ELIGIBILITY CRITERIA: English-language randomized controlled trials (RCTs) of preventive drugs compared to placebo or active treatments examining rates of ≥50 % reduction in monthly migraine frequency or improvement in quality of life. STUDY APPRAISAL AND SYNTHESIS METHODS:We assessed risk of bias and strength of evidence and conducted random effects meta-analyses of absolute risk differences and Bayesian network meta-analysis. RESULTS: Of 5,244 retrieved references, 215 publications of RCTs provided mostly low-strength evidence because of the risk of bias and imprecision. RCTs examined 59 drugs from 14 drug classes. All approved drugs, including topiramate (9 RCTs), divalproex (3 RCTs), timolol (3 RCTs), and propranolol (4 RCTs); offlabel beta blockers metoprolol (4 RCTs), atenolol (1 RCT), nadolol (1 RCT), and acebutolol (1 RCT); angiotensin-converting enzyme inhibitors captopril (1 RCT) and lisinopril (1 RCT); and angiotensin II receptor blocker candesartan (1 RCT), outperformed placebo in reducing monthly migraine frequency by ≥50 % in 200-400 patients per 1,000 treated. Adverse effects leading to treatment discontinuation (68 RCTs) were greater with topiramate, off-label antiepileptics, and antidepressants than with placebo. Limited direct evidence as well as frequentist and exploratory network Bayesian meta-analysis showed no statistically significant differences in benefits between approved drugs. Off-label angiotensin-inhibiting drugs and beta-blockers were most effective and tolerable for episodic migraine prevention. LIMITATIONS:We did not quantify reporting bias or contact principal investigators regarding unpublished trials. CONCLUSIONS: Approved drugs prevented episodic migraine frequency by ≥50 % with no statistically significant difference between them. Exploratory network meta-analysis suggested that off-label angiotensin-inhibiting drugs and beta-blockers had favorable benefit-to-harm ratios. Evidence is lacking for longterm effects of drug treatments (i.e., trials of more than 3 months duration), especially for quality of life.KEY WORDS: migraine; evidence based medicine; adverse drug effects.

Photodynamic therapy, a promising, new approach for destroying malignant cells, takes advantage of light, oxygen, and a drug (photosensitizer) that preferentially localizes in rapidly growing cells.

The COVID-19 pandemic required a shift of graduate medical education recruitment to a virtual format. In order to share information and insight into the culture of our program with applicants, we created a smartphone app for those that were invited for an interview. By collecting the analytics of the app, we were able to follow trends in the timing of applicants downloading the app, their viewing histories, and when information was accessed. The app was mostly downloaded at the time of the interview invite or 48 h prior to the interview day. Around the interview day, applicants tended to access trainee profiles, faculty profiles, and videos about the program and community. Closer to the rank list due date, training information, the graduate medical education (GME) documents, and the diversity and wellness initiatives seemed to have more activity. This analysis from the use of a smartphone app in virtual recruitment gives insight into the use of a smartphone app by applicants, and the information that they find useful during the process.

The Royal Swedish Academy of Sciences has awarded the 1998 Nobel Prize in Chemistry to Walter Kohn (University of California at Santa Barbara) for his development of the density-functional theory and to John A. Pople (Northwestern University at Evanston, Illinois) for his development of computational methods in quantum chemistry. Quantum Mechanics: A Historical BackgroundIn order to appreciate the significance of the contributions from this year's Nobel laureates, we must first realize that near the end of the 19th century the general consensus among physicists was that all principles of physics had been discovered, and little remained to be uncovered. Accomplishments made during the nineteenth century comprise what we now refer to as classical physics: the equivalence of heat and mechanical work as demonstrated by Count Rumford and Joule; Carnot's second law of thermodynamics; the development of thermodynamics by Gibbs; the study of the effects of electricity and magnetism; and the unification of optics, electricity, and magnetism with Maxwell's theory of the electromagnetic nature of light. However, classical physics was inadequate in explaining the complex structure of the atom, which became fully appreciated upon three significant discoveries: the electron by Thomson (1897), X-rays by Roentgen (1895), and radioactivity by Becquerel (1896).Early in the 20th century, Einstein completely transformed our ideas of space and time. He proposed that energy and mass are equivalent and that light consists of small, discrete packets (quanta or photons) whose energies depend on their wavelengths. In the 1920s, Schrödinger and Heisenberg introduced the theory of quantum mechanicsa field to be developed over several decades by many people. In quantum mechanics, we see the extension of classical physics to subatomic, atomic, and molecular sizes and distances: primarily that particles have wave-like properties, and the position and momentum of a particle cannot be simultaneously known with infinite precision. The theories of relativity and quantum mechanics constitute what is now called modern physics.The laws of quantum mechanics made it theoretically possible to understand and calculate how electrons and atomic nuclei interact to create chemical bonds. This gave rise to the field of quantum chemistry, in which quantum mechanics is applied to chemical problems. However, until the 1960s, it was not feasible to handle the complicated mathematical relations of quantum mechanics for complex systems like molecules. The conventional calculations of molecular properties required determining the motion of each individual electron, and molecules of practical importance contain large numbers of electrons. Many physicists and chemists simply believed that the structures of molecules were too complex for practical application of quantum mechanics. Two developments changed that idea: Kohn's proof that molecular energies could be calculated from the spatial distribution of electrons, and Pople's development of software that exploited the...

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