Annals of surgery
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Randomized Controlled Trial Comparative Study
Within-team debriefing versus instructor-led debriefing for simulation-based education: a randomized controlled trial.
To compare the effectiveness of an interprofessional within-team debriefing with that of an instructor-led debriefing on team performance during a simulated crisis. ⋯ Within-team debriefing results in measurable improvements in team performance in simulated crisis scenarios. This form of debriefing may be as effective as instructor-led team debriefing, which could improve resource utilization and feasibility of team-based simulation (NCT01067378).
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Multicenter Study
The comprehensive complication index: a novel continuous scale to measure surgical morbidity.
To develop and validate a comprehensive complication index (CCI) that integrates all events with their respective severity. ⋯ The CCI summarizes all postoperative complications and is more sensitive than existing morbidity endpoints. It may serve as a standardized and widely applicable primary endpoint in surgical trials and other interventional fields of medicine. The CCI can be readily computed on the basis of tabulated complications according to the Clavien-Dindo classification (available at www.assessurgery.com).
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To estimate the effect of preventing postoperative complications on readmission rates and costs. ⋯ This study provides substantial evidence that efforts to reduce postoperative readmissions should begin by focusing on postoperative complications that can be reliably and validly measured. Such an approach will not eliminate all postoperative readmissions but will likely have a major effect on readmission rates.
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We tested the hypothesis that the matricellular protein thrombospondin-1 (TSP1), through binding to and activation of the cell receptor CD47, inhibits basal and thermal-mediated cutaneous blood flow. ⋯ These results suggest that secreted TSP1, via its cognate receptor CD47, acutely modulates SkBF. These data further support therapeutically targeting CD47 to mitigate age-associated loss of SkBF and maximize wound healing.
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To elucidate whether duodenal-jejunal-bypass (DJB), which improves blood glucose control, changes activity of Na-D-glucose cotransporter SGLT1 in small intestine. ⋯ The data indicate that DJB surgery decreases glucose absorption in the small intestine by downregulation of SGLT1-mediated glucose uptake. We suggest that the downregulation of SGLT1 contributes to the body-weight independent improvement of diabetes type 2.