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The Baylor University Medical Center Department of Medical Education hosted its seventh annual Medical Education Research Forum on April 21, 2021, to showcase the research efforts of its medical students, residents, and fellows. Thirty-six posters were shared and 18 oral presentations were given. Here we present 17 award-winning abstracts.This prospectively designed, clinical quality improvement project compared pain scores and opioid consumption between ultrasound-guided, erector spinae plane blocks (ESPB) and thoracic paravertebral blocks (PVB) in patients undergoing total bilateral mastectomies without reconstruction. Twenty-five patients were included in an enhanced recovery pathway and received an ESPB on one side and a PVB on the contralateral side. Numeric rating scores at rest and with movement for each side were recorded in the recovery room at 2, 6, 12, 24, and 48 hours and on days 3 to 7. There were no significant differences in the resting or movement-evoked pain scores between sides receiving ESPB or PVB at any time point up to day 7 after surgery. Both ESPB and PVB confer equal analgesic effects in patients undergoing mastectomies. ESPB provides an alternative to PVB in reducing postoperative pain in patients undergoing mastectomy as part of an enhanced recovery pathway.This retrospective study examined clinical parameters associated with amantadine treatment of psychiatric symptoms in children. A total of 297 pediatric patients were prescribed amantadine and met study criteria to assess clinical responses and medication outcomes. More than 62% of patients experienced clinically significant symptom control and 83% achieved at least maintenance symptom control, while 11% discontinued amantadine for nonresponse and 6% stopped amantadine because of side effects. SGI-1776 chemical structure Among patients previously receiving other psychotropic medication, 42% and 28% of patients fully discontinued second- or third-generation antipsychotics or antidepressants, respectively. Patients responsive to amantadine who discontinued or reduced antipsychotic dose experienced a significant reduction in body mass index. Amantadine appears be an efficacious and safe alternative for treatment of a broad set of psychiatric symptoms in children and adolescents. Specifically, it may serve as an effective adjunct to stimulants for attention deficit/hyperactivity disorder-related symptoms and appears to be a safer alternative to second- or third-generation antipsychotics.16 Fr Salem Sump™ tubes have special features to facilitate suction drainage of the stomach, including a second lumen for air venting. These tubes are also commonly used to deliver enteral nutrition and medications to intensive care unit (ICU) patients, but we found no previous research to justify this practice. Because of the unused air vent, these tubes have a large external diameter and a small bore infusion channel (no larger than that of a single lumen 12 Fr feeding tube). The causes of 16 Fr Salem Sump tube obstructions in 17 ICU patients included clogged medications (8 cases) and precipitation of feeding formula (7 cases), each of which would be promoted by a narrow bore. Because of multiple drainage holes at their distal end, these tubes cannot be thoroughly cleansed by standard water flushing; moreover, their drainage holes mandate a deeper length of tube insertion beyond the gastroesophageal junction, which increases the likelihood of intestinal or pulmonary perforation. For these reasons, we conclude that 16 Fr Salem Sump tubes are inferior to standard feeding tubes for delivery of enteral nutrition and medications to patients in medical ICUs.The objective of this study was to evaluate the safety and efficacy of apixaban 5 mg twice daily vs 2.5 mg twice daily for nonvalvular atrial fibrillation or venous thromboembolism in patients with chronic kidney disease stage 4 and 5, including those on hemodialysis. Data were collected retrospectively on patients with advanced chronic kidney disease and nonvalvular atrial fibrillation and/or venous thromboembolism who received apixaban while hospitalized at our institution between January 2013 and August 2018. The 5 mg twice daily group included 22 patients, and the 2.5 mg twice daily group included 73 patients. There was no difference between groups in major bleeding events (9.1% vs. 12.3%, P = 1.00), any bleeding event (45.4% vs. 67.1%, P = 0.08), ischemic stroke (0% vs. 2.7%, P = 1.00), or venous thromboembolism (4.5% vs. 0%, P = 0.23). Subgroup analyses of patients with a serum creatinine >2.5 mg/dL or creatinine clearance less then 25 mL/min and patients on hemodialysis produced similar results. Until larger trials are conducted, clinicians should make patient-specific decisions about the optimal dose of apixaban in patients with severe renal impairment.This study aimed to describe the trends, inpatient outcomes, and disease burden of hospitalizations for ulcerative colitis (UC) and Crohn's disease (CD). Our study included data on hospitalizations with a principal discharge diagnosis of CD and UC gathered from the Nationwide Inpatient Sample for the years 2008, 2010, 2012, 2014, 2016, and 2018. Individuals ≤18 years and elective hospitalizations were excluded. From 2008 to 2018, we noted a rising trend for UC hospitalizations (P trend less then 0.001). However, there was no statistically significant trend for CD hospitalizations (P trend = 0.249). The overall inpatient mortality for UC downtrended from 1.09% in 2008 to 0.42% in 2014 (P trend less then 0.001). Additionally, inpatient mortality for CD also downtrended with a decrease from 0.28% in 2008 to 0.17% in 2016 (P trend = 0.002). Odds of inpatient mortality from 2008 to 2018 were significantly higher for UC than for CD. In conclusion, both CD and UC saw a significant decline in mortality over the study period, but UC hospitalizations had a higher odds of inpatient mortality for all study years.To gain understanding of the burden of cardiac arrhythmias in patients with acutely decompensated diabetes mellitus (ADDM) on a large scale, we reviewed data on ADDM patients and subtypes of arrhythmias from the National Inpatient Sample from 2010 to 2014. The frequency and prevalence of cardiac arrhythmias were measured, as well as outcomes. Among 874,107 hospitalized ADDM patients identified, 87,970 (10.1%) developed arrhythmias. The ADDM-arrhythmia cohort showed higher all-cause mortality (1.4% vs 0.3%; adjusted odds ratio 2.58, 95% confidence interval 2.39-2.79, P less then 0.001), prolonged hospital stays (4.2 ± 4.8 vs 3.3 ± 3.4 days), and higher hospital charges ($32,609 vs $23,741) compared to those without arrhythmias (P less then 0.001). The prevalence of supraventricular arrhythmia (atrial fibrillation, supraventricular tachycardia, and atrial flutter) and ventricular arrhythmia (ventricular tachycardia and ventricular fibrillation) was 2965 and 446 per 100,000 ADDM-related hospitalizations, respectively. The prevalence of any arrhythmias and atrial fibrillation in ADDM patients increased by 20.4% and 38.1%, respectively. The highest increase in the prevalence of arrhythmia among ADDM patients was observed in adults aged 18 to 44 years (22.5%).Our study aims to establish trends and frequencies of ventricular tachyarrhythmia (VTA) among patients with chronic coronary total occlusion (CCTO). We identified CCTO hospitalizations with and without VTA using the National Inpatient Sample. A total of 911,579 CCTO-related hospitalizations were identified, with 92,450 (10.1%) encounters associated with VTA. The CCTO-VTA cohort showed higher all-cause mortality (adjusted odds ratio [aOR] = 4.45, P less then  0.001), longer hospital stays (6.8 vs 4.6 days; P less then  0.001), and higher hospital charges ($117,382 vs $75,419; P less then  0.001) compared to the CCTO non-VTA group. Rates and odds of cardiogenic shock (aOR = 4.19), venous thromboembolism (aOR = 2.09), respiratory failure (aOR = 2.85), and requirement of mechanical ventilation (aOR = 4.23) were higher in the CCTO-VTA group (P less then  0.001). Over time, there was an increase in VTA (9.2% in 2010 to 12.1% in 2014) and all-cause mortality (7.5% in 2010 to 12.4% in 2014; P less then  0.001). Trends in VTA among patients with CCTO increased by 4.8% for undergoing percutaneous coronary intervention and by 2.5% for undergoing both percutaneous coronary intervention and coronary artery bypass grafting (P less then  0.001). Occurrence of VTA among CCTO patients is associated with worse outcomes and higher resource utilization.Existing research has shown that university-industry collaboration (UIC) helps a firm achieve superior innovation outcomes. However, little is known about how UIC affects firm innovation when considering interfirm alliances. In this paper, we examine the influence of UIC on firm innovation performance by considering the interfirm alliance network. Based on a panel of 285 biopharmaceutical firms across the world over a thirty-year period from 1985 to 2014, we find that UIC enhances firm innovation performance. More alliances with other firms hinder the positive effect of UIC on firm innovation, whereas technological diversity strengthens the influence of UIC. Theoretical and practical implications of the results are discussed.The current study addressed the role that perfectionism plays among professionals in this field of marriage and family therapy (MFT). Specifically, this study provides information about PS (personal standards) perfectionism and EC (evaluative concerns) and their relationship with both compassion satisfaction and compassion fatigue. The sample included 247 marriage and family therapists who answered demographic questions along with completing the professional quality of life scale (ProQOL; as reported by Stamm, B. H. (2009). Professional Quality of Life Compassion Satisfaction and Fatigue Version 5 (ProQOL). Retrieved from http//www.proqol.org/ProQol_Test.html; Stamm in The concise ProQOL manual, ProQOL.org, 2010;) and the multidimensional perfectionism scale (MPS; Hewitt and Flett, Journal of Personality and Social Psychology 60456-470, 1991). Results indicated three significant findings (1) higher levels of both self-oriented and socially oriented perfectionism are correlated with higher levels of both burnout and secondary traumatic stress; (2) as years of work as an MFT increase, level of burnout decreases; and (3) women demonstrated statistically significantly higher scores in PS perfectionism than men. Limitations, implications, and future directions are discussed.The emergence of the "4th Industrial Revolution," i.e. the convergence of artificial intelligence, the Internet of Things, advanced materials, and bioengineering technologies, could accelerate socioeconomic insecurities and anxieties or provide beneficial alternatives to the status quo. In the post-Covid-19 era, the entities that are best positioned to capitalize on these innovations are large firms, which use digital platforms and big data to orchestrate vast ecosystems of users and extract market share across industry sectors. Nonetheless, these technologies also have the potential to democratize ownership, broaden political-economic participation, and reduce environmental harms. We articulate the potential sociotechnical pathways in this high-stakes crossroads by analyzing cellular agriculture, an exemplary 4th Industrial Revolution technology that synergizes computer science, biopharma, tissue engineering, and food science to grow cultured meat, dairy, and egg products from cultured cells and/or genetically modified yeast.
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