Transforming safety culture in neonatal intensive care teams.

Background: Healthcare organisations face widespread challenges in optimising their safety culture, especially amid conflicting stakeholder needs, staffing shortages and increasing acuity of patients. McMaster University Children's Hospital Neonatal Intensive Care Unit developed a safety culture programme that prioritises the needs of patients, hospital staff and learners altogether.

Methods: The safety culture programme and activities revolve around six primary drivers: psychological safety, provider well-being, equity, diversity and inclusion, teamwork and communication, organisational learning and leadership.

Recurrent Xp22.31-Yq11 Unbalanced Translocations: Molecular Diagnosis and Clinical Implications in Three Families.

Unbalanced translocation between chromosomes X and Y is a recurring chromosomal rearrangement. The presence of a derivative chromosome X (derX), where a Yq11-qter segment is attached to the short arm of chromosome X, replacing a terminal Xpter-p22.31, poses challenges for interpretation of findings by prenatal cell-free DNA (cfDNA) screening, establishing genotype-phenotype correlation in male and female individuals, and for genetic counseling.

Restorative function of offshore longline mussel farms with ecological benefits for commercial crustacean species.

Offshore ocean aquaculture is expanding globally to meet the growing demand for sustainable food production. At the United Kingdom's largest longline mussel farm, we assessed the potential for the farm to improve the habitat suitability for commercially important crustaceans. Modelled distribution patterns (GAM & GLM) predicted the low complexity seabed beneath the mussel farm was 34-94 % less suitable for European lobster (Homarus gammarus) and brown crab (Cancer pagurus) than nearby rocky reefs.

Elucidating the migrations of European seabass from the southern north sea using mark-recapture data, acoustic telemetry and data storage tags.

The movement ecology of European seabass, Dicentrarchus labrax, remains poorly understood, especially in the northern ranges of its distribution. To investigate migration patterns of seabass from the southern North Sea, we combined data from different projects from four countries using various tagging techniques. This resulted in 146 recaptures (out of 5598 externally marked seabass), 138 detected animals (out of 162 seabass fitted with an acoustic transmitter) and 76 archived depth and temperature series (out of 323 seabass with an archival tag).

Wound Fluid Extracellular Microvesicles: A Potential Innovative Biomarker for Wound Healing.

Background: Extracellular vesicles, or microvesicles, are a large family of membrane-bound fluid-filled sacs that cells release into the extracellular environment. Extracellular microvesicles (EMVs) are essential for cell-to-cell communications that promote wound healing. We hypothesize a correlation between the concentration of EMVs in wound fluid and the percentage of wound healing in treated chronic, nonhealing, wounds.

Combining acoustic telemetry with archival tagging to investigate the spatial dynamic of the understudied pollack, Pollachius pollachius.

Combining fish tracking methods is a promising way of leveraging the strengths of each approach while mitigating their individual weaknesses. Acoustic telemetry provides presence information as the fish move within receiver range, eliminating the need for tag recovery. Archival tags, on the other hand, record environmental variables on tag retrieval, enabling continuous path reconstruction of a fish beyond coastal regions.

Impact of Mentoring for Underrepresented Groups in Undergraduate Medical Education: A Systematic Review.

Objectives: Despite efforts to mitigate challenges to advance underrepresented groups (URG) groups' representation in medical education, diversity remains underwhelming. In response to this several mentoring programs to increase diversification within medical education have been implemented. However, the impact of these programs on URG representation across disciplines is unknown.

Extended-Duration Work Shifts in Surgical Specialties: A Systematic Review.

Introduction: There has been widespread international implementation of duration-hour restrictions to prevent surgical resident burnout and promote patient safety and wellbeing of doctors. A variety of Extended-Duration Work Shifts (EDWS) have been implemented, with a variety of studies examining the effect of shift systems on both surgical performance and the stress response unestablished in the literature.

Methods: This was a systematic review evaluating the impact of extended working hours on surgical performance, cognitive impairment, and physiological stress responses.

Detecting sediment recovery below an offshore longline mussel farm: A macrobenthic Biological Trait Analysis (BTA).

Expansion of bivalve aquaculture offshore reports lower environmental impacts compared to inshore farms. Taking a Before-After Control-Impact approach, this study presents the first functional diversity analysis and long-term Biological Trait Analysis (BTA) of infauna functional traits following the development of the United Kingdom's first large-scale, offshore longline mussel farm. Located in an area historically impacted by mobile fishing gear, farm sites had the greatest number of taxa and abundance compared to control sites.

Multisite Quality Improvement Program Within the Project ECHO Diabetes Remote Network.

Background: The telementoring Project ECHO (Extension for Community Healthcare Outcomes) model has been shown to improve disease management in diabetes in many underserved communities. The authors aim to evaluate if ECHO could also be an effective tool for quality improvement (QI) of diabetes care in these communities.

Methods: Thirteen clinics in underserved communities in California and Florida participating in Project ECHO Diabetes were recruited for a 12-month QI program.

The Promising Success of Project Extension for Community Healthcare Outcomes (ECHO) Diabetes: Case Series.

Background: In the United States, there are over 37 million people with diabetes but only 8000 endocrinologists. Therefore, many people with diabetes receive care exclusively from primary care providers (PCPs). To democratize knowledge regarding insulin-requiring diabetes through tele-education, Stanford University and the University of Florida developed Project Extension for Community Healthcare Outcomes (ECHO) Diabetes.

Frequency of complications in intramedullary nailing of open tibial shaft fractures: a systematic review.

Background: Open tibial shaft fractures comprise almost 45% of all open fractures and are frequently the result of high-energy trauma. Due to contamination, limited soft tissue coverage of the tibial shaft and poor tibial blood supply, open tibial shaft fractures are associated with high rates of complication including malunion, non-union and infection. Intramedullary nailing (IMN) is a mainstay of treatment.

Preoperative priming results in improved operative performance with surgical trainees.

Background: Preoperative warm-up regimens are increasingly utilised in the surgical field, however no consensus on benefits of priming across surgical experience has been realised. The aim of this study was to evaluate the impact of simulation preoperative priming on operative performance across levels of resident experience.

Methods: A single-blinded randomised control trial was carried out in a regional surgical training centre.

Community-Acquired Pneumonia: Postpandemic, Not Post-COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic upended our approach to imaging community-acquired pneumonia, and this will alter our diagnostic algorithms for years to come. In light of these changes, it is worthwhile to consider several postpandemic scenarios of community-acquired pneumonia: (1) patient with pneumonia and recent positive COVID-19 testing; (2) patient with air space opacities and history of prior COVID-19 pneumonia (weeks earlier); (3) multifocal pneumonia with negative or unknown COVID-19 status; and (4) lobar or sublobar pneumonia with negative or unknown COVID-19 status. In the setting of positive COVID-19 testing and typical radiologic findings, the diagnosis of COVID-19 pneumonia is generally secure.

Prenatal and fetal diagnosis of trisomy 18 after low-risk cell-free fetal DNA screening: A report of four cases.

Introduction: Non-Invasive Prenatal Screening (NIPS) is a useful screening method for common aneuploidies that can occur in pregnancies. It yields high sensitivities and specificities for the targeted conditions it tests for. Most commonly, these include Trisomies in chromosomes 21, 18, and 13, as well as aneuploidies in chromosomes X and Y.

Surgical Priming Improves Operative Performance in Surgical Trainees: A Crossover Randomized Control Trial.

Objective: The aim of this study was to evaluate the impact of a surgical warm-up using a virtual reality simulator on operative performance.

Design: This was a single-blinded cross-over randomized control trial in a single tertiary Orthopedic training center.

Participants: Orthopedic trainees were recruited, and each morning participants rostered to theatre were randomized to either undergo a simulated surgical procedure on a virtual reality simulation system prior to their first case as primary operator (priming arm), or to perform their usual preparatory routine for surgery (control arm).

Preexisting psychological illness and its association with mortality in lung cancer patients with access to support resources.

Introduction: Diagnosis of lung cancer often results in tremendous stress for most patients, especially in patients with underlying psychological illness. Psychosocial support (consultation with psychologist, psychotherapist, or social worker) referral is considered standard for quality cancer care; however, which patients utilize these resources and how these resources affect patient outcomes remain unclear.

Objectives: We aimed to identify which newly diagnosed lung cancer patients accessed available psychosocial resources and assessed how utilization of these resources correlated with treatment and survival outcomes.

A novel method for identifying coded tags recorded on aquatic acoustic monitoring systems.

Aquatic biotelemetry increasingly relies on using acoustic transmitters ('tags') that enable passive detection of tagged animals using fixed or mobile receivers. Both tracking methods are resource-limited, restricting the spatial area in which movements of highly mobile animals can be measured using proprietary detection systems. Transmissions from tags are recorded by underwater noise monitoring systems designed for other purposes, such as cetacean monitoring devices, which have been widely deployed in the marine environment; however, no tools currently exist to decode these detections, and thus valuable additional information on animal movements may be missed.

Using Peer Power to Reduce Health Disparities: Implementation of a Diabetes Support Coach Program in Federally Qualified Health Centers.

Community health workers (CHWs) provide vital support to underserved communities in the promotion of health equity by addressing barriers related to the social determinants of health that often prevent people living with diabetes from achieving optimal health outcomes. Peer support programs in diabetes can also offer people living with diabetes invaluable support through a shared understanding of the disease and by offsetting diabetes-related stigma. As part of a Project Extension for Community Healthcare Outcomes (ECHO) Diabetes program, participating federally qualified healthcare centers were provided diabetes support coaches (DSCs) to facilitate patient engagement.