Attributes of rigor and quality and suggested best practices for qualitative research design as they relate to the steps of designing, conducting, and reporting qualitative research in health professions educational scholarship are presented. A research question must be clear and focused and supported by a strong conceptual framework, both of which contribute to the selection of appropriate research methods that enhance trustworthiness and minimize researcher bias inherent in qualitative methodologies. Qualitative data collection and analyses are often modified through an iterative approach to answering the research question. Researcher reflexivity, essentially a researcher's insight into their own biases and rationale for decision-making as the study progresses, is critical to rigor. This article reviews common standards of rigor, quality scholarship criteria, and best practices for qualitative research from design through dissemination.

No abstract

Tetraspanins regulate integrin-dependent tumor cell interactions with the extracellular matrix. Here we show that tetraspanin CD151, which plays critical roles in regulating the adhesion and motility of individual tumor cells, is also an important regulator of collective tumor cell migration. Near total silencing of CD151 destabilizes E-cadherin-dependent carcinoma cell-cell junctions and enhances the collective migration of intact tumor cell sheets. This effect does not depend on reduced E-cadherin cell-surface expression or intrinsic adhesivity, or on obvious disruptions in the E-cadherin regulatory complex. Instead, the loss of CD151 causes excessive RhoA activation, loss of actin organization at cell-cell junctions, and increased actin stress fibers at the basal cell surface. Cell-cell contacts within CD151-silenced monolayers display a nearly threefold increase in remodeling rate and a significant reduction in lifespan as compared to cell-cell contacts within wild-type monolayers. CD151 re-expression restores junctional stability, as does acute treatment of CD151-silenced cells with a cell-permeable RhoA inhibitor. However, a CD151 mutant with impaired association with α3β1 integrin fails to restore junctional organization. These data reveal that, in addition to its roles in regulating tumor cell-substrate interactions, CD151 is also an important regulator of the stability of tumor cell-cell interactions, potentially through its interaction with α3β1 integrin. This could help to explain the phenotypes in human patients and mice lacking CD151.

ADHD significantly increases the risk of eating disorders. The presence of an eating disorder in girls with ADHD heightens the risk of additional morbidity and dysfunction.

Human keratinocytes (KCs) express multiple EGF receptor (EGFR) ligands; however, their functions in specific cellular contexts remain largely undefined. To address this issue, first we measured mRNA and protein levels for multiple EGFR ligands in KCs and skin. Amphiregulin (AREG) was by far the most abundant EGFR ligand in cultured KCs, with > 19 times more mRNA and > 7.5 times more shed protein than any other family member. EGFR ligand expression in normal skin was low (< 8 ‰ of RPLP0/36B4); however, HB-EGF and AREG mRNAs were strongly induced in human skin organ culture. KC migration in scratch wound assays was highly metalloproteinase (MP)- and EGFR dependent, and markedly inhibited by EGFR ligand antibodies. However, lentivirus-mediated expression of soluble HB-EGF, but not soluble AREG, strongly enhanced KC migration, even in the presence of MP inhibitors. Lysophosphatidic acid (LPA)-induced ERK phosphorylation was also strongly EGFR and MP dependent and markedly inhibited by neutralization of HB-EGF. In contrast, autocrine KC proliferation and ERK phosphorylation were selectively blocked by neutralization of AREG. These data show that distinct EGFR ligands stimulate KC behavior in different cellular contexts, and in a MP-dependent fashion.

Concerns for cardiovascular sequelae of coronavirus disease 2019 (COVID-19), including myocardial injury or myocarditis, brought about recommendations for evaluating athletes after infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 1 Assessments that were based on symptoms, disease severity, and cardiovascular testing were refined to guide decision making and safe return to play in various groups. 2 However, cardiac magnetic resonance (CMR) findings of myocarditis in athletes have ranged from as high as 15% (4 out of 26 athletes in one study) to as low as 1.4% (2 out of 145 athletes in another study), many of whom had no or only mild symptoms, have raised concerns around testing in this population. 3,4 CMR is a recognized tool for diagnosing myocarditis yet is not generally recommended for athletes after COVID-19 without an elevated index of suspicion. 2,5 Given limited data in competitive athletes after infection with SARS-CoV-2, we report our initial experience with an algorithmguided screening of collegiate athletes and intermediate-term follow-up.Collegiate athletes were evaluated in sports cardiology clinic no sooner than 10 days after testing positive for SARS-CoV-2 by reverse transcriptase polymerase chain reaction. A 12-lead ECG, transthoracic echocardiogram, and conventional cardiac troponin I (cTn) level were obtained from all athletes regardless of symptom history or illness severity. Anyone with an abnormal test result or clinical evaluation of concern was referred for CMR. Those with normal evaluations and negative testing results or negative CMR were returned to full participation after a graduated reintroduction of exercise. Clinical follow-up occurred through communication with university athletic staff. The study was approved by the University of Tennessee Institutional Review Board. The data will be made available on reasonable request.We evaluated 137 athletes from July 9, 2020, to October 21, 2020. Athletes were young adults (median, 20 years; range, 18-27 years), majority male (n=93, 68%), and of various racial/ethnic backgrounds (Black, n=66, 48%; White, n=65, 47%; Hispanic, n=10, 7%). Median time to evaluation was 16 days (interquartile range, 12-34). A broad range of athletics was represented: football (n=51, 37%), dance (n=18, 13%), basketball (n=16, 12%), baseball (n=13, 10%), tennis (n=8, 6%), softball (n=7, 5%), soccer (n=7, 5%), cheer (n=6, 4%), track (n=5, 4%), volleyball (n=4, 3%), and golf (n=2, 1%). Students represented 3 universities and competed across National Collegiate Athletic Association Divisions 1 (majority), 2, and 3.Most athletes were symptomatic (n=112, 82%) and experienced only mild (n=75, 67%) or moderate (n=37, 33%) symptoms. The most frequent symptoms were loss of smell/taste (n=65, 58%), fever (<2 days, n=47, 42%), headache (n=46, 41%), and fatigue (n=45, 40%). Less frequently, shortness of breath (n=14, 12%) and chest pain/tightness (n=13, 11%) were reported. Black and Cardiovascular Evaluation After COVID-19 in 137 Collegiat...

Comparison of findings from both studies reveals many overlapping (e.g., entertainment for teens) and novel (e.g., collaboration) themes. Study results will be used to inform the potential development of a comprehensive healthcare program for AYA.

We have shown that autocrine proliferation of human keratinocytes (KC) is strongly dependent upon amphiregulin (AREG), whereas blockade of heparin-binding EGF-like growth factor (HB-EGF) inhibits KC migration in scratch wound assays. Here we demonstrate that expression of soluble HB-EGF (sHB-EGF) or full-length transmembrane HB-EGF (proHB-EGF), but not proAREG, results in profound increases in KC migration and invasiveness in monolayer culture. Coincident with these changes, HB-EGF significantly decreases mRNA expression of several epithelial markers including keratins 1, 5, 10, and 14, while increasing expression of markers of cellular motility including SNAI1, ZEB1, COX-2 and MMP1. Immunostaining revealed HB-EGF-induced expression of the mesenchymal protein vimentin and decreased expression of E-cadherin as well as nuclear translocation of β-catenin. Suggestive of a trade-off between KC motility and proliferation, overexpression of HB-EGF also reduced KC growth by more than 90%. We also show that HB-EGF is strongly induced in regenerating epidermis after partial thickness wounding of human skin. Taken together, our data suggest that expression of HB-EGF in human KC triggers a migratory and invasive phenotype with many features of epithelial-mesenchymal transition (EMT), which may be beneficial in the context of cutaneous wound healing.