Proceedings: Sixth International Futures of Aviation Medicine Symposium.

In June 2024, leaders in aviation medicine from across the United States, Canada, and Europe met for the sixth Leonardo Helicopters/Association of Critical Care Transport: The Path to High Reliability Futures of Aviation Medicine Symposium in Miami, FL. The symposia, now held every few years, grew from the 2003 Air Medical Leadership Congress: Setting the Healthcare Agenda for the Air Medical Community. The meetings' goal is to gather leaders to distill, debate, and synthesize the state of the science while identifying, refining, and outlining conditions facilitating favorable evolution in civilian aviation medicine.

Expanding Access to Psychiatric Care Through Universal Depression Screening: Lessons from an Urban Student-Run Free Clinic.

The purpose of this study is to report the utility of a universal depression screening in a student-run free clinic (SRFC) to improve bridging to psychiatric care. Patients (n = 224) seen by an SRFC between April 2017 and November 2022 were screened for depression in the patient's primary language using the standardized Patient Health Questionnaire (PHQ-9). A PHQ-9 score greater or equal to 5 prompted psychiatry referral.

Examining the Rate of Clostridioides (Formerly Clostridium) Difficile Infection Pre- and Post-COVID-19 Pandemic: An Institutional Review.

Background/ Rationale infection (CDI) is transmitted via the fecal-oral route and is implicated in antibiotic-associated colitis. Similar to CDI, patients with coronavirus disease 2019 (COVID-19) require early identification and isolation, appropriate personal protective equipment, and environmental disinfection to prevent further transmission. In light of this similarity between isolation and protective requirements to prevent transmission of these diseases, we aim to investigate whether there was a decrease in the incidence of CDI during the peak periods of the COVID-19 pandemic compared to historical rates.

Risk of Hepatobiliary-Gastrointestinal Malignancies and Appropriate Cancer Surveillance in Patients With Primary Sclerosing Cholangitis.

Patients with primary sclerosing cholangitis (PSC) are at risk of hepatobiliary and gastrointestinal cancers. Increased risk of cancer is a result of the chronic, progressive fibro-inflammatory state which ultimately results in the destruction of biliary ducts. PSC is often associated with inflammatory bowel disease (IBD).

Effects of Milkfat on the Gut Microbiome of Patients After Bariatric Surgery, a Pilot Study.

Background: The efficacy of bariatric surgery may be in part attributed to altered metabolism via new gut microbiome. Milkfat may promote the growth of microbes that are beneficial in long-term weight loss. Understanding the specific gut microbiome changes after surgery and their relationship to milkfat consumption may yield important strategies for managing obesity after bariatric procedures.

Multidisciplinary team perception of games-based therapy in critical care: A service evaluation.

Background: As survivorship following critical illness improves, there is greater focus on maximizing recovery. As well as physical effects, critical illness often results in cognitive impairments such as delirium, anxiety, or disorientation. In other populations, such as delirium, non-pharmacological approaches to manage these conditions are preferred, including re-orientation and ensuring personal care needs are met.

Designing strategies for eradication of Helicobacter pylori based on prevalence patterns of infection and antibiotic resistance in a low-income, medically underserved community in the United States.

Background: Regional variation in Helicobacter pylori resistance patterns is a significant contributing factor for the ineffectiveness of traditional treatments. To improve treatment outcomes, we sought to create an individualized, susceptibility-driven therapeutic approach among our patient population, which is one of the poorest in the nation. It is medically underserved, minority-predominant and has high incidence of H pylori infection.

Identification of Novel Therapeutic Molecular Targets in Inflammatory Bowel Disease by Using Genetic Databases.

Purpose: Utilization of genetic databases to identify genes involved in ulcerative colitis (UC), Crohn's disease (CD), and their extra-intestinal manifestations.

Methods: Protein coding genes involved in ulcerative colitis (3783 genes), Crohn's disease (3980 genes), uveitis (1043 genes), arthritis (5583 genes), primary sclerosing cholangitis (PSC) (1313 genes), and pyoderma gangrenosum (119 genes) were categorized using four genetic databases. These include Genecards: The Human Gene Database (www.

Cardiac Segmentation With Strong Anatomical Guarantees.

Convolutional neural networks (CNN) have had unprecedented success in medical imaging and, in particular, in medical image segmentation. However, despite the fact that segmentation results are closer than ever to the inter-expert variability, CNNs are not immune to producing anatomically inaccurate segmentations, even when built upon a shape prior. In this paper, we present a framework for producing cardiac image segmentation maps that are guaranteed to respect pre-defined anatomical criteria, while remaining within the inter-expert variability.

The Effect of Single and Multiple Doses of Rifampin on the Pharmacokinetics of Doravirine in Healthy Subjects.

Background And Objective: Doravirine is a novel, next-generation, non-nucleoside reverse transcriptase inhibitor in development for the treatment of human immunodeficiency virus-1 infection in combination with other antiretrovirals. Doravirine is a substrate for cytochrome P450 (CYP) 3A and P-glycoprotein. Rifampin (rifampicin) is used for treating tuberculosis in patients who are co-infected with human immunodeficiency virus.

Leader-team complementarity: Exploring the interactive effects of leader personality traits and team power distance values on team processes and performance.

Integrating the leader trait perspective with dominance complementarity theory, we propose team power distance as an important boundary condition for the indirect impact of leader extraversion, agreeableness, and conscientiousness on team performance through a team's potency beliefs and through relational identification with the leader. Using time-lagged, 3-source data from 71 teams, we found that leader extraversion had a positive indirect impact on team in-role and extrarole performance through relational identification, but only for high power distance teams; leader conscientiousness had a positive influence on team in-role performance through team potency, but only for high power distance teams; and leader agreeableness had a positive effect on team in-role and extrarole performance via relational identification and on team in-role performance via team potency, but only for low power distance teams. The findings address prior inconsistencies regarding the relationships between leader traits and team effectiveness, identify an important boundary condition and key team processes that bridge the links, and provide a deeper understanding of the role of leader traits in teams.

Job attitudes, job satisfaction, and job affect: A century of continuity and of change.

Over the past 100 years, research on job attitudes has improved in the sophistication of methods and in the productive use of theory as a basis for fundamental research into questions of work psychology. Early research incorporated a diversity of methods for measuring potential predictors and outcomes of job attitudes. Over time, methods for statistically assessing these relationships became more rigorous, but the field also became narrower.

Rate and Predictors of Interval Esophageal and Gastric Cancers after Esophagogastroduodenoscopy in the United States.

Background And Aims: In the United States, little is known about the rates of interval upper gastrointestinal (GI) cancer (possibly missed out) after an esophagogastroduodenoscopy (EGD) is performed. Data from non-US studies reported interval cancer rates of 7-26%. We aimed to study the rate and predictors of interval upper GI cancers in the United States.

A genetic database can be utilized to identify potential biomarkers for biphenotypic hepatocellular carcinoma-cholangiocarcinoma.

Background: Biphenotypic hepatocellular carcinoma-cholangiocarcinoma (HCC-CC) is an uncommon primary liver neoplasm. Due to limitations in radiologic imaging for the diagnosis of this condition, biopsy is a common method for diagnosis, which is invasive and holds potential complications. To identify alternative means for obtaining the diagnosis and assessing the prognosis of this condition, we evaluated biomarkers for biphenotypic HCC-CC using a genetic database.

The Acute Physiology and Chronic Health Evaluation IV, a New Scoring System for Predicting Mortality and Complications of Severe Acute Pancreatitis.

Objectives: Severe acute pancreatitis is associated with significant morbidity/mortality; thus, the ability to predict hospital course is imperative. An updated version of the Acute Physiology and Chronic Health Evaluation II (APACHE), APACHE IV, has recently been validated. Unlike other versions, APACHE IV uses hepatobiliary parameters and accounts for multiple comorbid conditions and sedation.

Impact of Video Laryngoscopy on Advanced Airway Management by Critical Care Transport Paramedics and Nurses Using the CMAC Pocket Monitor.

Accurate endotracheal intubation for patients in extremis or at risk of physiologic decompensation is the gold standard for emergency medicine. Field intubation is a complex process and time to intubation, number of attempts, and hypoxia have all been shown to correlate with increases in morbidity and mortality. Expanding laryngoscope technology which incorporates active video, in addition to direct laryngoscopy, offers providers improved and varied tools to employ in management of the advanced airway.

Understanding cycles of abuse: A multimotive approach.

Fundamental to the definition of abusive supervision is the notion that subordinates are often victims of a pattern of mistreatment (Tepper, 2000). However, little research has examined the processes through which such destructive relational patterns emerge. In this study, we draw from and extend the multimotive model of reactions to interpersonal threat (Smart Richman & Leary, 2009) to formulate and test hypotheses about how employees' emotional and behavioral responses may ameliorate or worsen supervisors' abuse.

Differentiation of antiinflammatory and antitumorigenic properties of stabilized enantiomers of thalidomide analogs.

Therapeutics developed and sold as racemates can exhibit a limited therapeutic index because of side effects resulting from the undesired enantiomer (distomer) and/or its metabolites, which at times, forces researchers to abandon valuable scaffolds. Therefore, most chiral drugs are developed as single enantiomers. Unfortunately, the development of some chirally pure drug molecules is hampered by rapid in vivo racemization.

The dispositional basis of attitudes: A replication and extension of Hepler and Albarracín (2013).

As a departure from traditional situational perspectives, researchers have given increased attention to the dispositional basis of attitudes. Recently, Hepler and Albarracín (2013) introduced a construct that they called "dispositional attitude" and provided validity evidence for a new scale--the Dispositional Attitude Measure (DAM). Although the DAM was introduced as a "new" approach for assessing the dispositional component of attitudes, there is considerable conceptual similarity between it and the Neutral Objects Satisfaction Questionnaire (NOSQ; Judge & Bretz, 1993; Weitz, 1952).

What I experienced yesterday is who I am today: relationship of work motivations and behaviors to within-individual variation in the five-factor model of personality.

Historically, organizational and personality psychologists have ignored within-individual variation in personality across situations or have treated it as measurement error. However, we conducted a 10-day experience sampling study consistent with whole trait theory (Fleeson, 2012), which conceptualizes personality as a system of stable tendencies and patterns of intraindividual variation along the dimensions of the Big Five personality traits (Costa & McCrae, 1992). The study examined whether (a) internal events (i.

Hierarchical representations of the five-factor model of personality in predicting job performance: integrating three organizing frameworks with two theoretical perspectives.

Integrating 2 theoretical perspectives on predictor-criterion relationships, the present study developed and tested a hierarchical framework in which each five-factor model (FFM) personality trait comprises 2 DeYoung, Quilty, and Peterson (2007) facets, which in turn comprise 6 Costa and McCrae (1992) NEO facets. Both theoretical perspectives-the bandwidth-fidelity dilemma and construct correspondence-suggest that lower order traits would better predict facets of job performance (task performance and contextual performance). They differ, however, as to the relative merits of broad and narrow traits in predicting a broad criterion (overall job performance).

Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting.

Objective: Recent drug shortages have required the occasional replacement of etomidate for endotracheal intubation (ETI) by helicopter emergency medical services (HEMS), with ketamine. The purpose of this study was to assess whether there was an association between ketamine vs etomidate use as the main ETI drug, with hemodynamic or clinical (airway) end points.

Methods: This retrospective study used data entered into medical records at the time of HEMS transport.

Does the urgency of endoscopic retrograde cholangiopancreatography (ercp)/percutaneous biliary drainage (pbd) impact mortality and disease related complications in ascending cholangitis? (deim-i study).

Background: The Tokyo Guidelines have greatly impacted the management of ascending cholangitis. Though ERCP is the favored modality for biliary decompression, no evidence exists for the timing of ERCP. The DEIM-I study set out to determine if the time from patient presentation to biliary decompression impacted in hospital all cause mortality in ascending cholangitis.