Plos One
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The Broadening Experiences in Scientific Training (BEST) program is an NIH-funded effort testing the impact of career development interventions (e.g. internships, workshops, classes) on biomedical trainees (graduate students and postdoctoral fellows). BEST Programs seek to increase trainees' knowledge, skills and confidence to explore and pursue expanded career options, as well as to increase training in new skills that enable multiple career pathways. Faculty mentors are vital to a trainee's professional development, but data about how faculty members of biomedical trainees view the value of, and the time spent on, career development are lacking. ⋯ Faculty stated unequivocally that institutional support for career development is important and needed. BEST Programs were considered beneficial to trainees, but the awareness of local BEST Programs and the national BEST Consortium was low at the time surveys were employed at some institutions. It is our hope that the work presented here will increase the awareness of the BEST national effort and the need for further career development for biomedical trainees.
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Observational Study
Association between sublingual microcirculation, tissue perfusion and organ failure in major trauma: A subgroup analysis of a prospective observational study.
Previous studies described impaired microvascular perfusion and tissue oxygenation as reliable predictors of Multiple Organ Failure in major trauma. However, this relationship has been incompletely investigated. The objective of this analysis is to further evaluate the association between organ dysfunction and microcirculation after trauma. ⋯ In our cohort of major traumas, sublingual microcirculation and peripheral microvascular reactivity were significantly more impaired early after trauma in those patients who developed more severe organ dysfunctions. Our data would support the hypothesis that restoration of macrocirculation can be dissociated from restoration of peripheral and tissue perfusion, and that microvascular alterations can be associated with organ failure.
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Nationwide and regional interventions can help improve bystander cardiopulmonary resuscitation (CPR) awareness, knowledge, and the willingness. Periodic community investigation will help monitor the effect. This study aimed to compare the experience of CPR education, CPR knowledge, and CPR willingness, during a 5-year interval. ⋯ Nationwide and regional interventions to promote bystander CPR and CPR education were associated with increased CPR education experience and improved correct CPR knowledge in performing bystander CPR. Willingness to perform bystander CPR on family did not increase significantly and CPR willingness to strangers was decreased. Additional legal and technological measures should be implemented to promote bystander CPR.
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Clinical guidelines recommend that metformin be continued after insulin is initiated among patients with type 2 diabetes, yet little is known regarding how often metformin or other non-insulin diabetes medications are continued in this setting. ⋯ While metformin was commonly continued among commercially insured adults starting insulin, rates of continuation of other non-insulin diabetes medications were also high. Further studies are needed to determine the comparative effectiveness and safety of continuing insulin secretagogues and newer diabetes medications after insulin initiation.
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To determine the impact of Sequential Organ Failure Assessment (SOFA) organ sub-scores for hospital mortality risk stratification in a contemporary cardiac intensive care unit (CICU) population. ⋯ In CICU patients with complete SOFA sub-score data, risk stratification for hospital mortality is determined primarily by the cardiovascular, central nervous system, renal and respiratory SOFA sub-scores.