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Sample records for microsurgical training preliminary

  1. Microsurgical training on an in vitro chicken wing infusion model.

    Science.gov (United States)

    Olabe, Jon; Olabe, Javier

    2009-12-01

    Microneurovascular anastomosis and aneurysm clipping require extensive training before mastering the technique and are a surgical challenge. We developed the "infused chicken wing method" to provide a simple but realistic training method minimizing animal use and need for special facilities for animal care and anesthesia. Fresh chicken wings were used in this model. The main brachial artery was cannulated, and water was infused at 140 mm Hg followed by anatomical neurovascular dissection. Multiple microsurgical training exercises were performed under microscope vision including terminoterminal, lateroterminal, laterolateral vascular anastomosis, and nerve anastomosis. Different complexity aneurysms were created using venous patches, clipping, rupture, and vascular reconstruction techniques were performed. This novel training model is inexpensive, easily obtainable, and no live animals are required. The diameter and characteristics of arteries and veins used are similar to those of the human brain. Great microsurgical technique progress may be obtained. The infused chicken wing artery model presents a realistic microvascular training method. It is inexpensive and easy to set up. Such simplicity provides the adequate environment for developing microsurgical technique. Copyright 2009 Elsevier Inc. All rights reserved.

  2. Microsurgical Bypass Training Rat Model: Part 2-Anastomosis Configurations.

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    Tayebi Meybodi, Ali; Lawton, Michael T; Yousef, Sonia; Mokhtari, Pooneh; Gandhi, Sirin; Benet, Arnau

    2017-11-01

    Mastery of microsurgical anastomosis is key to achieving good outcomes in cerebrovascular bypass procedures. Animal models (especially rodents) provide an optimal preclinical bypass training platform. However, the existing models for practicing different anastomosis configurations have several limitations. We sought to optimize the use of the rat's abdominal aorta and common iliac arteries (CIA) for practicing the 3 main anastomosis configurations commonly used in cerebrovascular surgery. Thirteen male Sprague-Dawley rats underwent inhalant anesthesia. The abdominal aorta and the CIAs were exposed. The distances between the major branches of the aorta were measured to find the optimal location for an end-to-end anastomosis. Also, the feasibility of performing side-to-side and end-to-side anastomoses between the CIAs was assessed. All bypass configurations could be performed between the left renal artery and the CIA bifurcation. The longest segments of the aorta without major branches were 1) between the left renal and left iliolumbar arteries (16.9 mm ± 4.6), and 2) between the right iliolumbar artery and the aortic bifurcation (9.7 mm ± 4.7). The CIAs could be juxtaposed for an average length of 7.6 mm ± 1.3, for a side-to-side anastomosis. The left CIA could be successfully reimplanted on to the right CIA at an average distance of 9.1 mm ± 1.6 from the aortic bifurcation. Our results show that rat's abdominal aorta and CIAs may be effectively used for all the anastomosis configurations used in cerebral revascularization procedures. We also provide technical nuances and anatomic descriptions to plan for practicing each bypass configuration. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Off-the-job microsurgical training on dry models: Siberian experience.

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    Belykh, Evgenii; Byvaltsev, Vadim

    2014-01-01

    Microsurgical training has become an obligatory part of many neurosurgical training programs. To assess the cost and effectiveness of acquiring and maintaining microneurosurgical skills by training on an off-the-job basis using dry models. A dry off-the-job microneurosurgical training module was set up. Training exercises involved microdissection in a deep operation field, suturing and tying on gauze, untying, pushing of thread end, and microanastomosis. The time to complete the task and success rate were evaluated. The total cost of all necessary equipment and expendables for the training module was US$910. Fifteen residents participated in the continuous off-the-job training. The average time taken to perform the anastomosis decreased after the month of training from 90 to 20 minutes. Authors revealed that at 2 months, the total time and time to complete anastomosis increased significantly for the participants who discontinued practice after the first month, compared with those who just practiced suturing on gauze after the first month (P job training showed to be readily available and can be helpful for microsurgical training in the low-income regions of the world. Our data suggest that microsurgical training should be continuous and repetitive. Simulation training may benefit from models for repetitive training of relevant technical part-skills. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Virtual Reality Glasses and "Eye-Hands Blind Technique" for Microsurgical Training in Neurosurgery.

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    Choque-Velasquez, Joham; Colasanti, Roberto; Collan, Juhani; Kinnunen, Riina; Rezai Jahromi, Behnam; Hernesniemi, Juha

    2018-04-01

    Microsurgical skills and eye-hand coordination need continuous training to be developed and refined. However, well-equipped microsurgical laboratories are not so widespread as their setup is expensive. Herein, we present a novel microsurgical training system that requires a high-resolution personal computer screen, smartphones, and virtual reality glasses. A smartphone placed on a holder at a height of about 15-20 cm from the surgical target field is used as the webcam of the computer. A specific software is used to duplicate the video camera image. The video may be transferred from the computer to another smartphone, which may be connected to virtual reality glasses. Using the previously described training model, we progressively performed more and more complex microsurgical exercises. It did not take long to set up our system, thus saving time for the training sessions. Our proposed training model may represent an affordable and efficient system to improve eye-hand coordination and dexterity in using not only the operating microscope but also endoscopes and exoscopes. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. An Affordable Microsurgical Training System for a Beginning Neurosurgeon: How to Realize the Self-Training Laboratory.

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    Chung, Sang-Bong; Ryu, Jiwook; Chung, Yeongu; Lee, Sung Ho; Choi, Seok Keun

    2017-09-01

    To provide detailed information about how to realize a self-training laboratory with cost-effective microsurgical instruments, especially pertinent for the novice trainee. Our training model is designed to allow the practice of the microsurgery skills in an efficient and cost-effective manner. A used stereoscopic microscope is prepared for microsurgical training. A sufficient working distance for microsurgical practice is obtained by attaching an auxiliary objective lens. The minimum instrument list includes 2 jeweler's forceps, iris scissors, and alligator clips. The iris scissors and alligator clip provide good alternatives to micro-scissors and microvascular clamp. The short time needed to set up the microscope and suture the gauze with micro-forceps makes the training model suitable for daily practice. It takes about 15 minutes to suture 10 neighboring fibers of the gauze with 10-0 nylon; thus, training can be completed more quickly. We have developed an inexpensive and efficient micro-anastomosis training system using a stereoscopic microscope and minimal micro-instruments. Especially useful for novice trainees, this system provides high accessibility for microsurgical training. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Easy, Efficient, and Mobile Way to Train Microsurgical Skills During Busy Life of Neurosurgical Residency in Resource-Challenged Environment.

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    Huotarinen, Antti; Niemelä, Mika; Jahromi, Behnam Rezai

    2017-11-01

    Residents' lives are hectic-it is hard to find a place and time for training basic and advanced microsurgical skills. Surgical instruments and sutures can be purchased (or loaned from another department), but the most expensive and space-occupying device is the microscope. In developing countries, microscopes are used where they are needed most, in operating rooms. Furthermore, a conventional microscope is not portable. For all of these reasons, the availability of microscopes for training microsurgery is limited. We used a coffee cup and smartphone (CCS) as a training device instead of a microscope. The coffee cup was the base, and the smartphone functioned to magnify, illuminate, and visualize objects. We measured 2 residents' performance on end-to-end artificial bypass before and after 5 days of CCS-based training. We were able to quickly set up the environment for practicing microsurgical skills in any surrounding. After 5 days of training with CCS we could see significant development of microsurgical performance with a conventional microscope as well. The learning curve was dependent on baseline performance. CCS is efficient, mobile, and easy to set up. Even though our smartphone-based training was in 2 dimensions, we could improve our microsurgical performance with conventional microscopes, which have 3-dimensional capability. CCS also provides an easy method to record one's microsurgical training. CCS improved both of the subjects' microsurgical performance, making it a good alternative for a traditional microscope. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Microsurgical training model for residents to approach to the orbit and the optic nerve in fresh cadaveric sheep cranium

    Directory of Open Access Journals (Sweden)

    M Emre Altunrende

    2014-01-01

    Full Text Available Background: Neurosurgery and ophthalmology residents need many years to improve microsurgical skills. Laboratory training models are very important for developing surgical skills before clinical application of microsurgery. A simple simulation model is needed for residents to learn how to handle microsurgical instruments and to perform safe dissection of intracranial or intraorbital nerves, vessels, and other structures. Materials and Methods: The simulation material consists of a one-year-old fresh cadaveric sheep cranium. Two parts (Part 1 and Part 2 were designed to approach structures of the orbit. Part 1 consisted of a 2-step approach to dissect intraorbital structures, and Part 2 consisted of a 3-step approach to dissect the optic nerve intracranially. Results: The model simulates standard microsurgical techniques using a variety of approaches to structures in and around the orbit and the optic nerve. Conclusions: This laboratory training model enables trainees to gain experience with an operating microscope, microsurgical instruments and orbital structures.

  8. Utility of a Validated Rating Scale for Self-Assessment in Microsurgical Training.

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    Grant, Aaron L; Temple-Oberle, Claire

    The purpose of this study is to determine the utility of self-assessment in microsurgical training using a previously validated rating scale. A prospective study of surgical residents taking a hands-on 5-day microsurgical training course. Learners completed multiple self-assessments of their technical skills using the University of Western Ontario Microsurgical Acquisition/Assessment instrument. Simultaneously, preceptors assessed the learners using the same scale. Self-assessment and preceptor scores were compared using the Pearson correlation coefficient (PCC). There was a significant agreement noted between the 32 preceptor assessments and 36 self-assessments that were completed. Correlation between scores for the knot-tying (PCC = 0.62) and anastomosis modules (PCC = 0.77) was good and excellent, respectively. Preceptor scores and self-scores improved over the duration of the course: for preceptors, knot-tying scores increased from 58% on day 1 to 78% on day 5 (p = 0.02) and anastomosis scores improved from 56% to 82% (p = 0.004); for self-scores, knot-tying scores increased from 44% to 81% (p = 0.001) and anastomosis scores from 49% to 84% (p = 0.001). Learners with greater experience (higher postgraduate year level) tended to have higher self as well as preceptor ratings, albeit not statistically significant. Self-assessment using the University of Western Ontario Microsurgical Acquisition/Assessment instrument has good to excellent agreement with preceptor-assessment scores suggesting good interrater reliability. Self-assessment using such tools may, therefore, be used along with preceptor supervision and assessment to potentially improve self-directed learning during these courses. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Microsurgical Bypass Training Rat Model, Part 1: Technical Nuances of Exposure of the Aorta and Iliac Arteries.

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    Tayebi Meybodi, Ali; Lawton, Michael T; Mokhtari, Pooneh; Yousef, Sonia; Gandhi, Sirin; Benet, Arnau

    2017-11-01

    Animal models using rodents are frequently used for practicing microvascular anastomosis-an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in 2 consecutive articles. In part 1, we describe the technical nuances for a safe and efficient exposure of the rat abdominal aorta and common iliac arteries (CIAs) for bypass. Over a 2-year period, 50 Sprague-Dawley rats underwent inhalant anesthesia for practicing microvascular anastomosis on the abdominal aorta and CIAs. Lessons learned regarding the technical nuances of vessel exposure were recorded. Several technical nuances were important for avoiding intraoperative bleeding and preventing animal demise while preparing an adequate length of vessels for bypass. The most relevant technical nuances include (1) generous subcutaneous dissection; (2) use of cotton swabs for the blunt dissection of the retroperitoneal fat; (3) combination of sharp and blunt dissection to isolate the aorta and iliac arteries from the accompanying veins; (4) proper control of the posterior branches of the aorta; and (5) efficient division and mobilization of the left renal pedicle. Applying the aforementioned technical nuances enables safe and efficient preparation of the rat abdominal aorta and CIAs for microvascular anastomosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Micro-surgical endodontics.

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    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  11. Suicide intervention training evaluation: a preliminary report.

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    Tierney, R J

    1994-01-01

    To date, very little work has been done on evaluating training in suicide intervention. This study developed and piloted a comprehensive method for evaluating suicide intervention training by applying three studies of immediate training effects on (a) suicide intervention abilities, (b) attitudes to suicide and suicide intervention, and (c) knowledge about suicide. The focus of the evaluation was a broadly used 2-day suicide intervention training program. Changes in suicide intervention abilities were measured by the Suicide Intervention Response Inventory (SIRI) and by performance in simulated suicide intervention situations, scored with the Suicide Intervention Protocol (SIP). Subjects consisted of 19 workshop participants in a pre-post condition and 17 participants in a post-test only condition. Results indicated significant increases in skills in suicide intervention situations. No significant effects were noted on the SIRI. Results from the attitudes and knowledge studies were very preliminary. They are reported here so that others may become aware of the methodology being used and the status of evaluation of the target program. Implications for further research are discussed.

  12. Microsurgical Composite Tissue Transplantation

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    Serafin, Donald; Georgiade, Nicholas G.

    1978-01-01

    Since 1974, 69 patients with extensive defects have undergone reconstruction by microsurgical composite tissue transplantation. Using this method, donor composite tissue is isolated on its blood supply, removed to a distant recipient site, and the continuity of blood flow re-established by microvascular anastomoses. In this series, 56 patients (81%) were completely successful. There have been eight (12%) failures, primarily in the extremities. There have been five (7%) partial successes, (i.e., a microvascular flap in which a portion was lost requiring a secondary procedure such as a split thickness graft). In those patients with a severely injured lower extremity, the failure rate was the greatest. Most of these were arterial (six of seven). These failures occurred early in the series and were thought to be related to a severely damaged recipient vasculature. This problem has been circumvented by an autogenous interpositional vein graft, permitting more mobility of flap placement. In the upper extremity, all but one case were successful. Early motion was permitted, preventing joint capsular contractures and loss of function. Twenty-three cases in the head and neck region were successful (one partial success). This included two composite rib grafts to the mandible. Prolonged delays in reconstruction following extirpation of a malignancy were avoided. A rapid return to society following complete reconstruction was ensured. Nine patients presented for reconstruction of the breast and thorax following radical mastectomy. All were successfully reconstructed with this new technique except one patient. Its many advantages include immediate reconstruction without delayed procedures and no secondary deformity of the donor site. Healthy, well vascularized tissue can now be transferred to a previously irradiated area with no tissue loss. This new method offers many advantages to older methods of reconstruction. Length of hospital stay and immobilization are reduced. The

  13. Successful microsurgical replantation of an amputated penis

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    Sanchit Garg

    2016-01-01

    Full Text Available Penile amputation is an uncommon injury for which immediate surgical replantation is warranted. Microsurgical replantation is the “standard” method for penile replantation. Early replantation yields a high success and low complication rate. We report a case of a 34-year-old male who presented with amputation at the proximal penile shaft which was successfully replanted using microsurgical techniques. Minor skin necrosis was noted post-operatively which was debrided and covered with skin graft. Follow-up at 6 months showed satisfactory cosmetic appearance, normal voiding, return of sensations and erectile function. The level of evidence was V.

  14. Mastectomy skin necrosis after microsurgical breast reconstruction.

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    Vargas, Christina R; Koolen, Pieter G; Anderson, Katarina E; Paul, Marek A; Tobias, Adam M; Lin, Samuel J; Lee, Bernard T

    2015-10-01

    Mastectomy skin necrosis represents a significant clinical morbidity after immediate breast reconstruction. In addition to aesthetic deformity, necrosis of the native mastectomy skin may require debridement, additional reconstruction, or prolonged wound care and potentially delay oncologic treatment. This study aims to evaluate patient and procedural characteristics to identify predictors of mastectomy skin necrosis after microsurgical breast reconstruction. A retrospective review was performed of all immediate microsurgical breast reconstructions performed at a single academic center. Patient records were queried for age, diabetes, active smoking, previous breast surgery, preoperative radiation, preoperative chemotherapy, body mass index, mastectomy type, mastectomy weight, flap type, autologous flap type, and postoperative mastectomy skin flap necrosis. There were 746 immediate autologous microsurgical flaps performed by three plastic surgeons at our institution during the study period. The incidence of mastectomy skin flap necrosis was 13.4%. Univariate analysis revealed a significantly higher incidence of mastectomy skin necrosis in patients with higher mastectomy weight (P mastectomy type. Multivariate analysis demonstrated statistically significant associations between mastectomy skin necrosis and both increasing mastectomy weight (odds ratio 1.348 per quartile increase, P = 0.009) and diabetes (odds ratio 2.356, P = 0.011). Increasing mastectomy weight and coexisting diabetes are significantly associated with postoperative mastectomy skin necrosis after microsurgical reconstruction. These characteristics should be considered during patient counseling, procedure selection, operative planning, and intraoperative tissue viability assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. [Destruction of microsurgical devices by sterilisation].

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    Berto, Raphaela; Strutz, Jürgen

    2017-11-01

    Hospital facilities issue numerous risk announcements on corrosion, deformation or premature wearout of medical devices every year. As there is yet little data on the impact of reprocessing on the quality and durability of microsurgical instruments, this paper aims at evaluating the effects of the reprocessing on microsurgical instruments. Material and Methods 22 brand new microsurgical instruments for stapes surgery were being reprocessed 30 times without being used for surgery or other purposes in the interim time. After each reprocessing the instruments were examined macroscopicly and microscopicly. The results were portrayed in a photo documentation and analysed on that basis. Results Almost all devices showed mechanical damage caused by the reprocessing procedure. The increasing deterioration was often associated with missing protective caps. Furthermore contaminations and stains were apparent in several cases. Conclusions The findings illustrate that careful handling of delicate surgical devices during reprocessing is vital. They also highlight problems of protective caps. As an alternative going forward it should be considered to store microsurgical instruments statically in special racks. Georg Thieme Verlag KG Stuttgart · New York.

  16. Microsurgical techniques in temporal lobe epilepsy.

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    Alonso Vanegas, Mario A; Lew, Sean M; Morino, Michiharu; Sarmento, Stenio A

    2017-04-01

    Temporal lobe resection is the most prevalent epilepsy surgery procedure. However, there is no consensus on the best surgical approach to treat temporal lobe epilepsy. Complication rates are low and efficacy is very high regarding seizures after such procedures. However, there is still ample controversy regarding the best surgical approach to warrant maximum seizure control with minimal functional deficits. We describe the most frequently used microsurgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (corticoamygdalohippocampectomy and selective amygdalohippocampectomy). The choice of surgical technique appears to remain a surgeon's preference for the near future. Meticulous surgical technique and thorough three-dimensional microsurgical knowledge are essentials for obtaining the best results. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  17. Microsurgical reconstruction of extensive oncological scalp defects

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    Ole eGoertz

    2015-09-01

    Full Text Available While most small to medium defects of the scalp can be covered by local flaps, large defects or complicating factors like a history of radiotherapy often require a microsurgical reconstruction.Several factors need to be considered in such procedures. A sufficient preoperative planning is based on adequate imaging of the malignancy and a multi-disciplinary concept. Several flaps are available for such reconstructions, of which the latissimus dorsi and anterior lateral thigh flaps are the most commonly used ones.In very large defects, combined flaps such as a parascapular / latissimus dorsi flaps can be highly useful or necessary. The most commonly used recipient vessels for microsurgical scalp reconstructions are the superficial temporal vessels, but various other feasible choices exist. If the concomitant veins are not sufficient, the jugular veins represent a safe backup alternative but require a vessel interposition or long pedicle. Postoperative care and patient positioning can be difficult in these patients but can be facilitated by various devices. Overall, microsurgical reconstruction of large scalp defects is a feasible undertaking if the mentioned key factors are taken into account.

  18. Preliminary development of the Active Colonoscopy Training Model

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    Choi J

    2011-06-01

    Full Text Available JungHun Choi1, Kale Ravindra1, Randolph Robert1, David Drozek21Mechanical Engineering, Ohio University, Athens, OH, USA; 2College of Osteopathic Medicine, Ohio University, Athens, OH, USAAbstract: Formal colonoscopy training requires a significant amount of time and effort. In particular, it requires actual patients for a realistic learning experience. The quality of colonoscopy training varies, and includes didactic courses and procedures proctored by skilled surgeons. A colonoscopy training model is occasionally used as part of the training method, but the effects are minute due to both the simple and tedious training procedures. To enhance the educational effect of the colonoscopy training model, the Active Colonoscopy Training Model (ACTM has been developed. ACTM is an interactive colonoscopy training device which can create the environment of a real colonoscopy procedure as closely as possible. It comprises a configurable rubber colon, a human torso, sensors, a display, and the control part. The ACTM provides audio and visual interaction to the trainee by monitoring important factors, such as forces caused by the distal tip and the shaft of the colonoscope and the pressure to open up the lumen and the localization of the distal tip. On the computer screen, the trainee can easily monitor the status of the colonoscopy, which includes the localization of the distal tip, maximum forces, pressure inside the colon, and surgery time. The forces between the rubber colon and the constraints inside the ACTM are measured and the real time display shows the results to the trainee. The pressure sensors will check the pressure at different parts of the colon. The real-time localized distal tip gives the colonoscopy trainee easier and more confident operation without introducing an additional device in the colonoscope. With the current need for colonoscopists and physicians, the ACTM can play an essential role resolving the problems of the current

  19. Digital Skill Training Research: Preliminary Guidelines for Distributed Learning

    National Research Council Canada - National Science Library

    Childs, Jerry

    2001-01-01

    This task was aimed at the development of guidelines for distributed learning (DL). A matrix was generated to evaluate the effectiveness of various DL media for training representative knowledge/skill types...

  20. Robotic instrumentation: Evolution and microsurgical applications

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    Sijo J Parekattil

    2010-01-01

    Full Text Available This article presents a review of the history and evolution of robotic instrumentation and its applications in urology. A timeline for the evolution of robotic instrumentation is presented to better facilitate an understanding of our current-day applications. Some new directions including robotic microsurgical applications (robotic assisted denervation of the spermatic cord for chronic orchialgia and robotic assisted vasectomy reversal are presented. There is a paucity of prospective comparative effectiveness studies for a number of robotic applications. However, right or wrong, human nature has always led to our infatuation with the concept of using tools to meet our needs. This chapter is a brief tribute to where we have come from and where we may be potentially heading in the field of robotic assisted urologic surgery.

  1. Microsurgical tubal recanalization: A hope for the hopeless

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    Jain M

    2003-01-01

    Full Text Available Objective: To analyse the various factors affecting pregnancy rate after microsurgical tubal recanalisation. Design: Prospective study, follow-up of 5 years in patients treated with tubal microsurgery. Setting: Referral Tertiary Care Hospital. Patients: Fifty women underwent microsurgical tubal recanalisation procedure. Principles of microsurgery were followed throughout the procedure meticulously. Interventions: Microsurgical tubal recanalisation. Main outcome measure: Pregnancy rate. Results: With microsurgery, an overall 60% pregnancy rate was achieved. In these patients, pregnancy outcome was in form of intrauterine pregnancy (96.66%, ectopic pregnancy (3.33%, term viable pregnancy (96.55% and spontaneous abortion (3.45%. Conclusions: The important factors for determining the success of operation were age of the patient, time interval between sterilization and reversal, site of ligation, method used for previous ligation & the remaining length of the tube after recanalisation. The microsurgical technique should be available at specialized centres to improve the success of family planning services.

  2. A preliminary report of music-based training for adult cochlear implant users: rationales and development

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    Gfeller, Kate; Guthe, Emily; Driscoll, Virginia; Brown, Carolyn J.

    2015-01-01

    Objective This paper provides a preliminary report of a music-based training program for adult cochlear implant (CI) recipients. Included in this report are descriptions of the rationale for music-based training, factors influencing program development, and the resulting program components. Methods Prior studies describing experience-based plasticity in response to music training, auditory training for persons with hearing impairment, and music training for cochlear implant recipients were reviewed. These sources revealed rationales for using music to enhance speech, factors associated with successful auditory training, relevant aspects of electric hearing and music perception, and extant evidence regarding limitations and advantages associated with parameters for music training with CI users. This information formed the development of a computer-based music training program designed specifically for adult CI users. Results Principles and parameters for perceptual training of music, such as stimulus choice, rehabilitation approach, and motivational concerns were developed in relation to the unique auditory characteristics of adults with electric hearing. An outline of the resulting program components and the outcome measures for evaluating program effectiveness are presented. Conclusions Music training can enhance the perceptual accuracy of music, but is also hypothesized to enhance several features of speech with similar processing requirements as music (e.g., pitch and timbre). However, additional evaluation of specific training parameters and the impact of music-based training on speech perception of CI users are required. PMID:26561884

  3. A Preliminary Evaluation of Reach: Training Early Childhood Teachers to Support Children's Social and Emotional Development

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    Conners-Burrow, Nicola A.; Patrick, Terese; Kyzer, Angela; McKelvey, Lorraine

    2017-01-01

    This paper describes the development, implementation and preliminary evaluation of the Reaching Educators and Children (REACH) program, a training and coaching intervention designed to increase the capacity of early childhood teachers to support children's social and emotional development. We evaluated REACH with 139 teachers of toddler and…

  4. Training Technology Handbook for System Acquisition Planners: Preliminary Version.

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    1981-09-01

    ION ALL COINTROLS XIAPNL IN VIH €1U11T- OPTIMALLY L OCALIs T-I E ElsA IEI MALFUNCTIOW TO THE CO--- INRT o I*LEVEL TWDE O IS EDS TEAR DOE %AIll ow...contact EXAMPLE OF HOW Tl lS SECTION SHOULD BE FOLLOWED the Chief of Navy Education and Training (CNET) for assistance and/or referral. ISTE CNET is

  5. Trained Quantity Abilities in Horses (Equus caballus: A Preliminary Investigation

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    Maria Elena Miletto Petrazzini

    2014-07-01

    Full Text Available Once believed to be a human prerogative, the capacity to discriminate between quantities now has also been reported in several vertebrates. To date, only two studies investigated numerical abilities in horses (Equus caballus but reported contrasting data. To assess whether horses can be trained to discriminate between quantities, I have set up a new experimental protocol using operant conditioning. One adult female was trained to discriminate between 1 and 4 (Test 1 in three different conditions: non-controlled continuous variables (numerical and continuous quantities that co-vary with number are simultaneously available, 50% controlled continuous variables (intermediate condition, and 100% controlled continuous variables (only numerical information available. The subject learned the discrimination in all conditions, showing the capacity to process numerical information. When presented with a higher numerical ratio (2 vs. 4, Test 2, the subject still discriminated between the quantities but its performance was statistically significant only in the non-controlled condition, suggesting that the subject used multiple cues in presence of a more difficult discrimination. On the whole, the results here reported encourage the use of this experimental protocol as a valid tool to investigate the capacity to process numerical and continuous quantities in horses in future research.

  6. Microsurgical anatomy of the abducens nerve.

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    Joo, Wonil; Yoshioka, Fumitaka; Funaki, Takeshi; Rhoton, Albert L

    2012-11-01

    The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications. Copyright © 2012 Wiley Periodicals, Inc.

  7. Development of a Five-Day Basic Microsurgery Simulation Training Course: A Cost Analysis

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    Masha Singh

    2014-05-01

    Full Text Available The widespread use of microsurgery in numerous surgical fields has increased the need for basic microsurgical training outside of the operating room. The traditional start of microsurgical training has been in undertaking a 5-day basic microsurgery course. In an era characterised by financial constraints in academic and healthcare institutions as well as increasing emphasis on patient safety, there has been a shift in microsurgery training to simulation environments. This paper reviews the stepwise framework of microsurgical skill acquisition providing a cost analysis of basic microsurgery courses in order to aid planning and dissemination of microsurgical training worldwide.

  8. [Microsurgical removal of olfactory groove meningiomas].

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    Liang, Ri-Sheng; Zhou, Liang-Fu; Mao, Ying; Zhang, Rong; Yang, Wei-Zhong

    2011-01-01

    To explore an effective method for further improving the surgical results of treatment of olfactory groove meningiomas. Sixty seven cases of olfactory groove meningiomas were treated by microneurosurgery, among which fifty seven were de novo cases, eight were recurrent tumors and the other two re-recurrent cases. Modified Derome approach was used in 12 cases, bilateral subfrontal approach in 28 cases, modified pterional approach in 21 cases and unilateral subfrontal approach in six cases. Tumors were resected microsurgically with radical removal of invaded dura, bone, and paranasal sinus mucosa. Reconstruction was performed in patients with skull base defect. Simpson grade I removal was accomplished in 59 cases, grade II in seven cases and grade IV in one case. Among 57 patients with de novo tumor, Simpson I resection was accomplished in 54 cases. Postoperative rhinorrhea and intracranial infection occurred in one case and was cured after temporal lumbar CSF drainage and antibiotic therapy. Two patients (2.9%) died within one month after operation, i.e.one aged patient of heart failure and the other of severe hypothalamus complication. Forty seven patients (72.3%) were followed up from one to ten years with an average of five years and four months. With the exception of two cases died, among the alive 45 patients, there were only three patients with tumor recurrence, which had undergone Simpson II or IV tumor resection. No recurrence was found in cases with Simpson I tumor removal. Previous blurred vision was not improved in three patients, hemiparalysis in two patients, and the other patients recovered well, resuming previous jobs or being able to take care themselves. Total tumor removal (Simpson I) should be the surgical goal for treatment of olfactory groove meningiomas, especially for de novo cases. An appropriate approach is fundamental in the effort to remove an OGM totally. Appropriate anterior skull base reconstruction with vascularized material is

  9. Microsurgical anatomy of the central lobe.

    Science.gov (United States)

    Frigeri, Thomas; Paglioli, Eliseu; de Oliveira, Evandro; Rhoton, Albert L

    2015-03-01

    The central lobe consists of the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface and corresponds to the sensorimotor cortex. The objective of the present study was to define the neural features, craniometric relationships, arterial supply, and venous drainage of the central lobe. Cadaveric hemispheres dissected using microsurgical techniques provided the material for this study. The coronal suture is closer to the precentral gyrus and central sulcus at its lower rather than at its upper end, but they are closest at a point near where the superior temporal line crosses the coronal suture. The arterial supply of the lower two-thirds of the lateral surface of the central lobe was from the central, precentral, and anterior parietal branches that arose predominantly from the superior trunk of the middle cerebral artery. The medial surface and the superior third of the lateral surface were supplied by the posterior interior frontal, paracentral, and superior parietal branches of the pericallosal and callosomarginal arteries. The venous drainage of the superior two-thirds of the lateral surface and the central lobe on the medial surface was predominantly through the superior sagittal sinus, and the inferior third of the lateral surface was predominantly through the superficial sylvian veins to the sphenoparietal sinus or the vein of Labbé to the transverse sinus. The pre- and postcentral gyri and paracentral lobule have a morphological and functional anatomy that differentiates them from the remainder of their respective lobes and are considered by many as a single lobe. An understanding of the anatomical relationships of the central lobe can be useful in preoperative planning and in establishing reliable intraoperative landmarks.

  10. Preliminary assessment report for Fort Custer Training Center, Installation 26035, Augusta, Michigan

    International Nuclear Information System (INIS)

    Flaim, S.; Krokosz, M.

    1993-08-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Michigan Army National Guard property near Augusta, Michigan. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Fort Custer Training Center, phase I of the Department of Defense Installation Restoration Program. The environmentally significant operations associated with the property are (1) storage of hazardous materials and hazardous waste, (2) storage and dispensing of fuel, (3) washing of vehicles and equipment, and (4) weapons training ranges that may have accumulated lead

  11. Training the Antifragile Athlete: A Preliminary Analysis of Neuromuscular Training Effects on Muscle Activation Dynamics.

    Science.gov (United States)

    Kiefer, Adam W; Myer, Gregory D

    2015-10-01

    Athletic injuries typically occur when the stable, emergent coordination between behavioral processes breaks down due to external noise, or variability. A physiological system that operates at an optimal point on a spectrum of rigidity and flexibility may be better prepared to handle extreme external variability, and the purpose of the current experiment was to examine whether targeted neuromuscular training resulted in changes to the rigidity and flexibility of the gluteal muscle tonus signal as measured with electromyography prior to the landing phase of a drop vertical jump task. 10 adolescent female athletes who participated in a targeted 10-week neuromuscular training program and 6 controls participated, and their tonus dynamics were examined with recurrence quantification analysis prior to training and after the 10-week program. The dependent measures, percent laminarity (%LAM) and percent determinism (%DET) were hypothesized to decrease following training, and were submitted to a one tailed mixed-model ANOVA. The training group exhibited a decrease in %LAM and %DET after training compared to pre-training and controls. The present findings indicate increased metaflexibility (i.e., greater intermittency and an increase in internal randomness) in tonus dynamics following neuromuscular training, and have important implications for the prevention of musculoskeletal injury in sport, specifically within the context of external noise and antifragility.

  12. A Preliminary Multiple Case Report of Neurocognitive Training for Children With AD/HD in China

    Directory of Open Access Journals (Sweden)

    Han Jiang

    2015-06-01

    Full Text Available This preliminary multiple case study examined the behavioral outcomes of neurocognitive training on children with attention-deficit/hyperactivity disorder (AD/HD in China, as well as parent acceptance of the treatment. The training approach targeted working memory, impulse control, and attention/relaxation (via brain electrical activity. Outcome measures included overt behavior as rated by parents and teachers, AD/HD symptom frequency, and parent opinion/feedback. Training was completed by five individuals and delivered via a themed computer game with electroencephalogram (EEG input via a wireless, single-channel, dry-sensor, portable measurement device. The objective (i.e., training outcomes and EEG and subjective (i.e., parent ratings/feedback and teacher ratings data suggested that use of the neurocognitive training resulted in reduced AD/HD behaviors and improvement in socially meaningful outcomes. The parents expressed satisfaction with the training procedure and outcomes. It is concluded that the innovative neurocognitive training approach is effective for improving behavior and reducing symptoms of AD/HD for children in China.

  13. Preliminary power train design for a state-of-the-art electric vehicle

    Science.gov (United States)

    Ross, J. A.; Wooldridge, G. A.

    1978-01-01

    The state-of-the-art (SOTA) of electric vehicles built since 1965 was reviewed to establish a base for the preliminary design of a power train for a SOTA electric vehicle. The performance of existing electric vehicles were evaluated to establish preliminary specifications for a power train design using state-of-the-art technology and commercially available components. Power train components were evaluated and selected using a computer simulation of the SAE J227a Schedule D driving cycle. Predicted range was determined for a number of motor and controller combinations in conjunction with the mechanical elements of power trains and a battery pack of sixteen lead-acid batteries - 471.7 kg at 0.093 MJ/Kg (1040 lbs. at 11.7 Whr/lb). On the basis of maximum range and overall system efficiency using the Schedule D cycle, an induction motor and 3 phase inverter/controller was selected as the optimum combination when used with a two-speed transaxle and steel belted radial tires. The predicted Schedule D range is 90.4 km (56.2 mi). Four near term improvements to the SOTA were identified, evaluated, and predicted to increase range approximately 7%.

  14. Preliminary Analyses Showed Short-Term Mental Health Improvements after a Single-Day Manager Training.

    Science.gov (United States)

    Boysen, Elena; Schiller, Birgitta; Mörtl, Kathrin; Gündel, Harald; Hölzer, Michael

    2018-01-10

    Psychosocial working conditions attract more and more attention when it comes to mental health in the workplace. Trying to support managers to deal with their own as well as their employees' psychological risk factors, we conducted a specific manager training. Within this investigation, we wanted to learn about the training's effects and acceptance. A single-day manager training was provided in a large industrial company in Germany. The participants were asked to fill out questionnaires regarding their own physical and mental health condition as well as their working situation. Questionnaires were distributed at baseline, 3-month, and 12-month follow-up. At this point of time the investigation is still ongoing. The current article focuses on short-term preliminary effects. Analyses only included participants that already completed baseline and three months follow-up. Preliminary results from three-month follow-up survey ( n = 33, nmale = 30, Mage = 47.5) indicated positive changes in the manager's mental health condition measured by the Patient Health Questionnaire for depression (PHQ-9: Mt1 = 3.82, Mt2 = 3.15). Training managers about common mental disorders and risk factors at the workplace within a single-day workshop seems to promote positive effects on their own mental health. Especially working with the managers on their own early stress symptoms might have been an important element.

  15. A novel attention training paradigm based on operant conditioning of eye gaze: Preliminary findings.

    Science.gov (United States)

    Price, Rebecca B; Greven, Inez M; Siegle, Greg J; Koster, Ernst H W; De Raedt, Rudi

    2016-02-01

    Inability to engage with positive stimuli is a widespread problem associated with negative mood states across many conditions, from low self-esteem to anhedonic depression. Though attention retraining procedures have shown promise as interventions in some clinical populations, novel procedures may be necessary to reliably attenuate chronic negative mood in refractory clinical populations (e.g., clinical depression) through, for example, more active, adaptive learning processes. In addition, a focus on individual difference variables predicting intervention outcome may improve the ability to provide such targeted interventions efficiently. To provide preliminary proof-of-principle, we tested a novel paradigm using operant conditioning to train eye gaze patterns toward happy faces. Thirty-two healthy undergraduates were randomized to receive operant conditioning of eye gaze toward happy faces (train-happy) or neutral faces (train-neutral). At the group level, the train-happy condition attenuated sad mood increases following a stressful task, in comparison to train-neutral. In individual differences analysis, greater physiological reactivity (pupil dilation) in response to happy faces (during an emotional face-search task at baseline) predicted decreased mood reactivity after stress. These Preliminary results suggest that operant conditioning of eye gaze toward happy faces buffers against stress-induced effects on mood, particularly in individuals who show sufficient baseline neural engagement with happy faces. Eye gaze patterns to emotional face arrays may have a causal relationship with mood reactivity. Personalized medicine research in depression may benefit from novel cognitive training paradigms that shape eye gaze patterns through feedback. Baseline neural function (pupil dilation) may be a key mechanism, aiding in iterative refinement of this approach. (c) 2016 APA, all rights reserved).

  16. A didactic and hands-on module enhances resident microsurgical knowledge and technical skill.

    Science.gov (United States)

    El Ahmadieh, Tarek Y; Aoun, Salah G; El Tecle, Najib E; Nanney, Allan D; Daou, Marc R; Harrop, James; Batjer, Hunt H; Bendok, Bernard R

    2013-10-01

    Simulation has been adopted as a powerful training tool in many areas of health care. However, it has not yet been systematically embraced in neurosurgery because of the absence of validated tools, assessment scales, and curricula. To use our validated microanastomosis module and scale to evaluate the effects of an educational intervention on the performance of neurosurgery residents at the 2012 Congress of Neurological Surgeons Annual Meeting. The module consisted of an end-to-end microanastomosis of a 3-mm vessel and was divided into 3 phases: (1) a cognitive and microsuture prelecture testing phase, (2) a didactic lecture, and (3) a cognitive and microsuture postlecture testing phase. We compared resident knowledge and technical proficiency from the pretesting and posttesting phases. One neurosurgeon and 7 neurosurgery residents participated in the study. None had previous experience in microsurgery. The average score on the microsuture prelecture and postlecture tests, as measured by our assessment scale, was 32.50 and 39.75, respectively (P = .001). The number of completed sutures at the end of each procedure was higher for 75% of participants in the postlecture testing phase (P = .03). The average score on the cognitive postlecture test (12.75) was significantly better than that of the cognitive prelecture test (8.38; P = .001). Simulation has the potential to enhance resident education and to elevate proficiency levels. Our data suggest that a focused microsurgical module that incorporates a didactic component and a technical component can enhance resident knowledge and technical proficiency in microsurgical anastomosis.

  17. Design and preliminary evaluation of an exoskeleton for upper limb resistance training

    Science.gov (United States)

    Wu, Tzong-Ming; Chen, Dar-Zen

    2012-06-01

    Resistance training is a popular form of exercise recommended by national health organizations, such as the American College of Sports Medicine (ACSM) and the American Heart Association (AHA). This form of training is available for most populations. A compact design of upper limb exoskeleton mechanism for homebased resistance training using a spring-loaded upper limb exoskeleton with a three degree-of-freedom shoulder joint and a one degree-of-freedom elbow joint allows a patient or a healthy individual to move the upper limb with multiple joints in different planes. It can continuously increase the resistance by adjusting the spring length to train additional muscle groups and reduce the number of potential injuries to upper limb joints caused by the mass moment of inertia of the training equipment. The aim of this research is to perform a preliminary evaluation of the designed function by adopting an appropriate motion analysis system and experimental design to verify our prototype of the exoskeleton and determine the optimal configuration of the spring-loaded upper limb exoskeleton.

  18. Training habits and injuries of masters' level football players: a preliminary report.

    Science.gov (United States)

    Newsham-West, R; Button, C; Milburn, P D; Mündermann, A; Sole, G; Schneiders, A G; Sullivan, S J

    2009-05-01

    To profile training habits and injuries in football players participating in a national Masters tournament. A cross-sectional retrospective study design was used to survey male football players attending the 2008 New Zealand Masters Games. Information regarding player demographics, football injuries, football related training, and risk factors for injury were collected. 199 Players were recruited, with a median age of 44 yrs (range 35-73) and a median football playing history of 15 yrs (range 0-66). Irrespective of age, 112 (84%) players included a warm-up and 104 (78%) included a stretching regime in their regular training programme. In the 12 months prior to the tournament, 128 football related injuries were reported by 93 players (64 injuries/100 players or 46 injured players/100 players). The most frequently injured region was the lower limb; specifically the lower leg (n=23), ankle (n=18), hamstring (n=17), knee (n=15), and Achilles tendon (n=15). This study provides a preliminary insight into the training habits and injury profiles of Masters football players. Despite all players including some form of injury prevention strategy in their training, a significant number of players experienced an injury in the 12 months prior to the tournament.

  19. Optimizing microsurgical skills with EEG neurofeedback

    Directory of Open Access Journals (Sweden)

    Benjamin Larry

    2009-07-01

    Full Text Available Abstract Background By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance. Here we assessed whether two distinct EEG neurofeedback protocols could develop surgical skill, given the important role this skill plays in medicine. Results National Health Service trainee ophthalmic microsurgeons (N = 20 were randomly assigned to either Sensory Motor Rhythm-Theta (SMR or Alpha-Theta (AT groups, a randomized subset of which were also part of a wait-list 'no-treatment' control group (N = 8. Neurofeedback groups received eight 30-minute sessions of EEG training. Pre-post assessment included a skills lab surgical procedure with timed measures and expert ratings from video-recordings by consultant surgeons, together with state/trait anxiety self-reports. SMR training demonstrated advantages absent in the control group, with improvements in surgical skill according to 1 the expert ratings: overall technique (d = 0.6, p Conclusion SMR-Theta neurofeedback training provided significant improvement in surgical technique whilst considerably reducing time on task by 26%. There was also evidence that AT training marginally reduced total surgery time, despite suboptimal training efficacies. Overall, the data set provides encouraging evidence of optimised learning of a complex medical specialty via neurofeedback training.

  20. Preliminary assessment report for National Guard Training Center, Georgia Army National Guard, Fort Stewart, Georgia

    International Nuclear Information System (INIS)

    1993-07-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Georgia Army National Guard (GAARNG) facility near Hinesville, Georgia, known as the National Guard Training Center (NGTC). Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a priority basis for completing corrective actions (where necessary) in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining previous site activities, types and quantities of hazardous substances utilized, and potential pathways by which contamination could affect public health and the environment. The scope of this assessment is limited to the facilities and past activities contained within the NGTC. Preliminary assessment site score sheet information is also provided for the NGTC. However, this assessment report is intended to be read in conjunction with a previous IRP assessment of Fort Stewart completed in 1992 (USATHAMA 1992) and to provide comprehensive information on the NGTC area for incorporation with information contained in that previous assessment for the entirety of Fort Stewart

  1. Comparative study on preliminary breakdown pulse trains observed in Johor, Malaysia and Florida, USA

    Science.gov (United States)

    Baharudin, Z. A.; Ahmad, Noor Azlinda; Fernando, M.; Cooray, V.; Mäkelä, J. S.

    2012-11-01

    In this paper, the preliminary breakdown (PB) pulse train preceding the negative first return stroke (RS) is recorded using a broad band antenna system. These analyses were carried out in Johor Bahru, Malaysia and Florida, United States. This is a novel initiative at examining and identifying the characteristics of the PB pulse trains in the negative cloud-to-ground flashes observed in Malaysia. The arithmetic mean of the total pulse train duration is 12.3 ms and the weighted arithmetic mean of the pulse durations and interpulse intervals are 11 μs and 152 μs, respectively. The arithmetic mean ratio between the maximum peak amplitude of the PB pulse and the peak RS electric field was 27.8%, and the corresponding value in Florida was 29.4%. The arithmetic mean of the time duration between the most active part of the pulse train, and the RS was 57.6 ms in Malaysia and 22 ms in Florida. A qualitative comparison of our results with those obtained earlier in Sri Lanka, Sweden and Finland supports the hypothesis that the PBP/RS ratio is higher in the northern regions compared to the tropical regions.

  2. Japanese Neurosurgeons and Microsurgical Anatomy: A Historical Review

    Science.gov (United States)

    MATSUSHIMA, Toshio; KAWASHIMA, Masatou; MATSUSHIMA, Ken; WANIBUCHI, Masahiko

    2015-01-01

    Research in microneurosurgical anatomy has contributed to great advances in neurosurgery in the last 40 years. Many Japanese neurosurgeons have traveled abroad to study microsurgical anatomy and played major roles in advancing and spreading the knowledge of anatomy, overcoming their disadvantage that the cadaver study has been strictly limited inside Japan. In Japan, they initiated an educational system for surgical anatomy that has contributed to the development and standardization of Japanese neurosurgery. For example, the Japanese Society for Microsurgical Anatomy started an annual educational meeting in the middle of 1980s and published its proceedings in Japanese every year for approximately 20 years. These are some of the achievements that bring worldwide credit to Japanese neurosurgeons. Not only should Japanese neurosurgeons improve their educational system but they should also contribute to the international education in this field, particularly in Asia. PMID:25797782

  3. Microsurgical replantation of a small segment of thumb volar skin.

    Science.gov (United States)

    Akyürek, Mustafa; Safak, Tunç

    2004-06-01

    This report presents a case of microsurgical replantation of a volar skin segment of the thumb. In a 24-year-old patient, a heavy object falling over the dominant thumb resulted in a crush-avulsion injury of a pure skin segment measuring 4 x 2 cm. Examination revealed that the distal fingertip as well as the bone-tendon structures remained intact. Exploration demonstrated that both neurovascular bundles were included in the avulsed skin segment. Microsurgical replantation was achieved successfully, repairing the radial digital artery at both ends with vein grafts as well as anastomosing a palmar vein. Both digital nerves were coapted proximally and distally. An excellent functional and cosmetic result was accomplished with a good sensory recovery. The authors conclude that microsurgical replantation should be attempted in cases of more proximal pure skin avulsions, even if the injury spares distal fingertip tissue or bone-tendon units. In such cases, replantation is superior to any other method of reconstruction. Liberal use of vein grafts is crucial to achieve success.

  4. Examining Length of Hospital Stay after Microsurgical Breast Reconstruction: Evaluation in a Case-Control Study

    Directory of Open Access Journals (Sweden)

    Jordan D. Frey, MD

    2017-12-01

    Conclusions:. Multiple patient-specific, intra-operative, and post-operative outcomes factors are associated with increased length of stay with immediate and delayed microsurgical breast reconstruction.

  5. Preliminary training of a self-pumped loop phase-conjugate mirror based on a photorefractive crystal

    International Nuclear Information System (INIS)

    Mogaddam, Mehran Wahdani; Shuvalov, Vladimir V

    2006-01-01

    It is shown by the example of a loop self-pumped phase-conjugate (SPPC) mirror based on a photorefractive crystal (PRC) BaTiO 3 that formation of a phase-conjugate (PC) wave in a SPPC mirror can be considerably accelerated by using a preliminary training of the mirror. For this purpose, it is necessary to direct preliminary an auxiliary (training) optical field on the SPPC mirror, which contains some information on the properties of the input signal whose wave front will be conjugated later. This procedure provides the writing of static refractive-index gratings in the PRC already at the training stage. The presence of these gratings ensures a much more rapid (by 6-20 times) production of volume refractive-index gratings required for the efficient conjugation of the signal radiation. Several variants of static and dynamic SPPC mirror training procedures are simulated and their efficiencies are compared. (nonlinear optical phenomena)

  6. AGR-2 Irradiated Test Train Preliminary Inspection and Disassembly First Look

    Energy Technology Data Exchange (ETDEWEB)

    Ploger, Scott [Idaho National Lab. (INL), Idaho Falls, ID (United States); Demkowciz, Paul [Idaho National Lab. (INL), Idaho Falls, ID (United States); Harp, Jason [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-05-01

    The AGR 2 irradiation experiment began in June 2010 and was completed in October 2013. The test train was shipped to the Materials and Fuels Complex in July 2014 for post-irradiation examination (PIE). The first PIE activities included nondestructive examination of the test train, followed by disassembly of the test train and individual capsules and detailed inspection of the capsule contents, including the fuel compacts and their graphite fuel holders. Dimensional metrology was then performed on the compacts, graphite holders, and steel capsule shells. AGR 2 disassembly and metrology were performed with the same equipment used successfully on AGR 1 test train components. Gamma spectrometry of the intact test train gave a preliminary look at the condition of the interior components. No evidence of damage to compacts or graphite components was evident from the isotopic and gross gamma scans. Disassembly of the AGR 2 test train and its capsules was conducted rapidly and efficiently by employing techniques refined during the AGR 1 disassembly campaign. Only one major difficulty was encountered while separating the test train into capsules when thermocouples (of larger diameter than used in AGR 1) and gas lines jammed inside the through tubes of the upper capsules, which required new tooling for extraction. Disassembly of individual capsules was straightforward with only a few minor complications. On the whole, AGR 2 capsule structural components appeared less embrittled than their AGR 1 counterparts. Compacts from AGR 2 Capsules 2, 3, 5, and 6 were in very good condition upon removal. Only relatively minor damage or markings were visible using high resolution photographic inspection. Compact dimensional measurements indicated radial shrinkage between 0.8 to 1.7%, with the greatest shrinkage observed on Capsule 2 compacts that were irradiated at higher temperature. Length shrinkage ranged from 0.1 to 0.9%, with by far the lowest axial shrinkage on Capsule 3 compacts

  7. Using a situational judgement test for selection into dental core training: a preliminary analysis.

    Science.gov (United States)

    Rowett, E; Patterson, F; Cousans, F; Elley, K

    2017-05-12

    Objective and setting This paper describes the evaluation of a pilot situational judgement test (SJT) for selection into UK Dental Core Training (DCT). The SJT's psychometric properties, group differences based on gender and ethnicity, and candidate reactions were assessed.Methods The SJT targets four non-academic attributes important for success in DCT. Data were collected alongside live selection processes from five Health Education England local teams in the UK (N = 386). Candidates completed the pilot SJT and an evaluation questionnaire to examine their reactions to the test.Results SJT scores were relatively normally distributed and showed acceptable levels of internal reliability (α = 0.68). Difficulty level and partial correlations between scenarios and SJT total score were in the expected ranges (64.61% to 90.03% and r = 0.06 to 0.41, respectively). No group differences were found for gender, and group differences between White and BME candidates were minimal. Most candidates perceived the SJT as relevant to the target role, appropriate and fair.Conclusions This study demonstrated the potential suitability of an SJT for use in DCT selection. Future research should replicate these preliminary findings in other cohorts, and assess the predictive validity of the SJT for predicting key training and practice-based outcomes.

  8. Semantic Feature Training for the Treatment of Anomia in Alzheimer Disease: A Preliminary Investigation.

    Science.gov (United States)

    Flanagan, Kieran J; Copland, David A; van Hees, Sophia; Byrne, Gerard J; Angwin, Anthony J

    2016-03-01

    This is a preliminary investigation into the effectiveness of semantic feature training for the treatment of anomia in Alzheimer disease (AD). Anomia is a common clinical characteristic of AD. It is widely held that anomia in AD is caused by the combination of cognitive deficits and progressive loss of semantic feature information. Therapy that aims to help participants relearn or retain semantic features should, therefore, help treat anomia in AD. Two men with AD and one man with progressive nonfluent aphasia received 10 treatment sessions focused on relearning the names of 20 animals and 20 fruits. Within each category, half of the items were of high and half were of low typicality. We individualized treatment items to each participant, using items that each had not named correctly at baseline. Treatment sessions consisted of naming, category sorting, and semantic feature verification tasks. Both participants with AD showed post-treatment improvements in naming, and one maintained the treatment effects at 6-week follow-up. The semantic category of the treatment items influenced post-treatment outcomes, but typicality did not. In contrast to the participants with AD, the man with progressive nonfluent aphasia had no improvement in naming ability. Our results suggest the potential viability of semantic feature training to treat anomia in AD and, therefore, the need for further research.

  9. Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

    Directory of Open Access Journals (Sweden)

    Sandini Giulio

    2009-12-01

    Full Text Available Abstract Background In the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life. Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion of the different DoFs (degrees of Freedom. Methods The IIT-wrist robot is a 3 DoFs light exoskeleton device, with direct-drive of each DoF and a human-like range of motion for Flexion/Extension (FE, Abduction/Adduction (AA and Pronation/Supination (PS. Subjects were asked to track a variable-frequency oscillating target using only one wrist DoF at time, in such a way to carry out a progressive splinting therapy. The RoM of each DoF was angularly scanned in a staircase-like fashion, from the "easier" to the "more difficult" angular position. An Adaptive Controller evaluated online performance parameters and modulated both the assistance and the difficulty of the task in order to facilitate smoother and more precise motor command patterns. Results Three stroke subjects volunteered to participate in a preliminary test session aimed at verify the acceptability of the device and the feasibility of the designed protocol. All of them were able to perform the required task. The wrist active RoM of motion was evaluated for each patient at the

  10. 21 CFR 874.4500 - Ear, nose, and throat microsurgical carbon dioxide laser.

    Science.gov (United States)

    2010-04-01

    ... laser. 874.4500 Section 874.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND..., nose, and throat microsurgical carbon dioxide laser. (a) Identification. An ear, nose, and throat microsurgical carbon dioxide laser is a device intended for the surgical excision of tissue from the ear, nose...

  11. Biliary fibrosis in microsurgical extrahepatic cholestasis in the rat.

    Science.gov (United States)

    Sánchez-Patán, Fernando; Anchuelo, Raquel; Corcuera, María-Teresa; Casado, Isabel; Gómez-Aguado, Fernando; Aller, María-Angeles; Cruz, Arturo; Alonso, María-José; Arias, Jaime

    2008-01-01

    A new model of extrahepatic cholestasis, using a microsurgical technique, is performed as an alternative to the traditional model of the bile duct ligated-rat, in order to study the stage of fibrosis in the long-term. Male Wistar rats were divided into two groups: I (Sham-operated, n = 9) and II [Microsurgical Cholestasis (MC), n = 10]. After 4 weeks, portal pressure, types of portosystemic collateral circulation, mesenteric venous vasculopathy, hepatic function test, and liver histopathology were studied by using the Knodell index and fibrosis was determined by reticulin and Sirius red stains. The animals with MC presented portal hypertension with extrahepatic portosistemic collateral circulation, associated with mesenteric venous vasculopathy and increased plasma levels of bilirubin (6.30 +/- 1.80 vs. 0.22 +/- 0.37 mg/dL; P = 0.0001), alkaline phosphatase (293.00 +/- 82.40 vs. 126.30 +/- 33.42 U/L; P = 0.001), AST (380.00 +/- 78.50 vs. 68.33 +/- 11.74 IU/L; P = 0.0001), ALT (87.60 +/- 22.32 vs. 42.22 +/- 7.89 IU/L; P = 0.0001), and LDH (697.76 +/- 75.13 vs. 384.80 +/- 100.03 IU/L; P = 0.0001). On the contrary, plasma levels of albumin decreased (2.72 +/- 0.12 mg/dl vs. 2.99 +/- 0.10; P = 0.001). The microsurgical resection of the extrahepatic biliary tract in the rat produces an experimental model of hepatic inflammation, characterized by a high Knodell hepatic activity index (4), bile proliferation, and fibrosis.

  12. Microsurgical spinothalamic chordotomy in the treatment of cancer pain.

    Science.gov (United States)

    Slavik, E; Ivanović, S; Grujisić, D; Djurović, B; Nikolić, I

    2005-01-01

    Advances in cancer treatment continue to lengthen survival among cancer patients. As patients live longer, the need for effective pain control has gained increased importance for improving quality of life. In patients who do not respond to all available conservative methods of therapy for cancer pain, surgical methods have been applied; one of them is the open high thoracic spinothalamic chordotomy. We present a group of 86 patients suffering from nociceptive cancer pain, caused by compression of lumbosacral plexus. All patients were treated by microsurgical open high thoracic spinothalamic chordotomy. These patients did not respond to any available conservative treatment. Immediately after surgery 68 (79%) patients had total pain relief. Of the remaining 18 (21%) patients, significant pain relief was achieved in 9 (10%), while in the remaining 9 patients this procedure had no effect. After a 6-month follow-up, total pain relief remained in 62 (72%) and significant pain relief in 10 (17%) of the patients. From 62 of patients with well-defined unilateral pain treated by "moderately deep" chordotomy, total pain relief was achieved in 53 (85%), lasting for 6 months in 49 (79%) of them. These results show that microsurgical chordotomy can achieve total control of intractable cancer pain in the majority (79%) of patients, especially in those with well-defined unilateral pain (85%), indicating the usefullness of this surgical approach in the treatment of nociceptive cancer pain.

  13. THE TRANSFORMATIONAL PROCESSES INVOLVING MOTOR SKILLS THAT OCCUR UNDER THE INFLUENCE OF BASIC PRELIMINARY TRAINING IN YOUNG HANDBALL PLAYERS

    Directory of Open Access Journals (Sweden)

    Markovic Sasa

    2011-06-01

    Full Text Available The population from which we extracted a sample of 76 subjects consisted of elementary school students in Kursumlija, all male, aged 12-13, who were divided into a sub-sample consisting of 38 young handball players who took part in the training sessions of a school of handball and another sub-sample consisting of 38 non-athletes, who only took part in their regular physical education classes. The aim of the research was to determine the transformation processes involving motor skills, which occur under the influence of basic preliminary training in young handball players. The subject matter of the study was to examine whether a statistically significant increase in the level of motor skills would occur under the influence of physical exercise as part of basic preliminary training in the final as compared to the initial state. Six motor tests which define the dimensions of explosive and repetitive strength were used. The results of the research indicate that significant transformational processes involving the motor skills of young handball players occurred in the final as compared to the initial measuring, under the influence of basic preliminary training.

  14. Preliminary safety analysis of high-intensity interval training (HIIT) in persons with chronic stroke.

    Science.gov (United States)

    Carl, Daniel L; Boyne, Pierce; Rockwell, Bradley; Gerson, Myron; Khoury, Jane; Kissela, Brett; Dunning, Kari

    2017-03-01

    The purpose of this study was to assess safety via electrocardiographic (ECG), blood pressure (BP), heart rate (HR), and orthopedic responses to 3 different high-intensity interval training (HIIT) protocols in persons with stroke. Eighteen participants (10 male; 61.9 + 8.3 years of age; 5.8 + 4.2 years poststroke) completed a symptom-limited graded exercise test (GXT) with ECG monitoring to screen for eligibility and determine HR peak. The 3 HIIT protocols involved repeated 30 s bursts of treadmill walking at maximum speed alternated with rest periods of 30 s (P30), 1 min (P60), or 2 min (P120). Sessions were performed in random order and included 5 min warm up, 20 min HIIT, and 5 min cool down. Variables measured included ECG activity, BP, HR, signs and symptoms of cardiovascular intolerance, and orthopedic concerns. Generalized linear mixed models and Tukey-Kramer adjustment were used to compare protocols using p HIIT session. HIIT elicited HRs in excess of 88% of measured HR peak including 6 (P30), 8 (P60), and 2 (P120) participants eliciting a HR response above their GXT HR peak . Both maximum BP and HR were significantly higher in P30 and P60 relative to P120. Preliminary data indicate that persons with chronic stroke who have been prescreened with an ECG stress test, a symptom-limited GXT, and a harness for fall protection may safely participate in HIIT, generating substantially higher HRs than what is seen in traditional moderate intensity training.

  15. Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery.

    Science.gov (United States)

    Pape, Theresa Louise-Bender; Rosenow, Joshua M; Harton, Brett; Patil, Vijaya; Guernon, Ann; Parrish, Todd; Froehlich, Kathleen; Burress, Catherine; McNamee, Shane; Herrold, Amy A; Weiss, Bessie; Wang, Xue

    2012-01-01

    Since there remains a need to examine the nature of the neural effect and therapeutic efficacy/effectiveness of sensory stimulation provided to persons in states of seriously impaired consciousness, a passive sensory stimulation intervention, referred to as the Familiar Auditory Sensory Training (FAST) protocol, was developed for examination in an ongoing, double-blind, randomized clinical trial (RCT). The FAST protocol is described in this article according to the preliminary framework, which is a synthesis of knowledge regarding principles of plasticity and capabilities of the human brain to automatically and covertly process sensory input. Feasibility issues considered during the development of the intervention are also described. To enable replication of this intervention, we describe procedures to create the intervention and lessons learned regarding the creation process. The potential effect of the intervention is illustrated using functional brain imaging of nondisabled subjects. This illustration also demonstrates the relevance of the rationale for designing the FAST protocol. To put the intervention within the context of the scientific development process, the article culminates with a description of the study design for the ongoing RCT examining the efficacy of the FAST protocol.

  16. A pilot training program for people in recovery of mental illness as vocational peer support workers in Hong Kong - Job Buddies Training Program (JBTP): A preliminary finding.

    Science.gov (United States)

    Yam, Kevin Kei Nang; Lo, William Tak Lam; Chiu, Rose Lai Ping; Lau, Bien Shuk Yin; Lau, Charles Ka Shing; Wu, Jen Kei Yu; Wan, Siu Man

    2016-10-24

    The present study reviews the delivery of a pilot curriculum-mentorship-based peer vocational support workers training in a Hong Kong public psychiatric hospital. The present paper reports (1) on the development of a peer vocational support workers training - Job Buddies Training Program (JBTP) in Hong Kong; and (2) preliminary findings from both quantitative and qualitative perspectives. The curriculum consists of 15-session coursework, 8-session storytelling workshop and 50-hour practicum to provide Supported Employment Peer Service (SEPS) under the mentorship of occupational therapists. Six trainees were assessed using three psychosocial assessments and qualitative methods. Compared to the baseline, the Job Buddies (JB) trainees showed an increase in awareness of their own recovery progress, occupational competence and problem-solving skills at the end of the training. Their perceived level of self-stigma was also lessened. In post-training evaluation, all Job Buddies trainees said they perceived positive personal growth and discovered their own strengths. They also appreciated the help from their mentors and gained mutual support from other trainees and from exposure with various mini-projects in the training. This pilot study provides an example of incorporating peer support and manualized training into existing work rehabilitation service for our JB trainees. Further studies on the effectiveness of service provided by peer support workers and for development on the potential use of peer support workers in other clinical and rehabilitation settings with larger subjects will be fruitful. Copyright © 2016. Published by Elsevier B.V.

  17. Cerebellar anatomy as applied to cerebellar microsurgical resections

    Directory of Open Access Journals (Sweden)

    Alejandro Ramos

    2012-06-01

    Full Text Available OBJECTIVE: To define the anatomy of dentate nucleus and cerebellar peduncles, demonstrating the surgical application of anatomic landmarks in cerebellar resections. METHODS: Twenty cerebellar hemispheres were studied. RESULTS: The majority of dentate nucleus and cerebellar peduncles had demonstrated constant relationship to other cerebellar structures, which provided landmarks for surgical approaching. The lateral border is separated from the midline by 19.5 mm in both hemispheres. The posterior border of the cortex is separated 23.3 mm from the posterior segment of the dentate nucleus; the lateral one is separated 26 mm from the lateral border of the nucleus; and the posterior segment of the dentate nucleus is separated 25.4 mm from the posterolateral angle formed by the junction of lateral and posterior borders of cerebellar hemisphere. CONCLUSIONS: Microsurgical anatomy has provided important landmarks that could be applied to cerebellar surgical resections.

  18. Endoport-Assisted Microsurgical Treatment of a Ruptured Periventricular Aneurysm

    Directory of Open Access Journals (Sweden)

    Ching-Jen Chen

    2016-01-01

    Full Text Available Background and Importance. Ruptured periventricular aneurysms in patients with moyamoya disease represent challenging pathologies. The most common methods of treatment include endovascular embolization and microsurgical clipping. However, rare cases arise in which the location and anatomy of the aneurysm make these treatment modalities particularly challenging. Clinical Presentation. We report a case of a 34-year-old female with moyamoya disease who presented with intraventricular hemorrhage. CT angiography and digital subtraction angiography revealed an aneurysm located in the wall of the atrium of the right lateral ventricle. Distal endovascular access was not possible, and embolization risked the sacrifice of arteries supplying critical brain parenchyma. Using the BrainPath endoport system, the aneurysm was able to be accessed. Since the fusiform architecture of the aneurysm prevented clip placement, the aneurysm was ligated with electrocautery. Conclusion. We demonstrate the feasibility of endoport-assisted approach for minimally invasive access and treatment of uncommon, distally located aneurysms.

  19. Microsurgery simulation training system and set up: An essential system to complement every training programme.

    Science.gov (United States)

    Masud, Dhalia; Haram, Nadine; Moustaki, Margarita; Chow, Whitney; Saour, Samer; Mohanna, Pari Naz

    2017-07-01

    Microsurgical techniques are essential in plastic surgery; however, inconsistent training practices, acquiring these skills can be difficult. To address this, we designed a standardised laboratory-based microsurgical training programme, which allows trainees to develop their dexterity, visuospatial ability, operative flow and judgement as separate components. Thirty trainees completed an initial microsurgical anastomosis on a chicken femoral artery, assessed using the structured assessment of microsurgical skills (SAMS) method. The study group (n = 18) then completed a 3-month training programme, while the control group (n = 19) did not. A final anastomosis was completed by all trainees (n = 30). The study group had a significant improvement in the microsurgical technique, assessed using the SAMS score, when the initial and final scores were compared (Mean: 24 SAMS initial versus 49 SAMS final) (p group had a significantly lower rate of improvement (Mean: 23 SAMS initial versus 25 SAMS final). There was a significant difference between the final SAMS score of the study group and that of senior surgeons (Mean: 49 study final SAMS versus 58 senior SAMS). This validated programme is a safe, cost-effective and flexible method of allowing trainees to develop microsurgical skills in a non-pressurized environment. In addition, the objectified skills allow trainers to assess the trainees' level of proficiency before operating on patients. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Training in Information Management for Army Brigade and Battalion Staff: Methods and Preliminary Findings

    National Research Council Canada - National Science Library

    Freeman, Jared

    1997-01-01

    Training, training Support software, and measurement instruments were developed to help Army brigade and below staff manage information and overcome information overload in a digital messaging environment...

  1. Comparison of vasovasostomy with conventional microsurgical suture and fibrin adhesive in rats

    Directory of Open Access Journals (Sweden)

    Wilson F. Busato Junior

    2007-12-01

    Full Text Available OBJECTIVE: Microsurgical procedures are currently the gold standard for vasovasostomy with excellent results, but it takes an increased operative time demanding special training and experience in microsurgery. The objective of this study is to reach the same results with reduced operative time. MATERIALS AND METHODS: Male adults Wistar rats were divided into 3 groups: I 20 rats in control group, II 20 with conventional one-layer microsuture and III 20 with fibrin glue. After four weeks each rat was left for two weeks with two female rats. RESULTS: The fertility rates were 80% in group I, 70% in group II and 65% in group III (p > 0.05. In group II granuloma was found in 75% of the rats, while in group III in 85% (p 0.05. Overall operative time was 41.7 ± 2.49 and 28.55 ± 1.14 minutes in groups II and III (p < 0.05 and the time to anastomosis of 24.6 ± 1.8 and 9.35 ± 0.78 minutes (p < 0.05, respectively. CONCLUSIONS: We can conclude that vasovasostomy with fibrin adhesive has the same results of the conventional microsurgery technique but with a reduced operative time and a simplified procedure.

  2. Technical Nuances of Exposing Rat Common Carotid Arteries for Practicing Microsurgical Anastomosis.

    Science.gov (United States)

    Tayebi Meybodi, Ali; Aklinski, Joseph; Gandhi, Sirin; Lawton, Michael T; Preul, Mark C

    2018-04-17

    Animal models are commonly used in training protocols for microsurgical vascular anastomosis. Rat common carotid arteries (CCAs) are frequently used for this purpose. Much attention has been paid to the technical details of various anastomosis configurations using these arteries. However, technical nuances of exposing rat CCAs have been understudied. The purpose of this study is to describe nuances of technique for safely and efficiently exposing rat CCAs in preparation for a vascular anastomosis. Bilateral CCAs were exposed and prepared for anastomosis in 10 anesthetized Sprague-Dawley rats through a midline cervical incision. The exposed length of the CCA was measured. Additionally, technical nuances of exposure and surgically relevant anatomic details were recorded. The CCAs were exposed from the sternoclavicular joint to their bifurcation (average length, 19.1 ± 2.8 mm). Tenets important for a safe and efficient exposure of the CCAs included 1) generous subcutaneous dissection to expose the external jugular veins (EJVs), 2) avoiding injury to or compression of the EJVs, 3) superior mobilization of the salivary glands, 4) division of internal jugular veins, 5) opening the carotid sheath at its midlevel and from medial to lateral, and 6) avoiding injury to the vagus nerve or sympathetic trunk. Using the principles introduced in this study, trainees may safely and efficiently expose rat CCAs in preparation for a bypass. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Improvement of technical training of sportswomen in rhythmic gymnastics by means of acrobatics at the stage of preliminary basic preparation

    Directory of Open Access Journals (Sweden)

    Petro Kyzim

    2016-10-01

    Full Text Available Purpose: to prove experimentally the technique of improvement of technical training of sportswomen in rhythmic gymnastics by means of acrobatics at the stage of preliminary basic preparation. Material & Methods: the following methods of the research were used: analysis and synthesis of references, pedagogical observations, pedagogical testing, pedagogical experiment, method of expert assessment (qualimetry, methods of mathematical statistics. Results: the level of technical skill of performance of pre-acrobatic elements by sportswomen of rhythmic gymnastics before carrying out the pedagogical experiment is determined. The dynamics of indicators of the level of technical preparedness of sportswomen of rhythmic gymnastics is defined. Conclusions: it is established that additional resources of acrobatics influence significantly the level of technical preparedness of sportswomen of rhythmic gymnastics at the stage of preliminary basic preparation.

  4. Preliminary assessment report for Grubbs/Kyle Training Center, Smyrna/Rutherford County Regional Airport, Installation 47340, Smyrna, Tennessee

    International Nuclear Information System (INIS)

    Dennis, C.; Stefano, J.

    1993-07-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Tennessee Army National Guard (TNARNG) property near Smyrna, Tennessee. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Grubbs/Kyle Training Center property, the requirement of the Department of Defense Installation Restoration Program

  5. Nuclear-related training and education offered by nonacademic organizations (preliminary)

    International Nuclear Information System (INIS)

    Howard, L.

    1981-11-01

    The results of a survey of nuclear-related training and education provided by nonacademic training organizations are presented in this report. The survey instrument was distributed by the Institute of Nuclear Power Operations to 136 training organizations. The scope of the survey was not intended to be comprehensive, but rather to include the primary sources of nonacademic nuclear-related training and education offered to utility personnel. The survey universe was compiled from training organizations listed in the 1981 Nuclear News Buyer's Guide. Forty-three percent of the survey population (59 organizations) responded to the questionnaire of which 31 percent (42) reported they offered nuclear-related training programs and 12 percent (17) reported they did not offer any nuclear-related training

  6. Use of autologous and microsurgical breast reconstruction by U.S. plastic surgeons.

    Science.gov (United States)

    Kulkarni, Anita R; Sears, Erika Davis; Atisha, Dunya M; Alderman, Amy K

    2013-09-01

    Concern exists that plastic surgeons are performing fewer autologous and microsurgical breast reconstructions, despite superior long-term outcomes. The authors describe the proportion of U.S. plastic surgeons performing these procedures and evaluate motivating factors and perceived barriers. A random national sample of American Society of Plastic Surgeons members was surveyed (n = 325; response rate, 76 percent). Surgeon and practice characteristics were assessed, and two multiple logistic regression models were created to evaluate factors associated with (1) high-volume autologous providers and (2) microsurgical providers. Qualitative assessments of motivating factors and barriers to microsurgery were also performed. Fewer than one-fifth of plastic surgeons perform autologous procedures for more than 50 percent of their breast cancer patients, and only one-quarter perform any microsurgical breast reconstruction. Independent predictors of a high-volume autologous practice include involvement with resident education (odds ratio, 2.57; 95 percent CI, 1.26 to 5.24) and a microsurgical fellowship (odds ratio, 2.09; 95 percent CI, 1.04 to 4.27). Predictors of microsurgical breast reconstruction include involvement with resident education (odds ratio, 6.8; 95 percent CI, 3.32 to 13.91), microsurgical fellowship (odds ratio, 2.4; 95 percent CI, 1.16 to 4.95), and high breast reconstruction volume (odds ratio, 6.68; 95 percent CI, 1.76 to 25.27). The primary motivator for microsurgery is superior outcomes, and the primary deterrents are time and reimbursement. The proportion of U.S. plastic surgeons with a high-volume autologous or microsurgical breast reconstruction practice is low. Involvement with resident education appears to facilitate both, whereas time constraints and reimbursement are primary deterrents. Future efforts should focus on improving the feasibility and accessibility of all types of breast reconstruction.

  7. Using a site-specific technical error to establish training responsiveness: a preliminary explorative study.

    Science.gov (United States)

    Weatherwax, Ryan M; Harris, Nigel K; Kilding, Andrew E; Dalleck, Lance C

    2018-01-01

    Even though cardiorespiratory fitness (CRF) training elicits numerous health benefits, not all individuals have positive training responses following a structured CRF intervention. It has been suggested that the technical error (TE), a combination of biological variability and measurement error, should be used to establish specific training responsiveness criteria to gain further insight on the effectiveness of the training program. To date, most training interventions use an absolute change or a TE from previous findings, which do not take into consideration the training site and equipment used to establish training outcomes or the specific cohort being evaluated. The purpose of this investigation was to retrospectively analyze training responsiveness of two CRF training interventions using two common criteria and a site-specific TE. Sixteen men and women completed two maximal graded exercise tests and verification bouts to identify maximal oxygen consumption (VO 2 max) and establish a site-specific TE. The TE was then used to retrospectively analyze training responsiveness in comparison to commonly used criteria: percent change of >0% and >+5.6% in VO 2 max. The TE was found to be 7.7% for relative VO 2 max. χ 2 testing showed significant differences in all training criteria for each intervention and pooled data from both interventions, except between %Δ >0 and %Δ >+7.7% in one of the investigations. Training nonresponsiveness ranged from 11.5% to 34.6%. Findings from the present study support the utility of site-specific TE criterion to quantify training responsiveness. A similar methodology of establishing a site-specific and even cohort specific TE should be considered to establish when true cardiorespiratory training adaptations occur.

  8. Microsurgical tunica albuginea transplantation in an animal model

    Directory of Open Access Journals (Sweden)

    Salvatore Sansalone

    2017-01-01

    Full Text Available Several andrological diseases require surgical repair or reconstruction of tunica albuginea, which envelops the corpora cavernosa penis. Despite intense research efforts involving a variety of biological materials, such as skin, muscle aponeurosis, human dura mater, tunica vaginalis, and pericardium, engineered tunica albuginea suitable for graft use is yet to be obtained. The study investigates microsurgical tunica albuginea allotransplantation in an animal model with the purpose of creation of an organ-specific tissue bank to store penile tissue, from cadaveric donors and male-to-female trans-sexual surgery, for allogeneic transplantation. Materials were tunica albuginea tissue explanted from 15 donor rats, cryopreserved at −80°C, gamma-irradiated, and implanted in 15 recipient rats, of which three rats were used as controls. Penile grafts were explanted at different time intervals; after macroscopic evaluation of the organ, the grafts were processed to morphological, histochemical, and immunohistochemical examinations by light microscopy. Detection of pro-inflammatory cytokines was also performed. Examination of the tunica albuginea allografts collected 1, 3, or 6 months after surgery and of control tunica albuginea fragments showed that tunica albuginea implants achieved biointegration with adjacent tissue at all-time points. The integration of cryopreserved rat tunica albuginea allografts, documented by our study, encourages the exploration of tunica albuginea allotransplantation in humans. In conclusion, the effectiveness and reliability of the tunica albuginea conditioning protocol described here suggest the feasibility of setting up a tunica albuginea bank as a further tissue bank.

  9. Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.

    Science.gov (United States)

    Corradino, Bartolo; Di Lorenzo, Sara; Mossuto, Carmela; Costa, Renato Patrizio; Moschella, Francesco

    2010-01-01

    Infiltration of botulinum toxin in the major salivary glands allows a temporary reduction of salivation that begins 8 days afterwards and returns to normal within 2 months. The inhibition of salivary secretion, carried out before the oral cavity reconstructive surgery, could allow a reduction of the incidence of oro-cutaneous fistulas and local complications. Saliva stagnation is a risk factor for patients who have to undergo reconstructive microsurgery of the oral cavity, because of fistula formation and local complications in the oral cavity. The authors suggest infiltration of botulinum toxin in the major salivary glands to reduce salivation temporarily during the healing stage. During the preoperative stage, 20 patients with oral cavity carcinoma who were candidates for microsurgical reconstruction underwent sialoscintigraphy and a quantitative measurement of the salivary secretion. Injection of botulinum toxin was carried out in the salivary glands 4 days before surgery. The saliva quantitative measurement was repeated 3 and 8 days after infiltration, sialoscintigraphy after 15 days. In all cases, the saliva quantitative measurement revealed a reduction of 50% and 70% of the salivary secretion after 72 h and 8 days, respectively. A lower rate of local complications was observed.

  10. Computer-based attention training in the schools for children with attention deficit/hyperactivity disorder: a preliminary trial.

    Science.gov (United States)

    Steiner, Naomi J; Sheldrick, Radley Christopher; Gotthelf, David; Perrin, Ellen C

    2011-07-01

    Objective. This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder (ADHD) to attend more effectively. Design/methods. A total of 41 children with ADHD from 2 middle schools were randomly assigned to receive 2 sessions a week at school of either neurofeedback (NF) or attention training through a standard computer format (SCF), either immediately or after a 6-month wait (waitlist control group). Parents, children, and teachers completed questionnaires pre- and postintervention. Results. Primary parents in the NF condition reported significant (P ADHD index, the BASC Attention Problems Scale, and on the Behavioral Rating Inventory of Executive Functioning (BRIEF). Conclusion. This randomized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting.

  11. Initiation and preliminary evaluation of an oncology pharmacy training course for staff pharmacists.

    Science.gov (United States)

    Saylor, Matthew S; Blanchette, Lisa M; Smith, Morgan B; Cambron, Katie; Andricopulos, Katie; Brown, M Jay

    2016-08-01

    There is currently a disparity between oncology pharmacy job openings and PGY2 trained pharmacists completing residency training each year. As a result, pharmacists without specialized training in oncology are filling much needed oncology positions and may need on-the-job oncology training. To improve oncology knowledge among non-PGY2 trained pharmacists working in oncology positions, Novant Health coordinated an Oncology Pharmacy Training Course (OPTC). The primary objective was to assess efficacy of the OPTC through evaluation of post-intervention oncology knowledge. Secondary objectives included efficacy of each lecture, assessment of knowledge improvement in those with and without residency or chemotherapy training, and assessment of satisfaction with the OPTC. This was a prospective, cohort study. All pharmacists expressing interest in the OPTC were included unless PGY2 oncology residency trained or Board-Certified in Oncology Pharmacy (BCOP). Participants were invited to attend twice monthly lectures and were evaluated using questionnaires at baseline, 1, 3, 6, and 12 months. At the 3-month evaluation, 29 pharmacists completed the per-protocol evaluation. Knowledge scores increased from a mean of 29.6% to 52.2% (p trained. Baseline knowledge scores were slightly higher in the chemotherapy-trained than training naïve participants (mean 42.5% vs. 27.4%). Both groups experienced significantly improved knowledge scores at 3 months (mean 59% and 48.1% respectively, p staff pharmacists in a community hospital system. This improvement in knowledge is consistent regardless of baseline chemotherapy training. © The Author(s) 2015.

  12. The Effect of Low Volume Interval Training on Resting Blood Pressure in Pre-hypertensive Subjects: A Preliminary Study.

    Science.gov (United States)

    Skutnik, Benjamin C; Smith, Joshua R; Johnson, Ariel M; Kurti, Stephanie P; Harms, Craig A

    2016-01-01

    Clinically pre-hypertensive adults are at a greater risk of developing hypertension, stiffened arteries, and other cardiovascular risks. Endurance exercise training has been shown to improve elevated resting blood pressure and C-reactive protein (CRP) levels. However, a primary barrier preventing individuals from engaging in regular physical activity is a lack of time. The purpose of our study was to determine if a high-intensity interval training (HIIT) protocol would be as effective as continuous aerobic endurance training (ET) on resting blood pressure in pre-hypertensive participants. Additionally, this study investigated the effects of HIIT vs. ET on CRP. Twelve pre-hypertensive participants (33.3±6.1 yrs; 3M/9W) participated in 8 weeks of cycle ergometer exercise training. The ET exercised for 30 continuous min/day, 4 days/week at 40% VO2max reserve. The HIIT exercised at a 1:1 work-to-rest for 20 min/day, 3 days/week at 60% peak power. Resting mean arterial pressure and CRP were compared throughout the study. Both groups showed decreases (pHIIT: -8.6 ± 4.8 mmHg) following the 8 weeks. For CRP, there was a significant decrease (p=0.014) as a main effect of time. VO2max increased (pHIIT and ET. These preliminary data suggest HIIT and ET similarly decreased resting blood pressure and increased VO2max.

  13. Predictive Factors for Natural Pregnancy after Microsurgical Reconstruction in Patients with Primary Epididymal Obstructive Azoospermia

    Directory of Open Access Journals (Sweden)

    Mihai Harza

    2014-01-01

    Full Text Available Primary epididymal obstructive azoospermia (OA is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34±4.5 years (range 24–46 years. Median follow-up time was 15 [IQR 12–21] months. The total patency rate was 77.7% (n=28. During follow-up, 8 (22.2% natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052–0.88; P=0.032 and higher total motile sperm count (TMSC (HR: 1.001; 95% CI 1–1.001; P=0.012 were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

  14. Predictive factors for natural pregnancy after microsurgical reconstruction in patients with primary epididymal obstructive azoospermia.

    Science.gov (United States)

    Harza, Mihai; Voinea, Sebastian; Ismail, Gener; Gagiu, Cristian; Baston, Catalin; Preda, Adrian; Manea, Ioan; Priporeanu, Tiberiu; Sinescu, Ioanel

    2014-01-01

    Primary epididymal obstructive azoospermia (OA) is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34 ± 4.5 years (range 24-46 years). Median follow-up time was 15 [IQR 12-21] months. The total patency rate was 77.7% (n = 28). During follow-up, 8 (22.2%) natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052-0.88; P = 0.032) and higher total motile sperm count (TMSC) (HR: 1.001; 95% CI 1-1.001; P = 0.012) were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

  15. Microsurgical robotic system for the deep surgical field: development of a prototype and feasibility studies in animal and cadaveric models.

    Science.gov (United States)

    Morita, Akio; Sora, Shigeo; Mitsuishi, Mamoru; Warisawa, Shinichi; Suruman, Katopo; Asai, Daisuke; Arata, Junpei; Baba, Shoichi; Takahashi, Hidechika; Mochizuki, Ryo; Kirino, Takaaki

    2005-08-01

    To enhance the surgeon's dexterity and maneuverability in the deep surgical field, the authors developed a master-slave microsurgical robotic system. This concept and the results of preliminary experiments are reported in this paper. The system has a master control unit, which conveys motion commands in six degrees of freedom (X, Y, and Z directions; rotation; tip flexion; and grasping) to two arms. The slave manipulator has a hanging base with an additional six degrees of freedom; it holds a motorized operating unit with two manipulators (5 mm in diameter, 18 cm in length). The accuracy of the prototype in both shallow and deep surgical fields was compared with routine freehand microsurgery. Closure of a partial arteriotomy and complete end-to-end anastomosis of the carotid artery (CA) in the deep operative field were performed in 20 Wistar rats. Three routine surgical procedures were also performed in cadavers. The accuracy of pointing with the nondominant hand in the deep surgical field was significantly improved through the use of robotics. The authors successfully closed the partial arteriotomy and completely anastomosed the rat CAs in the deep surgical field. The time needed for stitching was significantly shortened over the course of the first 10 rat experiments. The robotic instruments also moved satisfactorily in cadavers, but the manipulators still need to be smaller to fit into the narrow intracranial space. Computer-controlled surgical manipulation will be an important tool for neurosurgery, and preliminary experiments involving this robotic system demonstrate its promising maneuverability.

  16. Visual-spatial ability is more important than motivation for novices in surgical simulator training: a preliminary study.

    Science.gov (United States)

    Schlickum, Marcus; Hedman, Leif; Felländer-Tsai, Li

    2016-02-21

    To investigate whether surgical simulation performance and previous video gaming experience would correlate with higher motivation to further train a specific simulator task and whether visual-spatial ability would rank higher in importance to surgical performance than the above. It was also examined whether or not motivation would correlate with a preference to choose a surgical specialty in the future and if simulator training would increase the interest in choosing that same work field. Motivation and general interest in surgery was measured pre- and post-training in 30 medical students at Karolinska Institutet who were tested in a laparoscopic surgical simulator in parallel with measurement of visual-spatial ability and self-estimated video gaming experience. Correlations between simulator performance metrics, visual-spatial ability and motivation were statistically analyzed using regression analysis. A good result in the first simulator trial correlated with higher self-determination index (r =-0.46, p=0.05) in male students. Visual-spatial ability was the most important underlying factor followed by intrinsic motivation score and finally video gaming experience (p=0.02, p=0.05, p=0.11) regarding simulator performance in male students. Simulator training increased interest in surgery when studying all subjects (p=0.01), male subjects (p=0.02) as well as subjects with low video gaming experience (p=0.02). This preliminary study highlights individual differences regarding the effect of simulator training on motivation that can be taken into account when designing simulator training curricula, although the sample size is quite small and findings should be interpreted carefully.

  17. A Preliminary Evaluation of Instructional Effectiveness of Online Training Implemented at a Government Agency in Thailand

    Science.gov (United States)

    Supanakorn-Davila, Supawan; Bolliger, Doris U.

    2012-01-01

    Online training has become popular in the professional development of government employees in Thailand. One large government agency developed an online program to provide training to its employees across the country using two systems: an Internet and Intranet-based system. With the new program implemented, the evaluation of the instructional…

  18. Simulation training for emergency obstetric and neonatal care in Senegal preliminary results.

    Science.gov (United States)

    Gueye, M; Moreira, P M; Faye-Dieme, M E; Ndiaye-Gueye, M D; Gassama, O; Kane-Gueye, S M; Diouf, A A; Niang, M M; Diadhiou, M; Diallo, M; Dieng, Y D; Ndiaye, O; Diouf, A; Moreau, J C

    2017-06-01

    To describe a new training approach for emergency obstetric and neonatal care (EmONC) introduced in Senegal to strengthen the skills of healthcare providers. The approach was based on skills training according to the so-called "humanist" method and on "lifesaving skills". Simulated practice took place in the classroom through 13 clinical stations summarizing the clinical skills needed for EmONC. Evaluation took place in all phases, and the results were recorded in a database to document the progress of each learner. This approach was used to train 432 providers in 10 months and to document the increase in each participants' technical achievements. The combination of training with the "learning by doing" model ensured that providers learned and mastered all EmONC skills and reduced the missed learning opportunities observed in former EmONC training sessions. Assessing the impact of training on EmONC indicators and introducing this learning modality in basic training are the two major challenges we currently face.

  19. Effect of somatosensory and neurofeedback training on balance in older healthy adults: a preliminary investigation.

    Science.gov (United States)

    Azarpaikan, Atefeh; Taheri Torbati, Hamidreza

    2017-10-23

    The aim of this study was to assess the effectiveness of balance training with somatosensory and neurofeedback training on dynamic and static balance in healthy, elderly adults. The sample group consisted of 45 healthy adults randomly assigned to one of the three test groups: somatosensory, neurofeedback, and a control. Individualization of the balance program started with pre-tests for static and dynamic balances. Each group had 15- and 30-min training sessions. All groups were tested for static (postural stability) and dynamic balances (Berg Balance Scale) in acquisition and transfer tests (fall risk of stability and timed up and go). Improvements in static and dynamic balances were assessed by somatosensory and neurofeedback groups and then compared with the control group. Results indicated significant improvements in static and dynamic balances in both test groups in the acquisition test. Results revealed a significant improvement in the transfer test in the neurofeedback and somatosensory groups, in static and dynamic conditions, respectively. The findings suggest that these methods of balance training had a significant influence on balance. Both the methods are appropriate to prevent falling in adults. Neurofeedback training helped the participants to learn static balance, while somatosensory training was effective on dynamic balance learning. Further research is needed to assess the effects of longer and discontinuous stimulation with somatosensory and neurofeedback training on balance in elderly adults.

  20. Microsurgical Resection of Suprasellar Craniopharyngioma-Technical Purview.

    Science.gov (United States)

    Nanda, Anil; Narayan, Vinayak; Mohammed, Nasser; Savardekar, Amey R; Patra, Devi Prasad

    2018-04-01

    Objectives  Complete surgical resection is an important prognostic factor for recurrence and is the best management for craniopharyngioma. This operative video demonstrates the technical nuances in achieving complete resection of a suprasellar craniopharyngioma. Design and Setting  The surgery was performed in a middle-aged lady who presented with the history of progressive bitemporal hemianopia and excessive sleepiness over 8 months. On imaging, suprasellar craniopharyngioma was identified. The tumor was approached through opticocarotid cistern and lamina terminalis. Exposure of bilateral optic nerves, right internal carotid artery, anterior cerebral artery, and its perforator branches was then afforded and the tumor was gross totally resected. Results  The author demonstrates step-by-step technique of microsurgical resection of suprasellar craniopharyngioma. The narrow corridor to deeper structures, intricacies of multiple perforator vessels, and the technique of arachnoid and capsule dissection are the main challenging factors for the gross total resection of craniopharyngioma. The tumor portion which lies under the ipsilateral optic nerve is a blind spot region with a high chance of leaving residual tumor. Mobilization of optic nerve may endanger visual function too. The use of handheld mirror ['mirror-technique'] helps in better visualization of this blind spot and achieve complete excision. Conclusions  The technical pearls of craniopharyngioma surgery include the optimum utilization of translamina terminalis route, wide opening of the cisterns, meticulous separation of deep perforator vessels, capsular mobilization/traction avoidance, and the use of "mirror-technique" for blind-spot visualization. These surgical strategies help to achieve complete resection without causing neurological deficit. The link to the video can be found at: https://youtu.be/9wHJ4AUpG50 .

  1. Transsphenoidal hypophysectomy in beagle dogs: evaluation of a microsurgical technique

    Energy Technology Data Exchange (ETDEWEB)

    Meij, B. P. [Utrecht University, Utrecht (Netherlands); Voorhout, G.; Ingh, T.S.G.A.M. van den; Hazewinkel, H. A.W.; Verlaat, J.W. van ' t

    1997-07-15

    Objective-Assessment of a microsurgical technique for transsphenoidalhypophysectomy in dogs. Study Design-Prospective study using physicalexamination, pituitary function testing, computed tomography (CT), and histological examination at autopsy. Animals or Sample Population-Eight laboratory beagle dogs. Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary). Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropicresponse and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded infibrous tissue in the sella turcica. Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy. Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons.

  2. Transsphenoidal hypophysectomy in beagle dogs: evaluation of a microsurgical technique

    International Nuclear Information System (INIS)

    Meij, B.P.; Voorhout, G.; Ingh, T.S.G.A.M. van den; Hazewinkel, H.A.W.; Verlaat, J.W. van 't

    1997-01-01

    Objective-Assessment of a microsurgical technique for transsphenoidalhypophysectomy in dogs. Study Design-Prospective study using physicalexamination, pituitary function testing, computed tomography (CT), and histological examination at autopsy. Animals or Sample Population-Eight laboratory beagle dogs. Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary). Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropicresponse and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded infibrous tissue in the sella turcica. Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy. Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons

  3. [Microsurgical anatomy importance of A1-anterior communicating artery complex].

    Science.gov (United States)

    Monroy-Sosa, Alejandro; Pérez-Cruz, Julio César; Reyes-Soto, Gervith; Delgado-Hernández, Carlos; Macías-Duvignau, Mario Alberto; Delgado-Reyes, Luis

    2013-01-01

    The anterior cerebral artery originates from the bifurcation of the internal carotid artery lateral to the optic chiasm, then joins with its contralateral counterpart via the anterior communicating artery. A1-anterior communicating artery complex is the most frequent anatomical variants and is the major site of aneurysms between 30 to 37%. Know the anatomy microsurgical, variants anatomical and importance of complex precommunicating segment-artery anterior communicating in surgery neurological of the pathology vascular, mainly aneurysms, in Mexican population. The study was performed in 30 brains injected. Microanatomy was studied (length and diameter) of A1-anterior communicating artery complex and its variants. 60 segments A1, the average length of left side was 11.35 mm and 11.84 mm was right. The average diameter of left was 1.67 mm and the right was 1.64 mm. The average number of perforators on the left side was 7.9 and the right side was 7.5. Anterior communicating artery was found in 29 brains of the optic chiasm, its course depended on the length of the A1 segment. The average length of the segment was 2.84 mm, the average diameter was 1.41 mm and the average number of perforators was 3.27. A1-anterior communicating artery complex variants were found in 18 (60%) and the presence of two blister-like aneurysms. It is necessary to understand the A1-anterior communicating artery complex microanatomy of its variants to have a three-dimensional vision during aneurysm surgery.

  4. Microsurgical principles and postoperative adhesions: lessons from the past.

    Science.gov (United States)

    Gomel, Victor; Koninckx, Philippe R

    2016-10-01

    "Microsurgery" is a set of principles developed to improve fertility surgery outcomes. These principles were developed progressively based on common sense and available evidence, under control of clinical feedback obtained with the use of second-look laparoscopy. Fertility outcome was the end point; significant improvement in fertility rates validated the concept clinically. Postoperative adhesion formation being a major cause of failure in fertility surgery, the concept of microsurgery predominantly addresses prevention of postoperative adhesions. In this concept, magnification with a microscope or laparoscope plays a minor role as technical facilitator. Not surprisingly, the principles to prevent adhesion formation are strikingly similar to our actual understanding: gentle tissue handling, avoiding desiccation, irrigation at room temperature, shielding abdominal contents from ambient air, meticulous hemostasis and lavage, avoiding foreign body contamination and infection, administration of dexamethasone postoperatively, and even the concept of keeping denuded areas separated by temporary adnexal or ovarian suspension. The actual concepts of peritoneal conditioning during surgery and use of dexamethasone and a barrier at the end of surgery thus confirm without exception the tenets of microsurgery. Although recent research helped to clarify the pathophysiology of adhesion formation, refined its prevention and the relative importance of each factor, the clinical end point of improvement of fertility rates remains demonstrated for only the microsurgical tenets as a whole. In conclusion, the principles of microsurgery remain fully valid as the cornerstones of reproductive microsurgery, whether performed by means of open access or laparoscopy. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Utility of the Lone Star Retractor System in Microsurgical Carotid Endarterectomy.

    Science.gov (United States)

    Toyota, Shingo; Kumagai, Tetsuya; Goto, Tetsu; Mori, Kanji; Taki, Takuyu

    2017-05-01

    The retractor system is an important device in carotid endarterectomy (CEA). We applied the Lone Star (LS) Retractor System, which is a self-retaining retractor originally designed for improved visualization in many other surgical fields, in microsurgical CEA. The LS disposal retractor (14.1 cm × 14.1 cm) and LS elastic stays (5-mm sharp hook) were used as a retractor system in 38 consecutive CEAs. Using the LS retractor system, a shallow operative field could be obtained by lifting up the connective tissue surrounding the deep structures hooked by the LS elastic stays. The LS elastic stays were quick and easy to handle in the microsurgical operative field. There were no complications using the LS retractor system. The application of the LS retractor system in microsurgical CEA is feasible. An additional merit is that it is single use. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Preliminary Evaluation of a Novel Simulation-Based Tool for Training Rapid Decision-Making Skills

    National Research Council Canada - National Science Library

    Christ, Richard E

    2006-01-01

    ...). SimFX is different from other desktop trainers in that it uses a discrete, outcome-driven simulation for training leader decision making rather than a simulation driven by inputs from the virtual operating environment...

  7. Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results.

    Science.gov (United States)

    Žiak, Peter; Holm, Anders; Halička, Juraj; Mojžiš, Peter; Piñero, David P

    2017-06-28

    The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample of anisometropic amblyopic adults and to evaluate the potential usefulness of this option of treatment. A total of 17 subjects (10 men, 7 women) with a mean age of 31.2 years (range, 17-69 year) and anisometropic amblyopia were enrolled. Best corrected visual acuity (BCVA) and stereoacuity (Stereo Randot graded circle test) changes were evaluated after 8 sessions (40 min per session) of dichoptic training with the computer game Diplopia Game (Vivid Vision) run in the Oculus Rift OC DK2 virtual reality head mounted display (Oculus VR). Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.58 ± 0.35 before training to a post-training value of 0.43 ± 0.38 (p virtual reality head mounted display seems to be an effective option of treatment in adults with anisometropic amblyopia. Future clinical trials are needed to confirm this preliminary evidence. Trial ID: ISRCTN62086471 . Date registered: 13/06/2017. Retrospectively registered.

  8. Overdose prevention training with naloxone distribution in a prison in Oslo, Norway: a preliminary study.

    Science.gov (United States)

    Petterson, Aase Grønlien; Madah-Amiri, Desiree

    2017-11-21

    Prison inmates face a ten times increased risk of experiencing a fatal drug overdose during their first 2 weeks upon release than their non-incarcerated counterparts. Naloxone, the antidote to an opioid overdose, has been shown to be feasible and effective when administered by bystanders. Given the particular risk that newly released inmates face, it is vital to assess their knowledge about opioid overdoses, as well as the impact of brief overdose prevention training conducted inside prisons. Prison inmates nearing release (within 6 months) in Oslo, Norway, voluntarily underwent a brief naloxone training. Using a questionnaire, inmates were assessed immediately prior to and following a naloxone training. Descriptive statistics were performed for main outcome variables, and the Wilcoxon signed-rank test was used to compare the participants' two questionnaire scores from pre-and post-training. Participating inmates (n = 31) were found to have a high baseline knowledge of risk factors, symptoms, and care regarding opioid overdoses. Nonetheless, a brief naloxone training session prior to release significantly improved knowledge scores in all areas assessed (p < 0.001). The training appears to be most beneficial in improving knowledge regarding the naloxone, including its use, effect, administration, and aftercare procedures. Given the high risk of overdosing that prison inmates face upon release, the need for prevention programs is critical. Naloxone training in the prison setting may be an effective means of improving opioid overdose response knowledge for this particularly vulnerable group. Naloxone training provided in the prison setting may improve the ability of inmates to recognize and manage opioid overdoses after their release; however, further studies on a larger scale are needed.

  9. A preliminary evaluation of Acceptance and Commitment Therapy (ACT) training in Sierra Leone

    OpenAIRE

    Stewart, Corinna; White, Ross G.; Ebert, Beate; Mays, Iain; Nardozzi, Jennifer; Bockarie, Hannah

    2016-01-01

    Concerted efforts are being made to scale up psychological interventions in low and middle-income countries (LMIC). Acceptance and Commitment Therapy (ACT) aims to reduce psychological inflexibility and has been shown to be effective for treating a range of mental health difficulties. ACT training workshops have been shown to reduce the psychological inflexibility of individuals receiving training. There is a dearth of research investigating the acceptability and potential efficacy of ACT in ...

  10. Comparison of attention training and cognitive therapy in the treatment of social phobia: a preliminary investigation.

    Science.gov (United States)

    Donald, Juliet; Abbott, Maree J; Smith, Evelyn

    2014-01-01

    Prominent models of social phobia highlight the role played by attentional factors, such as self-focused attention, in the development and maintenance of social phobia. Elevated self-focused attention is associated with increases in self-rated anxiety. Treatments that aim to modify and change attentional processes, specifically self-focused attention, will have a direct effect on social phobia symptoms. Thus, Attention Training targets attentional focus. The present study aimed to investigate the efficacy of Attention Training in comparison to an established treatment for social phobia, Cognitive Therapy. Participants (Intention-to-treat = 45; completers = 30) were allocated to either 6 weeks of Attention Training or Cognitive Therapy. It was hypothesized that both treatments would be effective in reducing social phobia symptoms, but that Attention Training would work primarily by reducing levels of self-focused attention. The results found an overall effectiveness of both treatment conditions in reducing social phobia symptoms. However, Attention Training significantly improved scores on the Self-Focused Attention questionnaire and the Brief Fear of Negative Evaluation questionnaire compared to Cognitive Therapy. Attention Training seems to be a promising treatment for social phobia.

  11. Effects of dialectical behaviour therapy-mindfulness training on emotional reactivity in borderline personality disorder: preliminary results.

    Science.gov (United States)

    Feliu-Soler, Albert; Pascual, Juan C; Borràs, Xavier; Portella, Maria J; Martín-Blanco, Ana; Armario, Antonio; Alvarez, Enric; Pérez, Víctor; Soler, Joaquim

    2014-01-01

    Emotional dysregulation has been proposed as a hallmark of borderline personality disorder (BPD). Mindfulness techniques taught in dialectical behaviour therapy (DBT) appear to be effective in reducing affective symptoms and may enhance emotion regulation in BPD patients. In the present study, we assessed whether 10 weeks of DBT-mindfulness (DBT-M) training added to general psychiatric management (GPM) could improve emotion regulation in BPD patients. A total of 35 patients with BPD were included and sequentially assigned to GPM (n = 17) or GPM plus DBT-M (n = 18). Participants underwent a negative emotion induction procedure (presentation of standardized unpleasant images) both pre-intervention and post-intervention. Clinical evaluation was also performed before and after treatment. No differences were observed in emotional response at the post-treatment session. However, patients in the DBT-M group showed greater improvement in clinical symptoms. Formal mindfulness practice was positively correlated with clinical improvements and lower self-reported emotional reactivity. Our preliminary results suggest that mindfulness training reduces some psychiatric symptoms but may not have a clear effect on how patients respond to emotional stimuli in an experimental setting. No clear effect of mindfulness training was observed on emotional response to a negative emotion induction procedure. Application of the DBT-M module jointly to GPM induced better clinical outcomes than GPM alone. Formal mindfulness practice showed a positive impact on emotion regulation and clinical improvement. Copyright © 2013 John Wiley & Sons, Ltd.

  12. Novel mouse model for simulating microsurgical tumor excision with facial nerve preservation.

    Science.gov (United States)

    Lim, Jae H; Boyle, Glen M; Panizza, Benedict

    2016-01-01

    To determine the feasibility of using a mouse tumor model as a microsurgical training tool for otolaryngology-head and neck surgery (OHNS) trainees. Animal study. We injected athymic nude mice with human cutaneous squamous cell carcinoma (A431 cell line) deep to the parotid region overlying the masseter muscle. We sacrificed the animals 1 to 3 weeks postinjection, once a visible tumor growth was confirmed. We then asked 10 OHNS trainees to excise the tumor with preservation of the facial nerves under a high-magnification dissecting microscope. The trainees graded the tasks in several areas of specific measures using a visual analogue scale (VAS) including 1) tumor texture, 2) surgical realism, 3) usefulness, and 4) difficulty of the task. Noticeable tumor growth occurred within 5 days following A431 cell injection and reached measureable size (0.5-1.5 cm) within 1 to 3 weeks. The tumor displaced the facial nerve laterally and medially, with few demonstrating infiltration of the nerve. VAS scores (± standard deviation) were 8.1 (± 1.7), 7.7 (± 2.5), 9.0 (± 0.9) and 6.6 (± 1.9) for tumor texture, surgical realism, usefulness, and the difficulty of the task, respectively. We demonstrate a novel, reliable and cost-effective mouse model for simulating tumor extirpation microsurgery with preservation of important neural structures. OHNS trainees have found this simulation model to be realistic, useful, and appropriately challenging. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Development and validation of trauma surgical skills metrics: Preliminary assessment of performance after training.

    Science.gov (United States)

    Shackelford, Stacy; Garofalo, Evan; Shalin, Valerie; Pugh, Kristy; Chen, Hegang; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark; Mackenzie, Colin F

    2015-07-01

    Maintaining trauma-specific surgical skills is an ongoing challenge for surgical training programs. An objective assessment of surgical skills is needed. We hypothesized that a validated surgical performance assessment tool could detect differences following a training intervention. We developed surgical performance assessment metrics based on discussion with expert trauma surgeons, video review of 10 experts and 10 novice surgeons performing three vascular exposure procedures and lower extremity fasciotomy on cadavers, and validated the metrics with interrater reliability testing by five reviewers blinded to level of expertise and a consensus conference. We tested these performance metrics in 12 surgical residents (Year 3-7) before and 2 weeks after vascular exposure skills training in the Advanced Surgical Skills for Exposure in Trauma (ASSET) course. Performance was assessed in three areas as follows: knowledge (anatomic, management), procedure steps, and technical skills. Time to completion of procedures was recorded, and these metrics were combined into a single performance score, the Trauma Readiness Index (TRI). Wilcoxon matched-pairs signed-ranks test compared pretraining/posttraining effects. Mean time to complete procedures decreased by 4.3 minutes (from 13.4 minutes to 9.1 minutes). The performance component most improved by the 1-day skills training was procedure steps, completion of which increased by 21%. Technical skill scores improved by 12%. Overall knowledge improved by 3%, with 18% improvement in anatomic knowledge. TRI increased significantly from 50% to 64% with ASSET training. Interrater reliability of the surgical performance assessment metrics was validated with single intraclass correlation coefficient of 0.7 to 0.98. A trauma-relevant surgical performance assessment detected improvements in specific procedure steps and anatomic knowledge taught during a 1-day course, quantified by the TRI. ASSET training reduced time to complete vascular

  14. Evaluation of Exercise Tolerance in Dialysis Patients Performing Tai Chi Training: Preliminary Study

    Directory of Open Access Journals (Sweden)

    Wioletta Dziubek

    2016-01-01

    Full Text Available Introduction. Patients with end-stage renal disease (ESRD have poor physical performance and exercise capacity due to frequent dialysis treatments. Tai Chi exercises can be very useful in the area of rehabilitation of people with ESRD. Objectives. The aim of the study was to assess exercise capacity in ESRD patients participating in 6-month Tai Chi training. Patients and Methods. Twenty dialysis patients from Wroclaw took part in the training; at the end of the project, 14 patients remained (age 69.2±8.6 years. A 6-minute walk test (6MWT and spiroergometry were performed at the beginning and after 6 months of training. Results. After 6 months of Tai Chi, significant improvements were recorded in mean distance in the 6MWT (387.89 versus 436.36 m, rate of perceived exertion (7.4 versus 4.7, and spiroergometry (8.71 versus 10.08 min. Conclusions. In the ESRD patients taking part in Tai Chi training, a definite improvement in exercise tolerance was recorded after the 6-month training. Tai Chi exercises conducted on days without dialysis can be an effective and interesting form of rehabilitation for patients, offering them a chance for a better quality of life and fewer falls and hospitalisations that are the result of it.

  15. The role of a preliminary PGY-3 in general surgery training.

    Science.gov (United States)

    Tarpley, Margaret J; Van Way, Charles; Friedell, Mark; Deveney, Karen; Farley, David; Mellinger, John; Scott, Bradford; Tarpley, John

    2014-01-01

    Even before the preliminary postgraduate year (PGY)-3 was eliminated from surgical residency, it had become increasingly difficult to fill general surgery PGY-4 vacancies. This ongoing need prompted the Association of Program Directors in Surgery (APDS) leadership to form a task force to study the possibility of requesting the restoration of the preliminary PGY-3 to Accreditation Council for Graduate Medical Education-approved general surgery residency programs. The task force conducted a 10-year review of the APDS list serve to ascertain the number of advertised PGY-4 open positions. Following the review of the list serve, the task force sent IRB-approved electronic REDCap surveys to 249 program directors (PDs) in general surgery. The list serve review revealed more than 230 requests for fourth-year residents, a number that most likely underestimates the need, as such, vacancies are not always advertised through the APDS. A total of 119 PDs (~48%) responded. In the last 10 years, these 119 programs needed an average of 2 PGY-4 residents (range: 0-8), filled 1.3 positions (range: 0-7), and left a position unfilled 1.3 times (range: 0-7). Methods for finding PGY-4 residents included making personal contacts with other PDs (52), posting on the APDS Topica List Serve (47), and using the APDS Web site for interested candidates on residency and fellowship job listings (52). Reasons for needing a PGY-4 resident included residents leaving the program (82), extra laboratory years (39), remediation (31), and approved program expansion (21), as well as other issues. Satisfaction scores for the added PGY-4 residents were more negative (43) than positive (30). Problems ranged from lack of preparation to professionalism. When queried as to an optimal number of preliminary residents needed nationally at the PGY-3 level, responses varied from 0 to 50 (34 suggested 10). The survey of PDs supports the need for the reintroduction of a limited number of Accreditation Council for

  16. Police Training to Align Law Enforcement and HIV Prevention: Preliminary Evidence From the Field

    Science.gov (United States)

    Agrawal, Alpna; Moreau, Bruce; Kumar, Pratima; Weiss-Laxer, Nomi; Heimer, Robert

    2011-01-01

    Having identified gaps in implementation of Rhode Island's syringe access law and police occupational safety education, public health and police professionals developed police training to boost legal knowledge, improve syringe access attitudes, and address needlestick injuries. Baseline data (94 officers) confirmed anxiety about needlestick injuries, poor legal knowledge, and occupational risk overestimation. Before training, respondents believed that syringe access promotes drug use (51%), increases likelihood of police needlestick injuries (58%), and fails to reduce epidemics (38%). Pretraining to posttraining evaluation suggested significant shifts in legal and occupational safety knowledge; changes in attitudes toward syringe access were promising. Training that combines occupational safety with syringe access content can help align law enforcement with public health goals. Additional research is needed to assess street-level effect and to inform intervention tailoring. PMID:21940924

  17. The effects of strength and power training on single-step balance recovery in older adults: a preliminary study.

    Science.gov (United States)

    Pamukoff, Derek N; Haakonssen, Eric C; Zaccaria, Joseph A; Madigan, Michael L; Miller, Michael E; Marsh, Anthony P

    2014-01-01

    Improving muscle strength and power may mitigate the effects of sarcopenia, but it is unknown if this improves an older adult's ability to recover from a large postural perturbation. Forward tripping is prevalent in older adults and lateral falls are important due to risk of hip fracture. We used a forward and a lateral single-step balance recovery task to examine the effects of strength training (ST) or power (PT) training on single-step balance recovery in older adults. Twenty older adults (70.8±4.4 years, eleven male) were randomly assigned to either a 6-week (three times/week) lower extremity ST or PT intervention. Maximum forward (FLean(max)) and lateral (LLean(max)) lean angle and strength and power in knee extension and leg press were assessed at baseline and follow-up. Fifteen participants completed the study (ST =7, PT =8). Least squares means (95% CI) for ΔFLean(max) (ST: +4.1° [0.7, 7.5]; PT: +0.6° [-2.5, 3.8]) and ΔLLean(max) (ST: +2.2° [0.4, 4.1]; PT: +2.6° [0.9, 4.4]) indicated no differences between groups following training. In exploratory post hoc analyses collapsed by group, ΔFLean(max) was +2.4° (0.1, 4.7) and ΔLLean(max) was +2.4° (1.2, 3.6). These improvements on the balance recovery tasks ranged from ~15%-30%. The results of this preliminary study suggest that resistance training may improve balance recovery performance, and that, in this small sample, PT did not lead to larger improvements in single-step balance recovery compared to ST.

  18. Autogenic Training and Hand Temperature Biofeedback in the Treatment of Migraine: A Preliminary Analysis.

    Science.gov (United States)

    Jessup, B.; And Others

    The possibility of alleviating migraine headaches by autogenic relaxation training, with or without hand temperature biofeedback, was assessed. The study examined five independent groups in a bi-directional control group design. Volunteer migraine sufferers served as subjects, each participating for 12 weeks. The first four weeks of the study were…

  19. Training Directors' Conceptualizations of the Intersections of Diversity and Trainee Competence Problems: A Preliminary Analysis

    Science.gov (United States)

    Miller, David S. Shen; Forrest, Linda; Elman, Nancy S.

    2009-01-01

    Counseling psychology has demonstrated leadership on multicultural issues through serious and committed attention to diversity in scholarship, conferences, and training and recruitment. Yet a survey of the literature on trainees with competence problems resulted in limited references to race/ethnicity and/or gender (REG). Using transcripts of…

  20. A Preliminary Evaluation of Short Blended Online Training Workshop for TPACK Development Using Technology Acceptance Model

    Science.gov (United States)

    Alsofyani, Mohammed Modeef; Aris, Baharuddin bin; Eynon, Rebecca; Majid, Norazman Abdul

    2012-01-01

    The use of Short Blended Online Training (SBOT) for the development of Technological Pedagogical and Content Knowledge (TPACK) is a promising approach to facilitate the use of e-learning by academics. Adult learners prefer the blend of pedagogies such as the presentation, demonstration, practice and feedback if they are structured and…

  1. Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report.

    Science.gov (United States)

    McBride, Michael G; Binder, Tracy Jo; Paridon, Stephen M

    2007-01-01

    To determine the safety and feasibility of an inpatient exercise training program for a group of pediatric heart transplantation candidates on multiple inotropic support. Children with end-stage heart disease often require heart transplantation. Currently, no data exist on the safety and feasibility of an inpatient exercise training program in pediatric patients awaiting heart transplantation while on inotropic support. Twenty ambulatory patients (11 male; age, 13.6 +/- 3.2 years) were admitted, listed, and subsequently enrolled into an exercise training program while awaiting heart transplantation. Patient diagnoses consisted of dilated cardiomyopathy (n = 15), restrictive cardiomyopathy (n = 1), and failing single-ventricle physiology (n = 4). Inotropic support consisted of a combination of dobutamine, dopamine, or milrinone. Exercise sessions were scheduled three times a week lasting from 30 to 60 minutes and consisted of aerobic and musculoskeletal conditioning. Over 6.2 +/- 4.2 months, 1,251 of a possible 1,508 exercise training sessions were conducted, with a total of 615 hours (26.3 +/- 2.7 min/session) dedicated to low-intensity aerobic exercise. Reasons for noncompliance included a change in medical status, staffing, or patient cooperation. Two adverse episodes (seizures) occurred, neither of which resulted in termination from the program. No adverse episodes of hypotension or significant complex arrhythmias occurred. No complication of medication administration or loss of intravenous access occurred. Data from this study indicate that pediatric patients on inotropic support as a result of systemic ventricular or biventricular heart failure can safely participate in exercise training programs with relatively moderate to high compliance.

  2. Effects of Robot Assisted Gait Training in Progressive Supranuclear Palsy (PSP: a preliminary report.

    Directory of Open Access Journals (Sweden)

    Patrizio eSale

    2014-04-01

    Full Text Available Background and Purpose: Progressive supranuclear palsy (PSP is a rare neurodegenerative disease clinically characterized by prominent axial extrapyramidal motor symptoms with frequent falls. Over the last years the introduction of robotic technologies to recover lower limb function has been greatly employed in the rehabilitative practice. This observational trial is aimed at investigating the feasibility, the effectiveness and the efficacy of end-effector robot training in people with PSP.Method: Pilot observational trial.Participants: Five cognitively intact participants with PSP and gait disorders.Interventions: Patients were submitted to a rehabilitative program of robot-assisted walking sessions for 45 minutes, 5 times a week for 4 weeks.Main outcome measures: The spatiotemporal parameters at the beginning (T0 and at the end of treatment (T1 were recorded by a gait analysis laboratory.Results: Robot training was feasible, acceptable and safe and all participants completed the prescribed training sessions. All patients showed an improvement in the gait index (Mean velocity, Cadence, Step length and Step width (T0 versus T1.Conclusions: Robot training is a feasible and safe form of rehabilitation for cognitively intact people with PSP. This innovative approach can contribute to improve lower limb motor recovery. The focus on gait recovery is another quality that makes this research important for clinical practice. On the whole, the simplicity of treatment, the lack of side effects and the positive results in the patients support the recommendation to extend the trials of this treatment. Further investigation regarding the effectiveness of robot training in time is necessary.Trial registration: ClinicalTrials.gov NCT01668407.

  3. Implementation of a formal in-training assessment programme in anaesthesiology and preliminary results of acceptability

    DEFF Research Database (Denmark)

    Ringsted, C; Østergaard, D; van der Vleuten, C P M

    2003-01-01

    BACKGROUND: A new reform on postgraduate education in Denmark requires a formal in-training assessment in all specialties. The aim of this study was to survey the implementation and acceptability of the first example of a nation-wide in-training assessment programme for first-year trainees...... in anaesthesiology developed by a working group under the Danish Society of Anaesthesiology and Intensive Care Medicine. METHODS: A questionnaire about the implementation of the programme in practice and the characteristics of the trainees was sent to the educational responsible consultant (ERC) in each of the 26...... anaesthetic departments in the country with first-year trainees in anaesthesiology. Standard evaluations of the assessment programme were regularly collected from trainees. RESULTS: Twenty-five (96%) departments returned the questionnaire. In total the departments reported on 100 trainees and 83 of these had...

  4. Influence of Moderate Training on Gait and Work Capacity of Fibromyalgia Patients: A Preliminary Field Study

    OpenAIRE

    Tiidus, Peter M.; Pierrynowski, Michael; Dawson, Kimberley A.

    2002-01-01

    This field study examined the influence of moderate intensity training on gait patterns and work capacity of individuals with fibromyalgia syndrome (FS). FS is a chronic condition of unknown etiology, characterized by muscle tenderness, pain and stiffness and often accompanied by depression and fatigue which seems to occur primarily in middle aged females. There is no known cure for FS but treatment often includes a prescription of mild exercise. Few studies have evaluated the effectiveness o...

  5. Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD

    OpenAIRE

    Tamm, Leanne; Epstein, Jeffery N.; Peugh, James L.; Nakonezny, Paul A.; Hughes, Carroll W.

    2013-01-01

    A pilot randomized clinical trial was conducted to examine the initial efficacy of Pay Attention!, an intervention training sustained, selective, alternating, and divided attention, in children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). After a diagnostic and baseline evaluation, school-aged children with ADHD were randomized to receive 16 bi-weekly sessions of Pay Attention! (n = 54) or to a waitlist control group (n = 51). Participants completed an outcome evaluation ap...

  6. Effects of categorization training in patients with TBI during postacute rehabilitation: preliminary findings.

    Science.gov (United States)

    Constantinidou, Fofi; Thomas, Robin D; Scharp, Victoria L; Laske, Kate M; Hammerly, Mark D; Guitonde, Suchita

    2005-01-01

    Previous research suggests that traumatic brain injury (TBI) interferes with the ability to extract and use attributes to describe objects. This study explored the effects of a systematic Categorization Program (CP) in participants with TBI and noninjured controls. Ten persons with moderate to severe TBI who received comprehensive postacute rehabilitation services and 13 matched noninjured controls participated in the study. All participants received CP training for 3 to 5 hours per week for 10 to 12 weeks that consisted of 8 levels and targeted concept formation, object categorization, and decision-making abilities. The Mayo-Portland Adaptability Inventory-3 (MPAI-3) and the Community Integration Questionnaire (CIQ). Two Categorization Tests (administered pretraining and posttraining) and 3 Probe Tasks (administered at specified intervals during training) assessed skills relating to categorization. Both groups showed significant improvement in categorization performance after the CP training on the 2 Categorization Tests related to the CP. They also were able to generalize and apply categorization and sorting skills in new situations (as measured by the Probe Tasks). Participants with TBI had improved functional outcome performance measured by the MPAI-3 and the CIQ. The systematic and hierarchical structure of the CP is beneficial to participants with TBI during postacute rehabilitation. This study contributes to the growing body of evidence supporting cognitive rehabilitation after moderate to severe TBI.

  7. Cerebral Reorganization in Subacute Stroke Survivors after Virtual Reality-Based Training: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Xiang Xiao

    2017-01-01

    Full Text Available Background. Functional magnetic resonance imaging (fMRI is a promising method for quantifying brain recovery and investigating the intervention-induced changes in corticomotor excitability after stroke. This study aimed to evaluate cortical reorganization subsequent to virtual reality-enhanced treadmill (VRET training in subacute stroke survivors. Methods. Eight participants with ischemic stroke underwent VRET for 5 sections per week and for 3 weeks. fMRI was conducted to quantify the activity of selected brain regions when the subject performed ankle dorsiflexion. Gait speed and clinical scales were also measured before and after intervention. Results. Increased activation in the primary sensorimotor cortex of the lesioned hemisphere and supplementary motor areas of both sides for the paretic foot (p<0.01 was observed postintervention. Statistically significant improvements were observed in gait velocity (p<0.05. The change in voxel counts in the primary sensorimotor cortex of the lesioned hemisphere is significantly correlated with improvement of 10 m walk time after VRET (r=−0.719. Conclusions. We observed improved walking and increased activation in cortical regions of stroke survivors after VRET training. Moreover, the cortical recruitment was associated with better walking function. Our study suggests that cortical networks could be a site of plasticity, and their recruitment may be one mechanism of training-induced recovery of gait function in stroke. This trial is registered with ChiCTR-IOC-15006064.

  8. Metacognitive and social cognition training (MSCT) in schizophrenia: a preliminary efficacy study.

    Science.gov (United States)

    Rocha, Nuno B F; Queirós, Cristina

    2013-10-01

    Psychosocial interventions have proven to be effective in treating social cognition in people with psychotic disorders. The current study aimed to determine the effects of a metacognitive and social cognition training (MSCT) program, designed to both remediate deficits and correct biases in social cognition. Thirty-five clinically stable outpatients were recruited and assigned to the MSCT program (n=19) for 10 weeks (18 sessions) or to the TAU group (n=16), and they all completed pre- and post-treatment assessments of social cognition, cognitive biases, functioning and symptoms. The MSCT group demonstrated a significant improvement in theory of mind, social perception, emotion recognition and social functioning. Additionally, the tendency to jump to conclusions was significantly reduced among the MSCT group after training. There were no differential benefits regarding clinical symptoms except for one trend group effect for general psychopathology. The results support the efficacy of the MSCT format, but further development of the training program is required to increase the benefits related to attributional style. © 2013 Elsevier B.V. All rights reserved.

  9. Preliminary Evidence for Training-Induced Changes of Morphology and Phantom Limb Pain

    Directory of Open Access Journals (Sweden)

    Sandra Preißler

    2017-06-01

    Full Text Available The aim of this study was to investigate whether a special prosthetic training in phantom limb pain patients aimed at increasing the functional use of the prosthesis leads to neural morphological plasticity of brain structures and a reduction in phantom limb pain. For chronic pain disorders, it was shown that morphological alterations due to pain might become at least partially reversed by pain therapies. Phantom limb pain is a chronic pain disorder that is frequently followed by neural plasticity of anatomical brain structures. In our study, 10 patients with amputation of the upper limb participated in a two-week training with a myoelectric prosthesis with somatosensory feedback. Grip strength was fed back with electrocutaneous stimulus patterns applied to the stump. Phantom limb pain was assessed before and after the two-week training. Similarly, two T1 weighted MRI scans were conducted for longitudinal thickness analyses of cortical brain structures. As result of this treatment, patients experienced a reduction in phantom limb pain and a gain in prosthesis functionality. Furthermore, we found a change of cortical thickness in small brain areas in the visual stream and the post-central gyrus ipsilateral to the amputation indicating morphological alterations in brain areas involved in vision and pain processing.

  10. Influence of moderate training on gait and work capacity of fibromyalgia patients: a preliminary field study.

    Science.gov (United States)

    Tiidus, Peter M; Pierrynowski, Michael; Dawson, Kimberley A

    2002-12-01

    This field study examined the influence of moderate intensity training on gait patterns and work capacity of individuals with fibromyalgia syndrome (FS). FS is a chronic condition of unknown etiology, characterized by muscle tenderness, pain and stiffness and often accompanied by depression and fatigue which seems to occur primarily in middle aged females. There is no known cure for FS but treatment often includes a prescription of mild exercise. Few studies have evaluated the effectiveness of mild exercise on work capacity and gait patterns in FS patients. Participants were 14 females (age 47.0 ± 7.6 y) who participated in a 10 wk community based aerobic, strength and stretching program designed for FS individuals. Subjects were evaluated pre- and post-program and at a 2 month follow up. Work capacity was estimated by a sub-maximal PWC 170 cycle ergometer test and a Borg perceived exertion scale. Gait was assessed using OptoTrack three dimensional kinematics with 16 channel analogue data acquisition system. Trunk flexibility was also assessed. No significant change in estimated work capacity or flexibility was seen between pre- post- and follow up times. Nevertheless, a significant increase in self selected walking speed (p gait pattern that was sustained in the follow up testing was noted. We had previously also reported a significant improvement in muscle pain and other fibromyalgia symptoms in this population consequent to the training program. It was concluded that mild exercise training that does not influence work capacity or trunk flexibility can nevertheless positively influence gait mechanics and fibromyalgia symptoms in female FS patients.

  11. INFLUENCE OF MODERATE TRAINING ON GAIT AND WORK CAPACITY OF FIBROMYALGIA PATIENTS: A PRELIMINARY FIELD STUDY

    Directory of Open Access Journals (Sweden)

    Michael Pierrynowski

    2002-12-01

    Full Text Available This field study examined the influence of moderate intensity training on gait patterns and work capacity of individuals with fibromyalgia syndrome (FS. FS is a chronic condition of unknown etiology, characterized by muscle tenderness, pain and stiffness and often accompanied by depression and fatigue which seems to occur primarily in middle aged females. There is no known cure for FS but treatment often includes a prescription of mild exercise. Few studies have evaluated the effectiveness of mild exercise on work capacity and gait patterns in FS patients. Participants were 14 females (age 47.0± 7.6 y who participated in a 10 wk community based aerobic, strength and stretching program designed for FS individuals. Subjects were evaluated pre- and post-program and at a 2 month follow up. Work capacity was estimated by a sub-maximal PWC 170 cycle ergometer test and a Borg perceived exertion scale. Gait was assessed using OptoTrack three dimensional kinematics with 16 channel analogue data acquisition system. Trunk flexibility was also assessed. No significant change in estimated work capacity or flexibility was seen between pre- post- and follow up times. Nevertheless, a significant increase in self selected walking speed (p < 0.05 and a trend toward a more normal gait pattern that was sustained in the follow up testing was noted. We had previously also reported a significant improvement in muscle pain and other fibromyalgia symptoms in this population consequent to the training program. It was concluded that mild exercise training that does not influence work capacity or trunk flexibility can nevertheless positively influence gait mechanics and fibromyalgia symptoms in female FS patients

  12. Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD.

    Science.gov (United States)

    Tamm, Leanne; Epstein, Jeffery N; Peugh, James L; Nakonezny, Paul A; Hughes, Carroll W

    2013-04-01

    A pilot randomized clinical trial was conducted to examine the initial efficacy of Pay Attention!, an intervention training sustained, selective, alternating, and divided attention, in children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). After a diagnostic and baseline evaluation, school-aged children with ADHD were randomized to receive 16 bi-weekly sessions of Pay Attention! (n=54) or to a waitlist control group (n=51). Participants completed an outcome evaluation approximately 12 weeks after their baseline evaluation. Results showed significant treatment effects for parent and clinician ratings of ADHD symptoms, child self-report of ability to focus, and parent ratings of executive functioning. Child performance on neuropsychological tests showed significant treatment-related improvement on strategic planning efficiency, but no treatment effects were observed on other neuropsychological outcomes. Treatment effects were also not observed for teacher ratings of ADHD. These data add to a growing body of literature supporting effects of cognitive training on attention and behavior, however, additional research is warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. A preliminary evaluation of the simulation requirements of accident situations in a PWR training simulator

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.

    1978-07-01

    An attempt was made to establish here the need to incorporate ''Accident Situations'' in Training Simulators, and, to indicate that the modelling of such otherwise complex situations could admit a great deal of simplifications. In most cases, a ''semidynamic'' model to display time dependent flows or Tank levels would do while ESF actuated start/stop or open/close of equipment could be modelled merely ''Live''. Transport delays and Time Constants in most cases are of no significance as are the accuracy considerations of most variables. The systems which need complete Dynamic Simulation are the ones which are always running, such as Pressuriser, RCS, Reactor, and the Steam Generator with the added advantages of the modest accuracy requirements and the plant being shutdown. (author)

  14. Nuclear-related training and education offered by academic institutions (less than baccalaureate degree) (preliminary)

    International Nuclear Information System (INIS)

    Howard, L.

    1981-11-01

    This study presents the results of a survey of academic institutions offering nuclear-related training and education at the less than baccalaureate degree level. The scope of the survey includes only those programs which have a nuclear power industry application, and excludes all programs which are affiliated with nuclear medicine. The survey instrument was distributed by the Institute of Nuclear Power Operations to 262 academic institutions. The survey universe was compiled from a number of publications that listed nuclear-related academic programs. Since the initial mailing in May 1981, ten of the institutions have been determined to no longer exist and eight other listings have been identified as duplications, thus reducing the universe to 244 institutions. Fifty-five percent of the survey population (134 institutions) responded to the questionnaire, of which 45 percent (109) were out of the survey scope and 10 percent (25) indicated they offered less than baccalaureate degree, nuclear-related programs

  15. Effects of virtual reality-based training with BTs-Nirvana on functional recovery in stroke patients: preliminary considerations.

    Science.gov (United States)

    De Luca, Rosaria; Russo, Margherita; Naro, Antonino; Tomasello, Provvidenza; Leonardi, Simona; Santamaria, Floriana; Desireè, Latella; Bramanti, Alessia; Silvestri, Giuseppe; Bramanti, Placido; Calabrò, Rocco Salvatore

    2018-02-02

    Cognitive impairment occurs frequently in post-stroke patients. This study aimed to determine the effects of a virtual reality training (VRT) with BTs-Nirvana (BTsN) on the recovery of cognitive functions in stroke patients, using the Interactive-Semi-Immersive Program (I-SIP). We enrolled 12 subjects (randomly divided into two groups: experimental group (EG); and control group (CG)), who attended the Laboratory of Robotic and Cognitive Rehabilitation of IRCCS Neurolesi of Messina from January to June 2016. The EG underwent a VRT with BTsN, whereas CG received a standard cognitive treatment. Both the groups underwent the same conventional physiotherapy program. Each treatment session lasted 45 minutes and was repeated three times a week for 8 weeks. All the patients were evaluated by a specific clinical-psychometric battery before (T0), immediately (T1), and one month (T2) after the end of the training. At T1, the EG presented a greater improvement in the trunk control test (p = 0.03), the Montreal Cognitive Assessment (p = 0.01), the selective attention assessment scores (p = 0.01), the verbal memory (p = 0.03), and the visuospatial and constructive abilities (p = 0.01), as compared to CG. Moreover, such amelioration persisted at T2 only in the EG. According to these preliminary data, VRT with I-SIP can be considered a useful complementary treatment to potentiate functional recovery, with regard to attention, visual-spatial deficits, and motor function in patients affected by stroke.

  16. Preliminary study of HTS magnet using 2G wires for maglev train

    International Nuclear Information System (INIS)

    Ogata, Masafumi; Miyazaki, Yoshiki; Hasegawa, Hitoshi; Sasakawa, Takashi; Nagashima, Ken

    2010-01-01

    There are several advantages by applying a high temperature superconducting wire to an on-board superconducting magnet for the maglev train. At first, an increase of thermal capacity of superconducting coils contributes a stability of the superconducting state of the coils. In addition, a reliability of superconducting magnet improves by simplification of the magnet structure. And the weight of the superconducting magnet and the energy consumption of the on-board cryocooler will decrease. Therefore, we examined the possibility on application of the 2G wire with a high critical current density in a high magnetic field. We performed numerical analysis regarding the weight of a superconducting magnet and the energy consumption of an on-board cryocooler in consideration of the characteristics of the 2G wire. Furthermore, we have carried out the I c measurement for the commercial 2G wires under various experimental conditions such as temperature, magnetic field strength and angle. We also performed the trial manufacture and evaluation of I c characteristics for the small race track-shaped superconducting coil.

  17. Preliminary study of HTS magnet using 2G wires for maglev train

    Energy Technology Data Exchange (ETDEWEB)

    Ogata, Masafumi; Miyazaki, Yoshiki; Hasegawa, Hitoshi; Sasakawa, Takashi; Nagashima, Ken, E-mail: ogata@rtri.or.j [Railway Technical Research Institute, Hikari-cho 2-8-38, Kokubunji-shi, Tokyo (Japan)

    2010-06-01

    There are several advantages by applying a high temperature superconducting wire to an on-board superconducting magnet for the maglev train. At first, an increase of thermal capacity of superconducting coils contributes a stability of the superconducting state of the coils. In addition, a reliability of superconducting magnet improves by simplification of the magnet structure. And the weight of the superconducting magnet and the energy consumption of the on-board cryocooler will decrease. Therefore, we examined the possibility on application of the 2G wire with a high critical current density in a high magnetic field. We performed numerical analysis regarding the weight of a superconducting magnet and the energy consumption of an on-board cryocooler in consideration of the characteristics of the 2G wire. Furthermore, we have carried out the I{sub c} measurement for the commercial 2G wires under various experimental conditions such as temperature, magnetic field strength and angle. We also performed the trial manufacture and evaluation of I{sub c} characteristics for the small race track-shaped superconducting coil.

  18. Habit reversal training and educational group treatments for children with tourette syndrome: A preliminary randomised controlled trial.

    Science.gov (United States)

    Yates, Rachel; Edwards, Katie; King, John; Luzon, Olga; Evangeli, Michael; Stark, Daniel; McFarlane, Fiona; Heyman, Isobel; İnce, Başak; Kodric, Jana; Murphy, Tara

    2016-05-01

    Quality of life of children with Tourette Syndrome (TS) is impacted greatly by its symptoms and their social consequences. Habit Reversal Training (HRT) is effective but has not, until now, been empirically evaluated in groups. This randomised controlled trial evaluated feasibility and preliminary efficacy of eight HRT group sessions compared to eight Education group sessions. Thirty-three children aged 9-13 years with TS or Chronic Tic Disorder took part. Outcomes evaluated were tic severity and quality of life (QoL). Tic severity improvements were found in both groups. Motor tic severity (Yale Global Tic Severity Scale) showed greatest improvements in the HRT group. Both groups showed a strong tendency toward improvements in patient reported QoL. In conclusion, group-based treatments for TS are feasible and exposure to other children with tics did not increase tic expression. HRT led to greater reductions in tic severity than Education. Implications, such as cost-effectiveness of treatment delivery, are discussed. Copyright © 2016. Published by Elsevier Ltd.

  19. New Approach in Fibromyalgia Exercise Program: A Preliminary Study Regarding the Effectiveness of Balance Training.

    Science.gov (United States)

    Kibar, Sibel; Yıldız, Hatice Ecem; Ay, Saime; Evcik, Deniz; Ergin, Emine Süreyya

    2015-09-01

    To determine the effectiveness of balance exercises on the functional level and quality of life (QOL) of patients with fibromyalgia syndrome (FMS) and to investigate the circumstances associated with balance disorders in FMS. Randomized controlled trial. Physical medicine and rehabilitation clinic. Patients (N=57) (age range, 18-65y) with FMS were randomly assigned into 2 groups. Group 1 was given flexibility and balance exercises for 6 weeks, whereas group 2 received only a flexibility program as the control group. Functional balance was measured by the Berg Balance Scale (BBS), and dynamic and static balance were evaluated by a kinesthetic ability trainer (KAT) device. Fall risk was assessed with the Hendrich II fall risk model. The Nottingham Health Profile, Fibromyalgia Impact Questionnaire (FIQ), and Beck Depression Inventory (BDI) were used to determine QOL and functional and depression levels, respectively. Assessments were performed at baseline and after the 6-week program. In group 1, statistically significant improvements were observed in all parameters (P.05). When comparing the 2 groups, there were significant differences in group 1 concerning the KAT static balance test (P=.017) and FIQ measurements (P=.005). In the correlation analysis, the BDI was correlated with the BBS (r=-.434) and Hendrich II results (r=.357), whereas body mass index (BMI) was correlated with the KAT static balance measurements (r=.433), BBS (r=-.285), and fall frequency (r=.328). A 6-week balance training program had a beneficial effect on the static balance and functional levels of patients with FMS. We also observed that depression deterioration was related to balance deficit and fall risk. Higher BMI was associated with balance deficit and fall frequency. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. A clinical case of single-stage correction of penetration combined orofacial defect with two microsurgical autografts

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    resected mandible, and autografting into the chronically infected area.Single-stage repair, including that using a few microsurgical autografts, is the operation of choice for adequate anatomic and functional rehabilitation, permits the promptest recovery of patients, reduces a postoperative period, and allows them to undergo an antitumor treatment cycle. However, the repair is possible, when the risk of disease progression is low, in specialized centers and when there are trained head and neck surgery and reconstructive microsurgery specialists and anesthesiologists.

  1. How Research Moves into Practice: A Preliminary Study of What Training Professionals Read, Hear, and Perceive

    Directory of Open Access Journals (Sweden)

    Saul Carliner

    2009-09-01

    Full Text Available Abstract In the growing body of research on the practice of training and development, several studies suggest that use of research-based findings in practice is low. The present study was designed to better understand the research-practice gap by exploring these questions: (1 Which published sources in the field are practicing professionals reading? How frequently do they read these materials? (2 Which conferences and meetings do practicing professionals attend? How frequently do they attend these events? (3 In what formats are research content most usable to practicing professionals? (4 What are practicing professionals’ general perceptions of research publications and presentations? Key findings point to publications having a wider reach among practicing professionals than conferences and, of those publications, professional magazines have a wider reach than peer-reviewed journals. In terms of the manner in which the content is presented, practicing professionals prefer case studies from the workplace over other types of content. Résumé : Dans le corpus croissant de recherches portant sur la pratique de la formation et du perfectionnement, plusieurs études suggèrent une faible utilisation des résultats de recherche dans la pratique. La présente étude a été conçue afin de mieux comprendre l’écart entre la recherche et la pratique par l’examen des questions suivantes : (1 Quelles sources de publications du domaine les professionnels pratiquants lisent-ils? À quelle fréquence lisent-ils ces publications? (2 À quelles conférences et réunions les professionnels pratiquants assistent-ils? À quelle fréquence assistent-ils à ces événements? (3 Dans quels formats les contenus de recherche sont-ils le plus facilement utilisables par les professionnels pratiquants? (4 Quelles sont les perceptions générales des professionnels pratiquants envers les publications et présentations de recherche? Les résultats principaux

  2. Treatment of fingertip amputation: comparison of results between microsurgical replantation and pocket principle.

    Science.gov (United States)

    Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki

    2012-05-01

    In this article, a comparison of replantation using microsurgical replantation (replantation) and the Brent method and its modification (pocket principle) in the treatment of fingertip amputation is reported. As a classification of amputation level, we used Ishikawa's subzone classification of fingertip amputation, and the cases of amputations only in subzone 2 were included in this study. Between these two groups, there was no statistical difference in survival rate, postoperative atrophy, or postoperative range of motion. In terms of sensory recovery, some records were lost and exact study was difficult. But there was no obvious difference between these cases. In our comparison of microsurgical replantation versus the pocket principle in treatment of subzone 2 fingertip amputation, there was no difference in postoperative results. Each method has pros and cons, and the surgeon should choose which technique to use based on his or her understanding of the characteristics of both methods. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Stereotaxic microsurgical procedures of cerebral intracranial tumors guided by image and attended by computer

    International Nuclear Information System (INIS)

    Lopez Flores, Gerardo; Guerra Figueredo, Eritk; Ochoa Zaldivar, Luis

    2000-01-01

    It is reported that spatial guidance during microsurgery is an essential element. This application of stereotaxic surgery is shown at the International Center of Neurological Restoration (Cirene) from May, 1994, to February, 1998, on describing the performance of 65 microsurgical procedures under stereotaxic conditions among 62 patients with cerebral intracranial tumors. The procedure was divided into 3 stages: image acquisition, Cat, surgical planning , with Stasis planning system, and microsurgical procedures that included the Leksell, Micromar and Esteroflex stereotaxic systems. 27 of the total of patients presented glial tumors; 33, non-glial; and only 2 non-neoplastic lesions of diverse localization and size. 30 total resections We're made. Surgical morbidity was minimum and there was no surgical mortality. The main advantages of this method are: exact localization of the craniotomy, easy spatial guidance, and the opportunity to distinguish the limits between the tumor and the sound tissue. The possibility to apply Esteroflex to cerebral microsurgery was demonstrated

  4. Effects of Palliative Care Training Program on Knowledge, Attitudes, Beliefs and Experiences Among Student Physiotherapists: A Preliminary Quasi-experimental Study

    OpenAIRE

    Kumar, Senthil P; Jim, Anand; Sisodia, Vaishali

    2011-01-01

    Background: Physiotherapists play an inherent role in the multidisciplinary palliative care team. Existing knowledge, attitudes, beliefs and experiences influence their team participation in palliative care. Aims: The objective of this study was to assess the changes in knowledge, attitudes, beliefs and experiences among student physiotherapists who attended a palliative care training program. Settings and Design: Preliminary quasi-experimental study design, conducted at an academic...

  5. Minimal intervention dentistry II: part 6. Microscope and microsurgical techniques in periodontics.

    Science.gov (United States)

    Sitbon, Y; Attathom, T

    2014-05-01

    Different aspects of treatment for periodontal diseases or gingival problems require rigorous diagnostics. Magnification tools and microsurgical instruments, combined with minimally invasive techniques can provide the best solutions in such cases. Relevance of treatments, duration of healing, reduction of pain and post-operative scarring have the potential to be improved for patients through such techniques. This article presents an overview of the use of microscopy in periodontics, still in the early stages of development.

  6. Current practice and feasibility in microlaryngeal surgery: microsurgical pressing excision technique.

    Science.gov (United States)

    Lee, Ka-Wo; Chiang, Feng-Yu

    2009-12-01

    Since the introduction of endolaryngeal microsurgery, several basic microsurgical techniques have been described for the removal of benign vocal fold lesions. These techniques include conventional incision or dissection, bimanual retraction and cutting, microflap technique and the CO2 laser. Until recently, only a few microsurgical methods have emerged as new choices for the treatment of benign vocal fold lesions. This article introduces an innovative method that can precisely remove benign sessile vocal fold lesions with epithelial keratosis or hyperplasia without jeopardizing the intermediate or deep layer of the lamina propria. Instead of using conventional vertically opening microinstruments, this microsurgical pressing excision technique (MPET) utilized two pairs of custom-made horizontally left-opening or right-opening, curved microscissors/curved cupped microforceps to remove right or left vocal fold lesions accordingly. Using one instrument at a time, the lesion was subsequently removed with the microscissors and microforceps in a press-evert-cut manner. Among a total of 553 cases, the treatment results were satisfactory, with 520 (94%) patients retaining a satisfactory/normal (G0) voice 2 months postoperatively. More importantly, no patient's voice was worse postoperatively. This technique has several advantages: utilizing one instrument at a time can maximize exposure of the narrow endoscopic view, adjusting the pressing force makes precise excision easy in a well controlled horizontal plane. The MPET is particularly useful for removing sessile vocal nodules (especially those with epithelial keratosis), epithelial hyperplasia and leukoplakia in patients with difficult endolaryngeal exposure. This could be a well tolerated and precise microsurgical technique.

  7. Supraorbital Keyhole Microsurgical Fenestration of Symptomatic Temporal Arachnoid Cysts in Children: Advantages and Limitations.

    Science.gov (United States)

    Elkheshin, Sherif; Soliman, Ahmed

    2017-01-01

    To investigate the impact of endoscope-assisted microsurgical fenestration on temporal arachnoid cysts, and to determine the advantages and limitations of the technique. Twenty-five children with symptomatic temporal arachnoid cysts were operated via eyebrow supraorbital keyhole microsurgical fenestration targeting the medial cyst wall. Preoperative magnetic resonance imaging (MRI) of the brain was done for all patients. Preoperative clinical presentation of the patients included headache (80%), nausea & vomiting (64%), drug resistant epilepsy (52%), macrocephaly (12%) papilledema (28%), motor weakness in the form of right-sided hemiparesis (12%) and cranial nerve palsy. Postoperative complete subsidence of headache was noted in 50%, while 20% remained unchanged. Drug resistant epilepsy improved in 69% of the patients. Postoperative MRI showed initial decrease in cyst volume as early as 3 months, only in a range of 5-12% volume reduction, and the late follow-up done at 6 and 18 months continued to show further reduction reported to be significant (p CSF) collection was the most common complication (20%). Only 1 patient experienced CSF leak mandating cysto-peritoneal shunting. Conclusıon: Eyebrow supraorbital keyhole microsurgical fenestration for temporal arachnoid cysts can be performed with a fairly low risk of complications and yields a favorable improvement in clinical and neuroimaging outcomes.

  8. Nasolabial facial artery and vein as recipient vessels for midface microsurgical reconstruction.

    Science.gov (United States)

    Oh, Suk Joon; Jeon, Man Kyung; Koh, Sung Hoon

    2011-05-01

    Although free flap transfer is commonly performed to reconstruct facial defects, the submandibular facial artery and vein have historically been considered as adequate recipient vessels for microsurgical reconstruction. If the vascular pedicles of the free flap are short, vein grafts are necessary. The purpose of this study was to determine the indications for and effectiveness of using the nasolabial facial vessels for midfacial reconstruction. A retrospective chart review of 6 patients undergoing microsurgical reconstruction for defects of the face revealed 6 free tissue transfers in which the nasolabial facial artery and vein were considered for use as recipient vessels. Flap success rates were evaluated. Six patients (5 men and 1 woman) underwent 6 free flap transfers. Five anterior helix free flaps were used for the reconstruction of defects in the lower third of the nose. Nasal defects were due to trauma in 4 patients and squamous cell carcinoma in 1 patient. In 1 neurofibromatosis type 1 case, a radial forearm flap was used for reconstruction of the left orbital defect. The facial artery and vein in the nasolabial fold were used as the recipient artery and vein in every case. The mean length of follow-up was 5.8 years. All flaps survived. All patients were satisfied with the degree of aesthetic improvement after surgery.Use of the facial artery and vein in the nasolabial fold for facial reconstruction is reliable and safe. The nasolabial facial artery and vein should be considered as primary recipient vessels in microsurgical reconstruction of the midface.

  9. The Effects of Music on Microsurgical Technique and Performance: A Motion Analysis Study.

    Science.gov (United States)

    Shakir, Afaaf; Chattopadhyay, Arhana; Paek, Laurence S; McGoldrick, Rory B; Chetta, Matthew D; Hui, Kenneth; Lee, Gordon K

    2017-05-01

    Music is commonly played in operating rooms (ORs) throughout the country. If a preferred genre of music is played, surgeons have been shown to perform surgical tasks quicker and with greater accuracy. However, there are currently no studies investigating the effects of music on microsurgical technique. Motion analysis technology has recently been validated in the objective assessment of plastic surgery trainees' performance of microanastomoses. Here, we aimed to examine the effects of music on microsurgical skills using motion analysis technology as a primary objective assessment tool. Residents and fellows in the Plastic and Reconstructive Surgery program were recruited to complete a demographic survey and participate in microsurgical tasks. Each participant completed 2 arterial microanastomoses on a chicken foot model, one with music playing, and the other without music playing. Participants were blinded to the study objectives and encouraged to perform their best. The order of music and no music was randomized. Microanastomoses were video recorded using a digitalized S-video system and deidentified. Video segments were analyzed using ProAnalyst motion analysis software for automatic noncontact markerless video tracking of the needle driver tip. Nine residents and 3 plastic surgery fellows were tested. Reported microsurgical experience ranged from 1 to 10 arterial anastomoses performed (n = 2), 11 to 100 anastomoses (n = 9), and 101 to 500 anastomoses (n = 1). Mean age was 33 years (range, 29-36 years), with 11 participants right-handed and 1 ambidextrous. Of the 12 subjects tested, 11 (92%) preferred music in the OR. Composite instrument motion analysis scores significantly improved with playing preferred music during testing versus no music (paired t test, P music was significant even after stratifying scores by order in which variables were tested (music first vs no music first), postgraduate year, and number of anastomoses (analysis of variance, P music in

  10. The Acceptability and Potential Utility of Cognitive Training to Improve Working Memory in Persons Living With HIV: A Preliminary Randomized Trial.

    Science.gov (United States)

    Towe, Sheri L; Patel, Puja; Meade, Christina S

    HIV-associated neurocognitive impairments that impact daily function persist in the era of effective antiretroviral therapy. Cognitive training, a promising low-cost intervention, has been shown to improve neurocognitive functioning in some clinical populations. We tested the feasibility, acceptability, and preliminary effects of computerized cognitive training to improve working memory in persons living with HIV infection (PLWH) and working memory impairment. In this randomized clinical trial, we assigned 21 adult PLWH to either an experimental cognitive training intervention or an attention-matched control training intervention. Participants completed 12 training sessions across 10 weeks with assessments at baseline and post-training. Session attendance was excellent and participants rated the program positively. Participants in the experimental arm demonstrated improved working memory function over time; participants in the control arm showed no change. Our results suggest that cognitive training may be a promising intervention for working memory impairment in PLWH and should be evaluated further. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  11. A preliminary evaluation of the training effects of a didactic and simulation-based psychological first aid program in students and school counselors in South Korea.

    Science.gov (United States)

    Lee, Jong-Sun; You, Sungeun; Choi, Yun-Kyeung; Youn, Hyae-Young; Shin, Hye Sook

    2017-01-01

    The present study aimed to examine the training effects of a didactic and simulation-based psychological first aid (PFA) program. Based on the competency-based model, the study sought to examine whether the PFA training would enhance knowledge, skills, and attitudes. Study 1 examined the training effects of the PFA program in a sample of undergraduate and graduate students in psychology. Study 2 was conducted with school counselors. In both studies, all participants completed a one-day PFA workshop with a 3-hour didactic lecture and a 3-hour simulation-based practice. Assessments were conducted prior to the didactic lecture and upon completion of the simulation-based practice. In study 1, an examination of pre- and posttest comparisons indicated that the training significantly improved students' PFA knowledge and perceived competence in PFA skill. In study 2, the same PFA training significantly improved school counselors' PFA knowledge, perceived competence in PFA skill, perceived preparedness and confidence to provide psychological assistance for future disasters, but their perceived willingness to participate in psychological assistance did not significantly change after the training. This study provides preliminary evidence supporting the effectiveness of the PFA training program using a combined method of didactic and simulation-based practice for disaster mental health providers in Korea.

  12. A preliminary evaluation of the training effects of a didactic and simulation-based psychological first aid program in students and school counselors in South Korea.

    Directory of Open Access Journals (Sweden)

    Jong-Sun Lee

    Full Text Available The present study aimed to examine the training effects of a didactic and simulation-based psychological first aid (PFA program. Based on the competency-based model, the study sought to examine whether the PFA training would enhance knowledge, skills, and attitudes. Study 1 examined the training effects of the PFA program in a sample of undergraduate and graduate students in psychology. Study 2 was conducted with school counselors. In both studies, all participants completed a one-day PFA workshop with a 3-hour didactic lecture and a 3-hour simulation-based practice. Assessments were conducted prior to the didactic lecture and upon completion of the simulation-based practice. In study 1, an examination of pre- and posttest comparisons indicated that the training significantly improved students' PFA knowledge and perceived competence in PFA skill. In study 2, the same PFA training significantly improved school counselors' PFA knowledge, perceived competence in PFA skill, perceived preparedness and confidence to provide psychological assistance for future disasters, but their perceived willingness to participate in psychological assistance did not significantly change after the training. This study provides preliminary evidence supporting the effectiveness of the PFA training program using a combined method of didactic and simulation-based practice for disaster mental health providers in Korea.

  13. An integrated gait rehabilitation training based on Functional Electrical Stimulation cycling and overground robotic exoskeleton in complete spinal cord injury patients: Preliminary results.

    Science.gov (United States)

    Mazzoleni, S; Battini, E; Rustici, A; Stampacchia, G

    2017-07-01

    The aim of this study is to investigate the effects of an integrated gait rehabilitation training based on Functional Electrical Stimulation (FES)-cycling and overground robotic exoskeleton in a group of seven complete spinal cord injury patients on spasticity and patient-robot interaction. They underwent a robot-assisted rehabilitation training based on two phases: n=20 sessions of FES-cycling followed by n= 20 sessions of robot-assisted gait training based on an overground robotic exoskeleton. The following clinical outcome measures were used: Modified Ashworth Scale (MAS), Numerical Rating Scale (NRS) on spasticity, Penn Spasm Frequency Scale (PSFS), Spinal Cord Independence Measure Scale (SCIM), NRS on pain and International Spinal Cord Injury Pain Data Set (ISCI). Clinical outcome measures were assessed before (T0) after (T1) the FES-cycling training and after (T2) the powered overground gait training. The ability to walk when using exoskeleton was assessed by means of 10 Meter Walk Test (10MWT), 6 Minute Walk Test (6MWT), Timed Up and Go test (TUG), standing time, walking time and number of steps. Statistically significant changes were found on the MAS score, NRS-spasticity, 6MWT, TUG, standing time and number of steps. The preliminary results of this study show that an integrated gait rehabilitation training based on FES-cycling and overground robotic exoskeleton in complete SCI patients can provide a significant reduction of spasticity and improvements in terms of patient-robot interaction.

  14. Preliminary assessment report for Grubbs/Kyle Training Center, Smyrna/Rutherford County Regional Airport, Installation 47340, Smyrna, Tennessee. Installation Restoration Program

    Energy Technology Data Exchange (ETDEWEB)

    Dennis, C.; Stefano, J.

    1993-07-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Tennessee Army National Guard (TNARNG) property near Smyrna, Tennessee. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Grubbs/Kyle Training Center property, the requirement of the Department of Defense Installation Restoration Program.

  15. Views of physicians in training on the ethical and legal issues in preliminary reporting of echocardiographic data.

    Science.gov (United States)

    McDonald, R W; Rice, M J; Marcella, C P; Reller, M D; Imus, R L

    1991-01-01

    Cardiac sonographers may be pressured by physicians into giving diagnostic interpretations of echocardiographic data. This study investigated the issue of preliminary reporting of echocardiographic data. A questionnaire was sent to 292 physicians; 85 physicians (29%) responded. Seventy-two physicians (87%) thought they had more than a minimal knowledge of echocardiography, 94% wanted a written or verbal preliminary report, and 84% thought that giving a preliminary report should be part of the cardiac sonographer's job. If abnormalities were found, 80% wanted the results before a cardiologist reviewed the study, and 56% would want a diagnostic rather than a descriptive report. Fifty-four physicians (64%) would pressure the cardiac sonographer into giving a preliminary echocardiographic report and would use this information to manage the patient. The majority of the physicians thought that it is legal for the cardiac sonographer to give a preliminary echocardiogram report. Eighty percent said that the cardiac sonographer would not be "practicing medicine without a license," and 82% that the sonographer would not be "aiding and abetting the unauthorized practice of medicine." This data would indicate that physicians at Oregon Health Sciences University want the cardiac sonographer to give preliminary echocardiographic results, even though the sonographer may be breaking state statutes.

  16. Microsurgical free flap reconstructions of head and neck region in 406 cases: a 13-year experience.

    Science.gov (United States)

    Gerressen, Marcus; Pastaschek, Claudia Inge; Riediger, Dieter; Hilgers, Ralf-Dieter; Hölzle, Frank; Noroozi, Nelson; Ghassemi, Alireza

    2013-03-01

    The reconstruction of extended soft tissue and bony defects in the maxillofacial region with microsurgical flaps is considered to be the therapy of first choice. The aim of this retrospective study was to detect different influencing factors concerning flap survival. We examined the data of 406 patient cases (121 female and 285 male cases; mean age, 57 years) undergoing reconstruction with a microsurgical flap in our facility between 1998 and 2010. In these cases 326 soft tissue flaps (radial forearm flap, scapula flap, latissimus dorsi flap, anterolateral thigh flap, lateral arm flap, and jejunum flap) and 80 bony flaps (fibula flap and deep circumflex iliac artery flap) were examined. Evaluated parameters were, among others, the timing of reconstruction, defect localization, and recipient vessels used (external vs internal jugular system), as well as anticoagulative management. We statistically analyzed data by means of a χ(2) test, taking account of the odds ratio with P < .05, which was deemed significant. The overall flap survival rate was approximately 92%, without any gender- or age-specific differences. Primary reconstructions proceeded distinctly more successfully than secondary reconstructions (P < .01). Likewise, the defect localization exerted a significant effect on the survival rate (P = .01), with a more caudal localization affecting flap survival positively. Finally, neither the anticoagulation regimen nor the choice of recipient vein system exercised an influence on the survival rate. Microsurgical tissue transfer is a convenient and reliable method in maxillofacial surgery, provided that one is aware of the determining factors for success. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Microsurgical replantation and postoperative leech treatment of a large severed nasal segment

    DEFF Research Database (Denmark)

    Stemann Andersen, Peter; Elberg, Jens Jørgen

    2012-01-01

    The survival of a microsurgically replanted segment of nose in a 41-year-old woman was facilitated by the assistance of the medicinal leech Hirudo medicinalis. An arterial microanastomosis was made to a severed partial segment of nose with no possibility of recreating a venous anastomosis. The re....... The resulting venous congestion was treated with nine days of treatment with a medical leech until venous neovascularisation had been achieved. At follow-up six months after discharge there was a well-heeled nasal segment and a satisfying functional - as well as cosmetic - result....

  18. [Microsurgical drezotomy for the treatment of spasticity of the lower limbs].

    Science.gov (United States)

    Mertens, P; Sindou, M

    1998-09-01

    Ablative functional neurosurgery can be useful in some selected patients for the treatment of harmful spasticity in the lower limbs. Microsurgical drezotomy was introduced in 1972, on the basis of anatomical studies of the human dorsal root entry zone (DREZ) showing a topographical segregation of the afferent fibers according to their size and thus functional destinations. It consists of a 3 mm deep microsurgical lesion directed at a 45 degree angle in the postero-lateral sulcus, penetrating the DREZ in its ventro-lateral aspect, at the level of all the rootlets considered as involved in spasticity (and pain). It destroys mainly the lateral (nociceptive) and central (myotatic) afferent fibers as well as the facilitatory medial part of the Lissauer tract, whilst sparing most of the medial (lemniscal) fibers and the inhibitor lateral part of the Lissauer tract. We report a series of 121 bedridden patients suffering from harmful spasticity in one (15) or both (106) lower limbs and treated with microsurgical drezotomy. Surgery was decided on because of abnormal postures in flexion in two-thirds of the patients and in hyperextension in one-third, additional pain in 75 of them, and hyperactive bladder in 38 cases. The post-operative results were evaluated after a mean follow-up time of 5 years and 6 months. Both spasticity and spasms were significantly decreased or suppressed respectively in 78% and 88% of the patients. When present, pain was relieved without abolition of sensation in 82%. These benefits resulted in either disappearance or marked reduction of the abnormal postures and articular limitation in 90% of the patients. When present preoperatively, urinary leakage disappeared in 85% of the cases. Mild to severe complications occurred in 32 patients and precipitated or were responsible for death in 6 cases (5%). This is explained by the fact that most of the patients, especially those affected by multiple sclerosis, were in very precarious general and

  19. The results of surgical treatment of oviductal infertility with use of microsurgical technique

    International Nuclear Information System (INIS)

    Cislo, M.; Murawski, M.; Palczynski, B.

    1993-01-01

    40 women were operated on infertility due to oviductal factor. This kind of infertility has been previously diagnosed by hysterosalpingography examination and then verified in 22 cases (55%) by laparoscopy combined with chromotubation. The operations were carried out with use of microsurgical technique and instruments. At the same time the prophylactics of postoperative intraperitoneal adhesions was applied. Seven pregnancies were obtained, that makes 17.5% of success. It is an outcome comparable with results presented by many other world centers of gynecological microsurgery. (author)

  20. Effects of an Off-Axis Pivoting Elliptical Training Program on Gait Function in Persons With Spastic Cerebral Palsy: A Preliminary Study.

    Science.gov (United States)

    Tsai, Liang-Ching; Ren, Yupeng; Gaebler-Spira, Deborah J; Revivo, Gadi A; Zhang, Li-Qun

    2017-07-01

    This preliminary study examined the effects of off-axis elliptical training on reducing transverse-plane gait deviations and improving gait function in 8 individuals with cerebral palsy (CP) (15.5 ± 4.1 years) who completed an training program using a custom-made elliptical trainer that allows transverse-plane pivoting of the footplates during exercise. Lower-extremity off-axis control during elliptical exercise was evaluated by quantifying the root-mean-square and maximal angular displacement of the footplate pivoting angle. Lower-extremity pivoting strength was assessed. Gait function and balance were evaluated using 10-m walk test, 6-minute-walk test, and Pediatric Balance Scale. Toe-in angles during gait were quantified. Participants with CP demonstrated a significant decrease in the pivoting angle (root mean square and maximal angular displacement; effect size, 1.00-2.00) and increase in the lower-extremity pivoting strength (effect size = 0.91-1.09) after training. Reduced 10-m walk test time (11.9 ± 3.7 seconds vs. 10.8 ± 3.0 seconds; P = 0.004; effect size = 1.46), increased Pediatric Balance Scale score (43.6 ± 12.9 vs. 45.6 ± 10.8; P = 0.042; effect size = 0.79), and decreased toe-in angle (3.7 ± 10.5 degrees vs. 0.7 ± 11.7 degrees; P = 0.011; effect size = 1.22) were observed after training. We present an intervention to challenge lower-extremity off-axis control during a weight-bearing and functional activity for individuals with CP. Our preliminary findings suggest that this intervention was effective in enhancing off-axis control, gait function, and balance and reducing in-toeing gait in persons with CP.

  1. Microsurgical one-stage treatment of intracranial mirror aneurysms via bilateral frontolateral approaches

    Directory of Open Access Journals (Sweden)

    Hong-guang WANG

    2016-08-01

    Full Text Available Objective To investigate surgical strategies, clinical effects and complications of microsurgical one-stage treatment of intracranial mirror aneurysms via bilateral frontolateral approaches.  Methods Review clinical data of 18 cases with anterior circulation mirror aneurysms who underwent one-stage clipping via bilateral frontolateral approaches from July 2010 to July 2015 admitted to Department of Neurosurgery in Tianjin Huanhu Hospital. The operative efficacy was evaluated according to postoperative Glasgow Outcome Scale (GOS.  Results The 36 aneurysms in 18 patients were successfully clipped via bilateral frontolateral approaches at one-stage, including 18 posterior communicating artery (PCoA mirror aneurysms in 9 cases and 18 middle cerebral artery (MCA mirror aneurysms in 9 cases. GOS score of 5 was discovered in 16 cases, and 4 was discovered in 2 cases after operation. One case underwent ventriculoperitoneal shunting (VPS due to communicating hydrocephalus, one case got postoperative pulmonary infection and no death occurred. Intracranial CTA at 6 months postoperatively showed aneurysms of 18 patients were clipped completely, the parent artery blood flow was smooth, and no recurrence was found.  Conclusions Microsurgical one-stage clipping via bilateral frontolateral approaches for treating intracranial mirror aneurysms is a sugrical method with small incision, fitting surgical field, high safety, satisfactory effect and good prognosis, which is a new minimally invasive neurosurgical technique. DOI: 10.3969/j.issn.1672-6731.2016.08.012

  2. Microsurgical reconstruction of the head and neck region: Current concepts of maxillofacial surgery units worldwide.

    Science.gov (United States)

    Kansy, Katinka; Mueller, Andreas Albert; Mücke, Thomas; Koersgen, Friederike; Wolff, Klaus Dietrich; Zeilhofer, Hans-Florian; Hölzle, Frank; Pradel, Winnie; Schneider, Matthias; Kolk, Andreas; Smeets, Ralf; Acero, Julio; Haers, Piet; Ghali, G E; Hoffmann, Jürgen

    2015-10-01

    Microvascular surgery following tumor resection has become an important field of oral maxillofacial surgery (OMFS). Following the surveys on current reconstructive practice in German-speaking countries and Europe, this paper presents the third phase of the project when the survey was conducted globally. The DOESAK questionnaire has been developed via a multicenter approach with maxillofacial surgeons from 19 different hospitals in Germany, Austria and Switzerland. It was distributed in three different phases to a growing number of maxillofacial units in German-speaking clinics, over Europe and then worldwide. Thirty-eight units from Germany, Austria and Switzerland, 65 remaining European OMFS-departments and 226 units worldwide responded to the survey. There is wide agreement on the most commonly used flaps, intraoperative rapid sections and a trend towards primary bony reconstruction. No uniform concepts can be identified concerning osteosynthesis of bone transplants, microsurgical techniques, administration of supportive medication and postoperative monitoring protocols. Microsurgical reconstruction is the gold standard for the majority of oncologic cases in Europe, but worldwide, only every second unit has access to this technique. The DOESAK questionnaire has proven to be a valid and well accepted tool for gathering information about current practice in reconstructive OMFS surgery. The questionnaire has been able to demonstrate similarities, differences and global inequalities. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  3. Role of Adjuvant Radiosurgery after Thoracoscopic Microsurgical Resection of a Spinal Schwannoma

    Directory of Open Access Journals (Sweden)

    Toba N. Niazi

    2012-01-01

    Full Text Available Stereotactic radiosurgery to benign tumors of the spine has not been advocated as a primary treatment modality because of the favorable prognosis for these lesions after gross-total resection. There is even less evidence regarding its use as an adjuvant to neurosurgical resection of benign recurrent spinal disease. We describe the case of a 30-year-old man with a thoracic spinal schwannoma who had an interval increase of his lesion five months after thoracoscopic microsurgical resection. The patient opted for noninvasive stereotactic radiosurgery in lieu of additional surgical excision and has had stable disease 15 months after radiosurgical treatment with the linear accelerator (LINAC system. In this setting, stereotactic radiosurgery provided a useful adjunct to thoracoscopic microsurgical resection. Future Class I and II evidence should be sought to evaluate the utility of stereotactic radiosurgery as a primary treatment modality or as an adjuvant for microneurosurgical resection of benign spinal lesions in patients who want noninvasive treatment after disease recurrence or who harbor medical comorbidities that would preclude them from being safe surgical candidates.

  4. Microsurgical Resection of a Common Peroneal Nerve Schwannoma: A 3-Dimensional Operative Video.

    Science.gov (United States)

    Budohoski, Karol P; Guilfoyle, Mathew R; Kenyon, Olivia; Barone, Damiano G; Santarius, Thomas; Trivedi, Rikin A

    2018-01-01

    Peripheral nerve sheath tumors are benign entities that manifest with pain or neurological deficits from mass effect. Treatment is mostly surgical, however, the aggressiveness of treatment needs to be carefully considered with respect to preserving function. We present a case of a 62-year-old male with a 2-year history of left lower extremity pain radiating toward the dorsolateral foot. There was a tender and palpable mass in the lateral popliteal fossa with imaging consistent with Schwannoma of the common peroneal nerve. The patient was counseled for surgery and informed consent was obtained. Microsurgical resection was undertaken and gross total resection was achieved without compromise of function. We demonstrate the placement of neurophysiological monitoring electrodes in all 3 compartment of the calf as well as the use of stimulation to identify a nonfunctioning area for entering the nerve sheath. Anatomy of the popliteal fossa and microsurgical technique for resection of nerve sheath tumors are discussed. When dealing with these pathologies, it is important to use intraoperative neurophysiology as well as careful technique in order to achieve maximal resection without compromising neurological function. Copyright © 2017 by the Congress of Neurological Surgeons.

  5. Preliminary design for an institutional needs assessment process to guide the development of training programs at the Department of Energy Central Training Academy

    International Nuclear Information System (INIS)

    Golder, T.; Laktasic, S.

    1987-01-01

    In order to provide and maintain a high level of nuclear security at DOE installations, the Office of Safeguards and Security (OSS) is charged with the deployment of highly trained security staff at each DOE site. Faced with this mission, OSS must ensure that both Safeguards and Security personnel are adequately trained to meet present as well as potential future insider and outside threats. A major step toward meeting this goal was to begin to standardize training, establish an elite training cadre, and create a central training facility to implement training for safeguards and security personnel. These requirements were actualized by the creation of the Central Training Academy. After a 9 month start-up and 2 years of initial operation, the CTA can now provide a historical perspective on its evolution, early program development, and future plans and challenges. Central to future program planning at the Academy is the development and implementation of an internal DOE needs assessment process which is the focus of this study. Once institutionalized, the system would allow for the Academy to accurately assess and translate OSS needs into requirements for both OSS Safeguards and Security personnel and place the Academy in position to develop and tailor Tactical and Specialized programs that reflect and respond to changing threats and technological advances

  6. Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke.

    Science.gov (United States)

    Lee, Myung Mo; Lee, Kyeong Jin; Song, Chang Ho

    2018-04-27

    BACKGROUND Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. MATERIAL AND METHODS Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. RESULTS At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (pGame-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.

  7. Research on the Reform of the Preliminary Course of Architectural Design Based on Innovation & Practice Ability Training

    Science.gov (United States)

    Yuping, Cai; Shuang, Liang

    2017-01-01

    The traditional undergraduate education mode of architecture has been unable to adapt to the rapid development of society. Taking the junior professional course of architecture--the preliminary course of architectural design as an example, this paper analyzes the problems existing in the current professional courses of lower grades, puts forward…

  8. Preliminary Evaluation of a Social Skills Training and Facilitated Play Early Intervention Programme for Extremely Shy Young Children in China

    Science.gov (United States)

    Li, Yan; Coplan, Robert J.; Wang, Yuemin; Yin, Jingtong; Zhu, Jingjing; Gao, Zhuqing; Li, Linhui

    2016-01-01

    The goal of this study was to provide a preliminary evaluation of a social skills and facilitated play early intervention programme to promote social interaction, prosocial behaviours and socio-communicative skills among young extremely shy children in China. Participants were a sample of n = 16 extremely shy young children attending kindergarten…

  9. Job Training and Education of Disconnected Young Adults in New Orleans: Preliminary Analysis of Federal Funding Streams

    Science.gov (United States)

    Finance Project, 2012

    2012-01-01

    Baptist Community Ministries asked The Finance Project to examine the expenditure of federal funds for job training and education of New Orleans' disconnected young adults (i.e., persons between ages 16 and 24 who are not in school or work). Four major sources of federal funding for job training and education of this population are available: the…

  10. New nonabsorbable stent versus a microsurgical procedure for vasectomy reversal: evaluating tissue reactions at the anastomosis in rabbits

    NARCIS (Netherlands)

    Vrijhof, Eric J.; de Bruine, Adriaan; Zwinderman, Aeilko; Lycklama à Nijeholt, August A. B.; Koole, Leo

    2005-01-01

    To investigate whether a newly designed nonabsorbable polymeric stent for the reconstruction of the vas deferens provided less stricturing at the site of the anastomosis in comparison with the conventional microsurgical reconstruction of the vas deferens. Prospective randomized study in 26 rabbits,

  11. Case Report: Microsurgical excision of grade 5 cerebral AVM [version 2; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Sunil Munakomi

    2016-07-01

    Full Text Available In this case report, we discuss the microsurgical management of a Spetzler-Martin grade 5 arteriovenous malformation (AVM in a young boy who presented with a hemorrhagic episode and had a high calculated risk of rebleeding. We also outline the rationale for choosing the management option.

  12. Effects of robotic treadmill training on functional mobility, walking capacity, motor symptoms and quality of life in ambulatory patients with Parkinson's disease: a preliminary prospective longitudinal study.

    Science.gov (United States)

    Paker, Nurdan; Bugdayci, Derya; Goksenoglu, Goksen; Sen, Aysu; Kesiktas, Nur

    2013-01-01

    preliminary study, robotic treadmill training was useful to improve the functional mobility, walking capacity and motor symptoms in mild to moderate PD. Robotic treadmill training provided a transient improvement in the quality of life during the treatment.

  13. The Level of Anxiety and Depression in Dialysis Patients Undertaking Regular Physical Exercise Training - a Preliminary Study

    Directory of Open Access Journals (Sweden)

    Wioletta Dziubek

    2016-02-01

    Full Text Available Background/Aims: The aim of the study was to evaluate the effects of a six-month physical training undertaken by haemodialysis (HD patients, on the depression and anxiety. Methods: Patients with end stage renal disease (ESRD were recruited from the dialysis station at the Department of Nephrology and Transplantation Medicine in Wroclaw. Physical training took place at the beginning of the first 4-hours of dialysis, three times a week for six months. A personal questionnaire, Beck Depression Inventory (BDI and State-Trait Anxiety Inventory (STAI were used in the study. Results: A total of 28 patients completed the study: 20 were randomised to endurance training and 8 were randomised to resistance training. Statistical analysis of depression and anxiety at the initial (t1 and final examination (t2 indicated a significant reduction in depression and anxiety, particularly anxiety as a trait (X2 in the whole study group. The change in anxiety as a state correlated with the disease duration, duration of dialysis and the initial level of anxiety as a state (t1X1. The change in anxiety as a trait significantly correlated with age and the initial level of anxiety (t1X2. Conclusions: Undertaking physical training during dialysis by patients with ESRD is beneficial in reducing their levels of anxiety and depression. Both resistance and endurance training improves mood, but only endurance training additionally results in anxiety reduction.

  14. The Level of Anxiety and Depression in Dialysis Patients Undertaking Regular Physical Exercise Training--a Preliminary Study.

    Science.gov (United States)

    Dziubek, Wioletta; Kowalska, Joanna; Kusztal, Mariusz; Rogowski, Łukasz; Gołębiowski, Tomasz; Nikifur, Małgorzata; Szczepańska-Gieracha, Joanna; Zembroń-Łacny, Agnieszka; Klinger, Marian; Woźniewski, Marek

    2016-01-01

    The aim of the study was to evaluate the effects of a six-month physical training undertaken by haemodialysis (HD) patients, on the depression and anxiety. Patients with end stage renal disease (ESRD) were recruited from the dialysis station at the Department of Nephrology and Transplantation Medicine in Wroclaw. Physical training took place at the beginning of the first 4-hours of dialysis, three times a week for six months. A personal questionnaire, Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were used in the study. A total of 28 patients completed the study: 20 were randomised to endurance training and 8 were randomised to resistance training. Statistical analysis of depression and anxiety at the initial (t1) and final examination (t2) indicated a significant reduction in depression and anxiety, particularly anxiety as a trait (X2) in the whole study group. The change in anxiety as a state correlated with the disease duration, duration of dialysis and the initial level of anxiety as a state (t1X1). The change in anxiety as a trait significantly correlated with age and the initial level of anxiety (t1X2). Undertaking physical training during dialysis by patients with ESRD is beneficial in reducing their levels of anxiety and depression. Both resistance and endurance training improves mood, but only endurance training additionally results in anxiety reduction. © 2016 S. Karger AG, Basel.

  15. Improving outcomes in microsurgical breast reconstruction: lessons learnt from 406 consecutive DIEP/TRAM flaps performed by a single surgeon.

    Science.gov (United States)

    Damen, Tim H C; Morritt, Andrew N; Zhong, Toni; Ahmad, Jamil; Hofer, Stefan O P

    2013-08-01

    Multiple preoperative, intraoperative and postoperative decisions can influence the outcome of microsurgical breast reconstruction. We have simplified the decision-making process by incorporating a number of algorithms into our microsurgical breast reconstruction practice and critically review our results in this study. Prospectively maintained databases for all microsurgical breast reconstructions performed by a single surgeon over a nine-year period were examined to determine: patient demographics; operative details including flap choice, donor and recipient vessel selection; and, details of intraoperative and early postoperative (406 Consecutive free flap microsurgical breast reconstructions (164 unilateral and 121 bilateral) were performed in 285 patients over the study period. Deep inferior epigastric artery perforator (DIEP) flaps (88%, n=359) were used most commonly followed by muscle-sparing transverse rectus abdominis musculocutaneous (MS-TRAM) flaps (11%, n=44), and fascial-sparing TRAM (FS-TRAM) flaps (0.7%, n=3). One-hundred-seventy-one (48%) DIEP flaps were based on a single perforator while 188 (52%) had multiple perforators. The internal mammary (IM) artery and vein were used as the recipient vessels for 99% (n=403) of flaps. A second venous anastomosis was required for 11.8 percent (n=48) of flaps. Partial flap failure occurred in nine (2.2%) flaps while total flap failure occurred in two flaps (0.5%). Minimum follow-up was three months. Incorporating a number of algorithms into our practice has enabled us to simplify the decision-making processes involved in microsurgical breast reconstruction and to consistently obtain successful surgical outcomes. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Lessons Learned from Delayed Versus Immediate Microsurgical Reconstruction of Complex Maxillectomy and Midfacial Defects: Experience in a Tertiary Center in Mexico.

    Science.gov (United States)

    Santamaria, Eric; de la Concha, Erika

    2016-10-01

    Microsurgical reconstruction of complex midfacial and maxillectomy defects is among the most challenging procedures in plastic surgery, and it often requires composite flaps to improve functional and aesthetic results. Various factors have been identified as having influence in the outcome of microsurgical reconstruction. In this article, the authors present their experience with immediate and delayed reconstruction of complex maxillectomy defects in a tertiary center in Mexico. The authors present a total of 37 patients with microsurgical reconstruction of a complex maxillectomy defect; 13 patients had immediate and 24 had delayed reconstructions. The authors recommend doing immediate reconstruction when feasible. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results

    OpenAIRE

    Žiak, Peter; Holm, Anders; Halička, Juraj; Mojzis, Peter; Piñero, David P.

    2017-01-01

    Background The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. Purpose To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample ...

  18. A virtual-reality simulator and force sensation combined catheter operation training system and its preliminary evaluation.

    Science.gov (United States)

    Wang, Yu; Guo, Shuxiang; Tamiya, Takashi; Hirata, Hideyuki; Ishihara, Hidenori; Yin, Xuanchun

    2017-09-01

    Endovascular surgery benefits patients because of its superior short convalescence and lack of damage to healthy tissue. However, such advantages require the operator to be equipped with dexterous skills for catheter manipulation without resulting in collateral damage. To achieve this goal, a training system is in high demand. A training system integrating a VR simulator and a haptic device has been developed within this context. The VR simulator is capable of providing visual cues which assist the novice for safe catheterization. In addition, the haptic device cooperates with VR simulator to apply sensations at the same time. The training system was tested by non-medical subjects over a five days training session. The performance was evaluated in terms of safety criteria and task completion time. The results demonstrate that operation safety is improved by 15.94% and task completion time is cut by 18.80 s maximum. Moreover, according to subjects' reflections, they are more confident in operation. The proposed training system constructs a comprehensive training environment that combines visualization and force sensation. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  19. The Effect of Life Skills Training on Mental Health of Iranian Middle School Students: A Preliminary Study

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    Saman Jamali

    2016-12-01

    Full Text Available Objective: This research aimed to study the effect of life skill training on mental health of Iranian middle school students.Method: This experimental study was conducted In 2015 on 100 students of city of Ghaemshahr (North of Iran, who were randomly selected and divided into two equal groups of intervention (n = 50 and control (n = 50. Qualified trainers provided eight sessions (two sessions a week for 2 hours of life skills training to the intervention group for one month. The control group did not participate in any training sessions during the same period. Mental health in both groups was assessed by a questionnaire pre- and post-training. Data were analyzed using descriptive and infernal (ANCOVA and paired t-test statistic tests.Results: The average age of the participants in both groups was 13.5±1.01. ANCOVA test results revealed that the average score of violence, addiction, stress and sensation-seeking before and after the training was statistically significant in the intervention group and control groups (p<0.001.Conclusion: Life skills training had positive effects on mental health of the participants. Given the importance of mental health in modern societies, it is necessary for schools to incorporate life skills in their curriculum to support the mental health of adolescents.

  20. Successful microsurgical penile replantation following self amputation in a schizophrenic patient

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    Saurabh Gyan

    2010-01-01

    Full Text Available Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common etiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis in an acute paranoid schizophrenic patient .The penis was successfully reattached using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed.

  1. Giant partially thrombosed 4 th ventricular posterior inferior cerebellar artery aneurysm; microsurgical management

    Directory of Open Access Journals (Sweden)

    Forhad Hossain Chowdhury

    2014-01-01

    Full Text Available A 42-year-old woman presented with a 3-month history of progressive occipital headache, vomiting, walking difficulty, and repeated fall. She had no history of sudden and severe headache. She had positive cerebellar signs, predominantly on the right side. Computerized tomography (CT scan, CT angiogram, and magnetic resonance image (MRI of the brain showed suspected partially thrombosed giant 4 th ventricular posterior inferior cerebellar artery aneurysm. Patient developed severe hypersensitivity reaction during both CT scan and MRI after contrast injection. Though needed, digital subtraction angiogram (DSA of cerebral vessels was not done. The aneurysm was managed by microsurgical clipping of the aneurysm neck and partial excision of thrombosed aneurysm. Here, we report the details of management of these difficult giant aneurysm without DSA.

  2. Microsurgical resection of incompletely obliterated intracranial arteriovenous malformations following stereotactic radiosurgery

    International Nuclear Information System (INIS)

    Chang, S.D.; Steinberg, G.K.; Levy, R.P.; Marks, M.P.; Frankel, K.A.; Shuster, D.L.; Marcellus, M.L.

    1998-01-01

    Radiosurgery is effective in obliterating small arteriovenous malformations (AVMs), but less successful in thrombosing larger AVMs. This study reviewed patients who underwent surgical resection of their large AVMs following failed radiosurgical obliteration. AVMs from 36 patients (aged 7 to 64 years, mean 29.9) were surgically resected 1 to 11 years after radiosurgery. Initial AVM volumes were 0.7 to 117 cm 3 (mean 21.6 cm 3 ), and radiosurgical doses ranged from 4.6 to 45 Gray equivalent (GyE) (mean 21.1 GyE). Thirty AVMs (83%) were located in eloquent tissue. Venous drainage was deep (14), superficial (13), or both (9). Spetzler grades were II (2), III (12), IV (18), and V (4). Nine patients suffered rehemorrhage after radiosurgery but prior to surgery, while three patients developed radiation necrosis. Twenty-seven patients underwent endovascular embolization prior to surgery. During microsurgical resection, the AVMs were found to be significantly less vascular and more easily resected, compared to AVMs in patients who had not received radiosurgery. Histology showed endothelial proliferation with hyaline and mineralization in vessel walls. Partial or complete thrombosis of some AVM vessels, and evidence of vessel and brain necrosis were noted in many cases. Clinical outcome was excellent or good in 34 cases, with two patients dying of rebleeding from residual AVM. Five patients were neurologically worse following microsurgical resection. Final outcome was largely related to the pretreatment grade. Radiosurgery several years prior to surgical resection appears useful in treating unusually large and complex AVMs. (author)

  3. Microsurgical Performance After Sleep Interruption: A NeuroTouch Simulator Study.

    Science.gov (United States)

    Micko, Alexander; Knopp, Karoline; Knosp, Engelbert; Wolfsberger, Stefan

    2017-10-01

    In times of the ubiquitous debate about doctors' working hour restrictions, it is still questionable if the physician's performance is impaired by high work load and long shifts. In this study, we evaluated the impact of sleep interruption on neurosurgical performance. Ten medical students and 10 neurosurgical residents were tested on the virtual-reality simulator NeuroTouch by performing an identical microsurgical task, well rested (baseline test), and after sleep interruption at night (stress test). Deviation of total score, timing, and excessive force on tissue were evaluated. In addition, vital parameters and self-assessment were analyzed. After sleep interruption, total performance score increased significantly (45.1 vs. 48.7, baseline vs. stress test, P = 0.048) while timing remained stable (10.1 vs. 10.4 minutes for baseline vs. stress test, P > 0.05) for both students and residents. Excessive force decreased in both groups during the stress test for the nondominant hand (P = 0.05). For the dominant hand, an increase of excessive force was encountered in the group of residents (P = 0.05). In contrast to their results, participants of both groups assessed their performance worse during the stress test. In our study, we found an increase of neurosurgical simulator performance in neurosurgical residents and medical students under simulated night shift conditions. Further, microsurgical dexterity remained unchanged. Based on our results and the data in the available literature, we cannot confirm that working hour restrictions will have a positive effect on neurosurgical performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. A new strategy of fingertip reattachment: sequential use of microsurgical technique and pocketing of composite graft.

    Science.gov (United States)

    Kim, K S; Eo, S R; Kim, D Y; Lee, S Y; Cho, B H

    2001-01-01

    Many methods have been used to reattach amputated fingertips. Of these methods, microsurgery has been accepted as the procedure of choice because the defining characteristic of a microsurgically replanted finger is that its surival in the recipient bed is predicated on functioning intravascular circulation. Although considerable progress has been made in the techniques for microvascular replantation of amputated fingers, the replantation of an amputated fingertip is difficult because digital arteries branch into small arteries. This is in addition to digital veins that run from both sides of the nail bed to the median dorsal sides, which are difficult to separate from the immobile soft tissue. Furthermore, even with the most technically skilled microsurgeon, replantation failure often occurs, especially in severe injury cases. Therefore, the technique is not the only protection against failure, and a new strategy of fingertip reattachment is needed. From March of 1997 to December of 1999, 12 fingers of 11 patients with zone 1 or zone 2 fingertip amputations that were reattached microsurgically but were compromised were deepithelialized, reattached, and then inserted into the abdominal pocket. All had been complete amputations with crushing injuries. Approximately 3 weeks later, the fingers were depocketed and covered with a skin graft. Of the 12 fingers, 7 survived completely and 3 had partial necrosis on less than one-third the volume of the amputated part. The complete survival rate was approximately 58 percent. The results of the above 10 fingers were satisfactory from both functional and cosmetic aspects. The authors believe that this high success rate was achieved because the deepithelialized finger pulp was placed in direct contact with the deep abdominal fascia, which was equipped with plentiful vascularity, not subcutaneous fat. In addition, the pocketing was performed promptly before necrosis of the compromised fingertip occurred. From the results of this

  5. Microsurgical clipping of ophthalmic artery aneurysms: surgical results and visual outcomes with 208 aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Tabani, Halima; Safaee, Michael M; Burkhardt, Jan-Karl; Lawton, Michael T

    2018-01-26

    OBJECTIVE While most paraclinoid aneurysms can be clipped with excellent results, new postoperative visual deficits are a concern. New technology, including flow diverters, has increased the popularity of endovascular therapy. However, endovascular treatment of paraclinoid aneurysms is not without procedural risks, is associated with higher rates of incomplete aneurysm occlusion and recurrence, and may not address optic nerve compression symptoms that surgical debulking can. The increasing endovascular management of paraclinoid aneurysms should be justified by comparisons to surgical benchmarks. The authors, therefore, undertook this study to define patient, visual, and aneurysm outcomes in the most common type of paraclinoid aneurysm: ophthalmic artery (OphA) aneurysms. METHODS Results from microsurgical clipping of 208 OphA aneurysms in 198 patients were retrospectively reviewed. Patient demographics, aneurysm morphology (size, calcification, etc.), clinical characteristics, and patient outcomes were recorded and analyzed. RESULTS Despite 20% of these aneurysms being large or giant in size, complete aneurysm occlusion was accomplished in 91% of 208 cases, with OphA patency preserved in 99.5%. The aneurysm recurrence rate was 3.1% and the retreatment rate was 0%. Good outcomes (modified Rankin Scale score 0-2) were observed in 96.2% of patients overall and in all 156 patients with unruptured aneurysms. New visual field defects (hemianopsia or quadrantanopsia) were observed in 8 patients (3.8%), decreased visual acuity in 5 (2.4%), and monocular blindness in 9 (4.3%). Vision improved in 9 (52.9%) of the 17 patients with preoperative visual deficits. CONCLUSIONS The most important risk associated with clipping OphA aneurysms is a new visual deficit. Meticulous microsurgical technique is necessary during anterior clinoidectomy, aneurysm dissection, and clip application to optimize visual outcomes, and aggressive medical management postoperatively might potentially

  6. Goal Oriented Activity Towards Life Skill Training: Preliminary Indications of a Task-intensive Approach to Manage Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Saumen Gupta

    2013-02-01

    Full Text Available Purpose: To devise a viable programme of intervention for older people with Cerebral Palsy (CP. Methods: Using focus group interviews, a ‘top down’ model of intervention was devised among older children and adolescents with CP. Ten participants volunteered and a custom tailored approach was employed, in keeping with the participants’ goals. Results: The outcomes are described qualitatively. Conclusions: There are preliminary indications that the programme is versatile and feasible. Further trials must be conducted before conclusive comments can be made.

  7. Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials.

    Science.gov (United States)

    Mansfield, Avril; Wong, Jennifer S; Bryce, Jessica; Knorr, Svetlana; Patterson, Kara K

    2015-05-01

    Older adults and individuals with neurological conditions are at an increased risk for falls. Although physical exercise can prevent falls, certain types of exercise may be more effective. Perturbation-based balance training is a novel intervention involving repeated postural perturbations aiming to improve control of rapid balance reactions. The purpose of this study was to estimate the effect of perturbation-based balance training on falls in daily life. MEDLINE (1946-July 2014), EMBASE (1974-July 2014), PEDro (all dates), CENTRAL (1991-July 2014), and Google Scholar (all dates) were the data sources used in this study. Randomized controlled trials written in English were included if they focused on perturbation-based balance training among older adults or individuals with neurological conditions and collected falls data posttraining. Two investigators extracted data independently. Study authors were contacted to obtain missing information. A PEDro score was obtained for each study. Primary outcomes were proportion of participants who reported one or more falls (ie, number of "fallers") and the total number of falls. The risk ratio (proportion of fallers) and rate ratio (number of falls) were entered into the analysis. Eight studies involving 404 participants were included. Participants who completed perturbation-based balance training were less likely to report a fall (overall risk ratio=0.71; 95% confidence interval=0.52, 0.96; P=.02) and reported fewer falls than those in the control groups (overall rate ratio=0.54; 95% confidence interval=0.34, 0.85; P=.007). Study authors do not always identify that they have included perturbation training in their intervention; therefore, it is possible that some appropriate studies were not included. Study designs were heterogeneous, preventing subanalyses. Perturbation-based balance training appears to reduce fall risk among older adults and individuals with Parkinson disease. © 2015 American Physical Therapy Association.

  8. Athletic training in badminton players modulates the early C1 component of visual evoked potentials: a preliminary investigation.

    Science.gov (United States)

    Jin, Hua; Xu, Guiping; Zhang, John X; Ye, Zuoer; Wang, Shufang; Zhao, Lun; Lin, Chong-De; Mo, Lei

    2010-12-01

    One basic question in brain plasticity research is whether individual life experience in the normal population can affect very early sensory-perceptual processing. Athletes provide a possible model to explore plasticity of the visual cortex as athletic training in confrontational ball games is quite often accompanied by training of the visual system. We asked professional badminton players to watch video clips related to their training experience and predict where the ball would land and examined whether they differed from non-player controls in the elicited C1, a visual evoked potential indexing V1 activity. Compared with controls, the players made judgments significantly more accurately, albeit not faster. An early ERP component peaking around 65 ms post-stimulus with a scalp topography centering at the occipital pole (electrode Oz) was observed in both groups and interpreted as the C1 component. With comparable latency, amplitudes of this component were significantly enhanced for the players than for the non-players, suggesting that it can be modulated by long-term physical training. The results present a clear case of experience-induced brain plasticity in primary visual cortex for very early sensory processing. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. Military Mental Health First Aid: Development and Preliminary Efficacy of a Community Training for Improving Knowledge, Attitudes, and Helping Behaviors.

    Science.gov (United States)

    Mohatt, Nathaniel Vincent; Boeckmann, Robert; Winkel, Nicola; Mohatt, Dennis F; Shore, Jay

    2017-01-01

    Persistent stigma, lack of knowledge about mental health, and negative attitudes toward treatment are among the most significant barriers to military service members and veterans seeking behavioral health care. With the high rates of untreated behavioral health needs among service members and veterans, identifying effective programs for reducing barriers to care is a national priority. This study adapted Mental Health First Aid (MHFA), an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing laypeople's confidence in helping and frequency of referring people in need, for military and veteran populations and pilot tested the adapted training program with 4 Army National Guard armories. A total of 176 community first responders (CFRs) participated in a comparative outcomes study, with 69 receiving the training and 107 participating in the control group. CFRs were individuals in natural positions within the Armory or home communities of Guard members to identify and help service members in mental health crisis. Surveys assessing confidence in helping, attitudes toward help seeking, knowledge of resources, use of MHFA practices, and stigma were completed before the training, immediately post-training, at 4 months post-training, and at 8 months post-training. Analyses included repeated measures analysis of variances on data from CFRs who received the training and mixed between-within subjects analysis of variances comparing the intervention and control group longitudinally at three time points. Institutional review board approval for this study was received from Montana State University and the U.S. Army Medical Department, Medical Research and Materiel Command, Human Research Protection Office. Significant and meaningful improvements in confidence (p stigma (p stigma (η 2 = 0.02), with a significant and meaningful difference observed for practice behaviors (p mental health support. In addition, there were positive growth

  10. Aerobic exercise in adolescents with obesity: preliminary evaluation of a modular training program and the modified shuttle test

    Directory of Open Access Journals (Sweden)

    van der Baan-Slootweg Olga H

    2007-04-01

    Full Text Available Abstract Background Increasing activity levels in adolescents with obesity requires the development of exercise programs that are both attractive to adolescents and easily reproducible. The aim of this study was to develop a modular aerobic training program for adolescents with severe obesity, with a focus on variety, individual targets and acquiring physical skills. We report here the effects on aerobic fitness from a pilot study. Furthermore, we examined the feasibility of the modified shuttle test (MST as an outcome parameter for aerobic fitness in adolescents with severe obesity. Methods Fifteen adolescents from an inpatient body weight management program participated in the aerobic training study (age 14.7 ± 2.1 yrs, body mass index 37.4 ± 3.5. The subjects trained three days per week for 12 weeks, with each session lasting 30–60 minutes. The modular training program consisted of indoor, outdoor and swimming activities. Feasibility of the MST was studied by assessing construct validity, test-retest reliability and sensitivity to change. Results Comparing pretraining and end of training period showed large clinically relevant and significant improvements for all aerobic indices: e.g. VO2 peak 17.5%, effect size (ES 2.4; Wmax 8%, ES 0.8. In addition, a significant improvement was found for the efficiency of the cardiovascular system as assessed by the oxygen pulse (15.8%, ES 1.6. Construct validity, test-retest reliability and sensitivity to change of the MST were very good. MST was significantly correlated with VO2 peak (r = 0.79 and Wmax (r = 0.84 but not with anthropometric measures. The MST walking distance improved significantly by 32.5%, ES 2.5. The attendance rate at the exercise sessions was excellent. Conclusion This modular, varied aerobic training program has clinically relevant effects on aerobic performance in adolescents with severe obesity. The added value of our aerobic training program for body weight management programs

  11. Development of subliminal persuasion system to improve the upper limb posture in laparoscopic training: a preliminary study.

    Science.gov (United States)

    Zhang, Di; Sessa, Salvatore; Kong, Weisheng; Cosentino, Sarah; Magistro, Daniele; Ishii, Hiroyuki; Zecca, Massimiliano; Takanishi, Atsuo

    2015-11-01

    Current training for laparoscopy focuses only on the enhancement of manual skill and does not give advice on improving trainees' posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limb posture during laparoscopic training like the expert but leads to a lower increment in the workload. A 9-axis inertial measurement unit was used to compute the upper limb posture, and a Detection Reaction Time device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limb posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli. We found that subliminal visual stimulation is a valid method to improve trainees' upper limb posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level. We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limb posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: Subliminal persuasion improved upper limb posture of trainees, with a smaller increase on the overall workload.

  12. Effects of Virtual Reality Training using Xbox Kinect on Motor Function in Stroke Survivors: A Preliminary Study.

    Science.gov (United States)

    Park, Dae-Sung; Lee, Do-Gyun; Lee, Kyeongbong; Lee, GyuChang

    2017-10-01

    Although the Kinect gaming system (Microsoft Corp, Redmond, WA) has been shown to be of therapeutic benefit in rehabilitation, the applicability of Kinect-based virtual reality (VR) training to improve motor function following a stroke has not been investigated. This study aimed to investigate the effects of VR training, using the Xbox Kinect-based game system, on the motor recovery of patients with chronic hemiplegic stroke. This was a randomized controlled trial. Twenty patients with hemiplegic stroke were randomly assigned to either the intervention group or the control group. Participants in the intervention group (n = 10) received 30 minutes of conventional physical therapy plus 30 minutes of VR training using Xbox Kinect-based games, and those in the control group (n = 10) received 30 minutes of conventional physical therapy only. All interventions consisted of daily sessions for a 6-week period. All measurements using Fugl-Meyer Assessment (FMA-LE), the Berg Balance Scale (BBS), the Timed Up and Go test (TUG), and the 10-meter Walk Test (10mWT) were performed at baseline and at the end of the 6 weeks. The scores on the FMA-LE, BBS, TUG, and 10mWT improved significantly from baseline to post intervention in both the intervention and the control groups after training. The pre-to-post difference scores on BBS, TUG, and 10mWT for the intervention group were significantly more improved than those for the control group (P <.05). Evidence from the present study supports the use of additional VR training with the Xbox Kinect gaming system as an effective therapeutic approach for improving motor function during stroke rehabilitation. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. El Sistema-inspired ensemble music training is associated with changes in children's neurocognitive functional integration: preliminary ERP evidence.

    Science.gov (United States)

    Hedayati, Nina; Schibli, Kylie; D'Angiulli, Amedeo

    2016-12-01

    Children (aged 9-12) training in an El Sistema-inspired program (OrKidstra) and a matched comparison group participated in an auditory Go/No-Go task while event-related potentials (ERPs) were recorded. Entire-sweep waveform patterns correlated with known ERP peaks associated with executive and other cognitive functions and indicated that the spread of neural activity in the initial 250 ms of executive attention processing (pre-P300) showed higher level of topographical overlap in OrKidstra children. In these children, late potentials (post-P300) concurrent with response control were more widely distributed and temporally coordinated. Intensive ensemble music training, we suggest, may be associated with neuroplastic changes facilitating integration of neural information.

  14. Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study.

    Science.gov (United States)

    Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio

    2015-05-01

    Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study describes preliminary data from a group format manual-based intervention, the Interpersonal Problem-Solving for Workplace Adaptation Programme, aimed at improving the cognitive and metacognitive process of social problem-solving skills focusing on typical social situations in the workplace based on mediation as the main strategy. A total of 50 adults with Asperger syndrome received the programme and were compared with a control group of typical development. The feasibility and effectiveness of the treatment were explored. Participants were assessed at pre-treatment and post-treatment on a task of social problem-solving skills and two secondary measures of socialisation and work profile using self- and caregiver-report. Using a variety of methods, the results showed that scores were significantly higher at post-treatment in the social problem-solving task and socialisation skills based on reports by parents. Differences in comparison to the control group had decreased after treatment. The treatment was acceptable to families and subject adherence was high. The Interpersonal Problem-Solving for Workplace Adaptation Programme appears to be a feasible training programme. © The Author(s) 2014.

  15. Preliminary evidence that allelic variation in the LMX1A gene influences training-related working memory improvement.

    Science.gov (United States)

    Bellander, Martin; Brehmer, Yvonne; Westerberg, Helena; Karlsson, Sari; Fürth, Daniel; Bergman, Olle; Eriksson, Elias; Bäckman, Lars

    2011-06-01

    LMX1A is a transcription factor involved in the development of dopamine (DA)-producing neurons in midbrain. Previous research has shown that allelic variations in three LMX1A single nucleotide polymorphisms (SNPs) were related to risk of Parkinson's disease (PD), suggesting that these SNPs may influence the number of mesencephalic DA neurons. Prompted by the established link between striatal DA functions and working memory (WM) performance, we examined two of these SNPs in relation to the ability to benefit from 4 weeks of WM training. One SNP (rs4657412) was strongly associated with the magnitude of training-related gains in verbal WM. The allele linked to larger gains has previously been suggested to be associated with higher dopaminergic nerve cell density. No differential gains of either SNP were observed for spatial WM, and the genotype groups were also indistinguishable in tests of attention, interference control, episodic memory, perceptual speed, and reasoning for both SNPs. This pattern of data is in agreement with previous findings from our group, suggesting that cognitive effects of DA-related genes may be more easily detected in a training context than for single-assessment performance scores. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Transplantation and microsurgical anastomosis of free omental grafts: experimental animal model of a new operative technique in dogs.

    Science.gov (United States)

    Pap-Szekeres, Jozsef; Cserni, Gabor; Furka, Istvan; Svebis, Mihaly; Cserni, Tamas; Brath, Endre; Nemeth, Norbert; Miko, Iren

    2003-01-01

    Our objective was the elaboration of a new animal model for the free transplantation of an omental flap and the examination of its viability in dogs. The cooled omental flap from the abdomen was freely transplanted to the lateral cervical region, and its blood supply was established with microsurgical anastomoses. The technique was developed in 5 dogs, and short-term survival examinations were later carried out in 3 cases by means of this method. Postoperative viability was assessed by angiography, methylene blue testing, and histology. Of the 3 transplanted grafts, 2 still survived 1 week after the operation. For technical reasons, 1 flap thrombotized. For determination of the viability of the transplanted graft, histology proved best. Vital reactions, including granulation tissue and angiogenesis, were present on the histological slides. The short-term survival of an omental flap can be ensured with microsurgical transplantation in dogs. Copyright 2003 Wiley-Liss, Inc.

  17. Effects of palliative care training program on knowledge, attitudes, beliefs and experiences among student physiotherapists: A preliminary quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Senthil P Kumar

    2011-01-01

    Full Text Available Background: Physiotherapists play an inherent role in the multidisciplinary palliative care team. Existing knowledge, attitudes, beliefs and experiences influence their team participation in palliative care. Aims: The objective of this study was to assess the changes in knowledge, attitudes, beliefs and experiences among student physiotherapists who attended a palliative care training program. Settings and Design: Preliminary quasi-experimental study design, conducted at an academic institution. Materials and Methods: Fifty-two student physiotherapists of either gender (12 male, 40 female of age (20.51±1.78 years who attended a palliative care training program which comprised lectures and case examples of six-hours duration participated in this study. The study was performed after getting institutional approval and obtaining participants′ written informed consent. The lecture content comprised WHO definition of palliative care, spiritual aspects of life, death and healing, principles, levels and models of palliative care, and role of physiotherapists in a palliative care team. The physical therapy in palliative care-knowledge, attitudes, beliefs and experiences scale (PTiPC-KABE Scale- modified from palliative care attitudes scale were used for assessing the participants before and after the program. Statistical Analysis: Paired t-test and Wilcoxon signed rank test at 95% confidence interval using SPSS 11.5 for Windows. Results: Statistically significant differences (P<0.05 were noted for all four subscales- knowledge (7.84±4.61 points, attitudes (9.46±8.06 points, beliefs (4.88±3.29 points and experiences (15.8±11.28 points out of a total score of 104 points. Conclusions: The focus-group training program produced a significant positive change about palliative care in knowledge, attitudes, beliefs and experiences among student physiotherapists.

  18. Effectiveness of a psychoeducational skill training DVD program to reduce stress in Chinese American dementia caregivers: results of a preliminary study.

    Science.gov (United States)

    Gallagher-Thompson, Dolores; Wang, Peng-Chih; Liu, Weiling; Cheung, Vinnie; Peng, Rebecca; China, Danielle; Thompson, Larry W

    2010-04-01

    Prior research (Gallagher-Thompson, D., Gray, H., Tang, P., Pu, C.-Y., Tse, C., Hsu, S., et al. (2007). Impact of in-home intervention versus telephone support in reducing depression and stress of Chinese caregivers: Results of a pilot study. American Journal of Geriatric Psychiatry, 15, 425-434.) found that an in-home behavioral management program, derived conceptually from cognitive behavioral theories (CBT), was effective in reducing caregiver related stress and depressive symptoms in Chinese American dementia caregivers (CGs). Results were promising, but a more cost-effective intervention is needed to serve this growing population. Past work also found that a psychoeducational videotaped training program based on CBT was effective in reducing stress due to caregiving in Caucasian and African American dementia family CGs (Steffen, 2000, Anger management for dementia caregivers: A preliminary study using video and telephone interventions. Behavior Therapy, 31, 281-299.). To date no research has been conducted using a technological medium to deliver a similar kind of intervention to Chinese American caregivers. The present study evaluated the effectiveness of a similar but culturally "tailored" program in which 70 CGs were randomly assigned to a 12-week CBT skill training program delivered on a DVD, or to a general educational DVD program on dementia. Both were available in Mandarin Chinese or English as preferred. Pre post change analyses indicated that CGs did not differ on change in level of negative depressive symptoms, but positive affect was higher, and patient behaviors were appraised as less stressful and bothersome, for CGs in the CBT skill training program. They were also more satisfied with the program overall and reported that they believed they were able to give care more effectively. Results encourage further development of theoretically based interventions, delivered using modern technology, for this ever increasing group of CGs.

  19. Orbitopterional Approach for the Resection of a Suprasellar Craniopharyngioma: Adapting the Strategy to the Microsurgical and Pathologic Anatomy.

    Science.gov (United States)

    Nguyen, Vincent; Basma, Jaafar; Klimo, Paul; Sorenson, Jeffrey; Michael, L Madison

    2018-04-01

    Objectives  To describe the orbitopterional approach for the resection of a suprasellar craniopharyngioma with emphasis on the microsurgical and pathological anatomy of such lesions. Design  After completing the orbitopterional craniotomy in one piece including a supraorbital ridge osteotomy, the Sylvian fissure was split in a distal to proximal direction. The ipsilateral optic nerve and internal carotid artery were identified. Establishing a corridor to the tumor through both the opticocarotid and optic cisterns allowed for a wide angle of attack. Using both corridors, a microsurgical gross total resection was achieved. A radical resection required transection of the stalk at the level of the hypothalamus. Photographs of the region are borrowed from Dr Rhoton's laboratory to illustrate the microsurgical anatomy. Understanding the cisternal and topographic relationships of the optic nerve, optic chiasm, and internal carotid artery is critical to achieving gross total resection while preserving normal anatomy. Participants  The surgery was performed by the senior author assisted by Dr. Jaafar Basma. The video was edited by Dr. Vincent Nguyen. Outcome Measures  Outcome was assessed with extent of resection and postoperative visual function. Results  A gross total resection of the tumor was achieved. The patient had resolution of her bitemporal hemianopsia. She had diabetes insipidus with normal anterior pituitary function. Conclusions  Understanding the microsurgical anatomy of the suprasellar region and the pathological anatomy of craniopharyngiomas is necessary to achieve a good resection of these tumors. The orbitopterional approach provides the appropriate access for such endeavor. The link to the video can be found at: https://youtu.be/Be6dtYIGqfs .

  20. Effectiveness and safety of Nintendo Wii Fit Plus™ training in children with migraine without aura: a preliminary study.

    Science.gov (United States)

    Esposito, Maria; Ruberto, Maria; Gimigliano, Francesca; Marotta, Rosa; Gallai, Beatrice; Parisi, Lucia; Lavano, Serena Marianna; Roccella, Michele; Carotenuto, Marco

    2013-01-01

    Migraine without aura (MoA) is a painful syndrome, particularly in childhood; it is often accompanied by severe impairments, including emotional dysfunction, absenteeism from school, and poor academic performance, as well as issues relating to poor cognitive function, sleep habits, and motor coordination. The study population consisted of 71 patients affected by MoA (32 females, 39 males) (mean age: 9.13±1.94 years); the control group consisted of 93 normally developing children (44 females, 49 males) (mean age: 8.97±2.03 years) recruited in the Campania school region. The entire population underwent a clinical evaluation to assess total intelligence quotient level, visual-motor integration (VMI) skills, and motor coordination performance, the later using the Movement Assessment Battery for Children (M-ABC). Children underwent training using the Wii-balance board and Nintendo Wii Fit Plus™ software (Nintendo Co, Ltd, Kyoto, Japan); training lasted for 12 weeks and consisted of three 30-minute sessions per week at their home. The two starting populations (MoA and controls) were not significantly different for age (P=0.899) and sex (P=0.611). M-ABC and VMI performances at baseline (T0) were significantly different in dexterity, balance, and total score for M-ABC (PWii training (T1), MoA children showed a significant improvement in M-ABC global performance (Pbalance (PWii Fit Plus™ system as a rehabilitative device for the visuomotor and balance skills impairments among children affected by MoA, even if further research and longer follow-up are needed.

  1. Cultural consultation as a model for training multidisciplinary mental healthcare professionals in cultural competence skills: preliminary results.

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    Owiti, J A; Ajaz, A; Ascoli, M; de Jongh, B; Palinski, A; Bhui, K S

    2014-01-01

    Lack of cultural competence in care contributes to poor experiences and outcomes from care for migrants and racial and ethnic minorities. As a result, health and social care organizations currently promote cultural competence of their workforce as a means of addressing persistent poor experiences and outcomes. At present, there are unsystematic and diverse ways of promoting cultural competence, and their impact on clinician skills and patient outcomes is unknown. We developed and implemented an innovative model, cultural consultation service (CCS), to promote cultural competence of clinicians and directly improve on patient experiences and outcomes from care. CCS model is an adaptation of the McGill model, which uses ethnographic methodology and medical anthropological knowledge. The method and approach not only contributes both to a broader conceptual and dynamic understanding of culture, but also to learning of cultural competence skills by healthcare professionals. The CCS model demonstrates that multidisciplinary workforce can acquire cultural competence skills better through the clinical encounter, as this promotes integration of learning into day-to-day practice. Results indicate that clinicians developed a broader and patient-centred understanding of culture, and gained skills in narrative-based assessment method, management of complexity of care, competing assumptions and expectations, and clinical cultural formulation. Cultural competence is defined as a set of skills, attitudes and practices that enable the healthcare professionals to deliver high-quality interventions to patients from diverse cultural backgrounds. Improving on the cultural competence skills of the workforce has been promoted as a way of reducing ethnic and racial inequalities in service outcomes. Currently, diverse models for training in cultural competence exist, mostly with no evidence of effect. We established an innovative narrative-based cultural consultation service in an inner

  2. Preoperative Prediction of the Necessity for Anterior Clinoidectomy During Microsurgical Clipping of Ruptured Posterior Communicating Artery Aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Burkhardt, Jan-Karl; Tabani, Halima; Safaee, Michael M; Lawton, Michael T

    2018-01-01

    Although most posterior communicating artery (PCoA) aneurysms can be clipped easily with excellent results, some require anterior clinoidectomy for safe and complete clipping. To review our microsurgical series of ruptured PCoA aneurysms and identify the preoperative predictors for anterior clinoidectomy during microsurgical clipping for PCoA aneurysms. Results from microsurgical clipping of 104 patients with ruptured PCoA aneurysms were reviewed retrospectively. Distances and angles were obtained from computed tomographic angiography and compared between the anterior and nonanterior clinoidectomy groups. Anterior clinoidectomy was required in 19 of the 104 cases (18%). None developed surgical complications due to anterior clinoid process (ACP) resection, including postoperative visual deficit. Univariate and multivariate analyses revealed that the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were statistically significant predictive factors for the need of anterior clinoidectomy. Based on a receiver operating characteristic analysis, the distances from the ACP tip to the aneurysmal proximal neck PCoA aneurysm surgery, the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were both found to be useful predictors of whether anterior clinoidectomy was required. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Microsurgical Decompression of the Cochlear Nerve to Treat Disabling Tinnitus via an Endoscope-Assisted Retrosigmoid Approach: The Padua Experience.

    Science.gov (United States)

    Di Stadio, Arianna; Colangeli, Roberta; Dipietro, Laura; Martini, Alessandro; Parrino, Daniela; Nardello, Ennio; D'Avella, Domenico; Zanoletti, Elisabetta

    2018-05-01

    The use of surgical cochlear nerve decompression is controversial. This study aimed at investigating the safety and validity of microsurgical decompression via an endoscope-assisted retrosigmoid approach to treat tinnitus in patients with neurovascular compression of the cochlear nerve. Three patients with disabling tinnitus resulting from a loop in the internal auditory canal were evaluated with magnetic resonance imaging and tests of pure tone auditory, tinnitus, and auditory brain response (ABR) to identify the features of the cochlear nerve involvement. We observed a loop with a caliber greater than 0.8 mm in all patients. Patients were treated via an endoscope-assisted retrosigmoid microsurgical decompression. After surgery, none of the patients reported short-term or long-term complications. After surgery, tinnitus resolved immediately in 2 patients, whereas in the other patient symptoms persisted although they improved; in all patients, hearing was preserved and ABR improved. Microsurgical decompression via endoscope-assisted retrosigmoid approach is a promising, safe, and valid procedure for treating tinnitus caused by cochlear nerve compression. This procedure should be considered in patients with disabling tinnitus who have altered ABR and a loop that has a caliber greater than 0.8 mm and is in contact with the cochlear nerve. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Efficacy of Brain Gym Training on the Cognitive Performance and Fitness Level of Active Older Adults: A Preliminary Study.

    Science.gov (United States)

    Cancela, José M; Vila Suárez, Ma Helena; Vasconcelos, Jamine; Lima, Ana; Ayán, Carlos

    2015-10-01

    This study evaluates the impact of Brain Gym (BG) training in active older adults. Eighty-five participants were assigned to four training groups: BG (n = 18), BG plus water-based exercise (n = 18), land-based exercise (n = 30), and land plus water-based exercise (n = 19). The effects of the programs on the attention and memory functions were assessed by means of the symbol digit modality test. The two-min step and the eight-foot up-and-go tests were used to evaluate their impact on fitness level. No program had a significant influence on the participant's cognitive performance, while different effects on the sample' fitness levels were observed. These findings suggest that the effects of BG on the cognitive performance and fitness level of active older adults are similar to those obtained after the practice of a traditional exercise program. Whether BG is performed in isolation or combined with other exercise programs seems to have no influence on such effects.

  5. Effect of aquatic interval training with Mediterranean diet counseling in obese patients: results of a preliminary study.

    Science.gov (United States)

    Boidin, Maxime; Lapierre, Gabriel; Paquette Tanir, Laurie; Nigam, Anil; Juneau, Martin; Guilbeault, Valérie; Latour, Elise; Gayda, Mathieu

    2015-10-01

    No previous studies have investigated a high-intensity interval training program (HIIT) with an immersed ergocycle and Mediterranean diet counseling (Med) in obese patients. We aimed to compare the effects of an intensive lifestyle intervention, Med and HIIT with a water-immersed versus dryland ergocycle, on cardiometabolic and exercise parameters in obese patients. We retrospectively identified 95 obese patients at their entry into a 9-month Med and HIIT program: 21 were trained on a water-immersed ergocycle and 74 on a standard dryland ergocycle. Body composition, cardiometabolic and exercise parameters were measured before and after the program. For obese patients performing water- and dryland-exercise (mean age 58±9 years versus 55±7 years), BMI was higher for the water- than dryland-exercise group (39.4±8.3kg/m(2) versus 34.7±5.1kg/m(2), Pendurance were similarly improved (PHIIT program with water-cycling is as effective as a dryland program in improving body composition, fasting glucose, triglycerides level, blood pressure and fitness in obese patients. A Mediterranean diet combined with water-cycling HIIT may be efficient for severely obese patients at high risk of musculoskeletal conditions. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Dynamicimagestoaddressconceptualnodes about mechanical waves: Example materials and preliminary results of the experimentation of the teacher training module IMAGONDE

    Science.gov (United States)

    Testa, I.; Lombardi, S.; Monroy, G.; Sassi, E.

    2004-09-01

    In the framework of the 2002-03 project “Fisica per la Formazione Culturale - FORMazione Insegnanti" funded by Italy ministry of Education, a set of training materials, focused on mechanical waves, has been developed. The core of the materials is represented by animated images purposely designed in order to: 1) address intrinsically dynamic aspects of one-dimensional impulses/waves propagation on a string; 2) have the trainees reflect upon students' difficulties in reading/interpreting static images (as the ones which are featured in common textbooks) and animations. In this paper we discuss example materials concerning transversal impulses on strings to address conceptual nodes such as: 1) configuration of the string at a given time and its aaabstract representation; 2) displacement vs. time graph of a string element and its aaabstract representation; 3) relationships between the two aaabstract representations; 4) modelization of mechanical wave propagation in one dimension. Moreover the results of the experimentation of the training materials in the framework of the Post Graduate School to Became Physics Teacher in Secondary Schools are presented and commented.

  7. [Quality of Life and Functional Outcome after Microsurgical Decompression in Lumbar Spinal Stenosis: a Register Study].

    Science.gov (United States)

    Zarghooni, Kourosh; Beyer, Frank; Papadaki, Joanna; Boese, Christoph Kolja; Siewe, Jan; Schiffer, Gereon; Eysel, Peer; Bredow, Jan

    2017-08-01

    Introduction Because of recent increases in life expectancy, lumbar spinal stenosis (LSS) has become one of the most common degenerative changes in the spine. In patients not responding to conservative therapy, microsurgical decompression is the gold standard of operative treatment for degenerative LSS. The goal of the current study is to evaluate quality of life after microsurgical decompression for LSS, using data from the DWG Register (previously Spine Tango). Methods 36 patients were included in this single-center, prospective, observational study from January 2013 to June 2014. Data were collected from the Spine Tango or DWG Register. The core outcome measure index (COMI), Oswestry Disability Index (ODI), and the quality of life questionnaire EuroQoL-5D were used. Data were collected prior to surgery as well as six weeks, six months, and twelve months after the operation. Results The patient cohort comprised 13 females and 23 males (36.1 and 63.9 %). Complete 12-month follow-up data on 21 patients were available for analysis. Compared to preoperative measures, the COMI score increased 8.1 ± 1.5 over the entire follow up, with 4.5 ± 3.1 at 6 weeks (p < 0.001), 4.8 ± 3.1 at 6 months, and 3.8 ± 3.2 at 12 months. ODI scores, measuring spinal function impairment, were significantly better than preoperative values overall (47.5 ± 17.3) and after 6 weeks (29.1 ± 22.4; p < 0.005), 6 months (30.0 ± 19.3), and 12 months (23.8 ± 18.2). Quality of life measures improved in a similar manner (preoperative: 0.36 ± 0.38; 6 weeks: 0.57 ± 0.34 (p < 0.019); 6 months: 0.62 ± 0.28; 12 months: 0.67 ± 0.31). Conclusion Our study shows that LSS patients without previous surgery and neurologic deficits can expect significant pain relief and improved quality of life already six weeks after undergoing stabilizing decompression. There was an increase in positive postoperative effects over 12 months. The DWG

  8. Clinical study on microsurgical treatment of lumbar disc herniation assisted by METRx system

    Directory of Open Access Journals (Sweden)

    Xin-gang ZHAO

    2016-04-01

    Full Text Available Objective To explore the techniques and curative effect of microsurgical procedures assisted by minimal exposure tubular retractor system (METRx in the treatment of lumbar disc herniation (LDH.  Methods A total of 51 LDH patients, including 24 patients with L4-5 herniation and 27 patients with L5-S1 herniation, underwent discectomy assisted by METRx system. The operation time, intraoperative blood loss, postoperative complications and hospital stay were recorded. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate the degree of low back pain before operation, one week, 3 months after operation, and in the last follow-up. Lumbar MRI was used to evaluate the decompression of spinal canal.  Results The success rate of operations in 51 cases was 98.04% (50/51. The average operation time was 125 min, the average intraoperative blood loss was 50 ml, the mean hospital stay was 5 d, all patients were followed up for 6-48 months (average 24 months. Compared with preoperation, both VAS and ODI scores decreased significantly one week after operation (P = 0.036, 0.029, 3 months after operation (P = 0.018, 0.023 and in the last follow-up (P = 0.007, 0.013. The improvement rate of ODI was 35.37% in the last follow-up. No infection, postoperative cerebrospinal fluid (CSF fistula, neurological defects or incision infection was found. One patient presented acute abdominalgia on the 2nd day after operation, and was diagnosed as annexitis. One patient showed nerve root irritation symptoms after operation caused by thick nerve root during the surgery. They were cured after symptomatic treatment.  Conclusions Microsurgical procedures for treating LDH assisted by METRx system can effectively relieve nerve root compression, protect the dural sac and nerve roots, and reduce surgical complications. DOI: 10.3969/j.issn.1672-6731.2016.04.008

  9. A preliminary study of cognitive-behavioral family-based treatment versus parent training for young children with obsessive-compulsive disorder.

    Science.gov (United States)

    Rosa-Alcázar, Ana I; Iniesta-Sepúlveda, Marina; Storch, Eric A; Rosa-Alcázar, Ángel; Parada-Navas, José L; Olivares Rodríguez, José

    2017-01-15

    Cognitive-Behavioral Family-Based Treatment (CBFT) is the standard of care in young children with OCD. Developmental considerations, parent desires, and cost-effective advantages motivate research to explore the relative efficacy of parent-only interventions. The main goal in this study was to test the effectiveness and feasibility of a parent only intervention for OCD in young children, comparing, in a preliminary fashion the relative efficacy of reducing obsessive-compulsive symptoms through two treatment conditions: 1) an individual CBFT for early OCD involving both parents and children, and 2) the family component of the intervention involving only individual Parent Training (PT). Twenty treatment-seeking families from two private outpatient clinics in Spain were alternately assigned to one of the two treatment conditions. Participants had a primary diagnosis of OCD and a mean age of 6.62 years (65% males). Interventions were conducted by the same therapist and the assessments were administered by independent clinicians who were blind to the experimental conditions of the participants. Assessment time-points were pretreatment, posttreatment, and 3-month follow-up (including diagnosis, symptom severity, global functioning, family accommodation, externalizing and internalizing symptoms, and satisfaction measures). The two ways of implementation, involving child and parents (CBFT) or involving only parents (PT), produced clinical improvements and were well-accepted by parents and children. The CBFT condition was superior to the PT condition in reducing externalizing problems. reduced sample size and absence of randomization were the main limitations of this study. these results suggest, in a preliminary manner, that the need to have the child present at session with the clinician could be decreased for some children, as well as the overall feasibility of working only with parents for the implementation of CBT for OCD in very young children. Copyright © 2016

  10. Microvascular Anastomosis Training in Neurosurgery: A Review

    Directory of Open Access Journals (Sweden)

    Vadim A. Byvaltsev

    2018-01-01

    Full Text Available Cerebrovascular diseases are among the most widespread diseases in the world, which largely determine the structure of morbidity and mortality rates. Microvascular anastomosis techniques are important for revascularization surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms and even during resection of brain tumors that obstruct major cerebral arteries. Training in microvascular surgery became even more difficult with less case exposure and growth of the use of endovascular techniques. In this text we will briefly discuss the history of microvascular surgery, review current literature on simulation models with the emphasis on their merits and shortcomings, and describe the views and opinions on the future of the microvascular training in neurosurgery. In “dry” microsurgical training, various models created from artificial materials that simulate biological tissues are used. The next stage in training more experienced surgeons is to work with nonliving tissue models. Microvascular training using live models is considered to be the most relevant due to presence of the blood flow. Training on laboratory animals has high indicators of face and constructive validity. One of the future directions in the development of microsurgical techniques is the use of robotic systems. Robotic systems may play a role in teaching future generations of microsurgeons. Modern technologies allow access to highly accurate learning environments that are extremely similar to real environment. Additionally, assessment of microsurgical skills should become a fundamental part of the current evaluation of competence within a microneurosurgical training program. Such an assessment tool could be utilized to ensure a constant level of surgical competence within the recertification process. It is important that this evaluation be based on validated models.

  11. Robot-assisted microsurgical forceps with haptic feedback for transoral laser microsurgery.

    Science.gov (United States)

    Deshpande, Nikhil; Chauhan, Manish; Pacchierotti, Claudio; Prattichizzo, Domenico; Caldwell, Darwin G; Mattos, Leonardo S

    2016-08-01

    In this paper, a novel, motorized, multi-degrees-of-freedom (DoF), microsurgical forceps tool is presented, which is based on a master-slave teleoperation architecture. The slave device is a 7-DoF manipulator with: (i) 6-DoF positioning and orientation, (ii) 1 open/close gripper DoF; and (iii) an integrated force/torque sensor for tissue grip-force measurement. The master device is a 7-DoF haptic interface which teleoperates the slave device, and provides haptic feedback in its gripper interface. The combination of the device and the surgeon interface replaces the manual, hand-held device providing easy-to-use and ergonomic tissue control, simplifying the surgical tasks. This makes the system suitable to real surgical scenarios in the operating room (OR). The performance of the system was analysed through the evaluation of teleoperation control and characterization of gripping force. The new system offers an overall positioning error of less than 400 μm demonstrating its safety and accuracy. Improved system precision, usability, and ergonomics point to the potential suitability of the device for the OR and its ability to advance haptic-feedback-enhanced transoral laser microsurgeries.

  12. Clinical study on microsurgical treatment for craniopharyngioma in a single consecutive institutional series of 335 patients.

    Science.gov (United States)

    Guo, Fuyou; Wang, Guoqing; Suresh, Vigneyshwar; Xu, Dingkang; Zhang, Xiaoyang; Feng, Mengzhao; Wang, Fang; Liu, Xianzhi; Song, Laijun

    2018-04-01

    The optimal management of craniopharyngioma is still controversial. The aim of this study is to explore microsurgical outcomes of craniopharyngioma in 335 cases. Clinical data of 335 consecutive patients with craniopharyngioma between March 2011 and March 2017 were retrospectively analyzed. Gross total resection (GTR) was achieved in 265 cases (79.1%), subtotal resection (STR) was obtained in 70 cases (20.9%). The GTR rate was 81.93% in pediatric group and 78.17% in adult group respectively, no significant difference regarding the GTR rate was found in adult group compared with in pediatric group (p > 0.05). However, there was a noticeable difference in the elevated hypothalamic obesity in children group compared with in adult group after operation (p  0.05). Additionally, there were no statistically significant differences for recurrence-free curves between GTR and STR plus adjuvant radiotherapy (p > 0.05). Present findings demonstrated that tumor recurrence and surgical times contribute to negative total resection for craniopharyngioma. Postoperative precise adjuvant radiotherapy was considered in selected cases if pursuit of GTR was rather dangerous under disadvantageous removal factors. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Microsurgical and Tractographic Anatomy of the Supplementary Motor Area Complex in Humans.

    Science.gov (United States)

    Bozkurt, Baran; Yagmurlu, Kaan; Middlebrooks, Erik H; Karadag, Ali; Ovalioglu, Talat Cem; Jagadeesan, Bharathi; Sandhu, Gauravjot; Tanriover, Necmettin; Grande, Andrew W

    2016-11-01

    To evaluate the microsurgical anatomy of the fiber tract connections of the supplementary motor area (SMA) and pre-SMA, and examine its potential functional role with reference to clinical trials in the literature. Ten postmortem formalin-fixed human brains (20 sides) and 1 cadaveric head were prepared following Klingler's method. The fiber dissection was performed in a stepwise fashion, from lateral to medial and also from medial to lateral, under an operating microscope, with 3D images captured at each stage. Our findings were supported by in vivo magnetic resonance imaging tractography in 2 healthy subjects. The connections of the SMA complex, composed of the pre-SMA and the SMA proper, are composed of short "U" association fibers and the superior longitudinal fasciculus I, cingulum, claustrocortical fibers, callosal fibers, corticospinal tract, frontal aslant tract, and frontostriatal tract. The claustrocortical fibers may play an important role in the integration of motor, language, and limbic functions of the SMA complex. The frontostriatal tract connects the pre-SMA to the putamen and caudate nucleus, and also forms parts of both the internal capsule and the dorsal external capsule. The SMA complex has numerous connections throughout the cerebrum. An understanding of these connections is important for presurgical planning for lesions in the frontal lobe and helps explain symptoms related to SMA injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Modern use of smartphone applications in the perioperative management in microsurgical breast reconstruction

    Science.gov (United States)

    Rozen, Warren Matthew; Marsh, Daniel; Chow, Whitney T.H.; Vickers, Tobias; Khan, Lubna; Miller, George S.; Hunter-Smith, David J.; Ramakrishnan, Venkat V.

    2016-01-01

    Background Advances in mobile telecommunication, improved mobile internet and affordability have led to a significant increase in smartphone use within medicine. The capability of instant messaging, photography, videography, word processing, drawing and internet access allow significant potential in this small portable device. Smartphone use within medicine has grown tremendously worldwide given its affordability, improved internet and capabilities. Methods We have searched for apps specifically helpful in the perioperative care of microsurgical breast reconstructive patients. Results The useful apps have been subdivided: (I) communication apps—multimedia messaging, WhatsApp, PicSafeMedi: allow efficient communication via text, picture and video messages leading to earlier assessment and definitive management of free flaps; (II) storage apps—Notability, Elogbook: electronic storage of patient notes and logbooks of case which can be shared with others if required; (III) educational apps—FlapApp, Touch Surgery, PubMed on tap: step by step guides to surgical procedures to aid learning and medical journal database; (IV) flap monitoring app—SilpaRamanitor: free flap monitoring app based on photographic analysis for earlier detection of compromised flaps. Conclusions There has been remarkable growth in smartphones use among surgeons. Apps are being developed for every conceivable use. The future will be in wearable smart devices that allow continuous monitoring with the potential to instigate change should deviations from the norm occur. The smart watch is the start of this digital revolution. PMID:27047783

  15. Validation of Reverse-Engineered and Additive-Manufactured Microsurgical Instrument Prototype.

    Science.gov (United States)

    Singh, Ramandeep; Suri, Ashish; Anand, Sneh; Baby, Britty

    2016-12-01

    With advancements in imaging techniques, neurosurgical procedures are becoming highly precise and minimally invasive, thus demanding development of new ergonomically aesthetic instruments. Conventionally, neurosurgical instruments are manufactured using subtractive manufacturing methods. Such a process is complex, time-consuming, and impractical for prototype development and validation of new designs. Therefore, an alternative design process has been used utilizing blue light scanning, computer-aided designing, and additive manufacturing direct metal laser sintering (DMLS) for microsurgical instrument prototype development. Deviations of DMLS-fabricated instrument were studied by superimposing scan data of fabricated instrument with the computer-aided designing model. Content and concurrent validity of the fabricated prototypes was done by a group of 15 neurosurgeons by performing sciatic nerve anastomosis in small laboratory animals. Comparative scoring was obtained for the control and study instrument. T test was applied to the individual parameters and P values for force (P direct application of these additive-manufactured instruments in the operating room requires further validation. © The Author(s) 2016.

  16. Effectiveness and safety of Nintendo Wii Fit PlusTM training in children with migraine without aura: a preliminary study

    Directory of Open Access Journals (Sweden)

    Esposito M

    2013-11-01

    Full Text Available Maria Esposito,1 Maria Ruberto,2 Francesca Gimigliano,1,2 Rosa Marotta,3 Beatrice Gallai,4 Lucia Parisi,5 Serena Marianna Lavano,3 Michele Roccella,5 Marco Carotenuto11Center for Childhood Headache, Child and Adolescent Neuropsychiatry Clinic, Department of Mental Health, Physical and Preventive Medicine, 2Department of Odonto-Stomathologic Disciplines, Pathology – Orthopedic Sciences, Second University of Naples, Naples, Italy; 3Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, Italy; 4Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy; 5Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, ItalyBackground: Migraine without aura (MoA is a painful syndrome, particularly in childhood; it is often accompanied by severe impairments, including emotional dysfunction, absenteeism from school, and poor academic performance, as well as issues relating to poor cognitive function, sleep habits, and motor coordination.Materials and methods: The study population consisted of 71 patients affected by MoA (32 females, 39 males (mean age: 9.13±1.94 years; the control group consisted of 93 normally developing children (44 females, 49 males (mean age: 8.97±2.03 years recruited in the Campania school region. The entire population underwent a clinical evaluation to assess total intelligence quotient level, visual-motor integration (VMI skills, and motor coordination performance, the later using the Movement Assessment Battery for Children (M-ABC. Children underwent training using the Wii-balance board and Nintendo Wii Fit Plus™ software (Nintendo Co, Ltd, Kyoto, Japan; training lasted for 12 weeks and consisted of three 30-minute sessions per week at their home.Results: The two starting populations (MoA and controls were not significantly different for age (P=0.899 and sex (P=0.611. M-ABC and VMI performances at baseline (T0 were significantly different in dexterity

  17. Volition-adaptive control for gait training using wearable exoskeleton: preliminary tests with incomplete spinal cord injury individuals.

    Science.gov (United States)

    Rajasekaran, Vijaykumar; López-Larraz, Eduardo; Trincado-Alonso, Fernando; Aranda, Joan; Montesano, Luis; Del-Ama, Antonio J; Pons, Jose L

    2018-01-03

    Gait training for individuals with neurological disorders is challenging in providing the suitable assistance and more adaptive behaviour towards user needs. The user specific adaptation can be defined based on the user interaction with the orthosis and by monitoring the user intentions. In this paper, an adaptive control model, commanded by the user intention, is evaluated using a lower limb exoskeleton with incomplete spinal cord injury individuals (SCI). A user intention based adaptive control model has been developed and evaluated with 4 incomplete SCI individuals across 3 sessions of training per individual. The adaptive control model modifies the joint impedance properties of the exoskeleton as a function of the human-orthosis interaction torques and the joint trajectory evolution along the gait sequence, in real time. The volitional input of the user is identified by monitoring the neural signals, pertaining to the user's motor activity. These volitional inputs are used as a trigger to initiate the gait movement, allowing the user to control the initialization of the exoskeleton movement, independently. A Finite-state machine based control model is used in this set-up which helps in combining the volitional orders with the gait adaptation. The exoskeleton demonstrated an adaptive assistance depending on the patients' performance without guiding them to follow an imposed trajectory. The exoskeleton initiated the trajectory based on the user intention command received from the brain machine interface, demonstrating it as a reliable trigger. The exoskeleton maintained the equilibrium by providing suitable assistance throughout the experiments. A progressive change in the maximum flexion of the knee joint was observed at the end of each session which shows improvement in the patient performance. Results of the adaptive impedance were evaluated by comparing with the application of a constant impedance value. Participants reported that the movement of the

  18. A Preliminary Study on the Feasibility of Using a Virtual Reality Cognitive Training Application for Remote Detection of Mild Cognitive Impairment.

    Science.gov (United States)

    Zygouris, Stelios; Ntovas, Konstantinos; Giakoumis, Dimitrios; Votis, Konstantinos; Doumpoulakis, Stefanos; Segkouli, Sofia; Karagiannidis, Charalampos; Tzovaras, Dimitrios; Tsolaki, Magda

    2017-01-01

    It has been demonstrated that virtual reality (VR) applications can be used for the detection of mild cognitive impairment (MCI). The aim of this study is to provide a preliminary investigation on whether a VR cognitive training application can be used to detect MCI in persons using the application at home without the help of an examiner. Two groups, one of healthy older adults (n = 6) and one of MCI patients (n = 6) were recruited from Thessaloniki day centers for cognitive disorders and provided with a tablet PC with custom software enabling the self-administration of the Virtual Super Market (VSM) cognitive training exercise. The average performance (from 20 administrations of the exercise) of the two groups was compared and was also correlated with performance in established neuropsychological tests. Average performance in terms of duration to complete the given exercise differed significantly between healthy(μ  = 247.41 s/ sd = 89.006) and MCI (μ= 454.52 s/ sd = 177.604) groups, yielding a correct classification rate of 91.8% with a sensitivity and specificity of 94% and 89% respectively for MCI detection. Average performance also correlated significantly with performance in Functional Cognitive Assessment Scale (FUCAS), Test of Everyday Attention (TEA), and Rey Osterrieth Complex Figure test (ROCFT). The VR application exhibited very high accuracy in detecting MCI while all participants were able to operate the tablet and application on their own. Diagnostic accuracy was improved compared to a previous study using data from only one administration of the exercise. The results of the present study suggest that remote MCI detection through VR applications can be feasible.

  19. Effects of chronic Rhodiola Rosea supplementation on sport performance and antioxidant capacity in trained male: preliminary results.

    Science.gov (United States)

    Parisi, A; Tranchita, E; Duranti, G; Ciminelli, E; Quaranta, F; Ceci, R; Cerulli, C; Borrione, P; Sabatini, S

    2010-03-01

    Rhodiola Rosea, is an adaptogen plant which has been reported to promote fatty acids utilisation, to ameliorate antioxidant function, and to improve body resistance to physical strenuous efforts. The purpose of the present study was to investigate the effects on physical performance as well as on the redox status of a chronic Rhodiola Rosea supplementation in a group of competitive athletes during endurance exercise. Following a chronic supplementation with Rhodiola Rosea for 4 weeks, 14 trained male athletes underwent a cardio-pulmonary exhaustion test and blood samples to evaluate their antioxidant status and other biochemical parameters. These data were compared with those coming from the same athletes after an intake of placebo. The evaluation of physical performance parameters showed that HR Max, Borg Scale level, VO(2) max and duration of the test were essentially unaffected by Rhodiola Rosea assumption. On the contrary, Rhodiola Rosea intake reduced, in a statistically significative manner, plasma free fatty acids levels. No effect on blood glucose was found. Blood antioxidant status and inflammatory parameters resulted unaffected by Rhodiola Rosea supplementation. Blood lactate and plasma creatine kinase levels were found significantly lower (P<0.05) in Rhodiola Rosea treated subjects when compared to the placebo treated group. Chronic Rhodiola Rosea supplementation is able to reduce both lactate levels and parameters of skeletal muscle damage after an exhaustive exercise session. Moreover this supplementation seems to ameliorate fatty acid consumption. Taken together those observation confirm that Rhodiola Rosea may increase the adaptogen ability to physical exercise.

  20. Social cognitive training in adolescents with chromosome 22q11.2 deletion syndrome: feasibility and preliminary effects of the intervention.

    Science.gov (United States)

    Shashi, V; Harrell, W; Eack, S; Sanders, C; McConkie-Rosell, A; Keshavan, M S; Bonner, M J; Schoch, K; Hooper, S R

    2015-10-01

    Children with chromosome 22q11.2 deletion syndrome (22q11DS) often have deficits in social cognition and social skills that contribute to poor adaptive functioning. These deficits may be of relevance to the later occurrence of serious psychiatric illnesses such as schizophrenia. Yet, there are no evidence-based interventions to improve social cognitive functioning in children with 22q11DS. Using a customised social cognitive curriculum, we conducted a pilot small-group-based social cognitive training (SCT) programme in 13 adolescents with 22q11DS, relative to a control group of nine age- and gender-matched adolescents with 22q11DS. We found the SCT programme to be feasible, with high rates of compliance and satisfaction on the part of the participants and their families. Our preliminary analyses indicated that the intervention group showed significant improvements in an overall social cognitive composite index. SCT in a small-group format for adolescents with 22q11DS is feasible and results in gains in social cognition. A larger randomised controlled trial would permit assessment of efficacy of this promising novel intervention. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  1. Brain responses to biological motion predict treatment outcome in young adults with autism receiving Virtual Reality Social Cognition Training: Preliminary findings.

    Science.gov (United States)

    Yang, Y J Daniel; Allen, Tandra; Abdullahi, Sebiha M; Pelphrey, Kevin A; Volkmar, Fred R; Chapman, Sandra B

    2017-06-01

    Autism Spectrum Disorder (ASD) is characterized by remarkable heterogeneity in social, communication, and behavioral deficits, creating a major barrier in identifying effective treatments for a given individual with ASD. To facilitate precision medicine in ASD, we utilized a well-validated biological motion neuroimaging task to identify pretreatment biomarkers that can accurately forecast the response to an evidence-based behavioral treatment, Virtual Reality-Social Cognition Training (VR-SCT). In a preliminary sample of 17 young adults with high-functioning ASD, we identified neural predictors of change in emotion recognition after VR-SCT. The predictors were characterized by the pretreatment brain activations to biological vs. scrambled motion in the neural circuits that support (a) language comprehension and interpretation of incongruent auditory emotions and prosody, and (b) processing socio-emotional experience and interpersonal affective information, as well as emotional regulation. The predictive value of the findings for individual adults with ASD was supported by regression-based multivariate pattern analyses with cross validation. To our knowledge, this is the first pilot study that shows neuroimaging-based predictive biomarkers for treatment effectiveness in adults with ASD. The findings have potentially far-reaching implications for developing more precise and effective treatments for ASD. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Preliminary efficacy and feasibility of embedding high intensity interval training into the school day: A pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    S.A. Costigan

    2015-01-01

    Full Text Available Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in one secondary school in Newcastle, Australia. Participants (n = 65; mean age = 15.8(0.6 years were randomized into one of three conditions: aerobic exercise program (AEP (n = 21, resistance and aerobic exercise program (RAP (n = 22 and control (n = 22. The 8-week intervention consisted of three HIIT sessions per week (8–10 min/session, delivered during physical education (PE lessons or at lunchtime. Assessments were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness (multi-stage shuttle-run, muscular fitness (push-up, standing long jump tests, body composition (Body Mass Index (BMI, BMI-z scores, waist circumference and physical activity motivation (questionnaire, by researchers blinded to treatment allocation. Intervention effects for outcomes were examined using linear mixed models, and Cohen's d effect sizes were reported. Participants in the AEP and RAP groups had moderate intervention effects for waist circumference (p = 0.024, BMI-z (p = 0.037 and BMI (not significant in comparison to the control group. A small intervention effect was also evident for cardiorespiratory fitness in the RAP group.

  3. Preliminary efficacy and feasibility of embedding high intensity interval training into the school day: A pilot randomized controlled trial.

    Science.gov (United States)

    Costigan, S A; Eather, N; Plotnikoff, R C; Taaffe, D R; Pollock, E; Kennedy, S G; Lubans, D R

    2015-01-01

    Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT) for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in one secondary school in Newcastle, Australia. Participants (n = 65; mean age = 15.8(0.6) years) were randomized into one of three conditions: aerobic exercise program (AEP) (n = 21), resistance and aerobic exercise program (RAP) (n = 22) and control (n = 22). The 8-week intervention consisted of three HIIT sessions per week (8-10 min/session), delivered during physical education (PE) lessons or at lunchtime. Assessments were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness (multi-stage shuttle-run), muscular fitness (push-up, standing long jump tests), body composition (Body Mass Index (BMI), BMI-z scores, waist circumference) and physical activity motivation (questionnaire), by researchers blinded to treatment allocation. Intervention effects for outcomes were examined using linear mixed models, and Cohen's d effect sizes were reported. Participants in the AEP and RAP groups had moderate intervention effects for waist circumference (p = 0.024), BMI-z (p = 0.037) and BMI (not significant) in comparison to the control group. A small intervention effect was also evident for cardiorespiratory fitness in the RAP group.

  4. Surgical planning for microsurgical excision of cerebral arterio-venous malformations using virtual reality technology.

    Science.gov (United States)

    Ng, Ivan; Hwang, Peter Y K; Kumar, Dinesh; Lee, Cheng Kiang; Kockro, Ralf A; Sitoh, Y Y

    2009-05-01

    To evaluate the feasibility of surgical planning using a virtual reality platform workstation in the treatment of cerebral arterio-venous malformations (AVMs) Patient-specific data of multiple imaging modalities were co-registered, fused and displayed as a 3D stereoscopic object on the Dextroscope, a virtual reality surgical planning platform. This system allows for manipulation of 3D data and for the user to evaluate and appreciate the angio-architecture of the nidus with regards to position and spatial relationships of critical feeders and draining veins. We evaluated the ability of the Dextroscope to influence surgical planning by providing a better understanding of the angio-architecture as well as its impact on the surgeon's pre- and intra-operative confidence and ability to tackle these lesions. Twenty four patients were studied. The mean age was 29.65 years. Following pre-surgical planning on the Dextroscope, 23 patients underwent microsurgical resection after pre-surgical virtual reality planning, during which all had documented complete resection of the AVM. Planning on the virtual reality platform allowed for identification of critical feeders and draining vessels in all patients. The appreciation of the complex patient specific angio-architecture to establish a surgical plan was found to be invaluable in the conduct of the procedure and was found to enhance the surgeon's confidence significantly. Surgical planning of resection of an AVM with a virtual reality system allowed detailed and comprehensive analysis of 3D multi-modality imaging data and, in our experience, proved very helpful in establishing a good surgical strategy, enhancing intra-operative spatial orientation and increasing surgeon's confidence.

  5. Changes in gray matter volume after microsurgical lumbar discectomy: A longitudinal analysis

    Directory of Open Access Journals (Sweden)

    Michael eLuchtmann

    2015-02-01

    Full Text Available People around the world suffer chronic lower back pain. Because spine imaging often does not explain the degree of perceived pain reported by patients, the role of the processing of nociceptor signals in the brain as the basis of pain perception is gaining increased attention. Modern neuroimaging techniques (including functional and morphometric methods have produced results that suggest which brain areas may play a crucial role in the perception of acute and chronic pain. In this study, we examined twelve patients with chronic low back pain and sciatica, both resulting from lumbar disc herniation. Structural magnetic resonance imaging (MRI of the brain was performed one day prior to and about four weeks after microsurgical lumbar discectomy. The subsequent MRI revealed an increase in gray matter volume in the basal ganglia but a decrease in volume in the hippocampus, which suggests the complexity of the network that involves movement, pain processing, and aspects of memory. Interestingly, volume changes in the hippocampus were significantly correlated to preoperative pain intensity but not to the duration of chronic pain. Mapping structural changes of the brain that result from lumbar disc herniation has the potential to enhance our understanding of the neuropathology of chronic low back pain and sciatica and therefore may help to optimize the decisions we make about conservative and surgical treatments in the future. The possibility of illuminating more of the details of central pain processing in lumbar disc herniation, as well as the accompanying personal and economic impact of pain relief worldwide, calls for future large-scale clinical studies.

  6. Microsurgical head and neck tissue repair by visceral mini-autografting

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available Objective. To minimize surgical trauma in patients with head and neck tumors during microsurgical plasty with visceral autografts.Subjects and methods. Clinical experience has been gained in the treatment of 53 patients with locally advanced craniofascial (n = 27 and oropharyngeal (n = 36 cancers. Abdominal organs were used for plastic closure of extensive defects after surgical resection. Paraumbilical incision allowing for an adequate approach into the abdominal cavity with minimal external trauma in the anterior abdominal wall was chosen as an access procedure. Video-assisted techniques were used to excise the midline aponeurosis. Donor organs, such as the omentum, greater curvature of the stomach, transverse colon, small intestine were taken through a mini-laparotomic incision to the anterior abdominal wall, then the vascular pedicle was exposed and a visceral autograft was made. After forming and cutting off the autograft, organ anastomoses were created extracorporeally.Results. Mini-access surgery could be completed in 50 of the 53 cases (4 patients had previously undergone abdominal interventions. Omental (n = 26, colo-omental (n = 15, gastro-omental (n = 7, and entero-omental (n = 5 flaps were made and prepared for autografting. No intra- or postoperative abdominal complications were found.Conclusion. Minimally invasive technologies used to create visceral authografts for head and neck tissue repair can minimize surgical trauma and reduce treatment duration. The indications for this access are the debilitating state of a cancer patient or the young age of a patient who does not wish to have an additional scar in the donor region.

  7. Progression of vestibular schawnnoma after GammaKnife radiosurgery: A challenge for microsurgical resection.

    Science.gov (United States)

    Aboukaïs, Rabih; Bonne, Nicolas-Xavier; Touzet, Gustavo; Vincent, Christophe; Reyns, Nicolas; Lejeune, Jean-Paul

    2018-05-01

    We aimed to evaluate the outcome of patients who underwent salvage microsurgery for vestibular schwannoma (VS) that failed primary Gammaknife radiosurgery (GKS). Among the 1098 patients who received GKS for the treatment of VS in our center between January 2004 and December 2012, the follow-up was organized in our institution for 290 patients who lived in our recruitment area. Tumor progression was noted in 23 patients. A salvage microsurgical resection was performed in 11 patients, who were included in our study. Grading of facial function was done according to the House & Brackman scale. The mean age at diagnosis was 50.2 years (19-68 years) and the mean follow-up was 9.4 years (4-13 years). The mean dose was 11.8 Gy (11-12 Gy) and the mean volume was 922 mm3 (208-2500 mm3). The mean period between GKS and diagnosis of tumor progression was 32 months (18-72 months). Concerning salvage microsurgery, complete resection was obtained in 8 patients. Small residual tumor on the facial nerve was deliberately left in 3 patients and no tumor progression was noted with a mean follow-up of 26 months. At last follow-up, facial nerve function was grade 1 in 4 patients, grade 2 in 3 patients, grade 3 in 1 patient and grade 4 in 3 patients. Salvage surgery of recurrent vestibular schwannoma after failed initial GKS remains a good treatment. However, facial nerve preservation is more challenging in this case and small tumor remnant could be sometimes deliberately left. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

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    Rodrigo Ramos-Zúñiga

    2015-01-01

    Full Text Available Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, dysphonia, esophageal lesions and local hematoma; and a comparative analysis of the outcomes after changes in the retraction method. Results: All selected cases had a positive neurological symptom response in relation to neuropathic pain. Dysphagia and dysphonia were found during the first 72 h in 94.1% of the cases in which automatic mechanical retraction was used for more than one hour during the surgical procedure. A radical change was noted in the reduction of the symptoms after the use of only manual protective blades without automatic mechanical retraction: 5.1% dysphagia and 0% dysphonia in the immediate post-operative period, P = 0.001. Conclusions: Soft tissue damage due to the use of automatic retractors in MACDF is not minor and leads to general discomfort in the patient in spite of good neurological results. These problems most often occur when automatic retractors are used continuously for more than 1 hour, as well as when they are used in multiple levels. Dysphagia, dysphonia and local pain decreased with the use of transient manual blades for retraction, and with intermittent release following minimally invasive principles.

  9. Monitoring in microvascular tissue transfer by measurement of oxygen partial pressure: four years experience with 125 microsurgical transplants.

    Science.gov (United States)

    Jonas, René; Schaal, Thomas; Krimmel, Michael; Gülicher, Dirk; Reinert, Siegmar; Hoffmann, Jürgen

    2013-06-01

    In a prospective study, the characteristics and benefit of an invasive measurement of oxygen partial pressure (pO(2)) with the aid of a polarographic sensor were investigated in 125 microsurgical reconstructions of the head and neck area over a period of 45 months. Measurements were performed over 96 h in eight different types of microsurgically revascularized flaps for extra- and intraoral reconstructions and were evaluated separately for each flap type. Of 125 reconstructions the system indicated malperfusion in 18 cases. Salvage surgery was performed in 17 cases due to venous thrombosis (6 cases), arterial thrombosis (3 cases), a combination of arterial and venous thrombosis (2 cases), rheological problems (3 cases), venous insufficiency by hematoma (2 cases) and kinking of vessels (1 case). In 10 cases salvage surgery was successful, 7 flaps were lost despite salvage surgery. In all these cases, the polarographic probe indicated the necessity of salvage surgery correctly. After 96 h no malperfusion was seen. Postoperatively, a common and characteristic development of the oxygen partial pressure in different types of flaps was seen. Initially, a clear increase of pO(2) could be measured. During 96 h, a slow decrease of pO(2) was observed. In conclusion polarographic measurement of pO(2) can be an excellent apparative supplement for the postoperative clinical control of microsurgically revascularized transplants. In buried flaps, this technique represents the only reliable method for transplant monitoring. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  10. Microsurgical DREZotomy in the treatment of chronic pain due to spinal cord and cauda equina injuries: 2 cases report and related literature review

    Directory of Open Access Journals (Sweden)

    LIU Qing-jun

    2013-10-01

    Full Text Available Objective The dorsal root entry zone (DREZ is a hyperactive focus in neuropathic pain (NP syndromes, and DREZotomy has been used in selective cases of NP. This study aims to investigate the therapeutic effect of microsurgical DREZotomy in chronic pain due to spinal cord and cauda equina injuries. Methods Two patients suffered with chronic pain due to spinal cord and cauda equina injuries were treated with microsurgical DREZotomy, and postoperative therapeutic effect and complications were observed. Results One patient had great pain, and the pain was alleviated 2 weeks after surgery, while carbamazepine (300 mg/d was administered continously. Another patient was completely free of pain 2 weeks after surgery, and no recurrence occurred during 3-year follow up. No severe complications were found in the 2 patients. Conclusion Microsurgical DREZotomy is an effective approach in treating chronic pain due to spinal cord and cauda equina injuries.

  11. [The speed of nerve-conduction after micro-surgical suture of the tibial nerve of the rabbit (author's transl)].

    Science.gov (United States)

    Weigert, M; Mellerowicz, H; Werhahn, C

    1975-10-01

    Isolated division of the tibial nerve in the thigh preserving the peroneal and sural nerves does not cause loss of normal position of the animal, in particular of sitting. Nor does it lead to pressure sores. The animals are fitter then after division of the sciatic nerve. Microsurgical suture of the isolated tibial nerve in the thigh of the rabbit with 1 or 2 simple sutures with 10 x 0 thread show that an average recovery can be achieved in over 80 per cent. As few sutures as possible should be used. Otherwise there with be scarring and no return of function.

  12. [The use of a microsurgical precision technic for applying a gastroduodenal anastomosis in a Billroth-I gastric resection].

    Science.gov (United States)

    Galkin, R A; Makarov, I V

    1998-01-01

    Advantages of the formation of gastroduodenal anastomosis using the microsurgical precision technique as compared to the two-row interrupted Albert-Lembert suture and the one-row suture of Pirogov-Mateshuk were established in an experimental investigation in 63 dogs. The article describes the precision suture technique proposed by the authors which was used in Billroth-I resection of the stomach in 15 patients. It was shown that the use of the precision suture resulted in healing by the first intention type, without motor evacuatory disorders and with shorter time of hospital treatment.

  13. Advanced technical skills are required for microsurgical clipping of posterior communicating artery aneurysms in the endovascular era.

    Science.gov (United States)

    Sanai, Nader; Caldwell, Nolan; Englot, Dario J; Lawton, Michael T

    2012-08-01

    Many neurosurgeons feel competent clipping posterior communicating artery (PCoA) aneurysms and include this lesion in their practice. However, endovascular therapy removes simple aneurysms that would have been easiest to clip with the best results. What remains are aneurysms with complex anatomy and technical challenges that are not well described. A contemporary surgical series with PCoA aneurysms is reviewed to define the patients, microsurgical techniques, and outcomes in current practice. A total of 218 patients had 218 PCoA aneurysms that were treated microsurgically during an 11-year period. Complexities influencing aneurysm management included (1) large/giant size; (2) fetal posterior cerebral artery; (3) previous coiling; (4) anterior clinoidectomy; (5) adherence of the anterior choroidal artery (AChA); (6) intraoperative aneurysm rupture; (7) complex clipping; and (8) atherosclerotic calcification. Simple PCoA aneurysms were encountered in 113 patients (51.8%) and complex aneurysms in 105 (48.2%). Adherent AChA (13.8%) and intraoperative rupture (11.5%) were the most common complexities. Simple aneurysms had favorable outcomes in 86.6% of patients, whereas aneurysms with 1 or multiple complexities had favorable outcomes in 78.2% and 75.0%, respectively. Intraoperative rupture (P PCoA aneurysms requires advanced techniques including clinoidectomy, AChA microdissection, complex clipping, and facility with intraoperative rupture. Microsurgery is recommended for recurrent aneurysms after coiling, complex branches, aneurysms causing oculomotor nerve palsy, multiple aneurysms, and patients with hematomas.

  14. Diploid, but not haploid, human embryonic stem cells can be derived from microsurgically repaired tripronuclear human zygotes

    Science.gov (United States)

    Fan, Yong; Li, Rong; Huang, Jin; Yu, Yang; Qiao, Jie

    2013-01-01

    Human embryonic stem cells have shown tremendous potential in regenerative medicine, and the recent progress in haploid embryonic stem cells provides new insights for future applications of embryonic stem cells. Disruption of normal fertilized embryos remains controversial; thus, the development of a new source for human embryonic stem cells is important for their usefulness. Here, we investigated the feasibility of haploid and diploid embryo reconstruction and embryonic stem cell derivation using microsurgically repaired tripronuclear human zygotes. Diploid and haploid zygotes were successfully reconstructed, but a large proportion of them still had a tripolar spindle assembly. The reconstructed embryos developed to the blastocyst stage, although the loss of chromosomes was observed in these zygotes. Finally, triploid and diploid human embryonic stem cells were derived from tripronuclear and reconstructed zygotes (from which only one pronucleus was removed), but haploid human embryonic stem cells were not successfully derived from the reconstructed zygotes when two pronuclei were removed. Both triploid and diploid human embryonic stem cells showed the general characteristics of human embryonic stem cells. These results indicate that the lower embryo quality resulting from abnormal spindle assembly contributed to the failure of the haploid embryonic stem cell derivation. However, the successful derivation of diploid embryonic stem cells demonstrated that microsurgical tripronuclear zygotes are an alternative source of human embryonic stem cells. In the future, improving spindle assembly will facilitate the application of triploid zygotes to the field of haploid embryonic stem cells. PMID:23255130

  15. Open Tibia Shaft Fractures and Soft-Tissue Coverage: The Effects of Management by an Orthopaedic Microsurgical Team.

    Science.gov (United States)

    VandenBerg, James; Osei, Daniel; Boyer, Martin I; Gardner, Michael J; Ricci, William M; Spraggs-Hughes, Amanda; McAndrew, Christopher M

    2017-06-01

    To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopaedic trauma/microsurgical team. Retrospective cohort study. A single level 1 trauma center. Twenty-eight subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, and 42C) treated with flap coverage between January 2009 and March 2015. Flap coverage for open tibia shaft fractures treated before ("preintegration") and after ("postintegration") implementation of an integrated orthopaedic trauma/microsurgical team. Time from index injury to flap coverage. The unadjusted median time to coverage was 7 days (95% confidence interval, 5.9-8.1) preintegration, and 6 days (95% confidence interval, 4.6-7.4) postintegration (P = 0.48). For preintegration, 9 (69%) of the patients experienced complications, compared with 7 (47%) postintegration (P = 0.23). After formation of an integrated orthopaedic trauma/microsurgery team, we observed a 1-day decrease in median days to coverage from index injury. Complications overall were lowered in the postintegration group, although statistically insignificant. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  16. Prediction of the microsurgical window for skull-base tumors by advanced three-dimensional multi-fusion volumetric imaging

    International Nuclear Information System (INIS)

    Oishi, Makoto; Fukuda, Masafumi; Saito, Akihiko; Hiraishi, Tetsuya; Fujii, Yukihiko; Ishida, Go

    2011-01-01

    The surgery of skull base tumors (SBTs) is difficult due to the complex and narrow surgical window that is restricted by the cranium and important structures. The utility of three-dimensional multi-fusion volumetric imaging (3-D MFVI) for visualizing the predicted window for SBTs was evaluated. Presurgical simulation using 3-D MFVI was performed in 32 patients with SBTs. Imaging data were collected from computed tomography, magnetic resonance imaging, and digital subtraction angiography. Skull data was processed to imitate actual bone resection and integrated with various structures extracted from appropriate imaging modalities by image-analyzing software. The simulated views were compared with the views obtained during surgery. All craniotomies and bone resections except opening of the acoustic canal in 2 patients were performed as simulated. The simulated window allowed observation of the expected microsurgical anatomies including tumors, vasculatures, and cranial nerves, through the predicted operative window. We could not achieve the planned tumor removal in only 3 patients. 3-D MFVI afforded high quality images of the relevant microsurgical anatomies during the surgery of SBTs. The intraoperative deja-vu effect of the simulation increased the confidence of the surgeon in the planned surgical procedures. (author)

  17. Long-term visual outcome after microsurgical removal of occipital lobe cavernomas.

    Science.gov (United States)

    Kivelev, Juri; Koskela, Elina; Setälä, Kirsi; Niemelä, Mika; Hernesniemi, Juha

    2012-08-01

    Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatment of occipital cavernomas with special emphasis on visual outcome. Of the 390 consecutive patients with cavernomas who were treated at Helsinki University Central Hospital between 1980 and 2011, 19 (5%) had occipital cavernomas. Sixteen patients (4%) were surgically treated and are included in this study. The median age was 39 years (range 3-59 years). Seven patients (56%) suffered from hemorrhage preoperatively, 5 (31%) presented with visual field deficits, 11 (69%) suffered from seizures, and 4 (25%) had multiple cavernomas. Surgery was indicated for progressive neurological deterioration. The median follow-up after surgery was 5.25 years (range 0.5-14 years). All patients underwent thorough neuroophthalmological assessment to determine visual outcome after surgery. Visual fields were classified as normal, mild homonymous visual field loss (not disturbing the patient, driving allowed), moderate homonymous visual field loss (disturbing the patient, driving prohibited), and severe visual field loss (total homonymous hemianopia or total homonymous quadrantanopia). At the last follow-up, 4 patients (25%) had normal visual fields, 6 (38%) had a mild visual field deficit, 1 (6%) complained of moderate visual field impairment, and 5 (31%) had severe homonymous visual field loss. Cavernomas seated deeper than 2 cm from the pial surface carried a 4.4-fold risk of postoperative visual field deficit relative to superficial ones (p = 0.034). Six (55%) of the 11 patients presenting with seizures were seizure-free postoperatively. Eleven (69%) of 16 patients had no disability during the long-term follow-up. Surgical removal of occipital cavernomas may carry a

  18. Microsurgical resection of ventral foramen magnum meningiomas via a far-lateral suboccipital approach

    Institute of Scientific and Technical Information of China (English)

    Zhihua Cheng; Zhilin Guo; Meixiu Ding

    2006-01-01

    BACKGROUND: In recent years some reports have been published propagating microsurgical resection of ventral foramen magnum meningiomas (VFMMs). Operative approaches to these lesions have been studied by various authors, but remain controversial.OBJECTIVE: To discuss the operative technique and outcome in patients with VFMMs who had been treatedvia a far lateral suboccipital approach.DESIGN: Retrospectively clinic case investigation. SElrING: Department of Neurosurgery, the Ninth People's Hospital, Medical School of Shanghai Jiao Tong University.PARTICIPANTS: Between January 1997 and June 2003, 10 patients were treated surgically with VFMMs in Department of Neurosurgery, the Ninth People's Hospital, Medical School of Shanghai Jiao Tong University. In the series of 10 patients, ages ranged from 37 to 72 years, mean (53±10) years, were consisted of 6 males and 4 females. All the subjects were informed of the treatment plan and agreed to join the experiment. Early symptoms included headache and upper cervical pain. The time between the first occurrence of symptoms and the diagnosis ranged from 6 months to 17 months, mean (10.3±3.4) months. Main presenting symptoms were unilateral upper extremity sensory and motor deficits in 6 cases, swallowing difficulties in 2 and spastic quadriparesis in 2. VFMMs were demonstrated as round by the computed tomographic (CT) scan and magnetic resonance imaging (MRI) in all patients. The maximum diameter of tumors ranged from 2 to 4 cm,mean (2.55±0.57) cm, including 2 cm in one case, 2.0-3.0 cm in six and 3.0-4.0 cm in three.METHODS: ①All tumors were removed via the far lateral suboccipital approach. Resection of the posterior 5 mm of the condyle was necessary in one patient whose tumors' diameter were 2 cm. The patient was situated in the lateral decubitus position. The head was fixed in a Mayfield headrest. A C-shaped incision made behind the ear 2 cm medial to the mastoid process, turning vertically down to the level C4, to

  19. A Preliminary Study on the Effects of Training Using Behavior Support Plan Quality Evaluation Guide (BSP-QE) to Improve Positive Behavioral Support Plans

    Science.gov (United States)

    Wright, Diana Browning; Mayer, G. Roy; Cook, Clayton R.; Crews, S. Dean; Kraemer, Bonnie Rawlings; Gale, Bruce

    2007-01-01

    The purpose of this research was to evaluate the effects of two trainings designed to increase the competencies of professionals to develop high quality positive behavior support plans for students that engage in problem behaviors that interfere with theirs and/or others' ability to learn. Training one consisted of training attendees on six key…

  20. High fidelity simulation based team training in urology: a preliminary interdisciplinary study of technical and nontechnical skills in laparoscopic complications management.

    Science.gov (United States)

    Lee, Jason Y; Mucksavage, Phillip; Canales, Cecilia; McDougall, Elspeth M; Lin, Sharon

    2012-04-01

    Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents. Urology residents were randomly paired with anesthesiology residents to participate in a simulation based team training scenario involving the management of 2 scripted critical events during laparoscopic radical nephrectomy, including the vasovagal response to pneumoperitoneum and renal vein injury during hilar dissection. A novel kidney surgical model and a high fidelity mannequin simulator were used for the simulation. A debriefing session followed each simulation based team training scenario. Assessments of technical and nontechnical performance were made using task specific checklists and global rating scales. A total of 16 residents participated, of whom 94% rated the simulation based team training scenario as useful for communication skill training. Also, 88% of urology residents believed that the kidney surgical model was useful for technical skill training. Urology resident training level correlated with technical performance (p=0.004) and blood loss during renal vein injury management (p=0.022) but not with nontechnical performance. Anesthesia resident training level correlated with nontechnical performance (p=0.036). Urology residents consistently rated themselves higher on nontechnical performance than did faculty (p=0.033). Anesthesia residents did not differ in the self-assessment of nontechnical performance compared to faculty assessments. Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents

  1. The Effect of Teacher Training on the Knowledge of Positive Behavior Support and the Quality of Behavior Intervention Plans: A Preliminary Study in Taiwan

    Science.gov (United States)

    Wu, Pei-Fang

    2017-01-01

    The purpose of this study was to investigate whether through a series of teacher training. The participants could acquire better knowledge on Positive Behavior Support (PBS), and develop high quality behavior intervention plans. Thirty-six teachers from three public schools participated in the study. The competency-based training consisted of 12…

  2. Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context.

    Science.gov (United States)

    Lelutiu-Weinberger, Corina; Pachankis, John E

    2017-10-01

    Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills. We conducted a 2-day training for MHPs in Bucharest. Fifty-four attended and 33 provided training evaluation data at baseline and follow-up. The majority of trainees were female (90%) and heterosexual (73%) with a mean age of 36.4 (SD = 7.7). From baseline to follow-up, trainees demonstrated a significant increase in perceived LGBT-relevant clinical skills (P LGBT-affirmative practice attitudes (P LGBT individuals (P LGBT individuals were low at both baseline and follow-up. The majority of trainees reported being highly interested in the training (84%), which they reported had prepared them to interact with and care for LGBT individuals (74%). This pilot training appeared to be effective in increasing perceived LGBT competence among participating MHPs. This type of training model needs to be tested further in a randomized controlled trial with longer follow-up periods to assess intervention durability and implementation of clinical skills. Future trainings can be incorporated into existing curricula. National accreditation bodies might consider encouraging such training as part of standard educational requirements.

  3. Positive Reinforcement Training for Blood Collection in Grizzly Bears (Ursus arctos horribilis) Results in Undetectable Elevations in Serum Cortisol Levels: A Preliminary Investigation.

    Science.gov (United States)

    Joyce-Zuniga, Nicole M; Newberry, Ruth C; Robbins, Charles T; Ware, Jasmine V; Jansen, Heiko T; Nelson, O Lynne

    2016-01-01

    Training nonhuman animals in captivity for participation in routine husbandry procedures is believed to produce a lower stress environment compared with undergoing a general anesthetic event for the same procedure. This hypothesis rests largely on anecdotal evidence that the captive subjects appear more relaxed with the trained event. Blood markers of physiological stress responses were evaluated in 4 captive grizzly bears (Ursus arctos horribilis) who were clicker-trained for blood collection versus 4 bears who were chemically immobilized for blood collection. Serum cortisol and immunoglobulin A (IgA) and plasma β-endorphin were measured as indicators of responses to stress. Plasma β-endorphin was not different between the groups. Serum IgA was undetectable in all bears. Serum cortisol was undetectable in all trained bears, whereas chemically immobilized bears had marked cortisol elevations (p bears with extensive recent immobilization experience. These findings support the use of positive reinforcement training for routine health procedures to minimize anxiety.

  4. The measurement of enhancement in mathematical abilities as a result of joint cognitive trainings in numerical and visual- spatial skills: A preliminary study

    International Nuclear Information System (INIS)

    Agus, M; Mascia, M L; Fastame, M C; Melis, V; Pilloni, M C; Penna, M P

    2015-01-01

    A body of literature shows the significant role of visual-spatial skills played in the improvement of mathematical skills in the primary school. The main goal of the current study was to investigate the impact of a combined visuo-spatial and mathematical training on the improvement of mathematical skills in 146 second graders of several schools located in Italy. Participants were presented single pencil-and-paper visuo-spatial or mathematical trainings, computerised version of the above mentioned treatments, as well as a combined version of computer-assisted and pencil-and-paper visuo-spatial and mathematical trainings, respectively. Experimental groups were presented with training for 3 months, once a week. All children were treated collectively both in computer-assisted or pencil-and-paper modalities. At pre and post-test all our participants were presented with a battery of objective tests assessing numerical and visuo-spatial abilities. Our results suggest the positive effect of different types of training for the empowerment of visuo-spatial and numerical abilities. Specifically, the combination of computerised and pencil-and-paper versions of visuo-spatial and mathematical trainings are more effective than the single execution of the software or of the pencil-and-paper treatment

  5. The measurement of enhancement in mathematical abilities as a result of joint cognitive trainings in numerical and visual- spatial skills: A preliminary study

    Science.gov (United States)

    Agus, M.; Mascia, M. L.; Fastame, M. C.; Melis, V.; Pilloni, M. C.; Penna, M. P.

    2015-02-01

    A body of literature shows the significant role of visual-spatial skills played in the improvement of mathematical skills in the primary school. The main goal of the current study was to investigate the impact of a combined visuo-spatial and mathematical training on the improvement of mathematical skills in 146 second graders of several schools located in Italy. Participants were presented single pencil-and-paper visuo-spatial or mathematical trainings, computerised version of the above mentioned treatments, as well as a combined version of computer-assisted and pencil-and-paper visuo-spatial and mathematical trainings, respectively. Experimental groups were presented with training for 3 months, once a week. All children were treated collectively both in computer-assisted or pencil-and-paper modalities. At pre and post-test all our participants were presented with a battery of objective tests assessing numerical and visuo-spatial abilities. Our results suggest the positive effect of different types of training for the empowerment of visuo-spatial and numerical abilities. Specifically, the combination of computerised and pencil-and-paper versions of visuo-spatial and mathematical trainings are more effective than the single execution of the software or of the pencil-and-paper treatment.

  6. Modified classification and single-stage microsurgical repair of posttraumatic infected massive bone defects in lower extremities.

    Science.gov (United States)

    Yang, Yun-fa; Xu, Zhong-he; Zhang, Guang-ming; Wang, Jian-wei; Hu, Si-wang; Hou, Zhi-qi; Xu, Da-chuan

    2013-11-01

    Posttraumatic infected massive bone defects in lower extremities are difficult to repair because they frequently exhibit massive bone and/or soft tissue defects, serious bone infection, and excessive scar proliferation. This study aimed to determine whether these defects could be classified and repaired at a single stage. A total of 51 cases of posttraumatic infected massive bone defect in lower extremity were included in this study. They were classified into four types on the basis of the conditions of the bone defects, soft tissue defects, and injured limb length, including Type A (without soft tissue defects), Type B (with soft tissue defects of 10 × 20 cm or less), Type C (with soft tissue defects of 10 × 20 cm or more), and Type D (with the limb shortening of 3 cm or more). Four types of single-stage microsurgical repair protocols were planned accordingly and implemented respectively. These protocols included the following: Protocol A, where vascularized fibular graft was implemented for Type A; Protocol B, where vascularized fibular osteoseptocutaneous graft was implemented for Type B; Protocol C, where vascularized fibular graft and anterior lateral thigh flap were used for Type C; and Protocol D, where limb lengthening and Protocols A, B, or C were used for Type D. There were 12, 33, 4, and 2 cases of Types A, B, C, and D, respectively, according to this classification. During the surgery, three cases of planned Protocol B had to be shifted into Protocol C; however, all microsurgical repairs were completed. With reference to Johner-Wruhs evaluation method, the total percentage of excellent and good results was 82.35% after 6 to 41 months of follow-up. It was concluded that posttraumatic massive bone defects could be accurately classified into four types on the basis of the conditions of bone defects, soft tissue coverage, and injured limb length, and successfully repaired with the single-stage repair protocols after thorough debridement. Thieme Medical

  7. Changes in frontal-parietal activation and math skills performance following adaptive number sense training: preliminary results from a pilot study.

    Science.gov (United States)

    Kesler, Shelli R; Sheau, Kristen; Koovakkattu, Della; Reiss, Allan L

    2011-08-01

    Number sense is believed to be critical for math development. It is putatively an implicitly learned skill and may therefore have limitations in terms of being explicitly trained, particularly in individuals with altered neurodevelopment. A case series study was conducted using an adaptive, computerised programme that focused on number sense and general problem-solving skills. The study was designed to investigate training effects on performance as well as brain function in a group of children with Turner syndrome who are at risk for math difficulties and altered development of math-related brain networks. Standardised measurements of math and math-related cognitive skills as well as functional magnetic resonance imaging (fMRI) were used to assess behavioural and neurobiological outcomes following training. Participants demonstrated significantly increased basic math skills, including number sense, and calculation as well as processing speed, cognitive flexibility and visual-spatial processing skills. With the exception of calculation, increased scores also were clinically significant (i.e., recovered) based on reliable change analysis. Participants additionally demonstrated significantly increased bilateral parietal lobe activation and decreased frontal-striatal and mesial temporal activation following the training programme. These findings show proof of concept for an accessible training approach that may be potentially associated with improved number sense, math and related skills, as well as functional changes in math-related neural systems, even among individuals at risk for altered brain development.

  8. The effect of auditory perception training on reading performance of the 8-9-year old female students with dyslexia: A preliminary study

    Directory of Open Access Journals (Sweden)

    Nafiseh Vatandoost

    2014-01-01

    Full Text Available Background and Aim: Dyslexia is the most common learning disability. One of the main factors have role in this disability is auditory perception imperfection that cause a lot of problems in education. We aimed to study the effect of auditory perception training on reading performance of female students with dyslexia at the third grade of elementary school.Methods: Thirty-eight female students at the third grade of elementary schools of Khomeinishahr City, Iran, were selected by multistage cluster random sampling of them, 20 students which were diagnosed dyslexic by Reading test and Wechsler test, devided randomly to two equal groups of experimental and control. For experimental group, during ten 45-minute sessions, auditory perception training were conducted, but no intervention was done for control group. An participants were re-assessed by Reading test after the intervention (pre- and post- test method. Data were analyed by covariance test.Results: The effect of auditory perception training on reading performance (81% was significant (p<0.0001 for all subtests execpt the separate compound word test.Conclusion: Findings of our study confirm the hypothesis that auditory perception training effects on students' functional reading. So, auditory perception training seems to be necessary for the students with dyslexia.

  9. Slow cortical potential Neurofeedback and self-management training in outpatient care for children with ADHD: study protocol and first preliminary results of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hanna eChristiansen

    2014-11-01

    Full Text Available Background: Treatment for children with attention deficit/hyperactivity disorder (ADHD today is predominantly pharmacological. While it is the most common treatment, it might not always be the most appropriate one. Moreover, long term effects remain unclear. Behavior therapy and non-pharmacological treatments such as neurofeedback (NF are promising alternatives, though there are no routine outpatient care/effectiveness studies yet that have included children with medication or changes in medication.Methods/design: This paper presents the protocol of a randomized controlled trial to compare the effectiveness of a Slow Cortical Potential (SCP NF protocol with self-management (SM in a high frequent outpatient care setting. Both groups (NF/SM receive a total of 30 high frequent therapy sessions. Additionally, 6 sessions are reserved for comorbid problems. The primary outcome measure is the reduction of ADHD core symptoms according to parent and teacher ratings.Preliminary Results: Untill now 58 children were included in the study (48 males, with a mean age of 8.42 (1.34 years, and a mean IQ of 110 (13.37. Conners-3 parent and teacher ratings were used to estimate core symptom change. Since the study is still ongoing, and children are in different study stages, pre-post and follow-up results are not yet available for all children included. Preliminary results suggest overall good pre-post effects, though. For parent and teacher ratings an ANOVA with repeated measures yielded overall satisfying pre-post effects (η2 .175 to .513. Differences between groups (NF vs. SM could not yet be established (p = .81.Discussion: This is the first randomized controlled trial to test the effectiveness of a NF protocol in a high frequent outpatient care setting that does not exclude children on or with changes in medication. First preliminary results show positive effects. The rationale for the trial, the design, and the strengths and limitations of the study are

  10. Microsurgical management of cerebral aneurysms based in CT angiography with three-dimensional reconstruction (3D-CTA) and without preoperative cerebral angiography

    International Nuclear Information System (INIS)

    Gonzalez-Darder, J.M.; Pesudo-Martinez, J.V.; Feliu-Tatay, R.A.

    2001-01-01

    Objective. To study the possibilities of the microsurgical management of ruptured intracranial aneurysms with the sole preoperative information provided by computed tomography angiography with three-dimensional reconstruction (3D-CTA). Methods. Patients were studied with 3D-CTA after diagnosis of subarachnoid hemorrhage. If the study had an adequate quality and revealed an aneurysm congruent with the clinical findings or neurological examination and/or with the location of the bleeding on computed tomography (CT) scan an early microsurgical clipping of the lesion was done. When the quality of the 3D-CTA study was not adequate or the quality being adequate displayed no lesions or the findings were not accurate enough to warrant direct microsurgical treatment, the patient was studied with cerebral digital substraction (DS) angiography. A total of 44 consecutive patients harboring a total of 47 intracranial aneurysms diagnosed by 3D-CTA and without preoperative DS angiography were submitted to microsurgical clipping and included in the study. Results. The overall mortality was 15.9 % and the favorable results evaluated 6 months after discharge by means of the Glasgow outcome scale reached 70.4 %. All lesions were successfully clipped. Surgery was done a mean of 4.1 days after the admission bleeding. A total of four microlesions undiagnosed by 3D-CTA were found at surgery and clipped. Postoperative DS angiography and necropsy findings were also used as control of the 3D-CTA findings but no additional information was provided excepting the finding in DS angiography of an asymptomatic intracavemous aneurysm. Therefore the sensitivity of the 3D-CTA for diagnosis of symtomatic aneurysms was 100 % and the overall sensitivity 90.4 %. Conclusions. We have reached similar results in patients operated on with or without preoperative angiography. 3D-CTA provides very valuable anatomical information, which has an additional value in the microsurgical treatment of aneurysms of the

  11. Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke: Multi-Centre, Single-Blind Randomised Control Pilot Trial

    Science.gov (United States)

    Hollands, Kristen L.; Pelton, Trudy A.; Wimperis, Andrew; Whitham, Diane; Tan, Wei; Jowett, Sue; Sackley, Catherine M.; Wing, Alan M.; Tyson, Sarah F.; Mathias, Jonathan; Hensman, Marianne; van Vliet, Paulette M.

    2015-01-01

    Objectives Given the importance of vision in the control of walking and evidence indicating varied practice of walking improves mobility outcomes, this study sought to examine the feasibility and preliminary efficacy of varied walking practice in response to visual cues, for the rehabilitation of walking following stroke. Design This 3 arm parallel, multi-centre, assessor blind, randomised control trial was conducted within outpatient neurorehabilitation services Participants Community dwelling stroke survivors with walking speed adaptability practice using visual cues are feasible and may improve mobility and balance. Future studies should continue a carefully phased approach using identified methods to improve retention. Trial Registration Clinicaltrials.gov NCT01600391 PMID:26445137

  12. Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone - A preliminary randomized controlled trial

    DEFF Research Database (Denmark)

    Brage, K; Ris Hansen, Inge; Falla, D

    2015-01-01

    -shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT......OBJECTIVE: To evaluate the effect of training and pain education vs pain education alone, on neck pain, neck muscle activity and postural sway in patients with chronic neck pain. METHODS: Twenty women with chronic neck pain were randomized to receive pain education and specific training (neck......) and three postural control tests (two-legged: eyes open and closed, one-legged: eyes open). Sway parameters were calculated. RESULTS: Fifteen participants (CTRL: eight; INV: seven) completed the study. Per protocol analyses showed a larger pain reduction (p = 0.002) for the INV group with tendencies...

  13. A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy.

    Science.gov (United States)

    Lee, Tih-Shih; Goh, Siau Juinn Alexa; Quek, Shin Yi; Phillips, Rachel; Guan, Cuntai; Cheung, Yin Bun; Feng, Lei; Teng, Stephanie Sze Wei; Wang, Chuan Chu; Chin, Zheng Yang; Zhang, Haihong; Ng, Tze Pin; Lee, Jimmy; Keefe, Richard; Krishnan, K Ranga Rama

    2013-01-01

    Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life. Previously, we reported the successful use of a novel brain-computer interface (BCI) training system in improving symptoms of attention deficit hyperactivity disorder. Here, we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly. This study investigates the safety, usability and acceptability of our BCI system to elderly, and obtains an efficacy estimate to warrant a phase III trial. Thirty-one healthy elderly were randomized into intervention (n = 15) and waitlist control arms (n = 16). Intervention consisted of an 8-week training comprising 24 half-hour sessions. A usability and acceptability questionnaire was administered at the end of training. Safety was investigated by querying users about adverse events after every session. Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after training. Feedback on the usability and acceptability questionnaire was positive. No adverse events were reported for all participants across all sessions. Though the median difference in the RBANS change scores between arms was not statistically significant, an effect size of 0.6SD was obtained, which reflects potential clinical utility according to Simon's randomized phase II trial design. Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant (Mdn = 4.0; pattention (p = 0.039), and delayed memory (pattention in healthy elderly, and appears to be safe, user-friendly and acceptable to senior users. Given the efficacy signal, a phase III trial is warranted. ClinicalTrials.gov NCT01661894.

  14. Feasibility, acceptability and preliminary psychological benefits of mindfulness meditation training in a sample of men diagnosed with prostate cancer on active surveillance: results from a randomized controlled pilot trial.

    Science.gov (United States)

    Victorson, David; Hankin, Vered; Burns, James; Weiland, Rebecca; Maletich, Carly; Sufrin, Nathaniel; Schuette, Stephanie; Gutierrez, Bruriah; Brendler, Charles

    2017-08-01

    In a pilot randomized controlled trial, examine the feasibility and preliminary efficacy of an 8-week, mindfulness training program (Mindfulness Based Stress Reduction) in a sample of men on active surveillance on important psychological outcomes including prostate cancer anxiety, uncertainty intolerance and posttraumatic growth. Men were randomized to either mindfulness (n = 24) or an attention control arm (n = 19) and completed self-reported measures of prostate cancer anxiety, uncertainty intolerance, global quality of life, mindfulness and posttraumatic growth at baseline, 8 weeks, 6 months and 12 months. Participants in the mindfulness arm demonstrated significant decreases in prostate cancer anxiety and uncertainty intolerance, and significant increases in mindfulness, global mental health and posttraumatic growth. Participants in the control condition also demonstrated significant increases in mindfulness over time. Longitudinal increases in posttraumatic growth were significantly larger in the mindfulness arm than they were in the control arm. While mindfulness training was found to be generally feasible and acceptable among participants who enrolled in the 8-week intervention as determined by completion rates and open-ended survey responses, the response rate between initial enrollment and the total number of men approached was lower than desired (47%). While larger sample sizes are necessary to examine the efficacy of mindfulness training on important psychological outcomes, in this pilot study posttraumatic growth was shown to significantly increase over time for men in the treatment group. Mindfulness training has the potential to help men cope more effectively with some of the stressors and uncertainties associated with active surveillance. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Rat allotransplantation of epigastric microsurgical flaps: a study of rejection and the immunosuppressive effect of cyclosporin A

    Directory of Open Access Journals (Sweden)

    Carramaschi Fábio R.

    2000-01-01

    Full Text Available The rejection of allotransplantation of epigastric microsurgical flaps and the effect of immunosuppression have been studied in 58 rats. Three sets of experiments were planned: (1 Wistar Furth isogenic donors and receptors (control set; (2 Brown Norway donors and Wistar Furth receptors (rejection set; and (3 Brown Norway donors and Wistar Furth immunosuppressed receptors (cyclosporin A set. Cyclosporin A (10 mg/kg/d treated rats had a transplantation survival rate of up to 30 days: 83.3% among isogenic animals and 60% among allogeneic. There was 100% rejection by the 9th day after the transplantation in allogeneic non-immunosuppressed rats. Biopsies embedded with historesin were taken from the flap and normal contralateral skin (used as control on the 3rd, 7th, 15th, and 30th days after the surgery. A quantitative study of infiltrating lymphocytes in the flaps, with and without cyclosporin A, was done by evaluating the local inflammatory infiltrate. A significant increase in the number of lymphocytes among the rejection and immunosuppressed groups was seen, as compared to the isogenic set. Local lymphocytosis in allogeneic non-immunosuppressed transplantations reached its highest level on the 3rd day after surgery, before gross findings of rejection, which could only be seen by naked eye on the 5th or 6th day. Therefore, we conclude that cyclosporin A is effective in preserving allogenic transplantation in rats. Biopsies of transplanted areas may contribute to earlier diagnosis of the need for immunosuppressive therapy.

  16. [Empathy, inter-professional collaboration, and lifelong medical learning in Spanish and Latin-American physicians-in-training who start their postgraduate training in hospitals in Spain. Preliminary outcomes].

    Science.gov (United States)

    San-Martín, Montserrat; Roig-Carrera, Helena; Villalonga-Vadell, Rosa M; Benito-Sevillano, Carmen; Torres-Salinas, Miquel; Claret-Teruel, Gemma; Robles, Bernabé; Sans-Boix, Antonia; Alcorta-Garza, Adelina; Vivanco, Luis

    2017-01-01

    To identify similarities and differences in empathy, abilities toward inter-professional collaboration, and lifelong medical learning, between Spanish and Latin-American physicians-in-training who start their posgraduate training in teaching hospitals in Spain. Observational study using self-administered questionnaires. Five teaching hospitals in the province of Barcelona, Spain. Spanish and Latin-American physicians-in-training who started their first year of post-graduate medical training. Empathy was measured using the Jefferson scale of empathy. Abilities for inter-professional collaboration were measured using the Jefferson scale attitudes towards nurse-physician collaboration. Learning was measured using the Jefferson scale of medical lifelong learning scale. From a sample of 156 physicians-in-training, 110 from Spain and 40 from Latin America, the Spanish group showed the highest empathy (pempathy and inter-professional collaboration for the whole sample (r=+0.34; pempathy in the development of inter-professional collaboration abilities. In Latin-American physicians who start posgraduate training programs, lifelong learning abilities have a positive influence on the development of other professional competencies. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  17. Intraprocedural arterial perforation during neuroendovascular therapy: Preliminary result of a dual-trained endovascular neurosurgeon in the neurosurgical hybrid operating room

    Directory of Open Access Journals (Sweden)

    Yuang-Seng Tsuei

    2018-01-01

    Conclusion: IPAP can be rescued successfully with an aggressive approach and quick conversion to backup surgery by a dual-trained endovascular neurosurgeon in the hybrid OR. The value of the hybrid OR in neuroendovascular therapy should be further investigated in the future.

  18. Treadmill Training with HAL Exoskeleton—A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy—Preliminary Study

    Science.gov (United States)

    Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A.; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

    2017-01-01

    Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies. PMID:28848377

  19. Treadmill Training with HAL Exoskeleton-A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy-Preliminary Study.

    Science.gov (United States)

    Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

    2017-01-01

    Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.

  20. General Practitioners' Perceptions on Clinical Management and Training Needs regarding the Healthcare of Community-Dwelling People with Intellectual Disability: A Preliminary Survey in Singapore.

    Science.gov (United States)

    Sajith, Sreedharan Geetha; Goh, Yen-Li; Wee, Joshua Marcus

    2017-11-01

    Studies worldwide indicate that people with intellectual disability have high risks of physical and mental morbidities, and poor quality of health care. This study was aimed at determining general practitioners' perceptions on barriers in clinical assessment and training needs with regard to the healthcare of community-dwelling people with intellectual disability. A survey questionnaire was developed specifically for the study through focus group discussions and a literature review. The study was conducted as a cross-sectional anonymous survey of private general practitioners practicing in Singapore. The survey contained questions on their experience and training needs in assessing and treating patients with intellectual disability. Forty-nine of the 272 questionnaires sent out were returned. The respondents were predominantly male general practitioners working in "solo" practices. For most general practitioners, the proportion of patients with intellectual disability ranged from 1% to 5%. Nearly 90% of general practitioners identified problems in communicating with such patients as an important barrier that affected the quality of assessment of their health conditions. Other barriers identified were behavioral issues and sensory impairments. Only one-third of the general practitioners were confident that they had sufficient knowledge of physical and mental health conditions related to patients with intellectual disability. Three-fourths of the general practitioners believed that further training in this area would be beneficial. Appropriate interventions to address barriers in assessment and management of patients with intellectual disability with further training for general practitioners may improve the standard of healthcare provided to this population group.

  1. Group Training in Interpersonal Problem-Solving Skills for Workplace Adaptation of Adolescents and Adults with Asperger Syndrome: A Preliminary Study

    Science.gov (United States)

    Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio

    2015-01-01

    Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study…

  2. Treadmill Training with HAL Exoskeleton—A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy—Preliminary Study

    Directory of Open Access Journals (Sweden)

    Matthias Sczesny-Kaiser

    2017-08-01

    Full Text Available Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD.Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT, 6-minute walk test, and timed-up-and-go test (TUG. Parameters were assessed pre and post training and 6 weeks later (follow-up.Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up.Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.

  3. Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone--A preliminary randomized controlled trial.

    Science.gov (United States)

    Brage, K; Ris, I; Falla, D; Søgaard, K; Juul-Kristensen, B

    2015-10-01

    To evaluate the effect of training and pain education vs pain education alone, on neck pain, neck muscle activity and postural sway in patients with chronic neck pain. Twenty women with chronic neck pain were randomized to receive pain education and specific training (neck-shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT) and three postural control tests (two-legged: eyes open and closed, one-legged: eyes open). Sway parameters were calculated. Fifteen participants (CTRL: eight; INV: seven) completed the study. Per protocol analyses showed a larger pain reduction (p = 0.002) for the INV group with tendencies for increased GPE (p = 0.06), reduced sternocleidomastoid activity during the CCFT (p = 0.09), reduced sway length (p = 0.09), and increased neck extensor activity (p = 0.02) during sway compared to the CTRL group. Pain education and specific training reduce neck pain more than pain education alone in patients with chronic neck pain. These results provide encouragement for a larger clinical trial to corroborate these observations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Self-Assessment of competence during post-graduate training in general medicine: A preliminary study to develop a portfolio for further education

    Science.gov (United States)

    Huenges, Bert; Woestmann, Barbara; Ruff-Dietrich, Susanne; Rusche, Herbert

    2017-01-01

    Awareness of one’s own strengths and weaknesses is a key qualification for the specialist physician. We examined how physicians undergoing specialist training in general medicine rate themselves in different areas. For this purpose, 139 participants receiving post-graduate training in general practice offered by the Medical Association of Westfalen-Lippe assessed themselves regarding their subjective confidence in 20 core competencies and 47 situations involving patient counseling in general practice. Their self-assessments were recorded on a five-point Likert scale. The study questions addressed acceptance and practicability of self-assessment, mean values, reliability, stratification and plausibility of the results in group comparison. On average participants rated their subjective confidence with 3.4 out of 5 points. The results are self-consistent (Cronbach’s alpha >0.8), although there are considerable differences among competencies and among participants. The latter can be explained partly by biographical data, which supports the plausibility of the data. Participants stated that regularly gathering data on subjective learning needs and the discussion of these needs with mentors and trainers contributes to improving their specialist training. Elements for self-assessment are suitable for integration into a postgraduate training portfolio. These should be supplemented by formative assessment procedures. PMID:29226236

  5. Preliminary report on AED deployment on the entire Air France commercial fleet: a joint venture with Paris XII University Training Programme.

    Science.gov (United States)

    Bertrand, C; Rodriguez Redington, P; Lecarpentier, E; Bellaiche, G; Michel, D; Teiger, E; Morris, W; Le Bourgeois, J P; Barthout, M

    2004-11-01

    The positive effect of early defibrillation on survival from cardiac arrest has been demonstrated. We describe the use of AEDs over 1 year following the training of flight attendants. Air France and the University of Paris XII together designed a 1 year training programme for 14000 flight attendants. The university emergency departments (SAMU) provided 250 instructors. AEDs training and certification was conducted for crew members between November 2001 and November 2002. By January 2003, all aircraft were fully equipped with AEDs. All cases of cardiac arrest that occurred during the study were reviewed comprehensively. Comments from the crew were collected. Twelve cardiac arrests were reported between November 2002 and November 2003 out of 4194 cases of emergency care delivered to passengers. Shock treatment was advised initially in 5/12 cases. The survival rate after in-flight cardiac arrest was 3/12. The survival rate at discharge from hospital following in flight shock was 2/5. No complications arose from the use of AEDs. Training by professionals gave the flight attendants confidence and allowed for the survival of two young passengers. Our study highlights the ability of flight attendants to give better onboard care for the future. The next step is to consolidate the network between in-flight care and the medical dispatch centre in Paris.

  6. A ground-based magnetic survey of Frenchman Flat, Nevada National Security Site and Nevada Test and Training Range, Nevada: data release and preliminary interpretation

    Science.gov (United States)

    Phillips, Jeffrey D.; Burton, Bethany L.; Curry-Elrod, Erika; Drellack, Sigmund

    2014-01-01

    The Nevada National Security Site (NNSS, formerly the Nevada Test Site) is located in southern Nevada approximately 105 kilometers (km) (65 miles) northwest of Las Vegas. Frenchman Flat is a sedimentary basin located on the eastern edge of NNSS and extending eastward into the adjacent Nevada Test and Training Range (NTTR).

  7. Preliminary studies on the concentration of Na+,K(+)-ATPase in skeletal muscle of draught cattle in Mozambique: effect of sex, age and training.

    Science.gov (United States)

    Veeneklaas, R J; Verkleij, C B; van Schie, B; Harun, M A S; Everts, M E

    2002-09-01

    The effect of training on the potential for work in draught cattle was assessed by measuring the Na+,K(+)-ATPase in the muscle cell membrane and the elevation in the concentration of K+ in plasma during exercise. Biopsies of the semitendinosus muscle and venous blood samples were taken from the cattle used for draught work in Mozambique. No differences were found in the plasma ion or Na+,K(+)-ATPase concentrations in samples taken from Nguni, Africander and Angoni breeds. There were no significant differences in plasma ions (Na+,K+ and Cl-) or muscle Na+,K(+)-ATPase concentrations between the Angoni males and females, although the males showed an increase in Na+,K(+)-ATPase with age, while the females showed a decrease. The increase in males might be attributed to their higher level of activity in the herds than that of females. After a training period of 15 days, a significant increase in Na+,K(+)-ATPase concentration in semitendinosus muscle was found in Angoni cattle. In females, this was significant after 8 days of training (about 30%); in males after 15 days of training (about 16%). On day 15, there was a reduction in the elevation of plasma K+ during the 2 h of draught work, indicating an increased capacity of the Na+,K+ pumps to maintain the extracellular K+ concentration in working muscles and a possible delay in the moment of fatigue.

  8. Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

    OpenAIRE

    Lelutiu-Weinberger, Corina; Pachankis, John E.

    2017-01-01

    Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills.

  9. Effects of long-term balance training with vibrotactile sensory augmentation among community-dwelling healthy older adults: a randomized preliminary study.

    Science.gov (United States)

    Bao, Tian; Carender, Wendy J; Kinnaird, Catherine; Barone, Vincent J; Peethambaran, Geeta; Whitney, Susan L; Kabeto, Mohammed; Seidler, Rachael D; Sienko, Kathleen H

    2018-01-18

    Sensory augmentation has been shown to improve postural stability during real-time balance applications. Limited long-term controlled studies have examined retention of balance improvements in healthy older adults after training with sensory augmentation has ceased. This pilot study aimed to assess the efficacy of long-term balance training with and without sensory augmentation among community-dwelling healthy older adults. Twelve participants (four males, eight females; 75.6 ± 4.9 yrs) were randomly assigned to the experimental group (n = 6) or control group (n = 6). Participants trained in their homes for eight weeks, completing three 45-min exercise sessions per week using smart phone balance trainers that provided written, graphic, and video guidance, and monitored trunk sway. During each session, participants performed six repetitions of six exercises selected from five categories (static standing, compliant surface standing, weight shifting, modified center of gravity, and gait). The experimental group received vibrotactile sensory augmentation for four of the six repetitions per exercise via the smart phone balance trainers, while the control group performed exercises without sensory augmentation. The smart phone balance trainers sent exercise performance data to a physical therapist, who recommended exercises on a weekly basis. Balance performance was assessed using a battery of clinical balance tests (Activity Balance Confidence Scale, Sensory Organization Test, Mini Balance Evaluation Systems Test, Five Times Sit to Stand Test, Four Square Step Test, Functional Reach Test, Gait Speed Test, Timed Up and Go, and Timed Up and Go with Cognitive Task) before training, after four weeks of training, and after eight weeks of training. Participants in the experimental group were able to use vibrotactile sensory augmentation independently in their homes. After training, the experimental group had significantly greater improvements in Sensory

  10. Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training.

    Science.gov (United States)

    Siddiqui, Usman T; Khan, Anjum F; Shamim, Muhammad Shahzad; Hamid, Rana Shoaib; Alam, Muhammad Mehboob; Emaduddin, Muhammad

    2014-01-01

    A noncontrast computed tomography (CT) scan remains the initial radiological investigation of choice for a patient with suspected aneurysmal subarachnoid hemorrhage (aSAH). This initial scan may be used to derive key information about the underlying aneurysm which may aid in further management. The interpretation, however, is subject to the skill and experience of the interpreting individual. The authors here evaluate the interpretation of such CT scans by different individuals at different levels of training, and in two different specialties (Radiology and Neurosurgery). Initial nonontrast CT scan of 35 patients with aSAH was evaluated independently by four different observers. The observers selected for the study included two from Radiology and two from Neurosurgery at different levels of training; a resident currently in mid training and a resident who had recently graduated from training of each specialty. Measured variables included interpreter's suspicion of presence of subarachnoid blood, side of the subarachnoid hemorrhage, location of the aneurysm, the aneurysm's proximity to vessel bifurcation, number of aneurysm(s), contour of aneurysm(s), presence of intraventricular hemorrhage (IVH), intracerebral hemorrhage (ICH), infarction, hydrocephalus and midline shift. To determine the inter-observer variability (IOV), weighted kappa values were calculated. There was moderate agreement on most of the CT scan findings among all observers. Substantial agreement was found amongst all observers for hydrocephalus, IVH, and ICH. Lowest agreement rates were seen in the location of aneurysm being supra or infra tentorial. There were, however, some noteworthy exceptions. There was substantial to almost perfect agreement between the radiology graduate and radiology resident on most CT findings. The lowest agreement was found between the neurosurgery graduate and the radiology graduate. Our study suggests that although agreements were seen in the interpretation of some of

  11. A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy.

    Directory of Open Access Journals (Sweden)

    Tih-Shih Lee

    Full Text Available Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life. Previously, we reported the successful use of a novel brain-computer interface (BCI training system in improving symptoms of attention deficit hyperactivity disorder. Here, we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly. This study investigates the safety, usability and acceptability of our BCI system to elderly, and obtains an efficacy estimate to warrant a phase III trial. Thirty-one healthy elderly were randomized into intervention (n = 15 and waitlist control arms (n = 16. Intervention consisted of an 8-week training comprising 24 half-hour sessions. A usability and acceptability questionnaire was administered at the end of training. Safety was investigated by querying users about adverse events after every session. Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS before and after training. Feedback on the usability and acceptability questionnaire was positive. No adverse events were reported for all participants across all sessions. Though the median difference in the RBANS change scores between arms was not statistically significant, an effect size of 0.6SD was obtained, which reflects potential clinical utility according to Simon's randomized phase II trial design. Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant (Mdn = 4.0; p<0.001. Specifically, there were significant improvements in immediate memory (p = 0.038, visuospatial/constructional (p = 0.014, attention (p = 0.039, and delayed memory (p<0.001 scores. Our BCI-based system shows promise in improving memory and attention in healthy

  12. A German e-learning-training in the context of early preventive intervention and child protection: preliminary findings of a pre-post evaluation.

    Science.gov (United States)

    Bressem, Kristina; Ziegenhain, Ute; Doelitzsch, Claudia; Hofer, Alexandra; Besier, Tanja; Fegert, Joerg M; Kuenster, Anne K

    2016-01-01

    In recent years, a number of government-sponsored initiatives have been implemented in Germany that are focused on early preventive intervention in child protection. In response to the need for interdisciplinary training in this area, the internet-based e-learning program "Early Preventive Intervention and Child Protection" was developed for professionals in the child welfare and health care systems working with families with infants and toddlers. The program is currently undergoing evaluation for effectiveness and user satisfaction. In a pre-post design, users are requested to complete questionnaires that assess three measures of expertise: theoretical knowledge of relevant fields, the ability to correctly identify subtle signals of infant communication, and the ability to assess maternal sensitivity. This article presents the contents of the program and the pre-training results (N = 1.294 participants). Descriptive analyses as well as Pearson correlations and Bonferroni corrections of error were conducted using the statistical program SPSS v. 21.0. The findings show that a wide range of professionals are making use of the program, and that their existing theoretical knowledge about early preventive intervention, as well as their ability to identify subtle signals of infant communication, is relatively good. However, their ability to assess maternal sensitivity, which is considered a crucial indicator for the risk of child abuse, was low. The outcome of the pre-training results indicates that professionals working in the area of child protection need to develop more capability in recognizing maternal sensitivity, in order to ensure early detection of families who are at risk and thus in need of support. Finally, the number of years of professional experience did not correlate with the scores on any of the three measures, which emphasizes the importance of providing interdisciplinary training in this area for all those working in child and family services

  13. Development and evaluation of the LiSN & learn auditory training software for deficit-specific remediation of binaural processing deficits in children: preliminary findings.

    Science.gov (United States)

    Cameron, Sharon; Dillon, Harvey

    2011-01-01

    The LiSN & Learn auditory training software was developed specifically to improve binaural processing skills in children with suspected central auditory processing disorder who were diagnosed as having a spatial processing disorder (SPD). SPD is defined here as a condition whereby individuals are deficient in their ability to use binaural cues to selectively attend to sounds arriving from one direction while simultaneously suppressing sounds arriving from another. As a result, children with SPD have difficulty understanding speech in noisy environments, such as in the classroom. To develop and evaluate the LiSN & Learn auditory training software for children diagnosed with the Listening in Spatialized Noise-Sentences Test (LiSN-S) as having an SPD. The LiSN-S is an adaptive speech-in-noise test designed to differentially diagnose spatial and pitch-processing deficits in children with suspected central auditory processing disorder. Participants were nine children (aged between 6 yr, 9 mo, and 11 yr, 4 mo) who performed outside normal limits on the LiSN-S. In a pre-post study of treatment outcomes, participants trained on the LiSN & Learn for 15 min per day for 12 weeks. Participants acted as their own control. Participants were assessed on the LiSN-S, as well as tests of attention and memory and a self-report questionnaire of listening ability. Performance on all tasks was reassessed after 3 mo where no further training occurred. The LiSN & Learn produces a three-dimensional auditory environment under headphones on the user's home computer. The child's task was to identify a word from a target sentence presented in background noise. A weighted up-down adaptive procedure was used to adjust the signal level of the target based on the participant's response. On average, speech reception thresholds on the LiSN & Learn improved by 10 dB over the course of training. As hypothesized, there were significant improvements in posttraining performance on the LiSN-S conditions

  14. Effects of resistance training on body composition and functional capacity among sarcopenic obese residents in long-term care facilities: a preliminary study.

    Science.gov (United States)

    Chiu, Shu-Ching; Yang, Rong-Sen; Yang, Rea-Jeng; Chang, Shu-Fang

    2018-01-22

    Aging-related loss of muscle and strength with increased adiposity is prevalent among older people in long-term care (LTC) facilities. Studies have shown that people with sarcopenic obesity (SO) are at high risk of declining physical performance. At present, no interventional studies on residents with SO in nursing homes have been conducted in the literature. The objectives of this study include appraising the changes in body composition and physical performance following resistance training among residents with SO in LTC facilities. This study used a quasiexperimental research design. Residents who are 60 years of age or above and have been living a sedentary lifestyle in LTC facilities for the past 3 months will be eligible for inclusion. The intervention group engaged in chair muscle strength training twice a week for 12 weeks, whereas the control group underwent the usual care. The main variables were physical parameters of being lean and fat, the strength of grip and pinch, and a functional independence measure using descriptive analysis, chi-squared test, t-test, and generalized estimating equation for statistical analysis through SPSS. A total of 64 respondents with SO completed the study. After training, total grip strength (p = 0.001) and total pinch strength (p = 0.014) of the intervention group differed significantly from those of the control group. The right grip strength of the intervention group increased by 1.71 kg (p = 0.003) and the left grip strength improved by 1.35 kg (p = 0.028) compared with baseline values. The self-care scores of the intervention group increased by 2.76 points over baseline scores, particularly for the action of dressing oneself. Although grip strength and self-care scores improved more among those in the intervention group, body fat and skeletal muscle percentages did not differ significantly between the groups after training (p > 0.05). Resistance exercises for elderly residents in LTC facilities

  15. Long-Term Facial Nerve Outcomes after Microsurgical Resection of Vestibular Schwannomas in Patients with Preoperative Facial Nerve Palsy.

    Science.gov (United States)

    Mooney, Michael A; Hendricks, Benjamin; Sarris, Christina E; Spetzler, Robert F; Almefty, Kaith K; Porter, Randall W

    2018-06-01

    Objectives  This study aimed at evaluating facial nerve outcomes in vestibular schwannoma patients presenting with preoperative facial nerve palsy. Design  A retrospective review. Setting  Single-institution cohort. Participants  Overall, 368 consecutive patients underwent vestibular schwannoma resection. Patients with prior microsurgery or radiosurgery were excluded. Main Outcome Measures  Incidence, House-Brackmann grade. Results  Of 368 patients, 9 had confirmed preoperative facial nerve dysfunction not caused by prior treatment, for an estimated incidence of 2.4%. Seven of these nine patients had Koos grade 4 tumors. Mean tumor diameter was 3.0 cm (range: 2.1-4.4 cm), and seven of nine tumors were subtotally resected. All nine patients were followed up clinically for ≥ 6 months. Of the six patients with a preoperative House-Brackmann grade of II, two improved to grade I, three were stable, and one patient worsened to grade III. Of the three patients with grade III or worse, all remained stable at last follow-up. Conclusions  Preoperative facial nerve palsy is rare in patients with vestibular schwannoma; it tends to occur in patients with relatively large lesions. Detailed long-term outcomes of facial nerve function after microsurgical resection for these patients have not been reported previously. We followed nine patients and found that eight (89%) of the nine patients had either stable or improved facial nerve outcomes after treatment. Management strategies varied for these patients, including rates of subtotal versus gross-total resection and the use of stereotactic radiosurgery in patients with residual tumor. These results can be used to help counsel patients preoperatively on expected outcomes of facial nerve function after treatment.

  16. Microsurgical Clipping of an Anterior Communicating Artery Aneurysm Using a Novel Robotic Visualization Tool in Lieu of the Binocular Operating Microscope: Operative Video.

    Science.gov (United States)

    Klinger, Daniel R; Reinard, Kevin A; Ajayi, Olaide O; Delashaw, Johnny B

    2018-01-01

    The binocular operating microscope has been the visualization instrument of choice for microsurgical clipping of intracranial aneurysms for many decades. To discuss recent technological advances that have provided novel visualization tools, which may prove to be superior to the binocular operating microscope in many regards. We present an operative video and our operative experience with the BrightMatterTM Servo System (Synaptive Medical, Toronto, Ontario, Canada) during the microsurgical clipping of an anterior communicating artery aneurysm. To the best of our knowledge, the use of this device for the microsurgical clipping of an intracranial aneurysm has never been described in the literature. The BrightMatterTM Servo System (Synaptive Medical) is a surgical exoscope which avoids many of the ergonomic constraints of the binocular operating microscope, but is associated with a steep learning curve. The BrightMatterTM Servo System (Synaptive Medical) is a maneuverable surgical exoscope that is positioned with a directional aiming device and a surgeon-controlled foot pedal. While utilizing this device comes with a steep learning curve typical of any new technology, the BrightMatterTM Servo System (Synaptive Medical) has several advantages over the conventional surgical microscope, which include a relatively unobstructed surgical field, provision of high-definition images, and visualization of difficult angles/trajectories. This device can easily be utilized as a visualization tool for a variety of cranial and spinal procedures in lieu of the binocular operating microscope. We anticipate that this technology will soon become an integral part of the neurosurgeon's armamentarium. Copyright © 2017 by the Congress of Neurological Surgeons

  17. Effects of 16-week high-intensity interval training using upper and lower body ergometers on aerobic fitness and morphological changes in healthy men: a preliminary study.

    Science.gov (United States)

    Osawa, Yusuke; Azuma, Koichiro; Tabata, Shogo; Katsukawa, Fuminori; Ishida, Hiroyuki; Oguma, Yuko; Kawai, Toshihide; Itoh, Hiroshi; Okuda, Shigeo; Matsumoto, Hideo

    2014-01-01

    It is unclear whether combined leg and arm high-intensity interval training (HIIT) improves fitness and morphological characteristics equal to those of leg-based HIIT programs. The aim of this study was to compare the effects of HIIT using leg-cycling (LC) and arm-cranking (AC) ergometers with an HIIT program using only LC. Effects on aerobic capacity and skeletal muscle were analyzed. Twelve healthy male subjects were assigned into two groups. One performed LC-HIIT (n=7) and the other LC- and AC-HIIT (n=5) twice weekly for 16 weeks. The training programs consisted of eight to 12 sets of >90% VO2 (the oxygen uptake that can be utilized in one minute) peak for 60 seconds with a 60-second active rest period. VO2 peak, watt peak, and heart rate were measured during an LC incremental exercise test. The cross-sectional area (CSA) of trunk and thigh muscles as well as bone-free lean body mass were measured using magnetic resonance imaging and dual-energy X-ray absorptiometry. The watt peak increased from baseline in both the LC (23%±38%; PHIIT program improves aerobic capacity and muscle hypertrophy in both leg and trunk muscles.

  18. In vivo porcine training model for cranial neurosurgery.

    Science.gov (United States)

    Regelsberger, Jan; Eicker, Sven; Siasios, Ioannis; Hänggi, Daniel; Kirsch, Matthias; Horn, Peter; Winkler, Peter; Signoretti, Stefano; Fountas, Kostas; Dufour, Henry; Barcia, Juan A; Sakowitz, Oliver; Westermaier, Thomas; Sabel, Michael; Heese, Oliver

    2015-01-01

    Supplemental education is desirable for neurosurgical training, and the use of human cadaver specimen and virtual reality models is routine. An in vivo porcine training model for cranial neurosurgery was introduced in 2005, and our recent experience with this unique model is outlined here. For the first time, porcine anatomy is illustrated with particular respect to neurosurgical procedures. The pros and cons of this model are described. The aim of the course was to set up a laboratory scenery imitating an almost realistic operating room in which anatomy of the brain and neurosurgical techniques in a mentored environment free from time constraints could be trained. Learning objectives of the course were to learn about the microsurgical techniques in cranial neurosurgery and the management of complications. Participants were asked to evaluate the quality and utility of the programme via standardized questionnaires by a grading scale from A (best) to E (worst). In total, 154 residents have been trained on the porcine model to date. None of the participants regarded his own residency programme as structured. The bleeding and complication management (97%), the realistic laboratory set-up (89%) and the working environment (94%) were favoured by the vast majority of trainees and confirmed our previous findings. After finishing the course, the participants graded that their skills in bone drilling, dissecting the brain and preserving cerebral vessels under microscopic magnification had improved to level A and B. In vivo hands-on courses, fully equipped with microsurgical instruments, offer an outstanding training opportunity in which bleeding management on a pulsating, vital brain represents a unique training approach. Our results have shown that education programmes still lack practical training facilities in which in vivo models may act as a complementary approach in surgical training.

  19. Lifelong exercise, but not short-term high-intensity interval training, increases GDF11, a marker of successful aging: a preliminary investigation.

    Science.gov (United States)

    Elliott, Bradley T; Herbert, Peter; Sculthorpe, Nicholas; Grace, Fergal M; Stratton, Daniel; Hayes, Lawrence D

    2017-07-01

    Lifelong exercise is associated with regulation of skeletal mass and function, reductions in frailty, and successful aging. Yet, the influence of exercise on myostatin and myostatin-interacting factors is relatively under examined in older males. Therefore, we investigated whether serum total myostatin, free myostatin, follistatin, and growth and differentiation factor 11 (GDF11) were altered following high-intensity interval training (HIIT) in a group of 13 lifelong sedentary (SED; 64 [6] years) and 11 lifelong exercising (LEX; 62 [6] years) older males. SED follistatin was moderately greater than LEX pre-HIIT (Cohen's d  = 0.66), and was largely greater post-HIIT (Cohen's d  = 1.22). The HIIT-induced increase in follistatin was large in SED (Cohen's d  = 0.82) and absent in LEX (Cohen's d  = 0.03). GDF11 was higher in LEX pre-HIIT (Cohen's d  = 0.49) and post-HIIT (Cohen's d  = 0.63) compared to SED HIIT resulted in no change to GDF11 in LEX or SED (Cohen's d  = 0.00-0.03). Peak power output and GDF11 were correlated ( r  = 0.603), independent of grouping. Differences in GDF11 with lifelong exercise training, paired with the correlation between GDF11 and peak power output, suggested that GDF11 may be a relevant myostatin-interacting peptide to successful aging in humans, and strategies to maintain this need to be further explored. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  20. Effects of 16-week high-intensity interval training using upper and lower body ergometers on aerobic fitness and morphological changes in healthy men: a preliminary study

    Directory of Open Access Journals (Sweden)

    Osawa Y

    2014-11-01

    Full Text Available Yusuke Osawa,1,2,* Koichiro Azuma,3,* Shogo Tabata,3 Fuminori Katsukawa,2 Hiroyuki Ishida,2 Yuko Oguma,2 Toshihide Kawai,4 Hiroshi Itoh,4 Shigeo Okuda,5 Hideo Matsumoto3 1Japan Society for the Promotion of Science, Graduate School of Arts and Sciences, University of Tokyo, Tokyo, Japan; 2Sports Medicine Research Center, Keio University, Kanagawa, Japan; 3Institute for Integrated Sports Medicine, School of Medicine, Keio University, Tokyo, Japan; 4Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan; 5Department of Radiology, School of Medicine, Keio University, Tokyo, Japan *Yusuke Osawa and Koichiro Azuma are co-first authors of this article Abstract: It is unclear whether combined leg and arm high-intensity interval training (HIIT improves fitness and morphological characteristics equal to those of leg-based HIIT programs. The aim of this study was to compare the effects of HIIT using leg-cycling (LC and arm-cranking (AC ergometers with an HIIT program using only LC. Effects on aerobic capacity and skeletal muscle were analyzed. Twelve healthy male subjects were assigned into two groups. One performed LC-HIIT (n=7 and the other LC- and AC-HIIT (n=5 twice weekly for 16 weeks. The training programs consisted of eight to 12 sets of >90% VO2 (the oxygen uptake that can be utilized in one minute peak for 60 seconds with a 60-second active rest period. VO2 peak, watt peak, and heart rate were measured during an LC incremental exercise test. The cross-sectional area (CSA of trunk and thigh muscles as well as bone-free lean body mass were measured using magnetic resonance imaging and dual-energy X-ray absorptiometry. The watt peak increased from baseline in both the LC (23%±38%; P<0.05 and the LC–AC groups (11%±9%; P<0.05. The CSA of the quadriceps femoris muscles also increased from baseline in both the LC (11%±4%; P<0.05 and the LC–AC groups (5%±5%; P<0.05. In contrast, increases were observed in the CSA of

  1. A-Train Aerosol Observations Preliminary Comparisons with AeroCom Models and Pathways to Observationally Based All-Sky Estimates

    Science.gov (United States)

    Redemann, J.; Livingston, J.; Shinozuka, Y.; Kacenelenbogen, M.; Russell, P.; LeBlanc, S.; Vaughan, M.; Ferrare, R.; Hostetler, C.; Rogers, R.; hide

    2014-01-01

    We have developed a technique for combining CALIOP aerosol backscatter, MODIS spectral AOD (aerosol optical depth), and OMI AAOD (absorption aerosol optical depth) retrievals for the purpose of estimating full spectral sets of aerosol radiative properties, and ultimately for calculating the 3-D distribution of direct aerosol radiative forcing. We present results using one year of data collected in 2007 and show comparisons of the aerosol radiative property estimates to collocated AERONET retrievals. Use of the recently released MODIS Collection 6 data for aerosol optical depths derived with the dark target and deep blue algorithms has extended the coverage of the multi-sensor estimates towards higher latitudes. We compare the spatio-temporal distribution of our multi-sensor aerosol retrievals and calculations of seasonal clear-sky aerosol radiative forcing based on the aerosol retrievals to values derived from four models that participated in the latest AeroCom model intercomparison initiative. We find significant inter-model differences, in particular for the aerosol single scattering albedo, which can be evaluated using the multi-sensor A-Train retrievals. We discuss the major challenges that exist in extending our clear-sky results to all-sky conditions. On the basis of comparisons to suborbital measurements, we present some of the limitations of the MODIS and CALIOP retrievals in the presence of adjacent or underlying clouds. Strategies for meeting these challenges are discussed.

  2. Effectiveness of communication skills training of nurses on the quality of life and satisfaction with healthcare professionals among newly diagnosed cancer patients: a preliminary study.

    Science.gov (United States)

    Fukui, Sakiko; Ogawa, Keiko; Yamagishi, Akemi

    2011-12-01

    The importance of effective communication skills to sustain the cancer patient quality of life (QOL) and their satisfaction with healthcare professionals is well documented. This study aims to assess the effectiveness of communication skills training (CST) of nurses for patient QOL and their satisfaction with healthcare professionals just after being diagnosed with cancer. This is a secondary analysis of a randomized controlled trial. Eight nurses, who mainly provide psychological and informational support for patients soon after they were informed of their cancer diagnosis by physicians at a cancer screening center, were randomly assigned to an experimental group attending a CST program (four nurses) or to a control group (four nurses). Eighty-nine patients with gastric, colorectal, or breast cancer were supported and assessed by either group of nurses during the study period. The effectiveness for patient QOL and their satisfaction with healthcare professionals was assessed by administering the Short Form-8 Health Survey (SF-8) and a single-item VAS three times (1 week after diagnosis: T1; 1 month after diagnosis: T2; and 3 months after diagnosis: T3). Repeated measures analysis of variance showed a group-by-time significant increase of the mental aspects of SF-8 (F=3.48; P=0.03) and satisfaction with the nurse (F=3.18; p=0.04). Our findings underscore the importance of CST for healthcare professionals to improve the QOL of patients as well as their satisfaction with these professionals. Copyright © 2010 John Wiley & Sons, Ltd.

  3. Microsurgical and Endoscopic Anatomy for Intradural Temporal Bone Drilling and Applications of the Electromagnetic Navigation System: Various Extensions of the Retrosigmoid Approach.

    Science.gov (United States)

    Matsushima, Ken; Komune, Noritaka; Matsuo, Satoshi; Kohno, Michihiro

    2017-07-01

    The use of the retrosigmoid approach has recently been expanded by several modifications, including the suprameatal, transmeatal, suprajugular, and inframeatal extensions. Intradural temporal bone drilling without damaging vital structures inside or beside the bone, such as the internal carotid artery and jugular bulb, is a key step for these extensions. This study aimed to examine the microsurgical and endoscopic anatomy of the extensions of the retrosigmoid approach and to evaluate the clinical feasibility of an electromagnetic navigation system during intradural temporal bone drilling. Five temporal bones and 8 cadaveric cerebellopontine angles were examined to clarify the anatomy of retrosigmoid intradural temporal bone drilling. Twenty additional cerebellopontine angles were dissected in a clinical setting with an electromagnetic navigation system while measuring the target registration errors at 8 surgical landmarks on and inside the temporal bone. Retrosigmoid intradural temporal bone drilling expanded the surgical exposure to allow access to the petroclival and parasellar regions (suprameatal), internal acoustic meatus (transmeatal), upper jugular foramen (suprajugular), and petrous apex (inframeatal). The electromagnetic navigation continuously guided the drilling without line of sight limitation, and its small devices were easily manipulated in the deep and narrow surgical field in the posterior fossa. Mean target registration error was less than 0.50 mm during these procedures. The combination of endoscopic and microsurgical techniques aids in achieving optimal exposure for retrosigmoid intradural temporal bone drilling. The electromagnetic navigation system had clear advantages with acceptable accuracy including the usability of small devices without line of sight limitation. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Transversus Abdominis Plane Blocks with Single-Dose Liposomal Bupivacaine in Conjunction with a Nonnarcotic Pain Regimen Help Reduce Length of Stay following Abdominally Based Microsurgical Breast Reconstruction.

    Science.gov (United States)

    Jablonka, Eric M; Lamelas, Andreas M; Kim, Julie N; Molina, Bianca; Molina, Nathan; Okwali, Michelle; Samson, William; Sultan, Mark R; Dayan, Joseph H; Smith, Mark L

    2017-08-01

    Side effects associated with use of postoperative narcotics for pain control can delay recovery after abdominally based microsurgical breast reconstruction. The authors evaluated a nonnarcotic pain control regimen in conjunction with bilateral transversus abdominis plane blocks on facilitating early hospital discharge. A retrospective analysis was performed of consecutive patients who underwent breast reconstruction using abdominally based free flaps, with or without being included in a nonnarcotic protocol using intraoperative transversus abdominis plane blockade. During this period, the use of locoregional analgesia evolved from none (control), to continuous bupivacaine infusion transversus abdominis plane and catheters, to single-dose transversus abdominis plane blockade with liposomal bupivacaine solution. Demographic factors, length of stay, inpatient opioid consumption, and complications were reported for all three groups. One hundred twenty-eight consecutive patients (182 flaps) were identified. Forty patients (62 flaps) were in the infusion-liposomal bupivacaine group, 48 (66 flaps) were in the single-dose blockade-catheter group, and 40 (54 flaps) were in the control group. The infusion-liposomal bupivacaine patients had a significantly shorter hospital stay compared with the single-dose blockade-catheter group (2.65 ± 0.66 versus 3.52 ± 0.92 days; p plane blocks performed with single injections of liposomal bupivacaine help facilitate early hospital discharge after abdominally based microsurgical breast reconstruction. A trend toward consistent discharge by postoperative day 2 was seen. This could result in significant cost savings for health care systems. Therapeutic, III.

  5. Integrating mindfulness training in school health education to promote healthy behaviors in adolescents: Feasibility and preliminary effects on exercise and dietary habits.

    Science.gov (United States)

    Salmoirago-Blotcher, Elena; Druker, Susan; Frisard, Christine; Dunsiger, Shira I; Crawford, Sybil; Meleo-Meyer, Florence; Bock, Beth; Pbert, Lori

    2018-03-01

    Whether mindfulness training (MT) could improve healthy behaviors is unknown. This study sought to determine feasibility and acceptability of integrating MT into school-based health education (primary outcomes) and to explore its possible effects on healthy behaviors (exploratory outcomes). Two high schools in Massachusetts (2014-2015) were randomized to health education plus MT (HE-MT) (one session/week for 8 weeks) or to health education plus attention control (HE-AC). Dietary habits (24-h dietary recalls) and moderate-to-vigorous physical activity (MVPA/7-day recalls) were assessed at baseline, end of treatment (EOT), and 6 months thereafter. Quantile regression and linear mixed models were used, respectively, to estimate effects on MVPA and dietary outcomes adjusting for confounders. We recruited 53 9th graders (30 HEM, 23 HEAC; average age 14.5, 60% white, 59% female). Retention was 100% (EOT) and 96% (6 months); attendance was 96% (both conditions), with moderate-to-high satisfaction ratings. Among students with higher MVPA at baseline, MVPA was higher in HE-MT vs. HE-AC at both EOT (median difference = 81 min/week, p  = 0.005) and at 6 months ( p  = 0.004). Among males, median MVPA was higher (median difference = 99 min/week) in HE-MT vs. HEAC at both EOT ( p  = 0.056) and at 6 months ( p  = 0.04). No differences were noted in dietary habits. In sum, integrating school-based MT into health education was feasible and acceptable and had promising effects on MVPA among male and more active adolescents. These findings suggest that MT may improve healthy behaviors in adolescents and deserve to be reproduced in larger, rigorous studies.

  6. Establishment of Next-Generation Neurosurgery Research and Training Laboratory with Integrated Human Performance Monitoring.

    Science.gov (United States)

    Bernardo, Antonio

    2017-10-01

    Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training. Until recently, few means have allowed surgeons to obtain integrated surgical and technological training in an operating room setting. We report on a new model, currently in use at our institution, for technologically integrated surgical training and innovation using a next-generation microneurosurgery skull base laboratory designed to recreate the setting of a working operating room. Each workstation is equipped with a 3D surgical microscope, 3D endoscope, surgical drills, operating table with a Mayfield head holder, and a complete set of microsurgical tools. The laboratory also houses a neuronavigation system, a surgical robotic, a surgical planning system, 3D visualization, virtual reality, and computerized simulation for training of surgical procedures and visuospatial skills. In addition, the laboratory is equipped with neurophysiological monitoring equipment in order to conduct research into human factors in surgery and the respective roles of workload and fatigue on surgeons' performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. A Preliminary Review of Fatigue Among Rail Staff

    OpenAIRE

    Jialin Fan; Andrew P. Smith

    2018-01-01

    Background: Fatigue is a severe problem in the rail industry, which may jeopardize train crew's health and safety. Nonetheless, a preliminary review of all empirical evidence for train crew fatigue is still lacking. The aim of the present paper is, therefore, to provide a preliminary description of occupational fatigue in the rail industry. This paper reviews the literature with the research question examining the risk factors associated with train crew fatigue, covering both papers published...

  8. Direct costs of microsurgical management of radiosurgically amenable intracranial pathology in Germany: an analysis of meningiomas, acoustic neuromas, metastases and arteriovenous malformations of less than 3 cm in diameter

    International Nuclear Information System (INIS)

    Wellis, G.; Nagel, R.; Vollmar, C.; Steiger, H.-J.

    2003-01-01

    The purpose of the analysis was to appreciate and compare the effective direct costs of microsurgical treatment of intracranial pathology potentially amenable to radiosurgery as they arose in 1998-99. Treatment costs of 127 microsurgically treated patients harboring an arteriovenous malformation (AVM), acoustic neuroma, meningioma or brain metastasis potentially amenable to radiosurgery were reviewed. Costs for the surgical procedure, ICU rare, medical and nursing care on the ward, interclinical bills (ICB) for services provided by other departments and the overhead for basic hotel service were added. For comparison gamma knife costs were calculated by dividing the global operating cost of the gamma knife centre by the number of patients treated in 1999. Average hospitalization time for the entire microsurgical patients was 15.4 + 8.6 days. The patients spent an average of 1.2 ± 2.8 days on ICU. Average operating time for all patients, including preparation, was 393 ± 118 minutes. Average costs for the microsurgical therapy were Eur 10814 ± 6108. These consisted of Eur 1417 ± 426 for the surgical procedure, Eur 1188 ± 2658 for ICU care, Eur 2333 ± 1582 for medical and nursing care on the ward, Eur 1671 ± 1433 for interclinical bills and Eur 4204 ± 2338 for basic hotel service (overhead, Eur 273 per day). 70 % of the microsurgically treated patients needed ancillary inpatient rehabilitation or radiotherapy resulting in an average additional cost for all patients of Eur 2744. Furthermore 20 % of the microsurgically treated patients required an unplanned readmission after discharge, resulting in an average additional costs for all patients of Eur 1684. Average overall costs per patient including ancillary therapy and unplanned read-missions amounted to Eur 15242. For comparison, gamma knife treatment costs per patient amounted to Eur 7920 in 1999. The current analysis showed that for established radiosurgical indications the primary costs of microsurgery

  9. Checklist for Staff Technology Training.

    Science.gov (United States)

    Anderson, Mary Alice

    1997-01-01

    Presents a planning checklist for staff technology training. Includes forming a committee and developing proposals, contacting pertinent people, handling publicity, sending invitations, distributing schedules/registration information, arranging for equipment, purchasing prizes, conducting preliminary checks on equipment and software, ordering…

  10. Focal Dystonia in Hemiplegic Upper Limb: Favorable Effect of Cervical Microsurgical DREZotomy Involving the Ventral Horn - A Report of 3 Patients.

    Science.gov (United States)

    Sindou, Marc; Georgoulis, George

    2016-01-01

    Focal dystonia in hemiplegic upper limbs is poorly responsive to medications or classical neurosurgical treatments. Only repeated botulinum toxin injections show efficacy, but in most severe cases effects are transient. Cervical DREZ lesioning, which has proven efficacious in hyperspasticity when done deeply (3-5 mm) in the dorsal horn, may have favorable effects on the dystonic component when performed down to, and including, the base of the ventral horn (5-6 mm in depth). Three patients underwent deep cervical microsurgical DREZotomy (MDT) for focal dystonia in the upper limb. Hypertonia was reduced, and sustained dystonic postures were suppressed. Residual motor function (hidden behind hypertonia) came to the surface. Cervical MDT may be a useful armamentarium for treating refractory focal dystonia in the upper limb. © 2016 S. Karger AG, Basel.

  11. Microsurgical Repair of Ruptured Aneurysms Associated with Moyamoya-Pattern Collateral Vessels of the Middle Cerebral Artery: A Report of Two Cases.

    Science.gov (United States)

    Lang, Min; Moore, Nina Z; Witek, Alex M; Kshettry, Varun R; Bain, Mark D

    2017-09-01

    Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe 2 cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. The first patient was a 61-year-old man who presented with right frontal and intraventricular hemorrhage. Angiography revealed chronic right M1 occlusion and a 3-mm spherical lenticulostriate aneurysm. The frontal lobe hematoma was evacuated to reveal the aneurysm, which was safely cauterized and resected by coagulating and dividing the lenticulostriate parent vessel. The procedure was carried out with neuronavigation guidance and intraoperative neuromonitoring. The patient was discharged with no neurologic deficits. The second patient was a 53-year-old woman who presented with subarachnoid and intracerebral hemorrhage. Computed tomography angiogram showed a 2-mm saccular MCA aneurysm. Emergency left decompressive hemicraniectomy and hematoma evacuation were performed. The aneurysm, arising from a small collateral type vessel, was safely clipped without complications. Postoperative angiography revealed absence of the superior MCA trunk with a dense network of collateral vessels at the site of the clipped aneurysm. The patient recovered well and was ambulating independently 6 months postoperatively. No rebleeding occurred in the 2 patients. Our experience suggests that patients with MCA occlusion can harbor associated aneurysms related to flow through collateral vessels and can present with hemorrhage. Microsurgical repair of these aneurysms can be performed safely to prevent rebleeding. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Basic Microvascular Anastomosis Simulation Hub Microsurgery Course: An Innovative Competency-Based Approach to Microsurgical Training for Early Year's Plastic Surgery Trainees.

    Science.gov (United States)

    Ali, Stephen

    2018-04-01

    Early year's plastic surgery trainees are faced with a large choice of microsurgery courses to select from. In the context of dwindling study budgets and busy on-call rotas, the pressure to select a high yield course that delivers value for money is of paramount importance.The Basic Microvascular Anastomosis Simulation Hub Microsurgery Course is a GBP £600 (US $790) 5-day 40-hour course based at Barts and The London School of Medicine and Dentistry increasing in popularity among junior trainees to fit this brief.

  13. Alternative Approach to Traumatic Stensen’s Duct Injuries Accompanied by Glandular Involvement: Botulinum Toxin Injection to the Gland in Conjunction with Microsurgical Repair of the Duct in an Acute Setting

    OpenAIRE

    Mert Çalış; Zeynep Öz; Hakan Uzun; Burçe Özgen; Alp Çetin3; Ali Emre Aksu

    2017-01-01

    Objective: The aim of this study was to evaluate the long-term results of a simultaneous application of botulinum toxin to the parotid gland in conjunction with the microsurgical repair of the duct in an acute setting and to encourage using botulinum toxin as a first-line option to prevent future complications associated with glandular involvement. Material and Methods: Three patients who were referred to the Plastic Surgery Clinic by the emergency room of the Hacettepe University Hospita...

  14. Preliminary Monthly Climatological Summaries

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Preliminary Local Climatological Data, recorded since 1970 on Weather Burean Form 1030 and then National Weather Service Form F-6. The preliminary climate data pages...

  15. Microvascular anastomosis simulation using a chicken thigh model: Interval versus massed training.

    Science.gov (United States)

    Schoeff, Stephen; Hernandez, Brian; Robinson, Derek J; Jameson, Mark J; Shonka, David C

    2017-11-01

    To compare the effectiveness of massed versus interval training when teaching otolaryngology residents microvascular suturing on a validated microsurgical model. Otolaryngology residents were placed into interval (n = 7) or massed (n = 7) training groups. The interval group performed three separate 30-minute practice sessions separated by at least 1 week, and the massed group performed a single 90-minute practice session. Both groups viewed a video demonstration and recorded a pretest prior to the first training session. A post-test was administered following the last practice session. At an academic medical center, 14 otolaryngology residents were assigned using stratified randomization to interval or massed training. Blinded evaluators graded performance using a validated microvascular Objective Structured Assessment of Technical Skill tool. The tool is comprised of two major components: task-specific score (TSS) and global rating scale (GRS). Participants also received pre- and poststudy surveys to compare subjective confidence in multiple aspects of microvascular skill acquisition. Overall, all residents showed increased TSS and GRS on post- versus pretest. After completion of training, the interval group had a statistically significant increase in both TSS and GRS, whereas the massed group's increase was not significant. Residents in both groups reported significantly increased levels of confidence after completion of the study. Self-directed learning using a chicken thigh artery model may benefit microsurgical skills, competence, and confidence for resident surgeons. Interval training results in significant improvement in early development of microvascular anastomosis skills, whereas massed training does not. NA. Laryngoscope, 127:2490-2494, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  16. A laser microsurgical method of cell wall removal allows detection of large-conductance ion channels in the guard cell plasma membrane

    Science.gov (United States)

    Miedema, H.; Henriksen, G. H.; Assmann, S. M.; Evans, M. L. (Principal Investigator)

    1999-01-01

    Application of patch clamp techniques to higher-plant cells has been subject to the limitation that the requisite contact of the patch electrode with the cell membrane necessitates prior enzymatic removal of the plant cell wall. Because the wall is an integral component of plant cells, and because cell-wall-degrading enzymes can disrupt membrane properties, such enzymatic treatments may alter ion channel behavior. We compared ion channel activity in enzymatically isolated protoplasts of Vicia faba guard cells with that found in membranes exposed by a laser microsurgical technique in which only a tiny portion of the cell wall is removed while the rest of the cell remains intact within its tissue environment. "Laser-assisted" patch clamping reveals a new category of high-conductance (130 to 361 pS) ion channels not previously reported in patch clamp studies on plant plasma membranes. These data indicate that ion channels are present in plant membranes that are not detected by conventional patch clamp techniques involving the production of individual plant protoplasts isolated from their tissue environment by enzymatic digestion of the cell wall. Given the large conductances of the channels revealed by laser-assisted patch clamping, we hypothesize that these channels play a significant role in the regulation of ion content and electrical signalling in guard cells.

  17. [Intraoperative magnetic resonance imaging-guided functional neuronavigation plus intraoperative neurophysiological monitoring for microsurgical resection of lesions involving hand motor area].

    Science.gov (United States)

    Miao, Xing-lu; Chen, Zhi-juan; Yang, Wei-dong; Wang, Zeng-guang; Yu, Qing; Yue, Shu-yuan; Zhang, Jian-ning

    2013-01-15

    To explore the methods and applications of intraoperative magnetic resonance imaging (iMRI)-guided functional neuronavigation plus intraoperative neurophysiological monitoring (IONM) for microsurgical resection of lesions involving hand motor area. A total of 16 patients with brain lesions adjacent to hand motor area were recruited from January 2011 to April 2012. All of them underwent neuronavigator-assisted microsurgery. Also IONM was conducted to further map hand motor area and epileptogenic focus. High-field iMRI was employed to update the anatomical and functional imaging date and verify the extent of lesion resection. Brain shifting during the functional neuronavigation was corrected by iMRI in 5 patients. Finally, total lesion resection was achieved in 13 cases and subtotal resection in 3 cases. At Months 3-12 post-operation, hand motor function improved (n = 10) or remained unchanged (n = 6). None of them had persistent neurological deficit. The postoperative seizure improvement achieved Enge II level or above in 9 cases of brain lesions complicated with secondary epilepsy. Intraoperative MRI, functional neuronavigation and neurophysiological monitoring technique are complementary in microsurgery of brain lesions involving hand motor area. Combined use of these techniques can obtain precise location of lesions and hand motor functional structures and allow a maximum resection of lesion and minimization of postoperative neurological deficits.

  18. Superfund Hazard Ranking System Training Course

    Science.gov (United States)

    The Hazard Ranking System (HRS) training course is a four and ½ day, intermediate-level course designed for personnel who are required to compile, draft, and review preliminary assessments (PAs), site inspections (SIs), and HRS documentation records/packag

  19. Language Training: English Training

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. Language Training Françoise Benz tel. 73127 language.training@cern.ch General and Professional English Courses The next session will take place: from 1st March to 25 June 2004 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957.

  20. Language Training: English Training

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch General and Professional English Courses The next session will take place: from 1st March to 25 June 2004 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957.

  1. Livebirth and utero-placental insufficiency in Papio hamadryas baboons with uterus angiosome perfused by bilateral utero-ovarian microsurgical anastomoses alone.

    Science.gov (United States)

    Beran, B; Arnolds, K; Shockley, M; Rivas, K; Medina, M; Escobar, P F; Tzakis, A; Falcone, T; Sprague, M L; Zimberg, S

    2017-09-01

    Can the baboon uterus support a gestation to livebirth with an angiosome using microsurgically anastomosed utero-ovarian vessels and lacking uterine arteries and veins? Our angiosome model allows healthy livebirth albeit with risk of fetal growth restriction and stillbirth. Uterine transplant can provide livebirth in humans, but requires a living donor to undergo a prolonged laparotomy for hysterectomy. In an attempt to avoid the time-consuming dissection of the uterine vein, our group has previously shown maintenance of baboon uterine menstrual function after ligation of the uterine vein and after ligation of both the uterine artery and uterine vein. In a 19-month timespan, three baboons underwent laparotomy to surgically alter uterine perfusion, and pregnancy outcomes were monitored after spontaneous mating in a breeding colony. Three nulligravid female Papio hamadryas baboons in a breeding colony underwent laparotomy to ligate uterine arteries and veins along with colpotomy and cervico-vaginal anastomosis. During the same surgery, the utero-ovarian arteries and veins were microsurgically transected and re-anastomosed to themselves. Intraoperative organ perfusion was confirmed with laser angiography. After a recovery period, monitoring of menstrual cycling via menstrual blood flow and sex-skin cycling occurred, as well as uterine viability via sonography and cervical biopsy. Each baboon was released to the breeding colony for spontaneous mating and pregnancies dated by menstrual calendar and compared with early ultrasound. Delivery outcomes were monitored in each including neonate weight and placental pathology. In the event of a stillbirth, the animal was returned to the breeding colony for repeat mating attempts. After achieving a livebirth, the maternal baboon was removed from the study. Each baboon in the trial underwent successful surgery with all uteri demonstrating viability and return of menstrual function within 10 weeks of surgery. Pregnancies occurred

  2. Transversus abdominis plane block reduces morphine consumption in the early postoperative period following microsurgical abdominal tissue breast reconstruction: a double-blind, placebo-controlled, randomized trial.

    Science.gov (United States)

    Zhong, Toni; Ojha, M; Bagher, Shaghayegh; Butler, Kate; Srinivas, Coimbatore; McCluskey, Stuart A; Clarke, Hance; O'Neill, Anne C; Novak, Christine B; Hofer, Stefan O P

    2014-11-01

    The analgesic efficacy of the transversus abdominis plane peripheral nerve block following abdominal tissue breast reconstruction has not been studied in a randomized controlled trial. The authors conducted a double-blind, placebo-controlled, 1:1 allocation, two-arm parallel group, superiority design, randomized controlled trial in patients undergoing microsurgical abdominally based breast reconstruction. Intraoperatively, epidural catheters were inserted under direct vision through the triangle of Petit on both sides of the abdomen into the transversus abdominis plane just before rectus fascial closure. Patients received either bupivacaine (study group) or saline (placebo group) through the catheters for 2 postoperative days. All patients received hydromorphone by means of a patient-controlled analgesic pump. The primary outcome was the difference in the parenteral opioid consumption on each postoperative day between the groups. The secondary outcome measures included the following: total in-hospital opioid; antinausea medication; pain, nausea, and sedation scores; Quality of Recovery Score; time to ambulation; and hospital stay duration. Between September of 2011 and June of 2013, 93 patients were enrolled: 49 received bupivacaine and 44 received saline. There were 11 postoperative complications (13 percent); none were related to the catheter. Primary outcomes were completed by 85 of 93 patients (91.3 percent); the mean parenteral morphine consumption was significantly reduced on postoperative day 1 in the bupivacaine group (20.7±20.1 mg) compared with 30.0±19.1 mg in the control group (p=0.02). There were no significant differences in secondary outcomes. Following abdominally based breast reconstruction, transversus abdominis plane peripheral nerve block is safe and significantly reduces morphine consumption in the early postoperative period. Therapeutic, II.

  3. Prospective double-blind preoperative pain clinic screening before microsurgical denervation of the spermatic cord in patients with testicular pain syndrome.

    Science.gov (United States)

    Oomen, Robert J A; Witjens, Annemijke C; van Wijck, Albert J M; Grobbee, Diederik E; Lock, Tycho M T W

    2014-09-01

    Testicular pain syndrome (TPS), defined as an intermittent or constant pain in one or both testicles for at least 3 months, resulting in significant reduction of daily activities, is common. Microsurgical denervation of the spermatic cord (MDSC) has been suggested as an effective treatment option. The study population comprised 180 TPS patients admitted to our outpatient urology clinic between 1999 and 2011. On 3 different occasions, patients were offered a double-blind, placebo-controlled temporary blockade of the spermatic cord. A single blockade consisted of 10 mL 2% lidocaine, 10 mL 0.25% bupivacaine, or 10 mL 0.9% sodium chloride. If the results of these blockades were positive, MDSC was offered. All MDSCs were performed by a single urologist (M.T.W.T.L.) using an inguinal approach. Pain reduction was determined at prospective follow-up. This study evaluated 180 patients. Most patients (61.1%) had undergone a scrotal or inguinal procedure. Patients had complaints during sexual activities (51.7%), sitting (37.5%), and/or cycling (36.7%); 189 randomized blockades were offered to all patients. There was a positive response in 37% and a negative response in 51%. MDSC was performed on 58 testicular units, including 3 patients with a negative outcome of the blockades. At mean follow-up of 42.8 months, 86.2% had a ≥ 50% reduction of pain and 51.7% were completely pain free. MDSC is a valuable treatment option for TPS patients because in this study 86.2% experienced a ≥ 50% reduction of pain. To prevent superfluous diagnostics and treatment, it is mandatory to follow a systematic protocol in the treatment of TPS. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  4. Different Recipient Vessels for Free Microsurgical Fibula Flaps in the Treatment of Avascular Necrosis of the Femoral Head: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Tu, Yiji; Chen, Zenggan; Lineaweaver, William Charles; Zhang, Feng

    2017-12-01

    Several recipient vessels can be used in free microsurgical fibula flaps (MFFs) for the treatment of avascular necrosis of the femoral head (ANFH). Few articles investigate the influence of different recipient vessels on outcomes of MFF for ANFH. A comprehensive literature search of databases including PubMed-Medline, Ovid-Embase, and Cochrane Library was performed to collect the related studies. The Medical Subject Headings used were "femur head necrosis" and "bone transplantation." The relevant words in title or abstract included but not limited to "fibula flap," "fibular flap," "vascularized fibula," "vascularized fibular," "free fibula," "free fibular," "femoral head necrosis," "avascular necrosis of femoral head," and "ischemic necrosis of femoral head." The methodological index for nonrandomized studies was adopted for assessing the studies included in this review. Finally, 15 studies encompassing a total of 1267 patients (1603 hips) with ANFH were pooled in the overall analysis. Recipient vessels for MFF included the ascending branch of the lateral circumflex femoral artery and vein in 8 studies, descending branch of the lateral circumflex femoral artery and vein in 2 studies, second perforating branch of the deep femoral artery and vein in 4 studies, and inferior gluteal artery and vein in 1 study. Preoperative and postoperative average Harris hip score and pooled analyses of the rate of conversion, radiographic progression, and hip surgery-related complications showed no significant difference on the outcomes of MFF on ANFH between using different recipient vessels. Different recipient vessels did not affect outcomes in MFF procedures for ANFH. High-quality randomized controlled trials and prospective studies would be necessary to clarify reliable advantages and disadvantages between different recipient vessels. Until then, surgeons are justified in using ascending branch of the lateral circumflex femoral artery and vein, descending branch of the lateral

  5. Endoscopic-assisted interhemispheric parieto-occipital transtentorial approach for microsurgical resection of a pineal region tumor: operative video and technical nuances.

    Science.gov (United States)

    Liu, James K

    2016-01-01

    The angle of the straight sinus and tentorium cerebelli can often influence the choice of surgical approach to the pineal region. The supracerebellar infratentorial approach can be technically challenging and a relative contraindication in cases where the angle of the straight sinus and tentorium is very steep. Similarly, an occipital transtentorial approach, which uses a low occipital craniotomy at the junction of the superior sagittal sinus and transverse sinus, may not provide the best trajectory to the pineal region in patients with a steep tentorium. In addition, this approach often necessitates retraction on the occipital lobe to access the tentorial incisura and pineal region, which can increase the risk of visual compromise. In this operative video, the author demonstrates an alternative route using an endoscopic-assisted interhemispheric parieto-occipital transtentorial approach to a pineal region tumor in a patient with a steep straight sinus and tentorium. The approach provided a shorter route and more direct trajectory to the tumor at the tentorial incisura, and avoided direct fixed retraction on the occipital lobe when performed using the lateral position, thereby minimizing visual complications. This video atlas demonstrates the operative technique and surgical nuances, including the application of endoscopic-assisted microsurgical resection and operative pearls for preservation of the deep cerebral veins. In summary, the parieto-occipital transtentorial approach with endoscopic assistance is an important approach in the armamentarium for surgical management of pineal region tumors. The video can be found here: https://youtu.be/Ph4veG14aTk .

  6. Language Training: French Training

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch General and Professional French Courses The next session will take place from 26 April to 02 July 2004. These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: Tel. 73127. Writing Professional Documents in French The next session will take place from 26 April to 02 July 2004. This course is designed for people with a good level of s...

  7. Language Training: French Training

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch General and Professional French Courses The next session will take place from 26 April to 02 July 2004. These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: Tel. 73127. Writing Professional Documents in French The next session will take place from 26 April to 02 July 2004. This course is designed for people with a good level...

  8. Safety and economic study of special trains

    International Nuclear Information System (INIS)

    Loscutoff, W.V.; Hall, R.J.

    1976-01-01

    A comparative evaluation is being conducted of the safety and economics of special (35 mph and less) and regular trains for shipment of spent fuels. The approach, pertinent considerations, and results to date are discussed. The preliminary conclusion is that special train requirements have potential for only a small reduction in the accident likelihood, while increasing the cost

  9. Training management

    International Nuclear Information System (INIS)

    Martin, H.D.

    1986-01-01

    The following topics to be covered in this report are: Design principles for training programmes; training methods, materials and facilities; national and international organization; training assessment and documentation; relation between supplier and customer, licensing requirements and practices. (orig.)

  10. Language Training: English Training

    CERN Document Server

    Françoise Benz

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an 'application for training' form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. General and Professional English Courses The next session will take place from 04 October 2004 to 11 February 2005 (3 weeks break at Christmas). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow, tel. 72957. Oral Expression This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be approximately 8 participants in...

  11. Effects Of Desensitization Treatment On Core-Condition Training

    Science.gov (United States)

    Fry, P. S.

    1973-01-01

    Pre- and posttest ratings on measures of helping skills such as empathy, respect, concreteness, and genuineness were obtained in the preliminary and advanced training. A significant training effect was obtained for both groups. Desensitization treatment was a significant source of variance for the experimental subjects in training. (Author/LA)

  12. Language Training - French Training

    CERN Multimedia

    HR Department

    2008-01-01

    General and Professional French Courses The next session will take place from 26 January to 3rd April 2009. These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Nathalie Dumeaux : Tel. 78144. Writing Professional Documents in French The next session will take place from 26 January to 3rd April 2009. This course is designed for people with a good level of spoken French. Duration: 30 hours Price: 660 CHF For further information and registration, please consult our Web pages: http://cern.ch/Training or contact Mrs. Nathalie Dumeaux : Tel. 78144. Nathalie Dumeaux Tel. 78144 mailto:nathalie.dumeaux@cern.ch

  13. Language Training - French Training

    CERN Multimedia

    HR Department

    2009-01-01

    General and Professional French Courses The next session will take place from 26 January to 3rd April 2009. These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Nathalie Dumeaux : Tel. 78144. Writing Professional Documents in French The next session will take place from 26 January to 3rd April 2009. This course is designed for people with a good level of spoken French. Duration: 30 hours Price: 660 CHF For further information and registration, please consult our Web pages: http://cern.ch/Training or contact Mrs. Nathalie Dumeaux : Tel. 78144. Nathalie Dumeaux Tel. 78144 mailto:nathalie.dumeaux@cern.ch

  14. Training organisation

    International Nuclear Information System (INIS)

    Andrlova, Z.

    2012-01-01

    Slovenske elektrarne considers a specific training and education of experienced experts to be a key issue. The company gradually undergoes quite demanding change in the field of education and training of the nuclear power plants staff. We have an ambitious vision - to create one of the best training organisations in Europe by the means of systematic approach to the training. (author)

  15. Collagen Conduit Versus Microsurgical Neurorrhaphy

    DEFF Research Database (Denmark)

    Boeckstyns, Michel; Sørensen, Allan Ibsen; Viñeta, Joaquin Fores

    2013-01-01

    To compare repair of acute lacerations of mixed sensory-motor nerves in humans using a collagen tube versus conventional repair.......To compare repair of acute lacerations of mixed sensory-motor nerves in humans using a collagen tube versus conventional repair....

  16. Microsurgical therapy of pituitary adenomas.

    Science.gov (United States)

    Mortini, Pietro; Barzaghi, Lina Raffaella; Albano, Luigi; Panni, Pietro; Losa, Marco

    2018-01-01

    We report the efficacy and safety of transsphenoidal microsurgery in a large and homogeneous cohort of patients with pituitary adenomas (PAs) treated at a single Institute by a single neurosurgeon. A total of 2145 consecutive patients undergoing first surgery for a PA were included: 795 (37.1%) had a nonfunctioning pituitary adenoma (NFPA), 595 (27.7%) acromegaly, 496 (23.1%) Cushing's disease, 208 (9.7%) a PRL-secreting adenoma, and 51 patients (2.4%) a TSH-secreting adenoma. Remission was achieved when strict hormonal and radiological criteria were met. Early surgical remission was achieved in 66% of acromegalic patients, 79.6% of patients with Cushing's disease, 64.4% of prolactinomas, 74.5% of patients with a TSH-secreting adenoma, and 66.9% of NFPAs. The mean (±SE) follow-up was 60.1 ± 1.3 months. The recurrence-free survival at 10 years was 78.2% in acromegalic patients, 68.1% in prolactinomas, 74.3% in Cushing's disease, 70.3% in TSH-secreting adenomas, and 75.3% in NFPAs. Preoperative hypoadrenalism recovered in 35.3%, hypogonadism in 43.3% and hypothyroidism in 37.4% of patients with impaired function before surgery. The mortality rate was 0.2% and major morbidity 2.1%. New onset hypoadrenalism occurred after surgery in 2.5% of patients at risk, hypogonadism in 4.1%, and hypothyroidism in 1.8%. Permanent diabetes insipidus (DI) occurred in 0.9% of patients. In experienced hands, transsphenoidal microsurgery for PAs achieves remission in most patients with a low complication rate. Pituitary function is preserved in most cases and can recover in more than one-third of patients with preoperative hypopituitarism.

  17. Efficacy and safety of 0.75% ropivacaine instillation into subinguinal wound in patients after bilateral microsurgical varicocelectomy: a bi-center, randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Cui WS

    2017-07-01

    Full Text Available Wan Shou Cui,1,* Yu Seob Shin,2,3,* Jae Hyung You,3 A Ram Doo,4 Kiran Kumar Soni,3 Jong Kwan Park3 1Andrology Center, Peking University First Hospital, Beijing, People’s Republic of China; 2Department of Urology, Armed Forces Capital Hospital, Seongnam, 3Department of Urology, Chonbuk National University and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Medical Device Clinical Trial Center of Chonbuk National University Hospital, Jeonju, 4Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea *These authors contributed equally to this work Objective: To evaluate the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound in patients who have undergone bilateral microsurgical varicocelectomy.Patients and methods: Eighty-five men who were screened for bilateral varicoceles from March 2015 to July 2016 were randomized for the treatment. All patients underwent inguinal varicocelectomy by general anesthesia. After ligation of the internal spermatic veins from the spermatic cord, additional delivery of testis through inguinal incision site was done to ligate external spermatic veins and gubernacular veins. Before repairing external oblique aponeurosis, 6 mL of 0.75% ropivacaine and 6 mL of normal saline were instilled under the fascia and around the funiculus (spermatic cord by a randomized and double-blind method. Visual analog scale (VAS pain score and Prince Henry Pain Score (PHPS were used for evaluating operative sites at 1, 2, 4, and 8 hours and 7 days after surgery. Safety and tolerability were evaluated throughout the course of this study by assessing adverse events.Results: A total of 55 men completed the study. Of these 55 men, 31 received instillation of ropivacaine on the left operative site, while 24 received instillation of ropivacaine on the right operative site. VAS pain scores and PHPS in

  18. ENGLISH / PIDGIN-ENGLISH (WES-KOS), PRELIMINARY GLOSSARY.

    Science.gov (United States)

    SCHNEIDER, GILBERT D.

    THIS PRELIMINARY GLOSSARY OF ENGLISH / PIDGIN-ENGLISH (WES-KOS) HAS BEEN USED IN PEACE CORPS TRAINING PROGRAMS. WES-KOS (IN USE SINCE THE 18TH CENTURY) IS USED THROUGHOUT WEST AFRICA, HOWEVER THE GLOSSES IN THIS TEXT ARE THE COMMON CULTURAL-LINGUISTIC EQUIVALENTS USED IN WEST CAMEROON AND EASTERN NIGERIA. A BRIEF STATEMENT IS GIVEN IN THE…

  19. Continuous Curvilinear Capsulorhexis Training and Non-Rhexis Related Vitreous Loss: The Specificity of Virtual Reality Simulator Surgical Training (An American Ophthalmological Society Thesis).

    Science.gov (United States)

    McCannel, Colin A

    2017-08-01

    To assess the specificity of simulation-based virtual reality ophthalmic cataract surgery training on the Eyesi ophthalmic virtual reality surgical simulator, and test the hypothesis that microsurgical motor learning is highly specific. Retrospective educational interventional case series. The rates of vitreous loss and retained lens material, and vitreous loss and retained lens material associated with an errant continuous curvilinear capsulorhexis (CCC) were assessed among 1037 consecutive cataract surgeries performed during four consecutive academic years at a teaching hospital. The data were grouped by Eyesi use and capsulorhexis intensive training curriculum (CITC) completion. The main intervention was the completion of the CITC on the Eyesi. In the Eyesi simulator experience-based stratification, the vitreous loss rate was similar in each group (chi square p=0.95) and was not preceded by an errant CCC in 86.2% for "CITC done at least once", 57.1% for "CITC not done, but some Eyesi use", and 48.9% for "none" training groups (p=4×10-5). Retained lens material overall and occurring among the errant CCC cases was similar among training groups (p=0.82 and p=0.71, respectively). Eyesi capsulorhexis training was not associated with lower vitreous loss rates overall. However, non-errant CCC associated vitreous loss was higher among those who underwent Eyesi capsulorhexis training. Training focused on the CCC portion of cataract surgery may not reduce vitreous loss unassociated with an errant CCC. It is likely that surgical training is highly specific to the task being trained. Residents may need to be trained for all surgical steps with adequate intensity to minimize overall complication rates.

  20. Language Training - French Training

    CERN Document Server

    2007-01-01

    General and Professional French Courses The next session will take place from 29 January to 30 March 2007. These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz : Tel. 73127. Writing Professional Documents in French The next session will take place from 29 January to 30 March 2007. This course is designed for people with a good level of spoken French. Duration: 30 hours Price: 660 CHF (for 8 students) For further information and registration, please consult our Web pages:   http://cern.ch/Training or contact Mrs. Benz : Tel. 73127. Writing Professional Documents in English The next session will take place from January to June 2007 (break at Easter). This course is designed for people with a good level of spoken English. Duration: 30 hours Price: 660 CHF (for 8 students) Timetable will be fixed after discussion with the students. For registratio...

  1. Language Training: English Training

    CERN Multimedia

    Françoise Benz

    2004-01-01

    General and Professional English Courses The next session will take place from 04 October 2004 to 11 February 2005 (3 weeks break at Christmas). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow, tel. 72957. Oral Expression This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be approximately 8 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) For further information, please contact Mr. Liptow, tel. 72957. Date and timetable will be fixed when there are sufficient participants enrolled. FORMATION EN LANGUES LANGUAGE TRAINING Françoise Benz 73127 langua...

  2. Language Training: English Training

    CERN Document Server

    Françoise Benz

    2004-01-01

    General and Professional English Courses The next session will take place from 04 October 2004 to 11 February 2005 (3 weeks break at Christmas). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow, tel. 72957. Oral Expression This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be approximately 8 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) For further information, please contact Mr. Liptow, tel. 72957. Date and timetable will be fixed when there are sufficient participants enrolled. FORMATION EN LANGUES LANGUAGE TRAINING Françoise Benz 73127 languag...

  3. Language Training: English Training

    CERN Multimedia

    Françoise Benz

    2004-01-01

    La prochaine session se déroulera du 04 octobre 2004 au 11 février 2005 (interruption de 3 semaines à Noël). Ces cours s'adressent à toute personne travaillant au CERN ainsi qu'à leur conjoint. Pour vous inscrire et voir tout le détail des cours proposés, consultez nos pages Web : http://cern.ch/Training Vous pouvez aussi contacter M. Liptow, tél. 72957. General and Professional English Courses The next session will take place from 04 October 2004 to 11 February 2005 (3 weeks break at Christmas). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow, tel. 72957. Oral Expression This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be approximately 8 participants ...

  4. Alternative Approach to Traumatic Stensen’s Duct Injuries Accompanied by Glandular Involvement: Botulinum Toxin Injection to the Gland in Conjunction with Microsurgical Repair of the Duct in an Acute Setting

    Directory of Open Access Journals (Sweden)

    Mert Çalış

    2017-12-01

    Full Text Available Objective: The aim of this study was to evaluate the long-term results of a simultaneous application of botulinum toxin to the parotid gland in conjunction with the microsurgical repair of the duct in an acute setting and to encourage using botulinum toxin as a first-line option to prevent future complications associated with glandular involvement. Material and Methods: Three patients who were referred to the Plastic Surgery Clinic by the emergency room of the Hacettepe University Hospital after maxillofacial trauma are reviewed in this study. Exploration of the facial nerve and Stensen’s duct was planned for all patients within the first 72 hours after their injuries. After intraoral catheterization of the Stensen’s duct through the papilla using an epidural catheter, microsurgical end-to-end anastomosis was performed. Concurrently, 100 units of botulinum toxin A was injected at standardized eight points to the parotid gland. Results: Postoperative magnetic resonance (MR sialography revealed patency in all patients at the end of postoperative first year. The mean postoperative parotid volume of the injured and non-injured sides were 19.82±10.55 cm3 and 17.79±10.98 cm3, respectively, and the results were found to be comparable. Fibrillation potentials in the postoperative electromyography recordings and clinical examination demonstrated nerve regeneration. Conclusion: Botulinum toxin A appears to be effective in treating duct injuries accompanied by glandular involvement in an acute setting, as well as in preventing long-term complications.

  5. Superfund Hazard Ranking System Training Course: Table of Contents

    Science.gov (United States)

    The Hazard Ranking System (HRS) training course is a four and ½ day, intermediate-level course designed for personnel who are required to compile, draft, and review preliminary assessments (PAs), site inspections (SIs), and HRS documentation records/packag

  6. Snake Train

    Institute of Scientific and Technical Information of China (English)

    李鲁

    1993-01-01

    The Parisian Transit Authority (RATP) has beguntesting a new train it hopes will be the 'metro① of theyear 2000': a 150-foot-long continuous tube dubbed② the'Boa.' The train is not sectioned off into cars③, thusallowing as many as 890 passengers to walk from one endof the Boa to the other. Swiveling axles beneath the train

  7. Qualification and training of quality assurance personnel

    International Nuclear Information System (INIS)

    Ribeiro da Costa, J.

    1980-01-01

    Introduction. Qualification and certification: definitions; approach of the problem. A first attempt for its solutions. The 'sample' course; results and conclusions. Planning a comprehensive program: results. Analysis and preliminary conclusions. Absorption of the know-how and planning further programs for training. Development and updating the general training course with the introduction of German experience - summary of results. General planning of a training course for quality and reliability are as for the next courses. Evaluation, grading and final results awarded to participants, as followed in QA-Training courses - certification. Future trends (tentative) - conclusions. (orig./RW)

  8. Guiding role of typical cases in clinical training for ophthalmology professional degree graduate students

    Directory of Open Access Journals (Sweden)

    Zhe Wang

    2014-05-01

    Full Text Available With the change of the concept of graduate enrollment, the recruiting proportion of clinical medicine professional degree graduate students is more and more, and the training of professional degree graduate students is increasingly focusing on practical. In our experience in clinical training for ophthalmology professional degree graduate students, increasing the ward clinical practice time is important. For particular emphasis on the guiding role of the typical cases, each professional group combined their professional characteristics of the typical cases to instruct the graduate students, training their clinical diagnosis and treatment ability, training their microsurgical techniques. From clinical medical writing, record summary, literature review, professional degree graduate students could expand their knowledge structure, practice their thesis writing ability. Based on the typical cases, expansion of knowledge coverage, they could improve the ability of diagnosis and treatment for special disease cases. In this rigorous training system, professional degree graduate students can learn by analogy, and focus on typical cases to get the most intuitive panoramic understanding of the diseases, with a minimum of time to master the most clinical knowledge, to enrich clinical experience, and to lay the foundation for future work in the assessment.

  9. Towards a Global Understanding and Standardisation of Education and Training in Microsurgery

    Directory of Open Access Journals (Sweden)

    Clement Chi Ming Leung

    2013-07-01

    Full Text Available With an increasing emphasis on microsurgery skill acquisition through simulated training, the need has been identified for standardised training programmes in microsurgery. We have reviewed microsurgery training courses available across the six continents of the World. Data was collected of relevant published output from PubMed, MEDLINE (Ovid, and EMBASE (Ovid searches, and from information available on the Internet of up to six established microsurgery course from each of the six continents of the World. Fellowships and courses that concentrate on flap harvesting rather than microsurgical techniques were excluded. We identified 27 centres offering 39 courses. Total course length ranged from 20 hours to 1,950 hours. Student-to-teacher ratios ranged from 2:1 to 8:1. Only two-thirds of courses offered in-vivo animal models. Instructions in microvascular end-to-end and end-to-side anastomoses were common, but peripheral nerve repair or free groin flap transfer were not consistently offered. Methods of assessment ranged from no formal assessment, where an instructor monitored and gave instant feedback, through immediate assessment of patency and critique on quality of repair, to delayed re-assessment of patency after a 12 to 24 hours period. Globally, training in microsurgery is heterogeneous, with variations primarily due to resource and regulation of animal experimentation. Despite some merit to diversity in curricula, there should be a global minimum standard for microsurgery training.

  10. UVISS preliminary visibility analysis

    DEFF Research Database (Denmark)

    Betto, Maurizio

    1998-01-01

    The goal of this work is to obtain a preliminary assessment of the sky visibility for anastronomical telescope located on the express pallet of the International SpaceStation (ISS)} taking into account the major constraints imposed on the instrument by the ISSattitude and structure. Part of the w......The goal of this work is to obtain a preliminary assessment of the sky visibility for anastronomical telescope located on the express pallet of the International SpaceStation (ISS)} taking into account the major constraints imposed on the instrument by the ISSattitude and structure. Part...... of the work is also to setup the kernel of a software tool for the visibility analysis thatshould be easily expandable to consider more complex strucures for future activities.This analysis is part of the UVISS assessment study and it is meant to provide elementsfor the definition and the selection...

  11. Language Training - English Training

    CERN Multimedia

    HR Department

    2009-01-01

    General and Professional English Courses The next session will take place: from 2nd March to end of June 2009 (1/2 weeks break at Easter). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Nathalie Dumeaux, tel. 78144. Oral Expression The next session will take place from 2nd March to end of June 2009 (1/2 weeks break at Easter). This course is intended for people with a good knowledge of English who want to enhance their speaking skills. There will be an average of 8 participants per class. Speaking activities will include discussions, meeting simulations, role-plays, etc., depending on the needs of the students. Duration: 30 hours Price: 660 CHF (for a minimum of 8 students) Writing Professional Documents in English The next session will take place from 2nd March to end of June 2009 (1/2 weeks break at Easter). This course is designed for people ...

  12. Language Training - English Training

    CERN Multimedia

    HR Department

    2009-01-01

    General and Professional English Courses The next session will take place: from 2nd March to end of June 2009 (1/2 weeks break at Easter). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Nathalie Dumeaux, tel. 78144. Oral Expression The next session will take place from 2nd March to end of June 2009 (1/2 weeks break at Easter). This course is intended for people with a good knowledge of English who want to enhance their speaking skills. There will be on average of 8 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. Duration: 30 hours Price: 660 CHF (for a minimum of 8 students) Writing Professional Documents in English The next session will take place from 2nd March to end of June 2009 (1/2 weeks break at Easter). This course is designed for people w...

  13. Antares: preliminary demonstrator results

    International Nuclear Information System (INIS)

    Kouchner, A.

    2000-05-01

    The ANTARES collaboration is building an undersea neutrino telescope off Toulon (Mediterranean sea) with effective area ∼ 0.1 km 2 . An extensive study of the site properties has been achieved together with software analysis in order to optimize the performance of the detector. Results are summarized here. An instrumented line, linked to shore for first time via an electro-optical cable, has been immersed late 1999. The preliminary results of this demonstrator line are reported. (author)

  14. A preliminary study

    DEFF Research Database (Denmark)

    Rostgaard Andersen, Thomas; Schmidt, Jakob Friis; Thomassen, Martin

    2014-01-01

    The effects of regular football training on glycemic control, body composition, and peak oxygen uptake (VO2 peak) were investigated in men with type 2 diabetes mellitus (T2DM). Twenty-one middle-aged men (49.8 ± 1.7 years ± SEM) with T2DM were divided into a football training group (FG; n = 12) a...

  15. Preliminary design package for solar heating and hot water system

    Science.gov (United States)

    1976-01-01

    Two prototype solar heating and hot water systems for use in single-family dwellings or commercial buildings were designed. Subsystems included are: collector, storage, transport, hot water, auxiliary energy, and government-furnished site data acquisition. The systems are designed for Yosemite, California, and Pueblo, Colorado. The necessary information to evaluate the preliminary design for these solar heating and hot water systems is presented. Included are a proposed instrumentation plan, a training program, hazard analysis, preliminary design drawings, and other information about the design of the system.

  16. Instructor training

    International Nuclear Information System (INIS)

    Yuzhakov, A.Yu.

    1995-01-01

    A SAT-based Instructor Training Course was developed and implemented at NVTC. The duration of the initial course is 3 weeks and 2 weeks for annual refresher course. NVTC has had much experience with this Instructor Training Course generating the following lessons-learned: SAT implementation needs to be supported by plant management; age of instructors; developments of training materials and conducting training at the same time; knowledge and use of the PC; English language skills; social transitioning from the NPP to the TC; motivation; workplace environment and conditions

  17. Step training in a rat model for complex aneurysmal vascular microsurgery

    Directory of Open Access Journals (Sweden)

    Martin Dan

    2015-12-01

    Full Text Available Introduction: Microsurgery training is a key step for the young neurosurgeons. Both in vascular and peripheral nerve pathology, microsurgical techniques are useful tools for the proper treatment. Many training models have been described, including ex vivo (chicken wings and in vivo (rat, rabbit ones. Complex microsurgery training include termino-terminal vessel anastomosis and nerve repair. The aim of this study was to describe a reproducible complex microsurgery training model in rats. Materials and methods: The experimental animals were Brown Norway male rats between 10-16 weeks (average 13 and weighing between 250-400g (average 320g. We performed n=10 rat hind limb replantations. The surgical steps and preoperative management are carefully described. We evaluated the vascular patency by clinical assessment-color, temperature, capillary refill. The rats were daily inspected for any signs of infections. The nerve regeneration was assessed by foot print method. Results: There were no case of vascular compromise or autophagia. All rats had long term survival (>90 days. The nerve regeneration was clinically completed at 6 months postoperative. The mean operative time was 183 minutes, and ischemia time was 25 minutes.

  18. Environmental Survey preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    1988-04-01

    This report presents the preliminary findings from the first phase of the Environmental Survey of the United States Department of Energy (DOE) Sandia National Laboratories conducted August 17 through September 4, 1987. The objective of the Survey is to identify environmental problems and areas of environmental risk associated with Sandia National Laboratories-Albuquerque (SNLA). The Survey covers all environmental media and all areas of environmental regulation. It is being performed in accordance with the DOE Environmental Survey Manual. This phase of the Survey involves the review of existing site environmental data, observations of the operations carried on at SNLA, and interviews with site personnel. 85 refs., 49 figs., 48 tabs.

  19. Ruiz Volcano: Preliminary report

    Science.gov (United States)

    Ruiz Volcano, Colombia (4.88°N, 75.32°W). All times are local (= GMT -5 hours).An explosive eruption on November 13, 1985, melted ice and snow in the summit area, generating lahars that flowed tens of kilometers down flank river valleys, killing more than 20,000 people. This is history's fourth largest single-eruption death toll, behind only Tambora in 1815 (92,000), Krakatau in 1883 (36,000), and Mount Pelée in May 1902 (28,000). The following briefly summarizes the very preliminary and inevitably conflicting information that had been received by press time.

  20. Microsurgical anatomy and clinic significance of posterior inferior cerebellar artery%小脑后下动脉的显微解剖研究及其临床意义

    Institute of Scientific and Technical Information of China (English)

    吴江; 张世明; 徐峰

    2010-01-01

    目的 研究小脑后下动脉的显微解剖,为神经外科手术提供临床解剖资料.方法 手术显微镜下观察测量20具(共40侧)人脑标本的小脑后下动脉(PICA)的起始行径、直径、主要分支、穿动脉及分布,检查PICA与脑神经根的关系.结果 40侧标本共发出PICA 35支,平均管径(1.6±0.6)mm,距离椎基底动脉汇合点平均(16±5)mm.在35支PICA中28支PICA走行在第Ⅻ脑神经根之间,7支走行在第Ⅻ脑神经根下方,32支走行在第Ⅺ脑神经根之间.结论 PICA是椎基动脉系统重要的分支,变异多,走行与脑神经关系密切,熟悉解剖结构,在后颅窝手术中予以保护具有重要意义.%Objective To study the microsurgical anatomy of the posterior inferior cerebellar artery (PICA) for neurosurgery. Methods Twenty Chinese adult brain samples (40 sides) were measured with microscope for the diameters, lengths, origins, courses, and the branches of the PICA. The relationship between the PICA and cranial nerves was also checked. Results There were 35 PICAs in 20 brain samples.The mean diameter of the PICAs was (1.6±0.6) mm, the mean length from PICAs' origin of vertebral artery to the vertebrobasilar junction was (16±5) mm. In 35 PICAs,28 PICAs go through the rootlets of Ⅻ cranial nerves,7 PICAs go inferior Ⅻ cranial nerves, and 32 PICAs go through the rootlets of Ⅺ cranial nerves. Conclusions PICA is an important branch artery with more variation and complex relationship to the cranial nerves trend in the vertebral artery system. It is necessary to master the microsurgical anatomy of PICA and to be careful protection during the neurosurgical operations.

  1. Field training

    International Nuclear Information System (INIS)

    Mumford, G.E.; Hadaway, E.H.

    1991-01-01

    Individualized, personal training can be used to increase an employee's awareness of the HSE program. Such training can stimulate personal commitment and provide personal skills that can be utilized for the benefit of the overall HSE effort. But, providing such training within our industry can be a difficult task due to the scheduling, travel arrangements, and cost associated with bringing employees from isolated, remote locations to centrally located training facilities. One method of overcoming these obstacles involves the use of field instructors to provide the training at the many, and varied number of individuals can be reached with minimal disruption to their work scheduling or to their time off. In fact, this type of on-site training is already used by some oil companies and drilling contractors with encouraging results. This paper describes one drilling contractor's experiences with such a training program. The results after eight years how that this program not only can provide and efficient, economical means of employee training, but also can have a direct application to employee motivation regarding a company's HSE effort

  2. [Teacher Training.

    Science.gov (United States)

    Palmatier, Robert A., Ed.

    1977-01-01

    This issue collects three articles concerning reading-teacher training. "Language, Failure, and Panda Bears" by Patricia M. Cunningham calls attention to dialect difficulties in the classroom and provides ideas for teacher training programs and for public schools to solve this problem. William H. Rupley, in "Improving Teacher Effectiveness in…

  3. ENGLISH TRAINING

    CERN Multimedia

    2003-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch PLACES AVAILABLE Writing Professional Documents in English This course is designed for people with a good level of spoken English who need to improve their professional writing (administrative, scientific, technical). Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) Date and timetable will be fixed when there are sufficient participants enrolled. Oral Expression This course is intended for people with a good knowledge of English who want to practise and maintain their sp...

  4. Operator training

    International Nuclear Information System (INIS)

    Wirstad, J.

    1983-12-01

    The traditional operator job is changing, which among other things has generated a need for better job training. Surprisingly increased process automation has lead to increased operator qualifications, i.e. basic job training but also up-date and rehearsal training within certain fixed intervals. There are several, similar models for instructional system development available in the literature. One model which is of special interest integrates Operator Training development and Man-Machine Interfaces development. The extent to which Systematic Operator Training has been implemented varies with branches and companies. The nuclear power branch is given as an example in the report. This branch probably represents something better than the average among the process industries.(author)

  5. Training Standardization

    International Nuclear Information System (INIS)

    Agnihotri, Newal

    2003-01-01

    The article describes the benefits of and required process and recommendations for implementing the standardization of training in the nuclear power industry in the United States and abroad. Current Information and Communication Technologies (ICT) enable training standardization in the nuclear power industry. The delivery of training through the Internet, Intranet and video over IP will facilitate this standardization and bring multiple benefits to the nuclear power industry worldwide. As the amount of available qualified and experienced professionals decreases because of retirements and fewer nuclear engineering institutions, standardized training will help increase the number of available professionals in the industry. Technology will make it possible to use the experience of retired professionals who may be interested in working part-time from a remote location. Well-planned standardized training will prevent a fragmented approach among utilities, and it will save the industry considerable resources in the long run. It will also ensure cost-effective and safe nuclear power plant operation

  6. OMEGA Upgrade preliminary design

    International Nuclear Information System (INIS)

    Craxton, R.S.

    1989-10-01

    The OMEGA laser system at the Laboratory for Laser Energetics of the University of Rochester is the only major facility in the United States capable of conducting fully diagnosed, direct-drive, spherical implosion experiments. As such, it serves as the national Laser Users Facility, benefiting scientists throughout the country. The University's participation in the National Inertial Confinement Fusion (ICF) program underwent review by a group of experts under the auspices of the National Academy of Sciences (the Happer Committee) in 1985. The Happer Committee recommended that the OMEGA laser be upgraded in energy to 30 kJ. To this end, Congress appropriated $4,000,000 for the preliminary design of the OMEGA Upgrade, spread across FY88 and FY89. This document describes the preliminary design of the OMEGA Upgrade. The proposed enhancements to the existing OMEGA facility will result in a 30-kHJ, 351-nm, 60-beam direct-drive system, with a versatile pulse-shaping facility and a 1%--2% uniformity of target drive. The Upgrade will allow scientists to explore the ignition-scaling regime, and to study target behavior that is hydrodynamically equivalent to that of targets appropriate for a laboratory microfusion facility (LMF). In addition, it will be possible to perform critical interaction experiments with large-scale-length uniformly irradiated plasmas

  7. TECHNICAL TRAINING SEMINAR

    CERN Multimedia

    Davide Vitè

    2002-01-01

    Wednesday 22 May From 14:00 to 17:00 - Training Centre Auditorium - bldg. 593, room 11 Reliability, Availability, Maintainability and Safety (RAMS) Philippe Galley, Vincent Brindejonc / LIGERON S.A., Saint Aubin, France This seminar will address Reliability, Availability, Maintainability and Safety (RAMS) engineering concepts to guarantee availability and safety of critical equipments, in particular in a high technology and R&D environment. Applications of these concepts will be presented. 14h00-14h30 Introduction to Reliability, Availability, Maintainability and Safety activities: general introduction to RAMS, basic definitions, integration of RAMS in a large project. 14h40-16h10 RAMS methodologies: Functional Analysis methodologies Preliminary Hazard Analysis Failure Mode Effects and Criticality Analysis (FMECA) Fault Tree Analysis Use of standards for Reliability predictions Reliability Block Diagrams for a system Advanced models, e.g. Markov's Graphs 16h30-17h00 Presentation of the activ...

  8. Training Attestations

    CERN Multimedia

    HR Department

    2004-01-01

    In the past, paper Training Attestations were printed during the first quarter of a New Year for Staff Members having followed courses and seminars the previous year in the context of CERN's official Training Programmes.  The attestations were sent to Divisional Training Officers (DTO's) for distribution to all Staff Members concerned within their Division. In practise many Staff Members did not find this paper useful, however some expressed a wish to be able to have access to a self-service facility in case of need. This change was discussed by the Joint Training Board (JTB) and with the DTO's during 2003 and was supported. As a consequence, following a collaboration between HR-PMD and IT-AIS, from 2004 onwards paper Training Attestations will no longer be printed and distributed as before. Those requiring a list of training followed in the past can now obtain their attestation directly from the Human Resources Toolkit (HRT) application for all training followed since 1997. https://hrt.cern...

  9. LANGUAGE TRAINING

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch FRENCH TRAINING General and Professional French Courses The next session will take place from 26 January to 02 April 2004. These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: Tel. 73127. Writing Professional Documents in French The next session will take place from 26 January to 02 April 2004. This course is designed for people wi...

  10. LANGUAGE TRAINING

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch FRENCH TRAINING General and Professional French Courses The next session will take place from 26 January to 02 April 2004. These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz : Tel. 73127. Writing Professional Documents in French The next session will take place from 26 January to 02 April 2004. This course is designed for peop...

  11. Driverless Train

    OpenAIRE

    Törnqvist, Julia; Berglund, Emma

    2017-01-01

    As automation increases in train services, this project resulted in making a driver-less train. The main purpose was to see how security can be increased. By using sensors, today’s technologies and rebuild the stations with walls on the platforms, the safety can increase for the better. This project designs a railway system consisting of a train, boom barriers and a station. The mechanical parts were made from scratch to get the system to work beneficially. The use of Arduino as a micro contro...

  12. Preliminary exploration of the postgraduate education reform in interventional radiology

    International Nuclear Information System (INIS)

    Ni Caifang; Ouyang Yong

    2012-01-01

    Interventional radiology now is facing many challenges. The education quality has declined, and the high-level professional talents have been lost. This paper aims to analyze the present situation of the postgraduate education and the relevant issues in the field of interventional radiology, and to make a preliminary exploration into how we can train the postgraduates to become qualified interventional radiologists with high comprehensive quality in order to meet the urgent requirements demanded by the development of interventional radiology. (authors)

  13. Preliminary rail access study

    International Nuclear Information System (INIS)

    1990-01-01

    The Yucca Mountain site, located on the southwestern edge of the Nevada Test Site, is an undeveloped area under investigation as a potential site for nuclear waste disposal by the US Department of Energy. The site currently lacks rail service and an existing rail right-of-way. If the site is suitable and selected for development as a disposal site, rail service is desirable to the Office of Civilian Radioactive Waste Management Program because of the potential of rail to reduce number of shipments and costs relative to highway transportation. This preliminary report is a summary of progress to date for activities to identify and evaluate potential rail options from major rail carriers in the region to the Yucca Mountain site. It is currently anticipated that the rail spur will be operational after the year 2000. 9 refs., 13 figs., 2 tabs

  14. Resuscitation training.

    OpenAIRE

    Shepherd, A.

    1995-01-01

    All physicians, dentists, nurses and health care personnel should be adequately and regularly trained in cardiopulmonary resuscitation. Guidelines for acquiring the necessary skills in basic and advanced life support are now available.

  15. Interval Training

    Science.gov (United States)

    ... you're overdoing it, slow down. As your stamina improves, challenge yourself to vary the pace. You ... exercise training modes in young and old humans. Cell Metabolism. 2017;25:581. Xie B, et al. ...

  16. The Stanford Microsurgery and Resident Training (SMaRT) Scale: validation of an on-line global rating scale for technical assessment.

    Science.gov (United States)

    Satterwhite, Thomas; Son, Ji; Carey, Joseph; Echo, Anthony; Spurling, Terry; Paro, John; Gurtner, Geoffrey; Chang, James; Lee, Gordon K

    2014-05-01

    We previously reported results of our on-line microsurgery training program, showing that residents who had access to our website significantly improved their cognitive and technical skills. In this study, we report an objective means for expert evaluators to reliably rate trainees' technical skills under the microscope, with the use of our novel global rating scale. "Microsurgery Essentials" (http://smartmicrosurgery.com) is our on-line training curriculum. Residents were randomly divided into 2 groups: 1 group reviewed this online resource and the other did not. Pre- and post-tests consisted of videotaped microsurgical sessions in which the trainee performed "microsurgery" on 3 different models: latex glove, penrose drain, and the dorsal vessel of a chicken foot. The SMaRT (Stanford Microsurgery and Resident Training) scale, consisting of 9 categories graded on a 5-point Likert scale, was used to assess the trainees. Results were analyzed with ANOVA and Student t test, with P less than 0.05 indicating statistical significance. Seventeen residents participated in the study. The SMaRT scale adequately differentiated the performance of more experienced senior residents (PGY-4 to PGY-6, total average score=3.43) from less experienced junior residents (PGY-1 to PGY-3, total average score=2.10, P0.05). Additionally, junior residents who had access to our website showed a significant increase in their graded technical performance by 0.7 points when compared to residents who did not have access to the website who showed an improvement of only 0.2 points (P=0.01). Our SMaRT scale is valid and reliable in assessing the microsurgical skills of residents and other trainees. Current trainees are more likely to use self-directed on-line education because of its easy accessibility and interactive format. Our global rating scale can help ensure residents are achieving appropriate technical milestones.

  17. Personnel Training

    International Nuclear Information System (INIS)

    Tokar, M.

    2012-01-01

    The professional training of employees for Units 3 and 4 of the Mochovce Power Plant is approaching finals. At the beginning, in particular the main control room operators were trained, later all the other employees needed for power plant commissioning and operation. In June, the second phase of the project will start; it will be focused on the new equipment of the Units under commissioning. (author)

  18. Supervisor training

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2015-01-01

    on the experience of an integrated supervisor training programme offered in Aalborg, Denmark in 2009/2010. In this programme general issues of professional supervision and the application of artistic media as a core element in the supervisory process were Integrated. It is the hope of the author that this article...... will inspire other music therapists to develop supervisor training programmes for professional music therapists and also to undertake further research into professional supervision....

  19. Treatment of Unruptured Intracranial Aneurysms and Cognitive Performance: Preliminary Results of a Prospective Clinical Trial.

    Science.gov (United States)

    Bründl, Elisabeth; Böhm, Christina; Lürding, Ralf; Schödel, Petra; Bele, Sylvia; Hochreiter, Andreas; Scheitzach, Judith; Zeman, Florian; Brawanski, Alexander; Schebesch, Karl-Michael

    2016-10-01

    Few studies have addressed the effect of treatment of unruptured intracranial aneurysm (UIA) on cognitive function. Neuropsychological assessment after UIA treatment is underreported, and prospective trials have repeatedly been demanded. In 2014, we conducted a prospective controlled study to evaluate the differences in cognitive processing caused by the treatment of anterior circulation UIAs. Thirty patients were enrolled until September 2015. Ten patients received endovascular aneurysm occlusion (EV), 10 patients were treated microsurgically (MS), and 10 patients with surgically treated degenerative lumbar spine disease (LD) served as control. All patients underwent extended standardized neuropsychological assessment before (t 1 ) and 6 weeks after treatment (t 2 ). Tests included verbal, visual, and visuospatial memory, psychomotor functioning, executive functioning, and its subdomains verbal fluency and cognitive flexibility. We statistically evaluated intragroup and intergroup changes. Intragroup comparisons and group-rate analysis showed no significant impairment in overall neuropsychological performance, either postinterventionally or postoperatively. However, the postoperative performance in cognitive processing speed, cognitive flexibility, and executive functioning was significantly worse in the MS group than in the EV (P = 0.038) and LD group (P = 0.02). Compared with the EV group, patients with MS showed significant postoperative impairment in a subtest for auditory-verbal memory (Wechsler Memory Scale, Fourth Edition, Logical Memory II; MS vs. EV P = 0.011). The MS group trended toward posttreatment impairment in subtests for verbal fluency and semantic memory (Regensburg Word Fluency Test; MS vs. EV P = 0.083) and in auditory-verbal memory (Wechsler Memory Scale, Fourth Edition, Logical Memory II; MS vs. LD P = 0.06). Our preliminary data showed no effect of anterior circulation UIA treatment on overall neuropsychological function but impaired

  20. Business System Planning Project, Preliminary System Design

    International Nuclear Information System (INIS)

    EVOSEVICH, S.

    2000-01-01

    CH2M HILL Hanford Group, Inc. (CHG) is currently performing many core business functions including, but not limited to, work control, planning, scheduling, cost estimating, procurement, training, and human resources. Other core business functions are managed by or dependent on Project Hanford Management Contractors including, but not limited to, payroll, benefits and pension administration, inventory control, accounts payable, and records management. In addition, CHG has business relationships with its parent company CH2M HILL, U.S. Department of Energy, Office of River Protection and other River Protection Project contractors, government agencies, and vendors. The Business Systems Planning (BSP) Project, under the sponsorship of the CH2M HILL Hanford Group, Inc. Chief Information Officer (CIO), have recommended information system solutions that will support CHG business areas. The Preliminary System Design was developed using the recommendations from the Alternatives Analysis, RPP-6499, Rev 0 and will become the design base for any follow-on implementation projects. The Preliminary System Design will present a high-level system design, providing a high-level overview of the Commercial-Off-The-Shelf (COTS) modules and identify internal and external relationships. This document will not define data structures, user interface components (screens, reports, menus, etc.), business rules or processes. These in-depth activities will be accomplished at implementation planning time

  1. A PRELIMINARY JUPITER MODEL

    International Nuclear Information System (INIS)

    Hubbard, W. B.; Militzer, B.

    2016-01-01

    In anticipation of new observational results for Jupiter's axial moment of inertia and gravitational zonal harmonic coefficients from the forthcoming Juno orbiter, we present a number of preliminary Jupiter interior models. We combine results from ab initio computer simulations of hydrogen–helium mixtures, including immiscibility calculations, with a new nonperturbative calculation of Jupiter's zonal harmonic coefficients, to derive a self-consistent model for the planet's external gravity and moment of inertia. We assume helium rain modified the interior temperature and composition profiles. Our calculation predicts zonal harmonic values to which measurements can be compared. Although some models fit the observed (pre-Juno) second- and fourth-order zonal harmonics to within their error bars, our preferred reference model predicts a fourth-order zonal harmonic whose absolute value lies above the pre-Juno error bars. This model has a dense core of about 12 Earth masses and a hydrogen–helium-rich envelope with approximately three times solar metallicity

  2. A PRELIMINARY JUPITER MODEL

    Energy Technology Data Exchange (ETDEWEB)

    Hubbard, W. B. [Lunar and Planetary Laboratory, The University of Arizona, Tucson, AZ 85721 (United States); Militzer, B. [Department of Earth and Planetary Science, Department of Astronomy, University of California, Berkeley, CA 94720 (United States)

    2016-03-20

    In anticipation of new observational results for Jupiter's axial moment of inertia and gravitational zonal harmonic coefficients from the forthcoming Juno orbiter, we present a number of preliminary Jupiter interior models. We combine results from ab initio computer simulations of hydrogen–helium mixtures, including immiscibility calculations, with a new nonperturbative calculation of Jupiter's zonal harmonic coefficients, to derive a self-consistent model for the planet's external gravity and moment of inertia. We assume helium rain modified the interior temperature and composition profiles. Our calculation predicts zonal harmonic values to which measurements can be compared. Although some models fit the observed (pre-Juno) second- and fourth-order zonal harmonics to within their error bars, our preferred reference model predicts a fourth-order zonal harmonic whose absolute value lies above the pre-Juno error bars. This model has a dense core of about 12 Earth masses and a hydrogen–helium-rich envelope with approximately three times solar metallicity.

  3. Training Relations

    DEFF Research Database (Denmark)

    Smith, Aja

    This thesis explores the phenomenon of horse-assisted leadership training and the manners, in which the training relations between horses, managers and facilitators were entangled with perceptions of, what “proper sociality” entailed and felt like in contemporary Danish society. The study...... is positioned at the intersection of anthropology and consumer culture research and is based upon 15 months of ethnographic fieldwork in fields, offices and conference rooms throughout Denmark in 2012 and 2013 as well as reading of emic literature and marketing material. The main argument of the thesis is...

  4. French Training

    CERN Multimedia

    Françoise Benz

    2003-01-01

    General and Professional French Courses The next session will take place: from 13 October to 19 December 2003. These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages or contact Mrs. Fontbonne: Tel. 72844. Writing Professional Documents in French This course is designed for people with a good level of spoken French. Duration: 30 hours Price: 660 CHF (for 8 students) For further information and registration, please consult our Web pages or contact Mrs. Fontbonne: Tel. 72844. Language Training Françoise Benz Tel.73127 language.training@cern.ch

  5. Pickering safeguards: a preliminary analysis

    International Nuclear Information System (INIS)

    Todd, J.L.; Hodgkinson, J.G.

    1977-05-01

    A summary is presented of thoughts relative to a systems approach for implementing international safeguards. Included is a preliminary analysis of the Pickering Generating Station followed by a suggested safeguards system for the facility

  6. Cell emulation and preliminary results.

    Science.gov (United States)

    2016-07-01

    This report details preliminary results of the testing plan implemented by the Hawaii Natural Energy Institute to evaluate Electric Vehicle (EV) battery durability and reliability under electric utility grid operations. Commercial EV battery cells ar...

  7. Utility training

    International Nuclear Information System (INIS)

    Villaros, P.E.; Luxo, Armando; Bruant, Jacques

    1977-01-01

    The study of operational training systems for electro-nuclear utilities may be conducted through two different approaches. A first analytical approach consists of determining, for each position of a given organization chart, the necessary qualifications required and the corresponding complementary training to be provided. This approach applies preferentially to existing classical systems which are converted to nuclear operation with objectives of minimum structural changes and conservation of maximum efficiency. A second synthetical approach consists of determining the specific characteristics of nuclear plant operation, then, of deducting the training contingencies and the optimized organization chart of the plant, while taking into account, at each step, the parameters linked to local conditions. This last approach is studied in some detail in the present paper, taking advantage of its better suitability to the problems raised at the first stage of an electro-nuclear program development. In this respect, the possibility offered by this apprach to coordinate the training system of a given nuclear power station personnel with the overall problem of developing a skilled industrial labor force in the country, may lead to reconsideration of some usual priorities in the economy of operation of the nuclear power plant

  8. ACADEMIC TRAINING

    CERN Multimedia

    Françoise Benz

    2002-01-01

    12, 13, 14, March LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 POSTPONED! - Modern Project Management Methods - POSTPONED! By G. Vallet / Ed. Highware, Paris, F. Academic Training Françoise Benz Secretariat Tel. 73127 francoise.benz@cern.ch

  9. Language Training

    CERN Multimedia

    Françoise Benz

    2005-01-01

    If you wish to participate in one of the following courses, please tell to your supervisor and apply electronically from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an 'application for training' form available from your Departmental Secretariat or from your DTO (Departmental Training Officer). Applications will be accepted in the order in which they are received. General and Professional English Courses The next session will take place: from end of September 2005 to middle of February 2006 (2/ 3 weeks break at Christmas). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957. Oral Expression The next session will take place from end of September to December 2005. This course is intended for people with a good knowledge of English who want to practise and maintain the...

  10. Language training

    CERN Document Server

    Françoise Benz

    2006-01-01

    If you wish to participate in one of the following courses, please tell to your supervisor and apply electronically from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an 'application for training'form available from your Departmental Secretariat or from your DTO (Departmental Training Officer). Applications will be accepted in the order in which they are received. General and Professional English Courses The next session will take place from beginning of October 2006 to beginning of February 2007 (3 weeks break at Christmas).These courses are open to all persons working on the CERN site and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Tessa Osborne, tel.16 23 40. Oral Expression The next session will take place from beginning of October 2006 to beginning of February 2007 (3 weeks break at Christmas).This course is intended for people with a goo...

  11. Language training

    CERN Multimedia

    2006-01-01

    If you wish to participate in one of the following courses, please tell to your supervisor and apply electronically from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an 'application for training' form available from your Departmental Secretariat or from your DTO (Departmental Training Officer). Applications will be accepted in the order in which they are received. General and Professional English Courses The next session will take place from beginning of October 2006 to beginning of February 2007 (3 weeks break at Christmas).These courses are open to all persons working on the CERN site and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Tessa Osborne, tel.16 23 40. Oral Expression The next session will take place from beginning of October 2006 to beginning of February 2007 (3 weeks break at Christmas).This course is intended for people with a good knowl...

  12. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    TECHNICAL TRAINING Monique Duval tel. 74924 technical.training@cern.ch Monday 9 February 2004 From 10:00 to 12:00 - IT Auditorium - bldg. 31, 3rd floor ANSOFT High-Frequency Seminar David Prestaux, Application Engineer, ANSOFT F-78535 BUC, France This Technical Training seminar will present two Ansoft application products: Ansoft HFSS and Ansoft Designer. Ansoft HFSS makes use of the Finite Element Method (FEM) to calculate field solutions from first principles. It can accurately predict all high-frequency behaviours such as dispersion, mode conversion, and losses due to materials and radiation. Ansoft Designer is a suite of design tools to fully integrate high-frequency, physics-based electromagnetic simulations into a seamless system-level simulation environment. Ansoft Designer uses a simple interface to give complete control over every design task, by a method allowing multiple solvers, Solver on Demand. • Introduction • Overview of the Ansoft Total solution • Ansoft HFSS 9...

  13. Notification: Audit of EPA's Office of Criminal Enforcement, Forensics and Training's Law Enforcement Availability Pay Reporting

    Science.gov (United States)

    Project #OA-FY18-0075, November 30, 2017. The EPA OIG plans to begin preliminary research on the EPA Office of Criminal Enforcement, Forensics and Training's (OCEFT's) law enforcement availability pay (LEAP) reporting.

  14. Anatomia microcirúrgica do hipocampo na Amígdalo-hipocampectomia seletiva sob a perspectiva da técnica de Niemeyer e método pré-operatório para maximizar a corticotomia Hippocampal microsurgical anatomy regarding the selective amygdalohippocampectomy in the Niemeyer’s technique perspective and preoperative method to maximize the corticotomy

    Directory of Open Access Journals (Sweden)

    Gustavo Rassier Isolan

    2007-12-01

    Full Text Available O conhecimento da anatomia microcirúrgica do hipocampo tem importância fundamental na cirurgia da epilepsia do lobo temporal. Uma das técnicas mais utilizadas na cirurgia da epilepsia é a técnica de Niemeyer. OBJETIVO: Descrever em detalhes a anatomia do hipocampo e mostrar uma técnica na qual pontos de referências anatômicos pré-operatórios visualizados na RNM são usados para guiar a corticotomia. MÉTODO: Foram utilizados 20 hemisférios cerebrais e 8 cadáveres para dissecções anatômicas microcirúrgicas do lobo temporal e hipocampo para identificação e descrição das principais estruturas do hipocampo. Foram estudados prospectivamente 32 pacientes com epilepsia do lobo temporal refratários ao tratamento clínico submetidos a amígdalo-hipocampectomia seletiva pela técnica de Niemeyer três parâmetros anatômicos foram mensurados na RNM pré operatória e transferidos para o ato cirúrgico. RESULTADOS: O hipocampo foi dividido em cabeça, corpo e cauda e sua anatomia microcirúrgica descrita em detalhes. As medidas adquiridas são apresentadas e discutidas. CONCLUSÃO: A complexa anatomia do hipocampo pode ser entendida de uma forma tridimensional durante dissecções microcirúrgicas. As medidas pré-operatórias mostraram-se guias anatômicos úteis para corticotomia na técnica de Niemeyer.The deep knowledge of hippocampal microsurgical anatomy is paramount in epilepsy surgery. One of the most used techniques is those proposed by Niemeyer. PURPOSE: To describe the hippocampal anatomy in details and to present a technique which preoperative anatomical points in MRI are identified to guide the corticotomy. METHOD: Microsurgical dissections were performed in twenty brain hemispheres and eight cadaveric heads to identify temporal lobe and hippocampus structures. Thirty two patients with drug-resistent temporal lobe epilepsy underwent a selective amygdalohippocampectomy with Niemeyer’s technique being measured three

  15. Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery.

    Science.gov (United States)

    Dang, Yalong; Waxman, Susannah; Wang, Chao; Parikh, Hardik A; Bussel, Igor I; Loewen, Ralitsa T; Xia, Xiaobo; Lathrop, Kira L; Bilonick, Richard A; Loewen, Nils A

    2017-05-09

    Increasing prevalence and cost of glaucoma have increased the demand for surgeons well trained in newer, microincisional surgery. These procedures occur in a highly confined space, making them difficult to learn by observation or assistance alone as is currently done. We hypothesized that our ex vivo outflow model is sensitive enough to allow computing individual learning curves to quantify progress and refine techniques. Seven trainees performed nine trabectome-mediated ab interno trabeculectomies in pig eyes (n = 63). An expert surgeon rated the procedure using an Operating Room Score (ORS). The extent of outflow beds accessed was measured with canalograms. Data was fitted using mixed effect models. ORS reached a half-maximum on an asymptote after only 2.5 eyes. Surgical time decreased by 1.4 minutes per eye in a linear fashion. The ablation arc followed an asymptotic function with a half-maximum inflection point after 5.3 eyes. Canalograms revealed that this progress did not correlate well with improvement in outflow, suggesting instead that about 30 eyes are needed for true mastery. This inexpensive pig eye model provides a safe and effective microsurgical training model and allows objective quantification of outcomes for the first time.

  16. Sports Training

    Science.gov (United States)

    1988-01-01

    Practitioners of martial arts have long seen a need for a precise method of measuring the power of a karate kick or a boxer's punch in training and competition. Impax sensor is a piezoelectric film less than one thousandth of an inch thick, yet extremely durable. They give out a voltage impulse when struck, the greater the force of impact, the higher the voltage. The impulse is transmitted to a compact electronics package where voltage is translated into a force-pounds reading shown on a digital display. Impax, manufactured by Impulse Technology, Inc. is used by martial arts instructors, practitioners, U.S. Olympic Committee Training Center, football blocking sleds, and boxers as well as police defensive tactics, providing a means of evaluating the performance of recruits.

  17. Introducing handheld computing into a residency program: preliminary results from qualitative and quantitative inquiry.

    OpenAIRE

    Manning, B.; Gadd, C. S.

    2001-01-01

    Although published reports describe specific handheld computer applications in medical training, we know very little yet about how, and how well, handheld computing fits into the spectrum of information resources available for patient care and physician training. This paper reports preliminary quantitative and qualitative results from an evaluation study designed to track changes in computer usage patterns and computer-related attitudes before and after introduction of handheld computing. Pre...

  18. Highly Realistic Training for Navy Corpsmen: A Follow-up Assessment

    Science.gov (United States)

    2017-10-12

    based training for military medical providers. One such training is highly realistic training. Based on the success of the Infantry Immersion ...observation with minimal participation improves paediatric emergency medicine knowledge, skills and confidence. Emergency Medicine Journal , 32(3), 195... immersive training for Navy corpsmen: Preliminary results. Military Medicine, 179(12), 1439–1443. Booth-Kewley, S., McWhorter, S. K., Dell’Acqua, R

  19. Language Training

    CERN Multimedia

    HR Department

    Permanence A "permanence" for language Training has been set up. If anyone has a question or requires information on any aspect of English or French training please come to our office 5 4-016 at the following times. Lucette Fournier - French courses Monday 13.30 - 15.30 Tuesday\t10.30 - 12.30 Tessa Osborne - English courses Wednesday\t12.00 - 14.00 Thursday\t11.00 - 13.00   New courses Specific English and French courses - Exam preparation/ We are now offering specific courses in English and French leading to a recognised external examination (e.g. Cambridge, DELF, DALF). If you are interested in following one of these courses and have at least an upper intermediate level of English or French, please enrol through the following link:  English courses French courses Or contact: Tessa Osborne 72957 (English courses) Lucette Fournier 73483 (French courses) Language Training Nathalie Dumeaux Tel. 78144 nathalie.dumeaux@cern.ch

  20. Language Training

    CERN Multimedia

    HR Department

    2009-01-01

    PermanenceA "permanence" for language Training has been set up. If anyone has a question or requires information on any aspect of English or French training please come to our office 5 4-016 at the following times. Lucette Fournier French courses Monday 13.30 - 15.30 Tuesday\t10.30 - 12.30 Tessa Osborne English courses Wednesday\t12.00 - 14.00 Thursday\t11.00 - 13.00 New courses Specific English and French courses - Exam preparation/ We are now offering specific courses in English and French leading to a recognised external examination (e.g. Cambridge, DELF and BULATS). If you are interested in following one of these courses and have at least an upper intermediate level of English or French, please enrol through the following link: http://English courses http://French courses Or contact: Tessa Osborne 72957 (English courses) Lucette Fournier 73483 (French courses) Language Training Nathalie Dumeaux Tel. 78144 mailto:nathalie.dumeaux@cern.ch

  1. Evaluation of train-speed control algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Slavik, M.M. [BKS Advantech (Pty.) Ltd., Pretoria (South Africa)

    2000-07-01

    A relatively simple and fast simulator has been developed and used for the preliminary testing of train cruise-control algorithms. The simulation is done in software on a PC. The simulator is used to gauge the consequences and feasibility of a cruise-control strategy prior to more elaborate testing and evaluation. The tool was used to design and pre-test a train-cruise control algorithm called NSS, which does not require knowledge of exact train mass, vertical alignment, or actual braking force. Only continuous measurements on the speed of the train and electrical current are required. With this modest input, the NSS algorithm effected speed changes smoothly and efficiently for a wide range of operating conditions. (orig.)

  2. Towards a Global Understanding and Standardisation of Education and Training in Microsurgery

    Directory of Open Access Journals (Sweden)

    Clement Chi Ming Leung

    2013-07-01

    Full Text Available With an increasing emphasis on microsurgery skill acquisition through simulated training, the need has been identified for standardised training programmes in microsurgery. We have reviewed microsurgery training courses available across the six continents of the World. Data was collected of relevant published output from PubMed, MEDLINE (Ovid, and EMBASE (Ovid searches, and from information available on the Internet of up to six established microsurgery course from each of the six continents of the World. Fellowships and courses that concentrate on flap harvesting rather than microsurgical techniques were excluded. We identified 27 cen­tres offering 39 courses. Total course length ranged from 20 hours to 1,950 hours. Student­to­teacher ratios ranged from 2:1 to 8:1. Only two­thirds of courses offered in-vivo animal models. Instructions in microvascular end­to­end and end­to­side anastomoses were common, but peripheral nerve repair or free groin flap transfer were not consistently offered. Methods of assessment ranged from no formal assessment, where an instructor monitored and gave instant feedback, through immediate assessment of patency and critique on quality of repair, to delayed re­assessment of patency after a 12 to 24 hours period. Globally, training in micro­surgery is heterogeneous, with variations primarily due to resource and regulation of animal experimentation. Despite some merit to diversity in curricula, there should be a global min­imum standard for microsurgery training.

  3. Preliminary design county plan Zeeland

    International Nuclear Information System (INIS)

    1987-01-01

    The preliminary design 'Streekplan Zeeland' (Country plan Zeeland, with regard to the location of additional nuclear power plants in Zeeland, the Netherlands) has passed through a consultation and participation round. Thereupon 132 reactions have been received. These have been incorporated and answered in two notes. This proposal deals with the principal points of the preliminary design and treats also the remarks of the committees Environmental (town and country) Planning (RO), Provincial (town and country) Planning Committee (PPC) and Association of Communities of Zeeland (VZG), on the reply notes. The preliminary design with the modifications, collected in appendix 3, is proposed to be the starting point in the drawing-up of the design-country-plan. This design subsequently will pass the formal country-plan procedure. (author). 1 fig

  4. North Korean refugee doctors' preliminary examination scores

    Directory of Open Access Journals (Sweden)

    Sung Uk Chae

    2016-12-01

    Full Text Available Purpose Although there have been studies emphasizing the re-education of North Korean (NK doctors for post-unification of the Korean Peninsula, study on the content and scope of such re-education has yet to be conducted. Researchers intended to set the content and scope of re-education by a comparative analysis for the scores of the preliminary examination, which is comparable to the Korean Medical Licensing Examination (KMLE. Methods The scores of the first and second preliminary exams were analyzed by subject using the Wilcoxon signed rank test. The passing status of the group of NK doctors for KMLE in recent 3 years were investigated. The multiple-choice-question (MCQ items of which difficulty indexes of NK doctors were lower than those of South Korean (SK medical students by two times of the standard deviation of the scores of SK medical students were selected to investigate the relevant reasons. Results The average scores of nearly all subjects were improved in the second exam compared with the first exam. The passing rate of the group of NK doctors was 75%. The number of MCQ items of which difficulty indexes of NK doctors were lower than those of SK medical students was 51 (6.38%. NK doctors’ lack of understandings for Diagnostic Techniques and Procedures, Therapeutics, Prenatal Care, and Managed Care Programs was suggested as the possible reason. Conclusion The education of integrated courses focusing on Diagnostic Techniques and Procedures and Therapeutics, and apprenticeship-style training for clinical practice of core subjects are needed. Special lectures on the Preventive Medicine are likely to be required also.

  5. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    TECHNICAL TRAINING Monique Duval tel. 74924 technical.training@cern.ch Tuesday 3 February 2004 From 09:00 to 13:30 - Training Centre Auditorium - bldg. 593, room 11 USB (Universal Serial Bus) CYPRESS Seminar Claudia Colombini, Field Application Engineer CYPRESS ActiveComp Electronic GmbH D-85077 MANCHING, Germany As a pioneer in USB, CYPRESS sets the standard for cost-effective solutions without sacrificing functionality, performance or reliability. Having shipped over 200 million USB devices, Cypress is the undisputed market leader and demonstrates unmatched USB expertise. With the industry's broadest selection of USB solutions, Cypress has the right silicon, software and support for every USB application, from Low-speed to High-Speed and USB On-The-Go (OTG). 9:00 - 10:30 Overview of USB systems. USB CYPRESS product overview. Peripherals: Low Speed, Full Speed, High Speed (1.1 and 2.0). Hub Solutions, Embedded Host Solutions, On-The-Go (OTG) and wireless USB. USB Development Tools (first part) 10:30 -...

  6. Space reactor preliminary mechanical design

    International Nuclear Information System (INIS)

    Meier, K.L.

    1983-01-01

    An analysis was performed on the SABRE reactor space power system to determine the effect of the number and size of heat pipes on the design parameters of the nuclear subsystem. Small numbers of thin walled heat pipes were found to give a lower subsystem mass, but excessive fuel swelling resulted. The SP-100 preliminary design uses 120 heat pipes because of acceptable fuel swelling and a minimum nuclear subsystem mass of 1875 kg. Salient features of the reactor preliminary design are: individual fuel modules, ZrO 2 block core mounts, bolted collar fuel module restraints, and a BeO central plug

  7. Technetium removal: preliminary flowsheet options

    International Nuclear Information System (INIS)

    Eager, K.M.

    1995-01-01

    This document presents the results of a preliminary investigation into options for preliminary flowsheets for 99Tc removal from Hanford Site tank waste. A model is created to show the path of 99Tc through pretreatment to disposal. The Tank Waste Remediation (TWRS) flowsheet (Orme 1995) is used as a baseline. Ranges of important inputs to the model are developed, such as 99Tc inventory in the tanks and important splits through the TWRS flowsheet. Several technetium removal options are discussed along with sensitivities of the removal schemes to important model parameters

  8. School Improvement Plans and Student Achievement: Preliminary Evidence from the Quality and Merit Project in Italy

    Science.gov (United States)

    Caputo, Andrea; Rastelli, Valentina

    2014-01-01

    This study provides preliminary evidence from an Italian in-service training program addressed to lower secondary school teachers which supports school improvement plans (SIPs). It aims at exploring the association between characteristics/contents of SIPs and student improvement in math achievement. Pre-post standardized tests and text analysis of…

  9. A Preliminary Analysis of the Outcomes of Students Assisted by VET FEE-HELP: Summary

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2015

    2015-01-01

    This summary highlights the key findings from the report "A preliminary analysis of the outcomes of students assisted by VET FEE-HELP". VET FEE-HELP is an income-contingent loan scheme that assists eligible students undertaking certain vocational education training (VET) courses with an approved provider by paying for all or part of…

  10. ACADEMIC TRAINING

    CERN Multimedia

    Françoise Benz

    2002-01-01

    6, 7 May LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 Decoding the Human Genome, Scientific basis and ethic and social aspects by S.E. Antonarakis and A. Mauron / Univ. of Geneva Decoding the Human genome is a very up-to-date topic, raising several questions besides purely scientific, in view of the two competing teams (public and private), the ethics of using the results, and the fact that the project went apparently faster and easier than expected. The lecture series will address the following chapters: Scientific basis and challenges, Ethical and social aspects of genomics. Academic Training Françoise Benz Tel. 73127

  11. Media Training

    CERN Multimedia

    CERN. Geneva

    2009-01-01

    With the LHC starting up soon, the world's media are again turning their attention to CERN. We're all likely to be called upon to explain what is happening at CERN to media, friends and neighbours. The seminar will be given by BBC television news journalists Liz Pike and Nadia Marchant, and will deal with the kind of questions we're likely to be confronted with through the restart period. The training is open for everybody. Make sure you arrive early enough to get a seat - there are only 200 seats in the Globe. The session will also be webcast: http://webcast.cern.ch/

  12. Chapter 5: Training

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2018-04-01

    The chapter 5 presents the 1) initial training; 2) periodic training, which includes: a) periodic training for employees at lower levels of the hierarchy than that of the operator; b) period training for operators; 3) operator training; 4) record of training; 5) safety culture.

  13. French training

    CERN Multimedia

    2007-01-01

    The next session will take place from 29 January to 30 March 2007. These courses are open to all persons working on the CERN site, and their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: tel. 73127. Writing Professional Documents in French The next session will take place from 29 January to 30 March 2007. This course is designed for people with a good level of spoken French. Duration: 30 hours Price: 660 CHF (for 8 students) For further information and registration, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: tel. 73127. Writing Professional Documents in English The next session will take place from January to June 2007 (break at Easter). This course is designed for people with a good level of spoken English. Duration: 30 hours Price: 660 CHF (for 8 students) Timetable will be fixed after discussion with the students. For further information and registration, please consu...

  14. English Training

    CERN Multimedia

    2003-01-01

    General and Professional English Courses The next session will take place: from 03 March to 28 June 2003 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: tel.73127 or Mr. Liptow: tel.72957. Writing Professional Documents in English This course is designed for people with a good level of spoken English. Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) For registration and further information, please consult our Web pages: http://cern.ch/Training or contact Mrs. Tessa Osborne: Tessa.Osborne@cern. Oral Expression This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be approximately 8 participants in a class. Speaking activities will include discussions, meeting simulations, rol...

  15. English Training

    CERN Multimedia

    2003-01-01

    General and Professional English Courses The next session will take place: from 03 March to 28 June 2003 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: tel.73127 or Mr. Liptow: tel.72957. Writing Professional Documents in English This course is designed for people with a good level of spoken English. Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) For registration and further information, please consult our Web pages: http://cern.ch/Training or contact Mrs. Tessa Osborne: Tessa.Osborne@cern. Oral Expression This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be approximately 8 participants in a class. Speaking activities will include discussions, meeting simulations, role-p...

  16. Language Training

    CERN Multimedia

    2003-01-01

    Formation en anglais Cours d'anglais général et professionnel La prochaine session se déroulera: du 06 octobre 2003 au 13 février 2004 (interruption de 3/4 semaines à Noël). Ces cours s'adressent à toute personne travaillant au CERN ainsi qu'à leur conjoint. Pour vous inscrire et voir tout le détail des cours proposés, consultez nos pages Web: http://cern.ch/Training Vous pouvez aussi contacter Mme Benz, tél. 73127 ou Mr Liptow, tél. 72957. General and Professional English Courses The next session will take place: from 06 October 2003 to 13 February 2004 (3/4 weeks break at Christmas). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: tel. 73127 or Mr. Liptow: tel. 72957. Writing Professional Documents in English This course is designed for people with a good level of spoken English. Duration: 20 hours (2 hours a week) Price: ...

  17. Language Training

    CERN Multimedia

    2003-01-01

    Formation en anglais Cours d'anglais général et professionnel La prochaine session se déroulera: du 06 octobre 2003 au 13 février 2004 (interruption de 3/4 semaines à Noël). Ces cours s'adressent à toute personne travaillant au CERN ainsi qu'à leur conjoint. Pour vous inscrire et voir tout le détail des cours proposés, consultez nos pages Web: http://cern.ch/Training Vous pouvez aussi contacter M. Liptow, tél. 72957. General and Professional English Courses The next session will take place: from 06 October 2003 to 13 February 2004 (3/4 weeks break at Christmas). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957. Writing Professional Documents in English This course is designed for people with a good level of...

  18. Language Training

    CERN Multimedia

    2003-01-01

    Formation en anglais Cours d'anglais général et professionnel La prochaine session se déroulera: du 06 octobre 2003 au 13 février 2004 (interruption de 3/4 semaines à Noël). Ces cours s'adressent à toute personne travaillant au CERN ainsi qu'à leur conjoint. Pour vous inscrire et voir tout le détail des cours proposés, consultez nos pages Web: http://cern.ch/Training Vous pouvez aussi contacter Mme Benz, tél. 73127 ou Mr Liptow, tél. 72957. General and Professional English Courses The next session will take place: from 06 October 2003 to 13 February 2004 (3/4 weeks break at Christmas). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: tel. 73127 or Mr. Liptow: tel. 72957. Writing Professional Documents in Engl...

  19. Automated Motor Skills Training Optimized for Individual Differences.

    Science.gov (United States)

    1980-11-01

    Several preliminary applications of adaptive training to I complex synthetic flight trainers have been attempted (Loses, I ,5 I Ellis, Norman , and Matheny...Association, San Francisco, 1976. Lowes, A. H., Ellis, N. C., Norman , D. A., and Matheny, W. 3. Improving piloting skills in turbulent air using a self...intercept observer. Orlando, Florida: Naval Training Equipment Center, NAVTRAEQUIPCEN 71-C-6219-1, 1973. Smallwood , R. D. A decision structure for

  20. Strength Training. A Key to Athletic Training.

    Science.gov (United States)

    Whiteside, Patricia W.

    Characteristics of an effective strength training program are analyzed and descriptions are offered of different kinds of weight training activities. Comparisons are made between concentric, isometric, eccentric, and isokinetic training methods. The fundamentals and techniques of an exemplary training program are outlined and the organization and…

  1. Preliminary HECTOR analysis by Dragon

    Energy Technology Data Exchange (ETDEWEB)

    Presser, W; Woloch, F

    1972-06-02

    From the different cores measured in HECTOR, only ACH 4/B-B was selected for the Dragon analysis, since it presented the largest amount of uniform fuel loading in the central test region and is therefore nearest to an infinite lattice. Preliminary results are discussed.

  2. Neurosurgical tactile discrimination training with haptic-based virtual reality simulation.

    Science.gov (United States)

    Patel, Achal; Koshy, Nick; Ortega-Barnett, Juan; Chan, Hoi C; Kuo, Yong-Fan; Luciano, Cristian; Rizzi, Silvio; Matulyauskas, Martin; Kania, Patrick; Banerjee, Pat; Gasco, Jaime

    2014-12-01

    To determine if a computer-based simulation with haptic technology can help surgical trainees improve tactile discrimination using surgical instruments. Twenty junior medical students participated in the study and were randomized into two groups. Subjects in Group A participated in virtual simulation training using the ImmersiveTouch simulator (ImmersiveTouch, Inc., Chicago, IL, USA) that required differentiating the firmness of virtual spheres using tactile and kinesthetic sensation via haptic technology. Subjects in Group B did not undergo any training. With their visual fields obscured, subjects in both groups were then evaluated on their ability to use the suction and bipolar instruments to find six elastothane objects with areas ranging from 1.5 to 3.5 cm2 embedded in a urethane foam brain cavity model while relying on tactile and kinesthetic sensation only. A total of 73.3% of the subjects in Group A (simulation training) were able to find the brain cavity objects in comparison to 53.3% of the subjects in Group B (no training) (P  =  0.0183). There was a statistically significant difference in the total number of Group A subjects able to find smaller brain cavity objects (size ≤ 2.5 cm2) compared to that in Group B (72.5 vs. 40%, P  =  0.0032). On the other hand, no significant difference in the number of subjects able to detect larger objects (size ≧ 3 cm2) was found between Groups A and B (75 vs. 80%, P  =  0.7747). Virtual computer-based simulators with integrated haptic technology may improve tactile discrimination required for microsurgical technique.

  3. BIPS-FS preliminary design, miscellaneous notes

    International Nuclear Information System (INIS)

    1976-01-01

    A compendium of flight system preliminary design internal memos and progress report extracts for the Brayton Isotope Power System Preliminary Design Review to be held July 20, 21, and 22, 1975 is presented. The purpose is to bring together those published items which relate only to the preliminary design of the Flight System, Task 2 of Phase I. This preliminary design effort was required to ensure that the Ground Demonstration System will represent the Flight System as closely as possible

  4. Training apparatus

    International Nuclear Information System (INIS)

    Monteith, W.D.

    1983-01-01

    Training apparatus for use in contamination surveillance uses a mathematical model of a hypothetical contamination source (e.g. nuclear, bacteriological or chemical explosion or leak) to determine from input data defining the contamination source, the contamination level at any location within a defined exercise area. The contamination level to be displayed by the apparatus is corrected to real time from a real time clock or may be displayed in response to a time input from a keyboard. In a preferred embodiment the location is defined by entering UTM grid reference coordinates using the keyboard. The mathematical model used by a microprocessor of the apparatus for simulation of contamination levels in the event of a nuclear explosion is described. (author)

  5. ACADEMIC TRAINING

    CERN Multimedia

    Françoise Benz

    2002-01-01

    25, 26, 27, 28 February and 1st March from 11.00 to 12.00 hrs - Auditorium, bldg. 500 LECTURE SERIES Neutrino masses and oscillations by A. de Rujula / CERN-TH This course will not cover its subject in the customary way. The emphasis will be on the simple theoretical concepts (helicity, handedness, chirality, Majorana masses) which are obscure in most of the literature, and on the quantum mechanics of oscillations, that ALL books get wrong. Which, hopefully, will not deter me from discussing some of the most interesting results from the labs and from the cosmos. Academic Training Françoise Benz Secretariat Tel. 73127 francoise.benz@cern.ch

  6. English training

    CERN Multimedia

    2003-01-01

    You have a good level of English BUT... You still need to improve your speaking or You have problems writing professional documents Would you like to work in a small group on either of these areas? Then, the following courses are for you! Writing Professional Documents in English The aim of the course is for students to improve their professional writing. Participants will work on technical, scientific or administrative documents depending on the needs of the group. Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) Oral Expression The emphasis will be on oral expression with necessary feed-back. Speaking activities will include discussions, meeting simulations, role-plays etc. Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) For registration and further information, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957 / Mrs. Tessa Osborne: Tessa.Osborne@cern.ch.

  7. English Training

    CERN Multimedia

    2003-01-01

    You have a good level of English BUT... You still need to improve your speaking or You have problems writing professional documents Would you like to work in a small group on either of these areas? Then, the following courses are for you! Writing Professional Documents in English The aim of the course is for students to improve their professional writing. Participants will work on technical, scientific or administrative documents depending on the needs of the group. Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) Oral Expression The emphasis will be on oral expression with necessary feed-back. Speaking activities will include discussions, meeting simulations, role-plays etc. Duration: 20 hours (2 hours a week) Price: 440 CHF (for 8 students) For registration and further information, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957 / Mrs. Tessa Osborne: Tessa.Osborne@cern.ch.

  8. 45 CFR 150.217 - Preliminary determination.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preliminary determination. 150.217 Section 150.217... Are Failing To Substantially Enforce HIPAA Requirements § 150.217 Preliminary determination. If, at... designees). (b) Notifies the State of CMS's preliminary determination that the State has failed to...

  9. Cognitive control training for emotion-related impulsivity.

    Science.gov (United States)

    Peckham, Andrew D; Johnson, Sheri L

    2018-06-01

    Many forms of psychopathology are tied to a heightened tendency to respond impulsively to strong emotions, and this tendency, in turn, is closely tied to problems with cognitive control. The goal of the present study was to test whether a two-week, six-session cognitive control training program is efficacious in reducing emotion-related impulsivity. Participants (N = 52) reporting elevated scores on an emotion-related impulsivity measure completed cognitive control training targeting working memory and response inhibition. A subset of participants were randomized to a waitlist control group. Impulsivity, emotion regulation, and performance on near and far-transfer cognitive tasks were assessed at baseline and after completion of training. Emotion-related impulsivity declined significantly from pre-training to post-training and at two-week follow-up; improvements were not observed in the waitlist control group. A decrease in brooding rumination and an increase in reappraisal were also observed. Participants showed significant improvements on trained versions of the working memory and inhibition tasks as well as improvements on an inhibition transfer task. In sum, these preliminary findings show that cognitive training appears to be well-tolerated for people with significant emotion-driven impulsivity. Results provide preliminary support for the efficacy of cognitive training interventions as a way to reduce emotion-related impulsivity. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Personal Computer-less (PC-less) Microcontroller Training Kit

    Science.gov (United States)

    Somantri, Y.; Wahyudin, D.; Fushilat, I.

    2018-02-01

    The need of microcontroller training kit is necessary for practical work of students of electrical engineering education. However, to use available training kit not only costly but also does not meet the need of laboratory requirements. An affordable and portable microcontroller kit could answer such problem. This paper explains the design and development of Personal Computer Less (PC-Less) Microcontroller Training Kit. It was developed based on Lattepanda processor and Arduino microcontroller as target. The training kit equipped with advanced input-output interfaces that adopted the concept of low cost and low power system. The preliminary usability testing proved this device can be used as a tool for microcontroller programming and industrial automation training. By adopting the concept of portability, the device could be operated in the rural area which electricity and computer infrastructure are limited. Furthermore, the training kit is suitable for student of electrical engineering student from university and vocational high school.

  11. Human Factors in Training - Space Medicine Proficiency Training

    Science.gov (United States)

    Connell, Erin; Arsintescu, Lucia

    2009-01-01

    The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1

  12. Advanced training systems

    Science.gov (United States)

    Savely, Robert T.; Loftin, R. Bowen

    1990-01-01

    Training is a major endeavor in all modern societies. Common training methods include training manuals, formal classes, procedural computer programs, simulations, and on-the-job training. NASA's training approach has focussed primarily on on-the-job training in a simulation environment for both crew and ground based personnel. NASA must explore new approaches to training for the 1990's and beyond. Specific autonomous training systems are described which are based on artificial intelligence technology for use by NASA astronauts, flight controllers, and ground based support personnel that show an alternative to current training systems. In addition to these specific systems, the evolution of a general architecture for autonomous intelligent training systems that integrates many of the features of traditional training programs with artificial intelligence techniques is presented. These Intelligent Computer Aided Training (ICAT) systems would provide much of the same experience that could be gained from the best on-the-job training.

  13. Nuclear manpower training

    International Nuclear Information System (INIS)

    Suh, In Suk; Lee, H. Y.; Joe, B. J.; Lee, S. H.; Lee, E. J.; Yoo, B. H.; Seo, K. W.; Lee, W. K.; Jun, H. I.; Yang, K. N.; Kim, Y. J.; Kim, I. H.; Kim, M. Y.; Ju, Y. C.; Hyun, H. Y.; Choi, I. G.; Hong, C. S.; Won, J. Y.; Nam, J. Y.; Lee, H. J.

    1997-01-01

    This report describes the annual results of training courses. the scope and contents are as follows: 1. Regional and interregional training courses 2. Training courses assisted by foreign experts 3. Training courses for nuclear industry personnel 4. Training courses for internal staff-members 5. Training courses under the law. This Nuclear Training Center executed the open-door training courses for 2,400 engineers/scientists from the regulatory body, nuclear industries, research institutes and other related organizations by means of offering 51 training courses during the fiscal year 1996. (author). 23 refs

  14. Nuclear manpower training

    Energy Technology Data Exchange (ETDEWEB)

    Suh, In Suk; Lee, H. Y.; Joe, B. J.; Lee, S. H.; Lee, E. J.; Yoo, B. H.; Seo, K. W.; Lee, W. K.; Jun, H. I.; Yang, K. N.; Kim, Y. J.; Kim, I. H.; Kim, M. Y.; Ju, Y. C.; Hyun, H. Y.; Choi, I. G.; Hong, C. S.; Won, J. Y.; Nam, J. Y.; Lee, H. J.

    1997-01-01

    This report describes the annual results of training courses. the scope and contents are as follows: 1. Regional and interregional training courses 2. Training courses assisted by foreign experts 3. Training courses for nuclear industry personnel 4. Training courses for internal staff-members 5. Training courses under the law. This Nuclear Training Center executed the open-door training courses for 2,400 engineers/scientists from the regulatory body, nuclear industries, research institutes and other related organizations by means of offering 51 training courses during the fiscal year 1996. (author). 23 refs.

  15. Space Elevators Preliminary Architectural View

    Science.gov (United States)

    Pullum, L.; Swan, P. A.

    Space Systems Architecture has been expanded into a process by the US Department of Defense for their large scale systems of systems development programs. This paper uses the steps in the process to establishes a framework for Space Elevator systems to be developed and provides a methodology to manage complexity. This new approach to developing a family of systems is based upon three architectural views: Operational View OV), Systems View (SV), and Technical Standards View (TV). The top level view of the process establishes the stages for the development of the first Space Elevator and is called Architectural View - 1, Overview and Summary. This paper will show the guidelines and steps of the process while focusing upon components of the Space Elevator Preliminary Architecture View. This Preliminary Architecture View is presented as a draft starting point for the Space Elevator Project.

  16. Radioactive waste shredding: Preliminary evaluation

    International Nuclear Information System (INIS)

    Soelberg, N.R.; Reimann, G.A.

    1994-07-01

    The critical constraints for sizing solid radioactive and mixed wastes for subsequent thermal treatment were identified via a literature review and a survey of shredding equipment vendors. The types and amounts of DOE radioactive wastes that will require treatment to reduce the waste volume, destroy hazardous organics, or immobilize radionuclides and/or hazardous metals were considered. The preliminary steps of waste receipt, inspection, and separation were included because many potential waste treatment technologies have limits on feedstream chemical content, physical composition, and particle size. Most treatment processes and shredding operations require at least some degree of feed material characterization. Preliminary cost estimates show that pretreatment costs per unit of waste can be high and can vary significantly, depending on the processing rate and desired output particle size

  17. Exploratory shaft facility preliminary designs - Permian Basin

    International Nuclear Information System (INIS)

    1983-09-01

    The purpose of the Preliminary Design Report, Permian Basin, is to provide a description of the preliminary design for an Exploratory Shaft Facility in the Permian Basin, Texas. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers are included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description, and Construction Cost Estimate. 30 references, 13 tables

  18. Management Training in Retailing.

    Science.gov (United States)

    Veness, C. Rosina

    Intended for prospective members of the new Distributive Industrial Training Board in Great Britain, this training guide concentrates on managerial functions in retailing; the selection of trainees; the planning of in-company and external training programs; scheduling and continuity of training; roles of training personnel; and the use of various…

  19. Language Training

    CERN Multimedia

    Françoise Benz

    2005-01-01

    General and Professional English Courses The next session will take place: from end of September 2005 to middle of February 2006 (2/ 3 weeks break at Christmas). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957. Oral Expression in English The next session will take place from end of September to December 2005. This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be a maximum of 10 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. Duration: 20 hours Price: 440 CHF (for a minimum of 8 students) Writing Professional Documents in English The next session will take place from end of September 2005 to middle of Febr...

  20. Language training

    CERN Document Server

    2007-01-01

    General and Professional English Courses The next session will take place from 26 February or 5 March to end of June 2007 (1/2 weeks break at Easter). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Françoise Benz, tel. 73127. Oral Expression The next session will take place from 26 February or 5 March to end of June 2007 (1/2 weeks break at Easter). This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be a maximum of 10 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. Duration: 30 hours Price: 660 CHF (for a minimum of 8 students). Writing Professional Documents in English The next session will take place from 26 February or...

  1. Language training

    CERN Document Server

    Françoise Benz

    2005-01-01

    General and Professional English Courses The next session will take place: from end of September 2005 to middle of February 2006 (2/ 3 weeks break at Christmas). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957. Oral Expression in English The next session will take place from end of September to December 2005. This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be a maximum of 10 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. Duration: 20 hours Price: 440 CHF (for a minimum of 8 students) Writing Professional Documents in English The next session will take place from end of September 2005 to middle of Feb...

  2. Language training

    CERN Multimedia

    2007-01-01

    General and Professional English Courses The next session will take place: from 26 February or 5 March to end of June 2007 (1/2 weeks break at Easter). These courses are open to all persons working on the CERN site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Françoise Benz, tel. 73127. Oral Expression The next session will take place from 26 February or 5 March to end of June 2007 (1/2 weeks break at Easter). This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be a maximum of 10 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc. depending on the needs of the students. Duration: 30 hours Price: 660 CHF (for a minimum of 8 students). Writing Professional Documents in English The next session will take place from 26 February or 5 M...

  3. Language training

    CERN Multimedia

    2006-01-01

    General and Professional English Courses The next session will take place from beginning of October 2006 to beginning of February 2007 (3 weeks break at Christmas).These courses are open to all persons working on the CERN site and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Tessa Osborne, tel.16 23 40. Oral Expression The next session will take place from beginning of October 2006 to beginning of February 2007 (3 weeks break at Christmas).This course is intended for people with a good knowledge of English who want to practise and maintain their speaking skills while extending their vocabulary. There will be a maximum of 10 participants in a class. Speaking activities will include discussions, meeting simulations, role-plays etc., depending on the needs of the students. Duration: 30 hours (2 hours a week) Price: 660 CHF (for a minimum of 8 students). Writing Professional Documents in English The next ses...

  4. Quality or Quantity: A Statement for Teacher Training in Turkey

    Directory of Open Access Journals (Sweden)

    Ali AZAR

    2011-01-01

    Full Text Available Developed countries are initiating and implementing effective and appropriate technics in the field of teacher training. In Turkey, much research has been done in order to determine the qualification of teachers and, by this way, to train qualified teachers. Ministry of Education, Turkish Council of Higher Education, Faculties of Education and Faculties of Sciences have cooperated some certification systems, however, the research which is not supported by preliminary studies but exposured to political coercions lowered the quality of education. Besides, quantity is increased by pedagogical formation programs. In this study, Turkish teacher training system is analyzed with respect to quantity and quality.

  5. Trade-off results and preliminary designs of Near-Term Hybrid Vehicles

    Science.gov (United States)

    Sandberg, J. J.

    1980-01-01

    Phase I of the Near-Term Hybrid Vehicle Program involved the development of preliminary designs of electric/heat engine hybrid passenger vehicles. The preliminary designs were developed on the basis of mission analysis, performance specification, and design trade-off studies conducted independently by four contractors. THe resulting designs involve parallel hybrid (heat engine/electric) propulsion systems with significant variation in component selection, power train layout, and control strategy. Each of the four designs is projected by its developer as having the potential to substitute electrical energy for 40% to 70% of the petroleum fuel consumed annually by its conventional counterpart.

  6. Orthopaedic training in Kenya

    African Journals Online (AJOL)

    Background: Orthopaedic training in Kenya, like in other East, central and .... quite a number of good facilities that would train an ... provide a forum for exchange of ideas and training. (2,3) ... administrators purely interested in service provision,.

  7. Holmium:YAG laser stapedotomy: preliminary evaluation

    Science.gov (United States)

    Stubig, Ingrid M.; Reder, Paul A.; Facer, G. W.; Rylander, Henry G.; Welch, Ashley J.

    1993-07-01

    This study investigated the use of a pulsed Holmium:YAG ((lambda) equals 2.09 micrometers ) laser- fiber microsurgical system for laser stapedotomy. This system ablates human stapes bones effectively with minimal thermal damage. The study was designed to determine the effectiveness of the Ho:YAG laser (Schwartz Electro Optics, Inc., Orlando, FL) for stapedotomy and to evaluate temperature changes within the cochlea during the ablation process. Human cadaveric temporal bones were obtained and the stapes portion of the ossicular chain was removed. A 200 micrometers diameter low OH quartz fiber was used to irradiate these stapes bones in an air environment. The laser was pulsed at 2 Hz, 250 microsecond(s) ec pulse width and an irradiance range of 100 - 240 J/cm2 was used to ablate holes in the stapes footplate. The resultant stapedotomies created had smooth 300 micrometers diameter holes with a minimum of circumferential charring. Animal studies in-vivo were carried out in chinchillas to determine the caloric spread within the cochlea. A 0.075 mm Type T thermocouple was placed in the round window. Average temperature change during irradiation of the stapes footplate recorded in the round window was 3.6 degree(s)C. The data suggest that stapedotomy using the Ho:YAG laser can result in a controlled ablation of the stapes footplate with minimal thermal damage to the surrounding stapes. Optical coupling using fiberoptic silica fibers is an ideal method for delivering laser energy to the stapes during stapedotomy.

  8. Dynamic training devices in CRM training

    Science.gov (United States)

    Lawver, J.

    1984-01-01

    Pilot training effectiveness and flying safety of a seasonal tour flight company are described. The change from single pilot to two pilot operated twin otters is examined. The use of the ATC 810 training device, its possibilities and training capacity is outlined. Problem areas which may arise, emergency system and pilot/passenger interaction are analyzed.

  9. Microsurgery Workout: A Novel Simulation Training Curriculum Based on Nonliving Models.

    Science.gov (United States)

    Rodriguez, Jose R; Yañez, Ricardo; Cifuentes, Ignacio; Varas, Julian; Dagnino, Bruno

    2016-10-01

    Currently, there are no valid training programs based solely on nonliving models. The authors aimed to develop and validate a microsurgery training program based on nonliving models and assess the transfer of skills to a live rat model. Postgraduate year-3 general surgery residents were assessed in a 17-session program, performing arterial and venous end-to-end anastomosis on ex vivo chicken models. Procedures were recorded and rated by two blinded experts using validated global and specific scales (objective structured assessment of technical skills) and a validated checklist. Operating times and patency rates were assessed. Hand-motion analysis was used to measure economy of movements. After training, residents performed an arterial and venous end-to-end anastomosis on live rats. Results were compared to six experienced surgeons in the same models. Values of p < 0.05 were considered statistically significant. Learning curves were achieved. Ten residents improved their median global and specific objective structured assessment of technical skills scores for artery [10 (range, 8 to 10) versus 28 (range, 27 to 29), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 28), p < 0.05] and vein [8 (range, 8 to 11) versus 28 (range, 27 to 28), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 29), p < 0.05]. Checklist scores also improved for both procedures (p < 0.05). Trainees were slower and less efficient than experienced surgeons (p < 0.05). In the living rat, patency rates at 30 minutes were 100 percent and 50 percent for artery and vein, respectively. Significant acquisition of microsurgical skills was achieved by trainees to a level similar to that of experienced surgeons. Acquired skills were transferred to a more complex live model.

  10. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    Tuesday 30 March TECHNICAL TRAINING SEMINAR From 9:00 to 12:00 and from 13:00 to 16:00 hrs - Council Chamber, Salle B, Salle des Pas Perdus National Instruments (NI) on Tour 2004 Claudia Jüngel, Evrem Yarkin, Joel Clerc, Hervé Baour / NATIONAL INSTRUMENTS The special event NI on Tour 2004, run in Germany, Austria and Switzerland, will be at CERN on March 30. Technical seminars and free introductory courses will be offered all day long in the Council Chamber, Salle B, and Salle des Pas Perdus (buildings 61 and 503). Technical conferences: 09:00 - 12:00 Data acquisition systems on PCs. Industrial measurement and control techniques. 13:00 - 16:00 Advanced LabVIEW software and PXI instrumentation. Measuring instruments and system components for teststand automation. Introductory courses: 09:00 - 12:00 DIAdem: Data analysis and presentation 13:00 - 16:00 Data acquisition with LabVIEW Language: English and French Free special seminar. Registration is recommended with National Instruments Switzerland (please sp...

  11. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    Tuesday 30 March TECHNICAL TRAINING SEMINAR From 9:00 to 12:00 and from 13:00 to 16:00 hrs - Council Chamber, Salle B, Salle des Pas Perdus National Instruments (NI) on Tour 2004 Claudia Jüngel, Evrem Yarkin, Joel Clerc, Hervé Baour / NATIONAL INSTRUMENTS The special event NI on Tour 2004, run in Germany, Austria and Switzerland, will be at CERN on March 30. Technical seminars and free introductory courses will be offered all day long in the Council Chamber, Salle B, and Salle des Pas Perdus (buildings 61 and 503). Technical conferences: 09:00 - 12:00 Data acquisition systems on PCs. Industrial measurement and control techniques. 13:00 - 16:00 Advanced LabVIEW software and PXI instrumentation. Measuring instruments and system components for teststand automation. Introductory courses: 09:00 - 12:00 DIAdem: Data analysis and presentation 13:00 - 16:00 Data acquisition with LabVIEW Language: English and French Free special seminar. Registration is recommended with National Instruments Swi...

  12. Extending brain-training to the affective domain: increasing cognitive and affective executive control through emotional working memory training.

    Directory of Open Access Journals (Sweden)

    Susanne Schweizer

    Full Text Available So-called 'brain-training' programs are a huge commercial success. However, empirical evidence regarding their effectiveness and generalizability remains equivocal. This study investigated whether brain-training (working memory [WM] training improves cognitive functions beyond the training task (transfer effects, especially regarding the control of emotional material since it constitutes much of the information we process daily. Forty-five participants received WM training using either emotional or neutral material, or an undemanding control task. WM training, regardless of training material, led to transfer gains on another WM task and in fluid intelligence. However, only brain-training with emotional material yielded transferable gains to improved control over affective information on an emotional Stroop task. The data support the reality of transferable benefits of demanding WM training and suggest that transferable gains across to affective contexts require training with material congruent to those contexts. These findings constitute preliminary evidence that intensive cognitively demanding brain-training can improve not only our abstract problem-solving capacity, but also ameliorate cognitive control processes (e.g. decision-making in our daily emotive environments.

  13. 海绵窦内颅神经血液供应显微外科解剖研究%The blood supply of the intracavernous cranial nerves: a microsurgical anatomy study.

    Institute of Scientific and Technical Information of China (English)

    吴建东; 惠国桢; 夏春林

    2001-01-01

    Objective To minimize injurying of the blood supply of intracavernous cranial nerves during microsurgical operation on cavernous sinus. Methods 50 adult cadaver brains include cavernous sinus were dissected in detail under anatomical microscope. Results (1) The oculomotor nerve received branches from the inferolateral trunk in 90% of the specimens. (2) The proximal trochlear nerver received branches from the inferolateral trunk in 74% of the specimens and from the tentorial artery of the meningohypophyseal trunk in 26%. The distal half was supplied mainly by the branches from the inferolateral trunk. (3) In the region of Dorellos canal, the proximal part of the abducens nerve received branches from the dorsal meningeal artery. The middle and distal parts received branches from the inferolateral trunk. (4) The ophthalmic and proximal maxillary segments of the trigeminal nerve received branches from the inferolateral trunk. The medial part of ganglion received branches from inferolateral trunk and the tentorial artery. The middle part of it received branches from the inferolateral trunk. The lateral part of it received branches from either the inferolateral trunk or the middle meningeal artery. Conclusions The inferolateral trunk play an important role in the blood supply of the intracavernous cranial nerves. We should preserve the blood supply to the cranial nerves during cavernous sinus surgery, thus minimizing postoperative cranial nerve deficits.%目的 为减少海绵窦显微外科手术时损伤海绵窦内颅神经血供而研究这些颅神经的血液供应解剖。方法 50具成人尸体海绵窦标本,在解剖显微镜下解剖和分析。结果 (1)90侧(占90%)的标本示动眼神经由颈内动脉的下外侧动脉分支供血;(2)滑车神经近段有74侧(占74%)的标本示其接受下外侧动脉的分支供血,有26侧(占26%)的标本示其接受脑膜垂体动脉分支天幕动脉的供血,滑车神经远段主要由

  14. Privacy Training Program

    Science.gov (United States)

    Recognizing that training and awareness are critical to protecting agency Personally Identifiable Information (PII), the EPA is developing online training for privacy contacts in its programs and regions.

  15. Methods of Physical Recreation of Students Trained in Kickboxing Section

    Directory of Open Access Journals (Sweden)

    C. А. Пашкевич

    2016-09-01

    Full Text Available Research objective: to evaluate the effectiveness of implementing sports massage in recreation of kickboxing students to improve their sports performance. Materials and methods. The research used: review and analysis of literature, pedagogical observations, physiological (relay test, strength endurance test, fatigue intensity assessment and statistical methods. The participants of the research were three groups (5 persons in each group. The first group of students (C1 received preliminary warming massage (20 min, the second group (C2 received recreational massage after the training (20 min, the third group (C3 had passive rest before and after the training (20 min. Before and after the massage session, assessment of the response rate and strength endurance took place three times during the training (at the beginning, in the middle, and at the end with regard to the level of the students’ fatigue intensity during the training. For the rough evaluation of the cause-effect relationship between the influencing factor and the effect appearance, the research used the relative risk indicator (RR. Research results. The sports massage reduced the athletes’ fatigue during the training (RR = 5.0, p < 0.05, i.e. the coach could increase the training load without any significant impact on the functional systems of the athletes. The preliminary massage had a more distinct positive effect on the students’ response rate and endurance indicators. The recreational massage improved only the students’ endurance processes during the training.

  16. Simulator training effectiveness: instructor training and qualifications

    International Nuclear Information System (INIS)

    Scholand, G.W.

    1985-01-01

    Nuclear power plant simulators have become the most important tool in training nuclear power plant operators. Yet, as these machines continue to become even more sophisticated, highly trained and experienced instructors with unique skills and insights are still essential in order to achieve effective and meaningful training. The making of a qualified simulator instructor involves training and techniques that exceed the traditional programs required of a Senior Reactor Operator (SRO). This paper discusses (i) the training necessary to produce a competent simulator instructor; and (ii) the continuing task of maintaining his or her proficiency. (author)

  17. Preliminaries

    Directory of Open Access Journals (Sweden)

    Desde el jardín de Freud

    2014-10-01

    Full Text Available Desde el Jardín de Freud se encuentra indexada en el IBN-Publindex (Colciencias, en categoría C, y en Latindex. También se encuentra en las siguientes bases de datos y catálogos: ebsco, Dialnet, Rebiun, Doaj y e-Revistas.

  18. Preliminary

    Directory of Open Access Journals (Sweden)

    Desde el Jardín de Freud

    2017-01-01

    Full Text Available Desde el Jardín de Freud is indexed in the IBN-Publindex (Colciencias in category C, and the following databases and catalogs: EBSCO, ProQuest, Google Scholar, CLASE, Latindex, Dialnet, Rebiun, Doaj, e-revistas and Library Luis Angel Arango virtual.

  19. Preliminary considerations concerning actinide solubilities

    International Nuclear Information System (INIS)

    Newton, T.W.; Bayhurst, B.P.; Daniels, W.R.; Erdal, B.R.; Ogard, A.E.

    1980-01-01

    Work at the Los Alamos Scientific Laboratory on the fundamental solution chemistry of the actinides has thus far been confined to preliminary considerations of the problems involved in developing an understanding of the precipitation and dissolution behavior of actinide compounds under environmental conditions. Attempts have been made to calculate solubility as a function of Eh and pH using the appropriate thermodynamic data; results have been presented in terms of contour maps showing lines of constant solubility as a function of Eh and pH. Possible methods of control of the redox potential of rock-groundwater systems by the use of Eh buffers (redox couples) is presented

  20. TCA High Lift Preliminary Assessment

    Science.gov (United States)

    Wyatt, G. H.; Polito, R. C.; Yeh, D. T.; Elzey, M. E.; Tran, J. T.; Meredith, Paul T.

    1999-01-01

    This paper presents a TCA (Technology Concept Airplane) High lift Preliminary Assessment. The topics discussed are: 1) Model Description; 2) Data Repeatability; 3) Effect of Inboard L.E. (Leading Edge) Flap Span; 4) Comparison of 14'x22' TCA-1 With NTF (National Transonic Facility) Modified Ref. H; 5) Comparison of 14'x22' and NTF Ref. H Results; 6) Effect of Outboard Sealed Slat on TCA; 7) TCA Full Scale Build-ups; 8) Full Scale L/D Comparisons; 9) TCA Full Scale; and 10) Touchdown Lift Curves. This paper is in viewgraph form.

  1. Preliminary ECLSS waste water model

    Science.gov (United States)

    Carter, Donald L.; Holder, Donald W., Jr.; Alexander, Kevin; Shaw, R. G.; Hayase, John K.

    1991-01-01

    A preliminary waste water model for input to the Space Station Freedom (SSF) Environmental Control and Life Support System (ECLSS) Water Processor (WP) has been generated for design purposes. Data have been compiled from various ECLSS tests and flight sample analyses. A discussion of the characterization of the waste streams comprising the model is presented, along with a discussion of the waste water model and the rationale for the inclusion of contaminants in their respective concentrations. The major objective is to establish a methodology for the development of a waste water model and to present the current state of that model.

  2. Versator divertor experiment: preliminary designs

    International Nuclear Information System (INIS)

    Wan, A.S.; Yang, T.F.

    1984-08-01

    The emergence of magnetic divertors as an impurity control and ash removal mechanism for future tokamak reactors bring on the need for further experimental verification of the divertor merits and their ability to operate at reactor relevant conditions, such as with auxiliary heating. This paper presents preliminary designs of a bundle and a poloidal divertor for Versator II, which can operate in conjunction with the existing 150 kW of LHRF heating or LH current drive. The bundle divertor option also features a new divertor configuration which should improve the engineering and physics results of the DITE experiment. Further design optimization in both physics and engineering designs are currently under way

  3. On Preliminary Test Estimator for Median

    OpenAIRE

    Okazaki, Takeo; 岡崎, 威生

    1990-01-01

    The purpose of the present paper is to discuss about estimation of median with a preliminary test. Two procedures are presented, one uses Median test and the other uses Wilcoxon two-sample test for the preliminary test. Sections 3 and 4 give mathematical formulations of such properties, including mean square errors with one specified case. Section 5 discusses their optimal significance levels of the preliminary test and proposes their numerical values by Monte Carlo method. In addition to mea...

  4. A Preliminary Review of Fatigue Among Rail Staff

    Directory of Open Access Journals (Sweden)

    Jialin Fan

    2018-05-01

    Full Text Available Background: Fatigue is a severe problem in the rail industry, which may jeopardize train crew's health and safety. Nonetheless, a preliminary review of all empirical evidence for train crew fatigue is still lacking. The aim of the present paper is, therefore, to provide a preliminary description of occupational fatigue in the rail industry. This paper reviews the literature with the research question examining the risk factors associated with train crew fatigue, covering both papers published in refereed journals and reports from trade organizations and regulators. It assesses the progress of research on railway fatigue, including research on the main risk factors for railway fatigue, the association between fatigue and railway incidents, and how to better manage fatigue in the railway industry.Methods: Systematic searches were performed in both science and industry databases. The searches considered studies published before August 2017. The main exclusion criterion was fatigue not being directly measured through subjective or objective methods.Results: A total of 31 studies were included in the main review. The causes of fatigue included long working hours, heavy workload, early morning or night shifts, and insufficient sleep. Poor working environment, particular job roles, and individual differences also contributed to fatigue.Conclusion: Fatigue in the rail industry includes most of the features of occupational fatigue, and it is also subject to industry-specific factors. The effect of fatigue on well-being and the fatigued population in the railway industry are still not clear. Future studies can consider associations between occupational risk factors and perceived fatigue by examining the prevalence of fatigue and identifying the potential risk factors in staff within the railway industry.

  5. Budapest Training Technology Centre.

    Science.gov (United States)

    Budapest Training Technology Centre (Hungary).

    The Budapest Training Technology Centre (BTTC) grew out of a 1990 agreement calling for Great Britain to help Hungary develop and implement open and flexible training methods and technology-based training to support the labor force development and vocational training needs resulting from Hungary's transition to a market economy. The BTTC would be…

  6. Assessing Intercultural Training Designs

    Science.gov (United States)

    Graf, Andrea

    2004-01-01

    Training designs are critical to the success of intercultural training programmes. A common typology for classifying intercultural training designs distinguishes among the following dimensions: experiential discovery versus didactic expository and culture-specific versus culture-general training. The purpose of this paper is to assess different…

  7. Biolab Crew Training

    OpenAIRE

    Illmer, Norbert

    2005-01-01

    In order to return optimum scientific data for the evaluation on ground astronauts have to be efficiently trained on facility operations and the science background of the experiments. The European Astronaut Centre (EAC) provides training to all astronauts assigned to experiments on the BIOLAB research facility of Columbus. This training primarily uses the full scale BIOLAB training model at EAC.

  8. FFTF operator training

    International Nuclear Information System (INIS)

    1979-01-01

    The qualifications required and the training received by FFTF operators are described. The training includes sodium fill training and cold plant qualification. Requirements for supervisors are also outlined. Arrangement of personnel at FFTF is described. Requalification training and recertification are considered

  9. Nuclear manpower training

    International Nuclear Information System (INIS)

    Suh, In Suk; Lee, H. Y.; Lee, E. J.; Yang, K. N.; Jun, H. R.; Seo, K. W.; Lee, S. H.; Kim, Y. J.; Kim, I. H.; Joe, B. J.; Koh, Y. S.; Yoo, B. H.; Kim, M. Y.; Ju, Y. C.; Hyun, H. U.; Choi, I. K.; Hong, C. S.; Won, J. Y.; Nam, J. Y.; Lee, H. J.

    1997-12-01

    This report describes the annual results of training courses. The scope and contents are as follows: 1. Education program development of nuclear field 2. International training courses for foreigners 3. Training courses for industry personnel 4. Training courses for R and D staff-members 5. Training courses under the law. The nuclear training center executed 65 training courses for 2,700 engineers/ scientists from the regulatory body, nuclear industries, research institutes and other related organizations during the fiscal year 1997. (author). 18 refs., 3 tabs

  10. Training of maintenance personnel

    International Nuclear Information System (INIS)

    Rabouhams, J.

    1986-01-01

    This lecture precises the method and means developed by EDF to ensure the training of maintenance personnel according to their initial educational background and their experience. The following points are treated: General organization of the training for maintenance personnel in PWR and GCR nuclear power stations and in Creys Malville fast breeder reactor; Basic nuclear training and pedagogical aids developed for this purpose; Specific training and training provided by contractors; complementary training taking into account the operation experience and feedback; Improvement of velocity, competence and safety during shut-down operations by adapted training. (orig.)

  11. Nuclear manpower training

    Energy Technology Data Exchange (ETDEWEB)

    Suh, In Suk; Lee, H. Y.; Lee, E. J.; Yang, K. N.; Jun, H. R.; Seo, K. W.; Lee, S. H.; Kim, Y. J.; Kim, I. H.; Joe, B. J.; Koh, Y. S.; Yoo, B. H.; Kim, M. Y.; Ju, Y. C.; Hyun, H. U.; Choi, I. K.; Hong, C. S.; Won, J. Y.; Nam, J. Y.; Lee, H. J

    1997-12-01

    This report describes the annual results of training courses. The scope and contents are as follows: 1. Education program development of nuclear field 2. International training courses for foreigners 3. Training courses for industry personnel 4. Training courses for R and D staff-members 5. Training courses under the law. The nuclear training center executed 65 training courses for 2,700 engineers/ scientists from the regulatory body, nuclear industries, research institutes and other related organizations during the fiscal year 1997. (author). 18 refs., 3 tabs.

  12. Training propositional reasoning.

    Science.gov (United States)

    Klauer, K C; Meiser, T; Naumer, B

    2000-08-01

    Two experiments compared the effects of four training conditions on propositional reasoning. A syntactic training demonstrated formal derivations, in an abstract semantic training the standard truth-table definitions of logical connectives were explained, and a domain-specific semantic training provided thematic contexts for the premises of the reasoning task. In a control training, an inductive reasoning task was practised. In line with the account by mental models, both kinds of semantic training were significantly more effective than the control and the syntactic training, whereas there were no significant differences between the control and the syntactic training, nor between the two kinds of semantic training. Experiment 2 replicated this pattern of effects using a different set of syntactic and domain-specific training conditions.

  13. Processing speed and working memory training in multiple sclerosis: a double-blind randomized controlled pilot study.

    Science.gov (United States)

    Hancock, Laura M; Bruce, Jared M; Bruce, Amanda S; Lynch, Sharon G

    2015-01-01

    Between 40-65% of multiple sclerosis patients experience cognitive deficits, with processing speed and working memory most commonly affected. This pilot study investigated the effect of computerized cognitive training focused on improving processing speed and working memory. Participants were randomized into either an active or a sham training group and engaged in six weeks of training. The active training group improved on a measure of processing speed and attention following cognitive training, and data trended toward significance on measures of other domains. Results provide preliminary evidence that cognitive training with multiple sclerosis patients may produce moderate improvement in select areas of cognitive functioning.

  14. Operator training and the training simulator experience

    International Nuclear Information System (INIS)

    Mills, D.

    The author outlines the approach used by Ontario Hydro to train operators from the day they are hired as Operators-in-Training until they are Authorized Unit First Operators. He describes in detail the use of the simulator in the final year of the authorization program, drawing on experience with the Pickering NGS A simulator. Simulators, he concludes, are important aids to training but by no means all that is required to guarantee capable First Operators

  15. Preliminary Context Analysis of Community Informatics Social ...

    African Journals Online (AJOL)

    Preliminary context analysis is always part of the feasibility study phase in the development of information system for Community Development (CD) purposes. In this paper, a context model and a preliminary context analysis are presented for Social Network Web Application (SNWA) for CD in the Niger Delta region of ...

  16. 23 CFR 645.109 - Preliminary engineering.

    Science.gov (United States)

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Preliminary engineering. 645.109 Section 645.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS UTILITIES Utility Relocations, Adjustments, and Reimbursement § 645.109 Preliminary engineering. (a) As...

  17. Plutonium Immobilization Can Loading Preliminary Specifications

    Energy Technology Data Exchange (ETDEWEB)

    Kriikku, E.

    1998-11-25

    This report discusses the Plutonium Immobilization can loading preliminary equipment specifications and includes a process block diagram, process description, equipment list, preliminary equipment specifications, plan and elevation sketches, and some commercial catalogs. This report identifies loading pucks into cans and backfilling cans with helium as the top priority can loading development areas.

  18. Irisin and exercise training in humans - results from a randomized controlled training trial.

    Science.gov (United States)

    Hecksteden, Anne; Wegmann, Melissa; Steffen, Anke; Kraushaar, Jochen; Morsch, Arne; Ruppenthal, Sandra; Kaestner, Lars; Meyer, Tim

    2013-11-05

    The recent discovery of a new myokine (irisin) potentially involved in health-related training effects has gained great attention, but evidence for a training-induced increase in irisin remains preliminary. Therefore, the present study aimed to determine whether irisin concentration is increased after regular exercise training in humans. In a randomized controlled design, two guideline conforming training interventions were studied. Inclusion criteria were age 30 to 60 years, Physical performance provided positive control for the overall efficacy of training. Differences between groups were tested for significance using analysis of variance. For post hoc comparisons with the control group, Dunnett's test was used. Maximum performance increased significantly in the training groups compared with controls (controls: ±0.0 ± 0.7 km/h; AET: 1.1 ± 0.6 km/h, P error probability = 0.7). The general upward trend was mainly accounted for by a negative association of irisin concentration with the storage duration of frozen serum samples (P storage of samples from initial tests.

  19. KALIMER preliminary conceptual design report

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Do Hee; Kim, Y. J.; Kim, Y. G. and others

    2000-08-01

    This report, which summarizes the result of preliminary conceptual design activities during Phase 1, follows the format of safety analysis report. The purpose of publishing this report is to gather all of the design information developed so far in a systematic way so that KALIMER designers have a common source of the consistent design information necessary for their future design activities. This report will be revised and updated as design changes occur and more detailed design specification is developed during Phase 2. Chapter 1 describes the KALIMER Project. Chapter 2 includes the top level design requirements of KALIMER and general plant description. Chapter 3 summarizes the design of structures, components, equipment and systems. Specific systems and safety analysis results are described in the remaining chapters. Appendix on the HCDA evaluation is attached at the end of this report.

  20. Psychohistory and Slavery: Preliminary Issues.

    Science.gov (United States)

    Adams, Kenneth Alan

    2015-01-01

    "Psychohistory and Slavery: Preliminary Issues," begins an examination of slavery in the antebellum South. The paper suggests that how slavery and the group-fantasy of white male supremacy were perpetuated among slaveholders is a question of fundamental importance for psychohistorians. The family and childrearing are the focus of attention. Given the ferocity of slavery, it is argued that the psychological and emotional consequences of this barbarism were not limited to the slaves themselves, but had significant impact on the slaveholders as well-their parenting, their children, and their children's parenting of the next generation. In each generation the trauma of slavery was injected into slaveholder children and became a fundamental component of elite Southern personality.

  1. KALIMER preliminary conceptual design report

    International Nuclear Information System (INIS)

    Hahn, Do Hee; Kim, Y. J.; Kim, Y. G. and others

    2000-08-01

    This report, which summarizes the result of preliminary conceptual design activities during Phase 1, follows the format of safety analysis report. The purpose of publishing this report is to gather all of the design information developed so far in a systematic way so that KALIMER designers have a common source of the consistent design information necessary for their future design activities. This report will be revised and updated as design changes occur and more detailed design specification is developed during Phase 2. Chapter 1 describes the KALIMER Project. Chapter 2 includes the top level design requirements of KALIMER and general plant description. Chapter 3 summarizes the design of structures, components, equipment and systems. Specific systems and safety analysis results are described in the remaining chapters. Appendix on the HCDA evaluation is attached at the end of this report

  2. Preliminary hazards analysis -- vitrification process

    International Nuclear Information System (INIS)

    Coordes, D.; Ruggieri, M.; Russell, J.; TenBrook, W.; Yimbo, P.

    1994-06-01

    This paper presents a Preliminary Hazards Analysis (PHA) for mixed waste vitrification by joule heating. The purpose of performing a PHA is to establish an initial hazard categorization for a DOE nuclear facility and to identify those processes and structures which may have an impact on or be important to safety. The PHA is typically performed during and provides input to project conceptual design. The PHA is then followed by a Preliminary Safety Analysis Report (PSAR) performed during Title 1 and 2 design. The PSAR then leads to performance of the Final Safety Analysis Report performed during the facility's construction and testing. It should be completed before routine operation of the facility commences. This PHA addresses the first four chapters of the safety analysis process, in accordance with the requirements of DOE Safety Guidelines in SG 830.110. The hazards associated with vitrification processes are evaluated using standard safety analysis methods which include: identification of credible potential hazardous energy sources; identification of preventative features of the facility or system; identification of mitigative features; and analyses of credible hazards. Maximal facility inventories of radioactive and hazardous materials are postulated to evaluate worst case accident consequences. These inventories were based on DOE-STD-1027-92 guidance and the surrogate waste streams defined by Mayberry, et al. Radiological assessments indicate that a facility, depending on the radioactive material inventory, may be an exempt, Category 3, or Category 2 facility. The calculated impacts would result in no significant impact to offsite personnel or the environment. Hazardous materials assessment indicates that a Mixed Waste Vitrification facility will be a Low Hazard facility having minimal impacts to offsite personnel and the environment

  3. Preliminary hazards analysis -- vitrification process

    Energy Technology Data Exchange (ETDEWEB)

    Coordes, D.; Ruggieri, M.; Russell, J.; TenBrook, W.; Yimbo, P. [Science Applications International Corp., Pleasanton, CA (United States)

    1994-06-01

    This paper presents a Preliminary Hazards Analysis (PHA) for mixed waste vitrification by joule heating. The purpose of performing a PHA is to establish an initial hazard categorization for a DOE nuclear facility and to identify those processes and structures which may have an impact on or be important to safety. The PHA is typically performed during and provides input to project conceptual design. The PHA is then followed by a Preliminary Safety Analysis Report (PSAR) performed during Title 1 and 2 design. The PSAR then leads to performance of the Final Safety Analysis Report performed during the facility`s construction and testing. It should be completed before routine operation of the facility commences. This PHA addresses the first four chapters of the safety analysis process, in accordance with the requirements of DOE Safety Guidelines in SG 830.110. The hazards associated with vitrification processes are evaluated using standard safety analysis methods which include: identification of credible potential hazardous energy sources; identification of preventative features of the facility or system; identification of mitigative features; and analyses of credible hazards. Maximal facility inventories of radioactive and hazardous materials are postulated to evaluate worst case accident consequences. These inventories were based on DOE-STD-1027-92 guidance and the surrogate waste streams defined by Mayberry, et al. Radiological assessments indicate that a facility, depending on the radioactive material inventory, may be an exempt, Category 3, or Category 2 facility. The calculated impacts would result in no significant impact to offsite personnel or the environment. Hazardous materials assessment indicates that a Mixed Waste Vitrification facility will be a Low Hazard facility having minimal impacts to offsite personnel and the environment.

  4. Launch team training system

    Science.gov (United States)

    Webb, J. T.

    1988-01-01

    A new approach to the training, certification, recertification, and proficiency maintenance of the Shuttle launch team is proposed. Previous training approaches are first reviewed. Short term program goals include expanding current training methods, improving the existing simulation capability, and scheduling training exercises with the same priority as hardware tests. Long-term goals include developing user requirements which would take advantage of state-of-the-art tools and techniques. Training requirements for the different groups of people to be trained are identified, and future goals are outlined.

  5. Training effectiveness evaluation model

    International Nuclear Information System (INIS)

    Penrose, J.B.

    1993-01-01

    NAESCO's Training Effectiveness Evaluation Model (TEEM) integrates existing evaluation procedures with new procedures. The new procedures are designed to measure training impact on organizational productivity. TEEM seeks to enhance organizational productivity through proactive training focused on operation results. These results can be identified and measured by establishing and tracking performance indicators. Relating training to organizational productivity is not easy. TEEM is a team process. It offers strategies to assess more effectively organizational costs and benefits of training. TEEM is one organization's attempt to refine, manage and extend its training evaluation program

  6. Training warning flags

    International Nuclear Information System (INIS)

    Miller, Richard C.

    2003-01-01

    Problems in accredited training programmes at US nuclear stations have resulted in several programmes having their accreditation status designated as probationary. A limited probationary period allows time for problem resolution before the programmes are again reviewed by the National Nuclear Accrediting Board. A careful study of these problems has resulted in the identification of several 'Training Warning Flags' that singularly, or in concert, may indicate or predict degraded training programme effectiveness. These training warning flags have been used by several US nuclear stations as a framework for self-assessments, as a reference in making changes to training programmes, and as a tool in considering student and management feedback on training activities. Further analysis and consideration of the training warning flags has developed precursors for each of the training warning flags. Although more subjective than the training warning flags, the precursors may represent early indicators of factors that may lead to or contribute to degraded training programme effectiveness. Used as evaluative tools, the training warning flags and the precursors may help identify areas for improvements in training programmes and help prioritize training programme improvement efforts. (author)

  7. Suplementação oral de L-carnitina associada ao treinamento físico e muscular respiratório na doença pulmonar obstrutiva crônica: estudo preliminar Oral supplementation of L-carnitine combined with exercise and respiratory training in patients with chronic obstructive pulmonary disease: preliminary study

    Directory of Open Access Journals (Sweden)

    Matheus Guedes Fernandes Silva

    2012-12-01

    Full Text Available Avaliar os efeitos da suplementação oral de L-carnitina associada ao treinamento físico e muscular respiratório na doença pulmonar obstrutiva crônica (DPOC. Participaram 14 voluntários com idade de 65±10,4 anos e diagnóstico clínico de DPOC moderado, classificados de acordo com a espirometria prévia. Os voluntários foram divididos em grupo treino esteira (GTE e grupo treino muscular respiratório (GTMR. Realizaram o teste de caminhada de seis minutos (TC6', teste de caminhada com carga progressiva (TCP, avaliação nutricional do índice de massa corpórea (IMC, dose diária recomendada de L-carnitina, pressões inspiratórias (PImáx e expiratórias máximas (PEmáx. Fizeram 30 min de caminhada em esteira, 3 vezes/semana por 10 semanas, e o GTMR realizou, ainda, 10 min de treinamento muscular inspiratório (Threshold® IMT e 10 min de treinamento muscular expiratório (Threshold® PEP à 50% da PImáx e PEmáx ajustados semanalmente. Após 10 semanas, foram reavaliados. No TC6' pré e pós-programa de treinamento físico, as variáveis alteradas foram: distância percorrida (DP, frequência cardíaca (FC final, pressão arterial sistólica (PAS final, pressão arterial diastólica (PAD final e Borg final no GTMR, no GTE as variáveis alteradas foram FC repouso, FC final, PAS final, Borg repouso e DP. Comparando os grupos no TC6, o GTE apresentou FC final, PAD final e Borg final maiores do que o GTMR na reavaliação; já no TCP, a FC final, PAS final, Borg final foram maiores no GTE, e DP foi maior no GTMR. Na avaliação respiratória, a PEmáx foi maior no GTMR na reavaliação. O treino aeróbio e suplementação de L-carnitina na DPOC otimizou a performance, a capacidade física e a tolerância ao esforço.To evaluate the effects of oral supplementation of L-carnitine associated with physical and respiratory muscles training in chronic obstructive pulmonary disease (COPD. Participated 14 COPD volunteers (65±10.4 years, divided

  8. Benefits of extending and adjusting the level of difficulty on computerized cognitive training for children with intellectual disabilities

    Directory of Open Access Journals (Sweden)

    Jon eOttersen

    2015-08-01

    Full Text Available Training on working memory (WM improves attention and working memory in children with attention-deficit hyperactivity disorder and memory impairments. However, for children with intellectual disabilities (ID, the results have been less encouraging. In this preliminary study it was hypothesized that children with ID would benefit from an extended amount of training and that the level of difficulty during training would affect the outcome. We included 21 children with mild or moderate intellectual disabilities aged 8–13 years. They went through between 37 and 50 training sessions with an adaptive computerized program on WM and non-verbal reasoning (NVR. The children were divided into two subgroups with different difficulty levels during training. The transfer to untrained cognitive tests was compared to the results of 22 children with intellectual disabilities training only 25 sessions, and to a control group. We found that the training group with the extended training program improved significantly on a block design task measuring NVR and on a WM task compared to the control group. There was also a significantly larger improvement on block design relative to the training group with the shorter training time. The children that received easier training tasks also improved significantly more on a verbal WM task compared to children with more demanding tasks.In conclusion, these preliminary data suggest that children with ID might benefit from cognitive training with longer training periods and less demanding tasks, compared to children without disabilities.

  9. Benefits of extending and adjusting the level of difficulty on computerized cognitive training for children with intellectual disabilities.

    Science.gov (United States)

    Ottersen, Jon; Grill, Katja M

    2015-01-01

    Training on working memory (WM) improves attention and WM in children with attention-deficit hyperactivity disorder and memory impairments. However, for children with intellectual disabilities (ID), the results have been less encouraging. In this preliminary study it was hypothesized that children with ID would benefit from an extended amount of training and that the level of difficulty during training would affect the outcome. We included 21 children with mild or moderate ID aged 8-13 years. They went through between 37 and 50 training sessions with an adaptive computerized program on WM and non-verbal reasoning (NVR). The children were divided into two subgroups with different difficulty levels during training. The transfer to untrained cognitive tests was compared to the results of 22 children with ID training only 25 sessions, and to a control group. We found that the training group with the extended training program improved significantly on a block design task measuring NVR and on a WM task compared to the control group. There was also a significantly larger improvement on block design relative to the training group with the shorter training time. The children that received easier training tasks also improved significantly more on a verbal WM task compared to children with more demanding tasks. In conclusion, these preliminary data suggest that children with ID might benefit from cognitive training with longer training periods and less demanding tasks, compared to children without disabilities.

  10. Training and education

    International Nuclear Information System (INIS)

    Bauer, E.; Oria, M.

    1977-01-01

    The paper deals with problems of training and education in a developing country which decided to launch a nuclear propramme. The aims of training and education under such circumstances are described and tecniques for accomplishing these aims are suggested [fr

  11. Moldova - Value Chain Training

    Data.gov (United States)

    Millennium Challenge Corporation — The evaluation of the GHS value chain training subactivity wwas designed to measure the extent, if any, to which the training activities improved the productivity...

  12. Nuclear instrument technician training

    International Nuclear Information System (INIS)

    Wollesen, E.S.

    1991-01-01

    This paper reports on Nuclear Instrument Technician (NIT) training that has developed at an accelerated rate over the past three decades. During the 1960's commercial nuclear power plants were in their infancy. For that reason, there is little wonder that NIT training had little structure and little creditability. NIT training, in many early plants, was little more than On-The Job Training (OJT). The seventies brought changes in Instrumentation and Controls as well as emphasis on the requirements for more in depth training and documentation. As in the seventies, the eighties saw not only changes in technologies but tighter requirements, standardized training and the development of accredited Nuclear Instrument Training; thus the conclusion: Nuclear Instrument Training Isn't What It Used To Be

  13. Technical training: places available

    CERN Document Server

    2013-01-01

    If you would like more information on a course, or for any other inquiry/suggestions, please contact Technical.Training@cern.ch. Eva Stern and Elise Romero, Technical Training Administration (Tel: 74924)

  14. Technical training - places available

    CERN Document Server

    2013-01-01

    If you would like more information on a course, or have any other inquiry/suggestions, please contact Technical.Training@cern.ch. Eva Stern and Elise Romero, Technical Training Administration (Tel: 74924)

  15. Technical training: places available

    CERN Multimedia

    2013-01-01

    If you would like more information on a course, or for any other inquiry/suggestions, please contact Technical.Training@cern.ch. Eva Stern and Elise Romero, Technical Training Administration (Tél : 74924)  

  16. Training on a Shoestring.

    Science.gov (United States)

    Callahan, Madelyn R.

    1995-01-01

    Describes ways to train employees on a tight budget and cut training costs. Offers ideas such as using local colleges, negotiating outsourcing costs, using computers, making good use of experts, and sharing resources with other companies. (JOW)

  17. Technical training: places available

    CERN Multimedia

    2014-01-01

    If you would like more information on a course, or have any other inquiry/suggestions, please contact Technical.Training@cern.ch. Eva Stern and Elise Romero, Technical Training Administration (Tel: 74924)

  18. Technical training: places available

    CERN Multimedia

    2014-01-01

    If you would like more information on a course, or have any other inquiry/suggestions, please contact Technical.Training@cern.ch. Eva Stern and Marie Lahchimi, Technical Training Administration (Tel: 74924)

  19. Small Community Training & Education

    Science.gov (United States)

    Operators Small Systems Small Community Training & Education education, training and professional implement the 1996 Amendments to the Safe Drinking Water Act (SDWA). • EPA Environmental Education Center

  20. Mechanics of train collision

    Science.gov (United States)

    1976-04-30

    A simple and a more detailed mathematical model for the simulation of train collisions are presented. The study presents considerable insight as to the causes and consequences of train motions on impact. Comparison of model predictions with two full ...

  1. Human factors in training

    International Nuclear Information System (INIS)

    Dutton, J.W.; Brown, W.R.

    1981-01-01

    The Human Factors concept is a focused effort directed at those activities which require human involvement. Training is, by its nature, an activity totally dependent on the Human Factor. This paper identifies several concerns significant to training situations and discusses how Human Factor awareness can increase the quality of learning. Psychology in the training arena is applied Human Factors. Training is a method of communication represented by sender, medium, and receiver. Two-thirds of this communications model involves the human element directly

  2. Training Recurrent Networks

    DEFF Research Database (Denmark)

    Pedersen, Morten With

    1997-01-01

    Training recurrent networks is generally believed to be a difficult task. Excessive training times and lack of convergence to an acceptable solution are frequently reported. In this paper we seek to explain the reason for this from a numerical point of view and show how to avoid problems when...... training. In particular we investigate ill-conditioning, the need for and effect of regularization and illustrate the superiority of second-order methods for training...

  3. A Training Technology Evaluation Tool

    National Research Council Canada - National Science Library

    Livingston, Stephen C; Dyer, Jean L; Swinson, Diadra

    2005-01-01

    A Training Technology Evaluation Tool was developed to help procurers and developers of training technologies to make informed decisions and to improve the overall effectiveness of training technologies...

  4. District nurse training

    OpenAIRE

    Elliott, Arnold; Freeling, Paul; Owen, John

    1980-01-01

    Training for district nursing is being reviewed. By 1981 district nurses will have a new administrative structure, a new curriculum, and a new examination. Training for nursing, like that for general practice, is to become mandatory. The history of the development of district nurse training is briefly described.

  5. Human Factors in Training

    Science.gov (United States)

    Barshi, Immanuel; Byrne, Vicky; Arsintescu, Lucia; Connell, Erin

    2010-01-01

    Future space missions will be significantly longer than current shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. By researching established training principles, examining future needs, and by using current practices in space flight training as test beds, both in Flight Controller and Crew Medical domains, this research project is mitigating program risks and generating templates and requirements to meet future training needs. Training efforts in Fiscal Year 09 (FY09) strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center (MCC) operations. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: 1) Risk associated with poor task design; 2) Risk of error due to inadequate information; and 3) Risk associated with reduced safety and efficiency due to poor human factors design.

  6. Questionnaire measuring training's impact

    International Nuclear Information System (INIS)

    Corfield, R.A.

    1987-01-01

    A questionnaire has been prepared to evaluate the impact of training of a nuclear power plant. Items covered are the degree to which training is systematic, the influence that should be exerted by INPO, and the costs of an effective training program

  7. Computer Based Training Authors' and Designers' training

    Directory of Open Access Journals (Sweden)

    Frédéric GODET

    2016-03-01

    Full Text Available This communication, through couple of studies driven since 10 years, tries to show how important is the training of authors in Computer Based Training (CBT. We submit here an approach to prepare designers mastering Interactive Multimedia modules in this domain. Which institutions are really dedicating their efforts in training authors and designers in this area of CBTs? Television devices and broadcast organisations offered since year 60s' a first support for Distance Learning. New media, New Information and Communication Technologies (NICT allowed several public and private organisations to start Distance Learning projects. As usual some of them met their training objectives, other of them failed. Did their really failed? Currently, nobody has the right answer. Today, we do not have enough efficient tools allowing us to evaluate trainees' acquisition in a short term view. Training evaluation needs more than 10 to 20 years of elapsed time to bring reliable measures. Nevertheless, given the high investments already done in this area, we cannot wait until the final results of the pedagogical evaluation. A lot of analyses showed relevant issues which can be used as directions for CBTs authors and designers training. Warning - Our studies and the derived conclusions are mainly based on projects driven in the field. We additionally bring our several years experience in the training of movie film authors in the design of interactive multimedia products. Some of our examples are extracting from vocational training projects where we were involved in all development phases from the analysis of needs to the evaluation of the acquisition within the trainee's / employee job's. Obviously, we cannot bring and exhaustive approach in this domain where a lot of parameters are involved as frame for the CBT interactive multimedia modules authors' and designers' training.

  8. Simulator fidelity and training effectiveness: a comprehensive bibliography with selected annotations

    International Nuclear Information System (INIS)

    Rankin, W.L.; Bolton, P.A.; Shikiar, R.; Saari, L.M.

    1984-05-01

    This document contains a comprehensive bibliography on the topic of simulator fidelity and training effectiveness, prepared during the preliminary phases of work on an NRC-sponsored project on the Role of Nuclear Power Plant Simulators in Operator Licensing and Training. Section A of the document is an annotated bibliography consisting of articles and reports with relevance to the psychological aspects of simulator fidelity and the effectiveness of training simulators in a variety of settings, including military. The annotated items are drawn from a more comprehensive bibliography, presented in Section B, listing documents treating the role of simulators in operator training both in the nuclear industry and elsewhere

  9. Integrated Rolling Stock Planning for Suburban Passenger Trains

    DEFF Research Database (Denmark)

    Thorlacius, Per

    used, the result being the loss of optimality. The talk will present a new, integrated rolling stock planning model in which the many requirements are handled all at the same time. Preliminary results from DSB S-tog, the suburban train operator of the City of Copenhagen will also be presented.......A central issue for operators of passenger trains is providing sufficient number of seats while minimising operating costs. This process must be conducted taking a large number of practical, railway oriented requirements into account. Because of this complexity, a stepwise solution was previously...

  10. Sail training: an innovative approach to graduate nurse preceptor development.

    Science.gov (United States)

    Nicol, Pam; Young, Melisa

    2007-01-01

    A 1-day sail-training program that aims to increase graduate nurse preceptor skills was evaluated. Preliminary results suggest that this experiential learning is an effective way to develop graduate nurse preceptors. Awareness of graduate nurses' needs has been heightened, and skills in clinical teaching have been developed. It is indicated from the limited results that the outcomes are sustained over time, but further evaluation is needed.

  11. Abramovo Counterterrorism Training Center

    International Nuclear Information System (INIS)

    Hayes, Christopher M.; Ross, Larry; Kaldenbach, Karen Yvonne; Estigneev, Yuri; Murievav, Andrey

    2011-01-01

    The U.S. government has been assisting the Russian Federation (RF) Ministry of Defense (MOD) for many years with nuclear weapons transportation security (NWTS) through the provision of specialized guard escort railcars and cargo railcars with integrated physical security and communication systems, armored transport vehicles, and armored escort vehicles. As a natural continuation of the NWTS program, a partnership has been formed to construct a training center that will provide counterterrorism training to personnel in all branches of the RF MOD. The Abramovo Counterterrorism Training Center (ACTC) is a multinational, multiagency project with funding from Canada, RF and the U.S. Departments of Defense and Energy. ACTC will be a facility where MOD personnel can conduct basic through advanced training in various security measures to protect Category IA material against the threat of terrorist attack. The training will enhance defense-in-depth principles by integrating MOD guard force personnel into the overall physical protection systems and improving their overall response time and neutralization capabilities. The ACTC project includes infrastructure improvements, renovation of existing buildings, construction of new buildings, construction of new training facilities, and provision of training and other equipment. Classroom training will be conducted in a renovated training building. Basic and intermediate training will be conducted on three different security training areas where various obstacles and static training devices will be constructed. The central element of ACTC, where advanced training will be held, is the 'autodrome,' a 3 km road along which various terrorist events can be staged to challenge MOD personnel in realistic and dynamic nuclear weapons transportation scenarios. This paper will address the ACTC project elements and the vision for training development and integrating this training into actual nuclear weapons transportation operations.

  12. Virtual Reality Simulator Systems in Robotic Surgical Training.

    Science.gov (United States)

    Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

    2018-06-01

    The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.

  13. Microsurgical clipping in forty patients with unruptured anterior cerebral circulation aneurysms: an investigation into cognitive outcome Clipagem microcirúrgica em 40 pacientes com aneurisma de circulação cerebral anterior não-roto: uma investigação cognitiva

    Directory of Open Access Journals (Sweden)

    Arthur A Pereira-Filho

    2010-10-01

    Full Text Available OBJECTIVE: It is a consensus that most unruptured intracranial aneurysms (UIA can be treated with acceptably low morbidity. However, some studies recently reported postoperative cognitive impairment, suggesting that it could be attributable to surgical damage. Our goal is to evaluate cognitive function before and after microsurgical clipping in patients with UIA. METHOD: A consecutive series of 40 patients who underwent microsurgical clipping for UIA were studied. The cognitive assessment (Mini Mental State Examination, MMSE was performed immediately before and at least one month after surgery. Paired Student's "t" test and analysis of variance (ANOVA were used for statistical purposes. RESULTS: The mean MMSE score in the preoperative analysis was 28.12 (SD, 1.34. In the postoperative period the mean MMSE score was 28.40 (SD, 1.46. Paired Student's "t" test was applied to the scores and no significant difference was found (p=0.315. ANOVA did not find independent associations between MMSE scores and age, hypertension, smoking, dyslipidemia, education, aneurysm location, number, laterality or size. CONCLUSION: The present study suggests that microsurgical clipping for UIA does not result in major cognitive dysfunction as determined by the MMSEOBJETIVO: É consenso que a maioria dos aneurismas intracranianos não-rotos (AINR podem ser tratados com aceitável taxa de morbidade. Entretanto, alguns estudos reportaram déficits cognitivos no pós-operatório, sugerindo que poderiam ser atribuídos ao dano cirúrgico. O objetivo desse estudo é avaliar a função cognitiva antes e após clipagem microcirúrgica em pacientes com AINR. MÉTODO: Uma série de 40 pacientes com AINR submetidos à clipagem microcirúrgica foi estudada. A avaliação cognitiva (Mini Exame do Estado Mental, MEEM foi realizada antes e após a intervenção cirúrgica. A análise estatística foi realizada com teste "t" de Student e análise de variância (ANOVA. RESULTADOS: A m

  14. Preliminary nuclear decommissioning cost study

    International Nuclear Information System (INIS)

    Sissingh, R.A.P.

    1981-04-01

    The decommissioning of a nuclear power plant may involve one or more of three possible options: storage with surveillance (SWS), restricted site release (RSR), and unrestricted site use(USU). This preliminary study concentrates on the logistical, technical and cost aspects of decommissioning a multi-unit CANDU generating station using Pickering GS as the reference design. The procedure chosen for evaluation is: i) removal of the fuel and heavy water followed by decontamination prior to placing the station in SWS for thiry years; ii) complete dismantlement to achieve a USU state. The combination of SWS and USU with an interim period of surveillance allows for radioactive decay and hence less occupational exposure in achieving USU. The study excludes the conventional side of the station, assumes waste disposal repositories are available 1600 km away from the station, and uses only presently available technologies. The dismantlement of all systems except the reactor core can be accomplished using Ontario Hydro's current operating, maintenance and construction procedures. The total decommissioning period is spread out over approximately 40 years, with major activities concentrated in the first and last five years. The estimated dose would be approximately 1800 rem. Overall Pickering GS A costs would be $162,000,000 (1980 Canadian dollars)

  15. Preliminary Iron Distribution on Vesta

    Science.gov (United States)

    Mittlefehldt, David W.; Mittlefehldt, David W.

    2013-01-01

    The distribution of iron on the surface of the asteroid Vesta was investigated using Dawn's Gamma Ray and Neutron Detector (GRaND) [1,2]. Iron varies predictably with rock type for the howardite, eucrite, and diogenite (HED) meteorites, thought to be representative of Vesta. The abundance of Fe in howardites ranges from about 12 to 15 wt.%. Basaltic eucrites have the highest abundance, whereas, lower crustal and upper mantle materials (cumulate eucrites and diogenites) have the lowest, and howardites are intermediate [3]. We have completed a mapping study of 7.6 MeV gamma rays produced by neutron capture by Fe as measured by the bismuth germanate (BGO) detector of GRaND [1]. The procedures to determine Fe counting rates are presented in detail here, along with a preliminary distribution map, constituting the necessary initial step to quantification of Fe abundances. We find that the global distribution of Fe counting rates is generally consistent with independent mineralogical and compositional inferences obtained by other instruments on Dawn such as measurements of pyroxene absorption bands by the Visual and Infrared Spectrometer (VIR) [4] and Framing Camera (FC) [5] and neutron absorption measurements by GRaND [6].

  16. Stardust Interstellar Preliminary Examination (ISPE)

    Science.gov (United States)

    Westphal, A. J.; Allen, C.; Bajt, S.; Basset, R.; Bastien, R.; Bechtel, H.; Bleuet, P.; Borg, J.; Brenker F.; Bridges, J.

    2009-01-01

    In January 2006 the Stardust sample return capsule returned to Earth bearing the first solid samples from a primitive solar system body, C omet 81P/Wild2, and a collector dedicated to the capture and return o f contemporary interstellar dust. Both collectors were approximately 0.1m(exp 2) in area and were composed of aerogel tiles (85% of the co llecting area) and aluminum foils. The Stardust Interstellar Dust Col lector (SIDC) was exposed to the interstellar dust stream for a total exposure factor of 20 m(exp 2-) day during two periods before the co metary encounter. The Stardust Interstellar Preliminary Examination ( ISPE) is a three-year effort to characterize the collection using no ndestructive techniques. The ISPE consists of six interdependent proj ects: (1) Candidate identification through automated digital microsco py and a massively distributed, calibrated search (2) Candidate extr action and photodocumentation (3) Characterization of candidates thro ugh synchrotronbased FourierTranform Infrared Spectroscopy (FTIR), S canning XRay Fluoresence Microscopy (SXRF), and Scanning Transmission Xray Microscopy (STXM) (4) Search for and analysis of craters in f oils through FESEM scanning, Auger Spectroscopy and synchrotronbased Photoemission Electron Microscopy (PEEM) (5) Modeling of interstell ar dust transport in the solar system (6) Laboratory simulations of h ypervelocity dust impacts into the collecting media

  17. Preliminary design of smart fuel

    International Nuclear Information System (INIS)

    Kim, Y.; Ha, D.; Park, S.; Nahm, K.; Lee, K.; Kim, J.

    2007-01-01

    SMART (System-integrated Modular Advanced Reactor) is a novel light water rector with a modular, integral primary system configuration. This concept has been developing a 660 MWt by Korean Nuclear Power Industry Group with KAERI. SMART is being developed for use as an energy source for small-scale power generation and seawater desalination. Although the design of SMART is based on the current pressurized water reactor technology, new technologies such as enhanced safety, and passive safety have been applied, and system simplification and modularization, innovations in manufacturing and installation technologies have been implemented culminating in a design that has enhanced safety and economy, and is environment -friendly. In this paper described the preliminary design of the nuclear Fuel for this SMART, the design concept and the characteristics of SMART Fuel. In specially this paper describe the optimization of grid span adjustment to improve the thermal performance of the SMART Fuel as well as to improve the seismic resistance performance of the SMART Fuel, it is not easy to improve the both performance simultaneously because of design parameter of each performance inversely proportional. SMART Fuel enable to extra-long extended fuel cycle length and resistance of proliferation, enhanced safety, improved economics and reduced nuclear waste

  18. Radiological worker training

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-10-01

    This Handbook describes an implementation process for core training as recommended in Implementation Guide G441.12, Radiation Safety Training, and as outlined in the DOE Radiological Control Standard (RCS). The Handbook is meant to assist those individuals within the Department of Energy, Managing and Operating contractors, and Managing and Integrating contractors identified as having responsibility for implementing core training recommended by the RCS. This training is intended for radiological workers to assist in meeting their job-specific training requirements of 10 CFR 835. While this Handbook addresses many requirements of 10 CFR 835 Subpart J, it must be supplemented with facility-specific information to achieve full compliance.

  19. STS-96 Crew Training

    Science.gov (United States)

    1999-01-01

    The training for the crew members of the STS-96 Discovery Shuttle is presented. Crew members are Kent Rominger, Commander; Rick Husband, Pilot; Mission Specialists, Tamara Jernigan, Ellen Ochoa, and Daniel Barry; Julie Payette, Mission Specialist (CSA); and Valery Ivanovich Tokarev, Mission Specialist (RSA). Scenes show the crew sitting and talking about the Electrical Power System; actively taking part in virtual training in the EVA Training VR (Virtual Reality) Lab; using the Orbit Space Vision Training System; being dropped in water as a part of the Bail-Out Training Program; and taking part in the crew photo session.

  20. Training techniques for industry

    International Nuclear Information System (INIS)

    Jones, D.W.

    1978-01-01

    The advantages and disadvantages of commonly used training techniques in relation to cost-effective, prevention-oriented Quality Assurance are examined. Important questions are whether training techniques teach cost effectiveness and whether the techniques are, themselves, cost effective. To answer these questions, criteria for evaluating teaching techniques for cost effectiveness were developd, and then commonly used techniques are evaluated in terms of specific training program objectives. Motivation of personnel is also considered important to the success of a training program, and methods are outlined by which recognition of the academic quality of industrial training can be used as a motivational technique

  1. Effective mechanic training

    International Nuclear Information System (INIS)

    Burdge, R.E.

    1979-01-01

    The need for the training of mechanics is discussed, and the increased interest within the utility industry of placing a similar importance on this training as it has traditionally placed on operator training, is expressed. Effective approaches and techniques are described. Fundamental mechanical maintenance concepts and their practical application are discussed, including the use of supporting video programs. The importance of follow-up practical shop exercise which reinforces classroom instruction is stressed, drawing from practical utility experience. Utilizing success in training as a measure of eligibility for advancement is discussed as well as the interface between training and the company bargaining unit

  2. Training of nonlicensed personnel

    International Nuclear Information System (INIS)

    Hetrick, D.E.

    1975-01-01

    The safety and efficiency with which a station operates is a function of the competence and proficiency of all personnel. This includes the nonlicensed personnel who make up the bulk of the station staff. Thus the training of these members of the station complement is an important function in overall station performance. Standards, regulations, regulatory guides, and codes provide guidance to the training requirements for such personnel. Training needs and objectives must be established, a plan prepared and then all incorporated into a training program. A well planned and operated training program will stimulate effective communications between the different groups within the station and between the station and off site support groups

  3. Radiological worker training

    International Nuclear Information System (INIS)

    1998-10-01

    This Handbook describes an implementation process for core training as recommended in Implementation Guide G441.12, Radiation Safety Training, and as outlined in the DOE Radiological Control Standard (RCS). The Handbook is meant to assist those individuals within the Department of Energy, Managing and Operating contractors, and Managing and Integrating contractors identified as having responsibility for implementing core training recommended by the RCS. This training is intended for radiological workers to assist in meeting their job-specific training requirements of 10 CFR 835. While this Handbook addresses many requirements of 10 CFR 835 Subpart J, it must be supplemented with facility-specific information to achieve full compliance

  4. The second stage of long-term training in team games: experimental assessment of traditional training system

    Directory of Open Access Journals (Sweden)

    Maksimenko I.G

    2010-03-01

    Full Text Available The features of construction of the traditional system of preparation of young sportsmen are certain on the stage of the preliminary base training. In researches 200 players took part in age 12-15 years. The indexes of frequency of cardiac rhythm, expenses of energy, competition activity of young sportsmen are presented. Indexes are fixed during implementation of the different typical trainings programs, participating in bilateral and official games. The typical rations of feed are analysed. The results of deep medical inspection are rotined.

  5. Academic Training: Academic Training Lectures-Questionnaire

    CERN Multimedia

    2004-01-01

    ACADEMIC TRAINING Françoise Benz tel. 73127 academic.training@cern.ch SUGGEST AND WIN! Its time to plan the 2004-2005 lecture series. From today until March 19 you have the chance to give your contribution to planning for next year's Academic Training Lecture Series. At the web site: http://cern.ch/Academic.Training/questionnaire you will find questionnaires proposing topics in high energy physics, applied physics and science and society. Answering the questionnaire will help ensure that the selected topics are as close as possible to your interests. In particular requests and comments from students will be much appreciated. To encourage your contribution, the AT Committee will reward one lucky winner with a small prize, a 50 CHF coupon for a book purchase at the CERN bookshop.

  6. Synergy Repetition Training versus Task Repetition Training in Acquiring New Skill.

    Science.gov (United States)

    Patel, Vrajeshri; Craig, Jamie; Schumacher, Michelle; Burns, Martin K; Florescu, Ionut; Vinjamuri, Ramana

    2017-01-01

    Traditionally, repetitive practice of a task is used to learn a new skill, exhibiting as immediately improved performance. Research suggests, however, that a more experience-based rather than exposure-based training protocol may allow for better transference of the skill to related tasks. In synergy-based motor control theory, fundamental motor skills, such as hand grasping, are represented with a synergy subspace that captures essential motor patterns. In this study, we propose that motor-skill learning through synergy-based mechanisms may provide advantages over traditional task repetition learning. A new task was designed to highlight the range of motion and dexterity of the human hand. Two separate training strategies were tested in healthy subjects: task repetition training and synergy training versus a control. All three groups showed improvements when retested on the same task. When tested on a similar, but different set of tasks, only the synergy group showed improvements in accuracy (9.27% increase) compared to the repetition (3.24% decline) and control (3.22% decline) groups. A kinematic analysis revealed that although joint angular peak velocities decreased, timing benefits stemmed from the initial feed-forward portion of the task (reaction time). Accuracy improvements may have derived from general improved coordination among the four involved fingers. These preliminary results warrant further investigation of synergy-based motor training in healthy individuals, as well as in individuals undergoing hand-based rehabilitative therapy.

  7. Making training decisions proactively

    International Nuclear Information System (INIS)

    Hartman, R.F.

    1988-01-01

    The challenge of making training decisions with a high degree of confidence as to the results of those decisions face every DOD, Federal, State, and City agency. Training has historically been a very labor and paper intensive system with limited automation support. This paper outlines how one DOD component, the Air Force, is approaching that challenge. The Training Decision System (TDS) will provide the Air Force with an automated decision aid to help plan and estimate the consequences of various mixes of resident training, On-The-Job Training (OJT), and field training within a specialty such as security. The system described provides training from enlistment to separation and responds to hundreds of related security task needs. This system identifies what the tasks are, who should provide the training, what training setting should be used, what proficiency should be achieved, and through computer modeling provides an assessment of training effectiveness options and estimate the impact of implementing those options. With current budgetary constraints and with the possibility of further reductions in the future, the most cost effective training mix must be found to sustain required capabilities

  8. Training assessments and assistance

    International Nuclear Information System (INIS)

    Przybylski, J.L.

    1994-07-01

    The Transportation Management Division, Office of Environmental Restoration and Waste Management (TMD/EM-261), United States Department of Energy (DOE), Training Program Manager has established an independent Training Assessment Program, the intent of which is to evaluate, exclusively, transportation and packaging training activities throughout the Department of Energy (DOE) community. The results generated from an application of the Training Assessment Program are intended to be utilized as a management tool for maintaining compliance with applicable regulatory-driven training requirements. In addition, the Transportation Assessment Program can be employed to evaluate training methodologies and, through a pre-arranged, cooperative, technical assistance effort, provide each Department of Energy (DOE) site with the means necessary to enhance it's overall transportation and packaging training capabilities

  9. Influence of training and competitive sessions on peripheral β-endorphin levels in training show jumping horses.

    Science.gov (United States)

    Cravana, Cristina; Medica, P; Ragonese, G; Fazio, E

    2017-01-01

    To investigate the effects of training sessions on circulating β-endorphin changes in sport horses before and after competition and to ascertain whether competition would affect this response. A total of 24 trained jumping horses were randomly assigned to one of two training groups: Group A (competing) and Group B (not competing). To determined plasma β-endorphin concentrations, two pre- and post-competition training weeks at aerobic workout and two competitive show jumping event days at anaerobic workout were measured before, 5 and 30 min after exercise. Exercise intensity is described using lactate concentrations and heart rate. The circuit design, intensity, and duration of training sessions were the same for both groups. In Group A, one-way analysis of variance for repeated measures (RM-ANOVA) showed significant effects of exercise on β-endorphin changes (F=14.41; prelease of β-endorphin and it may depend on the duration of the exercise program. Moreover, the responses during exercise in the course of post-competition training sessions seem to be significantly different from those the pre-competition training. These data show that the preliminary competitive stress induced additional significant changes of β-endorphin pattern. It would reflect the need of a long-lasting modulation of fatigue and pain perception related to the effect of an additional physical and mental effort for the consecutive competitive and training sessions.

  10. Authentication by Keystroke Timing: Some Preliminary Results

    National Research Council Canada - National Science Library

    Gaines, R. S; Lisowski, William; Press, S. J; Shapiro, Norman

    1980-01-01

    ... of an individual seeking access to the computer. This report summarizes preliminary efforts to establish whether an individual can be identified by the statistical characteristics of his or her typing...

  11. Preliminary Phytochemical and Physicochemical Characterization of ...

    African Journals Online (AJOL)

    Purpose: To carry out phytochemical and physicochemical studies on the leaves of Gynura segetum. Methods: Preliminary phytochemical and physicochemical studies using chromatographic techniques,were carried out, Parameters evaluated include ash value, loss on drying and extractive value, amongst others.

  12. Original Article PRELIMINARY BIOAUTOGRAPHIC ANALYSIS OF ...

    African Journals Online (AJOL)

    PRELIMINARY BIOAUTOGRAPHIC ANALYSIS OF THE SEEDS OF GLYPHAEA BREVIS. (SPRENG) MONACHINO FOR ANTIOXIDANT AND ANTIBACTERIAL PRINCIPLES. Michael Lahai1, Tiwalade Adewale Olugbade2. 1Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, College of Medicine ...

  13. Preliminary engineering cost trends for highway projects.

    Science.gov (United States)

    2011-10-21

    Preliminary engineering (PE) for a highway project encompasses two efforts: planning to minimize the physical, social, and human environmental impacts of projects and engineering design to deliver the best alternative. PE efforts begin years in advan...

  14. Preliminary Analysis of Reinforced Concrete Waffle Walls

    National Research Council Canada - National Science Library

    Shugar, Theodore

    1997-01-01

    A preliminary analytical method based upon modified plate bending theory is offered for structural analysis of a promising new construction method for walls of small buildings and residential housing...

  15. Preliminary design data package. Appendix C

    Energy Technology Data Exchange (ETDEWEB)

    1979-07-25

    The design requirements, design philosophy, method and assumptions, and preliminary computer-aided design of the Near-Term Hybrid Vehicle including its electric and heat power units, control equipment, transmission system, body, and overall vehicle characteristics are presented. (LCL)

  16. Renewable Energy Park - Preliminary Feasibility & Engineering Report

    Energy Technology Data Exchange (ETDEWEB)

    Ariwite, Roderick [Fallon Paiute Shoshone Tribe, NV (United States)

    2015-07-31

    This "Renewable Energy Park - Preliminary Feasibility & Engineering Report" seeks to provide an overall assessment and review of renewable energy development opportunities on the Fallon Indian Reservation and Colony Lands.

  17. Decentralised wastewater treatment effluent fertigation: preliminary ...

    African Journals Online (AJOL)

    Decentralised wastewater treatment effluent fertigation: preliminary technical assessment. ... living in informal settlements with the effluent produced being used on agricultural land. ... Banana and taro required 3 514 mm of irrigation effluent.

  18. Computer training aids for nuclear operator training

    International Nuclear Information System (INIS)

    Phillips, J.G.P.; Binns, J.B.H.

    1983-01-01

    The Royal Navy's Nuclear Propulsion School at HMS SULTAN which is responsible for training all ratings and officers who operate Submarine Pressurised Water Reactor plants, has available a varied selection of classroom simulator training aids as well as purpose built Submarine Manoeuvring Room simulators. The use of these classroom training aids in the twelve months prior to Autumn 1981 is discussed. The advantages and disadvantages of using relatively expensive computer based aids to support classroom instruction for students who do not investigate mathematically the dynamics of the Reactor Plant are identified. The conclusions drawn indicate that for students of limited academic ability the classroom simulators are disproportionately expensive in cost, maintenance load, and instructional time. Secondly, the experience gained in the use of the Manoeuvring Room Simulators to train future operators who have just finished the academic phase of their training is outlined. The possible pitfalls for the instructor are discussed and the lessons learnt, concluding that these simulators provide a valuable substitute for the live plant enabling trainees to be brought up to a common standard and reducing their on job training time to an acceptable level. (author)

  19. Transferências microcirúrgicas do músculo grácil para flexão do cotovelo na lesão do plexo braquial do adulto: estudo retrospectivo de oito casos Microsurgical transfer of the gracilis muscle for elbow flexion in brachial plexus injury in adults: retrospective study of eight cases

    Directory of Open Access Journals (Sweden)

    Luiz Koiti Kimura

    2011-10-01

    Full Text Available OBJETIVO: O tratamento das lesões do plexo braquial representa um grande desafio, principalmente as lesões tardias, com mais de 12 meses de evolução. Analisamos retrospectivamente pacientes que foram submetidos a uma das possibilidades para tentar restaurar a função do membro superior afetado nestas condições, a transferência microcirúrgica do músculo grácil para flexão do cotovelo. MÉTODOS: Foram incluídos oito pacientes, divididos em dois grupos: um cujo procedimento realizado consistia em neurorrafia do retalho muscular com enxerto de nervo sural e anastomoses mais distais; o outro em que a neurorrafia era realizada diretamente no nervo espinal acessório, e anastomose nos vasos toracoacromiais. RESULTADOS: Encontramos significante diferença entre os grupos, sendo que aqueles submetidos à neurorrafia direta obtiveram resultados satisfatórios em maior número (75% M4 quando comparados com o outro grupo, que fez uso de enxerto para neurorrafia, em que foi menor o sucesso do procedimento (25% M4. CONCLUSÃO: Pacientes submetidos à transferência funcional microcirúrgica do músculo grácil cujas anastomoses vasculares foram realizadas nos vasos toracoacromiais apresentaram melhor resultado funcional do que aqueles que tiveram suas anastomoses realizadas na artéria braquial e consequente utilização de enxerto de nervo.OBJECTIVE: Treating brachial plexus injuries is a major challenge, especially lesions that are presented late, with more than 12 months of evolution. We retrospectively analyzed patients who underwent one of the possibilities for attempting to restore the function of upper limbs affected under such conditions: microsurgical transfer of the gracilis muscle for elbow flexion. METHODS: Eight patients were included, divided into two groups: one in which the procedure consisted of neurorrhaphy of the muscle flap with sural nerve grafting and anastomosis more distally; and the other, in which the neurorrhaphy was

  20. ECP divisional training: plan 1996

    OpenAIRE

    Storr, Kenneth Mick

    1996-01-01

    The divisional training plan is produced each year at the request of the Joint Training Board (JTB) following a recommendation in the 1991 CERN Training Plan which states that divisions should produce a plan setting out training priorities. This plan presents a review of training activities. a report on ECP progress in implementing the recommendations of the 1995 CERN training plan, a discussion of divisional training objectives, and a summary of training requests generated by the 1996 period...