Implementation of dedicated social worker coaching for emergency medicine residents - Lessons learned.

Emergency medicine training is associated with high levels of stress and burnout, which were exacerbated by the COVID-19 pandemic. The pandemic further exposed a mismatch between trainees' mental health needs and timely support services; therefore, the objective of our innovation was to create an opportunity for residents to access a social worker who could provide consistent coaching. The residency leadership team partnered with our graduate medical education (GME) office to identify a clinical social worker and professionally-trained coach to lead sessions.

The Berlin Bimanual Test for Tetraplegia (BeBiTT): development, psychometric properties, and sensitivity to change in assistive hand exoskeleton application.

Background: Assistive hand exoskeletons are promising tools to restore hand function after cervical spinal cord injury (SCI) but assessing their specific impact on bimanual hand and arm function is limited due to lack of reliable and valid clinical tests. Here, we introduce the Berlin Bimanual Test for Tetraplegia (BeBiTT) and demonstrate its psychometric properties and sensitivity to assistive hand exoskeleton-related improvements in bimanual task performance.

Methods: Fourteen study participants with subacute cervical SCI performed the BeBiTT unassisted (baseline).

Brain-Computer Interface-Controlled Exoskeletons in Clinical Neurorehabilitation: Ready or Not?

The development of brain-computer interface-controlled exoskeletons promises new treatment strategies for neurorehabilitation after stroke or spinal cord injury. By converting brain/neural activity into control signals of wearable actuators, brain/neural exoskeletons (B/NEs) enable the execution of movements despite impaired motor function. Beyond the use as assistive devices, it was shown that-upon repeated use over several weeks-B/NEs can trigger motor recovery, even in chronic paralysis.

Post-stroke Rehabilitation of Severe Upper Limb Paresis in Germany - Toward Long-Term Treatment With Brain-Computer Interfaces.

Severe upper limb paresis can represent an immense burden for stroke survivors. Given the rising prevalence of stroke, restoration of severe upper limb motor impairment remains a major challenge for rehabilitation medicine because effective treatment strategies are lacking. Commonly applied interventions in Germany, such as mirror therapy and impairment-oriented training, are limited in efficacy, demanding for new strategies to be found.

Teaching emergency medicine residents health equity through simulation immersion.

Objective: Our aim was to conduct a large, case-based diversity, equity, and inclusion (DEI) simulation exercise with a goal to improve the DEI pillars of cultural and structural awareness for residents.

Methods: Utilizing data resulting in poor health outcomes, the top eight themes were utilized, and via a modified Delphi approach, a diverse group of faculty developed representative cases. A mass simulation effort was organized with the assistance of our local simulation office.

Defining "county": A mixed-methods inquiry of county emergency medicine residency programs.

Introduction: There is no clear unified definition of "county programs" in emergency medicine (EM). Key residency directories are varied in designation, despite it being one of the most important match factors for applicants. The Council of Residency Directors EM County Program Community of Practice consists of residency program leadership from a unified collective of programs that identify as "county.

Implementation of holistic review into emergency medicine residency application screening to improve recruitment of underrepresented in medicine applicants.

Introduction: Increasing the diversity of the emergency medicine (EM) workforce is imperative, with more diverse teams showing improved patient care and increased innovation. Holistic review, adapted from the Association of American Medical Colleges (AAMC), focuses on screening applicants with a balanced method, valuing their experiences, attributes, and academic metrics equally. A core tenet to holistic review is that diversity is essential to excellence.

A Novel Approach to Neonatal Resuscitation Education for Senior Emergency Medicine Residents.

The majority of pediatric visits occur in general emergency departments. Caring for critically ill neonates is a low-frequency but high-stakes event for emergency physicians, which requires specialized knowledge and hands-on training. We describe a novel clinical rotation for emergency medicine (EM) residents that specifically augments skills in neonatal resuscitation through direct participation as a member of the neonatal resuscitation team.

Feasibility and Safety of Bilateral Hybrid EEG/EOG Brain/Neural-Machine Interaction.

Cervical spinal cord injuries (SCIs) often lead to loss of motor function in both hands and legs, limiting autonomy and quality of life. While it was shown that unilateral hand function can be restored after SCI using a hybrid electroencephalography/electrooculography (EEG/EOG) brain/neural hand exoskeleton (B/NHE), it remained unclear whether such hybrid paradigm also could be used for operating two hand exoskeletons, e.g.

Racial and Ethnic Diversity in Academic Emergency Medicine: How Far Have We Come? Next Steps for the Future.

Although the U.S. population continues to become more diverse, black, Hispanic, and Native American doctors remain underrepresented in emergency medicine (EM).

The Impact of the 2008 Council of Emergency Residency Directors (CORD) Panel on Emergency Medicine Resident Diversity.

Background: In 2008, the Council of Emergency Medicine Residency Directors (CORD) developed a set of recruitment strategies designed to increase the number of under-represented minorities (URMs) in Emergency Medicine (EM) residency.

Objectives: We conducted a survey of United States (US) EM residency program directors to: describe the racial and ethnic composition of residents; ascertain whether each program had instituted CORD recruitment strategies; and identify program characteristics associated with recruitment of a high proportion of URM residents.

Methods: The survey was distributed to accredited, nonmilitary US EM residency programs during 2013.

Increasing Resident Diversity in an Emergency Medicine Residency Program: A Pilot Intervention With Three Principal Strategies.

Problem: Much work remains to be done to align the diversity of the health care workforce with the changing racial and ethnic backgrounds of patients, especially in the field of emergency medicine.

Approach: In academic year (AY) 2012-2013, to increase the number of underrepresented minority (URM) candidates who were interviewed and matched, the Denver Health Residency in Emergency Medicine program (DHREM) initiated a focused pilot intervention with three principal strategies: (1) a scholarship-based externship program, (2) a funded second-look event, and (3) increased involvement and visibility of URM faculty in the interview and recruitment process.

Outcomes: One year after implementation of the pilot intervention, the percentage of URMs among all applicants invited to interview at the DHREM doubled (7.

Biological activities and 3D QSAR studies of a series of Delisea pulchra (cf. fimbriata) derived natural products.

Twenty-five natural products, mainly halogenated furanones, isolated from the temperate red algae Delisea pulchra were investigated for their cytotoxic, antimicrobial, and antiplasmodial effects, their inhibition of the activity of the enzymes HIV-1-RT (HIV-1-reverse transcriptase), PKC (protein kinase C), and TK (tyrosine kinase), and their inhibition of the biosynthesis of IL-1 (interleukin-1). All were found to mediate a positive response in one or more of these test systems. In particular, compounds 9, 11, 12, 14, 16, 17, 19, and 20 demonstrated cytotoxic activity in all of the assays they were tested in; compounds 11, 12, 17, 19, and 20 were also active in the majority of the anti-infective screens.

Evaluation of the efficiency of three different solvent systems to extract triterpene saponins from roots of Panax quinquefolius using high-performance liquid chromatography.

Despite the wide availability of liquid herbal extracts using mixtures of alcohol, glycerin, and water, or glycerin and water as solvents, no data on the chemical composition of such extracts is readily available. In this study, the amount and the stability of the major saponins in Panax quinquefolius root extracts, made either with 50% (v/v) aqueous ethanol, a mixture (v/v/v) of 20% ethanol, 40% glycerin, and 40% water, or with 65% (v/v) aqueous glycerin, were evaluated by HPLC-UV analysis. The amount of total saponins was highest in the 50% aqueous ethanol extract (61.

Analysis of Scutellaria lateriflora and its adulterants Teucrium canadense and Teucrium chamaedrys by LC-UV/MS, TLC, and digital photomicroscopy.

Methods using liquid chromatography with UV detection (LC-UV), thin-layer chromatography (TLC), and digital photomicroscopy were developed to distinguish between the different species of Scutellaria lateriflora L. and its adulterants Teucrium canadense L. and T.

Inhibition of [3H]-LSD binding to 5-HT7 receptors by flavonoids from Scutellaria lateriflora.

The hot water and 70% ethanol extracts of dried mad-dog skullcap (Scutellaria lateriflora) both bound to the 5-HT(7) receptor, with 87.2 +/- 6.2% and 56.

Stabilization of caffeic acid derivatives in Echinacea purpurea L. glycerin extract.

Recent work has shown that enzymatic degradation and oxidation of cichoric acid and other caffeic derivatives occurs in Echinacea preparations. However, very little is known as to the means of stabilizing these phytopreparations. To stabilize the glycerin extract of Echinacea purpurea, we have evaluated the effects of 3 natural antioxidants (citric acid, malic acid, and hibiscus extract) on the stability of the major caffeic acid derivatives (caftaric acid, caffeic acid, cichoric acid, and 2-O-feruloyl-tartaric acid).

Synthesis of new artemisinin analogues from artemisinic acid modified at C-3 and C-13 and their antimalarial activity.

Artemisinic acid (2) was modified through allylic oxidation at C-3 or conjugate addition at C-13 to afford 12 methyl artemisinate derivatives (4-15). Photooxidation of the derivatives yielded eight new artemisinin analogues, including 13-cyanoartemisinin (16), 13-methoxycarbonyl artemisinin (17), 13-methoxyartemisinin (18), 13-ethylsulfonylartemisinin (19), 13-nitromethylartemisinin (20), 13-(1-nitroethyl)artemisinin (21), (3R)-3-hydroxyartemisinin (22), and (3R)-3-acetoxyartemisinin (23). Among the analogues, only compound 20 had antimalarial activity comparable to artemisinin (1).

Biological screening of rain forest plot trees from Palawan Island (Philippines).

Study plots totaling 0.2 Ha were established in primary forest in the highlands of central Palawan Island, Philippines. Samples of various anatomical parts [typically leaf + twig (If/tw), stem bark (sb), and root (rt)] were collected from all tree species represented within the plots by individuals having a diameter at breast height > or = 10 cm.

Assessment of the antimalarial potential of tetraoxane WR 148999.

The antimalarial peroxide, dispiro-1,2,4,5-tetraoxane WR 148999, was synergistic with chloroquine, quinine, mefloquine, and artemisinin against both D6 and W2 clones of Plasmodium falciparum. In consideration of the contrasting antagonism between artemisinin and chloroquine, these drug combination data imply that WR 148999 and artemisinin may not share a common mechanism of action. For Plasmodium berghei-infected mice given oral, subcutaneous, and intraperitoneal doses of WR 148999 ranging from 2 to 1024 mg/kg in the Thompson test, median survival times were 8.

Phenolic aporphine-benzylisoquinoline alkaloids from Thalictrum faberi.

From the roots of Thalictrum faberi, six new phenolic aporphine-benzylisoquinoline alkaloids, 3-hydroxy-6'-desmethyl-9-O-methylthalifaboramine (1), 3-hydroxythalifaboramine (2), 6'-desmethylthalifaboramine (3); 3,5'-dihydroxythalifaboramine (4), 5'-hydroxythalifaboramine (5) and 3-hydroxy-6'-desmethylthalifaboramine (6) were isolated. Their structures were established through the use of one- and two-dimensional NMR techniques. All of the tested alkaloids showed potent cytotoxic and antimalarial activities.

Antiplasmodial and cytotoxic activity of natural bisbenzylisoquinoline alkaloids.

As part of an ongoing collaborative effort to discover new antimalarial agents from natural sources, we have tested 53 bisbenzylisoquinoline alkaloids for cytotoxicity against cultured mammalian cells and for antiplasmodial activity against chloroquine-sensitive and chloroquine-resistant clones of Plasmodium falciparum. The isolates from Cyclea barbata, Stephania pierrei, Stephania erecta, Pachygone dasycarpa, Cyclea atjehensis, Hernandia peltata, Curare candicans, Albertisia papuana, and Berberis valdiviana exhibited a wide range of biological potencies in antiplasmodial assays, and the majority exhibited some degree of cytotoxicity against human KB cells. More than half of the compounds tested, however, showed selective antiplasmodial activity, with >100-fold greater toxicity toward one or both of the P.

Isolation of gallic acid esters as antiplasmodial constituents of Swintonia foxworthyi (Anacardiaceae).

An extract of a leaf and twig sample from Swintonia foxworthyi demonstrated weak in vitro activity against two clones of Plasmodium falciparum. At the same time, the extract was inactive in cancer cell cytotoxicity assays. Bioassay-directed fractionation led to the isolation of methyl gallate as the principal antiplasmodial constituent; the compound demonstrated estimated IC(50) values of 2.

Antimalarial activity of tropical Meliaceae extracts and gedunin derivatives.

Extracts of 22 species of Meliaceae were examined for antimalarial activity using in vitro tests with two clones of Plasmodium falciparum, one sensitive to chloroquine (W2) and one chloroquine-resistant (D6). Twelve extracts were found to have activity, including extracts of Cedrela odorata wood and Azadirachta indica leaves, which contained the limonoid gedunin. These extracts were more effective against the W2 clone than the D6 clone, suggesting there is no cross-resistance to chloroquine.