Jochumsenskovbjerg4571

Significant improvements in RR-related knowledge, self-efficacy, and self- determination were noted. Workshop evaluation yielded a mean score of 4.85 (0.27) on a 5-point scale. At 6-months follow-up survey and interviews, participants reported application of the knowledge and increased confidence with participation in real-life RR events. The workshop gained traction across the hospital, was associated with improved RR clinical outcomes, and contributed to professional advancement of the educators.

We successfully implemented a self-determination theory-informed RR training program for pediatric RR activators, and the logic model framework was used to facilitate comprehensive evaluation.

We successfully implemented a self-determination theory-informed RR training program for pediatric RR activators, and the logic model framework was used to facilitate comprehensive evaluation.Non-infectious pulmonary complications (NIPC) after allogeneic hematopoietic stem cell transplantation (alloHSCT), including bronchiolitis obliterans syndrome (BOS), cause significant morbidity and mortality, but their impact on healthcare resource utilization (HRU) and costs is unknown. This longitudinal retrospective study quantified the economic burden of NIPC and BOS in alloHSCT patients using commercial claims data from the IQVIA PharMetrics Plus™ database. Study patients were aged 0-64 who underwent alloHSCT between 1/1/2006-9/30/2018 and observable 12 months before and up to 5 years after index alloHSCT. NIPC patients were identified using International Classification of Disease (ICD) diagnosis codes. Outcomes were mean per-patient HRU (inpatient admissions, outpatient office, hospital visits, and prescription medications) and costs paid by insurers in each post-transplant year. Among 2,162 alloHSCT patients, 254 developed NIPCs and 155; 147 were propensity score matched to non-NIPC patients. The The mean age was 43yrs and 46% were female. In the first year following transplantation, NIPC patients had significantly higher inpatient admission rates (3.8 ± 3.2 vs. non-NIPC 2.6 ±2.4; p less then 0.001) and higher total costs, ($567,870 vs. $412,400; p=0.07), reflecting higher costs for inpatient admissions ($452,475 vs. $300,202; p=.06) and pulmonary function testing ($519 vs. $587; p less then 0.001). Among those observable for more years, costs remained higher for NIPC patients, reflecting significantly higher inpatient admission rates in the first three years following transplant. Sub-analysis of patients with diagnoses likely reflected of BOS were consistent with these findings. AlloHSCT patients who developed NIPC had higher healthcare resource utilization, and incurred higher costs, compared to alloHSCT patients who did not develop NIPC following transplant.

We sought to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on the clinical exposure of pediatric interns to common pediatric inpatient diagnoses.

We analyzed electronic medical record data to compare intern clinical exposure during the COVID-19 pandemic from June 2020 through February 2021 with the same academic blocks from 2017 to 2020. We attributed patients to each pediatric intern on the basis of notes written during their pediatric hospital medicine rotation to compare intern exposures with common inpatient diagnoses before and during the pandemic. We compared the median number of notes written per intern per block overall, as well as for each common inpatient diagnosis.

Median counts of notes written per intern per block were significantly reduced in the COVID-19 group compared with the pre-COVID-19 group (96 [interquartile range (IQR) 81-119)] vs 129 [IQR 110-160]; P < .001). Median intern notes per block was lower in the COVID-19 group for all months except February 2021. Although the median number of notes for many common inpatient diagnoses was significantly reduced, they were higher for mental health (4 [IQR 2-9] vs 2 [IQR 1-6]; P < .001) and suicidality (4.5 [IQR 2-8] vs 0 [IQR 0-2]; P < .001). Median shifts worked per intern per block was also reduced in the COVID-19 group (22 [IQR 21-23] vs 23 [IQR 22-24]; P < .001).

Our findings reveal a significant reduction in resident exposure to many common inpatient pediatric diagnoses during the COVID-19 pandemic. Residency programs and pediatric hospitalist educators should consider curricular interventions to ensure adequate clinical exposure for residents affected by the pandemic.

Our findings reveal a significant reduction in resident exposure to many common inpatient pediatric diagnoses during the COVID-19 pandemic. Residency programs and pediatric hospitalist educators should consider curricular interventions to ensure adequate clinical exposure for residents affected by the pandemic.Adolescents with low von Willebrand factor (VWF) levels and heavy menstrual bleeding (HMB) experience significant morbidity. There is a need to better characterize these patients genetically and improve our understanding of the pathophysiology of bleeding. We performed whole-exome sequencing on 86 postmenarchal patients diagnosed with low VWF levels (30-50 IU/dL) and HMB and compared them with 660 in-house controls. We compared the number of rare stop-gain/stop-loss and rare ClinVar "pathogenic" variants between cases and controls, as well as performed gene burden and gene-set burden analyses. We found an enrichment in cases of rare stop-gain/stop-loss variants in genes involved in bleeding disorders and an enrichment of rare ClinVar "pathogenic" variants in genes involved in anemias. The 2 most significant genes in the gene burden analysis, CFB and DNASE2, are associated with atypical hemolytic uremia and severe anemia, respectively. VWF also surpassed exome-wide significance in the gene burden analysis (P = 7.31 × 10-6). Gene-set burden analysis revealed an enrichment of rare nonsynonymous variants in cases in several hematologically relevant pathways. Further, common variants in FERMT2, a gene involved in the regulation of hemostasis and angiogenesis, surpassed genome-wide significance. We demonstrate that adolescents with HMB and low VWF have an excess of rare nonsynonymous and pathogenic variants in genes involved in bleeding disorders and anemia. Variants of variable penetrance in these genes may contribute to the spectrum of phenotypes observed in patients with HMB and could partially explain the bleeding phenotype. By identifying patients with HMB who possess these variants, we may be able to improve risk stratification and patient outcomes.Epinephelidae (groupers) is an astonishingly diverse group of carnivorous fish widely distributed in reef environments around the world, with growing economic importance. The first chromosomal inferences suggested a conservative scenario for the family. However, to date, this has not been validated using biogeographic and phylogenetic approaches. Thus, to estimate karyotype diversification among groupers, eight species from the Atlantic and Indian oceans were investigated using conventional cytogenetic protocols and fluorescence in situ hybridization of repetitive sequences (rDNA, microsatellites, transposable elements). Despite the remarkable persistence of some symplesiomorphic karyotype patterns, such as all species sharing 2n=48 and most preserve a basal karyotype (2n=48 acrocentrics), the chromosomal diversification in the family revealed an unsuspected evolutionary dynamic, where about 40% of the species escape from the ancestral karyotype pattern. These karyotype changes showed a relation with the historical biogeography, likely as a byproduct of the progressive occupancy of new areas (huge diversity of adaptive and speciation conditions). read more In this context, oceanic regions harboring more recent clades such as those of the Indo-Pacific, exhibited a higher karyotype diversity. Therefore, the karyotype evolution of Epinephelidae fits well with the expansion and geographic contingencies of its clades, providing a more complex and diverse scenario than previously assumed.A large surface-to-volume ratio is an essential feature of 2D materials used in many potential electronic applications. This work proposed that the haeckelite-structured phosphorus can be another promising alternative to the known phosphorus allotropes by DFT calculations. This allotrope can be considered a suitable anode material that may provide outstanding performance in LIBs and SIBs. Our simulations confirm that the haeckelite-structured P, composed of alternate square and octagonal rings, is thermally and mechanically stable. The phosphorus haeckelite exhibits a semiconductor with a bandgap of 2 eV and converts to a metallic phase after Li/Na adsorption, which is profoundly the basis for ideal performance of a battery. It provides a high specific capacity and a small OCV with a minimal volume expansion during lithiation/sodiation. The haeckelite-structured P exhibits much higher Li/Na adsorption properties with a small Li/Na migration barrier, which are highly essential in the charge-discharge performance of LIBs/SIBs. Based on the details mentioned above, our study would supply supportive guidelines to advance better opportunities to design and develop flexible Li/Na-ion batteries for future energy conversion and storage applications.Dissolution of FeBr3 in a mixture of acetonitrile and 3,4-lutidine in the presence of an amine results in the formation of an [Fe30] molecular metal oxide containing alternating layers of tetrahedral and octahedral FeIII ions. Mass spectrometry suggests the cluster is formed quickly and remains stable in solution, while magnetic measurements and DFT calculations reveal competing antiferromagnetic exchange interactions.A new type of gold-coated magnetic nanoparticle with strongly magnetic zero-valent iron core-iron oxide shell were synthesized. The small size of the magnetic cores and the zero-valent iron ensured superparamagnetic behaviour and high saturation magnetization of the overall nanoparticles. The nanoparticles showed stability against magnetic aggregation and good colloidal stability, which is important for many biomedical applications.Reaction of the PNNP ligand system N,N'-bis[(2-diphenylphosphino)phenyl]formamidinate (dpfam) featuring different coordination compartments with [AuCl(tht)], [CuMes]5, [AgMes]4, or [AuC6F5(tht)] (tht = tetrahydrothiophene) resulted in tetranuclear homo- and heterometallic coinage metal complexes, as well as a hexanuclear gold complex. All of them feature a metal string conformation. Photophysical investigation revealed a significant dependence of the photoluminescence properties on the metal composition. Below 100 K, the PL efficiency of three compounds approaches nearly 100%.A series of model oligomers consisting of combinations of a traditional strong donor unit (3,4-ethylenedioxythiophene), a traditional strong acceptor unit (benzo[c][1,2,5]thiadiazole), and the ambipolar unit thieno[3,4-b]pyrazine were synthesized via cross-coupling methods. The prepared oligomers include all six possible dimeric combinations in order to characterize the extent and nature of donor-acceptor effects commonly used in the design of conjugated materials, with particular focus on understanding how the inclusion of ambipolar units influences donor-acceptor frameworks. The full oligomeric series was thoroughly investigated via photophysical and electrochemical studies, in parallel with density functional theory (DFT) calculations, in order to correlate the nature and extent of donor-acceptor effects on both frontier orbital energies and the desired narrowing of the HOMO-LUMO energy gap. The corresponding relationships revealed should then provide a deeper understanding of donor-acceptor interactions and their application to conjugated materials.