Upgrading a Social Media Strategy to Increase Twitter Engagement During the Spring Annual Meeting of the American Society of Regional Anesthesia and Pain Medicine.

Microblogs known as tweets are a rapid, effective method of information dissemination in health care. Although several medical specialties have described their Twitter conference experiences, Twitter-related data in the fields of anesthesiology and pain medicine are sparse. We therefore analyzed the Twitter content of 2 consecutive spring meetings of the American Society of Regional Anesthesia and Pain Medicine using publicly available online transcripts. We also examined the potential contribution of a targeted social media campaign on Twitter engagement during the conferences. The original Twitter meeting content was largely scientific in nature and created by meeting attendees, the majority of whom were nontrainee physicians. Physician trainees, however, represent an important and increasing minority of Twitter contributors. Physicians not in attendance predominantly contributed via retweeting original content, particularly picture-containing tweets, and thus increased reach to nonattendees. A social media campaign prior to meetings may help increase the reach of conference-related Twitter discussion

Effect of elevated CO2 and temperature on growth parameters of pea (Pisum sativum L.) crop

Global warming is predicted to have negative effect on plant growth due to the damaging effect of high temperature on plant development. The field experiment was conducted during 2014-15 to study effect of elevated CO2 and temperature on growth parameters of pea (Pisum sativum L.) crop in order to check the effect of climatechange on vegetable crops. Effect was studied under four conditions i.e. Open Top Chambers, T1: OTC - elevated CO2550±10 ppm; T2: OTC -elevated CO2 550±10 ppm and temperature 1°C; T3: OTC - ambient CO2 and temperature (reference) and T4: natural condition. Maximum plant height at 50 % flowering was recorded in T1 (84.29cm) at elevated CO2 which differed significantly with T2 (79.47cm) at elevated CO2 and temperature, T3 (73.60cm) at ambient CO2 and temperature and natural condition (70.73cm). Minimum days to 50 per cent flowering were recorded in plants growing under T2 (68.56 days). Maximum pollen viability was recorded in T1 (77.42%) followed by T3 (76.36%), T4 (74.65%) and T2 (69.97%). Internode length of plants grown under T1 was maximum (7.01cm) followed by T2 (6.68cm), T3 (6.00cm) and T4 (5.05cm). Elevated temperature and CO2 had significant effects on growth and development in vegetables. Overall, growth parameters of pea crop were affected positively by elevated CO2 whereas under interaction effect of elevated CO2 and temperature these positive effects of CO2 were offset by elevated temperature effect and hampered the growth of pea crop which interns can affect the yield and quality of crop under changing climate scenario

Impact of cropping systems on physico-chemical characteristics of surface water during different seasons in Shimla region of Himachal Pradesh

The present investigations were carried out in the year 2014 with an objective to find out the impact of different cropping systems on nearby surface water resources in Shimla region of Himachal Pradesh. The aim of the study was to monitor the surface water bodies for pollution caused by nearby cropping systems in the Shimla area. In this study fruit, fruit + vegetable, vegetable and cereal based cropping systems were selected along with control (uncultivated land) and sampling was done during winter, summer and rainy seasons. The estimated water quality parameters revealed very less organic pollution and pH values were within the BIS prescribed limits of 6.5-8.5. Under vegetable based cropping system EC (500.23 µS cm?1), TDS (329.17 mg/l), BOD (1.48 mg/l), COD (31.09 mg/l), Cl- (25.66 mg/l), Ca (75.59 mg/l) and Mg (11.14 mg/l) were in high concentration, whereas No3- content were high under fruit + vegetable based cropping system. DO were maximum (8.61mg/l) under uncultivated land. Calcium and COD were high in some samples, which could be from anthropogenic sources, rest of the parameters were within the desirable limits prescribed by Bureau of Indian Standards (BIS). The experimental data were statistically analysed through Analysis of variance (two way classification of data) indicated positive correlation among most of the physical and chemical parameters. Study reveals that cropping systems as well as seasonal changes has affected the water quality. The study carried out for water quality parameters, revealed the correlation of each parameter with one another under different cropping systems

A Smartphone-based Decision Support Tool Improves Test Performance Concerning Application of the Guidelines for Managing Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

BACKGROUND: The American Society of Regional Anesthesia and Pain Medicine (ASRA) consensus statement on regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy is the standard for evaluation and management of these patients. The authors hypothesized that an electronic decision support tool (eDST) would improve test performance compared with native physician behavior concerning the application of this guideline. METHODS: Anesthesiology trainees and faculty at 8 institutions participated in a prospective, randomized trial in which they completed a 20-question test involving clinical scenarios related to the ASRA guidelines. The eDST group completed the test using an iOS app programmed to contain decision logic and content of the ASRA guidelines. The control group completed the test by using any resource in addition to the app. A generalized linear mixed-effects model was used to examine the effect of the intervention. RESULTS: After obtaining institutional review board's approval and informed consent, 259 participants were enrolled and randomized (eDST = 122; control = 137). The mean score was 92.4 ± 6.6% in the eDST group and 68.0 ± 15.8% in the control group (P < 0.001). eDST use increased the odds of selecting correct answers (7.8; 95% CI, 5.7 to 10.7). Most control group participants (63%) used some cognitive aid during the test, and they scored higher than those who tested from memory alone (76 ± 15% vs. 57 ± 18%, P < 0.001). There was no difference in time to completion of the test (P = 0.15) and no effect of training level (P = 0.56). CONCLUSIONS: eDST use improved application of the ASRA guidelines compared with the native clinician behavior in a testing environment

Translating evidence into policy for cardiovascular disease control in India

Cardiovascular diseases (CVD) are leading causes of premature mortality in India. Evidence from developed countries shows that mortality from these can be substantially prevented using population-wide and individual-based strategies. Policy initiatives for control of CVD in India have been suggested but evidence of efficacy has emerged only recently. These initiatives can have immediate impact in reducing morbidity and mortality. Of the prevention strategies, primordial involve improvement in socioeconomic status and literacy, adequate healthcare financing and public health insurance, effective national CVD control programme, smoking control policies, legislative control of saturated fats, trans fats, salt and alcohol, and development of facilities for increasing physical activity through better urban planning and school-based and worksite interventions. Primary prevention entails change in medical educational curriculum and improved healthcare delivery for control of CVD risk factors-smoking, hypertension, dyslipidemia and diabetes. Secondary prevention involves creation of facilities and human resources for optimum acute CVD care and secondary prevention. There is need to integrate various policy makers, develop effective policies and modify healthcare systems for effective delivery of CVD preventive care

Testing and Validating Customer Relationship Management Implementation Constructs in Egyptian Tourism Organizations

To date, Critical Success Factors (CSFs) for implementing Customer Relationship Management (CRM) have not been systematically investigated. Existing studies have derived their CSFs from different perspectives. However, it lacks scientifically developed and tested constructs that represent an integrative CRM philosophy. Through a detailed analysis of the literature, as well as adding new factors, this research identifies eight constructs for integrated CRM implementation in developing economies. The proposed CSFs are tested and validated through a sample of 162 Egyptian tourism organizations that utilize CRM systems, using Amos 19. The overall results from the empirical assessment were positive, reflecting the appropriateness of the proposed CSFs. This study is one of very few studies to provide an integrative perspective of CSFs for implementing CRM in the tourism sector and developing economies; it adds to the extremely limited number of empirical studies that have been conducted to investigate CRM implementation in developing countries. Copyright © Taylor & Francis Group, LLC

Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Background and objectives: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. Results: Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia

Reconstruction and simulation of neocortical microcircuitry

We present a first-draft digital reconstruction of the microcircuitry of somatosensory cortex of juvenile rat. The reconstruction uses cellular and synaptic organizing principles to algorithmically reconstruct detailed anatomy and physiology from sparse experimental data. An objective anatomical method defines a neocortical volume of 0.29 ± 0.01 mm3 containing ∼31,000 neurons, and patch-clamp studies identify 55 layer-specific morphological and 207 morpho-electrical neuron subtypes. When digitally reconstructed neurons are positioned in the volume and synapse formation is restricted to biological bouton densities and numbers of synapses per connection, their overlapping arbors form ∼8 million connections with ∼37 million synapses. Simulations reproduce an array of in vitro and in vivo experiments without parameter tuning. Additionally, we find a spectrum of network states with a sharp transition from synchronous to asynchronous activity, modulated by physiological mechanisms. The spectrum of network states, dynamically reconfigured around this transition, supports diverse information processing strategies

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)