The Development of the Virtual Notebook, a Wiki-Based Ready Reference Technology

Traditionally, library professionals have used a variety of ready reference technologies to assist in providing reference and user services. Technologies such as card files, vertical files, and reference notebooks are frequent components of library service desks. Ready reference technologies serve many purposes, most notably, helping staff to answer frequently asked questions and facilitating the sharing of information between library staff. This paper traces the development of the Virtual Notebook, a wiki-based ready reference technology, at Purdue University. The tool is placed within the historical context of ready reference technologies within the library profession and at Purdue. The authors present preliminary results from the implementation of the Virtual Notebook and discuss the tool’s future. The manuscript is an outgrowth of a presentation at the 2008 Brick and Click Symposium at Northwest Missouri State University

Association of maternal tocolysis or antenatal corticosteroids with cerebral palsy: a study protocol

Cerebral palsy (CP) is the most common developmental disorder associated with lifelong motor impairment and disability. Although severe intrapartum hypoxia/ischaemia during birth may be instrumental in the causal pathway leading to cerebral palsy this accounts for only 10% of cases. Antenatal exposures that lead to cerebral palsy are, therefore, important to understand, particularly those that are modifiable. This application seeks to determine whether antenatal exposure to medications to prevent uterine contractions (tocolysis) and assist lung maturation (corticosteroids) have any association with cerebral palsy, particularly in pregnancies presenting moderately preterm. We plan to perform a secondary analysis on two large existing datasets (the ORACLE trials) of pregnancies presenting before term. If an association is found the results could have significant implications for clinical management and the direction of future research.The Research Foundation, Cerebral Palsy Allianc

CAEP 2021 Academic Symposium: recommendations for addressing racism and colonialism in emergency medicine

Purpose: Racism and colonialism impact health, physician advancement, professional development and medical education in Canada. The Canadian Association of Emergency Physicians (CAEP) has committed to addressing inequities in health in their recent statement on racism. The objective of this project was to develop recommendations for addressing racism and colonialism in emergency medicine. Methods: The authors, in collaboration with a 40 member working group, conducted a literature search, held a community consultation, solicited input from expert medical, academic and community advisors, conducted a national survey of emergency physicians, and presented draft recommendations at the 2021 CAEP Academic Symposium on Equity, Diversity and Inclusion for a live facilitated discussion with a post-session survey. Results: Sixteen recommendations were generated in the areas of patient care, hospital and departmental commitment to Equity, Diversity, and Inclusion, physician advancement, and professional development and medical education. Conclusion: Emergency physicians are uniquely positioned to promote equity at each encounter with patients, peers and learners. The 16 recommendations presented here are practical steps to countering racism and colonialism everyday in emergency medicine

miR-196b target screen reveals mechanisms maintaining leukemia stemness with therapeutic potential.

We have shown that antagomiR inhibition of miRNA miR-21 and miR-196b activity is sufficient to ablate MLL-AF9 leukemia stem cells (LSC) in vivo. Here, we used an shRNA screening approach to mimic miRNA activity on experimentally verified miR-196b targets to identify functionally important and therapeutically relevant pathways downstream of oncogenic miRNA in MLL-r AML. We found Cdkn1b (p27Kip1) is a direct miR-196b target whose repression enhanced an embryonic stem cell–like signature associated with decreased leukemia latency and increased numbers of leukemia stem cells in vivo. Conversely, elevation of p27Kip1 significantly reduced MLL-r leukemia self-renewal, promoted monocytic differentiation of leukemic blasts, and induced cell death. Antagonism of miR-196b activity or pharmacologic inhibition of the Cks1-Skp2–containing SCF E3-ubiquitin ligase complex increased p27Kip1 and inhibited human AML growth. This work illustrates that understanding oncogenic miRNA target pathways can identify actionable targets in leukemia

A Timely shift from shotgun to targeted proteomics and how it can be groundbreaking for cancer research

Funding The present work was funded by FUB/UnB, CNPq, FAP-DF, CAPES, and FINEP.Peer reviewedPublisher PD

Patterns of skeletal fractures in child abuse: systematic review

Objectives To systematically review published studies to identify the characteristics that distinguish fractures in children resulting from abuse and those not resulting from abuse, and to calculate a probability of abuse for individual fracture types

Description, Utilisation and Results from a Telehealth Primary Care Weight Management Intervention for Adults with Obesity in South Carolina

Introduction: In the US, obesity rates are higher in rural areas than in urban areas. Rural access to treatment of obesity is limited by a lack of qualified clinicians and by transportation and financial barriers. We describe a telemedicine weight management programme, Wellness Connect, developed through a partnership of academic clinicians and rural primary care providers in South Carolina, and present utilisation and weight outcomes from seven patient cohorts. Methods: Eight bi-weekly sessions were provided via telemedicine videoconferencing for groups of patients at these rural primary care clinics. Protocol-based sessions were led by registered dietitians, exercise physiologists and clinical psychologists at a central urban location. Results: Of 138 patients who started the programme, 62% (N ¼ 86) of patients met the criteria for completion. Completers lost an average of 3.5% (standard deviation (SD) ¼ 3.9%) body weight, which was statistically significant (p \u3c.001) and corresponded with an average loss of 3.8 kg (SD ¼ 4.5 kg). There were no differences in weight change among clinics (p ¼.972). Overall, patients and providers reported satisfaction with the programme and identified several challenges to sustainability. Discussion: The use of innovative telemedicine interventions continues to be necessary to alleviate barriers to accessing evidence-based services to reduce chronic diseases and decrease obesity rates among rural populations

Lung cancer diagnosis and staging with endobronchial ultrasound-guided transbronchial needle aspiration compared with conventional approaches: an open-label, pragmatic, randomised controlled trial

SummaryBackgroundThe diagnosis and staging of lung cancer is an important process that identifies treatment options and guides disease prognosis. We aimed to assess endobronchial ultrasound-guided transbronchial needle aspiration as an initial investigation technique for patients with suspected lung cancer.MethodsIn this open-label, multicentre, pragmatic, randomised controlled trial, we recruited patients who had undergone a CT scan and had suspected stage I to IIIA lung cancer, from six UK centres and randomly assigned them to either endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) or conventional diagnosis and staging (CDS), for further investigation and staging. If a target node could not be accessed by EBUS-TBNA, then endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was allowed as an alternative procedure. Randomisation was stratified according to the presence of mediastinal lymph nodes measuring 1 cm or more in the short axis and by recruiting centre. We used a telephone randomisation method with permuted blocks of four generated by a computer. Because of the nature of the intervention, masking of participants and consenting investigators was not possible. The primary endpoint was the time-to-treatment decision after completion of the diagnostic and staging investigations and analysis was by intention-to-diagnose. This trial is registered with ClinicalTrials.gov, number NCT00652769.FindingsBetween June 10, 2008, and July 4, 2011, we randomly allocated 133 patients to treatment: 66 to EBUS-TBNA and 67 to CDS (one later withdrew consent). Two patients from the EBUS-TBNA group underwent EUS-FNA. The median time to treatment decision was shorter with EBUS-TBNA (14 days; 95% CI 14–15) than with CDS (29 days; 23–35) resulting in a hazard ratio of 1·98, (1·39–2·82, p<0·0001). One patient in each group had a pneumothorax from a CT-guided biopsy sample; the patient from the CDS group needed intercostal drainage and was admitted to hospital.InterpretationTransbronchial needle aspiration guided by endobronchial ultrasound should be considered as the initial investigation for patients with suspected lung cancer, because it reduces the time to treatment decision compared with conventional diagnosis and staging techniques.FundingUK Medical Research Council