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Defining Priority Areas for Critical Care Simulation: A Modified Delphi Consensus Project.

Cureus 2021 Jun 22;13(6):e15844. Epub 2021 Jun 22.

Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, USA.

Background Simulation is used in critical care for skill development, formative assessment, and interprofessional team performance. Healthcare educators need to balance the relatively high cost to deliver simulation education with the potential impact on healthcare quality. It is unclear how to prioritize simulation in critical care education, especially considering interprofessional needs across adult and pediatric populations. Read More

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Automated content analysis of cultural Diversity Perspectives in Annual Reports (DivPAR): Development, validation, and future research agenda.

Cultur Divers Ethnic Minor Psychol 2021 Jul 29. Epub 2021 Jul 29.

Erasmus Research Centre for Media, Communication, and Culture (ERMeCC).

In this article, we present a digital tool (Diversity Perspectives in Annual Reports [DivPAR]) for automated content analysis of annual reports, designed to identify the presence of three cultural diversity perspectives-the Moral, Market, and Innovation perspectives-based on earlier work by Ely and Thomas (2001). In Study 1, we describe the development and validation of the instrument, through an iterative procedure in which manual annotation of independent subsamples ( = 24, 25) by human coders was compared to the computer coding in subsequent rounds, until sufficient agreement was reached. In Study 2, we illustrate the type of data that the script generates, by analyzing the prevalence of the three perspectives in annual reports of 55 Dutch organizations over a period of 2 decades (1999-2018; = 937). Read More

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Clinical practice guidelines for the treatment of allergic rhinitis in children with traditional Chinese medicine.

Anat Rec (Hoboken) 2021 Jul 29. Epub 2021 Jul 29.

Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

Allergic rhinitis (AR) is one of the most common allergic diseases in children and it can lead to physical and mental health problems. Traditional Chinese medicine (TCM) plays an important role in understanding the phenotypes and treatment of AR. However, there are currently no normative clinical practice guidelines (CPGs) for the treatment of AR in children. Read More

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Mass Drug Administration With Artemisinin-Piperaquine for the Elimination of Residual Foci of Malaria in São Tomé Island.

Front Med (Lausanne) 2021 12;8:617195. Epub 2021 Jul 12.

Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, China.

Mass drug administration with artemisinin-piperaquine (AP-MDA) is being considered for elimination of residual foci of malaria in Democratic Republic of São Tomé and Principe. Three monthly rounds of AP-MDA were implemented from July to October 2019. Four zones were selected. Read More

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A male-ABCD algorithm for hepatocellular carcinoma risk prediction in HBsAg carriers.

Chin J Cancer Res 2021 Jun;33(3):352-363

State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Objective: Hepatocellular carcinoma (HCC) development among hepatitis B surface antigen (HBsAg) carriers shows gender disparity, influenced by underlying liver diseases that display variations in laboratory tests. We aimed to construct a risk-stratified HCC prediction model for HBsAg-positive male adults.

Methods: HBsAg-positive males of 35-69 years old (N=6,153) were included from a multi-center population-based liver cancer screening study. Read More

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Diverse experts' perspectives on ethical issues of using machine learning to predict HIV/AIDS risk in sub-Saharan Africa: a modified Delphi study.

BMJ Open 2021 Jul 28;11(7):e052287. Epub 2021 Jul 28.

Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California, USA.

Objective: To better understand diverse experts' views about the ethical implications of ongoing research funded by the National Institutes of Health that uses machine learning to predict HIV/AIDS risk in sub-Saharan Africa (SSA) based on publicly available Demographic and Health Surveys data.

Design: Three rounds of semi-structured surveys in an online expert panel using a modified Delphi approach.

Participants: Experts in informatics, African public health and HIV/AIDS and bioethics were invited to participate. Read More

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Pediatric Intensive Care Unit (PICU) Patient Room Design: Identifying Safety Risks in Mirrored Rooms Through a Graphical Systems Analysis.

HERD 2021 Jul 29:19375867211032921. Epub 2021 Jul 29.

Division of Pediatric Critical Care, Department of Pediatrics, 1367 Children's Healthcare of Atlanta, GA, USA.

Objective: The objectives of this study are to graphically depict specific clinical challenges encountered in a mirrored pediatric intensive care unit patient room and to represent potential solutions to address these challenges using a systems approach.

Background: The intensive care unit (ICU) patient room is a highly complex patient care environment where the design of the room must support patient care delivery safely and efficiently. There is a lack of research examining how ICU design elements interact with other system components to impact patient care. Read More

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Twenty-One for 2021: The Most Influential Papers in Laryngology Since 2000.

Laryngoscope 2021 Jul 28. Epub 2021 Jul 28.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A.

Objectives/hypothesis: To identify the most influential publications in laryngology since 2000.

Study Design: Modified Delphi process.

Methods: Samples of laryngologists drawn from editors of leading journals, organization officers, and thought leaders were invited to participate in a modified Delphi identification of influential laryngology papers. Read More

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Content validation of a self-report daily diary in patients with sickle cell disease.

J Patient Rep Outcomes 2021 Jul 27;5(1):63. Epub 2021 Jul 27.

Optum, 1301 Atwood Ave, Suite 311N, Johnston, RI, USA.

Background: Sickle Cell Disease (SCD) is a genetic progressive vascular disease that impacts patients overall health and quality of life. Sickle-cell pain crises (SCPCs) are a hallmark clinical presentation of SCD and have been associated with increased morbidity and mortality. The Sickle Cell Pain Diary- Self Report (SCPD-S) was developed as a daily patient-reported outcome (PRO) measure primarily intended to capture the frequency and severity of SCD-related pain during and outside of a SCPC. Read More

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Leadership Competencies for Knowledge Translation in Public Health: A consensus study.

J Public Health (Oxf) 2021 Jul 27. Epub 2021 Jul 27.

Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, The Netherlands.

Background: In 2010, 240 billion US dollars was invested worldwide to conduct research for health; unfortunately, 200 billion was misused in the production and reporting of the evidence researched. Universities could facilitate students to acquire leadership competencies to move well-conducted research findings into practical use; this could be an essential move to reduce the misuse of investment.

Methods: A literature review was done based on the Equator Network and Cochrane guidelines, followed by three Delphi rounds to select competencies. Read More

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Enduring problems in the offspring of depressed parents followed up to 38 years.

EClinicalMedicine 2021 Aug 13;38:101000. Epub 2021 Jul 13.

Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA.

Background: while the increased risk of major depressive disorder (MDD) in offspring of depressed parents is one of the best-replicated findings in psychiatry, their long-term outcomes are less well known. The clinical outcomes of biological offspring of depressed (high-risk) and not depressed (low-risk) parents who have been directly interviewed over the years are presented.

Methods: longitudinal retrospective cohort study began in 1982, and 276 biological offspring of moderately-to-severely depressed or non-depressed parents from the same community were followed up to 38 years. Read More

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Antimicrobial Resistance Pilot Surveillance of Pigs and Chickens in Vietnam, 2017-2019.

Front Vet Sci 2021 8;8:618497. Epub 2021 Jul 8.

Food and Agriculture Organization of the United Nations Country Office for Vietnam, Hanoi, Vietnam.

Antimicrobial use (AMU) and antimicrobial resistance (AMR) are a growing public health and economic threat in Vietnam. We conducted a pilot surveillance programme in five provinces of Vietnam, two in the south and three in the north, to identify antimicrobial resistance (AMR) in rectal swab samples from pigs and fecal samples from chickens at slaughter points during three different points in time from 2017 to 2019. () and non-typhoidal (NTS) isolates were tested for antimicrobial susceptibility using disk diffusion assay for 19 antimicrobial agents belonging to nine antimicrobial classes and Etest for colistin (polymyxin). Read More

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Effect of genetic background on the evolution of Vancomycin-Intermediate (VISA).

PeerJ 2021 13;9:e11764. Epub 2021 Jul 13.

Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA.

Vancomycin-intermediate (VISA) typically arises through accumulation of chromosomal mutations that alter cell-wall thickness and global regulatory pathways. Genome-based prediction of VISA requires understanding whether strain background influences patterns of mutation that lead to resistance. We used an iterative method to experimentally evolve three important methicillin-resistant (MRSA) strain backgrounds-(CC1, CC5 and CC8 (USA300)) to generate a library of 120 laboratory selected VISA isolates. Read More

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Estimating the Minimal Number of Repeated Examinations for Random Responsiveness With the Coma Recovery Scale-Revised as an Example.

Front Integr Neurosci 2021 8;15:685627. Epub 2021 Jul 8.

School of Public Health, Sun Yat-sen University, Guangzhou, China.

The aim of this study was to develop a general method to estimate the minimal number of repeated examinations needed to detect patients with random responsiveness, given a limited rate of missed diagnosis. Basic statistical theory was applied to develop the method. As an application, 100 patients with disorders of consciousness (DOC) were assessed with the Coma Recovery Scale-Revised (CRS-R). Read More

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Patterns of multiple human papillomavirus clearance during 5-aminolevulinic acid-based photodynamic therapy in patients with genital warts.

Photodiagnosis Photodyn Ther 2021 Jul 22:102454. Epub 2021 Jul 22.

Nanfang hospital, Southern Medical University, Guangzhou, 510515, China. Electronic address:

Background: Multiple human papillomavirus infections are commonly encountered in genital warts. Infection can be eliminated using 5-aminolevulinic acid-based photodynamic therapy. The aim of this study was to identify the preponderant genotypes and patterns of human papillomavirus co-infection clearance during photodynamic therapy in patients with genital warts. Read More

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Development and field testing of a patient decision aid for management of acute Achilles tendon rupture: a study protocol.

BMC Med Inform Decis Mak 2021 Jul 24;21(1):225. Epub 2021 Jul 24.

Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, Canada.

Background: Achilles tendon ruptures are common injuries in an otherwise healthy, active population. Several treatment options exist, with both surgical and non-surgical options. Each treatment option has a unique set of risks and harms, which may present patients with decisional conflict. Read More

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Neuroplasticity induced by the retention period of a complex motor skill learning in rats.

Behav Brain Res 2021 Jul 21;414:113480. Epub 2021 Jul 21.

Master's and Doctoral Programs in Physical Therapy, University of the City of São Paulo, São Paulo, SP, Brazil. Electronic address:

Learning complex motor skills is an essential process in our daily lives. Moreover, it is an important aspect for the development of therapeutic strategies that refer to rehabilitation processes since motor skills previously acquired can be transferred to similar tasks (motor skill transfer) or recovered without further practice after longer delays (motor skill retention). Different acrobatic exercise training (AE) protocols induce plastic changes in areas involved in motor control and improvement in motor performance. Read More

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A New List for Choosing Wisely Canada From the "Hidden Profession" of Medical Laboratory Science.

Am J Clin Pathol 2021 Jul 24. Epub 2021 Jul 24.

University of Alberta, Edmonton, Canada.

Objectives: Choosing Wisely Canada (CWC) publishes practices that may contribute to medical overuse and patient harm. Many practices concern laboratory testing, but the recommendations are often written for the test-ordering professionals. Our objective was to develop a list for CWC reflecting the scope of practice of nonpathologist medical laboratory professionals (MLPs). Read More

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Interlaboratory comparison investigations (ICIs) and external quality assurance schemes (EQUASs) for flame retardant analysis in biological matrices: Results from the HBM4EU project.

Environ Res 2021 Jul 20;202:111705. Epub 2021 Jul 20.

University of Chemistry and Technology (UCT), Prague, Faculty of Food and Biochemical Technology, Department of Food Analysis and Nutrition, Technicka 5, Prague, 166 28, Czech Republic.

The European Human Biomonitoring Initiative (HBM4EU) is coordinating and advancing human biomonitoring (HBM). For this purpose, a network of laboratories delivering reliable analytical data on human exposure is fundamental. The analytical comparability and accuracy of laboratories analysing flame retardants (FRs) in serum and urine were investigated by a quality assurance/quality control (QA/QC) scheme comprising interlaboratory comparison investigations (ICIs) and external quality assurance schemes (EQUASs). Read More

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Development of an International Standardized Curriculum for Laparoscopic Sleeve Gastrectomy Teaching Utilizing Modified Delphi Methodology.

Obes Surg 2021 Jul 22. Epub 2021 Jul 22.

M306, CTEC, Medical School, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Australia.

Background: The performance of laparoscopic sleeve gastrectomy has increased markedly to become the single-most performed bariatric surgical procedure globally. To date, a means of standardized trainee teaching has not been developed. The aim of this study was to design a laparoscopic curriculum for trainees of bariatric surgery utilizing modified Delphi consensus methodology. Read More

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A three-phase population based sero-epidemiological study: Assessing the trend in prevalence of SARS-CoV-2 during COVID-19 pandemic in Jordan.

One Health 2021 Dec 10;13:100292. Epub 2021 Jul 10.

Jordan University Hospital, Amman, Jordan.

The evolution of the COVID-19 pandemic in Jordan during the first 10 months of the epidemic was peculiar and can be easily categorized in three different phases: a first period featuring a very low number of reported cases, a second period with exponential growth from August with up to 8000 cases on the 18th November 2020, and a third phase with steady and progressive decline of the epidemiological curve. With the aim of better determine the entity of the population exposed to SARS-CoV-2, the Jordan Ministry of Health with the support of the WHO launched three rounds of the nationwide sero-prevalence survey. Using population proportionate to size (PPS) methodology, around 5000 individuals were selected from all Jordan governorates. Read More

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December 2021

Morning report for all: a qualitative study of disseminating case conferences via podcasting.

BMC Med Educ 2021 Jul 22;21(1):392. Epub 2021 Jul 22.

University of California, 513 Parnassus, Suite S-245, San Francisco, CA, 94143-0454, USA.

Background: Despite its long-established importance, diagnostic reasoning (DR) education has suffered uneven implementation in medical education. The Clinical Problem Solvers (CPSolvers) podcast has emerged as a novel strategy to help teach DR through case conferences with expert diagnosticians and trainees. CPSolvers has 25,000 listeners in 147 countries. Read More

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Three changes to reduce the loss of dual degree trainees from OMFS national specialty selection in the UK: evidence based proposals.

Br J Oral Maxillofac Surg 2021 Feb 1. Epub 2021 Feb 1.

Sheffield Teaching Hospitals & Barnsley Hospitals NHS Foundation Trusts. Electronic address:

The training pathway for oral and maxillofacial surgery (OMFS) has remained relatively stable for around 30 years. Circumstances surrounding the training pathway have changed including the priorities of individuals considering entering OMFS training. Run-through Specialty Training (ST1) OMFS posts (which include core surgical training) are oversubscribed while direct entry to Specialty Training (ST3) OMFS specialty recruitment rounds have unfilled posts, including places declined by appointable candidates. Read More

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February 2021

A Modified Delphi Involving Laboratory Faculty to Define Essential Skills for Pharmacy Graduates.

Am J Pharm Educ 2021 Feb 13;85(2):848114. Epub 2020 Nov 13.

Marshall University, School of Pharmacy, Huntington, West Virginia.

To define essential skills for Doctor of Pharmacy (PharmD) graduates that are needed in the four most common sectors of pharmacy practice as determined by expert faculty who instruct within pharmacy skills laboratories. A three-round Delphi method was used to establish consensus. In the first round, participants were asked what skills were needed by students at entry to practice in community, health-system, ambulatory care, and managed care pharmacy settings. Read More

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February 2021

Automation Use and Dis-Use in Golf: The Impact of Distance Measuring Devices on Trust in Technology and Confidence in Determining Distance.

Front Psychol 2021 2;12:655387. Epub 2021 Jul 2.

School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.

An athlete's decision to use technology depends on trust in the automation, and confidence in their abilities. Distance measuring devices (DMD) are used in golf to estimate yardage. The purpose of these studies was to examine how DMD usage affects trust in the DMD, confidence in determining yardage manually, and golf performance over time. Read More

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Developing a National Set of Health Equity Indicators Using a Consensus Building Process.

Int J Health Policy Manag 2021 Jun 23. Epub 2021 Jun 23.

Department of Health Policy and Management, Faculty of Health Sciences & Guildford Glazer Faculty of Business and management, Ben Gurion University of the Negev, Beersheba, Israel.

Background: Considerable health inequities documented in Israel between communities, populations and regions, undermine the rights of all citizens to optimal health. The first step towards health equity is agreement on a set of national indicators, reflecting equity in healthcare provision and health outcomes, and allowing monitoring of the impact of interventions on the reduction of disparities. We describe the process of reaching a consensus on a defined set of national equity indicators. Read More

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A clinical study of carbon dioxide lattice laser-assisted or microneedle-assisted 5-aminolevulinic acid-based photodynamic therapy for the treatment of hypertrophic acne scars.

Photodermatol Photoimmunol Photomed 2021 Jul 17. Epub 2021 Jul 17.

General Hospital of Air Force, PLA, Beijing, China.

Objective: To study the clinical efficacy, recurrence rate and safety of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) combined with microneedle or CO2 lattice laser (CO2FL), in comparison with intrascar betamethasone injection in the treatment of hypertrophic acne scar.

Methods: Fifty-two patients with hypertrophic acne scars at the mandibular angle were enrolled and assigned to different therapy groups. Sixteen patients were treated with microneedle-assisted incorporation of ALA. Read More

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Defining a Severe Asthma Super-Responder: Findings from a Delphi Process.

J Allergy Clin Immunol Pract 2021 Jul 13. Epub 2021 Jul 13.

Optimum Patient Care, Brisbane, Queensland, Australia; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom; Observational and Pragmatic Research Institute, Singapore.

Background: Clinicians are increasingly recognizing severe asthma patients in whom biologics and other add-on therapies lead to dramatic improvement. Currently, there is no agreed-upon super-responder (SR) definition.

Objective: To survey severe asthma experts using a modified Delphi process, to develop an international consensus-based definition of a severe asthma SR. Read More

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Development of Tuberculosis Spine Instability Score (TSIS): An Evidence-Based and Expert Consensus-Based Content Validation Study Among Spine Surgeons.

Spine (Phila Pa 1976) 2021 Jul 16. Epub 2021 Jul 16.

Department of Orthopaedic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India Department of Spine, Wockhardt Hospital, Mumbai, India Department of Orthopaedics, Hinduja Healthcare Surgical, Mumbai, India Department of Orthopaedic Surgery, Lilavati Hospital & Research Centre, Mumbai, India Department of Orthopaedics, Breach Candy Hospital Trust, Mumbai, India Department of Orthopedics, Wadia Children's Hospital, Mumbai, India Department of Spine Surgery, Kothari Medical Center, Kolkata, India Department of Spine Surgery, Park Clinic, Kolkata, India Department of Spine Surgery, Ganga Hospital, Coimbatore, India Department of spine surgery, Sir Gangaram hospital, New Delhi, India Department of Spine Services, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, India Department of Orthopaedics, Primus Superspeciality Hospital, New Delhi, India.

Study Design: An expert-panel consensus-based content validation and case-based clinical validation study.

Objective: To develop a novel scoring system for diagnosing instability in tuberculosis (TB) spine using an expert-panel consensus followed by clinical validation for validating the content.

Summary Of Background Data: Currently, diagnosis of instability is primarily experience-based which may lead to considerable variability and misdiagnosis in the hands of a relatively in-experienced spine surgeon. Read More

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Developing a midwifery service task list for Chinese midwives in the task-shifting context: a Delphi study.

BMJ Open 2021 Jul 15;11(7):e044792. Epub 2021 Jul 15.

Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China

Objective: To develop and validate a midwifery-led task list in the task-shifting context.

Design: An extensive literature review followed by a two-iterative Delphi survey.

Setting: Twenty university hospitals, three non-university hospitals and four university colleges from nine provincial regions of China. Read More

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