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Transthoracic and transesophageal echocardiography with agitated saline contrast demonstrated bubbles in the left atrium within 3–5 cardiac cycles without evidence of intracardiac shunting (Figure 1B). Computed tomography (CT) angiography identified a large tubular structure in the right lung communicating with the right lower pulmonary vein, consistent with a pulmonary arteriovenous malformation (PAVM) with a feeding vessel diameter of 1.3 cm (Figures 1C and 1D). (C) Computed tomography angiography of the chest demonstrating a large tubular structure in the right lung communicating with the right lower pulmonary vein, consistent with pulmonary arteriovenous malformation (PAVM) with a feeding vessel diameter of 1.3 cm.

Background Interprofessional education (IPE), defined as when students from two or more professions learn about, from, and with each other, has been widely espoused as a way to promote collaborative and high-quality patient care. IPE initiatives are now commonplace in undergraduate medical education, but it is unclear whether the principles of IPE are reinforced during clinical rotations. Specifically, little is known about whether, when, and how interprofessional providers (IPPs), including nurses (RN), pharmacists (PharmD), and respiratory therapists (RT), participate in teaching medical students. This study aimed to elucidate the perspective of medical students about how IPPs impacted their education during clinical rotations in the intensive care unit (ICU). Methods Surveys were distributed to medical students who rotated in the medical ICUs at three academic medical centers over a 12-month period. Survey questions focused on three major domains: IPP roles during daily rounds, interprofessional teaching (IPT) outside of rounds, and students’ attitudes about IPT. Survey data were analyzed with descriptive and comparative statistics. Free text comments were analyzed using qualitative thematic analysis. Results Twenty five out of 53 medical students completed the survey (47%). Students reported that IPPs were commonly present on ICU rounds. Students’ reports of IPP teaching varied across professions. On a 5-point Likert scale, pharmacists were perceived to teach most frequently (mean 3.58, SD 0.81), compared to RTs (mean 2.88, SD 1.01) and nurses (mean 2.17, SD 0.80) (one-way ANOVA, F(2, 69) = [14.89], p  < 0.005). On a 7-point Likert scale, IPPs were described as teaching a moderate amount outside of rounds [RN (mean 3.46, SD 1.71), PharmD (mean 4.04, SD 1.49), RT (mean 4.00, SD 1.35)], with the majority of RN and RT teaching occurring at the bedside. Students reported generally positive attitudes about IPT, with most endorsing confidence in IPP knowledge base (92%) and teaching abilities (88%); 67% would have a positive reaction if attending physicians invited more IPT on rounds. Conclusions Medical students report variable levels of teaching from IPPs on ICU rounds, but similar levels of teaching outside of rounds. Students endorsed positive attitudes toward the idea of enhancing interprofessional teaching in the ICU.

Incidence of Pneumonitis with Use of Programmed Death 1 and Programmed Death-Ligand 1 Inhibitors in Non-Small Cell Lung Cancer: A Systematic Review and Meta-analysis of Trials. Nineteen single-arm or randomized controlled trials (N = 5,038 patients) examining PD-1 or PD-L1 (programmed death-ligand 1) inhibitors in patients with non-small cell lung cancer (NSCLC) were included, 12 with PD-1 inhibitors and 7 with PD-L1 inhibitors. Recommended Reading from Harvard-Brigham and Women's Hospital Pulmonary and Critical Care Medicine Fellows; Carolyn D'Ambrosio, M.D., Director (Received in original form March 20, 2018; accepted in final form August 10, 2018) Correspondence and requests for reprints should be addressed to Carolyn D'Ambrosio, M.D., Harvard-Brigham and Women's Pulmonary and Critical Care Fellowship, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115. Incidence of pneumonitis with use of programmed death 1 and programmed death-ligand 1 inhibitors in non-small cell lung cancer: a systematic review and meta-analysis of trials.

We know little about the neurologic bases of art production. The idea that the right brain hemisphere is the \"artistic brain\" is widely held, despite the lack of evidence for this claim. Artists with brain damage can offer insight into these laterality questions. The authors used an instrument called the Assessment of Art Attributes to examine the work of two individuals with left-brain damage and one with right-hemisphere damage. In each case, their art became more abstract and distorted and less realistic. They also painted with looser strokes, less depth and more vibrant colors. No unique pattern was observed following right-brain damage. However, art produced after left-brain damage also became more symbolic. These results show that the neural basis of art production is distributed across both hemispheres in the human brain.

Little about the neuropsychology of art perception and evaluation is known. Most neuropsychological approaches to art have focused on art production and have been anecdotal and qualitative. The field is in desperate need of quantitative methods if it is to advance. Here, we combine a quantitative approach to the assessment of art with modern voxel-lesion-symptom-mapping methods to determine brain-behavior relationships in art perception. We hypothesized that perception of different attributes of art are likely to be disrupted by damage to different regions of the brain. Twenty participants with right hemisphere damage were given the Assessment of Art Attributes, which is designed to quantify judgments of descriptive attributes of visual art. Each participant rated 24 paintings on 6 conceptual attributes (depictive accuracy, abstractness, emotion, symbolism, realism, and animacy) and 6 perceptual attributes (depth, color temperature, color saturation, balance, stroke, and simplicity) and their interest in and preference for these paintings. Deviation scores were obtained for each brain-damaged participant for each attribute based on correlations with group average ratings from 30 age-matched healthy participants. Right hemisphere damage affected participants' judgments of abstractness, accuracy, and stroke quality. Damage to areas within different parts of the frontal parietal and lateral temporal cortices produced deviation in judgments in four of six conceptual attributes (abstractness, symbolism, realism, and animacy). Of the formal attributes, only depth was affected by inferior prefrontal damage. No areas of brain damage were associated with deviations in interestingness or preference judgments. The perception of conceptual and formal attributes in artwork may in part dissociate from each other and from evaluative judgments. More generally, this approach demonstrates the feasibility of quantitative approaches to the neuropsychology of art.