bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Training on Teamwork and Simulated Debriefings on Real-Life Cardiopulmonary Arrest Events
Authors: Hunt Tara Mahramus , Anderson Mindi , Vo Mai , Penoyer Daleen Aragon
Published: March 2021

Background

Prior to the study, debriefings post-real-life cardiopulmonary arrest at the associated hospital were conducted only 3% of the time. However, debriefings post-cardiopulmonary arrests are recommended by multiple entities to improve team performance.

Methods

A course on teamwork, education on a structured method of debriefing, and debriefing practice via simulated role-play were provided to resuscitation team members. A prospective, mixed methods study including team member perceptions of debriefings and the number of debriefings conducted post-cardiopulmonary arrests were measured after the intervention.

Results

Debriefings increased from 3% to 39%. Debriefings were valued by all team members. Themes generated from team members’ comments included improvement, communication, and team function.

Conclusions

Debriefings post-real-life cardiopulmonary arrest events are feasible in a hospital setting. Teamwork principles training with simulated role-play of debriefing can impact the process of whether debriefings occur and are highly regarded by multidisciplinary team members.
Parental Perspectives on Family Mealtimes Related to Gastrostomy Tube Feeding in Children
Authors: Backman Ellen , Granlund Mats , Karlsson Ann-Kristin
Published: March 2021

Built on the important functions daily routines serve families and child health, this study aimed to explore parents’ descriptions of mealtimes and food-related challenges when living with a child using a gastrostomy feeding tube. The study was informed by ecocultural theory and based on in-depth interviews combined with stimulated recall. The interviews of 10 parents were inductively analyzed by means of qualitative content analysis. Four main categories comprised the parents’ descriptions: “One situation, different functions,” “On the child’s terms,” “Doing something to me,” and “An unpredictable pattern,” with one overarching theme. The analyses showed that the parents strived to establish mealtimes in line with their cultural context, although they struggled to reach a point of satisfaction. The study highlights the importance of health care professionals to address the medical aspects of caring for a child with a G-tube, but also the potential psychological and social consequences for ordinary family life.
Opening the Black Box of I-Deals Negotiation: Integrating I-Deals and Negotiation Research
Authors: Simosi Maria , Rousseau Denise M. , Weingart Laurie R.
Published: March 2021

Individualized work arrangements (“i-deals”) negotiated by employees are increasingly common in contemporary employment. Existing research largely focuses on phenomena emerging after the creation of i-deals, particularly their consequences for employees and organizations. This focus overlooks the fundamental processes associated with negotiating i-deals in the first place. I-deals research originating in the last two decades can benefit from the more advanced body of research on negotiations, particularly in its attention to negotiation preparation and the bargaining process. We examine how negotiation research and theory inform our understanding of the dynamics operating in the creation of i-deals. In doing so, we identify key features of negotiation research that apply to i-deal formulation and use these to develop an agenda for future research on i-deals.
Telehealth utilization among multi-ethnic patients with obesity during the COVID-19 pandemic
Authors: Almandoz Jaime P , Xie Luyu , Schellinger Jeffrey N , Mathew M Sunil , Edwards Khary , Ofori Ashley , Kukreja Sachin , Schneider Benjamin , Messiah Sarah E
Published: March 2021

Introduction

The science of telemedicine has shown great advances over the past decade. However, the field needs to better understand if a change in care delivery from in-person to telehealth as a result of the COVID-19 pandemic will yield durable patient engagement and health outcomes for patients with obesity. The objective of this study was to examine the association of mode of healthcare utilization (telehealth versus in-person) and sociodemographic factors among patients with obesity during the COVID-19 pandemic.

Methods

A retrospective medical chart review identified patients with obesity from a university outpatient obesity medicine clinic and a community bariatric surgery practice. Patients completed an online survey (1 June 2020–24 September 2020) to assess changes in healthcare utilization modality during subsequent changes in infection rates in the geographic area. Logistic regression analysis examined the association of mode of healthcare utilization and key sociodemographic characteristics.

Results

A total of 583 patients (87% female, mean age 51.2 years (standard deviation 13.0), mean body mass index 40.2 (standard deviation 6.7), 49.2% non-Hispanic white, 28.7% non-Hispanic black, 16.4% Hispanic, 7% other ethnicity, 33.1% completed bariatric surgery) were included. Adjusted logistic regression models showed older age was inversely associated with telehealth use (adjusted odds ratio = 0.58, 95% confidence interval 0.34–0.98) and non-Hispanic black were more likely to use telehealth compared to non-Hispanic white (adjusted odds ratio = 1.72, 95% confidence interval 1.05–2.81).

Conclusions

The COVID-19 pandemic is impacting access to healthcare among patients with obesity. Telehealth is an emerging modality that can maintain healthcare access during the pandemic, but utilization varies by age and ethnicity in this high-risk population.
Navigating COVID-19: Insights from research on social ostracism
Authors: Hales Andrew H. , Wood Natasha R. , Williams Kipling D.
Published: March 2021

The COVID-19 pandemic and associated social distancing and lockdowns has caused unprecedented changes to social life. We consider the possible implications of these changes for mental health. Drawing from research on social ostracism emphasizing the importance of social connection for mental well-being, there is reason for concern regarding the mental health effects of the crisis. However, there are also reasons for optimism; people can be surprisingly resilient to stressful situations, the impact of ostracism tends to depend on social norms (which are rapidly changing), and mental health depends primarily on having at least one or two close social connections. Given the scale and unprecedented nature of the social disruption that occurred, we see strong reason for concern, but not despair.
A simulation work for generating a novel dataset to detect distributed denial of service attacks on Vehicular Ad hoc NETwork systems
Authors: Alhaidari Fahd A , Alrehan Alia Mohammed
Published: March 2021

Vehicular Ad hoc NETwork is a promising technology providing important facilities for modern transportation systems. It has garnered much interest from researchers studying the mitigation of attacks including distributed denial of service attacks. Machine learning techniques, which mainly rely on the quality of the datasets used, play a role in detecting many attacks with a high level of accuracy. We conducted a comprehensive literature review and found many limitations on the datasets available for distributed denial of service attacks on Vehicular Ad hoc NETwork including the following: unavailability of online versions, an absence of distributed denial of service traffic, unrepresentative of Vehicular Ad hoc NETwork, and no information regarding the network configurations. Therefore, in this article, we proposed a novel simulation technique to generate a valid dataset called Vehicular Ad hoc NETwork distributed denial of service dataset, which is dedicated to Vehicular Ad hoc NETworks. Vehicular Ad hoc NETwork distributed denial of service dataset holds information on distributed denial of service attack traffic considering Vehicular Ad hoc NETwork architecture, traffic density, attack intensity, and nodes mobility. Well-known simulation tools such as SUMO, OMNeT++, Veins, and INET were used to ensure that all the properties of Vehicular Ad hoc NETwork have been captured. We then compared Vehicular Ad hoc NETwork distributed denial of service dataset with several studies to prove its novelty and evaluated the dataset using several machine learning models. We confirmed that studied models using this dataset achieved high accuracy above 99.5% except support-vector machine that achieved 97.3%.
Endovascular treatment of an ilio-iliac arteriovenous fistula accompanied by venous thromboembolism presenting with multiple organ failure – A case report and literature review
Authors: Wang Tiehao , Zhao Jichun , Yuan Ding
Published: March 2021

Objectives

Multiple organ failure is a rare manifestation of ilio-iliac arteriovenous fistula which can lead to a high rate of misdiagnosis and death.

Methods

We reported a 61-year-old man presenting with multiple organ failure rapidly after right lower limb swelling. Computed tomography angiography showed an ilio-iliac arteriovenous fistula caused by right common iliac artery aneurysm, and venous thrombosis of bilateral common iliac veins. A bifurcated stent-graft with coil embolization of right internal iliac artery was used for repair.

Results

The patient recovered rapidly and was discharged without complications. Although arteriovenous fistula persisted due to type II endoleak, aneurysm sac and inferior vena cava significantly shrunk at six months follow-up.

Conclusions

This report demonstrated that multiple organ failure may appear when the distal outflow tracts of arteriovenous fistula are obstructed. Moreover, endovascular repair is effective for reversal of multiple organ failure caused by arteriovenous fistula, even if arteriovenous fistula persists due to type II endoleak.
Assessing on-line medical education resources: A primer for acute care medical professionals and others
Authors: Brindley Peter G , Byker Leon , Carley Simon , Thoma Brent
Published: March 2021

The internet is increasingly used to propagate medical education, debate, and even disinformation. Therefore, this primer aims to help acute care medical professionals, as well as the public. This is because we all need to be able to critically appraise digital products, appraise content producers, and reflect upon our own on-line presence. This article discusses the challenges and opportunities associated with online medical resources. We then review Free Open Access Medical Education (FOAMed) and the key tools used to assess the trustworthiness of on-line medical products. Specifically, after discussing the pros and cons of traditional academic quality metrics, we compare and contrast the Social Media Index, the ALiEM AIR score, the Revised METRIQ Score, and gestalt. We also discuss internet search engines, peer review, and the important message behind the seemingly tongue-in-cheek Kardashian Index. Hopefully, this primer bolsters basic digital literacy and helps trainees, practitioners, and the public locate useful and reliable on-line resources. Importantly, we highlight the continued importance of traditional academic medicine and primary source publications.
Closer together or further apart? The impact of the COVID-19 pandemic on the conflicts in the EU’s eastern neighbourhood
Authors: Lozka Katsiaryna
Published: March 2021

The article discusses the impact of COVID-19 on the conflict zones in the EU’s eastern neighbourhood, and the EU’s and Russia’s approaches to addressing the pandemic. It illustrates that the pandemic has led to the further escalation of tensions in the region, while exposing the vulnerabilities of the secessionist territories and the limits to their reliance on external support. Addressing the crisis in its neighbourhood, the EU has largely focused on tackling the long-term consequences of the pandemic, while Russia has resorted to disinformation tactics to exercise influence among its neighbours. In this regard, the failure to push forward any negotiations on the global crisis within the existing mediation formats signals the political impotence of these formats to convey even a symbolic message of cooperation to the populations.
The Bioactivities and Potential Clinical Values of Angelica Sinensis Polysaccharides
Authors: Bi Shi-Jie , Fu Rui-Jia , Li Jia-Jia , Chen Yan-Yan , Tang Yu-Ping
Published: March 2021

Angelica sinensis Radix (ASR), one of the most commonly used traditional Chinese medicines, contains many chemical components such as polysaccharides, volatile oil, flavonoids, amino acids, and organic acids, among which polysaccharides play an indispensable role in the therapeutic effect of ASR. A. sinensis polysaccharide (ASP) has many biological activities, for instance, hematopoietic, anti-tumor, and liver protection, which are closely related to the treatment of human diseases such as chronic anemia, leukemia, and diabetes. In addition, there are excellent application prospects for drug delivery in nanoparticles. This paper reviews the chemical compositions, extraction methods, biological activity, action mechanism, potential clinical applications, nanoparticles, and research prospect of ASP from 2010 to 2020, so as to provide references for its further development.
Lack of association between erythropoietin treatment and risk of depression in patients with end-stage kidney disease on maintenance dialysis: a nationwide database study in Taiwan
Authors: Lin Pao-Yen , Li Lung-Chih , Wang Liang-Jen , Yang Yao-Hsu , Hsu Chih-Wei
Published: March 2021

Background:

Patients with end-stage kidney disease (ESKD), have been associated with higher risk of developing depression. Erythropoietin (EPO), frequently used for the treatment of anemia in ESKD patients, has been shown to have neuroprotective and antidepressant effects. In this study, we examined whether EPO treatment changed the risk of depression in ESKD patients.

Methods:

In a nationwide population-based cohort in Taiwan from 1998 to 2013, patients with a diagnosis of ESKD on maintenance dialysis and aged greater than 18 years were classified into EPO treatment group or non-EPO treatment group. All patients were followed up until the diagnosis of depressive disorder or the end of the study period.

Results:

In this cohort (13,067 patients in the EPO and 67,258 patients in the non-EPO group), 5569 patients were diagnosed as depressive disorder in the follow-up period. We found the risk of depression in EPO group was not significantly different from that in non-EPO group (adjusted hazard ratio = 0.98, 95% confidence interval 0.92–1.04, p = 0.499) after adjusting for sex, age, certification year of catastrophic illness for ESKD, physical co-morbidities, and use of benzodiazepines.

Conclusion:

In summary, using the nationwide reimbursement data in Taiwan, we found that EPO treatment in ESKD patients was not associated with their general risk of developing depression.
Does Regional Financial Resource Contribute to Economic Growth? From the Perspective of Spatial Correlation Network
Authors: Wang Feng , Chai Wei , Shi Xiaotian , Dong Mingru , Yan Bin
Published: March 2021

Using the method of social network analysis, this article explores the characteristics of financial resources distribution at the provincial level in China from 2000 to 2017, and analyzes the influencing factors and network effects of the spatial correlation network characteristics on distribution of financial resources, the results are as follows: The overall network characteristics of the financial resources distribution among provinces and cities in China are of low density, of high dependence and poor stability. The level of economic development, marketization, and integration are related to the spatial correlation network of the distribution of financial resources, and the level of integration and marketization have a significant positive impact on it. Due to the imbalance of economic development among regions in China, the overall network characteristics have a negative network effect on the speed of economic development. Individual network characteristics have a positive network effect on the speed of economic development. Improving network density, network correlation, and reducing network level can narrow the gap in economic development between provinces.
Relationship Between Patellar Morphology and Known Anatomic Risk Factors for Patellofemoral Instability
Authors: Jimenez Andrew E. , Levy Benjamin J. , Grimm Nathan L. , Andelman Steven M. , Cheng Chris , Hedgecock Jon P. , Cohen Andrew , Pace J. Lee
Published: March 2021

Background:

Patellar instability (PI) is a common problem among pediatric, adolescent, and young adult patients. Recent literature has shown a correlation between pathoanatomy and PI.

Purpose/Hypothesis:

The purpose of this study was to determine if there is any difference in patellar shape in patients with and without PI and if there is any association between the shape of the patella and the shape of the trochlea. Our hypothesis was that there would be no association between the shape of the patella and the likelinhood of having PI and that the shape of the trochlea would not be associated with patellar morphology.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Magnetic resonance imaging (MRI) scans were analyzed for 97 study patients with PI and 100 control patients with anterior cruciate ligament tears. Radiologic measurements of trochlear morphology were collected via MRI; 15 measurements of patellar morphology were then measured using axial MRI scans. Comparisons between the control and PI groups were performed using a 2-tailed t test. Regression analysis was performed to determine if associations existed between the 15 patellar morphology measurements and the trochlear dysplasia measurements.

Results:

There were no statistically significant differences between the PI and control groups for the majority of patellar morphology measurements. With regression analysis, there were no statistically significant associations between the majority of patellar morphology measurements and the trochlear dysplasia measurements.

Conclusion:

Patellar morphology is highly variable in knees with and without PI. There was a minimal association between measurements of patellar morphology and trochlear dysplasia.
Medical Malpractice Trends in Foot and Ankle Surgery
Authors: Kadakia Rishin J. , Orland Keith , Sharma Akhil , Chen Jie , Akoh Craig C. , Parekh Selene G.
Published: March 2021

Category:

Other

Introduction/Purpose:

Medical malpractice lawsuits can place significant economic and psychologic burden on a provider. Orthopaedic surgery is one of the most common subspecialties involved in malpractice claims. There is currently no study examining malpractice lawsuits within foot and ankle surgery. Accordingly, the purpose of this work is to examine trends in malpractice claims in foot and ankle surgery.

Methods:

The Westlaw legal database was queried for lawsuits pertaining to foot and ankle surgery from 2008 to 2018. Only cases involving medical malpractice were included for analysis. All available details pertaining to the cases were collected. This included plaintiff demographic and geographic data. Details regarding the cases were also collected such as anatomical location, pathology, complications, and case outcomes.

Results:

Forty nine malpractice lawsuits pertaining to foot and ankle were identified. Most plaintiffs in these cases were adult females, and the majority of cases occurred in the northeast (53.1%). The most common anatomical region involved in claims involved the forefoot (29%). The majority of these claims involved surgery (65%). Infection was the most common complication seen in claims (22%). The jury ruled in favor of the defendant surgeon in most cases (73%).

Conclusion:

This is the first study to examine trends in medical malpractice within foot and ankle surgery. Infection was the most frequent complication seen in claims and forefoot surgery was the most common anatomic location. A large portion of claims resulted after nonoperative treatment. A better understanding of the trends within malpractice claims is crucial to developing strategies for prevention.
Clinical Safety and Outcomes of a Novel Ultrasound Assisted Bioabsorbable Suture Anchor in Foot and Ankle Surgeries
Authors: Chen Jie , Sharma Akhil , Akoh Craig C. , Kadakia Rishin J. , Parekh Selene G.
Published: March 2021

Category:

Sports

Introduction/Purpose:

Bioabsorbable suture anchors have been popularized due to potential for osseous integration, less interference with diagnostic imaging, and ease of use. Recently, ultrasound assisted suture anchor systems have been introduced with the benefits of obtaining interdigitation with cancellous bone while maintaining a minimal footprint. In a cadaveric study, ultrasound assisted suture anchors demonstrated a similar pullout strength and less system displacement when compared to a benchmark bioabsorbable anchor system. However, the failure and complication rates of ultrasound assisted bioabsorbable anchors has never been demonstrated in a clinical setting. We studied the Stryker SonicAnchor by examining complication rates in foot and ankle procedures and secondarily determined the efficacy by evaluating clinical outcomes of surgeries using this anchor system.

Methods:

A retrospective analysis was performed on all patients treated by the primary investigator using the Stryker SutureAnchor between the dates of May 2016 and February 2018. We included all patients for which the anchor was used during surgery with at least 2 year followup including VAS and FAOS scores. We recorded baseline demographic information as well as the type of surgery patients underwent. We recorded all intraoperative and postoperative complications for these surgeries. In addition, we compared preoperative and postoperative clinical scores.

Results:

57 patients met inclusion criteria. On average, patients were 53 years old at the time of surgery. Mean followup was 32.8 months. Mean BMI was 30.36. Three patients reported current tobacco use (5.3%), four patients (7.0%) had type II diabetes mellitus at the time of their surgery, and only one patient (1.8%) had osteoporosis. Common procedures were Achilles repair including Haglund’s resection, peroneal surgery, and lateral ligament reconstruction. There were two deep infections requiring reoperation, one medial malleolus stress fracture following total ankle replacement, one metatarsal stress fracture not involving the surgery site, and one DVT. No reports of anchor pullout or soft tissue repair failure. VAS and FAOS scores improved from 6.2 to 1.2 and 54.3 to 93.9.

Conclusion:

In our review of 57 patients operated on with the SonicAnchor with at least two year followup, there were zero cases of complications stemming from the anchor including anchor pullout or soft tissue repair failure. Overall, patients improved tremendously in their clinical outcome scores across a wide range of different procedures. Previous studies have demonstrated the biomechanical strength of the SonicAnchor and our review supports its clinical safety and efficacy in long-term clinical followup.
Arthrodesis Tarsometatarsal in Lisfranc Fracture: Comparison of Different Fixing Methods
Authors: Muñoz Mario , Verschae Gregorio I. , Drago Sebastian , De la Paz Valenzuela Joaquín A. , Fuentes Jose M. Rojas
Published: March 2021

Category:

Midfoot/Forefoot; Trauma

Introduction/Purpose:

Lisfranc fractures are rare, but with a high degree of morbidity. Post-traumatic degenerative changes that result in pain and deformity, are common; with arthrodesis being a treatment option. There are several implants for midfoot arthrodesis, but with little literature regarding the best method for achieve bone fusion. We analice the fusion rates, comparing different joint stabilization techniques.

Methods:

A retrospective descriptive study of 20 patients with post traumatic osteoarthritis of the midfoot was performed, who underwent midfoot arthrodesis, between January 2016 - January 2018. The comparison between arthrodesis techniques with compression plate (CP) vs plates and / or screws (PS) was made. Data analysis was performed with SPSS software.

Results:

The fusion times were compared between the 2 groups, CP 18.7 (+- 8.01) vs PT 16.86 (+- 11.5) weeks, without significant differences. There were also no significant differences when comparing the discharge times between the 2 groups, CP 8 (+- 1.84) vs PS 9 weeks (+- 2.36) (p = 0.312). However, when comparing the proportion of complications between both groups, the CP group has lesser than the PS group (42.8% vs 83.3%). This difference was not statistically significant (p = 0.95) although there is a tendency for CP to have fewer complications. In addition, the proportion of complications in primary vs. secondary arthrodesis, 25% vs. 75% respectively, was compared, finding statistically significant differences (p = 0.028)

Conclusion:

At the moment, there is a lack of evidence to recommend the exclusive use of implants. However, when comparing complications between both groups, there would be a tendency that the use of compression plates would have fewer complications. In addition, it could be inferred that in patients with lesions with greater joint destruction, primary arthrodesis is valid as an option.
Retraction Note to: Downregulation of miR-483-5p decreases hypoxia-induced injury in human cardiomyocytes by targeting MAPK3
Authors: Hao Yan , Yuan Haitao , Yu Houzhi
Published: March 2021

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s11658-021-00252-1
Diagnostic yield of genetic testing in a heterogeneous cohort of 1376 HCM patients
Authors: Hathaway Julie , Heliö Krista , Saarinen Inka , Tallila Jonna , Seppälä Eija H. , Tuupanen Sari , Turpeinen Hannu , Kangas-Kontio Tiia , Schleit Jennifer , Tommiska Johanna , Kytölä Ville , Valori Miko , Muona Mikko , Sistonen Johanna , Gentile Massimiliano , Salmenperä Pertteli , Myllykangas Samuel , Paananen Jussi , Alastalo Tero-Pekka , Heliö Tiina , Koskenvuo Juha
Published: March 2021

Background

Genetic testing in hypertrophic cardiomyopathy (HCM) is a published guideline-based recommendation. The diagnostic yield of genetic testing and corresponding HCM-associated genes have been largely documented by single center studies and carefully selected patient cohorts. Our goal was to evaluate the diagnostic yield of genetic testing in a heterogeneous cohort of patients with a clinical suspicion of HCM, referred for genetic testing from multiple centers around the world.

Methods

A retrospective review of patients with a suspected clinical diagnosis of HCM referred for genetic testing at Blueprint Genetics was undertaken. The analysis included syndromic, myopathic and metabolic etiologies. Genetic test results and variant classifications were extracted from the database. Variants classified as pathogenic (P) or likely pathogenic (LP) were considered diagnostic.

Results

A total of 1376 samples were analyzed. Three hundred and sixty-nine tests were diagnostic (26.8%); 373 P or LP variants were identified. Only one copy number variant was identified. The majority of diagnostic variants involved genes encoding the sarcomere (85.0%) followed by 4.3% of diagnostic variants identified in the RASopathy genes. Two percent of diagnostic variants were in genes associated with a cardiomyopathy other than HCM or an inherited arrhythmia. Clinical variables that increased the likelihood of identifying a diagnostic variant included: an earlier age at diagnosis (p < 0.0001), a higher maximum wall thickness (MWT) (p < 0.0001), a positive family history (p < 0.0001), the absence of hypertension (p = 0.0002), and the presence of an implantable cardioverter-defibrillator (ICD) (p = 0.0004).

Conclusion

The diagnostic yield of genetic testing in this heterogeneous cohort of patients with a clinical suspicion of HCM is lower than what has been reported in well-characterized patient cohorts. We report the highest yield of diagnostic variants in the RASopathy genes identified in a laboratory cohort of HCM patients to date. The spectrum of genes implicated in this unselected cohort highlights the importance of pre-and post-test counseling when offering genetic testing to the broad HCM population.
Design and implementation of a massive open online course on enhancing the recruitment of minorities in clinical trials – Faster Together
Authors: Kusnoor Sheila V. , Villalta-Gil Victoria , Michaels Margo , Joosten Yvonne , Israel Tiffany L. , Epelbaum Marcia I. , Lee Patricia , Frakes Elizabeth T. , Cunningham-Erves Jennifer , Mayers Stephanie A. , Stallings Sarah C. , Giuse Nunzia B. , Harris Paul A. , Wilkins Consuelo H.
Published: March 2021

Background

Racial and ethnic minorities are often underrepresented in clinical trials, threatening the generalizability of trial results. Several factors may contribute to underrepresentation of minorities in clinical trials, including lack of training for researchers and staff on the importance of diversity in clinical trials and effective strategies for recruiting and retaining minority populations.

Methods

Applying community engaged research principles, we developed a massive open online course (MOOC) to help research team members develop knowledge and skills to enhance the recruitment of minorities in clinical trials. A transdisciplinary working group, consisting of clinical researchers, community engagement specialists, minority clinical trial recruitment and retention educators and specialists, and knowledge management information scientists, was formed to develop an evidence-based curriculum. Feedback from the Recruitment Innovation Center Community Advisory Board was incorporated to help finalize the curriculum. The course was implemented in Coursera, an online learning platform offering MOOCs. A bootstrap paired sample t-test was used to compare pre- and post-assessments of knowledge, attitudes, and intentions as it relates to minority recruitment.

Results

The final course, entitled Faster Together, was divided into eight 1-h modules. Each module included video presentations, reading assignments, and quizzes. After 10 months, 382 individuals enrolled in the course, 105 participants completed the pre-test, and 14 participants completed the post-test. Participants’ knowledge scores were higher with an increase in the mean number of correct answers from 15.4 (95% CI:12.1–18.7) on the pre-test to 18.7 (95% CI:17.42–20.2) on the post-test. All post-test respondents (n = 14) indicated that the course improved their professional knowledge, and 71.4% of respondents indicated that they were very likely to make changes to their recruitment practices.

Conclusions

Faster Together, a massive open online course, is an acceptable, accessible approach to educating research teams on minority recruitment in clinical trials. Preliminary evidence indicates the course increased knowledge on how to recruit minorities into clinical trials and could promote change in their recruitment practices.
Renal transplantation outcomes in obese patients: a French cohort-based study
Authors:   for the DIVAT consortium, Foucher Y. , Lorent M. , Albano L. , Roux S. , Pernin V. , Le Quintrec M. , Legendre C. , Buron F. , Morelon E. , Girerd S. , Ladrière M. , Glotz D. , Lefaucher C. , Kerleau C. , Dantal J. , Branchereau J. , Giral M.
Published: March 2021

Background

Whilst there are a number of publications comparing the relationship between body mass index (BMI) of kidney transplant recipients and graft/patient survival, no study has assessed this for a French patient cohort.

Methods

In this study, cause-specific Cox models were used to study patient and graft survival and several other time-to-event measures. Logistic regressions were performed to study surgical complications at 30 days post-transplantation as well as delayed graft function.

Results

Among the 4691 included patients, 747 patients were considered obese with a BMI level greater than 30 kg/m2. We observed a higher mortality for obese recipients (HR = 1.37,p = 0.0086) and higher risks of serious bacterial infections (HR = 1.24,p = 0.0006) and cardiac complications (HR = 1.45,p < 0.0001). We observed a trend towards death censored graft survival (HR = 1.22,p = 0.0666) and no significant increased risk of early surgical complications.

Conclusions

We showed that obesity increased the risk of death and serious bacterial infections and cardiac complications in obese French kidney transplant recipients. Further epidemiologic studies aiming to compare obese recipients versus obese candidates remaining on dialysis are needed to improve the guidelines for obese patient transplant allocation.
Management of anticoagulated patients in dentoalveolar surgery: a retrospective study comparing bridging with heparin versus unpaused vitamin K antagonist medication
Authors: Buchbender Mayte , Rößler Felix , Kesting Marco R. , Frohwitter Gesche , Adler Werner , Rau Andrea
Published: March 2021

Background

The aim of this study was to investigate the occurrence of postoperative bleeding following dentoalveolar surgery in patients with either continued vitamin K antagonist medication or perioperative bridging using heparin.

Methods

A retrospective study was performed analyzing patients who underwent tooth extraction between 2012 and 2017. Patients were retrospectively allocated into two comparative groups: un-paused vitamin K antagonist medication versus bridging using heparin. A healthy, non-anticoagulated cohort with equivalent surgery served as a control group. Main outcome measures were: the occurrence and frequency of postoperative bleeding, the number of removed teeth, the surgical technique of tooth removal (extraction/osteotomy/combined extraction and osteotomy) and the prothrombin time.

Results

In total, 475 patients were included in the study with 170 patients in the group of un-paused vitamin K antagonist medication VG, 135 patients in the Bridging group BG and 170 patients in the control group CG. Postoperative bleeding was significant: CG versus VG p = 0.004; CG versus BG p < 0.001, BG versus VG p < 0.001. A significant correlation of number of the extracted teeth in the BG (p = 0.014) and no significance in VG (p = 0.298) and CG (p = 0.210) and in the BG versus VG and CG with p < 0.001 in terms of surgical intervention extraction. No difference observed in terms of prothrombin time.

Conclusions

Bridging with heparin increases the risk for bleeding compared to un-paused vitamin K antagonist medication. The perioperative management of anticoagulated patients requires a well-coordinated interdisciplinary teamwork to minimize or at best avoid both: postoperative bleeding and thromboembolic incidences.
Mindfulness-based intervention helps preclinical medical students to contain stress, maintain mindfulness and improve academic success
Authors: Lampe Luisa Charlotte , Müller-Hilke Brigitte
Published: March 2021

Background

Stress among students is on the rise during early medical school and has been implicated in poor academic performance. Several methods are being discussed to efficiently reduce stress, among them mindfulness-based interventions. We therefore set out to assess how stress, mindfulness, and academic performance are connected and if an intervention on mindfulness based stress reduction could alleviate stress among medical students and improve their academic achievements.

Methods

A non-randomized controlled trial including 143 medical students in their preclinical years was performed in 2019. The students completed two surveys - one in the first, the other in the third term - recording perceived stress and mindfulness via validated scales (PSS-10 and MAAS). In between both, 41 students participated in a voluntary mindfulness-based intervention including six two-hours courses. 86 students served as controls. Scholarly success was assessed via the scores achieved in six exams written during the observation period.

Results

Stress was inversely related with mindfulness and with the results of the most challenging exam. The intervention on mindfulness based stress reduction helped to contain stress and maintain mindfulness during the observation period and this effect lasted for at least six months beyond completion of the intervention. In contrast, beneficial effects on scholarly success were transient and only detectable at completion of the intervention.

Conclusion

Our observation of short- and intermediate term effects resulting from six individual interventions on mindfulness based stress reduction is encouraging and calls for alternative strategies to induce long-lasting impacts.
Evolution of 3D weaving and 3D woven fabric structures
Authors: Perera Yasith Sanura , Muwanwella Rajapaksha Mudiyanselage Himal Wido , Fernando Philip Roshan , Fernando Sandun Keerthichandra , Jayawardana Thantirige Sanath Siroshana
Published: March 2021

3D fabric preforms are used as reinforcements in composite applications. 3D woven preforms have a huge demand in ballistic applications, aircraft industry, automobiles and structural reinforcements. A variety of 3D woven fabric reinforced composites and two dimensional woven fabric reinforced laminates can be found in the literature. However, the majority of the said products lack in delamination resistance and possess poor out-of-plane mechanical characteristics, due to the absence or insufficiency of through-thickness reinforcement. 3D fully interlaced preform weaving introduces a method of producing fully interlaced 3D woven fabric structures with through-thickness reinforcement, which enhances the delamination resistance as well as out-of-plane mechanical characteristics. 3D woven fabric preforms made from 3D fully interlaced preform weaving, using high-performance fiber yarns such as Dyneema, Carbon, Kevlar and Zylon, have exceptional mechanical properties with light-weight characteristics, which make them suitable candidates for high-end technical composite applications. In this work, a brief introduction is given to the history of weaving followed by an introduction to 3D woven fabrics. In the existing literature, an emphasis is given to the 3D fully interlaced preform weaving process, distinguishing it from other 3D woven fabric manufacturing methods. Subsequently, a comprehensive review is made on the existing literature on 3D fully interlaced preform weaving devices, such as primary and secondary mechanisms as well as modelling of 3D woven fabric structures produced by 3D fully interlaced preform weaving. Finally, the authors attempted to discuss the existing research gaps with potential directions for future research.
Modified spectral format based on probability level using site-specific uniform hazard spectrum
Authors: Ahmed Ali
Published: March 2021

Deficiencies of the four spectral formats i.e., 2%/50-yr, 5%/50-yr, 10%/50-yr and AASHTO (American Association of State Highway Officials) 2009 demand modification of the spectral formats for bridge design application in Canada. Among them the 10%/50-yr spectrum is dropped from current investigation as its difference with Canadian Highway Bridge Design Code (CHBDC) 2006 is too large to modify. This study introduces an approach calibrating on the values of elastic seismic response coefficient to provide a new shape of the Canadian bridge design spectrum based on modified 2%/50-yr, modified 5%/50-yr and modified AASHTO spectral formats. A Digital Visual Fortran program was prepared to determine the optimum values of the modification factors incorporated into the three spectral formats calibrated on the data of 389 cities of Canada. Thus, here it is developed the strategies of modifying the three spectral formats based on the best probability level for CHBDC using site-specific Uniform Hazard Spectrum (UHS). Finally, select the most suitable spectral format to apply for the design base shear calculations for the bridges of Canada.
The Xenophilia of a Japanese Ethnomusicologist
Authors: Urita Michiko
Published: March 2021

This autobiographical, sociological, and musicological essay, written for a symposium on xenophilia, concerns how the love of a foreign culture can lead to a better understanding and renewed love of one’s own. The author, a Japanese musicologist, studied Hindustani music with North Indian masters, both Hindu and Muslim, and concluded that it is the shared concept of a “sound-god” that brings them together on stage in peaceful celebration with audiences from religious communities often at odds. The author’s training in ethnomusicology began in India in 1992, immediately after the violent demolition of the Babri Masjid mosque in Ayodhya by militant Hindus, but even at that time she found no trace of such belligerence in the Hindustani musical world. Years later, while conducting research on the Shinto music rituals of her own culture, she discovered a little-known imperial and aristocratic cult of Myō’onten, a Japanese form of the Hindu goddess of music, Saraswati, who is presently an object of devotion for both Hindu and Muslim musicians in North India. This essay, based on nearly three decades of research in India and Japan, offers some answers to a question raised repeatedly in the Common Knowledge symposium on xenophilia: What is the source of the xenophilic impulse and the power that sustains it?
RNA Peach and Mango: orthogonal two-color fluorogenic aptamers distinguish nearly identical ligands
Authors: Kong Kristen Y.S. , Jeng Sunny C.Y. , Rayyan Batool , Unrau Peter J.
Published: March 2021

Two-channel fluorogenic RNA aptamer-based imaging is currently challenging. While we have previously characterized the Mango series of aptamers that bind tightly and specifically to the green fluorophore TO1-Biotin, the next aim was to identify an effective fluorogenic aptamer partner for two-color imaging. A competitive in vitro selection for TO3-Biotin binding aptamers was performed resulting in the Peach I and II aptamers. Remarkably, given that the TO1-Biotin and TO3-Biotin heterocycles differ by only two bridging carbons, these new aptamers exhibit a marked preference for TO3-Biotin binding relative to the iM3 and Mango III A10U aptamers, which preferentially bind TO1-Biotin. Peach I, like Mango I and II, appears to contain a quadruplex core isolated by a GAA^A type tetraloop-like adaptor from its closing stem. Thermal melts of the Peach aptamers reveal that TO3-Biotin binding is cooperative, while TO1-Biotin binding is not, suggesting a unique and currently uncharacterized mode of ligand differentiation. Using only fluorescent measurements, the concentrations of Peach and Mango aptamers could be reliably determined in vitro. The utility of this orthogonal pair provides a possible route to in vivo two-color RNA imaging.
Organization of the work of the outpatient computer tomography center to provide emergency care to patients with suspected new coronavirus infection
Authors: Berezina Natal'ya , Cherkashin Mihail , Kuplevackiy Vladimir , Kuplevackaya Dar'ya , Rakova Tat'yana , Nikolaev Aleksey , Fedorov Artem , Lavrent'eva Anna
Published: March 2021

The training manual discusses the organization of the outpatient computed tomography center, created to provide emergency care to patients with suspected new coronavirus infection (SARS-CoV-2). It is intended for health care organizers, radiologists, X-ray technicians, and other medical professionals who provide care to patients with suspected or laboratory-confirmed COVID-19 infection.
Sick day advice for people with diabetes
Authors: Stewart Martha
Published: March 2021

In this article Martha Stewart discusses how illness affects diabetes management and outlines the ‘sick-day advice’ that should be shared with people living with type 1 and type 2 diabetes

Intercurrent illness can cause glucose levels to rise in people with diabetes mellitus. These illnesses include the common cold, diarrhoea and vomiting, urinary tract infections and COVID-19. If diabetes is not managed well during illness it can escalate and result in more serious conditions, such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS), which would require emergency hospital admission. This article discusses how illness affects diabetes management and outlines the ‘sick-day advice’ that should be shared with people living with type 1 and type 2 diabetes.
Development of a rodent high-energy blast injury model for investigating conditions associated with traumatic amputations
Authors: Kazezian Zepur , Yu Xiancheng , Ramette Martin , Macdonald Warren , Bull Anthony M. J.
Published: March 2021

Aims

In recent conflicts, most injuries to the limbs are due to blasts resulting in a large number of lower limb amputations. These lead to heterotopic ossification (HO), phantom limb pain (PLP), and functional deficit. The mechanism of blast loading produces a combined fracture and amputation. Therefore, to study these conditions, in vivo models that replicate this combined effect are required. The aim of this study is to develop a preclinical model of blast-induced lower limb amputation.

Methods

Cadaveric Sprague-Dawley rats’ left hindlimbs were exposed to blast waves of 7 to 13 bar burst pressures and 7.76 ms to 12.68 ms positive duration using a shock tube. Radiographs and dissection were used to identify the injuries.

Results

Higher burst pressures of 13 and 12 bar caused multiple fractures at the hip, and the right and left limbs. Lowering the pressure to 10 bar eliminated hip fractures; however, the remaining fractures were not isolated to the left limb. Further reducing the pressure to 9 bar resulted in the desired isolated fracture of the left tibia with a dramatic reduction in the fractures to other sites.

Conclusion

In this paper, a rodent blast injury model has been developed in the hindlimb of cadaveric rats that combines the blast and fracture in one insult, necessitating amputation. Experimental setup with 9 bar burst pressure and 9.13 ms positive duration created a fracture at the tibia with total reduction in non-targeted fractures, rendering 9 bar burst pressure suitable for translation to a survivable model to investigate blast injury-associated diseases. Cite this article: Bone Joint Res 2021;10(3):166–172.
Toxicity of sodium nitrite-based vertebrate pesticides for European starlings (Sturnus vulgaris)
Authors: Werner Scott J. , DeLiberto Shelagh T. , McLean Hailey E. , Horak Katherine E. , VerCauteren Kurt C.
Published: March 2021

In the 21st century, invasive animals rank second only to habitat destruction as the greatest threat to global biodiversity. Socially-acceptable and cost-effective strategies are needed to reduce the negative economic and environmental impacts of invasive animals. We investigated the potential for sodium nitrite (SN; CAS 7632-00-0) to serve as an avian toxicant for European starlings (Sturnus vulgarisL.). We also assessed the non-target hazard of an experimental formulation of SN that is being developed as a toxicant for invasive wild pigs (Sus scrofaL.). In gavage experiments with European starlings, we identified a lowest observed adverse effect level (LOAEL) for mortality of 2.40% technical SN (w/v; 120 mg SN/kg body mass) and a no observed adverse effect level (NOAEL) for mortality of 1.30% technical SN (65 mg/kg). The exposure of ten starlings to the experimental formulation of SN (10% SN pig toxicant) resulted in one starling mortality during four days of exposure to the toxic bait. Sodium nitrite toxicity presented a moderate hazard to European starlings; thus, the future development of SN as an avian toxicant is dependent upon its cost-effectiveness. We discuss the management of toxic effects and non-target hazards of SN for wild birds, including best practices for toxic baiting of vertebrate pests and management of invasive wild pigs.