Virtual Obstetric Emergency Simulations: Enhancing Knowledge, Skills, and Confidence of Emergency Medicine and Obstetric Professionals.

Objective:  Between 2008 and 2016, 23% of pregnancy-related deaths in Ohio occurred in an emergency department (ED) or outpatient setting. Prior research showed that 98% of Ohio's delivery hospitals conduct obstetric (OB) emergency simulations, whereas only 30% include ED staff. The goal of the grant was to increase the knowledge, skill, and self-efficacy of emergency medicine (EM) professionals in managing OB emergencies.

Infants' and young children's dietary exposures to lead and cadmium: FDA total diet study 2018-2020.

Food can be a source of lead and cadmium exposure for infants and children. Employing a semi-probabilistic approach, dietary exposures to lead and cadmium were assessed for infants 0-11 months (excluding human milk-fed infants) and children 1-6 years using U.S.

Rising to the COVID-19 Challenge: Creating a Remote Experiential Simulation.

This article will describe the creation and implementation of a remote learning failure to rescue (FTR) class with remote experiential simulation technology into a nurse residency program. The COVID-19 pandemic impacted traditional delivery methods for education within nurse residency programs. Following is the background of this hospital's nurse residency program and FTR curriculum and a description of the creation and implementation of a remote FTR class using internally developed remote experiential simulation technology.

Current ecotoxicity testing needs among selected U.S. federal agencies.

U.S. regulatory and research agencies use ecotoxicity test data to assess the hazards associated with substances that may be released into the environment, including but not limited to industrial chemicals, pharmaceuticals, pesticides, food additives, and color additives.

Development of a Balloon Tamponade Task Trainer.

Variceal hemorrhage is a life-threatening complication of patients with cirrhosis. If a patient is hemodynamically unstable and unable to undergo endoscopic therapy, a balloon tamponade device may be placed to temporize the hemorrhage until definitive management may be performed. Placement of these devices may be performed by practitioners of several different medical specialties.

The effect of supplemental high Fidelity simulation training in medical students.

Background: Simulation-based education (SBE) with high-fidelity simulation (HFS) offers medical students early exposure to the clinical environment, allowing development of clinical scenarios and management. We hypothesized that supplementation of standard pulmonary physiology curriculum with HFS would improve the performance of first-year medical students on written tests of pulmonary physiology.

Methods: This observational pilot study included SBE with three HFS scenarios of patient care that highlighted basic pulmonary physiology.

Managing women who decline HIV testing in pregnancy and their infants? A multidisciplinary team guideline.

Objectives: The management of women at high risk of HIV infection who repeatedly decline HIV testing in pregnancy is not covered in any national guideline. In Leeds, we had a case which prompted us to consider maternal rights plus our duty of care to the infant once born.

Methods: Leeds has an established HIV and Syphilis in Pregnancy Multidisciplinary Team (MDT).

A New Technique for Radiographic Visualization of the Scaphotrapeziotrapezoid Joint.

Standard radiographs of the wrist do not provide adequate visualization of the scaphotrapeziotrapezoid joint. A radiographic technique that provides an improved and more complete visualization of the joint compared with routine views is described. [Orthopedics.

Physiologically Triggered Digital Cognitive Aid Facilitates Crisis Management in a Simulated Operating Room: A Randomized Controlled Study.

Introduction: Although the benefits of using cognitive aids in anesthesia care have previously been demonstrated, several challenges remain. It must be presented in a timely manner, and providers must be amenable to using the tool once it is available. We hypothesized that anesthesia residents would perform superiorly when presented with a digital cognitive aid (DCogA) that is automatically triggered by a set vital sign aberration.

Trauma Tactics: Rethinking Trauma Education for Professional Nurses.

According to the National Trauma Institute (2015), trauma accounts for more than 180,000 deaths each year in the United States. Nurses play a significant role in the care of trauma patients and therefore need appropriate education and training (L. ).

A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care.

Background: Reports suggest that gluten sensitivity (GS) exists in the absence of coeliac disease (CD). This clinical entity has been termed noncoeliac gluten sensitivity (NCGS).

Objectives: To determine the population prevalence of self-reported GS and referral characteristics to secondary care.

QM/MM simulation of liquid water with an adaptive quantum region.

The simulation of complex chemical systems often requires a multi-level description, in which a region of special interest is treated using a computationally expensive quantum mechanical (QM) model while its environment is described by a faster, simpler molecular mechanical (MM) model. Furthermore, studying dynamic effects in solvated systems or bio-molecules requires a variable definition of the two regions, so that atoms or molecules can be dynamically re-assigned between the QM and MM descriptions during the course of the simulation. Such reassignments pose a problem for traditional QM/MM schemes by exacerbating the errors that stem from switching the model at the boundary.

The DEDUCE Guided Query tool: providing simplified access to clinical data for research and quality improvement.

In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction--the Duke Enterprise Data Unified Content Explorer (DEDUCE).

Implementation of the European Working Time Directive in an NHS trust: impact on patient care and junior doctor welfare.

To comply with the European Working Time Directive (EWTD), from 1 August 2009, junior doctors are required to work no more than 48 hours per week. In accordance with this, East Sussex Hospitals Trust introduced changes to working practice in August 2007. To assess the impact upon patient care and junior doctor welfare a retrospective observational survey comparing data from the year prior to and the year following August 2007 was conducted.

Evaluating boundary dependent errors in QM/MM simulations.

Hybrid quantum mechanics/molecular mechanics (QM/MM) simulations provide a powerful tool for studying chemical reactions, especially in complex biochemical systems. In most works to date, the quantum region is kept fixed throughout the simulation and is defined in an ad hoc way based on chemical intuition and available computational resources. The simulation errors associated with a given choice of the quantum region are, however, rarely assessed in a systematic manner.

Bone morphogenetic protein signaling pathway plays multiple roles during gastrointestinal tract development.

The bone morphogenetic protein (BMP) signaling pathway plays an essential role during gastrointestinal (GI) tract development in vertebrates. In the present study, we use an antibody that recognizes the phosphorylated and activated form of Smad1, 5, and 8 to examine (by immunohistochemistry) the endogenous patterns of BMP signaling pathway activation in the developing GI tract. We show that the endogenous BMP signaling pathway is activated in the mesoderm, the endoderm, and the enteric nervous system (ENS) of the developing chick GI tract and is more widespread than BMP ligand expression patterns.

Kitchen table wisdom: a Freirian approach to medication adherence.

Most interventions to promote medication adherence are based on psychological theories of individual behavior. In contrast, this article describes the theory and practice of a socially based adherence intervention that is guided by the educational principles of Paolo Freire. This approach asserts that adherence is influenced by the patient's social context and attempts to improve adherence through identifying social constraints on adherence behavior.

Collaborative practice: development, implementation, and evaluation of a weaning protocol for patients receiving mechanical ventilation.

Background: Use of protocols to reduce weaning time for patients receiving mechanical ventilation helps reduce cost and length of stay. However, implementation of this type of protocol is not easy and requires a consistent collaborative effort.

Objective: To provide a systematic approach to the weaning process by developing, implementing, and evaluating a protocol for weaning patients from mechanical ventilation in a medical respiratory intensive care unit.

The structure and expression of the human neuroligin-3 gene.

The neuroligins are a family of proteins that are thought to mediate cell to cell interactions between neurons. During the sequencing at an Xq13 locus associated with a mental retardation syndrome in some studies, we discovered a portion of the human orthologue of the rat neuroligin-3 gene. We now report the structure and the expression of that gene.

The Senior Psychiatrist Survey III: attitudes towards personal ageing, life experiences and psychiatric practice.

Objective: The aim of this study is: to explore whether there is a relationship between the effects of gender, age and perceptions of personal health on psychiatrist's reactions to personal ageing; and to determine the effects of psychiatrist's reactions to personal ageing upon their approach to clinical practice, retirement planning and post-retirement activities.

Method: A postal survey was conducted. Respondents were Fellows of the Royal Australian and New Zealand College of Psychiatrists resident in Australia or New Zealand.

The Senior Psychiatrist Survey II: experience and psychiatric practice.

Objective: The aim of this study is to determine the effects of experience on the practice, roles, status and attitudes of psychiatrists within the Royal Australian and New Zealand College of Psychiatrists (RANZCP).

Method: A postal survey of Fellows of the RANZCP resident in Australia or New Zealand was conducted. The main outcome measures were: years of psychiatric experience; higher medical qualifications; location and type of psychiatric practice; attitudes about senior psychiatrists and mentorship; changes in work practices over the career; and the perceived benefits and drawbacks of experience on psychiatric practice and case selection.

The Senior Psychiatrist Survey I: age and psychiatric practice.

Objective: The aim of this study is to determine the effects of age on the practice, roles, status and attitudes of psychiatrists within the Royal Australian and New Zealand College of Psychiatrists (RANZCP).

Method: A postal survey of Fellows of the RANZCP resident in Australia or New Zealand was conducted. The main outcome measures were: age; location and type of psychiatric practice; hours of work; attitudes towards re-accreditation; changes in work practices over the career; and the perceived benefits and drawbacks of age to psychiatric practice and case selection.

The genomic structure and developmental expression patterns of the human OPA-containing gene (HOPA).

We determined the genomic organization of the human OPA-containing gene (HOPA) and characterized its developmental expression. The gene encoding HOPA, which contains a rare polymorphism tightly associated with non-specific mental retardation, is 25 kb in length and consists of 44 exons. A promoter scan analysis demonstrates two possible transcription initiation sites without TATA boxes upstream from the putative translation initiation start site.

Two novel polymorphic sequences in the glucocerebrosidase gene region enhance mutational screening and founder effect studies of patients with Gaucher disease.

Gaucher disease, an inherited glycolipid storage disorder, is caused by a deficiency of the catabolic enzyme glucocerebrosidase (EC 3.2.1.