Do technical skills correlate with non-technical skills in crisis resource management: a simulation study

Background Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario. Methods This study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score. Results TS and NTS were significantly correlated to each other (r=0.45, P<0.05). Conclusions During a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different T

Attachment and crying in patients with medically unexplained somatic symptoms

Mentalization deficits and disturbances in emotional functioning may contribute to somatization in patients with medically unexplained somatic symptoms (MUSS). The present study aimed to increase understanding the psychological factors that contribute to somatization by examining associations between attachment, crying attitudes and behavior, and somatic symptoms in these patients. Attachment security was measured with the Experiences in Close Relationships Questionnaire in sixty-eight outpatients diagnosed with MUSS. Somatic symptom severity was measured with the RAND-36, crying frequency, and attitudes with the Adult Crying Inventory. Patients were asked to evaluate photographs of crying individuals in order to assess the perception of crying and empathic responses to crying. Attachment anxiety was significantly related to somatic symptom severity and negative attitudes toward crying. In addition, somatic symptom severity was related to a more negative attitude toward crying and less awareness of the interpersonal impact of crying on others. The association between attachment anxiety and somatic symptoms was, however, not mediated by crying or negative attitude toward crying. Neither were there significant associations between attachment, somatic symptoms, and empathic responses to crying. Altered attitudes to crying may stem from a history of insecure attachment experiences and may reflect maladaptive emotion strategies in MUSS patients

Oxytocin Receptor Gene Associated with the Efficiency of Social Auditory Processing

Oxytocin has been shown to facilitate social aspects of sensory processing, thereby enhancing social communicative behaviors and empathy. Here we report that compared to the AA/AG genotypes, the presumably more efficient GG genotype of an oxytocin receptor gene polymorphism (OXTR rs53576) that has previously been associated with increased sensitivity of social processing is related to less self-reported difficulty in hearing and understanding people when there is background noise. The present result extends associations between oxytocin and social processing to the auditory and vocal domain. We discuss the relevance of our findings for autistic spectrum disorders (ASD), as ASD seems related to specific impairments in the orienting to, and selection of speech sounds from background noise, and some social processing impairments in patients with ASD have been found responsive to oxytocin treatment

The pathophysiological basis of pharmacological interventions in CAVD

Calcific aortic valve disease (CAVD) results in aortic valve stenosis and is one of the most common cardiac diseases in both Western and developing countries. The burden of this disease is expected to increase rapidly in the future, but there are still no relevant pharmacological therapies available and aortic valve replacement remains the sole definite therapy. This review presents an overview of the most common causes of CAVD, followed by current debates and trials related to the onset and progression of this disease. Several differences and similarities between the different causes of CAVD are presented. Additionally, stages of CAVD are compared with stages in atherosclerosis. Finally, future directions for research on CAVD will be discussed

Production of transmitochondrial cybrids containing naturally occurring pathogenic mtDNA variants

The human mitochondrial genome (mtDNA) encodes polypeptides that are critical for coupling oxidative phosphorylation. Our detailed understanding of the molecular processes that mediate mitochondrial gene expression and the structure–function relationships of the OXPHOS components could be greatly improved if we were able to transfect mitochondria and manipulate mtDNA in vivo. Increasing our knowledge of this process is not merely of fundamental importance, as mutations of the mitochondrial genome are known to cause a spectrum of clinical disorders and have been implicated in more common neurodegenerative disease and the ageing process. In organellar or in vitro reconstitution studies have identified many factors central to the mechanisms of mitochondrial gene expression, but being able to investigate the molecular aetiology of a limited number of cell lines from patients harbouring mutated mtDNA has been enormously beneficial. In the absence of a mechanism for manipulating mtDNA, a much larger pool of pathogenic mtDNA mutations would increase our knowledge of mitochondrial gene expression. Colonic crypts from ageing individuals harbour mutated mtDNA. Here we show that by generating cytoplasts from colonocytes, standard fusion techniques can be used to transfer mtDNA into rapidly dividing immortalized cells and, thereby, respiratory-deficient transmitochondrial cybrids can be isolated. A simple screen identified clones that carried putative pathogenic mutations in MTRNR1, MTRNR2, MTCOI and MTND2, MTND4 and MTND6. This method can therefore be exploited to produce a library of cell lines carrying pathogenic human mtDNA for further study

The detection of fraud activities on the stock market through forward analysis methodology of financial discussion boards

Financial discussion boards (FDBs) have been widely used for a variety of financial knowledge exchange activities through the posting of comments on the FDBs. Popular public FDBs are prone to be used as a medium to spread false financial information due to having a larger group of audiences. Although online forums, in general, are usually integrated with anti-spam tools such as Akismet, moderation of posted contents heavily relies on human moderators. Unfortunately, popular FDBs attract many comments per day which realistically prevents human moderators from continuously monitoring and moderating possibly fraudulent contents. Such manual moderation can be extremely time-consuming. Moreover, due to the absence of useful tools, no relevant authorities are actively monitoring and handling potential financial crimes on FDBs. This paper presents a novel forward analysis methodology implemented in an Information Extraction (IE) prototype system named FDBs Miner (FDBM). This methodology aims to detect potentially illegal comments on FDBs while integrating share prices in the detection process as this helps to categorise the potentially illegal comments into different risk levels for investigation priority. The IE prototype system will first extract the public comments and per minute share prices from FDBs for the selected listed companies on London Stock Exchange (LSE). In the forward analysis process, the comments are flagged using a predefined Pump and Dump financial crime related keyword template. By only flagging the comments against the keyword template yields an average of 9.82% potentially illegal comments. It is unrealistic and unaffordable for human moderators to read these comments on a daily basis in long run. Hence, by integrating the share prices’ hikes and falls to categorise the flagged comments based on risk levels, it saves time and allows relevant authorities to prioritise and investigate into the higher risk flagged comments as it can potentially indicate real Pump and Dump crimes on FDBs

Exploring the hormonal and neural correlates of paternal protective behavior to their infants

Infant protection is an important but largely neglected aspect of parental care. Available theory and research suggest that endocrine levels and neural responses might be biological correlates of protective behavior. However, no research to date examined associations between these neurobiological and behavioral aspects. This study, preregistered on https://osf.io/2acxd, explored the psychobiology of paternal protection in 77 new fathers by combining neural responses to infant-threatening situations, self-reported protective behavior, behavioral observations in a newly developed experimental set-up (Auditory Startling Task), and measurements of testosterone and vasopressin. fMRI analyses validated the role of several brain networks in the processing of infant-threatening situations and indicated replicable findings with the infant-threat paradigm. We found little overlap between observed and reported protective behavior. Robust associations between endocrine levels, neural responses, and paternal protective behavior were absent

The development of a HAMstring InjuRy (HAMIR) index to mitigate injury risk through innovative imaging, biomechanics, and data analytics : Protocol for an observational cohort study

Background The etiology of hamstring strain injury (HSI) in American football is multi-factorial and understanding these risk factors is paramount to developing predictive models and guiding prevention and rehabilitation strategies. Many player-games are lost due to the lack of a clear understanding of risk factors and the absence of effective methods to minimize re-injury. This paper describes the protocol that will be followed to develop the HAMstring InjuRy (HAMIR) index risk prediction models for HSI and re-injury based on morphological, architectural, biomechanical and clinical factors in National Collegiate Athletic Association Division I collegiate football players. Methods A 3-year, prospective study will be conducted involving collegiate football student-athletes at four institutions. Enrolled participants will complete preseason assessments of eccentric hamstring strength, on-field sprinting biomechanics and muscle–tendon volumes using magnetic-resonance imaging (MRI). Athletic trainers will monitor injuries and exposure for the duration of the study. Participants who sustain an HSI will undergo a clinical assessment at the time of injury along with MRI examinations. Following completion of structured rehabilitation and return to unrestricted sport participation, clinical assessments, MRI examinations and sprinting biomechanics will be repeated. Injury recurrence will be monitored through a 6-month follow-up period. HAMIR index prediction models for index HSI injury and re-injury will be constructed. Discussion The most appropriate strategies for reducing risk of HSI are likely multi-factorial and depend on risk factors unique to each athlete. This study will be the largest-of-its-kind (1200 player-years) to gather detailed information on index and recurrent HSI, and will be the first study to simultaneously investigate the effect of morphological, biomechanical and clinical variables on risk of HSI in collegiate football athletes. The quantitative HAMIR index will be formulated to identify an athlete’s propensity for HSI, and more importantly, identify targets for injury mitigation, thereby reducing the global burden of HSI in high-level American football players. Trial Registration The trial is prospectively registered on ClinicalTrials.gov (NCT05343052; April 22, 2022)