bluuebunny/crossref_metadata_2025 huggingface dataset:
Research Ethics Committee and Integrity Board Members’ Collaborative Decision Making in Cases in a Training Setting
Authors: Löfström E. , Pitkänen H. , Čekanauskaitė A. , Lukaševičienė V. , Kyllönen S. , Gefenas E.
Published: April 2024

This research focuses on how research ethics committee and integrity board members discuss and decide on solutions to case scenarios that involve a dimension of research ethics or integrity in collaborative settings. The cases involved issues around authorship, conflict of interest, disregard of good scientific practice and ethics review, and research with vulnerable populations (children and neonates). The cases were set in a university, a hospital, or a research institute. In the research, we used a deductive qualitative approach with thematic analysis. Twenty-seven research ethics committee and research integrity board members from 16 European countries and one country outside Europe participated. Participants represented natural and life sciences, social sciences, and humanities. They worked on cases involving ethical/integrity issues in six different constellations. Results show that experts apply key elements of ethical decision making, namely identification of ethical issues, stakeholders, guidelines, solutions, and own positionality, in dealing collaboratively with ethics/ integrity problems, and the nature of the application depends on the complexity of the case. Understanding how individuals knowledgeable in research ethics and integrity, in this case, individuals serving on research ethics committees and integrity boards, approach ethical/ moral issues can help to identify strategies that may be useful in the development of research ethics and integrity training for junior researchers who may benefit from learning professional strategies.
Can serum progesterone concentration direct a fresh or freeze-all transfer strategy in the first in vitro fertilisation cycle?
Authors: Hunt Sarah , Liu Jing , Luo Pulin , Zhong Ying , Mol Ben W. , Chi Ling , Wang Rui
Published: April 2024

Purpose

To examine the interaction between serum progesterone concentration on the trigger day and choice of freeze-all and fresh transfer strategies on live birth in an unselected population as well as in patients over 35 years old.

Methods

We performed a retrospective cohort study of 26,661 patients commencing their first IVF cycle in a large fertility centre between 2015 and 2019, including 4687 patients over 35 years old. We performed a multivariable fractional polynomial interaction analysis within a logistic regression model to investigate the interaction between serum progesterone concentration and the choice of freeze-all or fresh transfer strategy following the first transfer.

Results

15,539 patients underwent a fresh embryo transfer and 11,122 underwent a freeze-all strategy in their first IVF cycle. The freeze-all group had a higher live birth rate compared to the fresh group (43.9% vs 40.3%). After adjusting for confounding factors, there was a positive interaction between serum progesterone concentrations and the choice of a freeze-all versus fresh embryo transfer on live birth (p for interaction 0.0001), with a larger magnitude of effect when progesterone concentration was higher. Such an interaction was also observed in patients over 35 years old (p for interaction 0.01), but the treatment effect curve over progesterone concentrations was almost flat.

Conclusions

In an unselected population, frozen transfer is associated with greater chances of live birth, especially in patients with higher serum progesterone concentration. In patients over 35 years old, the benefit of a freeze-all policy appears small across all serum progesterone concentrations.
Continuous dependence in thermopiezoelectricity of nonsimple materials
Authors: Nunziata Martina
Published: April 2024

In this paper, we consider the linear theory for a model of a thermopiezoelectric nonsimple body as presented in Passarella and Tibullo (Entropy, https://doi.org/10.3390/e24091229. 2022) in which the second displacement gradient and the second electric potential gradient are included in the set of independent constitutive variables, adopting an entropy production inequality model proposed by Green and Laws. We set a mixed initial-boundary value problem and starting from two solutions we establish a reciprocity relation for the general case, which extends the analogue in Ciarletta et al. (Mech Res Commun, https://doi.org/10.1016/j.mechrescom.2022.103969, 2022), and two continuous dependence theorems for centrosymmetric materials. Both theorems consider the difference of two solutions of the problem: the first one depends only from supply terms, which are the external body forces, electric charge density and heat supply and the second one only depends from initial data for displacement, velocity, relative temperature and entropy fields. All these data, together with the boundary conditions, are assigned.
Efficient information reconciliation in quantum key distribution systems using informed design of non-binary LDPC codes
Authors: Mitra Debarnab , Shreekumar Jayanth , Tauz Lev , Sarihan Murat Can , Wong Chee Wei , Dolecek Lara
Published: April 2024

In quantum key distribution (QKD), two users extract a shared secret key using a quantum communication channel in the presence of an eavesdropper. Among QKD protocols, the ones based on energy-time (ET) entanglement of photons have been studied extensively due to their ability to generate high key rates from the arrival times of entangled photons. For theinformation reconciliation(IR) stage of ET-QKD protocols (where the users communicate using a classical channel in order to reconcile differences in their data), a scheme calledmulti-level coding(MLC) was proposed by Zhou et al. in prior work. The MLC scheme splits the raw key symbols into bit layers and utilizes binary low-density parity check (LDPC) codes to encode each layer. Although binary LDPC codes are able to offer low complexity decoding for IR, they have poor error-correcting performance compared to their non-binary counterparts, thus leading to low key rates. Additionally, existing LDPC codes do not fully utilize the properties of the QKD channel to optimize the key rates. In this paper, we mitigate the above issues by proposing a flexible protocol for IR in ET-QKD systems called non-binary multi-level coding (a) which is parameterized by a positive integera. The (a) protocol is a generalization of the MLC scheme and utilizes NB-LDPC codes from a Galois field of size$$2^a$$2a. We show that by using a small value ofa, the (a) protocol significantly improves the key rate without much increase in complexity. To further improve the key rates of the (a) protocol, we propose (i) a joint rate and degree distribution optimization (JRDO) algorithm to design the NB-LDPC codes for the protocol and (ii) an interleaved decoding and communication (IDC) scheme to decode the different layers of the (a) protocol. The JRDO algorithm is designed to use the QKD channel information, and we show that it results in a higher key rate than codes used in prior work. Additionally, the IDC scheme improves the key rate compared to the decoding and communication methods utilized previously in literature. Overall, the (a) protocol that uses JRDO-LDPC codes and the IDC scheme results in a significant 40–60$$\%$$%improvement in key rates compared to prior work for ET-QKD systems.
EndoViT: pretraining vision transformers on a large collection of endoscopic images
Authors: Batić Dominik , Holm Felix , Özsoy Ege , Czempiel Tobias , Navab Nassir
Published: April 2024

Purpose

Automated endoscopy video analysis is essential for assisting surgeons during medical procedures, but it faces challenges due to complex surgical scenes and limited annotated data. Large-scale pretraining has shown great success in natural language processing and computer vision communities in recent years. These approaches reduce the need for annotated data, which is of great interest in the medical domain. In this work, we investigate endoscopy domain-specific self-supervised pretraining on large collections of data.

Methods

To this end, we first collect Endo700k, the largest publicly available corpus of endoscopic images, extracted from nine public Minimally Invasive Surgery (MIS) datasets. Endo700k comprises more than 700,000 images. Next, we introduce EndoViT, an endoscopy-pretrained Vision Transformer (ViT), and evaluate it on a diverse set of surgical downstream tasks.

Results

Our findings indicate that domain-specific pretraining with EndoViT yields notable advantages in complex downstream tasks. In the case of action triplet recognition, our approach outperforms ImageNet pretraining. In semantic segmentation, we surpass the state-of-the-art (SOTA) performance. These results demonstrate the effectiveness of our domain-specific pretraining approach in addressing the challenges of automated endoscopy video analysis.

Conclusion

Our study contributes to the field of medical computer vision by showcasing the benefits of domain-specific large-scale self-supervised pretraining for vision transformers. We release both our code and pretrained models to facilitate further research in this direction: https://github.com/DominikBatic/EndoViT.
Research progress and prospect of low-carbon biological technology for nitrate removal in wastewater treatment
Authors: Zheng Ru , Zhang Kuo , Kong Lingrui , Liu Sitong
Published: April 2024

Wastewater treatment plants are the major energy consumers and significant sources of greenhouse gas emissions, among which biological nitrogen removal of wastewater is an important contributor to carbon emissions. However, traditional heterotrophic denitrification still has the problems of excessive residual sludge and the requirement of external carbon sources. Consequently, the development of innovative low-carbon nitrate removal technologies is necessary. This review outlines the key roles of sulfur autotrophic denitrification and hydrogen autotrophic denitrification in low-carbon wastewater treatment. The discovered nitrate/nitrite dependent anaerobic methane oxidation enables sustainable methane emission reduction and nitrogen removal by utilizing available methane in situ. Photosynthetic microorganisms exhibited a promising potential to achieve carbon-negative nitrate removal. Specifically, the algal-bacterial symbiosis system and photogranules offer effective and prospective low-carbon options for nitrogen removal. Then, the emerging nitrate removal technology of photoelectrotrophic denitrification and the underlying photoelectron transfer mechanisms are discussed. Finally, we summarize and prospect these technologies, highlighting that solar-driven biological nitrogen removal technology is a promising area for future sustainable wastewater treatment. This review has important guiding significance for the design of low-carbon wastewater treatment systems.
Idiopathic Intracranial Hypertension After Abrupt Cessation of Medication: A Case Report of Abrupt Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Cessation and Review of the Literature
Authors: Heckel Brittany
Published: April 2024

Purpose of Review

The purpose of this review is two-fold: (1) to discuss a case report of idiopathic intracranial hypertension (IIH) after abrupt cessation of a glucagon-like peptide-1 (GLP-1) receptor agonist with resultant rapid weight gain and (2) to review the literature regarding the potential role of GLP-1 receptor agonists in the treatment of IIH as well as potential pitfalls.

Recent Findings

GLP-1 receptor agonists have become widely used to treat obesity. Obesity is a known risk factor for the development of IIH, though the precise pathophysiology is unclear. GLP-1 receptor agonists may help treat IIH by promoting weight loss, lipolysis of adipose tissue, and potentially decreasing the secretion of CSF, as was seen in rat models. Abrupt cessation of GLP-1 receptor agonists can result in regaining lost weight rapidly. In the case that we present, the patient stopped duraglutide abruptly due to lack of insurance coverage and regained the weight she had lost within a month. She subsequently developed IIH.

GLP-1 receptor agonists have the potential to help treat IIH; however, this class of medication needs to be used carefully, as cessation of the medication and resultant rapid weight gain can result in IIH.
Probiotic-derived silver nanoparticles target mTOR/MMP-9/BCL-2/dependent AMPK activation for hepatic cancer treatment
Authors: Elmetwalli Alaa , Abdel-Monem Mohamed O. , El-Far Ali H. , Ghaith Gehad S. , Albalawi Noaf Abdullah N. , Hassan Jihan , Ismail Nadia F. , El-Sewedy Tarek , Alnamshan Mashael Mashal , ALaqeel Nouf K. , Al-Dhuayan Ibtesam S. , Hassan Mervat G.
Published: April 2024

Recent advances in nanotechnology have offered novel ways to combat cancer. By utilizing the reducing capabilities of Lactobacillus acidophilus, silver nanoparticles (AgNPs) are synthesized. The anti-cancer properties of AgNPs have been demonstrated in previous studies against several cancer cell lines; it has been hypothesized that these compounds might inhibit AMPK/mTOR signalling and BCL-2 expression. Consequently, the current research used both in vitro and in silico approaches to study whether Lactobacillus acidophilus AgNPs could inhibit cell proliferation autophagy and promote apoptosis in HepG2 cells. The isolated strain was identified as Lactobacillus acidophilus strain RBIM based on 16 s rRNA gene analysis. Based on our research findings, it has been observed that this particular strain can generate increased quantities of AgNPs when subjected to optimal growing conditions. The presence of silanols, carboxylates, phosphonates, and siloxanes on the surface of AgNPs was confirmed using FTIR analysis. AgNPs were configured using UV–visible spectroscopy at 425 nm. In contrast, it was observed that apoptotic cells exhibited orange-coloured bodies due to cellular shrinkage and blebbing initiated by AgNP treatment, compared to non-apoptotic cells. It is worth mentioning that AgNPs exhibited remarkable selectivity in inducing cell death, specifically in HepG2 cells, unlike normal WI-38 cells. The half-maximum inhibitory concentration (IC50) values for HepG2 and WI-38 cells were 4.217 µg/ml and 154.1 µg/ml, respectively. AgNPs induce an upregulation in the synthesis of inflammation-associated cytokines, including (TNF-α and IL-33), within HepG2 cells. AgNPs co-treatment led to higher glutathione levels and activating pro-autophagic genes such as AMPK.

Additionally, it resulted in the suppression of mTOR, MMP-9, BCL-2, and α-SMA gene expression. The docking experiments suggest that the binding of AgNPs to the active site of the AMPK enzyme leads to inhibiting its activity. The inhibition of AMPK ultimately results in the suppression of the mechanistic mTOR and triggers apoptosis in HepG2 cells. In conclusion, the results of our study indicate that the utilization of AgNPs may represent a viable strategy for the eradication of liver cancerous cells through the activation of apoptosis and the enhancement of immune system reactions.
Giant cell tumor of bone at distal radius suffered more soft tissue recurrence and ultrasonography is effective to detect the soft tissue recurrence
Authors: Cui Lukuan , Sun Yang , Jin Tao , Fan Daoyang , Liu Weifeng
Published: April 2024

Background

Soft tissue recurrence of giant cell tumor of bone (GCTB) is rare. This study aims to provide its prevalence, recurrent locations, risk factors, effective detection methods and a modified classification for this recurrence.

Methods

Patients with soft tissue recurrence after primary surgery for GCTB were screened from January 2003 to December 2022. General data, recurrence frequency, types according to an original classification (type-I: peripheral ossification; type-II: central ossification; type-III: without ossification), a modified classification with more detailed subtypes (type I-1: ≤ 1/2 peripheral ossification; type I-2: ≥ 1/2 peripheral ossification; type II-1: ≤ 1/2 central ossification; type II-2: ≥ 1/2 central ossification; type III: without ossification), locations, detection methods such as ultrasonography, X-ray, CT or MRI, Musculoskeletal Tumor Society (MSTS) scores were recorded. Multivariate regression analysis was conducted to identify risk factors for recurrence frequency.

Results

A total of 558 recurrent cases were identified from 2009 patients with GCTB. Among them, 32 were soft tissue recurrence. The total recurrence rate was 27.78% (558/2009). Soft tissue recurrence rate was 5.73% among 558 recurrent cases, and 1.59% among 2009 GCTB patients, respectively. After excluding one patient lost to follow-up, 10 males and 21 females with the mean age of 28.52 ± 9.93 (16–57) years were included. The definitive diagnosis of all recurrences was confirmed by postoperative pathology. The interval from primary surgery to the first recurrence was 23.23 ± 26.12 (2–27) months. Eight recurrences occurred from primary GCTB located at distal radius, followed by distal femur (6 cases). Recurrence occurred twice in 12 patients and 3 times in 7 patients. Twenty-seven recurrences were firstly detected by ultrasonography, followed by CT or X-ray (10 cases in each). Types at the first recurrence were 5 cases in type-I, 8 in type-II and 18 in type-III. According to the modified classification, 3 patients in type I-1, 2 in type I-2, 1 in type II-1, 7 in type II-2, and 18 in type III. The mean MSTS score was 26.62 ± 4.21 (14—30). Neither Campanacci grade nor recurrence type, modified classification and other characters, were identified as risk factors.

Conclusions

Soft tissue recurrence of GCTB may recur for more than once and distal radius was the most common location of primary GCTB that would suffer a soft tissue recurrence. Ultrasonography was a useful method to detect the recurrence. Since no risk factors were discovered, a careful follow-up with ultrasonography was recommended.
Establishment and molecular characterization of HCB-541, a novel and aggressive human cutaneous squamous cell carcinoma cell line
Authors: Laus Ana Carolina , Gomes Izabela Natalia Faria , da Silva Aline Larissa Virginio , da Silva Luciane Sussuchi , Milan Mirella Baroni , AparecidaTeixeira Silvia , Martin Ana Carolina Baptista Moreno , do Nascimento Braga Pereira Letícia , de Carvalho Carlos Eduardo Barbosa , Crovador Camila Souza , de Paula Flávia Escremin , Nascimento Flávia Caroline , de Freitas Helder Teixeira , de Lima Vazquez Vinicius , Reis Rui Manuel , da Silva-Oliveira Renato José
Published: April 2024

Cutaneous squamous cell carcinoma (cSCC) is a common type of skin cancer that can result in significant morbidity, although it is usually well-managed and rarely metastasizes. However, the lack of commercially available cSCC cell lines hinders our understanding of this disease. This study aims to establish and characterize a new metastatic cSCC cell line derived from a Brazilian patient. A tumor biopsy was taken from a metastatic cSCC patient, immortalized, and named HCB-541 after several passages. The cytokeratin expression profile, karyotypic alterations, mutational analysis, mRNA and protein differential expression, tumorigenic capacity in xenograft models, and drug sensitivity were analyzed. The HCB-541 cell line showed a doubling time between 20 and 30 h and high tumorigenic capacity in the xenograft mouse model. The HCB-541 cell line showed hypodiploid and hypotetraploidy populations. We found pathogenic mutations in TP53 p.(Arg248Leu), HRAS (Gln61His) and TERT promoter (C228T) and high-level microsatellite instability (MSI-H) in both tumor and cell line. We observed 37 cancer-related genes differentially expressed when compared with HACAT control cells. The HCB-541 cells exhibited high phosphorylated levels of EGFR, AXL, Tie, FGFR, and ROR2, and high sensitivity to cisplatin, carboplatin, and EGFR inhibitors. Our study successfully established HCB-541, a new cSCC cell line that could be useful as a valuable biological model for understanding the biology and therapy of metastatic skin cancer.
Extreme Weather Disruptions and Emergency Preparedness Among Older Adults in Ohio: An Eight-County Assessment
Authors: Rao Smitha , Doherty Fiona C. , Traver Anthony , Sheldon Marisa , Sakulich Emma , Dabelko-Schoeny Holly
Published: April 2024

The disproportionate risks and impacts of climate change and extreme weather on older adults are increasingly evident. While especially true in disaster-prone areas, human-caused climate change introduces an element of uncertainty even in previously identified “safe” regions such as the Midwestern United States. Using a cumulative disadvantage and vulnerability-informed framework and descriptive statistics from multiple data sources, this article provides an overview of climate impacts, vulnerabilities, and county-level characteristics, focusing on older adults living in Central Ohio. A comparative multiple-case study methodology was used to triangulate regionally representative primary and secondary data sources to examine state and county-level measures of vulnerability, emergency preparedness, and disruptions caused by extreme weather among older adults across eight counties in Central Ohio. Seventy-eight percent of older adults in the sample reported being prepared for emergencies per Federal Emergency Management Agency guidelines. Older adults in Union County reported the highest rates of preparedness, while those in Fayette County reported the lowest. County-level rates of disruption of life activities by extreme weather ranged widely. Among the most rural in the region, Fayette County emerged as uniquely disadvantaged, with the lowest median income, the most vulnerable across multiple social vulnerability dimensions, and the most reported disruptions to life activities from extreme weather. County profiles offer a snapshot of existing vulnerabilities, socioeconomic conditions, special needs, preparedness, and current disruptions among older adults in the region and can inform resource mobilization across community and policy contexts.
Prescriber's Guide
Authors: Stahl Stephen M.
Published: April 2024

With the range of psychotropic drugs expanding and the usages of existing medications diversifying, we are pleased to present the Eighth Edition of the world's best-selling formulary in psychopharmacology. The new edition features seven brand new compounds as well as information about several newly approved formulations of existing drugs. Many important new indications are covered for existing drugs, as are updates to the profiles of the entire content and collection, including new injectable and transdermal formulations, as well as updated warnings and indications. The icons and Pearls have been refreshed throughout, and with the book's its easy-to-use, full-colour template-driven navigation system, Prescriber's Guide combines evidence-based data with clinically informed advice to support everyone who is prescribing in the field of mental health.
Room acoustics of Mycelium Textiles: the Myx Sail at the Danish Design Museum
Authors: Dwan Albert , Edvard Nielsen Jonas , Wurm Jan
Published: April 2024

Taking the Myx Sail displayed at the Danish Design Museum as a case study, this article investigates the room acoustics of an architectural installation made of Mycelium Textiles. Mycelium Textiles represent a novel typology of mycelium-based composites (MBC). The Myx Sail absorbers are grown on a composition of different layers of plant fibres combining woven jute textile with hemp mat and loose wood wool substrate enhancing the mechanical and acoustic properties of the composite. Two complementary acoustic tests were conducted to measure the absorbing properties of the mycelium material and its effects on the acoustics of the exhibition hall. The results show that the sail acts effectively as an acoustic absorber especially in higher range of frequencies, reducing the reverberation time and improving speech intelligibility. The effect of the sail on the overall room acoustics is especially effective, if the sound source is placed directly underneath the sail. The results of a complementary survey amongst visitors on their subjective perception of comfort and well-being however indicate that the degree to which a grown surface (and by extension, a grown building) is perceived positively or negatively depends on the relationship the individual has with Nature.
103 Parental Occupation and Orthopaedic Surgery Residency Applicants: Implications on Educational Debt, Scholarships, Medical School Ranking, and Resulting Match Rates
Authors: Vankara Ashish , Harris Andrew , Oni Julius , LaPorte Dawn , Aiyer Amiethab
Published: April 2024

OBJECTIVES/GOALS: Parental SES may influence the trajectory of students applying to orthopaedic surgery residency, perpetuating opportunistic disparities. Thus, we sought to examine the relationship between parental occupation/education and applicant match rate, education financing, and medical school background. METHODS/STUDY POPULATION: Data from the Association of American Medical Colleges (AAMC) documented parental occupation and education levels of 10,697 orthopedics applicants from 2011 to 2021. Parental occupations were categorized into physician vs non-physician, healthcare vs non-healthcare, working class vs non-working class, and STEMM (Science, Technology, Engineering, Mathematics, Medicine) vs non-STEMM. Parental education levels spanned from no college degree to doctorate degrees and were used as a proxy for SES. Outcomes analyzed included match success, premedical and medical school debt, total educational debt, scholarships, and representation from top 40 research medical schools as determined by NIH funding. RESULTS/ANTICIPATED RESULTS: Physician parent applicants (20.1%) had better match rates (75.5% vs. 73.5%), lower debts, lesser scholarships, and higher top 40 school representation. Healthcare parent applicants (37.0%) had similar match rates, less debt and scholarships. Working class parent applicants (6.0%) had more debt and scholarships. STEMM parent applicants (48.6%) had higher match rates, lesser debts and scholarships, and higher top 40 representation. Applicants with parents without college degrees had lower match rates (68.6% vs 74.5%), more debt and scholarships. Doctorate parent applicants had better match success (75.9% vs 72.9%), lesser debts, and higher top 40 school representation (34.9% vs 29.6%). DISCUSSION/SIGNIFICANCE: Parental SES was associated with substantial variation in applicant financial burden and educational pedigree. Notably, applicants with parents lacking degrees had lower match rates, underscoring the need for supportive strategies to ensure equitable opportunities for aspiring orthopaedic surgeons.
117 Applying the Competency Index for Clinical Research Professionals (CICRP) for Educational Program Evaluation
Authors: Jones Carolynn Thomas , Liu Xin , Hornung Carlton , Fritter Jessica , Neidecker Marjorie V.
Published: April 2024

OBJECTIVES/GOALS: To demonstrate the value of the Competency Index for Clinical Research Professional (CICRP) as a tool in program evaluation using a pre- and post- design to evaluate student perceived self-efficacy in clinical trial competencies at program entry and at program completion. METHODS/STUDY POPULATION: Using a separate-sample pre-post study design, we administered the CICRP questionnaire to students in the entry and exit courses of the Master of Clinical Research (MCR) Program during the 2021-2022 academic year, using QualtricsTM (Provo, Utah) survey instrument for use on desktop or mobile device. We included the 20 CICRP competency items asking students to rate their self-efficacy in performing each item using a Likert Scale (from 0-10) (0=not at all confident; 10= extremely confident). Links to the survey were included in the courses for the foundational entry course and for the final culminating project course. RESULTS/ANTICIPATED RESULTS: Overall, 54 students took the CICRP during the entry course and 56 during the exit. Cronbach’s alpha for each assessment ranged from 0.93 to 0.98. Both the Welch’s two-sample t-test and Wilcoxon rank-sum test show very significant differences between the group of students entering the program and leaving the program (p value < 0.001). A significant increase in mean CICRP total score is seen at each experience level between program entry and program exit (p<0.001) A linear regression, adjusting for available covariates, individuals taking the exit course have a mean CICRP total score 92.690 (p value < 0.001) higher than individuals taking the entry course. DISCUSSION/SIGNIFICANCE: Competency indices have been used to measure self-efficacy in translational research scientists, thus the use of CICRP to measure self-efficacy can be useful in assessing whether our competency-based program is meeting the JTF Competency needs of students.
129 LaparoscopiX: Expanding Minimally Invasive Surgery Training in Kenya
Authors: Karukappadath Azmina
Published: April 2024

OBJECTIVES/GOALS: Open surgery prevails in low- and middle-income countries (LMICs) due to scarcity of laparoscopic equipment and poor access to training. LaparosopiX is a box trainer system designed for teaching hospitals in LMICs; it includes an open-source laser print design and an app to allow surgical trainees to receive feedback from laparoscopic experts. METHODS/STUDY POPULATION: This study aims to assess the usability of Laparoscopix for surgical trainees and mentors at five large teaching hospitals in Kenya. Surgical trainees and mentors who participate in this study will be observed while setting up and using the app to identify natural pain-points. A post-session survey will be conducted to assess immediate perceptions of the platform including ease of navigation and intuitive design. Over three months, aggregate data regarding platform usage at these hospital sites will be collected and analyzed to assess user retention rates, usage and traffic patterns, and skill progression over time. Surveys will be sent out to assess attitudes towards the platform and to elucidate any aspects of the system we can improve. RESULTS/ANTICIPATED RESULTS: We hope to find overall positive impressions towards the LaparoscopiX system during this study. We expect there to be some pain-points that arise during navigation of the app, but we expect no large changes to the application architecture required. We anticipate an immediate increase and eventual plateau of users recruited. We hope to see that surgical trainees are advancing through the app while gaining practice and confidence. We will gather insightful data on which aspects of the app were helpful for trainees, and which can be improved. We also hope to learn what factors may play into trainee and mentor retention in the system. DISCUSSION/SIGNIFICANCE: Through this study, we hope to elucidate ways in which we can improve the LaparoscopiX platform, identify which features to prioritize, and determine the direction of future app development. We believe and hope that LaparoscopiX can expand access to laparoscopic surgical mentorship to improve surgical outcomes and health equity worldwide.
130 Developing a Conceptual Data Model for Nursing Workload
Authors: Tiase Victoria L. , Sward Katherine A. , Facelli Julio
Published: April 2024

OBJECTIVES/GOALS: Nurses are leaving the profession at an alarming rate due to increased workload and burnout.#_msocom_1 Computational models that are reliable and reproducible are needed to quantitatively examine nursing workload and estimate potential effect of interventions. This project developed a logical data model to represent nursing EHR interactions. METHODS/STUDY POPULATION: With nursing EHR interactions as a starting point, we expand upon literature that examined the EHR workload of physicians. We conducted an exploratory analysis of nursing EHR audit log data at a large academic medical center, and explored components of nursing workload that can be extracted from other health system data. Using concepts derived from the studying temporal biomedical data patterns, we formulated a data structure that describes nurse EHR interactions, nurse intrinsic and situational characteristics, and nurse outcomes of interest in a scalable and extensible manner. RESULTS/ANTICIPATED RESULTS: Temporal machine learning models are grounded in the concept of vectors. We developed a logical data model that describes tasks performed by nurses (NTask), nurse types (NType), and nursing outcomes (NOutcome). For each nurse (k), we define a function , i=1 to N as a vector of dimension N, where N is the number of time periods in the study. The i component corresponds to the activity that the nurse is doing. The model will allow the quantitative classification of activity patterns for any finite number of nurses for an arbitrary set of tasks and for time at any specified resolution. The expected outcome is a set of vectors that can then be utilized to quantitatively model nurse activity trajectories and other patterns of nurse EHR interactions. DISCUSSION/SIGNIFICANCE: By instantiating the logical data model, we will demonstrate how nurse EHR interactions can be studied using temporal unsupervised learning and state-of-the-art artificial intelligence methods. We plan to simulate the potential impact of workload interventions and predict risk for nurse burnout.
132 Modernizing Onboarding for Clinical Research Professionals: An Interactive and Adoptable Approach
Authors: Kingsley Erin , McClain Bradford , Meisman Andrea , Fontaine Erin
Published: April 2024

OBJECTIVES/GOALS: The Clinical Research Professionals (CRP) at Cincinnati Children’s Hospital Medical Center (CCHMC) identified and addressed gaps in a static on boarding material by transforming it into an interactive, centralized, and customizable REDCap checklist to better meet researcher needs across the institution. METHODS/STUDY POPULATION: The CRP On boarding Checklist is a tool designed to assist clinical researchers in their onboarding process at CCHMC. This tool helps CRPs determine the required/recommended trainings available to assist with skill-building and establishing job role competency. CRP supervisorsand subject matter experts were included incontent revisions, format, and transition to a RED Capsurvey. The new checklist is interactive, targets training requirements by job function, and clearly labels mandatory training. A companion document allows new CRPs to create and track their own individualized training plan. RESULTS/ANTICIPATED RESULTS: The revised CRP On boarding Checklist was launched in April 2022 and announced via email communication. Alive demonstration was presented to all CRPs during the May 2022 CRP Monthly Meeting. The checklist and companion document are linked to the internal CRP website, which is accessible institutionally. Sincelaunch, almost 100 new and internally transferring CRPs have utilized the online tool to guide their training needs. The checklist is intended to reflect real-time changes in educational offerings. In addition to feedback and change requests from the CRP community, the checklist is updated as necessary and routinely reviewed on a biannual basisby the CRP Education Committee. DISCUSSION/SIGNIFICANCE: The creation and maintenance of the CRP Onboarding Checklist is a modern and accessible way for CRPs and supervisors to explore role-applicable training and take active roles in the on boarding process. The RED Capformat allows easy sharing and adoptability to other institutions via data dictionary.
133 Research in Action: Engaging Clinicians to Advance the Academic Learning Health System
Authors: Munn Lindsay Thompson , Dawson Amy P. , Lewis Kristina H.
Published: April 2024

OBJECTIVES/GOALS: Research in Action is an on-demand, interactive curriculum designed to increase the ability of clinicians to advance the Academic Learning Health System (aLHS). The 7-module course provides clinicians with the knowledge and skills to lead rigorous quality improvement (QI) projects, translating research evidence into practice. METHODS/STUDY POPULATION: We engaged nurses, physicians, and advanced practice providers (APPs) working in the health system to participate in focus group and advise us in the creation of the curriculum. We conducted focus groups with these stakeholders on the proposed learning objectives, course content, and mode of delivery (in person, virtual, hybrid). Informed by the focus groups, the course was designed for hybrid format so participants could either (1) access the modules on-demand, or (2) learners could participate in a facilitator moderated course where the modules served as the curriculum to guide development of a QI project. The Iowa Model of Evidence-Based Practice was the framework for curriculum development. Upon completion of the modules, stakeholders reviewed each module and provided feedback for improvement. RESULTS/ANTICIPATED RESULTS: Research in Action is a 7-module course, with modules addressing the following topics: (1) Introduction to Quality Improvement, (2) Identify the Problem and Write a Purpose Statement, (3) Form a Team, (4) Appraise and Synthesize the Literature, (5) Design and Pilot the Project, (6) Integrate and Sustain Practice Change, (7) Disseminate the Results. The curriculum is being piloted with multiple clinician groups in the health system. In the next phase of development, a facilitator guide will be created to guide a cohort of clinicians to apply knowledge through discussion sessions and completion of a QI project in the healthcare setting. We anticipate scaling the program for spread to diverse clinician groups in the health system. Pre- and post-implementation data are being collected from current pilot sites. DISCUSSION/SIGNIFICANCE: The aLHS is an essential means for improving healthcare delivery. Research in Action, a hybrid training curriculum, engages frontline clinicians in creating and leading QI projects that implement research evidence into practice to solve problems commonly encountered in the healthcare setting; thus, supporting the advancement of the aLHS.
138 Supporting Early-Career Faculty Grant Proposals through Narrative Development Training: A Proposal Narrative Development Program for Early-Career Faculty
Authors: Foucher Kharma , O’Shea Kelly , Milczarek Rebecca
Published: April 2024

OBJECTIVES/GOALS: Faculty pursuing their first independent research grants often struggle to express their ideas in a concise, compelling way. Thus, we developed the “Research and Scholarship Storytelling Bootcamp” to equip these faculty with narrative development skills applicable across disciplines and mechanisms. METHODS/STUDY POPULATION: Early-career researchers who were preparing either their first NIH R-series application or an NSF CAREER award proposal were invited to participate. Enrollment was limited to 20 participants. Those accepted learned the “And-But-Therefore” narrative framework by reading a short book and attending 4 synchronous lectures. Between sessions, they applied the framework by drafting abstracts and Specific Aims/Project Summary documents and reviewing their fellow participants’ work. We assessed participants' comfort with storytelling, perceptions of preparedness, and confidence regarding funding chances, before and after the program using a visual analog scale (max 100 points) and calculated Cohen’s d to evaluate the effect size of any changes. RESULTS/ANTICIPATED RESULTS: Thirty people applied for 20 slots, indicating strong demand. Eleven NIH applicants and 9 NSF applicants enrolled. Before the program, participants rated their comfort with storytelling at 45 ± 25, their preparedness at 39 ± 24, and their funding confidence at 39 ± 26. Nine total participants completed all sessions, assignments, and surveys. Completion rates were comparable for NIH- and NSF-targeting participants. After the program, completing participants reported increases in their comfort with storytelling (68 ± 14 post vs 32 ± 20 pre, d = 1.46), perceived preparedness (64 ± 20 post vs 48 ± 26 pre, d=0.58), and confidence in funding chances (56 ± 19 post vs 40 ± 27 pre, d=0.75). DISCUSSION/SIGNIFICANCE: This program was the first of its kind for multidisciplinary early-career faculty at our institution. The program successfully achieved its objectives for those who completed all activities. Future analysis of survey comments and proposal success rates will reveal barriers to full program engagement and opportunities for further training.
149 Leadership Development for Women in Academic Medicine: Impact of Leader Self-Efficacy Change and Sustainability Over Time
Authors: Pelfrey Clara M. , Gerlick Joshua A. , Cola Philip A.
Published: April 2024

OBJECTIVES/GOALS: Our objective was to evaluate the FLEX Leadership Development Program for School of Medicine Women Faculty affiliated with 4 independent hospital systems throughout Northern Ohio to determine whether women faculty develop leader self and means efficacy. We also examined whether self-efficacy is sustained over time following program completion. METHODS/STUDY POPULATION: We did a prospective multiple cohort study to determine whether FLEX Program graduates develop and sustain leader self and means efficacy as measured by the Leader Efficacy Questionnaire (LEQ) (Hannah & Avolio, 2012). The LEQ assesses both leader confidence in their capabilities (self-efficacy) and the availability of sufficient external resources (means efficacy) to achieve their goals. We surveyed participants from 5 FLEX cohorts (2017-2021) using a pre-, post-, and 1-year follow-up LEQ, which allowed each participant to act as their own control subject, pre-test, and experimental post-test. The follow-up tested whether the change from pre- to post-test was sustained over time. The comparison group was non-participant women faculty from the same institutions over a similar 2-year period. RESULTS/ANTICIPATED RESULTS: Diverse FLEX graduates from 5 different cohorts showed highly significant increases in pre- to post-program leader self-efficacy which were sustained up to one year after program completion. Overall leader efficacy as well as its three component sub-constructs (action-, means- and self-regulation- efficacy) all significantly increased equally, suggesting both that the FLEX program had robust effects on its participants, and all aspects of leader efficacy improved. We observed a mildly significant decrease at 1-year follow-up in the overall LEQ, which appeared to be driven entirely by the leader means efficacy. The large comparison group of women faculty did not show any significant changes in leader self-efficacy over a comparable 2-year period. DISCUSSION/SIGNIFICANCE: FLEX confers sustainable gains in leader self-efficacy. Post-program self-efficacy decreases are driven by the leader means efficacy which measures how work environments affect their leadership. This suggests that institutions must take responsibility for making structural changes to improve the working environment for women leaders.
155 Bridging Gaps in Global Health Engineering Education
Authors: Bevilacqua Mary
Published: April 2024

OBJECTIVES/GOALS: This project aims to improve the design of medical technology for global health by addressing gaps in engineering education. Our primary goal is to develop open educational resource’curriculum boosters’ that can be added to existing BME curricula to build skills in transdisciplinary collaboration, practical ethics, and failure resilience. METHODS/STUDY POPULATION: A phasic mixed-method research strategy has been employed. The Needs Analysis includes a systematic review and meta-analysis of existing knowledge regarding the three conceptual pillars of Transdisciplinary Collaboration, Practical Ethics, and Integrated Resilience. The Behavioral Study includes surveys, interviews, observations, and biometric data collection from working engineers, engineering students, global health stakeholders, and clinicians. The Validation Study will be conducted via small group workshops, a semester-long engineering design course, and a summer study-abroad course. Data collected will be analyzed and used to refine the proposed educational strategies. RESULTS/ANTICIPATED RESULTS: The final educational strategies will be structured into 'curriculum boosters' and published as open educational resource materials. The boosters and their supporting data will be made available to other engineering education programs with the goal of promoting widespread adoption and integration of these methods. DISCUSSION/SIGNIFICANCE: The long-term outcome of this ongoing work is to train a new generation of engineers prepared to participate adeptly in the co-design of technological solutions for complex global healthcare challenges by working ‘with, not for,’ clinicians, communities, and other stakeholders in peripheral healthcare settings.
162 Training in Responsible Conduct of Research: Evolution over 12 years
Authors: McCracken Karen , Mudd Melissa , McNichol Savannah , Morris Cynthia , Schuff Kathyrn
Published: April 2024

OBJECTIVES/GOALS: We developed institution-wide RCR training to include all required elements; support trainees to identify key ethical questions that arise in research; and to identify methods to identify a solution; and disseminate results. METHODS/STUDY POPULATION: In 2011, we participated in developing an experimental model of RCR training led by the University of Michigan. We continue to offer this training model to career development awardees in clinical and translational research at OHSU across the institution. Interactive discussion in faculty and trainee groups includes responsibilities of a researcher and a systematic process to address real world research ethics issues. Each participant identifies a key research issue they have encountered and presents a poster at the final session. We have tracked post-training assessment of participant confidence in ethical decision making and in the range of topics identified by participants. RESULTS/ANTICIPATED RESULTS: Since 2012, 227 scholars and trainees have participated in the program with 44 faculty mentors facilitating. We will describe the current curriculum as it has evolved over the past 12 years, presenting trainees with an approach to identify ethical challenges that arise in their research and identify approaches to find a practical solution. We will report on the specific challenges in research ethics identified by participants over this period and how they have evolved. We will also present pre- and post-training data about confidence in ethical decision making. DISCUSSION/SIGNIFICANCE: This approach to RCR training is well-received, has evolved over time, and has led to dissemination. Success is attributed to allowing choice in topics relevant to trainees and practicality of the stepwise approach that is transferable to any situation.