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Understanding context specificity: the effect of contextual factors on clinical reasoning.

Abigail Konopasky, Anthony R Artino, Alexis Battista, Megan Ohmer, Paul A Hemmer, Dario Torre, Divya Ramani, Jeroen van Merrienboer, Pim W Teunissen, Elexis McBee, Temple Ratcliffe, Steven J Durning,

Background Situated cognition theory argues that thinking is inextricably situated in a context. In clinical reasoning, this can lead to context specificity: a physician arriving at two different diagnoses for two patients with the same symptoms, findings, and diagnosis but different contextual factors (something beyond case content potentially influencing reasoning). ... Read more >>

Diagnosis (Berl) (Diagnosis (Berlin, Germany))
[2020, :]

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Uniformed Services University Medical Student Mentorship Experiences and Gender From 2010 to 2017.

Kerry Latham, Ting Dong, Deanna Schreiber, Dario Torre, Steve Durning, Alexis Battista,

INTRODUCTION:Gender disparity in medicine has drawn increased attention in the form of root cause analysis and programmatic solutions with the goal of equity. Research indicates that mentoring, guidance, and support, which include the provision of social and academic guidance and support from more experienced practitioners, can mitigate challenges associated with ... Read more >>

Mil Med (Military medicine)
[2020, :]

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Reflections on Career Pathways of Simulation-Focused Experts in the Field.

Jill Steiner Sanko, Aaron W Calhoun, S Barry Issenberg, Michelle Kelly, Alexis Battista,

STATEMENT:This article presents reflections of career pathways of simulation researchers as well as a discussion of the themes found in the stories presented. It is the intent of the authors to present and foster a discussion around the ways in which we as a simulation community wish to promote recognition ... Read more >>

Simul Healthc (Simulation in healthcare : journal of the Society for Simulation in Healthcare)
[2020, :]

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The Linguistic Effects of Context Specificity: Exploring Affect, Cognitive Processing, and Agency in Physicians' Think-Aloud Reflections.

Abigail Konopasky, Steven J Durning, Anthony R Artino, Divya Ramani, Alexis Battista,

Background The literature suggests that affect, higher-level cognitive processes (e.g. decision-making), and agency (the capacity to produce an effect) are important for reasoning; however, we do not know how these factors respond to context. Using situated cognition theory as a framework, and linguistic tools as a method, we explored the ... Read more >>

Diagnosis (Berl) (Diagnosis (Berlin, Germany))
[2020, :]

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The relationship between symptom burden and systemic inflammation differs between male and female athletes following concussion.

Alex Di Battista, Nathan Churchill, Shawn Rhind, Doug Richards, Michael Hutchison,

Abstract Background: Inflammation appears to be an important component of concussion pathophysiology. However, its relationship to symptom burden is unclear. Therefore, the purpose of this study was to evaluate the relationship between symptoms and inflammatory biomarkers measured in the blood of male and female athletes following sport-related concussion (SRC). Results ... Read more >>

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Capacity-Resolution Trade-Off in the Optimal Learning of Multiple Low-Dimensional Manifolds by Attractor Neural Networks.

Aldo Battista, Rémi Monasson,

Recurrent neural networks (RNN) are powerful tools to explain how attractors may emerge from noisy, high-dimensional dynamics. We study here how to learn the ∼N^{2} pairwise interactions in a RNN with N neurons to embed L manifolds of dimension D≪N. We show that the capacity, i.e., the maximal ratio L/N, ... Read more >>

Phys. Rev. Lett. (Physical review letters)
[2020, 124(4):048302]

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Two case reports of fetal alcohol syndrome: broadening into the spectrum of cardiac disease to personalize and to improve clinical assessment.

R Onesimo, C De Rose, A B Delogu, A Battista, C Leoni, S Veltri, G De Rosa, G Zampino,

BACKGROUND:Fetal alcohol spectrum disorder (FASD) refers to a broad spectrum of disabilities, in infants and children, resulting from moderate to excessive prenatal alcohol exposure. Significant associations with alcohol exposure were already reported with congenital structural heart defects: i.e. ventricular septal defects, atrial septal defects, conotruncal defects. CASES PRESENTATION:We describe two ... Read more >>

Ital J Pediatr (Italian journal of pediatrics)
[2019, 45(1):167]

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It Totally Possibly Could Be: How a Group of Military Physicians Reflect on Their Clinical Reasoning in the Presence of Contextual Factors.

Abigail Konopasky, Divya Ramani, Megan Ohmer, Alexis Battista, Anthony R Artino, Elexis McBee, Temple Ratcliffe, Steven J Durning,

INTRODUCTION:Contextual factors (eg, diagnostic suggestion and burnout) can affect physician clinical reasoning performance, leading to diagnostic error. Yet, contextual factors have only recently been studied and none of that work focused on how physicians appraise (ie, evaluate) the clinical situation as they reason. The purpose of this qualitative study was ... Read more >>

Mil Med (Military medicine)
[2020, 185(Suppl 1):575-582]

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Heart Rate and Heart Rate Variability Correlate with Clinical Reasoning Performance and Self-Reported Measures of Cognitive Load.

Soroosh Solhjoo, Mark C Haigney, Elexis McBee, Jeroen J G van Merrienboer, Lambert Schuwirth, Anthony R Artino, Alexis Battista, Temple A Ratcliffe, Howard D Lee, Steven J Durning,

Cognitive load is a key mediator of cognitive processing that may impact clinical reasoning performance. The purpose of this study was to gather biologic validity evidence for correlates of different types of self-reported cognitive load, and to explore the association of self-reported cognitive load and physiologic measures with clinical reasoning ... Read more >>

Sci Rep (Scientific reports)
[2019, 9(1):14668]

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Clinical Reasoning in the Ward Setting: A Rapid Response Scenario for Residents and Attendings.

Megan Ohmer, Steven J Durning, Walter Kucera, Matthew Nealeigh, Sarah Ordway, Thomas Mellor, Jeffery Mikita, Anna Howle, Sarah Krajnik, Abigail Konopasky, Divya Ramani, Alexis Battista,

Introduction:There is a need for educational resources supporting the practice and assessment of the complex processes of clinical reasoning in the inpatient setting along a continuum of physician experience levels. Methods:Using participatory design, we created a scenario-based simulation integrating diagnostic ambiguity, contextual factors, and rising patient acuity to increase complexity. ... Read more >>

MedEdPORTAL (MedEdPORTAL : the journal of teaching and learning resources)
[2019, 15:10834]

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In Response to RE: Uniformed Services University Women's Enrollment and Career Choices in Military Medicine: A Retrospective Descriptive Analysis.

Ronald M Cervero, Alexis Battista, Deanna N Schreiber-Gregory, Abigail Konopasky, Dario Torre, Lauren A Maggio, John R Boulet, Brian V Reamy, Steven J Durning,

Mil Med (Military medicine)
[2019, 184(9-10):195]

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Why health professions education needs functional linguistics: the power of 'stealth words'.

Abigail Konopasky, Divya Ramani, Megan Ohmer, Steven J Durning, Anthony R Artino, Alexis Battista,

CONTEXT:Language is one of the primary modalities for teaching and learning in the health professions in contexts ranging from the more formal teaching relationships of medical school to the guided practice of trainees through continuing education and the deliberate practice of lifelong learning. Yet linguistic analysis, with the possible exception ... Read more >>

Med Educ (Medical education)
[2019, 53(12):1187-1195]

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Usefulness of Red Cells Distribution Width to Predict Worse Outcomes in Patients With Atrial Fibrillation.

Vincenzo Livio Malavasi, Marco Proietti, Stefano Spagni, Anna Chiara Valenti, Antonella Battista, Daniele Pettorelli, Jacopo Colella, Marco Vitolo, Gregory Yh Lip, Giuseppe Boriani,

Red cells distribution width (RDW) is a measure of red cell size variability, but little is known about the relation between RDW and outcomes in atrial fibrillation (AF).The aims of our study were to evaluate the association between RDW values, AF patients' profile and outcomes. Consecutive patients with ECG-confirmed AF ... Read more >>

Am. J. Cardiol. (The American journal of cardiology)
[2019, 124(10):1561-1567]

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Situated learning theory in health professions education research: a scoping review.

Bridget C O'Brien, Alexis Battista,

At a time when cognitive and behavioral theories dominated the landscape of learning theories, Lave and Wenger's situated learning theory (SLT) opened new territory by illuminating social and cultural learning processes. Many researchers and educators in the health professions embraced this theory, but few have considered how SLT has been ... Read more >>

Adv Health Sci Educ Theory Pract (Advances in health sciences education : theory and practice)
[2020, 25(2):483-509]

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Uniformed Services University Women's Enrollment and Career Choices in Military Medicine: A Retrospective Descriptive Analysis.

Ronald M Cervero, Alexis Battista, Deanna N Schreiber-Gregory, Abigail Konopasky, Dario Torre, Lauren A Maggio, John R Boulet, Brian V Reamy, Steven J Durning,

INTRODUCTION:The purpose of this study was to examine Uniformed Services University (USU) women graduates in terms of percent of graduates', specialty choices and practice choices as compared to civilian women who graduate and practice medicine in the USA. This is a perspective that is currently not well understood. MATERIALS AND ... Read more >>

Mil Med (Military medicine)
[2019, 184(5-6):e158-e163]

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Clinical Reasoning in the Primary Care Setting: Two Scenario-Based Simulations for Residents and Attendings.

Alexis Battista, Abigail Konopasky, Divya Ramani, Megan Ohmer, Jeffrey Mikita, Anna Howle, Sarah Krajnik, Dario Torre, Steven J Durning,

Introduction:We describe the development and implementation of tools medical educators or researchers can use for developing or analyzing residents' through attending physicians' clinical reasoning in an outpatient clinic setting. The resource includes two scenario-based simulations (i.e., diabetes, angina), implementation support materials, an open-ended postencounter form, and a think-aloud reflection protocol. ... Read more >>

MedEdPORTAL (MedEdPORTAL : the journal of teaching and learning resources)
[2018, 14:10773]

Cited: 1 time

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Cardiac resynchronization therapy: How did consensus guidelines from Europe and the United States evolve in the last 15 years?

Giuseppe Boriani, Matteo Ziacchi, Martina Nesti, Antonella Battista, Filippo Placentino, Vincenzo Livio Malavasi, Igor Diemberger, Luigi Padeletti,

Cardiac resynchronization therapy (CRT) was proposed around 20 years ago, and its clinical use rapidly moved from pioneering experiences to randomized controlled trials (RCT). Since 2002 recommendations for CRT have been included in international consensus guidelines that even in an early phase recommended CRT as an effective treatment for improving symptoms, ... Read more >>

Int. J. Cardiol. (International journal of cardiology)
[2018, 261:119-129]

Cited: 2 times

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Use of the International Classification of Functioning, Disability and Health Generic-30 Set for the characterization of outpatients: Italian Society of Physical and Rehabilitative Medicine Residents Section Project.

Francesca Gimigliano, Alessandro De Sire, Marco Gastaldo, Irene Maghini, Marco Paoletta, Andrea Pasquini, Paolo Boldrini, Melissa Selb, Birgit Prodinger, ,

BACKGROUND:The International Classification of Functioning, Disability and Health (ICF) Generic-30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and ... Read more >>

Eur J Phys Rehabil Med (European journal of physical and rehabilitation medicine)
[2019, 55(2):258-264]

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Symptomatic partial and transitional atrioventricular septal defect repaired in infancy.

Sylvia Krupickova, Gareth J Morgan, Mun Hong Cheang, Michael L Rigby, Rodney C Franklin, Andrea Battista, Ariana Spanaki, Beatrice Bonello, Olivier Ghez, David Anderson, Victor Tsang, Guido Michielon, Jan Marek, Alain Fraisse,

OBJECTIVES:Infants with symptomatic partial and transitional atrioventricular septal defect undergoing early surgical repair are thought to be at greater risk. However, the outcome and risk profile of this cohort of patients are poorly defined. The aim of this study was to investigate the outcome of symptomatic infants undergoing early repair ... Read more >>

Heart (Heart (British Cardiac Society))
[2018, 104(17):1411-1416]

Cited: 3 times

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Creating a quality improvement culture in standardized/simulated patient methodology: the role of professional societies.

Debra Nestel, Jan Roche, Alexis Battista,

Adv Simul (Lond) (Advances in simulation (London, England))
[2017, 2:18]

Cited: 1 time

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An activity theory perspective of how scenario-based simulations support learning: a descriptive analysis.

Alexis Battista,

The dominant frameworks for describing how simulations support learning emphasize increasing access to structured practice and the provision of feedback which are commonly associated with skills-based simulations. By contrast, studies examining student participants' experiences during scenario-based simulations suggest that learning may also occur through participation. However, studies directly examining student ... Read more >>

Adv Simul (Lond) (Advances in simulation (London, England))
[2017, 2:23]

Cited: 3 times

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Injury-induced purinergic signalling molecules upregulate pluripotency gene expression and mitotic activity of progenitor cells in the zebrafish retina.

Matías P Medrano, Claudio A Bejarano, Ariadna G Battista, Graciela D Venera, Ramón O Bernabeu, Maria Paula Faillace,

Damage in fish activates retina repair that restores sight. The purinergic signalling system serves multiple homeostatic functions and has been implicated in cell cycle control of progenitor cells in the developing retina. We examined whether changes in the expression of purinergic molecules were instrumental in the proliferative phase after injury ... Read more >>

Purinergic Signal. (Purinergic signalling)
[2017, 13(4):443-465]

Cited: 1 time

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Microstructured Blood Vessel Surrogates Reveal Structural Tropism of Motile Malaria Parasites.

Mendi J Muthinja, Johanna Ripp, Janina K Hellmann, Tamas Haraszti, Noa Dahan, Leandro Lemgruber, Anna Battista, Lucas Schütz, Oliver T Fackler, Ulrich S Schwarz, Joachim P Spatz, Friedrich Frischknecht,

Plasmodium sporozoites, the highly motile forms of the malaria parasite, are transmitted naturally by mosquitoes and traverse the skin to find, associate with, and enter blood capillaries. Research aimed at understanding how sporozoites select blood vessels is hampered by the lack of a suitable experimental system. Arrays of uniform cylindrical ... Read more >>

Adv Healthc Mater (Advanced healthcare materials)
[2017, 6(6):]

Cited: 4 times

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PLA-grafting of collagen chains leading to a biomaterial with mechanical performances useful in tendon regeneration.

Davide Bellini, Claudia Cencetti, Anna Cristina Sacchetta, Angela Maria Battista, Andrea Martinelli, Laura Mazzucco, Anna Scotto D'Abusco, Pietro Matricardi,

With the aim to obtain a scaffold with improved mechanical properties with respect to collagen for tendon augmentation and regeneration, a novel collagen-based material was prepared via heterogeneous phase derivatization of type I collagen sponges using polylactic acid. Compared to the untreated collagen, the functionalized sponge (Coll-PLA) was characterized by ... Read more >>

J Mech Behav Biomed Mater (Journal of the mechanical behavior of biomedical materials)
[2016, 64:151-160]

Cited: 1 time

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Grass pollen sublingual immunotherapy and paediatric allergic rhinitis: A patient-oriented decision.

Stefano Miceli Sopo, Andrea Battista, Monica Greco, Serena Monaco,

Guidelines and systematic review report that allergen immunotherapy (AIT) is, in general, effective in the treatment of allergic rhinitis. However, experts suggest not generalising the results of different clinical studies: for example, it would not be advisable to translate the results found in an adult population to a paediatric population ... Read more >>

Allergol Immunopathol (Madr) (Allergologia et immunopathologia)
[2016, 44(4):382-386]

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