An Exploratory Mixed-Methods Analysis of Factors Contributing to Students' Perceptions of Inclusion in Introductory STEM Courses.

In this exploratory mixed-methods analysis of students' perceptions of inclusion in introductory STEM courses for STEM majors, we asked students to rate inclusion in their class and to provide an open-text explanation of their rating. Analyzing 1930 qualitative responses resulted in a codebook containing academic, identity, and nonspecific categories. The majority of responses (>80%) cited academic factors such as interactions between students and instructors or course elements and policies.

Continuous sepsis trajectory prediction using tensor-reduced physiological signals.

The quick Sequential Organ Failure Assessment (qSOFA) system identifies an individual's risk to progress to poor sepsis-related outcomes using minimal variables. We used Support Vector Machine, Learning Using Concave and Convex Kernels, and Random Forest to predict an increase in qSOFA score using electronic health record (EHR) data, electrocardiograms (ECG), and arterial line signals. We structured physiological signals data in a tensor format and used Canonical Polyadic/Parallel Factors (CP) decomposition for feature reduction.

Women With Acute Aortic Dissection Have Higher Prehospital Mortality Than Men.

Background: Acute aortic dissection (AAD) often leads to out-of-hospital cardiac arrest (OHCA) and death before hospital arrival.

Objectives: The purpose of this study was to investigate differences in AAD incidence by sex.

Methods: A population-based study in a city with 121,180 residents was conducted using postmortem computed tomography data to identify patients with AAD who died before hospital arrival in 2008-2020.

Sepsis Trajectory Prediction Using Privileged Information and Continuous Physiological Signals.

The aim of this research is to apply the learning using privileged information paradigm to sepsis prognosis. We used signal processing of electrocardiogram and electronic health record data to construct support vector machines with and without privileged information to predict an increase in a given patient's quick-Sequential Organ Failure Assessment score, using a retrospective dataset. We applied this to both a small, critically ill cohort and a broader cohort of patients in the intensive care unit.

A Study Planning Exercise Associated with Decreased Distraction Levels among Introductory Biology Students.

Students struggle to regulate their learning during independent study sessions. In this study, we ask whether an online behavioral intervention helped introductory students decrease distraction while studying. The intervention consisted of exam 1 reflection, exam 2 planning, and exam 2 reflection exercises.

Focused Cardiac Ultrasound Findings of Fluid Tolerance and Fluid Resuscitation in Septic Shock.

Objectives: Compliance with the fluid bonus component of the SEP-1 (severe sepsis and septic shock management) bundle remains poor due to concerns for iatrogenic harm from fluid overload. We sought to assess whether patients who received focused cardiac ultrasound (FCU) and were found to be fluid tolerant (FT) were more likely to receive the recommended 30 mL/kg fluid bolus within 3 hours of sepsis identification.

Design: Retrospective, observational cohort study.

Changes in neurological outcomes of out-of-hospital cardiac arrest during the COVID-19 pandemic in Japan: a population-based nationwide observational study.

Background: There is growing interest in the indirect negative effects of coronavirus disease 2019 (COVID-19) on mortality. We aimed to assess its indirect effect on out-of-hospital cardiac arrest (OHCA) outcomes.

Methods: We analysed a prospective nationwide registry of 506,935 patients with OHCA between 2017 and 2020.

Perceptions of Gender Stereotypes among Women Residents in Surgical and Nonsurgical Specialties.

Objective: The objective of this study was to determine whether and to what degree residents experience stereotype perception by gender and specialty type (surgical vs nonsurgical).

Methods: A cross-sectional survey was sent to resident physicians across all specialties at a single academic institution in February 2021. The survey items asked whether participants believe residents, faculty, and the public expect men or women to be better physicians on a numerical scale from 1 to 7.

A nested case-control study of untargeted albumin adductomics and acute myeloid leukemia.

Environmental exposures often produce reactive electrophiles in vivo, leading to oxidative stress, which plays a major role in carcinogenesis. These electrophiles frequently form adducts with human albumin, which can be measured to assess in vivo oxidative stress. Here, we aimed to examine the associations between circulatory albumin adducts and acute myeloid leukemia (AML), the most common adult myeloid leukemia that showed consistent associations with environmental exposures.

Workshop, Assessment, and Validity Evidence for Tools Measuring Performance of Knee and Shoulder Arthrocentesis.

Introduction: Musculoskeletal concerns are common, yet residents at our institution lacked arthrocentesis training. We created a workshop to teach residents knee and shoulder arthrocentesis, developed simulated assessment scenarios (SASs) with tools to measure procedural proficiency, and collected validity evidence.

Methods: A multidisciplinary group conducted a modified Delphi to define content for the workshop, SASs, and assessment tools.

Experimental Neurotherapeutics: Surfing the Tidal Wave of New Opportunities.

The subspecialty of experimental neurotherapeutics trains neurologists in discovering and developing new treatments for neurologic diseases. Based on development of exciting new treatments for genetic and inflammatory diseases, we predict that there will be many other breakthroughs. The job market has expanded rapidly in academia, the pharmaceutical industry, government, and not-for-profit sectors; many new opportunities can be anticipated.

Adverse childhood experience categories and subjective cognitive decline in adulthood: an analysis of the Behavioral Risk Factor Surveillance System.

Context: Adverse childhood experiences (ACEs) negatively impact health outcomes later in life, in a dose-dependent relationship; however, little is known about the impact of the individual ACE categories and subjective cognitive decline (SCD) later in life.

Objectives: The aim of this study was to determine the associations among the eight ACEs and SCD.

Methods: We analyzed data from two cycles of the Behavioral Risk Factor Surveillance System (BRFSS; 2019-2020).

Prehospital Administration of Aspirin and Nitroglycerin for Patients With Suspected Acute Coronary Syndrome - A Systematic Review.

Recent guidelines for acute coronary syndrome (ACS) recommend prehospital administration of aspirin and nitroglycerin for ACS patients. However, there is no clear evidence to support this. We investigated the benefits and harms of prehospital administration of aspirin and nitroglycerin by non-physician healthcare professionals in patients with suspected ACS.

Learning Introductory Biology: Students' Concept-Building Approaches Predict Transfer on Biology Exams.

Previous studies have found that students' concept-building approaches, identified a priori with a cognitive psychology laboratory task, are associated with student exam performances in chemistry classes. Abstraction learners (those who extract the principles underlying related examples) performed better than exemplar learners (those who focus on memorizing the training exemplars and responses) on transfer exam questions but not retention questions, after accounting for general ability. We extended these findings to introductory biology courses in which active-learning techniques were used to try to foster deep conceptual learning.

Surfaces with instant and persistent antimicrobial efficacy against bacteria and SARS-CoV-2.

Surfaces contaminated with bacteria and viruses contribute to the transmission of infectious diseases and pose a significant threat to global public health. Modern day disinfection either relies on fast-acting (>3-log reduction within a few minutes), yet impermanent, liquid-, vapor-, or radiation-based disinfection techniques, or long-lasting, but slower-acting, passive antimicrobial surfaces based on heavy metal surfaces, or metallic nanoparticles. There is currently no surface that provides instant and persistent antimicrobial efficacy against a broad spectrum of bacteria and viruses.

Supplemental Oxygen and Acute Myocardial Infarction - A Systematic Review and Meta-Analysis.

In Japan, oxygen is commonly administered during the acute phase of myocardial infarction (MI) to patients without oxygen saturation monitoring. In this study we assessed the effects of supplemental oxygen therapy, compared with ambient air, on mortality and cardiac events by synthesizing evidence from randomized controlled trials (RCTs) of patients with suspected or confirmed acute MI. PubMed was systematically searched for full-text RCTs published in English before June 21, 2020.

Prediction of Postoperative Deterioration in Cardiac Surgery Patients Using Electronic Health Record and Physiologic Waveform Data.

Background: Postoperative hemodynamic deterioration among cardiac surgical patients can indicate or lead to adverse outcomes. Whereas prediction models for such events using electronic health records or physiologic waveform data are previously described, their combined value remains incompletely defined. The authors hypothesized that models incorporating electronic health record and processed waveform signal data (electrocardiogram lead II, pulse plethysmography, arterial catheter tracing) would yield improved performance versus either modality alone.

Performance of a Standardized Clinical Assay for Urinary C-C Motif Chemokine Ligand 14 (CCL14) for Persistent Severe Acute Kidney Injury.

Background: Clinical use of biomarkers requires the development of standardized assays and establishment of cutoffs. Urinary C-C motif chemokine ligand 14 (CCL14) has been validated to predict persistent severe AKI in critically ill patients with established AKI. We now report on the performance of standardized cutoffs using a clinical assay.

Systematic Review and Meta-Analysis of Diagnostic Accuracy to Identify ST-Segment Elevation Myocardial Infarction on Interpretations of Prehospital Electrocardiograms.

The aim of this study was to assess and discuss the diagnostic accuracy of prehospital ECG interpretation through systematic review and meta-analyses. Relevant literature published up to July 2020 was identified using PubMed. All human studies of prehospital adult patients suspected of ST-segment elevation myocardial infarction in which prehospital electrocardiogram (ECG) interpretation by paramedics or computers was evaluated and reporting all 4 (true-positive, false-positive, false-negative, and true-negative) values were included.

Prediction of postoperative cardiac events in multiple surgical cohorts using a multimodal and integrative decision support system.

Postoperative patients are at risk of life-threatening complications such as hemodynamic decompensation or arrhythmia. Automated detection of patients with such risks via a real-time clinical decision support system may provide opportunities for early and timely interventions that can significantly improve patient outcomes. We utilize multimodal features derived from digital signal processing techniques and tensor formation, as well as the electronic health record (EHR), to create machine learning models that predict the occurrence of several life-threatening complications up to 4 hours prior to the event.

Performance of the 0-Hour/1-Hour Algorithm for Diagnosing Myocardial Infarction in Patients With Chest Pain in the Emergency Department - A Systematic Review and Meta-Analysis.

This study assessed the diagnostic performance of the 0-hour/1-hour (0/1-h) algorithm to rule in and rule out acute myocardial infarction (MI) in patients presenting to the emergency department (ED) for suspected acute coronary syndrome without ST-segment elevation, as recommended in the 2015 European Society of Cardiology (ESC) guideline. Following the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy (PRISMA-DTA) guidelines, a systematic review was conducted using the PubMed database from inception to March 31, 2020. We included any article published in English investigating the diagnostic performance of the ESC 0/1-h algorithm for diagnosing MI in patients with chest pain visiting the ED.

Redox Potential Correlates with Changes in Metabolite Concentrations Attributable to Pathways Active in Oxidative Stress Response in Swine Traumatic Shock.

Introduction: Oxidation-reduction (redox) reactions, and the redox potential (RP) that must be maintained for proper cell function, lie at the heart of physiologic processes in critical illness. Imbalance in RP reflects systemic oxidative stress, and whole blood RP measures have been shown to correlate with oxygen debt level over time in swine traumatic shock. We hypothesize that RP measures reflect changing concentrations of metabolites involved in oxidative stress.

Impact of Prehospital 12-Lead Electrocardiography and Destination Hospital Notification on Mortality in Patients With Chest Pain - A Systematic Review.

To achieve early reperfusion therapy for ST-elevation myocardial infarction (STEMI), proper and prompt patient transportation and activation of the catheterization laboratory are required. We investigated the efficacy of prehospital 12-lead electrocardiogram (ECG) acquisition and destination hospital notification in patients with STEMI. This is a systematic review of observational studies.

Teaching Discipline-Based Problem Solving.

Problem solving plays an essential role in all scientific disciplines, and solving problems can reveal essential concepts that underlie those disciplines. Thus, problem solving serves both as a common tool and desired outcome in many science classes. Research on teaching problem solving offers principles for instruction that are guided by learning theories.