Key Points Question What is the benefit of a short hypnosis session before general anesthesia on postoperative outcomes (pain, nausea/vomiting, fatigue, comfort/well-being, anxiety, postanesthesia care unit length of stay, and patient satisfaction) in patients who underwent minor breast cancer surgery? Findings In this randomized clinical trial, 150 women were randomized to receive hypnosis or a control group, and the mean breast pain score before discharge was 1.75 in the control arm vs 2.63 in the hypnosis arm. At discharge, no statistically significant difference in breast pain was reported. Meaning No benefit of hypnosis was found on postoperative breast pain; however, hypnosis seems to have other benefits regarding fatigue, anxiety, and patient satisfaction.

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Context Simulated clinical immersion (SCI), in which clinical situations are simulated in a realistic environment, safely and gradually exposes novices to complex problems. Given their limited experience, undergraduate students can potentially be quite overwhelmed by SCI learning tasks, which may result in misleading learning outcomes. Although task complexity should be adapted to the learner's level of expertise, many factors, both intrinsic and extraneous to the learning task, can influence perceived task complexity and its impact on cognitive processes. Objectives The purpose of this mixed‐methods study was to understand the effects of task complexity on undergraduate pharmacy students’ cognitive load, task performance and perception of learning in SCI. Methods A total of 167 second‐year pharmacy students were randomly assigned to undertake one simple and one complex learning task in SCI consecutively. Participants’ cognitive load was measured after each task and debriefing. Task performance and time on task were also assessed. As part of a sequential explanatory design, semi‐structured interviews were conducted with students showing maximal variations in intrinsic cognitive load to elucidate their perceptions of learning when dealing with complexity. Results Although the complex task generated significantly higher cognitive load and time on task than the simple task, performance was high for both tasks. Qualitative results revealed that a lack of clinical experience, an unfamiliar resource in the environment and the constraints inherent to SCI, such as time limitations, hindered the clinical reasoning process and led to poorer self‐evaluation of performance. Simple tasks helped students gain more self‐confidence, whereas complex tasks further encouraged reflective practice during debriefings. Conclusions Although complex tasks in SCI were more cognitively demanding and took longer to execute, students indicated that they learned more from them than they did from simple tasks. Complex tasks constitute an additional challenge in terms of clinical reasoning and thus provide a more valuable learning experience from the student's perspective.

Epidermolysis bullosa simplex (EBS) is a skin disorder resulting from a weakened cytoskeleton of the proliferative compartment of the epidermis, leading to cell fragility and blistering. Although many mutations have been identified in intermediate filament keratins KRT5 and KRT14, detailed pathogenic mechanisms and the way these mutations affect cell metabolism are unclear. Therefore, we performed genomic and transcriptomic study in six Canadian EBS patients and six healthy subjects. We first characterized these patients at the genetic level and identified six pathogenic mutations of which two were novel. Then, we performed an expression microarray analysis of the EBS epidermis tissue to identify potential regulatory pathways altered in this disease. Expression profiling comparisons show that 28 genes are differentially expressed in EBS patients compared to control subjects and 41 genes in severe phenotype patients (EBS-DM) compared to their paired controls. Nine genes involved in fatty acid metabolism and two genes in epidermal keratinization are common altered expressed genes (up regulated) between the two subgroups. These two biological pathways contribute both to the formation of the cell envelope barrier and seem to be defective in the severe EBS phenotype. This study identifies, for the first time, the fatty acid metabolism disruption in EBS.

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The presence of epoxy resin in a reformulated immersion oil for microscopy has caused an epidemic of occupational contact dermatitis in laboratory technicians from some European centers. We report 6 additional cases, the mode of presentation of which was similar to the European patients. All patients were patch tested to the undiluted oil, and some were tested to the European or North American standard series and to an extensive series of glues and adhesives allergens. At 96 hours, all 6 patients displayed a strong 2+ to 3+ reaction to the undiluted oil. Two patients were not further tested, but in the remaining 4, positive reactions were seen to epoxy resin from the standard tray. One patient reacted to cycloaliphatic epoxy resin, and 2 displayed positive tests to the reactive diluents phenyl glycidyl ether and cresyl glycidyl ether. These further cases confirm the strong sensitizing properties of this particular immersion oil. The product, manufactured by Leica Microsystems (Wetzlar, Germany), since has been withdrawn from sale.

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