Quality and Publication of Emergency Medicine Trials Registered in ClinicalTrials.gov

Introduction: Promoting emergency medicine (EM) clinical trials research remains a priority. To characterize the status of clinical EM research, this study assessed trial quality, funding source, and publication of EM clinical trials and compared EM and non-EM trials on these key metrics. We also examined the volume of EM trials and their subspecialty areas.Methods: We abstracted data from ClinicalTrials.gov (February 2000 - September 2013) and used individual study National Clinical Trial numbers to identify published trials (January 2007 - September 2016). We used descriptive statistics and chi-square tests to examine study characteristics by EM and non-EM status, and Kaplan-Meier curves and log-rank tests to compare time to publication of completed EM and non-EM studies.Results: We found 638 interventional EM trials and 59,512 non-EM interventional trials conducted in the United States between February 2000 and September 2013, registered on ClinicalTrials.gov. EM studies were significantly less likely than non-EM studies to be National Institutes of Health-funded or to evaluate a drug or biologic. However, EM studies had significantly larger sample sizes, and were significantly more likely to use randomization and blinding. Overall, 34.3% of EM and 26.0% of non-EM studies were published in peer-reviewed journals. By subspecialty, more EM trials concerned medical/surgical and psychiatric/neurological conditions than trauma.Conclusion: Although EM studies were less likely to have received federal or industry funding, and the EM portfolio consisted of only 638 trials over the 14-year study period, the quality of EM trials surpassed that of non-EM trials, based on indices such as randomization and blinding. This novel finding bodes well for the future of clinical EM research, as does the higher proportion of published EM than non-EM trials. Our study also revealed that trauma studies were under-represented among EM studies. Periodic assessment of EM trials with the metrics used here could provide an informative and valuable longitudinal view of progress in clinical EM research

Students With Emotional–Behavioral Disorders as Cross-Age Tutors: A Synthesis of the Literature

The purpose of this quantitative synthesis was to evaluate the effectiveness and related outcomes of the cross-age tutoring model when students with or at risk for emotional–behavioral disorders (EBD) serve as tutors. Research questions were posed to identify the shared and unique components (e.g., dosage, tutor training) of the cross-age tutoring model; the extent to which students with EBD can effectively serve as cross-age tutors (i.e., fidelity of implementation and tutees’ improvement); the extent to which the model was effective in promoting desired academic and/or social–emotional–behavioral outcomes for tutees and tutors with EBD; the generalization, maintenance, and social validity of the effects; and the overall methodological quality and rigor of the included studies. Findings showed common training and instructional components across interventions and that tutors with EBD can implement cross-age tutoring procedures with fidelity. The cross-age model was shown to be effective in promoting academic and social–behavioral skills for the tutees as well as the tutors. Evidence for effectiveness in improving self-concept and attitude of the tutor with EBD was inconsistent. Implications and future research considerations are discussed

Outer Retinal Structure in Best Vitelliform Macular Dystrophy

Importance Demonstrating the utility of adaptive optics scanning light ophthalmoscopy (AOSLO) to assess outer retinal structure in Best vitelliform macular dystrophy (BVMD). Objective To characterize outer retinal structure in BVMD using spectral-domain optical coherence tomography (SD-OCT) and AOSLO. Design, Setting, and Participants Prospective, observational case series. Four symptomatic members of a family with BVMD with known BEST1 mutation were recruited at the Advanced Ocular Imaging Program research lab at the Medical College of Wisconsin Eye Institute, Milwaukee. Intervention Thickness of 2 outer retinal layers corresponding to photoreceptor inner and outer segments was measured using SD-OCT. Photoreceptor mosaic AOSLO images within and around visible lesions were obtained, and cone density was assessed in 2 subjects. Main Outcome and Measure Photoreceptor structure. Results Each subject was at a different stage of BVMD, with photoreceptor disruption evident by AOSLO at all stages. When comparing SD-OCT and AOSLO images from the same location, AOSLO images allowed for direct assessment of photoreceptor structure. A variable degree of retained photoreceptors was seen within all lesions. The photoreceptor mosaic immediately adjacent to visible lesions appeared contiguous and was of normal density. Fine hyperreflective structures were visualized by AOSLO, and their anatomical orientation and size were consistent with Henle fibers. Conclusions and Relevance The AOSLO findings indicate that substantial photoreceptor structure persists within active lesions, accounting for good visual acuity in these patients. Despite previous reports of diffuse photoreceptor outer segment abnormalities in BVMD, our data reveal normal photoreceptor structure in areas adjacent to clinical lesions. This study demonstrates the utility of AOSLO for understanding the spectrum of cellular changes that occur in inherited degenerations such as BVMD. Photoreceptors are often significantly affected at various stages of inherited degenerations, and these changes may not be readily apparent with current clinical imaging instrumentation

Atypical use of audience response system provides opportunity to formatively assess faculty teaching and improve learning outcomes

In response to curricular reform, a particularly effective new approach was developed for a course offered at all nine IUSM centers. Participants will learn about interdisciplinary planning, implementation of a "Grand Rounds" approach, novel use of audience response system for retrieval practice and formative assessment of teaching methods, and how Bloom scale ratings relate to student engagement and focus

Evaluating Terrorist and Extremist Reintegration Programming: A Systematic Literature Review

This systematic literature review focuses on the evaluation of programs or interventions designed to deradicalize, disengage, rehabilitate, and/or reintegrate terrorists and/or extremists. Though a robust literature describing such interventions exists, it has long been recognized that more data are needed on the effectiveness of programs designed to facilitate reintegration. Thus, the objective of this review is to present an overview of academic and grey literature on the evaluation of programming designed to facilitate the deradicalization, disengagement, rehabilitation, and/or reintegration of terrorists and/or extremists. Our initial queries yielded 271 seemingly relevant peer-reviewed and grey literature articles, but after a more robust screening we determined that only 37 of those articles directly related to the evaluation of interventions. These articles are presented by evaluation design (e.g., quantitative, qualitative); we also review the evaluation mechanisms (e.g., survey, interviews, note review), study design (e.g., experimental, quasi-experimental), data types (i.e., quantitative or qualitative), and findings. Finally, we include ten articles discussing theory of program evaluation. Though the review is limited to available data (e.g., not including unpublished evaluations or government evaluations), we conclude by discussing the state of program evaluation relating to interventions designed to deradicalize, disengage, rehabilitate, and/or reintegrate terrorists and/or extremists, and offering several recommendations for how to improve evaluation methods and overcome barriers to evaluation.   AcknowledgementsThis project was made possible by funding and support from the National Institute of Justice (Applying a Developmental Evaluation Approach to Address Community Safety and Health Challenges of Reintegration Programs in the USA - Award Number 2019-ZA-CX-001). The content of this manuscript, as well as the views and discussions expressed, are solely those of the authors and do not necessarily represent the official views of any of the above institutions, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. government

2022 Lesson Plan | The Play Is the Thing

The most important part of studying Shakespeare is infusing meaning into the text. These activities will help you get Shakespeare on its feet and remove Shakes fear from your students.https://digitalcommons.jsu.edu/shakespeare_proj/1016/thumbnail.jp

Changing the rules at the drop of a hat: An ERP study of preschoolers\u27 set-shifting ability

We examined the neural correlates of set-shifting in 5-year-old children and examined whether the ease of switching was affected by varying the number of non-switch trials preceding a switch

Changing the rules at the drop of a hat: An ERP study of preschoolers\u27 set-shifting ability

We examined the neural correlates of set-shifting in 5-year-old children and examined whether the ease of switching was affected by varying the number of non-switch trials preceding a switch

Endovascular foreign body retrieval

ObjectiveThe number of endovascular procedures performed is increasing exponentially as technology improves. A serious complication of endovascular therapy is loss of a foreign body in the vasculature. We reviewed our experience and evaluated the cause, management, and outcomes of intravascular foreign body (IVFB) misplacement.MethodsWe completed a retrospective review of patients who underwent endovascular retrieval of IVFBs between 2005 and 2010. Patients were identified by current procedural terminology code or by our hospital's risk management team. Patients undergoing routine endovascular retrieval of temporary vena cava filters were excluded.ResultsTwenty-seven IVFBs were identified in 26 patients. Twenty patients were asymptomatic (76.9%). Six patients were symptomatic (22.2%) with either pain (n = 4) or abnormal physical findings (n = 2). There were 13 (48.1%) catheter fragments, six (22.2%) guidewires, five (18.5%) inferior vena cava (IVC) filter (embolisms), two (7.4%) stents, and one (3.7%) sheath fragment. There were five (15.6%) embolizations of an IVFB into the right heart, three (9.4%) into a pulmonary artery, eight (25%) into the vena cava, eight (25%) into peripheral veins, five (15.6%) into peripheral arteries, one (3.1%) into a coronary artery, one (3.1%) into a hepatic vein, and one (3.1%) into adjacent soft tissue. The mechanism of endovascular loss was device fracture in 16 (59.3%) cases, loss of control in six cases (22.2%), migration in four (14.8%) cases, and incorrect device deployment in one case (3.7%). The probable cause of foreign body loss was technical error in eight (29.6%) cases. In three cases, IVFB retrieval was not attempted. The misplacement and retrieval were completed during the same procedure in 13 (48%) cases. Twenty-four endovascular retrievals were performed. Fifteen (62.5%) procedures used a snare to remove the IVFB and two (8.2%) used balloon catheters. Three IVFBs could not be removed and two cases were converted to open procedures. Technical success was achieved in 19/24 cases (79.2%). There were no immediate complications related to the retrieval of the IVFB; however, there was a single late complication of pulmonary embolism after failed endovascular retrieval (1/24, 4.2%). Thirty-day survival was 100%.ConclusionsIntravascular foreign bodies are a serious complication of endovascular therapy that can be minimized with proper device selection and deployment. When an intravascular foreign body is identified, endovascular retrieval should be attempted due to its high success rate and minimal morbidity

Analisis dan Perancangan Sistem Informasi Pendistribusian Gas Lpg Bersubsidi dengan Metodologi Object Oriented Studi Kasus PT. Xyz

Kemajuan peradaban dan populasi manusia, serta revolusi industri telah membawa manusia pada era eksploitasi Sumber Daya Alam(SDA) sehingga persediaannya terus berkurang secara signifikan. SDA mutlak diperlukan untuk menunjang kebutuhan manusia. Indonesia merupakan negara dengan tingkat biodiversitas tertinggi kedua di dunia setelah Brazil. Berdasarkan sifatnya dapat digolongkan menjadi SDA yang dapat diperbaharui dan SDA tak dapat diperbaharui seperti tumbuhan, hewan, mikroorganisme, sinar matahari, angin, dan air. Minyak bumi, emas, besi, Gas dan berbagai bahan tambang lainnya adalah SDA tak dapat diperbaharui yang jumlahnya terbatas karena penggunaanya lebih cepat daripada proses pembentukannya. LPG adalah kependekan dari Liquefied Petroleum Gas. LPG merupakan gas hasil produksi dari kilang minyak atau kilang gas, yang komponen utamanya adalah gas propane (C3H8) dan butane (C4H10) yang dicairkan. Menimbang bahwa dalam rangka untuk menjamin penyediaan dan pengadaan bahan bakar di dalam negeri dan mengurangi subsidi Bahan Bakar Minyak (BBM) guna meringankan beban keuangan negara, perlu dilakukan substitusi penggunaan minyak tanah ke LPG maka keluar Peraturan Presiden Republik Indonesia Nomor 104 Tahun 2007 tentang penyediaan, pendistribusian, dan penetapan harga LPG. PT. XYZ menjadi salah satu Badan Usaha yang menyelenggarakan penyediaan dan pendistribusian LPG bersubsidi. Dalam prosesnya dibutuhkan laporan – laporan mengenai pendistribusian, terutama pada data penerima subsidi. Data ini sangat banyak sehingga menyulitkan jika dilakukan secara manual. PT. XYZ membantu proses pendistribusian untuk menghindari kecurangan – kecurangan yang mungkin dilakukan pada saat pendistribusian. PERTAMINA sebagai pemberi subsidi mengharapkan distribusi merata di seluruh wilayah Indonesia. Untuk mengurangi kesalahan dan kecurangan pada saat distrubisi Gas maka dibutuhkan Sistem informasi, dengan sistem informasi proses pendistrubusian Gas akan lebih cepat dan akurat sehingga Perusahaan dapat bekerja secara baik, efektif, dan efisien. Anaisis dan perancangan sistem menggunakan Metodologi Object Oriented dan UML, database yang digunakan adalah Mysql Server dengan Microsoft Visual Studio 2005 sebagai bahasa program nya