Improving Resident Physician History and Physical in Challenging Situations.

Objective: To educate physician trainees using simulation on best management of children with autism spectrum disorder who have neurocognitive and behavioral challenges when experiencing acute illness.

Method: A simulation-based curriculum including baseline assessment, communication techniques, and use of calming resources was developed to educate residents in assessing children with sensory barriers. Traditional simulation and deliberate practice were used to teach this curriculum to second- and third-year pediatric and internal medicine-pediatric residents.

Molecular Strain Accelerates Electron Transfer for Enhanced Oxygen Reduction.

Fe-N-C materials are emerging catalysts for replacing precious platinum in the oxygen reduction reaction (ORR) for renewable energy conversion. However, their potential is hindered by sluggish ORR kinetics, leading to a high overpotential and impeding efficient energy conversion. Using iron phthalocyanine (FePc) as a model catalyst, we elucidate how the local strain can enhance the ORR performance of Fe-N-Cs.

Vaginal delivery of the second twin: simulation to improve trainee knowledge and comfort.

Background: Vaginal delivery in twins is feasible but challenging. Successful vaginal delivery of a non-vertex second twin depends on knowledge of specific obstetrical maneuvers. Skill acquisition at the patient's bedside is difficult, making simulation training an integral part of obstetrics and gynecology residency programs.

Sacrificial MOF-derived MnNi hydroxide for high energy storage supercapacitor electrodes via DFT-based quantum capacitance study.

Electrochemical energy storage plays a critical role in the transition to clean energy. With the growing demand for efficient and sustainable energy solutions, supercapacitors have gained significant attention due to their high specific capacitance, rapid charge/discharge capabilities, long lifespan, safe operation across various temperatures, and minimal maintenance needs. This study introduces a novel approach for the synthesis of high-performance supercapacitor electrodes by using MnNi-MOF-74 as a precursor.

Periductal Mastitis Occurring Among Hubble-Bubble Smokers: A Report of Two Cases and Literature Review.

Periductal mastitis (PM) is a form of nonlactational mastitis. The clinical picture varies from mild periareolar inflammation to frank retroareolar abscess formation. A huge amount of literature is incriminating cigarette smoking as a major contributing factor to the etiology of PM, and cessation of smoking is essential for a successful treatment.

Localizing and Tailoring the Debriefing Assessment for Simulation in Healthcare to Optimize Fit.

Introduction Debriefing in healthcare simulation is helpful in reinforcing learning objectives, closing performance gaps, and improving future practice and patient care. The Debriefing Assessment for Simulation in Healthcare (DASH) is a validated tool. However, localized rater training for the DASH has not been described.

Nonprecious Triple-Atom Catalysts with Ultrahigh Activity for Electrochemical Reduction of Nitrate to Ammonia: A DFT Screening.

Electrochemical nitrate reduction to ammonia (NORR) is promising to not only tackle environmental issues caused by nitrate but also produce ammonia at room temperatures. However, two critical challenges are the lack of effective electrocatalysts and the understanding of related reaction mechanisms. To overcome these challenges, we employed first-principles calculations to thoroughly study the performance and mechanisms of triple-atom catalysts (TACs) composed of transition metals (including 27 homonuclear TACs and 4 non-noble bimetallic TACs) anchored on N-doped carbon (NC).

Distance simulation in surgical education.

Distance and remote simulation have emerged as vital tools in modern surgical education, offering solutions to challenges such as limited operating hours, growing clinical demands, and the need for consistent, high-quality training. This review examines the benefits, limitations, and strategies for implementing sustainable distance simulation, structured around 3 foundational pillars: (1) effective hardware and infrastructure, including simulators and realistic scenarios that enable trainees to develop essential skills; (2) validated training programs grounded in educational theory with a clear focus on skill transfer and predictive validity; and (3) timely access to effective feedback. Distance simulation permits adaptable, scalable training environments, but the addition of remote and deferred feedback has further broadened its impact, helping to overcome the challenges posed by faculty availability and clinician time constraints.

Dynamic supramolecular snub cubes.

Mimicking the superstructures and properties of spherical biological encapsulants such as viral capsids and ferritin offers viable pathways to understand their chiral assemblies and functional roles in living systems. However, stereospecific assembly of artificial polyhedra with mechanical properties and guest-binding attributes akin to biological encapsulants remains a formidable challenge. Here we report the stereospecific assembly of dynamic supramolecular snub cubes from 12 helical macrocycles, which are held together by 144 weak C-H hydrogen bonds.

Metabotropic GABA Receptor Activation Induced by G Protein Coupling.

G protein-coupled receptors (GPCRs) play central roles in regulating cellular responses through heterotrimeric G proteins (GP). Extensive studies have elucidated the complex cellular signaling mediated by GPCRs that accompany dynamic conformational changes upon activation. However, there has been less focus on the role of the GP on the activation process, particularly for class C GPCRs that function as obligate dimers.

Impact of surrogates for insulin resistance on mortality and life expectancy in primary care: a nationwide cross-sectional study with registry linkage (LIPIDOGRAM2015).

Background: Insulin resistance (IR) is an important risk factor for multiple chronic diseases, increasing mortality and reducing life expectancy. The associations between emerging surrogates for IR, triglyceride-glucose index (TyG) and TyG-related indicators, with all-cause mortality and life expectancy in middle-aged and older patients in primary care are unclear.

Methods: This study originated from the Polish primary care cohort LIPIDOGRAM2015, including patients aged ≥45 years.

Tantalum-stabilized ruthenium oxide electrocatalysts for industrial water electrolysis.

The iridium oxide (IrO) catalyst for the oxygen evolution reaction used industrially (in proton exchange membrane water electrolyzers) is scarce and costly. Although ruthenium oxide (RuO) is a promising alternative, its poor stability has hindered practical application. We used well-defined extended surface models to identify that RuO undergoes structure-dependent corrosion that causes Ru dissolution.

Application of Large Language Models in Medical Training Evaluation-Using ChatGPT as a Standardized Patient: Multimetric Assessment.

Background: With the increasing interest in the application of large language models (LLMs) in the medical field, the feasibility of its potential use as a standardized patient in medical assessment is rarely evaluated. Specifically, we delved into the potential of using ChatGPT, a representative LLM, in transforming medical education by serving as a cost-effective alternative to standardized patients, specifically for history-taking tasks.

Objective: The study aims to explore ChatGPT's viability and performance as a standardized patient, using prompt engineering to refine its accuracy and use in medical assessments.

Simulation training with haptic feedback of instrument vibrations reduces resident workload during live robot-assisted sleeve gastrectomy.

Background: New surgeons experience heavy workload during robot-assisted surgery partially because they must use vision to compensate for the lack of haptic feedback. We hypothesize that providing realistic haptic feedback during dry-lab simulation training may accelerate learning and reduce workload during subsequent surgery on patients.

Methods: We conducted a single-blinded study with 12 general surgery residents (third and seventh post-graduate year, PGY) randomized into haptic and control groups.

How many cases do young pediatric surgeons need to experience to achieve autonomy in performing pediatric endoscopic surgery? A nationwide survey to establish an ideal curriculum for pediatric endoscopic surgery in Japan.

Purpose: To ensure the safe prevalence of pediatric endoscopic surgery in Japan, a training curriculum should be established. In addition, the number of pediatric surgical cases is decreasing due to the decreasing birth rate in Japan, and it is necessary to clarify the number of surgical cases required for young pediatric surgeons to achieve autonomy in pediatric endoscopic surgery.

Methods: An online nationwide survey was conducted among young pediatric surgeons with 3-15 years of clinical experience in Japan.

Noninvasive estimation of PaCO from volumetric capnography in animals with injured lungs: an Artificial Intelligence approach.

To investigate the feasibility of non-invasively estimating the arterial partial pressure of carbon dioxide (PaCO) using a computational Adaptive Neuro-Fuzzy Inference System (ANFIS) model fed by noninvasive volumetric capnography (VCap) parameters. In 14 lung-lavaged pigs, we continuously measured PaCO with an optical intravascular catheter and VCap on a breath-by-breath basis. Animals were mechanically ventilated with fixed settings and subjected to 0 to 22 cmHO of positive end-expiratory pressure steps.

A General Nonbonded Force Field Based on Accurate Quantum Mechanics Calculations for Elements H-La and Hf-Rn.

Noncovalent interactions (NCI) play a central role in numerous physical, chemical, and biological phenomena. An accurate description of NCI is the key to success for any theoretical study in such areas. Although quantum mechanics (QM) methods such as dispersion-corrected density functional theory are sufficiently accurate, their applications are practical only for <300 atoms and <100 ps of simulation time.

Comparative effectiveness of self-learning and instructor-assisted pediatric cardiopulmonary resuscitation training: A prospective randomized study.

Background: Unlike that for adults, training for cardiopulmonary resuscitation of infant and child is scarce, and warrants efforts for greater accessibility. Effective self-learning could expand training accessibility and facilitate the development of effective infant and child cardiopulmonary resuscitation training methods.

Aim: This study was conducted to develop a pediatric cardiopulmonary resuscitation self-learning training program, implement nurse training, and evaluate training effectiveness by comparing trainees' achievement of self-efficacy in pediatric cardiopulmonary resuscitation, with or without instructor assistance.

Breast-Related Herniation: A Call for Multidisciplinary Awareness and a Proposal for a Classification.

Breast-related herniation (BRH) is a vague term for many clinicians. The absence of a universal nomenclature and the different nature of the herniation process involved, being true or false, contribute to this vagueness. BRH includes a spectrum of disorders ranging from a few congenital breast disorders to commoner herniation processes related to acquired breast diseases.

Evaluating the Impact of an Interprofessional Poverty Virtual Simulation Game.

The aim of the study was to compare the impact of a virtual simulation game to a poverty live interactive simulation with regard to perceptions of poverty. An interprofessional sample of pharmacy and nursing students completed pre/post surveys with 13 questions (total possible score: 39); the 395 responses were analyzed using a two-way analysis of variance and descriptive statistics. The virtual group had a score improvement of 3.

Surgical skill analysis focused on tissue traction in laparoscopic wet lab training.

Background: Tissue handling is one of the pivotal parts of surgical procedures. We aimed to elucidate the characteristics of experts' left-hand during laparoscopic tissue dissection.

Methods: Participants performed tissue dissection around the porcine aorta.

Understanding ACGME Standards for Simulation: A Document Analysis of Institutional and Program Requirements.

Our institution has established priorities for graduate medical education (GME) simulation which include increasing adoption of, garnering additional financial support for, and creating a core simulation curriculum. Better understanding of the Accreditation Council for Graduate Medical Education (ACGME) simulation requirements will inform our efforts and serve as a guide for other institutions. The purpose of this study was to perform a structured review of ACGME simulation standards using a document analysis to guide GME simulation activities at an institutional level.

Enhancing risk and crisis communication with computational methods: A systematic literature review.

Recent developments in risk and crisis communication (RCC) research combine social science theory and data science tools to construct effective risk messages efficiently. However, current systematic literature reviews (SLRs) on RCC primarily focus on computationally assessing message efficacy as opposed to message efficiency. We conduct an SLR to highlight any current computational methods that improve message construction efficacy and efficiency.

Development and validity evidence of an interactive 3D model for thoracic and lumbar spinal fractures pedagogy: a first step of validity study.

Background: Thoracic and lumbar spinal fractures are common in trauma care, requiring accurate classification to guide appropriate treatment. While traditional teaching methods use static 2D images, there is a growing need for interactive tools to improve understanding. This study addresses the lack of interactive three-dimensional (3D) models for teaching the AO (Arbeitsgemeinschaft für Osteosynthesefragen) Spine classification for thoracic and lumbar fractures.