E-cigarette nicotine deposition and persistence on glass and cotton surfaces.

Nicotine from electronic cigarette aerosol will deposit on surfaces immediately after vaping, but how long deposited nicotine will persist on various surfaces is unknown. This work exposed glass and terrycloth (cotton) materials to electronic cigarette aerosols for 1 hr, assessed the initial nicotine sorption, and characterized surface persistence over a 72-hr period. Exponential decay of surface concentration was observed for both materials. Terrycloth had higher initial nicotine deposition and retained nicotine substantially longer than glass. Residual nicotine concentrations persisted on both surface types for 72 hr. Statistical modeling predicted surface concentrations to reach background levels after 4 and 16 days for glass and terrycloth, respectively. Nicotine persistence was long enough to pose a potential thirdhand nicotine exposure risk, and reactions to produce tobacco-specific nitrosamines may be possible from nicotine deposition from electronic cigarette aerosols, but further study is needed.

Pediatric Resident-as-Teacher Curricula: A National Survey of Existing Programs and Future Needs.

BACKGROUND: We conducted a national survey of US pediatric program directors to explore the current status, content, and teaching methods of Resident-as-Teacher (RAT) curricula. The purposes of the survey were to (1) determine the level and method of evaluation of such curricula, and (2) assess the need for a national curricular resource in this area. METHODS: A survey was sent to US pediatric program directors that asked questions regarding demographics, support, design, development, content, and evaluation of RAT curricula, as well as existing needs and desires for RAT curricular resources. RESULTS: Sixty-two percent of pediatric program directors completed our survey. Eighty-seven percent have a formal RAT curriculum, but more than 50% allocate 10 hours or less to it during residency. The primary teaching modalities are lectures and workshops. Content areas include feedback, in-patient teaching, communication skills, case-based teaching, role modeling, evaluation, leadership skills, 1-minute preceptors, teaching/learning styles, professionalism, and small-group teaching. Sixty-three percent of programs report evaluating their curricula, but only 27% perceive their program to be very/extremely effective. Nearly all respondents expressed interest in a national RAT curriculum, preferring web-based modules for dissemination. CONCLUSIONS: Despite an Accreditation Council for Graduate Medical Education requirement for a RAT curriculum, some pediatrics programs still lack one, and some consider their program only moderately effective. A wealth of curricular material exists across programs, which could be shared nationally. Establishing a national RAT curriculum would offer programs resources to meet educational mandates and the ability to tailor programs to best fit their own program needs.

An unusual congenital hepatic cyst in an adolescent and review of differential diagnoses of complex liver cysts.

The diagnosis of a simple hepatic cyst is not difficult, but diagnostic confusion occurs when atypical features such as intracystic debris or extremely large size are present. In children, simple liver cysts are described as small, asymptomatic, and rarely hemorrhagic. We report an adolescent male presenting with an unusually large hepatic cyst that did not have typical imaging characteristics. The imaging findings and histology are displayed along with the differential diagnoses of complex liver cysts.