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Summary:. Microsurgery is a complex subspecialty requiring fine manual dexterity and a thorough understanding of microsurgical techniques, requiring years of training to reach proficiency. On a global scale, trainees may not have access to a longitudinal microsurgery curriculum and instead attend brief courses to learn microsurgical techniques, limiting their ability to practice the nuances of microsurgery. There remains a gap in global microsurgical education for trainees to have consistent educational exposure. This article presents a novel and easy to use software-based microsurgical system for virtual microsurgical teaching. In doing so, this system provides a free-of-cost and highly accessible avenue to deliver consistent microsurgical education worldwide.

Orthopedic fractures have a significant impact on patients in the form of economic loss and functional impairment. Beyond the standard methods of reduction and fixation, one adjunct that has been explored since the late 1970s is electrical stimulation. Despite robust evidence for efficacy in the preclinical arena, human trials have mixed results, and this technology is not widely accepted. The purpose of this review is to examine the body of literature supporting electrical stimulation for the purpose of fracture healing in humans with an emphasis on device specifications and stimulation protocols and delineate a minimum reporting checklist for future studies of this type. We have isolated 12 studies that pertain to the administration of electrical stimulation for the purpose of augmenting fracture healing in humans. Of these, one was a direct current electrical stimulation study. Six studies utilized pulsed electromagnetic field therapy and five used capacitive coupling. When examining these studies, the device specifications were heterogenous and often incomplete in what they reported, which rendered studies unrepeatable. The stimulation protocols also varied greatly study to study. To demonstrate efficacy of electrical stimulation for fractures, the authors recommend isolating a fracture type that is prone to nonunion to maximize the electrical stimulation effect, a homogenous study population so as to not dilute the effect of electrical stimulation, and increasing scientific rigor in the form of pre-registration, blinding, and sham controls. Finally, we introduce the critical components of minimum device specification reporting for repeatability of studies of this type.

Since the piezoelectric quality of bone was discovered in 1957, scientists have applied exogenous electrical stimulation for the purpose of healing. Despite the efforts made over the past 60 years, electronic bone growth stimulators are not in common clinical use. Reasons for this include high cost and lack of faith in the efficacy of bone growth stimulators on behalf of clinicians. The purpose of this narrative review is to examine the preclinical body of literature supporting electrical stimulation and its effect on bone properties and elucidate gaps in clinical translation with an emphasis on device specifications and mechanisms of action. When examining these studies, trends become apparent. In vitro and small animal studies are successful in inducing osteogenesis with all electrical stimulation modalities: direct current, pulsed electromagnetic field, and capacitive coupling. However, large animal studies are largely unsuccessful with the non-invasive modalities. This may be due to issues of scale and thickness of tissue planes with varying levels of resistivity, not present in small animal models. Additionally, it is difficult to draw conclusions from studies due to the varying units of stimulation strength and stimulation protocols and incomplete device specification reporting. To better understand the disconnect between the large and small animal model, the authors recommend increasing scientific rigor for these studies and reporting a novel minimum set of parameters depending on the stimulation modality.

Utilizing a novel computerized task, we aimed to examine whether social anxiety symptoms would be related to individual differences in facial emotion recognition (FER) in a sample of autistic male adolescents and young adults without intellectual disability. Results indicated that social anxiety and IQ predicted poorer FER, irrespective of specific emotion type. When probing specific effects within emotion and condition types, social anxiety impacted surprise and disgust FER during a "truncated" viewing condition and not "full viewing" condition. Collectively, results suggest that social anxiety in autism may play a larger role in FER than previously thought. Future work should consider the role of social anxiety within autism as a factor that may meaningfully relate to FER assessment and intervention.

Abstract Background Antimicrobial resistance (AMR) in Enterobacterales constitutes a significant threat to the health of both humans and animals and a socioeconomic problem. Enterobacterales, mainly Escherichia coli, carrying β-lactamases has become one of the main indicators to estimate the burden of AMR in animals within “One Health” approach. Objectives To assess the presence of extended-spectrum cephalosporin-resistant Enterobacterales associated with ruminants (cattle, sheep, goats) habituated in all five provinces of Rwanda and to perform in depth characterization of isolates. Methods We screened 454 rectal swabs from 203 cows, 170 goats, and 81 sheep and selective isolation of extended-spectrum cephalosporin-resistant Enterobacterales was conducted. Isolates were identified as a members of the order Enterobacterales by MALDI-TOF MS and further characterized by susceptibility testing and by whole-genome sequencing. Results Out of the 454 samples, 64 extended-spectrum cephalosporin-resistant Enterobacterales were isolated from 58 animals. Isolates belonged to seven bacterial species and were identified as Escherichia coli (n = 54), Enterobacter bugandensis (n = 4), Enterobacter mori (n = 2), Klebsiella pneumoniae (n = 2), Enterobacter dykesii (n = 1), and Citrobacter freundii (n = 1). All isolates displayed an Extended-spectrum β-lactamases (ESBL) phenotype, with exception of Citrobacter freundii isolate displayed both an ESBL and AmpC phenotype. In addition, all Enterobacter isolates were identified as stably de-repressed AmpC-producers. ESBLs genes, bla CTX−M−15 was predominant. Resistance to tetracycline and tet(A) was most frequently observed among non-β-lactam resistance. Forty-eight isolates displayed multidrug-resistance phenotypes. A shiga toxin-producing E. coli and an enterotoxigenic E. coli isolate were observed. Genome comparisons revealed thirty-five E. coli sequence types (ST) (ST10, ST307 being predominate). Conclusions Considering the high proximity between ruminants and humans in Rwanda, the dissemination of antimicrobial drug resistance highlights the public health threats and requires the joint and multisectoral action of human and veterinary medicine, at human-animal-environment interfaces. Therefore, it is important to establish national and global “One Health” surveillance programs of AMR to tackle the antibiotic-resistant crisis in human and veterinary medicine.

Objective: The current study aimed to examine whether brief online stress reduction exercises supplemented with sleep improvement strategies would reduce stress, arousal, and sleep difficulties in college students who were not required to use the sleep improvement strategies for participation. Participants: A sample of 114 college student participants were enrolled because they were experiencing stress and/or wanted to improve their sleep. Methods: Participants were randomized into an abbreviated progressive muscle relaxation, a mindful breathing, or a self-monitoring control condition for the 4-week intervention. Measures of physical relaxation, mindfulness, perceived stress, pre-sleep arousal, and insomnia symptom severity were collected. Results: The APMR group improved on five of the six dependent measures and was significantly different than the SM group at posttest, but not different than the MB group. Conclusion: The results suggests promise for brief, online, scaled back stress reduction interventions to reduce stress, arousal, and sleep difficulties in college students.

Compared to urban counties, Utah's rural counties experienced high levels of unemployment. Informed by a statewide needs assessment, Utah State University Extension developed a remote work leadership course to equip business leaders with knowledge and skills to create remote jobs as a solution to rural unemployment. This descriptive evaluation study collected data from course participants (N = 62). Findings showed short-term outcomes were achieved; participants experienced increases in knowledge and skills and had more positive intentions toward creating remote jobs and hiring employees from rural counties. Extension professionals can design and evaluate their programs using the framework in this study.

Purpose We aimed to determine undergraduate students’ use and knowledge of fad diets as well as examine how appealing students found these diets given the goal of rapid weight loss and/or improved health. Twenty-three students from a Midwestern university (mean age = 19.2, mean BMI = 27.35, 69.6% female) were recruited through new student orientations for this qualitative study. Approximately 52% of participants identified as White, 30% as Black, 13% as Asian, and 4% as multi-racial. Methods Knowledge and opinions about fad diets were collected via focus groups and individual interviews. Coding of transcripts was conducted by hand using the constant comparative method and data were analysed based on grounded theory. Results Two primary themes emerged: very negative views of fad diets and the importance of healthy eating. Although few participants had tried fad diets, they thought these diets: 1) did not lead to sustained weight loss, 2) were associated with disappointment and health issues, and 3) were money-making schemes delivered heavily through social media. Participants also valued healthy eating. Conclusion Experimental studies are needed to examine how healthy eating among university students can be supported through credible sources, accurate information, and established connections via innovative social media platforms.

Over 60% of college students are poor-quality sleepers, and many have inconsistent weekday and weekend sleep patterns. Technology usage (e.g., cellphone, computer, television) may contribute to poor sleep, but there is limited experimental research. In a comparison trial, 60 college students (mean age = 18.76, 86.7% female, 53.3% White) were randomly assigned to a 4-week sleep hygiene and stimulus control (SHSC) intervention or an enhanced intervention including technology stimulus control instructions (SHSC-E). Both groups showed improvements in sleep hygiene practices, perceived barriers to stimulus control, sleep quality, general technology usage, and technology usage before bed. However, the SHSC-E group did not have greater improvements compared to SHSC group as hypothesized, which suggests that the combination of sleep hygiene and stimulus control is a robust enough method for reducing self-reported technology usage. A longer intervention period might be necessary to observe the benefits of technology stimulus control procedures. KEYWORDS: college students, intervention, sleep hygiene, stimulus control, technology, Poor-quality sleep is linked to a higher risk of physical (e.g., type 2 diabetes, cardiovascular disease) and mental (e.g., anxiety, depression) disorders (Institute of Medicine (US) Committee on Sleep Medicine [...]

Medical practice requires physicians to have a broad understanding of the basic sciences, have competent clinical skills, and have an ability to practice in evolving health systems in a cost-effective and evidence-based manner. Essential to the practice of medicine is an understanding of the common laboratory tests and the ability to use them effectively. The Essential Laboratory Tests for Medical Education (ELTME) is a concise document explaining the pathophysiology of common laboratory tests and clinical context for each test and was developed in response to an expressed need from medical students, residents and fellows, and medical educators. The ELTME is linked to the Pathology Competencies in Medical Education and its third competency of diagnostic medicine and therapeutic pathology. The ELTME table is a document of common laboratory tests in alphabetical listing. Laboratory tests may be easily queried by name or organ system, and with simple editing tools, new tables may be constructed to fit the needs of individual curricula or learners. Furthermore, the table may be easily expanded by educators who wish to add specific tests to complement their curricula.