Simulating Vehicle Movement and Multi-Hop Connectivity from Basic Safety Messages

The Basic Safety Message (BSM) is a standardized communication packet that is sent every tenth of a second between connected vehicles using Dedicated Short Range Communication (DSRC). BSMs contain data about the sending vehicle's state, such as speed, location, and the status of the turn signal. Currently, many BSM datasets are available through the connected vehicle testbeds of U.S. Department of Transportation from all over the country. However, without a proper visualization tool, it is not possible to analyze or visually get an overview of the spatio-temporal distribution of the data. With this goal, a web application has been developed which can ingest a raw BSM dataset and display a time-based simulation of vehicle movement. The simulation also displays multi-hop vehicular network connectivity over DSRC. This paper gives details about the application, including an explanation of the multi-hop partitioning algorithm used to classify the vehicles into separate network partitions. A performance analysis for the simulation is included, in which it is suggested that calculating a connectivity matrix with the multi-hop partitioning algorithm is computationally expensive for large number of vehicles

Double-Row Repair Technique for Bursal-Sided Partial-Thickness Rotator Cuff Tears

Rotator cuff pathology is a common cause of shoulder pain in the athletic and general population. Partial-thickness rotator cuff tears (PTRCT) are commonly encountered and can be bursal-sided, articular-sided, or intratendinous. Various techniques exist for the repair of bursal-sided PTRCTs. The 2 main distinctions when addressing these lesions include tear completion versus preservation of the intact fibers, and single- versus double-row suture anchor fixation. We present our method for addressing bursal-sided PTRCTs using an in situ repair technique with double-row suture anchors. © 2017 Arthroscopy Association of North Americ

A prospective analysis of glove perforation in primary and revision total hip and total knee arthroplasty.

Literature in regard to glove perforation rates in revision total joint arthroplasty (TJA) is scarce. Our purpose was to determine the incidence of perforation in revision TJA. Gloves from all scrubbed personnel were tested based on the American Society for Testing and Materials. A total of 3863 gloves were collected from 58 primary and 36 revision arthroplasty cases. Surgeons had a 3.7% outer-glove perforation rate in primary TJA compared with 8.9% in revision TJA. When both gloves were perforated, the outer-glove perforation was recognized intraoperatively 100% of the time, and the inner-glove perforation was noted only 19% of the time. The surgeon has the highest rate of glove perforation. Outer-glove perforations should prompt careful inspection of the inner glove

High Variability in Outcomes of Two-Stage Exchange to Treat Periprosthetic Joint Infection

Introduction: Periprosthetic joint infection (PJI) is a challenging condition to manage with sobering morbidity and mortality.1,2 Treatment options range from simple irrigation and debridement with prosthetic retention to explantation and placement of a temporary cement spacer. Indictations for each option are unclear and non-uniform despite signi­cant efforts to understand the management outcomes. Until recently, a uniform de­nition of success was unavailable, thus clouding the discussion of treatment options. Two-stage exchange is currently considered the “gold-standard” in North America, yet an appropriate understanding of the actual success and ancillary effects of treatment is needed. With the advantage of an expert opinion de­ning success, this study was designed to understand the status of the current literature and the guidance it provides regarding two-stage exchange arthroplasty

Virtual Coaching and Deliberate Practice to Enhance Medical Students\u27 Clinical Reasoning during Oral Case Presentations

ABSTRACT: Introduction Oral case presentations (OP) provide an opportunity for medical students to practice clinical reasoning and communication skills, and for faculty to provide assessment. Specific teaching strategies are needed to improve students’ OP skills. Objective To compare the effectiveness of Virtual Coaching (VC) to Small Group (SG) discussion or Traditional Feedback (TF/control) in improving clinical reasoning during OP, using a validated PBEAR (Problem Representation, Background Evidence, Analysis, Recommendation) tool. Design/Methods Students from two medical schools were randomly assigned to three groups during their inpatient pediatric clerkship. All completed an eLearning module about using illness scripts to promote clinical reasoning and presenting in the PBEAR format. TF/control students completed online “Aquifer” cases; VC students recorded abstracted data from the same cases with on-line faculty feedback and self-reflection; SG students attended faculty facilitated discussions of the same cases. Students were video recorded presenting pre- and post-curriculum cases. Reviewers blinded to assignment groups rated pre and post videos with the PBEAR OP tool. Results The overall score and sub-scale scores improved for all groups. VC students significantly improved in the Analysis subscale compared to SG or controls. Students rated the SG teaching sessions as more enjoyable and effective in improving their clinical reasoning and presentation skills. Conclusions A blended learning curriculum using VC significantly improved students’ clinical reasoning as assessed by the Analysis subscale

Biodiversity in a changing climate: a synthesis of current and projected trends in the US

This paper provides a synthesis of the recent literature describing how global biodiversity is being affected by climate change and is projected to respond in the future. Current studies reinforce earlier findings of major climate-change-related impacts on biological systems and document new, more subtle after-effects. For example, many species are shifting their distributions and phenologies at faster rates than were recorded just a few years ago; however, responses are not uniform across species. Shifts have been idiosyncratic and in some cases counterintuitive, promoting new community compositions and altering biotic interactions. Although genetic diversity enhances species\u27 potential to respond to variable conditions, climate change may outpace intrinsic adaptive capacities and increase the relative vulnerabilities of many organisms. Developing effective adaptation strategies for biodiversity conservation will not only require flexible decision-making and management approaches that account for uncertainties in climate projections and ecological responses but will also necessitate coordinated monitoring efforts

Screening for Social Determinants of Health in Children with Attention-Deficit/Hyperactivity Disorder

Purpose/Background Increased social determinants of health (SDoH) are associated with poorer health outcomes and decreased treatment compliance. Addressing SDoH can be associated with increased treatment compliance, although currently there is no standard for completing SDoH screening. The WE CARE screening tool is a validated screen that asks about 6 SDoH and whether the family is interested in assistance if the screen is positive. The purpose of this project was to implement the use of the WE CARE screening tool for patients with attention deficit hyperactivity disorder (ADHD) at follow-up visits. Methods From October 17, 2022 through November 22, 2022, charts were reviewed for patients scheduled with the participating nurse practitioner and physicians who met inclusion criteria. The WE CARE screening tool was administered and reviewed by the provider, then a referral to social work could be initiated if needed. Results Following chart review, 23 patients met eligibility criteria, and of these 12 (52%) completed a WE CARE form. Needs were identified on 2 of the completed forms (17 %), and no referrals were made to social work. Implications for Nursing Practice During the implementation period of this quality improvement project, only about half of eligible families had a screening form completed, either because the parent refused or because the physician or nurse practitioner forgot to give the form to the family. Based on the results of this initial implementation phase, more information is needed from the participating healthcare providers about whether they did not feel comfortable using the screen, thought the screen was helpful, or if there were other factors impacting the rate of form completion. It may also be helpful to try to use this screening tool with new patients first instead of follow-ups. The results of the current project do not yet support a change in practice by implementing this tool

Appropriate ECMO Screening Protocols for Critically Ill Patients During COVID-19

Introduction: The use of Extracorporeal membrane oxygenation (ECMO) for COVID-19 patients has proven to have several advantages that advocate for increased use, but current screening protocols have limited its use and availability. The purpose of this study was to evaluate screening criteria for ECMO patients during COVID-19 and determine their appropriateness based on resource availability. Methods: The population included patients referred for ECMO screening, and were stratified based upon referral outcome, survival length and patient disposition. The referring physicians were contacted to gather information regarding the referral process, the patient’s status prior to referral, and possible referral to another hospital if the patient was declined. Results: Currently, data regarding the referral patients is still being collected and analyzed. Expectations are that the data will reveal the most common reasons for referral declination, and improved referral patient outcomes when accepted for ECMO treatment. Areas for improvement with the referral process are also being identified with the goal of optimizing and refining the current referral process. Discussion: The expectation when all data has been analyzed is that it will indicate a need to expand the ECMO screening criteria to allow for increased treatment and improved outcomes for referred COVID-19 patients. An increase in accepted ECMO referrals for COVID-19 patients could lead to better resource allocation for treatment and overall improved patient outcomes