Medical Students' Perceptions on Identifying and Addressing Emotional Responses in Emergency Medicine: Pilot Investigation.

Background: Training in acute care, such as emergency medicine (EM), where exposure to critically ill and injured patients is high, impacts the well-being of trainees and contributes to burnout. Investigating how, and if, trainees prepare for these situations is necessary to ensure they are supported.

Objective: This study aimed to evaluate medical students' perspectives and emotional preparedness for handling acute care and trauma.

Beyond quality and quantity: Spatial distribution of contact encodes frictional strength.

Classically, the quantity of contact area A_{R} between two bodies is considered a proxy for the force of friction. However, bond density across the interface-quality of contact-is also relevant, and contemporary debate often centers around the relative importance of these two factors. In this work, we demonstrate that a third factor, often overlooked, plays a significant role in static frictional strength: The spatial distribution of contact.

A Consensus-Driven Revision of the Accreditation Council for Graduate Medical Education Case Log System: Pediatric Anesthesiology Fellowship Education.

Background: Clinical experiences, quantified by case logs, are an integral part of pediatric anesthesiology fellowship programs. Accreditation of pediatric anesthesiology fellowships by the Accreditation Council of Graduate Medical Education (ACGME) and establishment of case log reporting occurred in 1997 and 2009, respectively. The specialty has evolved since then, but the case log system remains largely unchanged.

Evaluation of Autologous Protein Solution Injection for Treatment of Superficial Digital Flexor Tendonitis in an Equine Model.

Autologous protein solution (APS) has been used anecdotally for intralesional treatment of tendon and ligament injuries, however, its use in these injuries has never been studied . Our objective was to evaluate the effect of APS on tendon healing in an equine superficial digital flexor (SDF) tendonitis model. We hypothesized intralesional injection of APS would result in superior structural and biomechanical healing.

Association between behavioral phenotypes and response to a physical activity intervention using gamification and social incentives: Secondary analysis of the STEP UP randomized clinical trial.

Participants often vary in their response to behavioral interventions, but methods to identify groups of participants that are more likely to respond are lacking. In this secondary analysis of a randomized clinical trial, we used baseline characteristics to group participants into distinct behavioral phenotypes and evaluated differential responses to a physical activity intervention. Latent class analysis was used to segment participants based on baseline participant data including demographics, validated measures of psychosocial variables, and physical activity behavior.

Assessing the effects of maternal HIV infection on pregnancy outcomes using cross-sectional data in Malawi.

Background: Several studies have shown that maternal HIV infection is associated with adverse pregnancy outcomes such as low birth weight and perinatal mortality. However, the association is conflicted with the effect of antiretroviral therapy (ART) on the pregnancy outcomes and it remains unexamined. If the association is confirmed then it would guide policy makers towards more effective prevention of mother to child HIV transmission interventions.

Transforming Mental Health Delivery Through Behavioral Economics and Implementation Science: Protocol for Three Exploratory Projects.

Background: Efficacious psychiatric treatments are not consistently deployed in community practice, and clinical outcomes are attenuated compared with those achieved in clinical trials. A major focus for mental health services research is to develop effective and cost-effective strategies that increase the use of evidence-based assessment, prevention, and treatment approaches in community settings.

Objective: The goal of this program of research is to apply insights from behavioral economics and participatory design to advance the science and practice of implementing evidence-based practice (EBP) for individuals with psychiatric disorders across the life span.

Title: efficacy of a food parenting intervention for mothers with low income to reduce preschooler's solid fat and added sugar intakes: a randomized controlled trial.

Background: Few interventions have shown efficacy to influence key energy balance behaviors during the preschool years.

Objective: A randomized controlled trial (RCT) was used to evaluate the efficacy of Food, Fun, and Families (FFF), a 12 week authoritative food parenting intervention for mothers with low-income levels, to reduce preschool-aged children's intake of calories from solid fat and added sugar (SoFAS).

Methods: Mothers were randomly assigned to receive FFF (n = 59) or to a delayed treatment control (n = 60).

Update on simulation for the Neonatal Resuscitation Program.

The goal of the Neonatal Resuscitation Program is to have a trained provider in neonatal resuscitation at every delivery. The Neonatal Resuscitation Program develops its course content on review of the scientific evidence available for the resuscitation of newborns. Just as importantly, the educational structure and delivery of the course are based on evidence and educational theory.

The genetics of blood pressure regulation and its target organs from association studies in 342,415 individuals.

To dissect the genetic architecture of blood pressure and assess effects on target organ damage, we analyzed 128,272 SNPs from targeted and genome-wide arrays in 201,529 individuals of European ancestry, and genotypes from an additional 140,886 individuals were used for validation. We identified 66 blood pressure-associated loci, of which 17 were new; 15 harbored multiple distinct association signals. The 66 index SNPs were enriched for cis-regulatory elements, particularly in vascular endothelial cells, consistent with a primary role in blood pressure control through modulation of vascular tone across multiple tissues.

Traumatic Shoulder Dislocation Among Adolescents: Hill-Sachs Lesion Volume and Recurrent Instability.

Background: Accurate assessment of Hill-Sachs lesions (HSLs) and their relationship to the glenoid track is essential to optimizing management following traumatic shoulder dislocation. The purpose of this study was to measure the size of HSLs by a novel method with magnetic resonance (MR) arthrography and to investigate the relationship between lesion size and instability history in adolescents (below 19 y of age) with a history of traumatic dislocation.

Methods: All shoulder MR arthrograms queried to identify HSLs over a 4-year period were retrospectively reviewed and independently evaluated by 2 blinded musculoskeletal radiologists.

Mouse mammary tumor virus suppresses apoptosis of mammary epithelial cells through ITAM-mediated signaling.

Many receptors in hematopoietic cells use a common signaling pathway that relies on a highly conserved immunoreceptor tyrosine-based activation motif (ITAM), which signals through Src family tyrosine kinases. ITAM-bearing proteins are also found in many oncogenic viruses, including the mouse mammary tumor virus (MMTV) envelope (Env). We previously showed that MMTV Env expression transformed normal mammary epithelial cells and that Src kinases were important mediators in this transformation.

Engineering of a periodontal ligament construct: cell and fibre alignment induced by shear stress.

Aim: We report an in vitro technique to establish alignment of collagen fibres and cells within a three-dimensional tissue equivalent that mimics the natural periodontal ligament (PDL) using a novel custom-designed bioreactor.

Material And Methods: Shear stress was applied to the tissue equivalent prepared with collagen solution and seeded with human PDL cells. Stress-strain dynamics and the alignment of collagen fibres and PDL cells in tissue equivalents were analysed.

Multicenter pivotal trial results of the Lifepath System for endovascular aortic aneurysm repair.

Purpose: This study was undertaken to assess the results of endovascular aortic aneurysm repair with the Lifepath abdominal aortic aneurysm (AAA) graft system.

Method: In a prospective clinical trial, 23 centers used the Lifepath System balloon-expandable, modular bifurcated stent graft for elective endovascular aortic aneurysm repair. Stent grafts were sized according to computed tomographic angiography-based diameter measurements.

Real-time inverse kinematics techniques for anthropomorphic limbs.

In this paper we develop a set of inverse kinematics algorithms suitable for an anthropomorphic arm or leg. We use a combination of analytical and numerical methods to solve generalized inverse kinematics problems including position, orientation, and aiming constraints. Our combination of analytical and numerical methods results in faster and more reliable algorithms than conventional inverse Jacobian and optimization-based techniques.

Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer.

Purpose: To identify factors that may predict for severe radiation pneumonitis or pneumonopathy (RP), we reviewed a set of simple, commonly available characteristics.

Methods And Materials: Medical records of 148 lung cancer patients with good performance status (ECOG 0-1) treated definitively with chemoradiation from 6/92-6/98 at the University of Pennsylvania were reviewed. Actuarial survival and the crude rate of severe radiation pneumonitis were determined as a function of several variables.

The peroxisome proliferator-activated receptor gamma 2 Pro12Ala mutation is associated with early onset extreme obesity and reduced fasting glucose.

We screened the peroxisome proliferator activated receptor gamma 2 (PPAR gamma 2) for sequence variants in 165 unrelated obese (BMI >/= 30 kg/m(2)) Caucasian women, and 49 normal weight Caucasian female controls (BMI < 27 kg/m(2)). The allele frequency of the Pro12Ala mutation was higher in obese(18.18%) than in normal weight women (8.

Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night.

To determine whether a cumulative sleep debt (in a range commonly experienced) would result in cumulative changes in measures of waking neurobehavioral alertness, 16 healthy young adults had their sleep restricted 33% below habitual sleep duration, to an average 4.98 hours per night [standard deviation (SD) = 0.57] for seven consecutive nights.

Identification of an Spl-like element within the immunoglobulin kappa 3' enhancer necessary for maximal enhancer activity.

A number of functional DNA sequences have been identified within the murine immunoglobulin kappa 3' enhancer (kappaE3'). These DNA sequences were identified using plasmid reporter constructs in which the centrally active core region (or mutants of that region) of the enhancer was placed directly adjacent to the promoter of a reporter construct. Functional DNA sequences thus identified were found to bind to the transcription factors PU.

The chemokine C10: immunological and functional analysis of the sequence encoded by the novel second exon.

The gene for C10, a member of the beta-chemokine family of cytokines, contains a novel second exon encoding a 16 amino acid sequence which is inserted into the amino-terminal region of the protein. We propose a model of C10 structure in which the sequence encoded by the second exon is located on the surface of the protein where it interacts with receptors and defines the predominant epitope of the C10 protein. To test this model we produced C10 protein without the sequence encoded by the second exon, termed C10(-).

Pericardial blood activates the extrinsic coagulation pathway during clinical cardiopulmonary bypass.

Background: Coagulation during cardiopulmonary bypass (CPB) traditionally has been attributed to activation of the contact system of plasma proteins and the intrinsic coagulation pathway by blood contact with negatively charged surfaces not lined by endothelium. Recent studies have focused on the possible role of the extrinsic coagulation pathway during cardiac surgery. We postulated that the wound activates the extrinsic coagulation pathway during CPB by producing procoagulant cells and enzymes that enter the general circulation.

Regionally and temporally distinct patterns of induction of c-fos, c-jun and junB mRNAs following experimental brain injury in the rat.

Lateral (parasagittal) fluid-percussion brain injury of mild (1.0-1.5 atm) and moderate (2.