A Pilot Rapid Triage Process for Prehospital ST-Segment Myocardial Infarction Patients Direct to the Catheterization Lab.

Background Rapid treatment of ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) significantly reduces morbidity and mortality rates. Recent studies emphasize the importance of reducing total ischemic time, making first-medical-contact-to-balloon (FMCTB) time a key performance indicator. To improve FMCTB times in patients brought to the Emergency Department (ED) by Emergency Medical Services (EMS), we implemented a "Direct to Lab" (DTL) workflow during the following conditions: weekday daytime hours, when the lab is fully staffed, and for hemodynamically stable STEMI patients presenting via EMS.

Big data analysis: examination of the relationship between candidates' sociodemographic characteristics and performance in the UK's Membership of the Royal College of Physicians Part 1 examination.

Big datasets and data analytics enable granular analyses examining group differences in performance. Our focus is on differential attainment (DA) in postgraduate College (Board) examinations. We asked: Are candidates' sociodemographic characteristics associated with performance on the UK's Membership of the Royal College of Physicians (MRCP) Part 1 after adjusting for medical school performance (MSP) and type of medical programme? This was a retrospective longitudinal cohort study of 6040 medical graduates with linked sociodemographic data in the UK Medical Education Database qualifying from a UK medical school (2012-2014) and sitting MRCP Part 1 before October 2019.

'Maybe we're not past the traditional gender roles then!' Exploring less than full-time training among men in Scotland: a qualitative study.

Objectives: A more sustainable work-life balance is desired by trainees, and increasing access to flexibility in training may improve staff morale and retention. Although a number of less than full-time (LTFT) trainees are increasing, only a minority identify as men. This study aimed to explore the perception and experience of LTFT training among postgraduate medical trainees (PMTs) identifying as men in Scotland.

Advances in Anatomic Total Shoulder Arthroplasty Glenoid Implant Design.

Since the advent of Neer's total shoulder arthroplasty in 1974, glenoid implant design has evolved to optimize patient function and increase implant longevity. Glenoid loosening continues to be a major cause of total shoulder arthroplasty failure due to both patient and implant factors. The more recent development of posterior augmented glenoids, peg fixation with ingrowth potential, inlay implants, zoned conformity implants, and convertible glenoids have all shown promising results in improving glenoid fixation and survival in different clinical circumstances.

Recent fieldwork and fungarium studies double known diversity of and improve understanding of species distributions.

is a small genus comprising five species of inoperculate discomycetes in the order Helotiales (Leotiomycetes) often recognizable by their bright yellowish-green colors and gregarious growth on wood. In this study, we describe five new species-, and -based on a combination of recent fieldwork and examination of previously collected fungarium specimens. We use an integrative taxonomic approach to support the distinction of new species, incorporating morphology and DNA sequence data with biogeography.

Successful Intravascular Lithotripsy Use for Acute Stent Underexpansion in Saphenous Vein Grafts.

Experience with intravascular lithotripsy (IVL) following stent deployment in saphenous vein graft (SVG) lesions is limited. We present 2 cases of percutaneous intervention in SVG in which acute stent underexpansion was successfully managed with IVL. In the first case, recalcitrant plaque required prestent deployment IVL, with intracoronary imaging showing persistent calcification.

Insight Into the Clinical Practices of US-Based Surgical Nongovernmental Organizations.

Introduction: A growing sector of humanitarian surgical nongovernmental organizations (NGOs) is providing care in low- and middle-income countries. Minimal data exists regarding this extremely heterogeneous community. This study aims to describe the demographics and clinical practices of surgical NGOs.

"For us, whatever we do is wrong, until we do something really good": a qualitative study of the lived experiences of doctors from minority ethnic backgrounds in Scotland.

Objectives: To evaluate the lived experiences of doctors from minority ethnic (ME) backgrounds during postgraduate medical training, in particular their experiences of discrimination (if any); any impact of intersectionality and perceptions on how ME doctors may be better supported in their learning and working environments.

Design: This was a qualitative study grounded in social constructivism, using semi-structured online individual interviews as the data collection method and an exploratory thematic analysis process.

Setting: Participants were recruited from postgraduate specialist medical training programmes within one Deanery (Scotland Deanery) in the UK.

Long-term outcomes of liver transplantation for homozygous familial hypercholesterolaemia in Australia and New Zealand.

Background And Aims: Homozygous familial hypercholesterolaemia (FH) causes severe cardiovascular disease from childhood. Conventional drug therapy is usually ineffective; lipoprotein apheresis (LA) is often required. Liver transplantation (LT) can correct the metabolic defect but is considered a treatment of last resort.

Solvent-Free Aerobic Oxidative Cleavage of Methyl Oleate to Biobased Aldehydes over Mechanochemically Synthesized Supported AgAu Nanoparticles.

The performance of mechanochemically synthesized supported bimetallic AgAu nanoalloy catalysts was evaluated in the oxidative cleavage of methyl oleate, a commonly available unsaturated bio-derived raw material. An extensive screening of supports (SiO , C, ZrO , Al O ), metallic ratios (Ag : Au), reaction times, temperatures, and use of solvents was carried out. The performance was optimized towards productivity and selectivity for the primary cleavage products (aldehydes and oxoesters).

Bacterial shedding and serologic responses following an outbreak of Salmonella Typhi in an endemic cohort.

Background: Salmonella enterica serovar Typhi (Salmonella Typhi) is the cause of typhoid fever. Salmonella Typhi may be transmitted through shedding in the stool, which can continue after recovery from acute illness. Shedding is detected by culturing stool, which is challenging to co-ordinate at scale.

'A Unique opportunity to test things out': a qualitative study of broad-based training in Scotland.

Objectives: A recent review recommended UK postgraduate medical education should produce doctors capable of providing general care in broad specialties across a range of different settings. Responding to this, broad-based training (BBT) was introduced in Scotland in 2018 to provide postgraduate trainees with a grounding in four specialties. Introduced as an option for trainees after initial postgraduate 'Foundation' training, it comprises 6 months in general medicine, general practice, paediatrics and psychiatry.

Recognizing the best catalyst for a reaction.

Heterogeneous catalysis is immensely important, providing access to materials essential for the well-being of society, and improved catalysts are continuously required. New catalysts are frequently tested under different conditions making it difficult to determine the best catalyst. Here we describe a general approach to identify the best catalyst using a data set based on all reactions under kinetic control to calculate a set of key performance indicators (KPIs).

Clinical and radiographic outcomes following anatomic total shoulder arthroplasty utilizing an inset glenoid component at 2-year minimum follow-up: a dual center study.

Background: Anatomic total shoulder arthroplasty (aTSA) is a successful and reproducible treatment for patients with painful glenohumeral arthritis. However, long-term outcomes using traditional onlay glenoid components have been tempered by glenoid loosening. Inset components have been proposed to minimize glenoid loosening by reducing edge-loading and opposite-edge lift-off forces with humeral translation.

Train the Trainer in Bleeding Control: A Two-Year Pilot Study in Low-Income and Middle-Income Countries.

Introduction: Traumatic hemorrhage represents a major cause of mortality in low-income and middle-income countries (LMICs). Thus, LMICs can benefit from improvements to prehospital hemorrhage management. One strategy is implementation of a bleeding control course using the "train the trainer" model (TTT) to increase course availability.

Effect of glenosphere lateralization with and without coracoacromial ligament transection on acromial and scapular spine strain in reverse shoulder arthroplasty.

Background: Small changes in deltoid tension and moment arm due to glenosphere lateralization may be associated with an increase in acromion or scapular spine strain in reverse shoulder arthroplasty (RSA), which can lead to stress fracture. The coracoacromial ligament (CAL) may be protective and lower the strain seen on the acromion or scapular spine. This biomechanical study investigated the impact of glenosphere lateralization and CAL integrity on acromion and scapular spine strain after RSA.

Outcomes Between Stemmed and Stemless Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Introduction: Both stemmed and stemless designs for total shoulder arthroplasty (TSA) have demonstrated efficacious outcomes for the surgical treatment of primary glenohumeral joint osteoarthritis. The purpose of this systematic review and meta-analysis was to compare the clinical outcomes of stemmed versus stemless TSA in randomized controlled trials. We hypothesized that there would be no differences in Constant Score (CS), range of motion, or adverse events, such as periprosthetic fracture and/or revision surgery.

Utilising Surrogate Models to Approximate Cardiac Potentials when Solving Inverse Problems via Bayesian Techniques.

Solving inverse problems is computationally expensive, if not infeasible, under specific scenarios. For example, many forward solutions are required when solving inverse problems using Bayesian techniques. In this work, a novel inference protocol is established, that can be used to infer the cardiac bidomain conductivities and the cardiac fibre rotation angle (bidomain parameters).

Paracrine-mediated rejuvenation of aged mesenchymal stem cells is associated with downregulation of the autophagy-lysosomal pathway.

Age-related differences in stem-cell potency contribute to variable outcomes in clinical stem cell trials. To help understand the effect of age on stem cell potency, bone marrow-derived mesenchymal stem cells (MSCs) were isolated from young (6 weeks) and old (18-24 months) mice. HUVEC tubule formation (TF) induced by the old and young MSCs and ELISA of conditioned media were compared to one another, and to old MSCs after 7 d in indirect co-culture with young MSCs.

Species of the common discomycete genus reassigned to at least four genera.

as typically conceived is a genus of noticeable, bright yellow inoperculate discomycetes. This interpretation of the genus, however, is at odds with , the current name of the type species of the genus; furthermore, the genus has been interpreted as including the unusual species . By comparing morphological and molecular traits of species traditionally included in , we show that the genus is polyphyletic, with many "typical" members of the genus belonging instead in in Pezizellaceae.