Having a Bad Day Is Not an Option: Learner Perspectives on Learner Handover.

Purpose: Learner handover is the sharing of learner-related information between supervisors involved in their education. The practice allows learners to build upon previous assessments and can support the growth-oriented focus of competency-based medical education. However, learner handover also carries the risk of biasing future assessments and breaching learner confidentiality.

The Anatomic Variability of the Lateral Ventricles of the Human Brain Depending on Age and Sex.

The evaluation of the different parameters of the brain ventricles is used in the diagnostics of age-related degenerative diseases of the central nervous system, as well as psychiatric disorders. The purpose of this study was to obtain data about the normal morphologic parameters of the lateral ventricles of the human brain and their relations with age and sex to establish a solid background for the diagnostics of any pathologic changes. Computed tomography (CT) studies of 108 healthy individuals aged from 17 to 86 (mean age: 46.

Correlation of D-dimer and Outcomes in COVID-19 Patients.

Background: The coronavirus disease 2019 (COVID-19) global pandemic has impacted daily life and medical practices around the world. Hospitals are continually making observations about this unique population as it relates to laboratory data and outcomes. Plasma D-dimer levels have been shown to be promising as a prognostic factor for outcomes in COVID-19 patients.

Do All Isolated Traumatic Subarachnoid Hemorrhages Need to Be Transferred to a Level 1 Trauma Center?

Background: The management of isolated traumatic subarachnoid hemorrhage (itSAH) in non-trauma centers usually results in transfer to a Level 1 trauma center with neurosurgical capabilities. Due to lack of trauma center resources, we sought to evaluate if patients with itSAH need transfer to a Level I trauma center.

Methods: A retrospective review of the trauma registry was conducted from Jan 2015-Dec 2020.

Prospective randomized trial of metal versus resorbable plates in surgical stabilization of rib fractures.

Background: Surgical stabilization of rib fractures has gained popularity as both metal and resorbable plates have been approved for fracture repair. Is there a difference between metal and resorbable plate rib fixation regarding rib fracture alignment, control of pain, and quality-of-life (QOL) scores (Rand SF-36 survey)?

Methods: Eligible patients (pts) included 18 years or older with one or more of the following: flail chest, one or more bicortical displaced fractures (3-10), nondisplaced fractures with failure of medical management. Patients were randomized to either metal or resorbable plate fixation.

Development and validation of a novel method "SpermX™" for high throughput differential extraction processing of sexual assault kits (SAKs) for DNA analysis.

The Sperm X method uses a nanotechnology derived polymer membrane that functions as a separation medium to effectively trap sperm cells while enabling efficient flow through of the digested epithelial cell DNA. This specialized membrane enabled development of a method that could significantly increase a forensic laboratory's ability to obtain male sperm fraction DNA profiles. The SpermX device provides a rapid, reproducible procedure that is easy to implement in a single-tube format as well as high-throughput truly automated hands-free workflows.

Surgical Stabilization of Rib Fractures Improves Outcomes in the Geriatric Patient Population.

Introduction: Rib fractures in the ≥65-year-old population have been shown to strongly influence mortality and pneumonia rates. There is a growing body of evidence demonstrating improvements in the geriatric patient's survival statistics and respiratory performances after surgical stabilization of rib fractures (SSRF). We have observed a strong survival and complication avoidance trend in geriatric patients who undergo SSRF.

Crotalidae Polyvalent Immune Fab and Cost-Effective Management of Hospital Admissions for Snakebites.

Background: Venomous snakebites are a common clinical scenario in the Southeastern United States. CroFab® (Crotalidae Polyvalent Immune Fab (Ovine), BTG, Wales, UK) antivenom is indicated in cases involving pit vipers and is known to be expensive. The treatment protocol for snakebites is based on clinically subjective measures triggering the application, or escalation of, antivenom administration.

Continuous transversus abdominis plane blocks in patients undergoing minimally invasive colorectal surgery: a randomized pilot study.

Purpose: Transversus abdominis plane (TAP) blocks are used in an attempt to decrease narcotic use and its subsequent consequences. The primary goal of this study was to see if TAP blocks decreased narcotic use in patients undergoing minimally invasive colorectal surgery.

Methods: A randomized pilot study was conducted.

Comprehensive Initiative to Decrease Trauma Venous Thromboembolism.

Background: Our trauma center was a high outlier for pulmonary embolism on a 2017 American College of Surgeons Trauma Quality Improvement Program (TQIP) report. The odds ratio for developing a pulmonary embolus was 1.76 and was in the 10th decile (worst results).

Can Education and Enhanced Medical Director Oversight Improve Definitive Airway Control in the Prehospital Environment?

Background: Endotracheal intubation (ETI) is the most definitive technique for airway management. However, supraglottic airway (SGA) may be used when ETI is not feasible. The purpose of this study was to determine the effect of updated field sedation protocols, simulation teaching, robust Quality Assurance/Continuing Quality Improvement (QA/CQI) program, and enhanced emergency medical services (EMSs) medical director oversight on ETI and SGA usage at a Level 1 trauma center.

Insurance Status in Rectal Cancer is Associated With Age at Diagnosis and May be Associated With Overall Survival.

Background: There are approximately 44 180 new cases of rectal cancer diagnosed annually. While surgical resection remains the standard of care for definitive treatment, neoadjuvant chemoradiation therapy (NCRT) has significantly reduced recurrence rates postoperatively. NCRT is indicated for T3/T4 tumors, and relative indications include patients with T1/T2 lesions with clinically positive nodes.

Wittmann Patch : Superior Closure for the Open Abdomen.

Introduction: Damage control laparotomy (DCL) is a life-saving surgical technique, but the resultant open abdomen (OA) carries serious morbidity/mortality. Many methods are utilized to manage OAs, but discrepancy exists in distinguishing closure from coverage techniques. We observed a difference in our DCL patient outcomes managed with the Wittmann Patch (WP) closure device versus the more popular ABThera (AB) coverage device.

Does Human Amnion Membrane Prevent Postoperative Abdominal Adhesions?

Background: Adhesions are bands of tissue that form postoperatively after intra-abdominal surgery. Adhesions cause significant morbidity and despite ongoing research no agent or method has been shown to completely prevent adhesions. Human amnion-derived matrix is a complex tissue matrix derived from human placenta and has been used in other areas of surgery to promote healing and decrease scar tissue formation.

A cross-sectional study of social inequities in medical crowdfunding campaigns in the United States.

Americans are increasingly relying on crowdfunding to pay for the costs of healthcare. In medical crowdfunding (MCF), online platforms allow individuals to appeal to social networks to request donations for health and medical needs. Users are often told that success depends on how they organize and share their campaigns to increase social network engagement.

Development and validation of InnoQuant HY, a system for quantitation and quality assessment of total human and male DNA using high copy targets.

The development and validation of InnoQuant HY, a real-time PCR system containing four DNA targets-two RE autosomal targets of different sizes, male specific targets, and an internal positive control target-are described herein. The ratio of the two autosomal targets provides a Degradation Index, or a quantitative value of a sample's degradation state. The male specific targets are multi-copy targets located on the Y chromosome, which provides information about a sample's male DNA composition.

Development and validation of a novel multiplexed DNA analysis system, InnoTyper 21.

We report here a novel multiplexed DNA analysis system consisting of 20 Alu markers and Amelogenin for analysis of highly degraded forensic biological samples. The key to the success of the system in obtaining results from degraded samples is the primer design yielding small amplicon size (60-125bp) for all 20 markers. The markers included in the InnoTyper 21 system are bi-allelic, having two possible allelic states (insertion or null) and thus termed INNULs.

Creating A Nationwide Nonpartisan Initiative for Family Caregivers in Political Party Platforms.

Policymakers have been slow to support family caregivers, and political agendas mostly fail to address the cost burdens, impact on employment and productivity, and other challenges in taking on long-term care tasks. This project set out to raise policymakers' awareness of family caregivers through proposals to Republican and Democratic party platforms during the 2016 political season. The Family Caregiver Platform Project (FCPP) reviewed the state party platform submission process for Democratic and Republican parties in all 50 states and the District of Columbia.

Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

Policy Points: At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living.

Obesity as a Risk Factor for Complications After Second-Trimester Abortion by Dilation and Evacuation.

Objective: To evaluate the association between obesity (body mass index [BMI] 30 or higher) and dilation and evacuation (D&E) complications.

Methods: We conducted a retrospective cohort study of women who underwent D&E abortion from February 2009 to April 2013 at a hospital-based abortion practice in California. We evaluated the association between obesity and risk of complication after D&E using logistic regression.

Creating a comprehensive care system for frail elders in "age boom" america.

Current options being discussed by policymakers cannot yield the highly reliable, highly efficient service delivery system-inclusive of both health care and community-based supportive services-that the nation's upcoming and transformative "age wave" will require. More far-reaching and rapid innovations in policy and health care delivery are essential. The MediCaring Accountable Care Community initiative is a comprehensive model that can deliver higher quality care for frail elderly Medicare beneficiaries at a lower per capita cost.