An updated AL-base reveals ranked enrichment of immunoglobulin light chain variable genes in AL amyloidosis.

Background: Each monoclonal antibody light chain associated with AL amyloidosis has a unique sequence. Defining how these sequences drive amyloid deposition could facilitate faster diagnosis and lead to new treatments.

Methods: Light chain sequences are collected in the AL-Base repository.

Accelerated protein retention expansion microscopy using microwave radiation.

Protein retention expansion microscopy (ExM) retains fluorescent signals in fixed tissue and isotropically expands the tissue to allow nanoscale (<70 nm) resolution on diffraction-limited confocal microscopes. Despite the numerous advantages of ExM, the protocol is time-consuming. Here, we adapted an ExM protocol to vibratome-sectioned brain tissue of Xenopus laevis tadpoles and implemented a microwave (M/W)-assisted protocol (ExM) to reduce the workflow from days to hours.

An updated AL-Base reveals ranked enrichment of immunoglobulin light chain variable genes in AL amyloidosis.

Background: Each monoclonal antibody light chain associated with AL amyloidosis has a unique sequence. Defining how these sequences lead to amyloid deposition could facilitate faster diagnosis and lead to new treatments.

Methods: Light chain sequences are collected in the Boston University AL-Base repository.

Accelerated protein retention expansion microscopy using microwave radiation.

Protein retention expansion microscopy (ExM) retains genetically encoded fluorescent proteins or antibody-conjugated fluorescent probes in fixed tissue and isotropically expands the tissue through a swellable polymer network to allow nanoscale (<70 nm) resolution on diffraction-limited confocal microscopes. Despite numerous advantages ExM brings to biological studies, the full protocol is time-consuming and can take multiple days to complete. Here, we adapted the ExM protocol to the vibratome-sectioned brain tissue of tadpoles and implemented a microwave-assisted protocol to reduce the workflow from days to hours.

Feasibility of paying people who use drugs cash to distribute naloxone within their networks.

Introduction: Immediate access to naloxone is needed to prevent fatal opioid-related overdoses in the presence of fentanyl analogs saturating the opioid supply. Peer models engage impacted populations who are not accessing naloxone through standard venues, yet compensating peers who utilize syringe service programs with cash stipends to distribute naloxone within networks of people who use drugs is not well described.

Methods: As part of the HEALing Communities Study, syringe service program-based interventions were developed in Holyoke and Gloucester, MA, which paid people who use drugs ("peers") cash to distribute naloxone.

Acute-on-Chronic Lithium Toxicity: A Simulation Case for Emergency Medicine Residents.

Introduction: Simulation-based education has become standard within emergency medicine training. Toxicological clinical presentations are challenging to identify and treat in the emergency department. Recognizing that active teaching methods are superior to standard lecture for learner retention, we created an experiential simulation case for education on lithium toxicity.

Investigation on the Synthesis, Application and Structural Features of Heteroaryl 1,2-Diketones.

A set of unsymmetrical heteroaryl 1,2-diketones were synthesized by a heteroarylation/oxidation sequence with up to 65% isolated yields. Palladium catalyst XPhos Pd G4 and SeO were the key reagents used in this methodology, and microwave irradiation was utilized to facilitate an efficient and ecofriendly process. The application of heteroaryl 1,2-diketones is demonstrated through the synthesis of an unsymmetrical 2-phenyl-3-(pyridin-3-yl)quinoxaline () from 1-phenyl-2-(pyridin-3-yl)ethane-1,2-dione ().

Sex differences in the fecal microbiome and hippocampal glial morphology following diet and antibiotic treatment.

Rising obesity rates have become a major public health concern within the United States. Understanding the systemic and neural effects of obesity is crucial in designing preventive and therapeutic measures. In previous studies, administration of a high fat diet has induced significant weight gain for mouse models of obesity.

Virtual Healthcare Simulation: Implementation, Distractions, and Preferences.

Introduction: Social distancing guidelines related to COVID-19 resulted in many simulation centers temporarily closing or adopting virtual simulation-based education (SBE). This mixed methods study aimed to evaluate our center's readiness to implement virtual SBE, the preferred method of delivery (virtual vs. nonvirtual), and any reported distractions.

Transgender Attitudes and Beliefs Scale (TABS): Validation with a Sample of Self-Identified Christians.

Transgender people suffer from a variety of consequences as victims of anti-transgender prejudice. Christians have been frequently identified as holding negative attitudes toward transgender people; however, there is evidence that these attitudes may be changing. Accurate measurement of attitudes is important in understanding currently held beliefs and to assess potential changes over time.

Midwifery continuity of care and vaginal birth after caesarean section: A randomised controlled trial.

Problem And Background: Caesarean section (CS) rates in Australia and many countries worldwide are high and increasing, with elective repeat caesarean section a significant contributor.

Aim: To determine whether midwifery continuity of care for women with a previous CS increases the proportion of women who plan to attempt a vaginal birth in their current pregnancy.

Methods: A randomised controlled design was undertaken.

Unifying Resident Education: 12 Interdisciplinary Critical Care Simulation Scenarios.

Introduction: Unified critical care training within residency education is a necessity. We created a simulation-based curriculum designed to educate residents on core topics and procedural skills, which crossed all adult disciplines caring for critically ill patients.

Methods: Residents from seven adult disciplines participated in this annual program during intern year.

Consistency of triage scores by presenting complaint pre- and post-implementation of a real-time electronic triage decision support tool.

Objective: eCTAS is a real-time electronic decision-support tool designed to standardize the application of the Canadian Triage and Acuity Scale (CTAS). This study addresses the variability of CTAS score distributions across institutions pre- and post-eCTAS implementation.

Methods: We used population-based administrative data from 2016-2018 from all emergency departments (EDs) that had implemented eCTAS for 9 months.

Management of Postpartum Hemorrhage With a Mini-Sponge Tamponade Device.

Background: Postpartum hemorrhage is a leading cause of maternal mortality globally. A tamponade agent that can be quickly and easily placed in a range of settings could advance the treatment of atonic hemorrhage.

Method: We adapted a highly effective trauma dressing for use in postpartum hemorrhage.

Influence of Socioeconomic Bias on Emergency Medicine Resident Decision Making and Patient Care.

Introduction: Physician bias impacts clinical decision making, resulting in disparities in patient care. Most existing studies focus on sex and racial bias. This study aimed to investigate disparities in physician decision making among patients of varying socioeconomic status (SES).

Sex differences in response to a high fat, high sucrose diet in both the gut microbiome and hypothalamic astrocytes and microglia.

: Obesity is a major epidemic in our population and has emerged as a primary health concern. Consumption of a high fat, high sugar (HFHS) diet can specifically lead to gut dysbiosis, increased inflammation, and neuroinflammation. Interestingly, sex differences in the response to a HFHS diet are emerging.

Interrater Reliability, Accuracy, and Triage Time Pre- and Post-implementation of a Real-Time Electronic Triage Decision-Support Tool.

Study Objective: The electronic Canadian Triage and Acuity Scale (eCTAS) is a real-time electronic triage decision-support tool designed to improve patient safety and quality of care by standardizing the application of the Canadian Triage and Acuity Scale (CTAS). The objective of this study is to determine interrater agreement of triage scores pre- and post-implementation of eCTAS.

Methods: This was a prospective, observational study conducted in 7 emergency departments (EDs), selected to represent a mix of triage documentation practices, hospital types, and patient volumes.

Simulation-based interdisciplinary education improves intern attitudes and outlook toward colleagues in other disciplines.

Background: Cooperative interdisciplinary patient care is a modern healthcare necessity. While various medical and surgical disciplines have independent educational requirements, a system-wide simulation-based curriculum composed of different disciplines provides a unique forum to observe the effect of interdisciplinary simulation-based education (IDSE). Our hypothesis: IDSE positively affects intern outlook and attitudes towards other medical disciplines.

Development and Empirical Testing of a Novel Team Leadership Assessment Measure: A Pilot Study Using Simulated and Live Patient Encounters.

Background: Team leadership is critical to health care resuscitation team performance. There has been increased focus on competency in team leadership behaviors; however, there is still variability in how team leadership is assessed within emergency medicine. The objective of this study was to develop and pilot a novel team leadership assessment measure for emergency medicine resuscitation teams.

A Mixed-methods Comparison of Participant and Observer Learner Roles in Simulation Education.

Background: Traditional simulation-based education prioritizes participation in simulated scenarios. The educational impact of observation in simulation-based education compared with participation remains uncertain. Our objective was to compare the performances of observers and participants in a standardized simulation scenario.

Emergency Physician Use of the Alberta Netcare Portal, a Province-Wide Interoperable Electronic Health Record: Multi-Method Observational Study.

Background: The adoption and use of an electronic health record (EHR) can facilitate real-time access to key health information and support improved outcomes. Many Canadian provinces use interoperable EHRs (iEHRs) to facilitate health information exchange, but the clinical use and utility of iEHRs has not been well described.

Objective: The aim of this study was to describe the use of a provincial iEHR known as the Alberta Netcare Portal (ANP) in 4 urban Alberta emergency departments.

Nursing duties and accreditation standards and their impacts: The nursing perspective.

Background: Medical advances and increasingly complex patients presenting to the Emergency Department (ED) make nursing challenging. Gaining new knowledge and skills is a perpetual requirement. New quality initiatives to improve patient safety and care are being constantly introduced and create significant work and time pressures for healthcare providers involved.

Palliative care in the emergency department: an educational investigation and intervention.

Background: To investigate the value of a novel simulation-based palliative care educational intervention within an emergency medicine (EM) residency curriculum.

Methods: A palliative care scenario was designed and implemented in the simulation program at an urban academic emergency department (ED) with a 3-year EM residency program. EM residents attended one of eight high-fidelity simulation sessions, in groups of 5-6.