bluuebunny/crossref_metadata_2025 huggingface dataset:
トラゾドン，リスペリドンによる薬剤性QT延長症候群からtorsade de pointesを呈した重症患者の1例(A serious case of drug–induced QT prolongation and torsade de pointes by using trazodone and risperidone)
Authors: (Masayoshi Horino) 堀野 雅祥 , (Satoyuki Ogino) 荻野 聡之 , (Kei Yoshikawa) 吉川 慧 , (Takashi Igarashi) 五十嵐 昂 , (Yasuhiko Kaita) 海田 賢彦 , (Yoshihiro Yamaguchi) 山口 芳裕
Published: April 2022

向精神薬はQT延長を来しうるが，トラゾドンやリスペリドンによってQT延長，torsade de pointes（以下TdP）を呈した報告は少ない。今回，重症熱傷治療中に同薬剤によりQT延長症候群，TdPを呈した1例を経験した。症例は70代の女性。気道熱傷，重症熱傷と診断し，人工呼吸器管理としたのちに，入院日から熱傷創の手術を行った。第6病日，抜管後にせん妄を発症しリスペリドンを開始，第8病日から不眠に対してトラゾドンを開始した。来院時QTc時間は479msecであり，第23病日には509msecと延長していた。第24病日，16連続の心室頻拍（TdP）となった。自己心拍再開後QTc時間は509msecであり，QT延長を来す可能性のあるリスペリドン，トラゾドンを中止するとともに，電解質補正を行った。電解質を補正したが，頻回にTdPを認めたため，一時的ペースメーカーを挿入した。薬剤中止後5日でQTc時間は497msecまで改善し，第31病日に抜去した。熱傷治療を継続し，第110病日に転院した。本症例において，入院後にQT延長，TdPが生じた要因はリスペリドン，トラゾドンと推察された。QT延長の危険因子である高齢，女性，心疾患の既往の存在，もしくは入院時にQT時間の延長を認める患者に対して同薬剤を投与する際にはTdPを生じる可能性があり注意を要する。
救急科専門医を目指す専攻医の職業満足度調査(Career satisfaction among emergency medicine residents in Japan)
Authors: (Takashi Shiga) 志賀 隆 , (Toru Hifumi) 一二三 亨 , (Yusuke Hagiwara) 萩原 佑亮 , (Norio Otani) 大谷 典生 , (Hiroshi Tanaka) 田中 裕 , (Minoru Nakano) 中野 実 , (Yasuhiro Kuroda) 黒田 泰弘
Published: April 2022

【目的】新専門医制度のなか，救急医の確保が課題となっている。過去に若手救急医の職業満足度の報告はあったが全国調査は限られている。本研究では，救急科専門医を目指す専攻医の職業満足度を調査し，各々に影響を与える因子を明らかにすることを目的とした。【対象】2018年度の専門医試験受験時に職業満足度について受験者にアンケートを実施した。その後，最尤法・プロマックス回転にて因子分析を行った。職業満足度を従属変数，得られた因子を独立変数とし多変量ロジスティック回帰分析を行った。【結果】回答は427名で回収率は98.2%であった。男性は332名（80.8%）であった。因子分析にて，満足度を規定する因子として，指導環境因子，労働環境因子，個人学習因子，ストレス因子が抽出された。高い職業満足度ありは137名（36.6%）であった。ロジスティック回帰分析にて高い職業満足度と有意に関連したのは，指導環境因子（Odds比2.18, 95%信頼区間：1.43–3.33），労働環境因子（Odds比1.78, 95%信頼区間：1.25–2.53），個人学習因子（Odds比1.55, 95%信頼区間：1.02–2.36）の3因子であった。Fisherの正確検定にて，職業満足度と他科転向の意思には有意な相関はなかった。【結語】高い職業満足度のために指導環境，労働環境，個人学習の整備が必要であることが示唆された。
内因性脳梗塞が先行した外傷症例に対し急性期再灌流療法を施行した1例(A case of revascularization therapy for acute ischemic stroke with a chief complaint of traumatic injury)
Authors: (Arisa Aoyagi) 青柳 有沙 , (Kei Miyata) 宮田 圭 , (Ayumu Yamaoka) 山岡 歩 , (Takehiko Kasai) 葛西 毅彦 , (Shuji Uemura) 上村 修二 , (Eichi Narimatsu) 成松 英智
Published: April 2022

標準的な外傷診療では生理学的機能の管理および安定化を重視しており，神経学的所見は見逃されやすい。内因性脳梗塞が先行した外傷症例の診療について検討した。症例は78歳の男性，階段2階の踊り場から転落した。右共同偏視，右片麻痺，Glasgow coma scale（GCS）12の意識障害を認めた。外傷全身computed tomography（CT）で頭蓋内に占拠性病変は認めず，動脈優位相で左中大脳動脈の造影欠損を認めた。急性期脳梗塞と診断し，機械的血栓回収療法を行った。外傷機転を介在する内因性脳梗塞では，見逃しや治療介入に時間を要する可能性がある。病院前脳卒中スケールが症状検出に役立つ可能性があり，頭頂部の動脈優位相を含む造影CT検査で主幹動脈閉塞の検索が可能である。画像評価には熟練を要するため，3次元画像処理を行うとともに，適切に専門医へコンサルトし早期診断治療へつなげることが重要である。
胃原発悪性T細胞リンパ腫による大量出血に対して胃内ガーゼパッキングで救命しえた1例(Primary gastric peripheral T–cell lymphoma presenting as massive bleeding treated with intragastric gauze packing: a case report)
Authors: (Shingo Sasamatsu) 笹松 信吾 , (Tadao Kubota) 窪田 忠夫 , (Wataru Ishii) 石井 亘
Published: April 2022

症例は66歳の男性。吐血を主訴に救急搬送された。上部消化管内視鏡検査で胃3型腫瘍からの出血と診断され経過観察目的に入院した。搬入10時間後，1L以上の吐血を来し出血性ショックとなり，大動脈閉塞バルーン留置下で緊急開腹した。胃穹窿部後壁に潰瘍化した腫瘍を認め, 同部位から出血が持続していた。縫合止血が困難であり胃内ガーゼパッキングで一時止血を得た。集学的管理で全身状態を改善させ，2日後に再開腹しガーゼを抜去すると，腫瘍が脾動脈に浸潤しており，同部位からの再出血を認めた。腫瘍は膵尾部・脾門部・横隔膜に浸潤しており，胃全摘術・膵尾部脾合併切除術を行った。病理組織検査で非特定型末梢性T細胞リンパ腫と診断した。胃原発悪性リンパ腫は稀に大量出血を来すことがあり，damage control strategyが要求される可能性がある。胃腫瘍からの大量出血に対するdamage control surgeryとして胃内ガーゼパッキングが有用であると考えられる。
外科的介入が遅延し，入院後に多発膿瘍を合併した化膿性胸鎖関節炎の1例(Delayed surgical intervention after admission caused whole body multiple abscesses in the patients with septic arthritis of the sternoclavicular joint: a case report)
Authors: (Yuichiro Nishida) 西田 雄一朗 , (Hiroshi Matsuura) 松浦 裕司 , (Yukari Miki) 三木 由香里 , (Hiroshi Fukuoka) 福岡 大史 , (Hitoshi Yamamura) 山村 仁
Published: April 2022

化膿性胸鎖関節炎は，胸鎖関節周囲の軟部組織に膿瘍形成を来す疾患で，主に整形外科で扱われるが，敗血症性ショックで救命救急センターに搬入される症例は稀である。今回，外科的介入を含めた集学的治療が必要であった化膿性胸鎖関節炎の1例を経験したので報告する。症例は既往歴にコントロール不良の糖尿病がある49歳の男性。1週間前より左鎖骨痛，その2日後に右肩痛が出現し，徐々に痛みの増悪と意識障害を来し，前医にて敗血症性ショックとなり当院へ救急搬送された。CTでは頸部から胸骨にかけて小さな膿瘍形成を認めた。保存的加療で全身状態の改善が得られ，第9病日には一般病棟へ転床した。その後，炎症反応の再燃があり，第16病日の造影CTで，膿瘍は縦隔に進展し，左前腕部，左膝部，両側大腿骨周囲に膿瘍の形成を認めた。抗菌薬投与に加えて胸腔鏡補助下縦隔ドレナージ術および多発膿瘍に対して開窓術を行い，炎症所見は改善し，第69病日にリハビリ目的に転院となった。頸部領域の膿瘍で胸鎖関節周囲が関与している場合は本疾患を鑑別に挙げ，MRIも踏まえた関節炎・骨髄炎の有無について早期に診断を行い，常に外科的介入を念頭に置いたうえで遅延なく的確に行うことが重要である。
突然の心不全を契機に発見された基礎疾患のない若年者の褐色細胞腫の1例(A case of pheochromocytoma in young patient without cardiovascular risk factors that found out due to sudden heart failure)
Authors: (Mayuko Kato) 加藤 万由子 , (Toshihiro Hatakeyama) 畠山 稔弘 , (Ryutaro Nakamura) 中村 龍太郎 , (Tatsuhiko Suzuki) 鈴木 達彦 , (Mitsuhiro Suzuki) 鈴木 光洋 , (Daisuke Sugiki) 杉木 大輔 , (Hisao Matsushima) 松島 久雄
Published: April 2022

30代女性。呼吸苦で救急受診し，胸部X線で全肺野スリガラス陰影，computed tomographyで肺水腫・右副腎腫瘍を認めた。経胸壁心エコーで推定左室駆出率 約30%・全周性壁運動低下を認め，急性心不全として緊急入院した。人工呼吸管理後，呼吸苦や頻呼吸は消失し，酸素化も速やかに改善した。第2病日，胸部X線・経胸壁心エコー所見も正常となり抜管した。入院時病態は不明のまま，第9病日退院した。入院時，偶発的に発見された右副腎腫瘍から褐色細胞腫による肺水腫・心機能低下を考慮し，退院後に精査された。血中カテコラミン濃度・123I–MIBG（metaiodobenzylguanidine）シンチグラフィ・クロニジン負荷試験などより褐色細胞腫と診断された。その後，右副腎摘出術により寛解した。入院時の症状は褐色細胞腫から多量に分泌されたカテコラミンによる心不全であったと考えられた。
奈良公園の鹿が関係した外傷症例49例の検討：記述疫学研究(Deer–related 49 trauma cases around Nara Park: descriptive epidemiological study)
Authors: (Ryosuke Kawaguchi) 川口　 竜助 , (Takeshi Ando) 安藤　 剛 , (Yasunobu Goto) 後藤　 安宣
Published: April 2022

2014年1月1日～2018年12月31日の5年間に奈良公園およびその周辺に生息するニホンジカ（以下「奈良のシカ」）が関係した外傷による当院への救急搬送症例の特徴を記述疫学的に検討した。計49例の搬送があり，男性18名，女性31名で，5年間で3.6倍に増加していた。平均年齢は男性15.3±23.3歳，女性35.1±25.1歳と差を認めており，男性は5歳以下が67%を占め成人男性の搬送は少なかった。奈良市の居住者よりも，旅行者が86%と圧倒的に多かった。打撲傷が80%を占めていたが不安定型骨盤骨折などの入院を要する症例も含まれていた。受傷機転は角や体当たりによる外傷が59%，咬傷が4%，鹿との接触がなく鹿の接近を契機に人が転倒するなどして受傷した症例が31%，車両乗車中の鹿に関係した交通事故が6%であった。救急搬送された「奈良のシカ」による人への外傷症例の特徴として，犬外傷と同様に男児の受傷が多い傾向があるが，比較して咬傷は少なく，直接鹿との接触がないのに外傷を負う受傷形態があることが明らかになった。
複合的指標に基づく重症外傷患者選別基準とアンダートリアージの低下(Composite criteria for identification of severely injured patients and decreased undertriage)
Authors: (Keitaro Yajima) 矢島　 慶太郎 , (Ryo Yamamoto) 山元　 良 , (Tomohiro Funabiki) 船曳　 知弘 , (Mitsuhide Kitano) 北野　 光秀 , (Junichi Sasaki) 佐々木　 淳一
Published: April 2022

【目的】重症外傷の病院前選別ではアンダートリアージの減少が予後改善に寄与するとされているが，本邦では病院前の重症外傷選定基準に関する研究は少ない。そこで，受傷機転と生理学的・解剖学的所見による複合的基準が重症外傷のアンダートリアージ減少に関連しているか検証した。【対象】2016年10月からの2年間に横浜市指定4区で発生した外傷患者を対象に，後ろ向き観察研究を行った。現場から搬送され入院あるいは外来死亡した症例の中で，来院時心肺停止を除外し解析を行った。研究期間前半はショックを伴う頸胸腹損傷・両側大腿骨骨折を重症外傷と判定し（基準A），後半は高リスク受傷機転および生理学的・解剖学的異常所見を複合的に用いて判定した（基準B）。基準を満たさず搬送され重症外傷と診断された症例をアンダートリアージとし，各基準のアンダートリアージ率を比較した。【結果】539例の対象症例のうち，基準A運用期間は281例，基準B運用期間は258例であった。年齢や重症度は両期間とも相似していたが，緊急手術は基準B運用期間で多かった。アンダートリアージ率は，基準Aで27.6%，基準Bで18.1%であり，基準Bで有意に低かった（p=0.04）。【結語】外傷患者の搬送プロトコールにおいて，受傷機転，生理学的所見，および解剖学的所見を複合的に用いた重症患者選別基準がアンダートリアージの減少につながることが示唆された。
シートベルトにより生じた鈍的腹部大動脈損傷の2例(Prevalent sites and conditions of blunt abdominal aortic injury caused by seat belt: Case series)
Authors: (Jun Maruyama) 丸山 潤 , (Daisuke Kobashi) 小橋 大輔 , (Mitsunobu Nakamura) 中村 光伸 , (Tomoya Nishimura) 西村 朋也 , (Yoshihiko Takahashi) 高橋 慶彦
Published: April 2022

シートベルトによる鈍的腹部大動脈損傷（BAAI）は死亡率が高く，また，見逃されやすい。今回，シートベルトにより生じたと考えられるBAAIを2例経験した。症例1：30才男性，ガードレールに衝突し受傷した。シートベルト痕，腸間膜損傷，第2腰椎骨折，BAAIを認め，腸間膜損傷に対し開腹止血術を施行，BAAIについては第9病日にステントグラフト内挿術を施行した。症例2：77才女性，ガードレールに衝突し受傷した。シートベルト痕，肝損傷，膵損傷，小腸損傷，腰椎骨折，BAAIを認めた。ガーゼパッキングと小腸穿孔部の縫合を行い，BAAIは保存的に管理した。いずれの症例もCTでシートベルト痕と思われる皮下組織の濃度上昇，腹腔内臓器損傷，腰椎骨折を認め，ともに第2/3腰椎椎間板高位でのBAAIを認めた。シートベルト痕，腸管・腸間膜損傷，腰椎骨折を3徴とするシートベルト症候群ではBAAIを考慮した画像評価を行う必要があること，シートベルトによるBAAIは第2–3腰椎高位が好発部位であることが示唆された。
VV–ECMO施行中の難治性気胸に対して気管支充填術と胸膜癒着術に肺完全虚脱管理を行い治癒し得た1例(Successful treatment by managing a completely collapsed lung with bronchial occlusion and pleurodesis in a patient with refractory pneumothorax during VV–ECMO: a case report)
Authors: (Ryutaro Tojo) 東條 隆太郎 , (Ryuichiro Kakizaki) 柿崎 隆一郎 , (Naofumi Bunya) 文屋 尚史 , (Hirotoshi Mizuno) 水野 浩利 , (Shuji Uemura) 上村 修二 , (Eichi Narimatsu) 成松 英智
Published: April 2022

症例は49歳の男性。2週間前から感冒症状が出現し近医で肺炎と診断され抗菌薬加療していた。呼吸苦が増悪したため救急要請され，著明な低酸素血症を認め当院に搬送された。重症急性呼吸窮迫症候群（acute respiratory distress syndrome: ARDS）を認め人工呼吸器管理を行ったが低酸素血症の改善を認めず，第１病日よりveno–venous extracorporeal membrane oxygenation（VV–ECMO）を導入した。第9病日にECMO回路交換時に心停止を来し胸骨圧迫が行われ，その合併症として大量血気胸を生じた。開胸止血術や肺部分切除を行い止血したが，気胸再発を認め保存的加療では改善を得られなかった。第26病日より気管支充填剤EWS（endobronchial Watanabe spigot）を用いた気管支充填と胸膜癒着術を行い，1週間患側肺を完全に虚脱させ呼吸をECMOに依存させることで気胸治療に専念した。その後気胸は再燃なく経過し，徐々に呼吸状態も改善し，第53病日にECMOを離脱し，第67病日にリハビリテーション目的に転院となった。VV–ECMO施行中に気胸を合併した際に，ECMOに呼吸を依存させ気胸治療に専念することは有用である。
新型コロナウイルス感染症（COVID–19）に伴う難治性大量下痢症の1例(A case of refractory massive diarrhea in a patient with COVID–19)
Authors: (Kentaro Shimizu) 清水 健太郎 , (Haruhiko Hirata) 平田 陽彦 , (Natsuko Tokuhira) 德平 夏子 , (Akiko Ueda) 上田 安希子 , (Daisuke Motooka) 元岡 大祐 , (Shota Nakamura) 中村 昇太 , (Hiroshi Ogura) 小倉 裕司
Published: April 2022

新型コロナウイルス感染症（COVID–19）は下痢などの消化器症状を引き起こすことが知られている。本報告では，難治性大量下痢症例とその腸内細菌叢の推移を報告する。症例は60代の男性。呼吸苦で救急搬送された。新型コロナウイルス感染症と診断され，呼吸不全に対して，人工呼吸管理，extracorporeal membrane oxygenation（ECMO），抗ウイルス薬，抗菌薬を開始した。第12病日より下痢を認め，第21病日には6,384mL/日の水様下痢に至り，循環動態を維持するために大量の輸液および昇圧薬を要する状態となった。吸着薬，ペクチン含有濃厚流動食品，シンバイオティクスを使用することで下痢量は翌日より減少に転じ，第30病日以降は1,000mL/日以下となった。下痢便のメタゲノム解析では，ほとんどがFirmicutes門のEnterococcus属，Staphylococcus属で占められていた。健常人の最優勢菌の一つであるBacteroides属は1%以下と腸内細菌叢は劇的に変化していた。その後，下痢は1日数回になったが症状は残存したまま第104病日に転棟となった。重症COVID–19に伴い肺炎治療のみならず消化器合併症に対する腸管内治療を要する症例を経験した。本例のような大量下痢症には吸着薬などの腸管内治療が効果的であった。
VA–ECMOを用いて救命し得た重症日本紅斑熱による敗血症性ショックの１例(Septic shock due to severe Japanese spotted fever that could be saved by using VA–ECMO: a case report)
Authors: (Nao Yamamoto) 山本　 奈緒 , (Masao Narita) 成田　 正雄 , (Chikako Hiwatari) 樋渡　 智香子 , (Kiyotaka Yano) 矢野　 清崇
Published: April 2022

日本紅斑熱はリケッチア感染症の一種であり，しばしば重症化し死亡報告例もある。切迫心停止にまで至った状態から体外式膜型人工肺（VA–ECMO）を用いて救命された症例の報告はなく，その経過と治療経験について報告する。症例は70歳代の女性，来院2週間前より自宅周辺の草刈りをしていた。発熱，倦怠感により前医を受診し，肝酵素上昇などから胆道系感染症を疑われ，当院へ紹介，救急搬送された。右大腿外側部に刺し口を疑わせる痂皮を認め，リケッチア敗血症が疑われた。しかし入院後は急速に状態悪化し，第2病日に気管挿管呼吸器管理とし，ICU入室となった。その後もショックは進行し，心エコーではたこつぼ様の壁運動を認めた。血液浄化療法を含めた集中治療管理を行ったが血行動態はさらに悪化し心停止の切迫する状態となったため，VA–ECMOを導入した。その後，血行動態は安定化し，第5病日には左室壁運動は著明に改善がみられた。第6病日にVA–ECMOを離脱した。第8病日に抜管した。その後，入院中にペア血清および痂皮PCR法により日本紅斑熱の診断が確認された。リハビリ目的に第58病日に転院となった。重症日本紅斑熱による敗血症性ショックの治療としてVA–ECMOは有効な選択肢となりうると考えられた。
妊娠中期に重症化した新型コロナウイルス感染症に対して集学的加療を行い母子ともに救命した1例(A case of a pregnant woman with severe COVID–19 who was treated by multidisciplinary therapy)
Authors: (Tatsuya Harada) 原田 巽矢 , (Satoyuki Ogino) 荻野 聡之 , (Shunkichi Sasazawa) 笹沢 俊吉 , (Fumio Asano) 浅野 史男 , (Shinji Tanigaki) 谷垣 伸治 , (Yasuhiko Kaita) 海田 賢彦 , (Yoshihiro Yamaguchi) 山口 芳裕
Published: April 2022

妊婦は，新型コロナウイルス感染症（COVID–19）が重症化するリスクが高く，母子ともに生命の危機に瀕するため注意が必要である。今回妊娠中期に重症化したCOVID–19患者に対して胎児の在胎週数を鑑み，集学的加療を行い良好な転帰を得た症例を経験したので報告する。症例は30歳代の女性，COVID–19発症7日目（妊娠27週6日）に重症化し翌日当院に転院搬送された。在胎週数を延ばすため腹臥位療法を導入，第2病日に人工呼吸器管理とし，腹臥位でPaO2/FiO2（P/F）比200以上を保てていたが，第8病日にP/F比120と悪化し，妊娠29週を越え，胎児の発育も良好であったことから帝王切開術を行った。第9病日にP/F比85まで増悪したため静脈–静脈体外式膜型人工肺（venovenous extracorporeal membrane oxygenation: VV–ECMO）を導入した。合併症として帝王切開術創部に血腫を認めたため，血腫除去，動脈塞栓術を実施し止血を得た。その後呼吸状態は安定し第22病日にVV–ECMOを，第24病日に人工呼吸器を離脱し，第62病日に自宅退院とした。胎児は1,479gの極低出生体重児であったが，発達の異常なく経過し日齢79日に体重3,213gで自宅退院とした。妊娠中期に重症化したCOVID–19症例においては，在胎週数を念頭に入れた集学的な加療が必要である。
Phylogenetic analysis of BKV genetic variations, based on the whole sequence of the genome and different genomic sections
Authors: Rahimi Baghi Fatemeh , Harzandi Naser , Moniri Afshin , Nadji Seyed A.
Published: April 2022

BK polyomavirus (BKV) primarily infects humans in their early life stages, and in later life stages, immunosuppressed patients may develop asymptomatic infections. The nucleotides 1744–1812 in the VP1 gene are traditionally used to determine this virus's genotype. The complete genome of the BKV samples from patients referred to Masih Daneshvari Hospital's Virology Research Center was amplified by previously known primer sets. The phylogenetic diversity of the whole genome, different genomic sections, and the noncoding control region of BKV samples were investigated. Using software Mega X and references, the samples' genotype was determined in separate genomic fragments and the whole genome. The samples were classified into two genotypes (I and IV) and five subtypes (Ia, Ib‐1, Ib‐2, IVc‐1, and IVc‐2), but none of the isolates belonged to genotypes II, III, V, or VI. The large T antigen‐based phylogenetic tree provided 100% bootstrap values for these divisions, which were superior to those (96%–100%) used in the VP1 sequence. Among the genomic segments, large tumor antigen and VP1 had the most mutations. The noncoding control area contained mutations at the O41 position in the granulocyte/macrophage stimulus gene and the P31 position in the NF‐1 gene. The validity of the phylogenetic analysis was supported by sequence analysis, which found single‐nucleotide polymorphisms (SNPs) that could be useful for subclassifying isolates. More research with a large number of samples and in the wider geographical areas is needed to understand the genetic diversity of the BKV in Iran and also to determine these SNPs' clinical significance in terms of patient outcome and viral load dynamics.
Chinese parents’ caregiving ability for children with haematological malignancies: A latent class analysis
Authors: Wang Jingting , Bi Xuanyi , Wang Jichuan , Gu Ying , Zheng Xianlan , Wang Yingwen , Wu Huifang , Yang Qi , Ma Linyu , Liu Fang , Yuan Changrong
Published: April 2022

Aim

The aim of this study was to identify unobserved subgroups of Chinese parents’ caregiving ability for children with haematological malignancies and examine the associations of the latent class membership with individual characteristics.

Design

A multicentre cross‐sectional survey study was conducted.

Methods

A total of 392 parents of children with haematological malignancies in China were surveyed with the Hematologic Malignancies’ Family Caregiver Skills Scale and a study‐specific demographic information questionnaire. Latent class analysis (LCA) and multinomial logistic regression model were applied in data analysis.

Results

LCA results suggested that there existed three distinct a priori unknown classes of parents of children with haematological malignancies in regard to caregiving ability: Class 1—“high caregiving ability” class (n = 131, 33.4%), Class 2—“medium caregiving ability” class (n = 170, 43.4%) and Class 3—“low caregiving ability” class (n = 91, 23.2%). Socio‐demographics and clinical characteristics had significant associations with the latent class membership.
Prenatal diagnosis of microcephaly as shown by plateauing of head circumference growth during the 3rd trimester in a fetus with a CCND2 inverse growth variant
Authors: Malinger Gustavo , Haratz Krajden Karina , Brinbaum Roee , Tsur Erez , Berger Racheli , Shohat Mordechai
Published: April 2022

Key points

What's already known?

Variants in CCND2 gene are known to cause syndromic macrocephaly. Recently inverse growth proximal variants were described in five individuals with microcephaly.

What does this study add?

CCND2 loss of function distal variants can cause fetal microcephaly.
Extending the degrees of freedom in laser beam microwelding
Authors: Häusler André , Hummel Marc
Published: April 2022

Using spatial and temporal power modulation, new degrees of freedom can be gained in process efficiency, quality and seam geometry, which are of particular interest for the increasing requirements of electromobility in the production of battery cells and power electronics. Through the targeted synchronization of these two compensation methods, synergies can be used and any limitations that may arise can be overcome.
Chinese laser market under the new globalization
Authors: Gu Bo
Published: April 2022

The Chinese industrial laser market continued to grow in 2021 despite Covid‐19, tariff barriers, and disrupted global supply chains. It is becoming more challenging than ever for laser and photonics companies to navigate in this world's largest growing market while serious tension between the US and China still remains, and potentially worsens. We present here the annual performance of the Chinese laser market in 2021, underline some of the developments and trends, and provide some strategies to navigate the Chinese laser market under the new world order. We forecast that the Chinese laser market will have another double‐digit growth in 2022.
Solvolytic behavior of some ferrocenylphenylmethyl‐4‐methoxypyridinium cations in various solvents
Authors: Jurić Sandra
Published: April 2022

The nucleofugalities of 4‐methoxypyridine (4‐OMePy) in pure and aqueous solvents were derived from the rate constants for SN1 solvolysis with respect to the corresponding ferrocenylphenylmethyl‐4‐methoxypyridinium salts by applying the linear free energy relationship (LFER) equation, log k (25°C) = sf (Nf + Ef). In more polar solvents, pyridinium ions become more stabilized by solvation in the reactant ground state than in the corresponding transition state and the reactivity (nucleofugality, Nf) of 4‐OMePy decreases increasing solvent polarity. Due to the strong electron‐donor effect of the ferrocenyl group, it seems that 4‐methoxypyridine is a somewhat better leaving group (stronger nucleofuge) if the substrate is benzhydryl‐4‐methoxypyridinium salts rather than ferrocenylphenylmethyl‐4‐methoxypyridinium salts. Given that the electron‐withdrawing substituents on the 4‐position of the pyridine ring increase the rate of the heterolysis step of solvolysis for benzhydryl and ferrocenylphenylmethyl pyridinium salts, the Nf value of substituted pyridine decreases in order Nf (4‐ClPy) > Nf (Py) > Nf (4‐MePy) > Nf (4‐OMePy) across in all examined solvents.
eLearning to improve prescribing safety in primary care
Authors: Knox Richard , Gookey Gill
Published: April 2022

Prescribing errors in UK general practice are common and have a substantial impact on morbidity and mortality. In this article, Richard Knox and Gill Gookey describe the development of an interactive eLearning package for primary care prescribers designed to improve prescribing safety, and discuss its evaluation by users.
Compressive strength and impact resistance of hybrid fiber reinforced concrete exposed to elevated temperatures
Authors: Krishna Arathi , Kaliyaperumal Saravana Raja Mohan , Kathirvel Parthiban
Published: April 2022

This paper presents a comprehensive experimental investigation to explore the effect of synthetic and natural fibers, both individual and hybrid, on the strength properties and impact resistance of concrete exposed to different elevated temperatures (27, 200, 400, and 800°C). The influence of steel, polypropylene, and sisal fibers on compressive strength and impact resistance under the elevated temperature was investigated, and a comparison was made with conventional concrete. Apart from mono‐fiber reinforced concrete, the resistance of hybrid fiber reinforced concrete containing steel‐polypropylene and sisal fibers in different hybrid combinations to impact loading and compressive strength was also evaluated. The results revealed that the incorporation of fibers helps in improving the mechanical properties of concrete both at ambient and elevated temperatures. Finally, this study confirms that mono steel fibers can be replaced with a hybrid mix containing natural fiber to improve concrete's residual hardened properties and fire resistance.
The effect of price on cigarette consumption among youth in Indonesia: Implications for tobacco tax policy
Authors: Fauzi Ridhwan , Pongpanich Sathirakorn
Published: April 2022

The study aimed to estimate cigarette price elasticity among youth in Indonesia. We used a two‐part model to estimate the impact of price on smoking participation and smoking intensity on smokers. Data were obtained from National Socioeconomic Survey or Survei Sosial Ekonomi Nasional 2015, 2016, 2017, 2019, and 2020. This study included males and females aged 15–24 years from all districts. We controlled for socioeconomic variables such as age, sex, education, working status, marital status, wealth quintile, place of residence, geographical region, and year of the survey. Price was negatively associated with cigarette consumption. The estimated total cigarette price elasticity was approximately −0.6740, meaning a 10% increase in price would reduce cigarette consumption by 6.74%. We also found that females were more sensitive to price change than males. This result indicated that the percentage change in demand for cigarettes among youth is less than the percentage change in price or inelastic. Therefore, a higher tariff and simpler tobacco tax structure is necessary to make cigarettes less affordable in Indonesia.
Cyclic spacetimes through singularity scattering maps. The laws of quiescent bounces
Authors: Le Floch Bruno , LeFloch Philippe G. , Veneziano Gabriele
Published: April 2022

Abstract

For spacetimes containing quiescent singularity hypersurfaces we propose a general notion of junction conditions based on a prescribedsingularity scattering map, as we call it, and we introduce the notion of acyclic spacetime(also called a multiverse) consisting of spacetime domains bounded by spacelike or timelike singularity hypersurfaces, across which our scattering map is applied. A local existence theory is established here while, in a companion paper, we construct plane-symmetric cyclic spacetimes. We study the singularity data space consisting of the suitably rescaled metric, extrinsic curvature, and matter fields which can be prescribed on each side of the singularity, and for the class of so-called quiescent singularities we establish restrictions that a singularity scattering map must satisfy. We obtain a full characterization of all scattering maps that are covariant and ultralocal, in a sense we define and, in particular, we distinguish between, on the one hand,three laws of bouncing cosmologyof universal nature and, on the other hand,model-dependent junction conditions.The theory proposed in this paper applies to spacelike and timelike hypersurfaces and without symmetry restriction. It encompasses bouncing-cosmology scenarios, both in string theory and in loop quantum cosmology, and puts strong restrictions on their possible explicit realizations.
Comparative sub-chronic toxicity studies in rats of two indistinguishable herbal plants, Cynanchum wilfordii (Maxim.) Hemsley and Cynanchum auriculatum Royle ex Wight
Authors: Yu Changwoo , Hong So-Hye , Lee Jin Hee , Jung Ki Kyung , Oh Jae-Ho , Jeong Jayoung , Kwon HoonJeong , Kang Jong-Koo , Yang Jun-Young
Published: April 2022

Sub-chronic toxicity studies using rats have been conducted for Cynanchum wilfordii (Maxim.) Hemsley (CW) and Cynanchum auriculatum Royle ex Wight (CA). CW water extract didn’t show any adverse effects whereas administering CW powder decreased body weights in complication with decreased food consumptions. In the case of CA water extract, triglyceride and absolute/relative liver weights were elevated and vacuolation was observed in liver. Treated CA powder in male rats increased alanine aminotransferase and aspartate aminotransferase and induced single cell necrosis and multinucleated hepatocyte in liver. As for female rats, increased absolute/relative weights and hypertrophy/vacuolation in adrenal glands and vacuolation in ovaries were observed when administered CA powder. In conclusion, no observed adverse effect level (NOAEL) of CW water extract was over 5000 mg/kg/day, while NOAEL of CW powder was 700 mg/kg/day for female and 150 mg/kg/day for male. In case of CA, NOAEL of water extract was 1500 mg/kg/day for male and 2000 mg/kg/day for female, while NOAEL of powder was 150 mg/kg/day for both gender. To the best of our knowledge, this is the first sub-chronic toxicity study on the adverse effects, target organs and its dose levels of C. wilfordii (Maxim.) Hemsley and C. auriculatum Royle ex Wight following GLP protocols.
Effects of pituitary adenylate cyclase activating polypeptide (PACAP) in corneal epithelial regeneration and signal transduction in rats
Authors: Kiss Peter , Farkas Jozsef , Kovacs Krisztina , Gaal Valeria , Biro Zsolt , Szabo Aliz , Atlasz Tamas , Bosnyak Inez , Toth Gabor , Tamas Andrea , Reglodi Dora
Published: April 2022

Corneal epithelium responds to insults with a rapid wound healing, which is essential for maintaining vision. The proper balance of apoptotic and proliferation-stimulating pathways is critical for normal regeneration. Pituitary adenylate cyclase activating polypeptide (PACAP) is an important growth factor during the development of the nervous system and exerts cytoprotective effects in injuries. The aim of the present study was to investigate the effects of PACAP on corneal epithelial wound healing in rats and on two important protective signaling molecules, Akt and ERK1/2, both of which have been reported to play important roles during cell survival and regeneration, including corneal wound healing. Wistar rats received PACAP treatment in form of eyedrops, containing 1, 5 and 10 µg PACAP27, immediately and every two hours after corneal abrasion. Corneas were stained with fluorescein dye and further processed for histological staining or Western blot analysis for Akt and ERK1/2 expression. Our results showed that topical PACAP application enhanced corneal wound healing, as the area of injury was significantly less in PACAP-treated groups. Furthermore, both ERK1/2 and Akt signaling was induced upon PACAP administration in both injured and intact corneas. In summary, the present results show that PACAP enhances corneal wound healing in a rat model of corneal abrasion.
Eine explorative Untersuchung der Einflüsse von ABW-Büromerkmalen auf die Wahrnehmung der Organisationskultur
Authors: Weber Clara , Bébié-Gut Pascale , Riebli Alyssa , Windlinger Lukas
Published: April 2022

Dieser Beitrag der Zeitschrift Gruppe. Interaktion. Organisation. (GIO) untersucht, wie Designmerkmale aktivitätsorientierter Arbeitsumgebungen (activity-based working, ABW) Einfluss auf die Wahrnehmung von Clan-Organisationskulturen nehmen können. Bisherige Forschungsarbeiten haben Designmerkmale selten isoliert von anderen Eigenschaften der physischen Umgebung betrachtet und in Zusammenhang mit Organisationskulturen gestellt. Es wurden halbstrukturierte Interviews mit acht Teilnehmenden aus verschiedenen Organisationen geführt, die eine ABW-Umgestaltung mit Ziel einer hierarchisch flachen Clan-Kulturentwicklung miterlebt haben. Die Mehrheit zuvor berichteterfunktionalerundassoziativerEinflüsse auf Clan-Kultur-Indikatoren wieKommunikation, Zusammenarbeit, Beziehungen, Zugehörigkeitundkollegial-beratende Führungskulturwurden identifiziert. Besonders Unterthemen, wie z. B.dynamische Atmosphäre, fokussierter Austausch, OffenheitundFirmenidentifikationwurden bestätigt oder neu identifiziert. Querschnittsthemen, die funktionale und assoziative Einflussmechanismen vertiefen, warenZugänglichkeit, Serendipität, psychologische DistanzundTerritorialprinzipien. Die Ergebnisse deuten darauf hin, dass die Bürogestaltungsmerkmale auf komplexe Weise mit der Organisationskultur zusammenhängen; die Bürogestaltung scheint die Organisationskultur unterstützen zu können.
Particle Swarm Optimization Algorithm and Its Applications: A Systematic Review
Authors: Gad Ahmed G.
Published: April 2022

Throughout the centuries, nature has been a source of inspiration, with much still to learn from and discover about. Among many others, Swarm Intelligence (SI), a substantial branch of Artificial Intelligence, is built on the intelligent collective behavior of social swarms in nature. One of the most popular SI paradigms, the Particle Swarm Optimization algorithm (PSO), is presented in this work. Many changes have been made to PSO since its inception in the mid 1990s. Since their learning about the technique, researchers and practitioners have developed new applications, derived new versions, and published theoretical studies on the potential influence of various parameters and aspects of the algorithm. Various perspectives are surveyed in this paper on existing and ongoing research, including algorithm methods, diverse application domains, open issues, and future perspectives, based on the Systematic Review (SR) process. More specifically, this paper analyzes the existing research on methods and applications published between 2017 and 2019 in a technical taxonomy of the picked content, including hybridization, improvement, and variants of PSO, as well as real-world applications of the algorithm categorized into: health-care, environmental, industrial, commercial, smart city, and general aspects applications. Some technical characteristics, including accuracy, evaluation environments, and proposed case study are involved to investigate the effectiveness of different PSO methods and applications. Each addressed study has some valuable advantages and unavoidable drawbacks which are discussed and has accordingly yielded some hints presented for addressing the weaknesses of those studies and highlighting the open issues and future research perspectives on the algorithm.
The Impact of Social Workers in Cirrhosis Care: a Systematic Review
Authors: Ufere Nneka N. , Hinson Jan , Finnigan Simon , Powell Elizabeth E. , Donlan John , Martin Cathy , Clark Phil , Valery Patricia C.
Published: April 2022

Purpose of review

To report social workers’ involvement in supporting patients with cirrhosis.

Recent findings

Six intervention studies (three published in the past 3 years) highlighed the potential role of social worker-led interventions to improve the outcomes of patients with cirrhosis. In studies of patients with alcohol-related liver disease (n = 4), social workers conducted psychosocial assessments, screened for substance use disorder and psychological distress, coordinated referrals to addiction services, and provided relapse prevention therapy. In studies including transplant recipients or candidates (n = 2), social workers focused on psychosocial interventions. In two studies (n = 1 patient with alcohol-related liver disease; n = 1 transplant recipients), social workers provided practical support (e.g., housing, transportation). Most articles provided limited information about the intervention and the role of the social worker, making comparisons of the studies difficult.

More high-quality evidence is needed to formally assess the impact of social workers in improving the outcomes of patients with cirrhosis.
Gorenstein points in $${\mathbb {P}}^{3}$$ via Hadamard products of projective varieties
Authors: Bocci C. , Capresi C. , Carrucoli D.
Published: April 2022

We show how to construct a stick figure of lines in $${\mathbb {P}}^3$$

P

3

using the Hadamard product of projective varieties. Then, applying the results of Migliore and Nagel, we use such a stick figure to build a Gorenstein set of points with given $$h-$$

h
-

vector $${\varvec{h}}$$

h

. Since the Hadamard product is a coordinate-wise product, we show, at the end, how the coordinates of the points, in the Gorenstein set, can be directly determined.
Fit and Proper Requirements in the EU Banking Sector. A Step Further
Authors: Arrigoni Matteo , Rivolti Mattia
Published: April 2022

Prudential regulation has become increasingly important over time. In such a context, strict suitability requirements for members of the management body and key function holders are considered an adequate tool to safeguard the sound and prudent management of banks. In the years following the Great Financial Crisis in 2008–2009 and the Eurozone sovereign debt crisis in 2010–2012, the regulatory and supervisory approach to banks’ corporate governance has seen a significant evolution. The centralisation of banking supervision at the Eurozone level was complemented by the application of a single rulebook throughout the European Union which stated, in compliance with the Capital Requirements Directive, higher suitability requirements for being appointed as a member of a management body or as a key function holder at a bank. Furthermore, the choice to identify fit and proper requirements through standards attributes significant power to the decision maker, thus allowing greater public control over private choices, and is justified by the need to prevent negative externalities. This approach is open to debate. Against the background of the pursuit of public interest, the lawmaker confers discretionary power on the supervisory authorities (the European Central Bank and the national competent authorities), and sets restrictions on the job market for board member candidates. This paper is a contribution enriching the ongoing discussion about the existing regulatory and policy regime, with a special focus on the specific functions performed by the management body members and particularly by the chairs of the management body’s special committees.
Firms and climate change: a review of carbon risk in corporate finance
Authors: Wang Yao , Wu Zhenshu , Zhang Guangxiao
Published: April 2022

This paper provides an overview of financial economics-based research on carbon risk with an emphasis on corporate finance. In the corporate finance literature, carbon risk refers to the impact of society’s transition to a low-carbon economy on firm value due to tightening regulations, changing consumer preferences, reputational damage, etc. We focus on the links between carbon risk and different firm performance factors, such as firm risk, cost of capital, financial performance, firm value, and corporate decisions. Although research on carbon risk is still emerging in the corporate finance field, the amount of literature on this topic has been increasing, especially in the last 2 years. We find that some results are robust, while others are mixed. This indicates that conflicting hypotheses still exist, leading to a need for more in-depth exploration.
Dynamic Ad Network Ordering Method Using Reinforcement Learning
Authors: Afshar Reza Refaei , Zhang Yingqian , Kaymak Uzay
Published: April 2022

Real time bidding is one of the most popular ways of selling impressions in online advertising, where online ad publishers allocate some blocks in their websites to sell in online auctions. In real time bidding, ad networks connect publishers and advertisers. There are many available ad networks for publishers to choose from. A possible approach for selecting ad networks and sending ad requests is called Waterfall Strategy, in which ad networks are selected sequentially. The ordering of the ad networks is very important for publishers, and finding the ordering that will provide maximum revenue is a hard problem due to the highly dynamic environment. In this paper, we propose a dynamic ad network ordering method to find the best ordering of ad networks for publishers that opt for Waterfall Strategy to select ad networks. This method consists of two steps. The first step is a prediction model that is trained on real time bidding historical data and provides an estimation of revenue for each impression. These estimations are used as initial values for the Q-table in the second step. The second step is based on Reinforcement Learning and improves the output of the prediction model. By calculating the revenue of our method and comparing that with the revenue of a fixed and predefined ordering method, we show that our proposed dynamic ad network ordering method increases publishers’ revenue.
Principles of Behavioral Neuroscience
Authors: Horvitz Jon C. , Jacobs Barry L.
Published: April 2022

How does brain activity give rise to sleep, dreams, learning, memory, and language? Do drugs like cocaine and heroin tap into the same neurochemical systems that evolved for life's natural rewards? What are the powerful new tools of molecular biology that are revolutionizing neuroscience? This undergraduate textbook explores the relation between brain, mind, and behavior. It clears away the extraneous detail that so often impedes learning, and describes critical concepts step by step, in straightforward language. Rich illustrations and thought-provoking review questions further illuminate the relations between biological, behavioral, and mental phenomena. With writing that is focused and engaging, even the more challenging topics of neurotransmission and neuroplasticity become enjoyable to learn. While this textbook filters out non-critical details, it includes all key information, allowing readers to remain focused and enjoy the feeling of mastery that comes from a grounded understanding of a topic, from its fundamentals to its implications.
198 A Team-based Approach to an Integrated Model of Diabetes Care
Authors: Croisant Sharon , Bohn Krista , Prochaska John , Sallam Hanaa , Serag Hani , Urban Randall
Published: April 2022

OBJECTIVES/GOALS: Diabetes is related to risk for heart disease, stroke, high blood pressure, and COVID-19. It is exacerbated by built/social environment issues, e.g., food insecurity, access to healthy foods and health care, and other poverty-related factors. Our goal is to assess the efficacy of an integrated care model for patients with poorly controlled diabetes. METHODS/STUDY POPULATION: We utilize an integrated, team-based approach to diabetes treatment. In a traditional care model, too little focus is on social determinants and their impacts on health and well-being. Our project involves enrollment of patients with diabetes in an intervention whereby their medical care is integrated with intensive diabetes education and provision of social and other health services, including diet and nutrition, exercise, provision of foods and nutritional supplements, and other support services as needed to achieve optimal health and to reduce morbidity and unnecessary hospitalization and emergency room visits. Subjects are underserved patients treated through our non-profit community clinic partners. We track metrics including individual outcomes, organizational outcomes, and collective impact. RESULTS/ANTICIPATED RESULTS: We anticipate that patients enrolled in this study will demonstrate significant improvements in diabetes control and management. Clinical improvements will include better glycemic control, improved hypertension and dyslipidemia management, reduced complications, and increased preventive measures including foot, eye and oral health exams and monitoring of microalbuminuria. Overall, we anticipate decreased frequency of hospitalizations and readmissions as well as decreased frequency of emergency care visits for treatment of diabetes-related issues. We expect patients to experience enhanced self-efficacy, increased physical activity, and improved quality of life. Their outcomes will be compared to controls receiving the standard medical regimen, matched on age, race, gender, and time of onset. DISCUSSION/SIGNIFICANCE: These activities will improve understanding of factors influencing diabetes outcomes at individual and upstream levels. It will inform food distribution and models of care for improved patient outcomes, including social determinants of health and will establish new protocols for community-based provision of health care to our most vulnerable.
199 Diversity Among Research Coordinators in a Pediatric Emergency Medicine Collaborative Research Network
Authors: Shihabuddin Bashar , Ellison Angela M. , Cruz Andrea T.
Published: April 2022

OBJECTIVES/GOALS: Our primary objective was to determine the demographic and linguistic characteristics of research coordinators (RCs) in a large pediatric emergency medicine research collaborative network. Our secondary objective was to determine if the RCs perceived any impact of those characteristics on their duties. METHODS/STUDY POPULATION: We conducted a 15-question electronic survey of RCs at the member institutions of the Pediatric Emergency Care Applied Research Network (PECARN). A total of 74 potential respondents were identified and received the survey. RESULTS/ANTICIPATED RESULTS: Fifty-three surveys (71.6%) were completed. Most respondents identified as female; white; and not Hispanic or Latino. Fourteen respondents (26.4%) identified as underrepresented minorities in medicine (UIM), which is similar to the percentage of UIM among the general population (30%). Twenty-eight respondents (52%) felt that their race/ethnicity positively impacted recruitment efforts. Twenty-three respondents (43%) felt that their ability to speak a language other than English positively impacted recruitment efforts. Four female respondents felt that their gender hindered their recruitment activities and impacted their sense of belonging within the research team. DISCUSSION/SIGNIFICANCE: RCs felt that their backgrounds and attributes positively impacted subject recruitment. However, some female coordinators felt negatively impacted by their gender. Increasing diversity amongst clinical research professionals and incorporating team cultural humility practices, may help increase diversity among clinical research subjects.
212 Development and implementation of research team: Lessons learned from conducting studies focusing on sleep and brain aging
Authors: Moon Chooza , Hoth Karin
Published: April 2022

OBJECTIVES/GOALS: This poster summarizes the development and implementation of research exploring the relationship between sleep and brain health. METHODS/STUDY POPULATION: Three pilot studies and two secondary data analyses were conducted on 20 older adults with coronary artery disease and 30 older adults without major cardiovascular disease. They were recruited for 10 older adults with multiple chronic conditions. The study included interviews, magnetic resonance imaging, and sleep assessment of participants. Data were also gathered from two secondary sources on multiple chronic conditions, sleep, neuroimaging, cognition, and Alzheimers biomarkers. RESULTS/ANTICIPATED RESULTS: The multidisciplinary team was from nursing, medicine, cardiology, psychology, neuroscience, radiology, and data science to address the separate research aims. The pilot studies and secondary data analyses were successfully implemented. The University of Iowa Institute for Clinical and Translational Science, Center for Advancing Multimorbidity Science, and Iowa Neuroscience Consortium supported the collaboration. The teams have found that sleep and circadian rhythms characteristics may be associated with not only coronary artery disease, but also multiple chronic conditions. Having sleep disorders and reduced circadian amplitude can be associated with white matter microstructure and functional connectivity. These collaborations provided multiple funding and publication opportunities. DISCUSSION/SIGNIFICANCE: Interdisciplinary team research is important to enhance translational science. Although challenges were identified, using multiple methods and dataset sources with multidisciplinary team members enabled opportunities to explore multifaced topics related to sleep and brain aging.
218 Reframing the JTF Clinical Trial Competencies from a CRP Team Science Perspective
Authors: Kolb Robert H. , Jones Carolynn , Fritter Jessica , Carter Karen , Summerside Nicole , Exe Nicole , Sprecher Jennifer , Kopras Elizabeth , Saldana Ty , Aslaner David , Hildreth Laura , Thanthaeng Nopporn , Owens Katherine , Means JT , Capili Bernadette
Published: April 2022

OBJECTIVES/GOALS: Our goal is to explore and collaboratively identify the team science competencies essential for Clinical Research Professionals at all experience levels and how these competencies relate to the Joint Task Force for Clinical Translational Research Professionals Competencies. METHODS/STUDY POPULATION: Team science competencies for clinical research professionals are poorly defined. The JTF Clinical Trial Competencies lack sufficient emphasis on team science, though it is briefly included in two JTF competency domains: Leadership & Professionalism, and Communication & Teamwork. The competencies primarily focus on tasks related to clinical research and basic knowledge of product development; however, a conceptual model for applying the competencies using a team science lens is needed. Currently, the JTF competency figure is often thought of as sequential, given the competencies are numbered, creating the misconception that the last competencies are less important. We support a new figure showing the permeability of team science across competencies and the connectedness and equality of the competencies. RESULTS/ANTICIPATED RESULTS: Our anticipated results are to show the integral nature of team science in clinical research professional communities of practice. Once complete, we will have identified measurable team science competency-based skills essential for clinical research professionals at various levels of expertise. Understanding the multi-dimensional team science competencies will inform targeted team science education and training for clinical research professionals. Our revised competency framework provides an improved team science conceptual model for clinical translational science. DISCUSSION/SIGNIFICANCE: Our work will define team science competencies as related to clinical research professionals at all experience levels. The interdependence of teams across clinical trial activities necessitates a consideration of an improved conceptual framework for clinical translational team science competencies.
219 Analyzing the NJ ACTS Education and Offering Inventory to Assess Training across the CTSA Consortium
Authors: Ebanks Yasheca T , Hassan Sohaib , Prado Del , Ebanks Justine , Yasheca T
Published: April 2022

OBJECTIVES/GOALS: The New Jersey Alliance for Clinical and Translational Science (NJ ACTS) interest in developing a comprehensive education and training program for enhancing the quality, efficacy, and safety of the clinical research enterprise led to the release of a survey distributed nationwide to assess initiatives in the translational science workforce. METHODS/STUDY POPULATION: Twenty-one hubs responded to the survey and data was exported from REDCap to Excel. Respondent demographics were categorized to formalize roles and data was categorically divided into sections based on training type (engagement, basic, postgraduate etc…) utilizing conditional formatting. The limitation in this survey was a branching logic defect aligned with questions on competency tool usage and the roles that they play which led to only six hubs having the advantage to respond to all questions. RESULTS/ANTICIPATED RESULTS: Summary findings showed that the majority of respondents for the survey (30%) were the Director of Operations’. Further; the Joint Task Force (JTF) domain Scientific Concepts and Research Design’ was the most preferred Hard Skill (81%) while the least preferred was Investigational Product Development and Regulation’ (29%). In spite of only six hubs receiving the short competency assessment; 50% of those hubs stated they would utilize ‘In House Assessment Tools’ and 83% stated they used the tools to ‘Develop Personalized Training Plans’. The assessment of this Inventory was indeed necessary to identify trends in available trainings across the CTSA consortium. DISCUSSION/SIGNIFICANCE: The internal cross training catalogue will help to develop an infrastructure for the NJ ACTS community to work along with other CTSA hubs while creating comprehensive clinical research training initiatives and programs.