747 results match your criteria clinically influential


Career Development Strategies for the Clinical Educator.

Authors:
Jess Mandel

ATS Sch 2020 May 26;1(2):101-109. Epub 2020 May 26.

University of California San Diego School of Medicine, La Jolla, California.

Over the past several decades, fewer faculty members at American medical schools have engaged in an equally balanced portfolio of clinical, research, and education efforts, and increasing numbers of faculty members have become more differentiated into physician-scientists or clinician-educators. Career paths among clinician-educators are quite variable, and aspiring clinician-educators are frequently unsure of how to maximize their chances for success in a clinician-educator academic pathway. In the author's opinion, the aspiring clinician-educator should seek to develop their skill set in four main areas. Read More

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Florence Nightingale's legacy for clinical academics: A framework analysis of a clinical professorial network and a model for clinical academia.

J Clin Nurs 2021 Apr 2. Epub 2021 Apr 2.

University of Manchester, Manchester, UK.

Background: Clinical academic nursing roles are rare, and clinical academic leadership positions even more scarce. Amongst the United Kingdom (UK) academia, only 3% of nurses who are employed within universities are clinically active. Furthermore, access to research fellowships and research grant funding for nurses in clinical or academic practice is also limited. Read More

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ESGO/ISUOG/IOTA/ESGE Consensus statements on the pre-operative diagnosis of ovarian tumours.

Ultrasound Obstet Gynecol 2021 Apr 1. Epub 2021 Apr 1.

Department of Gynecologic Oncology, Hammersmith Hospital, Imperial College, London, United Kingdom.

The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis group (IOTA) and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based consensus statements on the pre-operative diagnosis of ovarian tumours, including imaging techniques, biomarkers and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group consisting of expert practising clinicians and researchers who have demonstrated leadership and expertise in the pre-operative diagnosis of ovarian tumours and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. Read More

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The study on the clinical effectiveness and safety of traditional Chinese medicine acupoint catgut embedding guided by musculoskeletal ultrasound in the treatment of nerve root sciatica: A protocol for systematic review and meta-analysis of randomized controlled trials.

Medicine (Baltimore) 2021 Apr;100(13):e25387

Department of Ultrasound.

Background: Nerve root sciatica (NRS) is a common orthopedic disease, which usually occurs between 20 and 40 years of age, and the incidence rate is increasing year by year and is being younger. The disease has no special effect of treatment, clinically generally taking the symptomatic treatment, such as taking short-term glucocorticoids, sedatives, analgesics, and so on. Long-term use of drugs will adversely affect the patient's gastrointestinal tract, liver, and kidney function. Read More

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Prevalence and associated factors of Electrocardiogram abnormalities in patients with systemic lupus erythematosus: a machine learning study.

Arthritis Care Res (Hoboken) 2021 Mar 30. Epub 2021 Mar 30.

Division of Cardiology, Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, No.600, Tianhe Road, Guangzhou City, 51000, China.

Objectives: Electrocardiogram (ECG) abnormalities are predictive of subsequent cardiovascular events. Cardiac involvement is common in systemic lupus erythematosus (SLE). We aimed to determine the prevalence of ECG abnormalities in SLE patients and to examine the factors associated with ECG abnormalities with machine learning approaches. Read More

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Adult Neurogenesis and Antidepressant Treatment: The Surprise Finding by Ron Duman and the Field 20 Years Later.

Biol Psychiatry 2021 Jan 23. Epub 2021 Jan 23.

Hoba Therapeutics, Copenhagen, Denmark.

Of Duman's many influential findings, the finding that long-term treatment with antidepressant drugs produces an increase in neurogenesis in the subgranular zone of the adult hippocampus may be one of the most enduring and far-reaching. This novel discovery and his decades of continued research in the field led to a new hypothesis about the mechanism of action of antidepressants, providing a critical step in our understanding of the neurotrophic hypothesis of depression and synaptic plasticity. It is now accepted that antidepressant treatments can oppose and even reverse the effects of stress on the brain and on newly born hippocampal cells, possibly via neurotrophic factors, which Duman had continued to explore. Read More

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January 2021

The impact of intersectionality on nursing leadership, empowerment and culture: A case study exploring nurses and managers' perceptions in an acute care hospital in Aotearoa, New Zealand.

J Clin Nurs 2021 Mar 24. Epub 2021 Mar 24.

School of Nursing, University of Auckland, Auckland, New Zealand.

Aim: This study determines whether the culture within an acute care hospital empowers 'all' nurses to be leaders by exploring intersectionality and nursing leadership in the context of the social environment.

Background: Nurses practice leadership in their day-to-day activities as clinical leaders alongside traditional roles of management and leadership. However, some nurses do not acknowledge nursing work as leadership activity, nor is it seen so by others where hierarchical leadership approaches remain prevalent. Read More

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Development, spread and impact of primary care and musculoskeletal communities of practice to assist rapid translation of evidence into practice.

Musculoskeletal Care 2021 Mar 23. Epub 2021 Mar 23.

The Impact Accelerator Unit, The Medical School Keele University, Keele, UK.

Background: Embedding research into practice is challenging. Barriers include: a shortage of time, lack of understanding of the evidence and a poor support in the clinical setting. A community of practice (CoP) model has been used to address these issues. Read More

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Flavonoids against the SARS-CoV-2 induced inflammatory storm.

Biomed Pharmacother 2021 Jun 25;138:111430. Epub 2021 Feb 25.

Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia. Electronic address:

The disease severity of COVID-19, especially in the elderly and patients with co-morbidities, is characterized by hypercytokinemia, an exaggerated immune response associated with an uncontrolled and excessive release of proinflammatory cytokine mediators (cytokine storm). Flavonoids, important secondary metabolites of plants, have long been studied as therapeutic interventions in inflammatory diseases due to their cytokine-modulatory effects. In this review, we discuss the potential role of flavonoids in the modulation of signaling pathways that are crucial for COVID-19 disease, particularly those related to inflammation and immunity. Read More

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Development of the new CPTSD diagnosis for ICD-11.

Authors:
Andreas Maercker

Borderline Personal Disord Emot Dysregul 2021 Mar 1;8(1). Epub 2021 Mar 1.

Department of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8044, Zurich, Switzerland.

Background: The diagnosis of complex post-traumatic stress disorder (CPTSD) was proposed several decades ago by scientist-practitioners, almost parallel to the first description of the diagnosis of post-traumatic stress disorder (PTSD). In the previous International Classification of Diseases, version 10 (ICD-10) issued by the World Health Organization (WHO), this symptom constellation was termed 'enduring personality change after catastrophic experience'. This diagnosis has not been clinically influential, nor has it been subjected to much research. Read More

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"I don't have any emotions": An ethnography of emotional labour and feeling rules in the emergency department.

J Adv Nurs 2021 Apr 11;77(4):1956-1967. Epub 2021 Feb 11.

Nottingham University Business School, Nottingham, UK.

Aims: This study aims to apply Hochschild's theory of emotional labour to emergency care, and uncover the 'specialty-specific' feeling rules driving this labour. Despite the importance of positive nurse well-being, the emotional labour of nursing (a great influencer in wellbeing) remains neglected.

Design And Methods: Ethnography enabled immersion in the ED setting, gathering the lived experiences and narratives of the ED nursing team. Read More

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Designing deep learning studies in cancer diagnostics.

Nat Rev Cancer 2021 03 29;21(3):199-211. Epub 2021 Jan 29.

Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.

The number of publications on deep learning for cancer diagnostics is rapidly increasing, and systems are frequently claimed to perform comparable with or better than clinicians. However, few systems have yet demonstrated real-world medical utility. In this Perspective, we discuss reasons for the moderate progress and describe remedies designed to facilitate transition to the clinic. Read More

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An observational feasibility study - does early limb ergometry affect oxygen delivery and uptake in intubated critically ill patients - a comparison of two assessment methods.

BMC Anesthesiol 2021 Jan 25;21(1):27. Epub 2021 Jan 25.

Centre for Innovation and Leadership, Faculty of Health Sciences, University of Southampton, Building 45, Room 2035, Highfield Campus, S017 1BJ, Southampton, UK.

Background: Early rehabilitation can reduce ventilation duration and improve functional outcomes in critically ill patients. Upper limb strength is associated with ventilator weaning. Passive muscle loading may preserve muscle fibre function, help recover peripheral muscle strength and improve longer term, post-hospital discharge function capacity. Read More

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January 2021

Translating COVID-19 knowledge to practice: Enhancing emergency medicine using the "wisdom of crowds".

J Am Coll Emerg Physicians Open 2021 Feb 16;2(1):e12356. Epub 2021 Jan 16.

St Joseph's Health Paterson New Jersey USA.

In the spring of 2020, emergency physicians found themselves in new, uncharted territory as there were few data available for understanding coronavirus disease 2019 (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. In response, knowledge was being crowd sourced and shared across online platforms. The "wisdom of crowds" is an important vehicle for sharing information and expertise. Read More

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February 2021

Effect of linagliptin, a dipeptidyl peptidase-4 inhibitor, compared with the sulfonylurea glimepiride on cardiovascular outcomes in Asians with type 2 diabetes: subgroup analysis of the randomized CAROLINA® trial.

Diabetol Int 2021 Jan 27;12(1):87-100. Epub 2020 Jun 27.

Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Aachen, Germany.

Objective: Linagliptin, a dipeptidyl peptidase-4 inhibitor, recently demonstrated cardiovascular (CV) safety versus placebo in Asians with advanced type 2 diabetes mellitus (T2DM) in the CARMELINA trial. We assessed its CV safety compared with the sulfonylurea glimepiride in Asians with relatively early T2DM in the CAROLINA trial.

Methods: Based on prespecified and post hoc subgroup analyses of the multinational CAROLINA trial in which adults with relatively early T2DM and elevated CV risk were randomized to linagliptin or glimepiride added to usual care, we analyzed data for participants from Asian countries. Read More

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January 2021

Subclinical Auditory Dysfunction: Relationship Between Distortion Product Otoacoustic Emissions and the Audiogram.

Am J Audiol 2021 Jan 19:1-16. Epub 2021 Jan 19.

VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR.

Purpose Distortion product otoacoustic emissions (DPOAEs) and audiometric thresholds have been used to account for the impacts of subclinical outer hair cell (OHC) dysfunction on auditory perception and measures of auditory physiology. However, the relationship between DPOAEs and the audiogram is unclear. This study investigated this relationship by determining how well DPOAE levels can predict the audiogram among individuals with clinically normal hearing. Read More

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January 2021

Practical recommendations for timely, accurate diagnosis of symptomatic Alzheimer's disease (MCI and dementia) in primary care: a review and synthesis.

J Intern Med 2021 Jan 18. Epub 2021 Jan 18.

Lou Ruvo Center for Brain Health - Cleveland Clinic Nevada, Las Vegas, NV, USA.

The critical role of primary care clinicians (PCCs) in Alzheimer's disease (AD) prevention, diagnosis and management must evolve as new treatment paradigms and disease-modifying therapies (DMTs) emerge. Our understanding of AD has grown substantially: no longer conceptualized as a late-in-life syndrome of cognitive and functional impairments, we now recognize that AD pathology builds silently for decades before cognitive impairment is detectable. Clinically, AD first manifests subtly as mild cognitive impairment (MCI) due to AD before progressing to dementia. Read More

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January 2021

Development and validation of a rapid-decision pathway to diagnose malnutrition in patients with lung cancer.

Nutrition 2021 04 5;84:111102. Epub 2020 Dec 5.

Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China. Electronic address:

Objectives: Malnutrition is frequently developed and outcome-related in patients with lung cancer (LC). Making a rapid and accurate diagnosis of malnutrition is the major concern for dietitians and clinicians.

Methods: We performed a multicenter, observational cohort study including 1219 patients with LC. Read More

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Mental distress and influencing factors in nurses caring for patients with COVID-19.

Nurs Crit Care 2021 03 27;26(2):94-101. Epub 2020 Jul 27.

Advanced Nursing Practice & Education Department, College of Nursing, East Carolina University, Greenville, North Carolina, USA.

Background: Nurses are experiencing tremendous stress during the new coronavirus disease 2019 (COVID-19) pandemic, especially intensive care nurses. The pandemic of the disease is a tragedy, which may leave a catastrophic psychological imprint on nurses. Understanding nurses' mental distress can help when implementing interventions to mitigate psychological injuries to nurses. Read More

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Cell therapy for the treatment of heart disease: Renovation work on the broken heart is still in progress.

Authors:
Paolo Madeddu

Free Radic Biol Med 2021 Feb 6;164:206-222. Epub 2021 Jan 6.

Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol Royal Infirmary, Upper Maudlin Street, BS28HW, Bristol, United Kingdom. Electronic address:

Cardiovascular disease (CVD) continues to be the number one killer in the aging population. Heart failure (HF) is also an important cause of morbidity and mortality in patients with congenital heart disease (CHD). Novel therapeutic approaches that could restore stable heart function are much needed in both paediatric and adult patients. Read More

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February 2021

Men's experiences of radiotherapy treatment for localized prostate cancer and its long-term treatment side effects: a longitudinal qualitative study.

Cancer Causes Control 2021 Mar 4;32(3):261-269. Epub 2021 Jan 4.

Department of Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK.

Purpose: To investigate men's experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial.

Methods: A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. Read More

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Integrating Clinical Reasoning Skills in a Pre-professional Undergraduate Human Anatomy Course.

Anat Sci Educ 2021 Jan 2. Epub 2021 Jan 2.

Doctoral Program in Educational Leadership Policy Studies, School of Education, Edgewood College, Madison, Wisconsin.

Clinically integrated curricula in health science education has been shown to promote the development of problem-solving schema and positively impact knowledge acquisition. Despite its' purported benefits, this type of curricula can impose a high cognitive load, which may negatively impact novice learners' knowledge acquisition and problem-solving schema development. Introducing explicit clinical reasoning instruction within pre-professional undergraduate basic science courses may limit factors that increase cognitive load, enhance knowledge acquisition, and foster developing clinical problem-solving skills. Read More

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January 2021

The comparison of the effectiveness and safety of drospirone ethinyl estradiol and ethinyl estradiol cyproterone in the treatment of polycystic ovarian syndrome: A protocol for systematic review and meta-analysis.

Medicine (Baltimore) 2020 Dec;99(51):e23811

Department of Obstetrics, People's Hospital of Wanning, No. 1 Huanshi 3rd East Road, Wancheng Town, Wanning City, Hainan Province, PR China.

Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder syndrome with reproductive dysfunction and abnormal glucose metabolism. Persistent non-ovulation, excessive androgens and insulin resistance are important features and they are the most common causes of menstrual disorders in women during childbearing years. At present, the cause of PCOS is not clinically clear. Read More

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December 2020

Prognostication and contemporary management of clinically isolated syndrome.

J Neurol Neurosurg Psychiatry 2020 Dec 24. Epub 2020 Dec 24.

Department of Clinical Neurology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.

Clinically isolated syndrome (CIS) patients present with a single attack of inflammatory demyelination of the central nervous system. Recent advances in multiple sclerosis (MS) diagnostic criteria have expanded the number of CIS patients eligible for a diagnosis of MS at the onset of the disease, shrinking the prevalence of CIS. MS treatment options are rapidly expanding, which is driving the need to recognise MS at its earliest stages. Read More

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December 2020

How to Support a Surgeon Scientist: Lessons from National Institutes of Health K-Award Recipients.

J Surg Res 2021 Apr 17;260:163-168. Epub 2020 Dec 17.

NewYork-Presbyterian Hospital/Weill Cornell Medicine, Department of Surgery, New York, New York; Weill Cornell Medicine, Department of Healthcare Policy and Research, New York, New York. Electronic address:

Background: Success in academic surgery is challenging and research cannot survive without funding. NIH K-awards are designed to mentor junior investigators to achieve independence. As a result we aimed to study K awardees in departments of surgery and learn from their experience. Read More

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Intermittent and continuous energy restriction result in similar weight loss, weight loss maintenance, and body composition changes in a 6 month randomized pilot study.

Clin Obes 2021 Apr 10;11(2):e12430. Epub 2020 Dec 10.

Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA.

Poor adherence is a barrier to successful weight control. Intermittent energy restriction (IER) provides an alternative approach to those for whom daily energy restriction is not ideal. This study assessed changes in weight, body composition, and macronutrient intake for an IER and a continuous energy restriction (CONT) approach within a multicomponent weight management intervention. Read More

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A critical review of weight loss recommendations before total knee arthroplasty.

Joint Bone Spine 2021 03 2;88(2):105114. Epub 2020 Dec 2.

Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 8205 - 114 Street, 2-64 Corbett Hall, T6G 2G4 Edmonton, AB, Canada.

Objective: Increased infection risk after total knee arthroplasty (TKA) in patients with a higher body mass index (BMI), particularly a BMI ≥40kg/m, suggests that BMI reduction (through weight loss) prior to TKA may be important. However, the impact of weight loss on TKA risk reduction is unclear. Furthermore, weight loss could have detrimental consequences with respect to muscle loss and development of sarcopenic obesity, whereby a potential weight loss paradox in adults with advanced knee OA and obesity may be present. Read More

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Considerations to Support Use of Patient-Reported Outcomes Measurement Information System Pediatric Measures in Ambulatory Clinics.

J Pediatr 2021 03 30;230:198-206.e2. Epub 2020 Nov 30.

Department of Health and Rehabilitation Sciences, Temple University College of Public Health, Philadelphia, PA.

Objective: To identify challenges to the use of Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric measures in the ambulatory pediatric setting and possible solutions to these challenges.

Study Design: Eighteen semistructured telephone interviews of health system leaders, measurement implementers, and ambulatory pediatric clinicians were conducted. Five coders used applied thematic analysis to iteratively identify and refine themes in interview data. Read More

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Integrating Patient Priorities with Science by Community Engagement in the Kidney Precision Medicine Project.

Clin J Am Soc Nephrol 2021 Apr 30;16(4):660-668. Epub 2020 Nov 30.

Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

The Kidney Precision Medicine Project (KPMP) is a multisite study designed to improve understanding of CKD attributed to diabetes or hypertension and AKI by performing protocol-driven kidney biopsies. Study participants and their kidney tissue samples undergo state-of-the-art deep phenotyping using advanced molecular, imaging, and data analytical methods. Few patients participate in research design or concepts for discovery science. Read More

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Age of diagnosis clinically differentiates atypical teratoid/rhabdoid tumors diagnosed below age of 3 years: a database study.

Childs Nerv Syst 2021 Apr 24;37(4):1077-1085. Epub 2020 Nov 24.

Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL, 33136, USA.

Background: Atypical teratoid/rhabdoid tumor (ATRT) is a rare and largely pediatric diagnosis, with poor survival. Diagnosis below the age of 3 years is characteristically seen as a poor prognostic sign. However, elucidating if clinical differences exist within this niche age group has never been attempted before. Read More

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