bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mind the gap: Psycholinguistic and individual factors affecting expressive and receptive vocabulary skills in English-Gaelic bilingual children
Authors: Chondrogianni Vicky , Butcher Morna 
Published: June 2023

AbstractThis study investigated the psycholinguistic and child-related variables that modulate vocabulary development and the so-called receptive–expressive gap in child L2 learners of Gaelic with English as their L1. In total, 50 6- to 8-year-old English-Gaelic bilingual children attending Gaelic-medium immersion education were administered the English and the Gaelic Crosslinguistic Receptive and Expressive Lexical Tasks (CLTs). On the Gaelic CLT, children performed better on nouns than verbs. Accuracy was modulated by item-related variables such as the estimated age when a word is acquired and its morphophonological complexity. The receptive–expressive gap was larger in the minority L2 than in the majority L1 and did not narrow after 1 year of schooling. The gap was smaller for nouns than verbs in English but not in Gaelic. Exposure to English differentially affected the receptive–expressive gap across languages. This study offers new insights into the psycholinguistic and individual factors affecting the receptive–expressive gap in bilingual children in immersion education.
Protective effect of onion peel extract on ageing mouse oocytes
Authors: Xu Yong-Nan , Han Guo-Bo , Li Ying-Hua , Piao Chun-Hao , Li Guan-Hao , Kim Nam-Hyung 
Published: June 2023

SummaryMammalian oocytes not fertilized immediately after ovulation can undergo ageing and a rapid decline in quality. The addition of antioxidants can be an efficient approach to delaying the oocyte ageing process. Onion peel extract (OPE) contains quercetin and other flavonoids with natural antioxidant activities. In this study, we investigated the effect of OPE on mouse oocyte ageing and its mechanism of action. The oocytes were aged in vitro in M16 medium for 16 h after adding OPE at different concentrations (0, 50, 100, 200, and 500 μg/ml). The addition of 100 μg/ml OPE reduced the oocyte fragmentation rate, decreased the reactive oxygen species (ROS) level, increased the glutathione (GSH) level, and improved the mitochondrial membrane potential compared with the control group. The addition of OPE also increased the expression of SOD1, CAT, and GPX3 genes, and the caspase-3 activity in OPE-treated aged oocytes was significantly lower than that in untreated aged oocytes and similar to that in fresh oocytes. These results indicated that OPE delayed mouse oocyte ageing by reducing oxidative stress and apoptosis and enhancing mitochondrial function.
Strengthening Global Systems to Prevent and Respond to High-Consequence Biological Threats
Authors: Hansen Jan-Cédric , Barach Paul , Donahue Donald , Göbbels Stefan , Quinn John , Van Trimpont Frank 
Published: June 2023

Introduction:The world is facing the devastating impact a biological event can have on human health, economies, and political stability. COVID-19 has revealed that national governments and the international community are woefully unprepared to respond to pandemics—underscoring our shared vulnerability to future catastrophic biological threats that could meet or exceed the severe consequences of the current pandemic. This study examines potential threats related to deliberate Russian military use and misuse of the tools of modern biology or an accident caused by a CBRN event evolving rapidly in the highly volatile political environment in and around Ukraine and other conflicts.Method:A participatory foresight, co-creative, future and transformation-oriented methodology was used to structure a transformative model for a disciplined exploration of scenarios to confront complex challenges and facilitate improved outcomes. Foresight helps to evaluate current policy priorities and potential new policy directions; see how the impact of possible policy decisions may combine with other developments; inform, support and link policy-making in and across a range of sectors; identify future directions, emerging technologies, new societal demands and challenges; and anticipate future developments, disruptive events, risks and opportunities.Results:The study found that the “mitigation scenarios” are based on the “Confront, Regulate, Overcome” metamodel combined with the “Security, Rescue, Care” response modalities. These require the cooperation/coordination of law enforcement forces along with military forces, fire departments and civil security resources, hospital and first-line responder teams, in order to appropriately address populations, assets and territories issues elicited by the identified threat, which drives key decision makers’ tasks at the strategic level.Conclusion:The participatory foresight exercise demonstrated gaps in national and international biosecurity and pandemic preparedness architectures highlighted by the challenges of the Ukraine war—exploring opportunities for better cooperation to improve prevention and response capabilities for high-consequence biological events, and generate actionable recommendations for the international community.
RAIN: Simplifying Decontamination Response for Hospital First Receivers
Authors: Booth Kathryn , Daniels Mackenzie 
Published: June 2023

Introduction:Considerations for patient and staff safety are critical during an encounter with an individual who is potentially contaminated by hazardous materials in the hospital setting. Decontamination training for all team members may be ideal, however, there are significant barriers precluding implementation including time-spent, associated costs, and staffing limitations. Studies demonstrate that immediate recognition of potential contaminants and removal of clothing mitigates risks with a best-estimated 85% hazard reduction. Initial risk-reducing best practices like focused training and resources, allow for more adequate decontamination response and improve team training gaps with potential first receivers throughout the hospital setting.Method:A two-step process was implemented to address a training disparity including a deployment of high-impact resources and the installment of these resources at high-risk locations. First, a slide deck with focused education to both clinical and non-clinical staff was developed from the established decontamination team training program. The focus of this training was to introduce the concept of RAIN (Recognition, Avoidance, Isolation, and Notification). This education highlights how to safely remove potentially contaminated clothing and contain the materials. RAIN kits were created with the items necessary to safely accomplish this while prioritizing patient privacy and safety to patient and staff. The kits included instructions, privacy kits, thermal blankets, and trauma shears. Next, the RAIN kits were deployed at pre-identified locations where potentially contaminated patients may present.Results:Qualitative improvement in staff satisfaction was noted after the implementation of the abridged, high-impact RAIN kits. The pre-deployed kits at critical high-likelihood locations throughout the hospital created a more accessible model with improved ease of use and effectiveness, reducing current gaps in training. Limitations should be considered when implementing a high-acuity, low-frequency program to clinical and non-clinical staff with support from leadership.Conclusion:Focused education and pre-deployed kits empower staff to respond in hospital settings for potentially contaminated patients.
Prehospital Whole Blood Transfusion Training in Ukraine: A Case Study Highlighting the Efficacy of Collaboration and Advocacy
Authors: Ryder Jessica , Nelson Erica , Turconi Michael , Fisher Andrew , Levchecko Valerii , Bidovanets Olena , Bilgram Calley , Quaranta Alyssa , Ross Madeline , Callaway David 
Published: June 2023

Introduction:Early in the Russian-Ukrainian conflict, the Ukrainian Ministry of Health (MoH) implemented policy reform to allow for pre-hospital whole blood transfusion (pWBT). Team Rubicon (TR) worked with a multinational group of experts to disseminate training that accelerated the implementation of pWBT across the country.Method:TR utilized an assess, align, and act (A3) approach to drive the pWBT implementation. TR established relationships with Ukrainian providers to understand current needs, restrictions, and protocols for pWBT. TR aligned pWBT advocacy efforts, working with the disaster medicine program at Ivano-Frankivsk Medical National University to create a local lead advocate. Existing and novel coordination mechanisms were used to unite and inform MoH, World Health Organization, Non-Governmental Organizations, and local health systems. Finally, TR coordinated a multispecialty, multi-national team of healthcare providers who developed and delivered a training package in alignment with national guidelines utilizing a combination of didactics, videos, and demonstrations. From August to October of 2022, TR conducted pWBT trainings across Ukraine. Pre- and post-surveys were utilized to determine comfort with pWBT and usefulness of the training.Results:TR emerged as the point of reference for pWBT in Ukraine. 109 individuals from over 14 organizations were trained. Participants included 69 physicians, 23 paramedics, 7 nurses, and 10 other professionals. 95% of those surveyed had not received prior pWBT training. Participants reported increased comfort levels, with average pre- and post-course comfort scores of 1.7 and 3.2 (4=very comfortable), respectively. The majority of participants found the training useful (average score of 3.8, 4=very useful). Feedback demonstrated high satisfaction ratings and an increased awareness of the regulatory changes.Conclusion:TR utilized the A3 model to drive a coalition that supported policy reform and trauma system improvements in Ukraine. TR’s ability to leverage international medical expertise, work collaboratively with MoH, and provide material resources supported local implementation of pWBT.
Triage, Trauma, and Civil Unrest: Decreasing Critical Care Overcrowding and Nursing 'Undertriage' Praxes at the University of Gondar Public Hospital, Ethiopia
Authors: Richter Roxane , Workagegnehu Hailu , Mengistu Miklol , Silamsaw Mezgebu , Flowers Thomas , Cobbold Sonia , Richter Rainier 
Published: June 2023

Introduction:In March of 2022, the Washington Post reported that the: “Deadliest war isn’t in Ukraine, it’s in Ethiopia.” Current death toll estimates are around 600,000: 50,000-100,000 (warfare); 150,000-200,000 (starvation), and 100,000 (lack of medical treatment). Due to increasing civil unrest, a mixed-methods study began at the University of Gondar Hospital in Gondar, Ethiopia. Between 2018-2022, the estimated (daily average) of patients was reported to have quadrupled, from 100 to 400. The global research team implemented 12 new systemic revisions in overcrowding, triage nursing praxes, and resuscitations. Patient data from 521 hospital records was evaluated, as well as resource allocation(s) in staffing, equipment, and training.Method:The study’s inclusion criteria for A&E data included all patients who sought emergency care at UoG Teaching Hospital’s Emergency Department between May 13, 2018, and June 29, 2018, primarily during the normal daytime working hours between 9am and 2pm, as nighttime security and road travel were deemed less secure for data collectors.Results:After the 12-benchmark implementation, there was an approximate 15%-25% decrease in direct-from-triage ‘Red’ patient admission; congestion dropped 50%-70%; and the occurrences of successful resuscitations increased. The study revealed that over 75% of patients presented with symptoms indicative of illness(es), and 24.4% presented with trauma (remaining psychiatric). Of the trauma cases, approximately 28.3% were ‘intentional’ injuries. The patients’ mean TEWS triage score was 3.294, with a standard deviation from the mean of 1.9938.Conclusion:The overall prevalence of patients necessitating surgical evaluation, the elevated use of triage discriminators due to space, equipment, and staff concerns, and the predominant use of ‘Yellow Zone’ services–all pointed to the vital need for resource re-allocation(s), stricter ECCN adherences to TEWS triage indices, as well as future Mass Casualty Planning, Triage, and Response, and Mass Casualty Medical Operations training.
Preliminary Analysis of the Competencies Needed by EMTs Members to Address Safety and Security when Deployed to Unsecured Environments: A scoping review of the available evidence
Authors: Saade Elias , Echeverri Lina , Barbar Ana 
Published: June 2023

Introduction:During armed conflicts and other situations of violence, EMTs are deployed to respond to the needs of the affected population. It is when fighting breaks out that healthcare services are most needed, but it is also when they are most exposed to violence and insecurity. Current evidence indicates that health personnel, health infrastructure and patients have been the target of different types of attacks.A new report published on 24 of May 2022 by the Safeguarding Health in Conflict Coalition identified there were 1,335 incidents of violence or obstruction against health care perpetrated in 2021: 161 health workers killed; 320 injured; 170 kidnapped; 713 arrested. Health facilities were destroyed or damaged in 188 incidents, 111 health transports destroyed or damaged and 64 health transports stolen or hijacked.In a nutshell, health facilities and health workers were subjected to devastating and widespread violence and obstruction of care in 49 conflict-affected countries in 2021.Method:This presentation analyzes the current challenges, describes the method used consisting of a scoping review of the available evidence in addition to semi-structured feedback from key stakeholders working in unsecured environments, and supports the identification of skills and competencies that EMT members need before deployment. This presentation will also propose the definition of skills and competencies for EMT members needed before deployment to unsecured environments.Results:Recommendations for future action focus on International norms and standards, a competencies framework, evidence and data, and state-of-the-art competencies to address safety and security during deployment needed for a capability-building framework.Conclusion:How to optimize EMTs' response in unsecured environments requires designing training and learning pathways that improve skills and knowledge on safety and security for EMT members before their deployment to prevent and mitigate violence against health care during deployment in unsecured environments.
Evaluating the Educational Effectiveness of Hospital Healthcare Providers after Chemical Mass Casualty Response Training Program
Authors: Shin Heejun , Hertelendy Attila , Hart Alexander , Issa Fadi , Ciottone Gregory 
Published: June 2023

Introduction:Chemical exposures can cause direct and indirect injuries to responding medical personnel. Therefore, hospital healthcare providers should be provided with disaster response training that includes identification of chemical hazards, establishment of the hazard zone, personal protective equipment use, decontamination, and chemical injury antidote use. This study evaluates the educational effectiveness of the chemical-mass casualty incident response education module (C-MCIREM) for hospital healthcare providers.Method:This was a retrospective quasi-experimental study. Subjects were hospital providers who enrolled in the C-MCIREM program between May 1, 2021, and July 26, 2022. Subjects were hospital providers from Bucheon, Mokpo, Iksan, Jeonju, and Dae-gu cities in South Korea. Subjects completed pre, post, and three-month knowledge retention and self-assessments of readiness tests, as well as evaluations on tabletop exercises (TTX), and a satisfaction survey (11-point Likert) after the course. The instructors scored teamwork measures via standardized evaluations on TTX throughout the course. The K-paired Sample Friedman test was used to compare samples.Results:127 respondents were enrolled. The median knowledge score rose from 51/100 (39, 66) to 85.5/100 (73.75, 90) with a median retention score of 74/100 (64, 88) (p<0.001). Participants felt their readiness to respond increased in all facets (all p<0.001) on the post and retention test for the MCI situation. All three hospital teams showed significant increases in teamwork between the median of the 1st and 4th TTX as 27/100 (23.5, 29) and 69/100 (66.75, 69.5) (p<0.05). Participants were overall satisfied (9.1/10 SD 1.13) and would recommend the training to others (9.15/10 SD 1.2).Conclusion:C-MCIREM participants had high satisfaction with a significant increase and persistence in knowledge, improved teamwork, and self-assessed readiness to respond to a chemical mass casualty incident.
“Baby Steps” for Baby Breaths–How Incremental Changes Changed Our Performance
Authors: Goswami Rahul 
Published: June 2023

Introduction:Neonatal resuscitations are challenging to any mixed ED with rotating medical staff. Covid-19 decimated nursing numbers and reduced training to a standstill. New doctors and nurses find pediatric resuscitations (simulations and in real cases) challenging as there are complex algorithms/calculations as well as preparing and operating systems such as a Drager ResuscitaireR.Training rotating or new staff for rare complex resuscitations can be time and resource consuming with little yield.We describe our experience of applying incremental measures after almost every simulation to improve team performance and knowledge.Method:This is an ongoing audit of simulations and cases for neonatal / infant resuscitations using our pediatric bay and Drager ResuscitaireR system. Our main aim was to improve:1. Nursing preparation time / competence for:- Pediatric / neonatal drug doses- Drager ResuscitaireR system setup2. Medical staff competence for:- Neonatal resuscitation algorithms- Drager ResuscitaireR usage (PPV/Ventilator setup)Two ED consultants ran “in-situ” simulations and recorded gaps/errors (including feedback in debrief). Any measures deemed fixable were implemented ASAP. Improvement was made if error was not repeated in subsequent two independent simulations.Results:Audits of five real cases and fifteen simulations revealed gaps (e.g. dose miscalculations, equipment unfamiliarity) which were corrected by simple measures after each discovery. These include:
1. Neonatal resuscitation checklist with steps to setup the Resuscitaire2. Weight-based resuscitation cards / pre-made packs of equipment instead of manual calculations3. Position markers for "ideal" ResuscitaireR ventilator settings4. Step by step ResuscitaireR numbered markers on machine
We found improvements in knowledge gaps, task accomplishment rates, staff satisfaction, appreciation of deficits and in-situ simulation uptake. More gaps are found and resolved at every simulation.Conclusion:A Human Factors approach with incremental adjustments and simple improvements with each simulation led to better team task accomplishment in complex preparation and resuscitation.
Developing a HazMat Decontamination Training Program for a Hospital in Singapore for National Emergency Preparedness.
Authors: Selamat Suraidah 
Published: June 2023

Introduction:Sengkang General Hospital (SKH) is a part of the national network of hospitals to respond to civil emergencies including hazardous material (Hazmat) incidents in Singapore. The HDS course aims to train our staff on basic knowledge of the effects of hazardous material exposure and the operations of the HDS.Method:HDS course was planned in three phases:Phase one aimed to train all DEM personnel so as to have a critical mass of personnel equipped to operate the HDS upon immediate notice. Phase two involves hospital staff from non-emergency departments. Material and simulations for phase two was simplified to focus on the skills and prompt decontamination. Phase three aims to test out capabilities of HDS and review processes through department simulations and hospital.Results:155 staff have completed HDS training since 2019, amongst them, 23 as instructors. 67.7% found the demonstrations, skills and practices exceeded expectations. 69% were able to apply skills taught during simulation and overall, 71.2% were able to understand topics covered in the modules.SKH was at the forefront of battling Covid-19 and resources were tight. We have resumed trainings to complete Phase two. We aim to train more than 35% of manpower in non-emergency departments to achieve higher recall.Conclusion:Training for national emergencies is challenging. HDS is located right outside the emergency department and has advantages of allowing smooth traffic to decontaminate patients and prompt treatment. However, training can get disrupted with incoming ambulances, patient influx and lack of resources.SKH aims to be well prepared in handling pandemics and still maintain its capabilities in assisting in national emergencies. There are plans for hospital simulation exercises for all relevant stakeholders and internal and external reviews are required to improve decontamination systems and processes. It is important to continue training hospital personnel to support HDS during crises.
The JDR Method. Our 20 Years of Experience and Practice in Developing Human Resources for Disaster Medicine.
Authors: Sakamoto Taigo , Inoue Junichi , Shirokawa Masamitsu , Ooyama Futoshi , Irahara Takayuki , Ihara Noriyuki , Nakajima Yasushi , Fukushima Kenji , Sugita Manabu 
Published: June 2023

Introduction:The Japan Disaster Relief Search and Rescue Team (the JDR Rescue Team) Medical Unit consists of EMT (emergency medical team) registered doctors and nurses who provide health care and medical advice to rescue operations. The JDR Medical Unit began 20 years ago when they voluntarily participated in rescue training and is characterized by volunteers who belong to different hospitals across the country. As a result, there were problems due to varied skills, and motivation. Until 2017, all applicants were recruited and trained as provisionally registered members, but only about 30% of them became fully registered members.Method:Since 2018, we have fundamentally changed our personnel training methods, establishing three main pillars. The first is a screening process based on work experience, expertise, and motivation; the second is dedicated guidance through training, textbooks, online study sessions, and training; and finally, we have created abundant training opportunities and visualized the growth process through a ladder to keep them motivated and goal-oriented at all times. Specific trainers are defined as task force members and they analyze each scene of the deployment practically and reflect on training. The task force also receives training abroad and absorbs good practice from other teams.Results:After changing the personnel training methods, the number of participants who dropped out of the training program was significantly reduced, and approximately 90% of the participants became fully registered members. The team members are more motivated and the team's capabilities have improved, leading to IER (INSARAG External Reclassification) certification as a heavy team twice.Conclusion:By selecting experienced and capable members and providing them with sufficient guidance and abundant training opportunities, we succeeded in improving the efficiency and capacity of human resource development. Ideally, victims are handed over to EMTs as patients for the future goal.