects. A part of pol gene encompassing integrase-coding region was amplified and directly sequenced by Sanger sequencing method. Subtype analysis revealed subtype A1, C, D and inter-subtype recombinants were 42%, 38%, 11% and 9% respectively. Though multiple subtypes co-circulate, IN gene exhibited a relatively conserved amino acid sequence pattern with average Shannon entropy score of 0.16. No major INSTIs resistance mutations were found, however accessory resistance mutations at positions T97A, E157Q, G163E/K and 128A/T were detected in 5% of subjects.Iran is a great country with a long history of civilization and medicine. Following the increase in the prevalence of multiple sclerosis (MS), Iranian scientists and physicians started considering this disease and its outcomes in Iran. The first MS paper published by Iranian scientists dates back to 1963, when a case of hereditary spastic ataxia mimicking MS was reported. With the cooperation of his colleagues, Prof. Jamshid Lotfi conducted the first MS-related paper. The Iranian MS Society was established in 1998 in Iran, and is currently a member of the MS International Federation (MSIF). Progressively, after the scientific development of Iranian universities and recognizing the importance of the disease, the first specialized MS ward was established in Sina hospital by Prof. Mohammad Ali Sahraian and was followed by the establishment of the first MS research center. MS Society is presently quite active and the Iranian MS congress is annually held in one of the Iranian universities to review the most recent achievements in the field of the disease. The present study aims to illustrate the history of the efforts made on the way, and attempts to introduce the people who took significant steps in this regard. © 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http//creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Hereditary spherocytosis (HS), a familial defect involving red blood cell (RBC) membrane proteins, is associated with reduced deformability, increased fragility, and progressive destruction of spherical cells. The present study focuses on three subjects of a family showing a history of repeated episodes of lethargy and pallor of unknown etiology. All patients displayed reticulocytosis and spherocytosis and one of them had anemia and splenomegaly. The patients underwent screening tests to rule in/out possible underlying disorders, and deficiency/dysfunction of RBC membrane proteins was suspected. Definitive diagnosis can be made on the basis of membrane protein analysis by quantitative sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Interestingly, all patients showed marked decrease in the protein 4.2 expression and therefore, HS was confirmed. This case report highlights the simultaneous occurrence of protein 4.2-dependent “typical” and “atypical” HS in a family and serves as a reminder to clinicians to consider RBC membrane disorders in patients presenting with suspicious and unexplained clinical signs.