Barriers and enablers to achieving clinical procedure competency-based outcomes in a national paediatric training/residency program-a multi-centered qualitative study.

Background: In 2018, the Royal College of Physicians of Ireland revised its paediatric training program to a competency-based medical education (CBME) training/residency curriculum. This included a requirement to achieve competence in a number of core procedural skills to progress within the program. Internationally, simulation-based medical education (SBME) is gaining interest as an effective teaching pedagogy for training procedural skill competency.

Do deepfake videos undermine our epistemic trust? A thematic analysis of tweets that discuss deepfakes in the Russian invasion of Ukraine.

Deepfakes are a form of multi-modal media generated using deep-learning technology. Many academics have expressed fears that deepfakes present a severe threat to the veracity of news and political communication, and an epistemic crisis for video evidence. These commentaries have often been hypothetical, with few real-world cases of deepfake's political and epistemological harm.

Face/Off: Changing the face of movies with deepfakes.

There are growing concerns about the potential for deepfake technology to spread misinformation and distort memories, though many also highlight creative applications such as recasting movies using other actors, or younger versions of the same actor. In the current mixed-methods study, we presented participants (N = 436) with deepfake videos of fictitious movie remakes (such as Will Smith staring as Neo in The Matrix). We observed an average false memory rate of 49%, with many participants remembering the fake remake as better than the original film.

Guidelines for Thrombolytic Therapy for Frostbite.

The data are insufficient to support standardized treatment of all patients with frostbite with thrombolytic therapy. The following guidelines, however, should be applied to all patients with cyanosis persisting proximal to the distal phalanx (Grade 3 or 4 frostbite injury) and demonstrated loss of perfusion at or proximal to the middle phalanx immediately after rewarming.

Profiling emergency department presentations of 14-15-year-olds in modern Ireland.

Background: Mid-adolescence, that twilight era when the human child transitions to adulthood, is an often overlooked developmental age yet harbours a subpopulation of patients with their own myriad of medical problems somewhat unique to their age group.

Aims: Our study is aimed at reviewing the typical presentations to a paediatric emergency department of modern Irish teenagers in mid-adolescence, the profile of which has changed significantly over the past 10 years.

Methods: Hospital electronic databases were used to conduct a retrospective review of the paediatric emergency department presentations of patients aged 14-15 years during the year of 2017.

A case of peripheral ulcerative keratitis associated with neutrophilic dermatosis of the dorsal hand.

We report a case of peripheral ulcerative keratitis associated with neutrophilic dermatosis of the dorsal hand, a recently described clinical entity. A 68-year-old man presented with concurrent peripheral ulcerative keratitis of the right eye and neutrophilic dermatosis of the dorsal hand causing pustular skin eruptions on the dorsal surface of both hands. Systemic investigations suggested an underlying diagnosis of Wegener's granulomatosis.

Ethical, legal, psychosocial, and cultural implications of genomics for oncology nurses.

Objectives: To summarize the role of oncology nurses in the ethical, legal, psychosocial, and cultural issues inherent in genetic testing for hereditary cancer risk and to describe the recent trend and implications of direct-to-consumer genetic tests.

Data Sources: Published articles/books, legal rulings, professional organization statements.

Conclusions: Ethical, legal, psychosocial, and cultural implications are inherent in the growing field of genetic science that is transforming modern health care.

Health care professionals' views of sharing information with families who have a child with a genetic condition.

The purpose of this study was to examine health care professionals' views and strategies for individualizing information sharing in families who have a child with a genetic condition. The sample consisted of 37 health professionals from three clinical sites in the greater metropolitan area of a large Midwestern city. Qualitative content thematic analysis was used to analyze data from the health professionals' semi-structured interviews.

Evaluation of nanostructural, mechanical, and biological properties of collagen-nanotube composites.

Collagen I is an essential structural and mechanical building block of various tissues, and it is often used as tissue-engineering scaffolds. However, collagen-based constructs reconstituted in vitro often lacks robust fiber structure, mechanical stability, and molecule binding capability. To enhance these performances, the present study developed 3-D collagen-nanotube composite constructs with two types of functionalized carbon nanotubes, carboxylated nanotubes and covalently functionalized nanotubes (CFNTs).

Group C streptococcal subperiosteal abscess of the orbit.

Group C Streptococcus is a well recognised pathogen in acute pharyngitis and sinusitis. To our knowledge group c streptococcus has not been reported to cause orbital cellulitis or subperiosteal abscess. We wish to report a case of a child with orbital subperiosteal abscess caused by Group C streptococcus.

Presymptomatic genetic testing in children for neurofibromatosis 2.

Genetic testing in children, when there is a question of whether or not there is a clear medical benefit that will accrue to the child, is a controversial topic within the health care community. A convenience sample of 10 parents from nine families who had made the decision whether or not to test their children for the neurofibromatosis 2 gene mutation was asked in interviews to describe why they made their choice about presymptomatic testing for this late-onset disease. Findings from a narrative analysis revealed how the nine parents who tested or intended to test their young children saw the decision as a pathway to knowledge that would help the family unit.

Slightly hypertonic saline and dextran-40 in resuscitation of methamphetamine burn patients.

The inherent danger of illegal manufacture of methamphetamine is explosion and fire with the "cookers" presenting to burn centers for treatment. Recent studies have shown that methamphetamine burn patients required resuscitation volumes two to three times that of the standard Parkland formula and experienced a higher mortality rate. The purpose of this study was to compare the fluid resuscitation requirements and other characteristics of our methamphetamine-positive burn patients with a control group of methamphetamine-negative burn patients.

Investigation into the multidimensional genetic basis of drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis.

Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe blistering skin diseases, which are mainly caused by drugs. The two idiosyncratic conditions are distinguished on the basis of the degree of blistering, possibly representing diseases at different ends of the same spectrum. A genetic predisposition has been postulated.

Keratectasia as a presentation of surgically induced necrotizing sclerokeratitis (SINS).

Purpose: A case of keratectasia is reported as a severe presentation of surgically induced necrotizing sclerokeratitis (SINS).

Methods: A 72-year-old white woman had a painful, raised lesion on the superior cornea of her right eye 3 years after uncomplicated extracapsular cataract extraction with intraocular lens implantation. Examination showed a large ectatic area of the superior cornea with inflamed sclera adjacent to the surgical wound, which was diagnosed as SINS.

Issues in genetic testing of children.

Commentary about the ethical issues involved in the genetic testing in children (GTIC) has centered around beliefs that early testing of children when no medical benefits are anticipated should be discouraged. This article discusses the types of GTIC and the contexts of possible testing scenarios, and provides a review of the current research into the effects of such testing on children and their families. As data cannot support either substantive benefits or harms accrued after GTIC, it is recommended that the traditional ethical analysis based on principled theory be augmented by theories that reflect a family-centered ethic.

Randomized clinical study of Hydrofiber dressing with silver or silver sulfadiazine in the management of partial-thickness burns.

This prospective, randomized study compared protocols of care using either AQUACEL Ag Hydrofiber (ConvaTec, a Bristol-Myers Squibb company, Skillman, NJ) dressing with silver (n = 42) or silver sulfadiazine (n = 42) for up to 21 days in the management of partial-thickness burns covering 5% to 40% body surface area (BSA). AQUACEL Ag dressing was associated with less pain and anxiety during dressing changes, less burning and stinging during wear, fewer dressing changes, less nursing time, and fewer procedural medications. Silver sulfadiazine was associated with greater flexibility and ease of movement.

An open-label study to evaluate the safety and efficacy of tissue plasminogen activator in treatment of severe frostbite.

Background: Severe frostbite can have devastating consequences with loss of limbs and digits. One of the mechanisms of cold injury to human tissue is vascular thrombosis. The effect of tissue plasminogen activator (tPA) and heparin in limb and digit preservation in severe frostbite patients has not been previously studied.

Genetic testing of children: confluence or collision between parents and professionals?

Nursing has been challenged to lead in all areas of knowledge development in genetics. In addition to participation in genetic counseling and research, the profession must be an advocate for the proper use of new clinical practices in genetic care. One of these areas is the largely unregulated practice of genetic testing of minor children.