1C12, 1E12, and 2E1 displayed higher affinity for PF4/H complexes than 5B9 and KKO, comparable to human group-3 Abs. Only 1C12, 1E12, 2E1, and group-3 Abs formed large complexes with native PF4, and activated platelets without heparin. The predicted binding sites of 1C12, 1E12, and 2E1 on PF4 differed from those of KKO and 5B9, but were close to each other. 2E1 exhibited unique bivalent binding, involving its antigen recognition site to PF4 and charge-dependent interactions with heparin.

 1C12, 1E12, and 2E1 are tools for studying the pathophysiology of autoimmune HIT. 2E1 provides evidence for a new binding mechanism of HIT Abs.

 1C12, 1E12, and 2E1 are tools for studying the pathophysiology of autoimmune HIT. 2E1 provides evidence for a new binding mechanism of HIT Abs.

Suboptimal information display in electronic health records (EHRs) is a notorious pain point for users. Designing an effective display is difficult, due in part to the complex and varied nature of clinical practice.

This article aims to understand the goals, constraints, frustrations, and mental models of inpatient medical providers when accessing EHR data, to better inform the display of clinical information.

A multidisciplinary ethnographic study of inpatient medical providers.

Our participants’ primary goal was usually to assemble a clinical picture around a given question, under the constraints of time pressure and incomplete information. To do so, they tend to use a mental model of multiple layers of abstraction when thinking of patients and disease; they prefer immediate pattern recognition strategies for answering clinical questions, with breadth-first or depth-first search strategies used subsequently if needed; and they are sensitive to data relevance, completeness, and reliability when readiractice of separating data by type (test results, medications, notes, etc.), a mismatch that is known to encumber efficient mental processing by increasing both navigation burden and memory demands on users. A popular and obvious solution is to select or filter the data to display exactly what is presumed to be relevant to the clinical question, but this solution is both brittle and mistrusted by users. A less brittle approach that is more aligned with our users’ mental model could use abstraction to summarize details instead of filtering to hide data. An abstraction-based approach could allow clinicians to more easily assemble a clinical picture, to use immediate pattern recognition strategies, and to adjust the level of displayed detail to their particular needs. It could also help the user notice unanticipated patterns and to fluidly shift attention as understanding evolves.

This study demonstrates application of human factors methods for understanding causes for lack of timely follow-up of abnormal test results (“missed results”) in outpatient settings.

We identified 30 cases of missed test results by querying electronic health record data, developed a critical decision method (CDM)-based interview guide to understand decision-making processes, and interviewed physicians who ordered these tests. Tauroursodeoxycholic nmr We analyzed transcribed responses using a contextual inquiry (CI)-based methodology to identify contextual factors contributing to missed results. We then developed a CI-based flow model and conducted a fault tree analysis (FTA) to identify hierarchical relationships between factors that delayed action.

The flow model highlighted barriers in information flow and decision making, and the hierarchical model identified relationships between contributing factors for delayed action. Key findings including underdeveloped methods to track follow-up, as well as mismatches, in communication channels, timeframes, and expectations between patients and physicians.

This case report illustrates how human factors-based approaches can enable analysis of contributing factors that lead to missed results, thus informing development of preventive strategies to address them.

This case report illustrates how human factors-based approaches can enable analysis of contributing factors that lead to missed results, thus informing development of preventive strategies to address them.The external ear is highly vulnerable to burn injury due to its location and thin integument. Reconstruction of the external ear after burns is a major challenge to undertake, and surgeons face many problems, including excessive scar tissue, poor blood supply, a paucity of available skin, and a high infection rate, when designing an operative plan for patients with postburn auricular deformity. In this article, the authors describe their experience of using an expanded postauricular scar flap combined with a postauricular fascial flap as the coverage for the framework for subtotal and total ear reconstruction in 27 burned patients. Four patients developed expander exposure and two developed framework exposure, which were resolved with good results after further repair. After an average follow-up time of 6 months, all of the patients experienced very good cosmetic outcomes, high satisfaction, and low morbidity.

 Facelift is now the fourth most common aesthetic procedure in men. Facial ageing is very different in men and women. Therefore, individual techniques are used since a uniform concept for the surgical facelift in men does not exist. This study aims to evaluate a gender-specific facelift concept especially developed for men.

 Women and men (n = 10 each) were subjected to a three-dimensional face scan and a subsequent simulation of a V-shaped lift vector (standard lift) and a new facelift concept especially for men in a double T shape (male lift). In an online survey with 262 participants, the simulated as well as the unchanged images were presented and the attributes masculinity, femininity, attractiveness and youthfulness were queried. Statistical models were used to identify attributes of lifting as well as other factors and differences between the simulations.

 Facelift changes are generally associated with a significant improvement in the attributes of youthfulness and attractiveness compared with unchanged control faces.