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Sample records for optimizing microsurgical skills

  1. Optimizing microsurgical skills with EEG neurofeedback

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    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.

  2. Skills acquisition and assessment after a microsurgical skills course for ophthalmology residents.

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    Ezra, Daniel G; Aggarwal, Raj; Michaelides, Michel; Okhravi, Narciss; Verma, Seema; Benjamin, Larry; Bloom, Philip; Darzi, Ara; Sullivan, Paul

    2009-02-01

    To assess the impact of a skills course on microsurgical skills acquisition and to investigate the validity of a video-based modified Objective Structured Assessment of Technical Skill (OSATS) assessment tool that has not previously been applied to ophthalmic surgery. Prospective longitudinal cohort study. Fourteen residents were recruited from 20 attendees at the Moorfields Eye Hospital microsurgical skills course for residents. Each resident performed a standardized microsurgical task consisting of the placement of a 10-0 nylon corneal suture into a model eye using an operating microscope with standardized equipment in a standardized environment. Objective measurements were made using the Imperial College Surgical Assessment Device (ICSAD). This is a motion-tracking device returning 3 parameters for economy of movement: total path length, time, and number of individual hand movements. A concurrent video recording was made of each task by 2 independent observers who were masked to the time of the recording relative to the course and the identity of the resident. Video footage was marked in accordance with the OSATS video scoring template. Each resident had motion-tracking analysis performed during corneal suturing before and after the course (total path length, time, and number of individual hand movements), along with concurrent OSATS video scores. Skills improvement after the course was found to be statistically significant for all 3 ICSAD economy of movement parameters: path length, P = 0.001; hand movements, P = 0.012; and time, P = 0.009. Differences in the combined OSATS scores of the 2 raters before and after the course were found to be significant (P = 0.039). Interrater reliability of OSATS scorers was 0.78 (alpha Cronbach). Correlations between the OSATS scores and each of the ICSAD parameters were found to be significant (Psystem has significant correlation with the ICSAD motion-tracking parameters, demonstrating concurrent validity between the 2

  3. Male infertility microsurgical training

    Institute of Scientific and Technical Information of China (English)

    Akanksha Mehta; Philip S Li

    2013-01-01

    Microsurgical training is imperative for urologists and clinical andrologists specializing in male infertility.Success in male infertility microsurgery is heavily dependent on the surgeon's microsurgical skills.Laboratory-based practice to enhance microsurgical skills improves the surgeon's confidence,and reduces stress and operating time,benefiting both the patient and the surgeon.This review provides guidelines for setting up a microsurgical laboratory to develop and enhance microsurgical skills using synthetic and animal models.The role of emerging techniques,such as robotic-assisted microsurgery,is also discussed.

  4. Evaluation of the Microvascular Research Center Training Program for Assessing Microsurgical Skills in Trainee Surgeons

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    Seiji Komatsu

    2013-05-01

    Full Text Available Background  We established the Microvascular Research Center Training Program (MRCPto help trainee surgeons acquire and develop microsurgical skills. Medical students wererecruited to undergo theMRCP to assessthe effectiveness oftheMRCP fortrainee surgeons.Methods  Twenty-two medical students with no prior microsurgical experience, who completed the course from2005 to 2012,were included. TheMRCP comprises 5 stages oftraining,each with specific passing requirements. Stages 1 and 2 involve anastomosing silicone tubesand blood vessels of chicken carcasses,respectively,within 20minutes. Stage 3 involves anastomosing the femoral artery and vein oflive ratswith a 1-day patency rate of > 80%. Stage4 requires replantation of free superficial inferior epigastric artery flaps in rats with a 7-daysuccessrate of > 80%. Stage 5 involvessuccessful completion of one case ofratreplantation/transplantation. We calculated the passing rate for each stage and recorded the number ofanastomosesrequired to passstages 3 and 4.Results  The passing rates were 100% (22/22 for stages 1 and 2, 86.4% (19/22 for stage3, 59.1% (13/22 for stage 4, and 55.0% (11/20 for stage 5. The number of anastomosesperformedwas 17.2± 12.2 in stage 3 and 11.3± 8.1 in stage 4.Conclusions  Majority ofthemedicalstudentswho undertook theMRCP acquired basicmicrosurgicalskills. Thus,we conclude thatthe MRCP is an effective microsurgery training programfortrainee surgeons.

  5. Bridging the gap: theory-based design of a microsurgical skills course for ophthalmology residents.

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    Koukkoulli, Antigoni; Chandra, Aman; Sheth, Hithen; Okhravi, Narciss; Verma, Seema; Sullivan, Paul; Ezra, Daniel G

    2015-01-01

    Although theory-based schemes for course design are widely used in educational settings, making use of cognitive theory in the design of surgical skills courses in ophthalmology is rare. The primary aim of this study is to describe the application of instructional design, an established theory-based approach in course design, to the development of a surgical skills course for ophthalmology residents. The secondary aim of this study is to assess the educational effect of this theory-based course. A 1-day skills course was designed according to Gagné׳s events of instruction model, which was employed as a template for the instructional sequence of learning steps. Skills acquisition following the implementation of the model was measured with precourse and postcourse assessments. Moorfields Eye Hospital organized the 1-day annual intermediate surgical skills course, which was hosted at the Royal College of Ophthalmologists' microsurgical skills laboratory. A total of 20 ophthalmology residents of Moorfields Eye Hospital participated in the study. A 1-day surgical skills course was formulated according to the instructional design principles outlined. The 4 objectives of the course (corneal suturing, corneal gluing, intravitreal injections, and eyelid suturing) were addressed in a parallel fashion as to allow for multiple objectives to be processed simultaneously, in the context of the instructional design sequence. Assessments demonstrated significant improvement in skills acquisition for the 4 course objectives. Instructional design is a valuable tool for planning effective surgical training courses as it is portable, allowing its application to a wide variety of outcomes and settings, and its terminology is simple and understandable to those working in clinical education. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. The 'round-the-clock' training model for assessment and warm up of microsurgical skills: a validation study.

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    Chan, Woan-Yi; Figus, Andrea; Ekwobi, Chidi; Srinivasan, Jeyaram R; Ramakrishnan, Venkat V

    2010-08-01

    Microsurgery is an essential technique in free flap reconstructions today. The technical skills involved require a learning curve, which may be affected by the current issues of limited training resources and patient safety. We describe a study on the value of a microsurgery training device as an assessment and warm up tool in basic microsurgery skills. Forty volunteers with different levels of microsurgery experience performed a microsurgical 'round-the-clock' exercise on the training device three consecutive times. Video-recordings of these performances were rated by two blinded independent assessors using a modified Global Rating Scale to assess basic microsurgery skills on the following parameters: steadiness, instruments handling and speed. Time to complete a round was also recorded objectively. The Kruskal-Wallis test was used to analyse the construct validity of the parameters assessed between the groups of level of microsurgery experience. Crohnbach's coefficient alpha was used to determine the reliability index of the independent assessors. All participants improved their time on consecutive rounds of the exercise. A median of 82 s (range 6-583 s) improvement in time between the first and third round was observed. Different mean performance time could be identified between the groups, but individual speed did not correlate significantly with microsurgery experience. Assessment of microsurgery skills using the modified Global Rating Scale demonstrated statistically significant differences for instruments handling (p=0.03) and speed (p=0.01) between the groups with regard to microsurgery experience, and improvement in the parameters assessed for all groups. Difference in steadiness (p=0.07) was not significant amongst the juniors. Consultants performed better than juniors but, at all levels of experience, significant improvement in skills was demonstrated after practice. The 'round-the-clock' microsurgery training device is an inexpensive and readily

  8. Predicting Microsurgical Aptitude.

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    Osborn, Heather A; Kuthubutheen, Jafri; Yao, Christopher; Chen, Joseph M; Lin, Vincent Y

    2015-08-01

    Microscopic techniques are an essential part of otolaryngologic practice. These procedures demand advanced psychomotor and visuospatial skills, and trainees possess these abilities to varying degrees. No method currently exists to predict who will possess an aptitude for microscopic surgery. Our goal was to determine whether performance can be predicted by background experiences or skills. Retrospective cohort study. Tertiary academic hospital. Students with no previous surgical experience. Subjects were surveyed on a wide range characteristics thought to affect surgical aptitude, with a primary focus on video gaming and musical training. Subjects performed a microsurgical task using a novel simulator and their performance was assessed by blinded investigators. Forty-six students were assessed. There was no correlation between video gaming and improved microsurgical performance. Rather, video gamers obtained worse scores, although this difference did not reach significance. The majority of students played a musical instrument. Within this group, musicians who began playing at younger ages obtained higher scores, with the highest scores obtained by musicians who began playing before age 6. However, musicians did not obtain higher scores than non-musicians, regardless of their age of initiation. No improvement in microsurgical aptitude was seen in subjects who had a history of video gaming or musical instrument playing.

  9. Presentation of training modality in microsurgical skills for medical students%医学生显微外科技能培训教学模式的探讨

    Institute of Scientific and Technical Information of China (English)

    王洪刚; 顾立强; 秦本刚; 郑剑文

    2013-01-01

    Training in microsurgical skills for medical students is an important component of clinical skills training, in order to learning the knowledge of microsurgery and the basic microsurgical skills. High quality training in microsurgical skills will improve students' practical ability and overall quality. It will help medical students adapt to clinical work and research in the future. The article presents the training modality in microsurgical skills used by the ifrst afifliated hospital of Sun Yat-sen university, which is available for medical students to learn the knowledge of microsurgery and the practical skill, step by step.%显微外科技能培训是培养医学生掌握显微外科基础知识、基本操作技能的一门基础训练课程,是医学生临床技能培训的一项重要内容。高质量的显微外科技能培训对提高学生的操作能力和综合素质,适应临床和科研工作具有重要意义。详细介绍了中山大学附属第一医院采用阶梯式循序渐进的显微外科技能培训模式。

  10. Discussion of skill improvement in marine ecosystem dynamic models based on parameter optimization and skill assessment

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    Shen, Chengcheng; Shi, Honghua; Liu, Yongzhi; Li, Fen; Ding, Dewen

    2016-07-01

    Marine ecosystem dynamic models (MEDMs) are important tools for the simulation and prediction of marine ecosystems. This article summarizes the methods and strategies used for the improvement and assessment of MEDM skill, and it attempts to establish a technical framework to inspire further ideas concerning MEDM skill improvement. The skill of MEDMs can be improved by parameter optimization (PO), which is an important step in model calibration. An efficient approach to solve the problem of PO constrained by MEDMs is the global treatment of both sensitivity analysis and PO. Model validation is an essential step following PO, which validates the efficiency of model calibration by analyzing and estimating the goodness-of-fit of the optimized model. Additionally, by focusing on the degree of impact of various factors on model skill, model uncertainty analysis can supply model users with a quantitative assessment of model confidence. Research on MEDMs is ongoing; however, improvement in model skill still lacks global treatments and its assessment is not integrated. Thus, the predictive performance of MEDMs is not strong and model uncertainties lack quantitative descriptions, limiting their application. Therefore, a large number of case studies concerning model skill should be performed to promote the development of a scientific and normative technical framework for the improvement of MEDM skill.

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

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    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.

  12. Parameter variations in prediction skill optimization at ECMWF

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    Ollinaho, P.; Bechtold, P.; Leutbecher, M.; Laine, M.; Solonen, A.; Haario, H.; Järvinen, H.

    2013-11-01

    Algorithmic numerical weather prediction (NWP) skill optimization has been tested using the Integrated Forecasting System (IFS) of the European Centre for Medium-Range Weather Forecasts (ECMWF). We report the results of initial experimentation using importance sampling based on model parameter estimation methodology targeted for ensemble prediction systems, called the ensemble prediction and parameter estimation system (EPPES). The same methodology was earlier proven to be a viable concept in low-order ordinary differential equation systems, and in large-scale atmospheric general circulation models (ECHAM5). Here we show that prediction skill optimization is possible even in the context of a system that is (i) of very high dimensionality, and (ii) carefully tuned to very high skill. We concentrate on four closure parameters related to the parameterizations of sub-grid scale physical processes of convection and formation of convective precipitation. We launch standard ensembles of medium-range predictions such that each member uses different values of the four parameters, and make sequential statistical inferences about the parameter values. Our target criterion is the squared forecast error of the 500 hPa geopotential height at day three and day ten. The EPPES methodology is able to converge towards closure parameter values that optimize the target criterion. Therefore, we conclude that estimation and cost function-based tuning of low-dimensional static model parameters is possible despite the very high dimensional state space, as well as the presence of stochastic noise due to initial state and physical tendency perturbations. The remaining question before EPPES can be considered as a generally applicable tool in model development is the correct formulation of the target criterion. The one used here is, in our view, very selective. Considering the multi-faceted question of improving forecast model performance, a more general target criterion should be developed

  13. NWP model forecast skill optimization via closure parameter variations

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    Järvinen, H.; Ollinaho, P.; Laine, M.; Solonen, A.; Haario, H.

    2012-04-01

    We present results of a novel approach to tune predictive skill of numerical weather prediction (NWP) models. These models contain tunable parameters which appear in parameterizations schemes of sub-grid scale physical processes. The current practice is to specify manually the numerical parameter values, based on expert knowledge. We developed recently a concept and method (QJRMS 2011) for on-line estimation of the NWP model parameters via closure parameter variations. The method called EPPES ("Ensemble prediction and parameter estimation system") utilizes ensemble prediction infra-structure for parameter estimation in a very cost-effective way: practically no new computations are introduced. The approach provides an algorithmic decision making tool for model parameter optimization in operational NWP. In EPPES, statistical inference about the NWP model tunable parameters is made by (i) generating an ensemble of predictions so that each member uses different model parameter values, drawn from a proposal distribution, and (ii) feeding-back the relative merits of the parameter values to the proposal distribution, based on evaluation of a suitable likelihood function against verifying observations. In this presentation, the method is first illustrated in low-order numerical tests using a stochastic version of the Lorenz-95 model which effectively emulates the principal features of ensemble prediction systems. The EPPES method correctly detects the unknown and wrongly specified parameters values, and leads to an improved forecast skill. Second, results with an ensemble prediction system emulator, based on the ECHAM5 atmospheric GCM show that the model tuning capability of EPPES scales up to realistic models and ensemble prediction systems. Finally, preliminary results of EPPES in the context of ECMWF forecasting system are presented.

  14. Unilateral hemilaminectomy for the microsurgical removal of intraspinal tumors

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    WANG Hong

    2013-11-01

    Full Text Available Objective To evaluate the advantages and disadvantages of unilateral hemilaminectomy for the microsurgical removal of intraspinal tumors. Methods Clinical data of 19 patients with intraspinal tumors were analyzed from August 2008 to April 2013. All cases were treated microsurgically using unilateral hemilaminectomy procedures. Results Tumors were totally removed in all patients, including 12 cases of schwannoma, 1 case of neurofibroma, 5 cases of spinal meningioma and 1 case of hemangioblastoma. After operation signs and symptoms of every patient were significantly improved. Postoperative follow-up period was 6-60 months. No recurrence and spinal instability were found. The average area of intraoperative unilateral hemilaminectomy was (15 ± 2 mm × (32 ± 5 mm. Conclusion Unilateral hemilaminectomy for the removal of intraspinal tumors is a mini-invasive procedure, and is beneficial to the stability of spine, with the advantages of short hospitalization time, slight postoperative reaction and good long-term outcome. However, the procedure requires a skilled technology.

  15. 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.

  16. Data-driven warehouse optimization : Deploying skills of order pickers

    NARCIS (Netherlands)

    M. Matusiak (Marek); M.B.M. de Koster (René); J. Saarinen (Jari)

    2015-01-01

    textabstractBatching orders and routing order pickers is a commonly studied problem in many picker-to-parts warehouses. The impact of individual differences in picking skills on performance has received little attention. In this paper, we show that taking into account differences in the skills of in

  17. Data-driven warehouse optimization : Deploying skills of order pickers

    NARCIS (Netherlands)

    M. Matusiak (Marek); M.B.M. de Koster (René); J. Saarinen (Jari)

    2015-01-01

    textabstractBatching orders and routing order pickers is a commonly studied problem in many picker-to-parts warehouses. The impact of individual differences in picking skills on performance has received little attention. In this paper, we show that taking into account differences in the skills of

  18. Novel modular 2-DOF microsurgical forceps for transoral laser microsurgeries: Ergonomic design and preliminary evaluation.

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    Chauhan, Manish; Barresi, Giacinto; Deshpande, Nikhil; Caldwell, Darwin G; Mattos, Leonardo S

    2016-08-01

    Transoral Laser Microsurgeries (TLM) demand a great level of control and precision in intraoperative tissue manipulation. The optimal eradication of the diseased tissue is possible only with coordinated control of the laser aiming for incision and the microsurgical tools for orienting and stretching the tissue. However, the traditional microsurgical tools are long, single purpose, one degree-of-freedom (DOF), rigid tools with small range of motion and a normal grasping handle inducing non-ergonomic usage. This paper presents a novel, modular microsurgical tool to overcome the challenges of the traditional tools and improve the surgeon-tool usage experience. The novel design adds a rotational DOF to expand the reach and functionality of the tool. The device is provided with an ergonomic grasping handle that avoids extreme wrist excursions and is capable of adapting to the variety of tools used in TLM within the same design. The performance of the new microsurgical tool was evaluated through a subjective assessment with both medical students and expert surgeons. The evaluation demonstrated a general acceptance of the new forceps tool, with the expert surgeons providing positive appraisals for the improved functionality and user experience with the tool, which indicates towards the potential suitability of the device for TLM. The parameters assessed in the preliminary evaluation not only provide a sense of the advantages of the novel design, but also guide future evolution of the tool design.

  19. 虚拟现实技术量化经额入路显露海绵窦区显微解剖研究%Quantitative research of microsurgical anatomy of transfrontal approach for cavernous sinus by virtual reality skill

    Institute of Scientific and Technical Information of China (English)

    汤可; 鲍圣德; 周敬安; 周青; 刘策; 赵亚群

    2011-01-01

    目的 利用Dextroscope虚拟现实系统定量评价经额入路显露海绵窦区的显微解剖特点.方法 根据尸头CT和MRI影像数据,以Dextroscope虚拟现实系统构建海绵窦三维解剖模型,分别选择颅盖和颅底标识点连成三角形模拟手术骨窗和海绵窦不同显露术野(三角面A、B、C).结果 不同术野三角形面积比较,B面术野最大(均P=0.000),但是到达术野前的操作空间和经过脑组织的体积A、B、C三面之间差异无统计学意义(P>0.05).经C面术野到达海绵窦前所需磨除前床突和显露颈内动脉及其分支的体积,分别大于经B面和经A面术野(均P=0.000);经B面术野进入海绵窦后磨除前床突的体积,以及显露脑神经和颈内动脉的体积分别大于经C面和A面术野(均P=0.000);经A面术野与经B面术野进入海绵窦后显露垂体的体积差异无统计学意义(P>0.05);经C面术野不显露垂体.结论 虚拟现实技术模拟经额显露海绵窦显微手术入路具有快捷、直观、量化、可重复等优势.%Objective To evaluate the microsurgical characteristics of different exposure for cavernous sinus through transfrontal approach by Dextroscope virtual reality system quantitatively. Methods Three-dimensional anatomic models of cavernous sinus were constructed in the Dextroscope virtual reality system according to CT and MRI of five adult cadaver heads. Triangular facets were made by lining landmark points selected on the calvaria and skull base to simulate craniotomy window and regions exposed for cavernous sinus (triangular facet A, B, and C), respectively. Results As comparison showed for areas of different triangular facets of exposed region, facet B was largest with significant difference (P = 0.000, for all). Comparison did not show significant difference among facet A, B, and C for volume of operative space and brain tissue involved (P > 0.05). Volume of anterior clinoid process drilled before cavernous sinus

  20. Local Optimization and Adversarial Consideration:Agent Skills in Everest Simulation Team

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    顾洋; 崔立辉; 刘俊峰; 王庆林

    2004-01-01

    Skilled individual agents are firm basis of a strong soccer team. The skills available to Everest 2002 agents include kicking, dribbling, forwarding, ball interception and tackling. These intermediate sub goals are implemented by a combination of local optimization which hopes to determine the optimal primitive action from a local perspective and adversarial consideration which takes into account opponents and limitations imposed by simulation environment. Everest 2002 RoboCup simulation teams, building on 11 skilled agents and an on-line coach, won the 2nd place in RoboCup 2002 simulation league.

  1. Microsurgical training course for clinicians and scientists at a German University hospital: a 10-year experience.

    Science.gov (United States)

    Klein, Ingo; Steger, Ulrich; Timmermann, Wolfgang; Thiede, Arnulf; Gassel, Heinz-Jochen

    2003-01-01

    Microsurgical techniques are being increasingly applied in almost all surgical disciplines. However, the opportunities to learn these skills in a structured course are rare. We have conducted a 5-day microsurgical training course on a yearly basis since 1991. The course follows step-by-step training, starting with nonvital models for vascular and nerval microanastomoses. As the participants improve, exercises on laboratory animals are offered to close the gap between nonliving models and the clinical situation. Lectures provide theoretical and clinical background information. Clinical and experimental applications can be witnessed and practiced in a second part of the course. With this step-by-step curriculum, we conduct a successful training program, e.g., each participant is able to perform microvascular and nerval anastomoses on a reproducible basis. The organization, program, and execution of the training course are presented, together with an evaluation of the course concept by the participants concerning expectations, learning success, and level of satisfaction.

  2. SYNTHESIS OF ROBOTIC MECHANISM FOR MICROSURGICAL CORNEAL GRAFTING

    Institute of Scientific and Technical Information of China (English)

    Hu Yida; Zhao Zhiwen; Li Dazhai; Zong Guanghua

    2005-01-01

    In order to enhance the effect of corneal grafting, an assisting microsurgical robot has been developed. As one of principal issues for the robotic system design, type and size synthesis of the robotic mechanism is discussed. For this purpose, timeline subtask is analyzed with surgical component motion in manual corneal grafting microsurgery, as the reference of robotic mechanism synthesis. On the basis of study on the kinematic correlation between the arm structures and the wrist structures, configuration of joint is determined for the surgical task and motion in type synthesis of the mechanism. The objective for size synthesis of robotic mechanism is optimization of the mechanism dexterity as a manipulation capability. The condition number based on Jacob matrix is chosen as dexterity measure of the mechanism. The prototype is developed.

  3. Microsurgical anatomy of the middle cerebral artery

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    Pai S

    2005-01-01

    Full Text Available Background: The microsurgical anatomy of the middle cerebral artery (MCA is of particular interest to the cerebrovascular surgeon. The purpose of this study was to define the microsurgical anatomy of the MCA and its various branches in the Indian population. Methods: Ten MCAs were studied from five cadaveric brain specimens. The authors studied the outer diameter, length, branches, perforators and site of these on the main trunk (M1, the division of the main trunk, the secondary trunks and their various cortical branches using the operating microscope under 5-20x magnification. Results: The outer diameter of the MCA main trunk ranges from 2.5 to 4 mm with a mean of 3.35 mm. The superolateral branches consisted of polar temporal artery and anterior temporal artery that had a common origin and sometimes the uncal artery or the accessory uncal artery. Perforators or lenticulostriate arteries were seen in the inferomedial surface all along the length of M1. Eight bifurcations and two trifurcations were noted. Cortical branches and their origin are discussed. Conclusion: Although the microsurgical anatomy of the MCA in Indian population correlated with the findings in the western literature, some structural and statistical variations were noted.

  4. Optimization of Skill Retention in the U. S. Army through Initial Training Analysis and Design: Skill Sustainment Exercises. Volume 3.

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    1983-05-01

    well. 3. Screws the M605 fuze into fuze well. 4. Buries the mine up to the bottom of the release pin ring. S. Removes the locking safety pin . 6...positive safety pin . MGA SSE-3 TRIAL "- d 7D-Rl31 988 OPTIMIZATION OF SKILL RETENTION IN THE U S RRMY THROUJGH 216 INITIAL TRAINING..(U) MCFANN GRAY...DATE: TASK NO.: 051-192-1012 PAGE I OF I GO NO GO I. Checks mine for boobytraps. 2. Uncovers top of mine. 3. Inserts original safety pin , if available

  5. [Microsurgical treatment of internal carotid bifurcation aneurysms].

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    González-Darder, J M; González-López, P; Botella-Maciá, L

    2010-06-01

    Clinical and imaging findings of a series of 14 internal carotid artery bifurcation aneurysms microsurgically treated are presented. A total of 10 lesions were diagnosed before rupture and 4 patients presented with subarachnoidal hemorrhage and frontobasal intracerebral bleeding. Diagnosis was done using neuroimaging (CT scan, angio-CT-3D, angio-MRI, angiography) but patients with ruptured aneurysms were treated with the sole information provided by the angio-CT-3D. The average fundus size was 8.4mm (3-13.3) and the average neck size was 6.8mm (3-9.6), being the fundus-to-neck ratio 1.32 (0.46-2.05). All lesions were microsurgically treated through a pterional approach with the help of temporary clipping of the afferent vessels in all cases. We used peroperative neuroprotective, neuromonitorization and micro-doppler cerebral flow measurement. Clinical results were excellent with 13 patients GOS grade 5 and one grade 4 three month afterwards of hospital discharge and complete exclusion of the lesion in angiographic controls done solely in patients with ruptured lesions.

  6. Microsurgical free flaps at Kathmandu Model Hospital.

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    Rai, S M; Grinsell, D; Hunter-Smith, D; Corlett, R; Nakarmi, K; Basnet, S J; Shakya, P; Nagarkoti, K; Ghartimagar, M; Karki, B

    2014-01-01

    Microsurgery is an emerging subspecialty in Nepal. Microsurgery was started at Kathmandu Model Hospital in 2007 with the support from Interplast Australia and New Zealand. This study will be useful for establishing a baseline for future comparisons of outcome variables and for defining the challenges of performing microsurgical free flaps in Nepal. A retrospective cross sectional study was conducted using the clinical records of all the microsurgical free flaps performed at Kathmandu Model Hospital from April 2007 to April 2014. Fifty-six free flaps were performed. The commonest indication was neoplasm followed by post-burn contracture, infection and trauma. Radial artery forearm flap was the commonest flap followed by fibula, antero-lateral thigh, rectus, tensor facia lata, lattisimus dorsi, deep inferior epigastric artery perforator, and deep circumflex iliac artery flap. Radial artery forearm flaps and anterolateral thigh flaps were mostly used for burn contracture reconstructions. Twelve of the 13 (92%) fibulae were used for mandibular reconstruction for oral cancer and ameloblastoma. Rectus flaps were used mainly for covering defects over tibia. Hospital stay ranged from six to 67 days with an average of fourteen. Fifteen patients (26%) developed complications. The duration of operation ranged from six hours to 10.5 hours with an average of nine hours. The longest follow up was for four years. Microsurgery can be started even in very resource-poor center if there is support from advanced centers and if there is commitment of the institution and surgical team.

  7. Optimizing Inquiry Skills: A View of Teacher Behavior Using Flanders' Categories and Blooms' Taxonomy

    Science.gov (United States)

    Zevin, Jack

    1976-01-01

    Discusses optimal teacher actions in developing inquiry skills through Flanders Category System, (created to describe and classify classroom interactions), and Blooms Taxonomy of Educational Objectives, (created to identify levels of intellectual operations). Identifies different purposes served by different level questions. (Author/DB)

  8. Clinicopathological features and microsurgical outcomes for giant pediatric intracranial tumor in 60 consecutive cases.

    Science.gov (United States)

    Guo, Ailing; Suresh, Vigneyshwar; Liu, Xianzhi; Guo, Fuyou

    2017-03-01

    Giant pediatric intracranial tumor (GPIT) remains to be a challenging disease with high morbidity and mortality. The clinical data of 60 patients under 18 years of age operated on with GPIT (≥5 cm in diameter) were retrospectively analyzed. Gross total resection was achieved in 46 cases (77%) and subtotal resection was obtained in 14 cases (23%). Ninety percent (47/52) of the cases with obstructive hydrocephalus were resolved remarkably and only 10% (5/52) of the patients needed a ventriculoperitoneal shunt after tumor resection. Postoperative histopathological type revealed malignant brain tumors in 51 cases (85%). The most common neoplasm was medulloblastoma; other types include the following: ependymoma, pilocytic astrocytoma, mixed glioma, primitive neuroectoderm tumor (PNET), subependymal giant cell astrocytoma, gangliocytoma, gliosarcoma, choroid plexus carcinoma, and atypical teratoid rhabdoid tumor (AT/RT). Benign histopathological categories include the following: craniopharyngioma, choroid plexus papilloma, and meningioma. No death or serious complications occurred after the operation. However, transient subcutaneous effusion occurred in 14 patients postoperatively, nerve injury including the posterior cranial nerve in two cases and abduction nerve in one case, and mutism and pulmonary infection were observed in two cases, respectively. The follow-up period ranged from 1 to 72 months, with an average of 32 months. Poor prognosis occurred significantly in the high-grade malignant tumors and PNET, AT/RT, and gliosarcoma were implicated in the death of patients within 1 year. To the best of our knowledge, the present study is the first description of clinicopathological features and the largest case analysis for GPIT. Optimal outcomes for GPIT were achieved by strict evaluation and perioperative management as well as microsurgical skills.

  9. OPTIMIZING LISTENING SKILLS TO IMPROVE THE TOEFL SCORE OF STAIN PEKALONGAN STUDENTS

    Directory of Open Access Journals (Sweden)

    Riskiana .

    2015-10-01

    Full Text Available The fact that the students have problems in the three micro-skills of listening namely recognizing the English stress patterns, the reduced forms of words, and words boundaries and that the teachers never teach the students how to listen have made them get low TOEFL scores on listening section. This research aims at: (1 finding out whether optimizing listening skills can improve the students’ TOEFL scores on listening; and (2 describing the class situation during the teaching of toefl listening by optimizing listening skills. This action research is conducted in two cycles each of which is divided into planning, acting, observing, and reflecting. There are two kinds of data. The qualitative data taken from observation, interview, and questionnaire are analyzed by using Constant Comparative Method. The quantitative data taken from the pre-test in the pre-research, post-test in cycle 1, and post-test in cycle 2 are analyzed by using descriptive statistics. The subjects of the research are the STAIN Pekalongan students taking English 3 class, the TOEFL Preparation Class, in the Academic Year 2014/2015. The result of the research shows that: (1 teaching toefl listening section by optimizing listening skills is able to overcome the students’ problems in the three micro-skills of listening and consequently improve the students’ TOEFL scores on listening. Their average scores improve from 101 in the pre-test to 118 in the post-test of cycle 1 and 129 in the post-test of cycle 2; (2 The class situation is attractive and the students are actively involved in the various activities done during the teaching and learning process. In line with the success of optimizing listening skills in teaching TOEFL listening, it is suggested that teachers should examine their students’ listening problems so as to be able to teach them what they need in listening to English.

  10. A Cognitive Skill Classification Based On Multi Objective Optimization Using Learning Vector Quantization for Serious Games

    Directory of Open Access Journals (Sweden)

    Moh. Aries Syufagi

    2011-12-01

    Full Text Available Nowadays, serious games and game technology are poised to transform the way of educating and training students at all levels. However, pedagogical value in games do not help novice students learn, too many memorizing and reduce learning process due to no information of player’s ability. To asses the cognitive level of player ability, we propose a Cognitive Skill Game (CSG. CSG improves this cognitive concept to monitor how players interact with the game. This game employs Learning Vector Quantization (LVQ for optimizing the cognitive skill input classification of the player. CSG is using teacher’s data to obtain the neuron vector of cognitive skill pattern supervise. Three clusters multi objective target will be classified as; trial and error, carefully and, expert cognitive skill. In the game play experiments using 33 respondent players demonstrates that 61% of players have high trial and error cognitive skill, 21% have high carefully cognitive skill, and 18% have high expert cognitive skill. CSG may provide information to game engine when a player needs help or when wanting a formidable challenge. The game engine will provide the appropriate tasks according to players’ ability. CSG will help balance the emotions of players, so players do not get bored and frustrated. Players have a high interest to finish the game if the player is emotionally stable. Interests in the players strongly support the procedural learning in a serious game.

  11. Microsurgical anatomy of the posterior circulation

    Directory of Open Access Journals (Sweden)

    Pai Balaji

    2007-01-01

    Full Text Available Context: The microsurgical anatomy of the posterior circulation is very complex and variable. Surgical approaches to this area are considered risky due to the presence of the various important blood vessels and neural structures. Aims: To document the microsurgical anatomy of the posterior circulation along with variations in the Indian population. Materials and Methods: The authors studied 25 cadaveric brain specimens. Microsurgical dissection was carried out from the vertebral arteries to the basilar artery and its branches, the basilar artery bifurcation, posterior cerebral artery and its various branches. Measurements of the outer diameters of the vertebral artery, basilar artery and posterior cerebral artery and their lengths were taken. Results: The mean diameter of the vertebral artery was 3.4 mm on the left and 2.9 mm on the right. The diameter of the basilar artery varied from 3-7 mm (mean of 4.3 mm. The length varied from 24-35 mm (mean of 24.9 mm. The basilar artery gave off paramedian and circumferential perforating arteries. The origin of the anterior inferior cerebellar artery (AICA varied from 0-21 mm (mean 10.0 mm from the vertebrobasilar junction. The diameter of the AICA varied from being hypoplastic i.e., < 0.5 mm to 2 mm (mean 1.0 mm. The superior cerebellar artery (SCA arises very close to the basilar bifurcation, in our series (1-3 mm from the basilar artery bifurcation. The diameter of the SCA varied from 0.5-2.5 mm on both sides. The posterior cerebral artery (PCA is divided into four segments. The PCA gave rise to perforators (thalamoperforators, thalamogeniculate arteries, circumflex arteries and peduncular arteries, medial posterior choroidal artery, lateral posterior choroidal artery and cortical branches. In 39 specimens the P1 segment was found to be larger than the posterior communicating artery, in six specimens it was found to be equal to the diameter of the posterior communicating artery and in five specimens it

  12. Robotic instrumentation: Evolution and microsurgical applications

    Directory of Open Access Journals (Sweden)

    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.

  13. Relearning of writing skills in Parkinson's disease: a literature review on influential factors and optimal strategies.

    Science.gov (United States)

    Nackaerts, Evelien; Vervoort, Griet; Heremans, Elke; Smits-Engelsman, Bouwien C M; Swinnen, Stephan P; Nieuwboer, Alice

    2013-03-01

    Patients with Parkinson's disease (PD) suffer from severe motor symptoms which can only be partly alleviated by means of dopaminergic medication. Motor rehabilitation, i.e. relearning of a known motor skill through intensive practice, can be an effective and lasting therapeutic supplement in chronic neurodegenerative diseases. Recent studies on motor learning in PD provide insights for the development of optimal motor rehabilitation strategies, with a particular focus on achieving consolidated learning and retention. In this review, findings from the last couple of years are discussed with specific interest in the potential benefits from cueing and feedback strategies as means to achieve lasting changes. In addition, current neuroscientific insights on the impact of dopamine and cognitive functioning on learning are summarized. Finally, the knowledge on these topics is combined to propose an optimal strategy for relearning of writing skills in PD, a frequently reported motor deficit also known as micrographia.

  14. A Cognitive Skill Classification Based on Multi Objective Optimization Using Learning Vector Quantization for Serious Games

    Directory of Open Access Journals (Sweden)

    Moh. Aries Syufagi

    2013-09-01

    Full Text Available Nowadays, serious games and game technology are poised to transform the way of educating and training students at all levels. However, pedagogical value in games do not help novice students learn, too many memorizing and reduce learning process due to no information of player’s ability. To asses the cognitive level of player ability, we propose a Cognitive Skill Game (CSG. CSG improves this cognitive concept to monitor how players interact with the game. This game employs Learning Vector Quantization (LVQ for optimizing the cognitive skill input classification of the player. CSG is using teacher’s data to obtain the neuron vector of cognitive skill pattern supervise. Three clusters multi objective XE "multi objective"  target will be classified as; trial and error, carefully and, expert cognitive skill. In the game play experiments employ 33 respondent players demonstrates that 61% of players have high trial and error, 21% have high carefully, and 18% have high expert cognitive skill. CSG may provide information to game engine when a player needs help or when wanting a formidable challenge. The game engine will provide the appropriate tasks according to players’ ability. CSG will help balance the emotions of players, so players do not get bored and frustrated. 

  15. Microsurgical anatomy of the ocular motor nerves.

    Science.gov (United States)

    Zhang, Yi; Liu, Hao; Liu, En-Zhong; Lin, You-Zhi; Zhao, Shi-Guang; Jing, Guo-Hua

    2010-08-01

    This study was designed to provide anatomic data to help surgeons avoid damage to the ocular motor nerves during intraorbital operations. The microsurgical anatomy of the ocular motor nerves was studied in 50 adult cadaveric heads (100 orbits). Dissections were performed with a microscope. The nerves were exposed and the neural and muscular relationships of each portion of the nerve were examined and measured. The superior division of the oculomotor nerve coursed between the optic nerve and the superior rectus muscle after it left the annular tendon, and its branches entered into the superior rectus muscle and levator muscle. A mean of five fibers (range 3-7) innervated the superior rectus muscle, and a mean of one fiber (range 1-2) followed a medial direction (84%) or went straight through the superior rectus muscle (16%). The inferior division of the oculomotor nerve branched into the medial rectus, inferior rectus and inferior oblique muscles. The trochlear nerve ended on the orbital side of the posterior one-third of the superior oblique muscle in 76 specimens. The abducens nerve ended on the posterior one-third of the lateral rectus muscle in 86 specimens. If the belly of the lateral rectus muscle was divided into three superior-inferior parts, the nerve commonly entered into the middle one-third in 74 specimens. Based on the observed data, microanatomical relationships of the orbital contents were revised.

  16. Microsurgical anatomy of the posterior fossa cisterns.

    Science.gov (United States)

    Matsuno, H; Rhoton, A L; Peace, D

    1988-07-01

    The microsurgical anatomy of the posterior fossa cisterns was examined in 15 cadavers using 3X to 40X magnification. Liliequist's membrane was found to split into two arachnoidal sheets as it spreads upward from the dorsum sellae: an upper sheet, called the diencephalic membrane, which attaches to the diencephalon at the posterior edge of the mamillary bodies, and a lower sheet, called the mesencephalic membrane, which attaches along the junction of the midbrain and pons. Several other arachnoidal membranes that separate the cisterns were identified. These include the anterior pontine membrane, which separates the prepontine and cerebellopontine cisterns; the lateral pontomesencephalic membrane, which separates the ambient and cerebellopontine cisterns; the medial pontomedullary membrane, which separates the premedullary and prepontine cisterns; and the lateral pontomedullary membrane, which separates the cerebellopontine and cerebellomedullary cisterns. The three cisterns in which the arachnoid trabeculae and membranes are the most dense and present the greatest obstacle at operation are the interpeduncular and quadrigeminal cisterns and the cisterna magna. Numerous arachnoid membranes were found to intersect the oculomotor nerves. The neural and vascular structures in each cistern are reviewed.

  17. 21 CFR 874.4500 - Ear, nose, and throat microsurgical carbon dioxide laser.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat microsurgical carbon dioxide..., 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,...

  18. MICROSURGICAL LANDMARKS IN MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION

    Directory of Open Access Journals (Sweden)

    Javier Quillo-Olvera

    2015-12-01

    Full Text Available Microsurgical landmarks of the facet joint complex were defined to provide guidance and security within the tubular retractor during transforaminal surgery. A retrospective observational study was performed in segments L4-L5 by the left side approach. Microsurgical relevant photos, anatomical models and drawing were used to expose the suggested landmarks. The MI-TLIF technique has advantages compared with conventional open TLIF technique, however minimally invasive technique implies lack of security for the surgeon due to the lack of defined microanatomical landmarks compared to open spine surgery, and disorientation within the tubular retractor, the reason why to have precise microsurgical references and its recognition within the surgical field provide speed and safety when performing minimally invasive technique.

  19. Microsurgical treatment of medial sphenoid ridge meningioma

    Directory of Open Access Journals (Sweden)

    Wei-qi HE

    2011-02-01

    Full Text Available Objective To explore the microsurgical technique of medial sphenoid ridge meningioma resectional therapy.Methods The clinical data were retrospectively analyzed of 29 patients(13 males and 16 females;aged 18-68 years with average of 42 years;duration of disease was 5 months to 8 years,averaged 28 months with medial sphenoidal ridge meningioma and admitted from Jan.2005 to Jan.2010.The anatomical relationship of the tumor to surrounding structures was assessed intraoperatively,the tumor was then completely resected through cutting off the tumor supplying vessels,shrinking the tumor volume and separating the tumors from adjacent vessels and nerves.All the patients were followed up for 4 months to 4 years.Results Of the 29 cases,20 got total tumor removal,7 got subtotal and 2 got partial tumor removal.Of the 20 patients with obviously preoperative visual impairment,12 were obviously relieved,6 showed no improvement and 2 got symptoms aggravation.Hemiplegia occurred in 2 cases and oculomoter nerve palsy in 6 cases.There was no death after surgery.A 6 months to 4 years follow-up showed that no recurrence was found in 27 patients with tumor resection level of Simpson I and II,2 patients with tumor resection level of Simpson III received postoperative radiotherapy or gamma knife surgery,and 1 recurred and received reoperation.Conclusions Fine intraoperative assessment of the anatomical relationship of the tumor to surrounding structures,separating and excising tumor according to the assessed result is the key of medial sphenoid ridge meningioma resection,and the tumor resection is favorable to visual rehabilitation and tumor control.

  20. Robotic-assisted microsurgery for an elective microsurgical practice.

    Science.gov (United States)

    Gudeloglu, Ahmet; Brahmbhatt, Jamin V; Parekattil, Sijo J

    2014-02-01

    Robotic-assisted microsurgery can be utilized for either intracorporal or extracorporeal surgical procedures. Three-dimensional high-definition magnification, a stable ergonomic platform, elimination of physiologic tremor, and motion scaling make the robotic platform attractive for microsurgeons for complex procedures. Additionally, robotic assistance enables the microsurgeon to take microsurgery to challenging intracorporeal locations in a minimally invasive manner. Recent adjunctive technological developments offer the robotic platform enhanced optical magnification, improved intraoperative imaging, and more precise ablation techniques for microsurgical procedures. The authors present the current state-of-the art tools available in the robotic-assisted microsurgical platform.

  1. [Microsurgical varicocele operation: a retrospective statement of Danish results

    DEFF Research Database (Denmark)

    Fode, M.; Sonksen, J.; Mikines, K.J.

    2009-01-01

    INTRODUCTION: Varicoceles are present in about 15% of the male population. The treatment is surgical and internationally there has been an increase in the use of a subinguinal microsurgical approach in which the veins of the spermatic cord are ligated. The purpose of this paper is to evaluate...... to a single surgeon only, the number of recurrences and complications for the last 47 operated patients decreased to 0% and 4%, respectively. CONCLUSION: In trained hands microsurgical varicocelectomy was an effective method with few complications and recurrences Udgivelsesdato: 2009/11/16...

  2. Microsurgical treatment of sacral perineural (Tarlov) cysts: case series and review of the literature.

    Science.gov (United States)

    Burke, John F; Thawani, Jayesh P; Berger, Ian; Nayak, Nikhil R; Stephen, James H; Farkas, Tunde; Aschyan, Hovik John; Pierce, John; Kanchwala, Suhail; Long, Donlin M; Welch, William C

    2016-05-01

    OBJECTIVE Tarlov cysts (TCs) occur most commonly on extradural components of the sacral and coccygeal nerve roots. These lesions are often found incidentally, with an estimated prevalence of 4%-9%. Given the low estimated rates of symptomatic TC and the fact that symptoms can overlap with other common causes of low-back pain, optimal management of this entity is a matter of ongoing debate. Here, the authors investigate the effects of surgical intervention on symptomatic TCs and aim to solidify the surgical criteria for this disease process. METHODS The authors performed a retrospective review of data from consecutive patients who were surgically treated for symptomatic TCs from September 2011 to March 2013. Clinical evaluations and results from surveying pain and overall health were used. Univariate statistical analyses were performed. RESULTS Twenty-three adults (4 males, 19 females) who had been symptomatic for a mean of 47.4 months were treated with laminectomy, microsurgical exposure and/or imbrication, and paraspinous muscle flap closure. Eighteen patients (78.3%) had undergone prior interventions without sustained improvement. Thirteen patients (56.5%) underwent lumbar drainage for an average of 8.7 days following surgery. The mean follow-up was 14.4 months. Univariate analyses demonstrated that an advanced age (p = 0.045), the number of noted perineural cysts on preoperative imaging (p = 0.02), and the duration of preoperative symptoms (p = 0.03) were associated with a poor postoperative outcome. Although 47.8% of the patients were able to return to normal activities, 93.8% of those surveyed reported that they would undergo the operation again if given the choice. CONCLUSIONS This is one of the largest published studies on patients with TCs treated microsurgically. The data suggest that patients with symptomatic TCs may benefit from open microsurgical treatment. Although outcomes seem related to patient age, duration of symptoms, and extent of disease

  3. Immediate Microsurgical Bone and Nerve Reconstruction in the Irradiated Patient: A Case Report.

    Science.gov (United States)

    Tursun, Ramzey; Green, J Marshall

    2016-12-11

    Microsurgical reconstructive techniques have revolutionized the treatment of large head and neck defects. These defects were once forever life altering because of the considerable morbidity to both the form and function of the patient. As time has progressed, microsurgical technique has improved dramatically and has become institutionalized in our training programs. Free flap outcomes in head and neck reconstruction have improved dramatically, and optimization of these outcomes is now key. One overlooked area has been neurosensory reconstruction. In our practice we have focused on this detail, which has proved to be quite important to the patient. This case report details one such case in which a mandibular resection was performed to treat osteoradionecrosis. We, as the reconstructive team, elected to perform a double-barrel fibular free flap procedure with simultaneous inferior alveolar nerve reconstruction using a 70-cm processed nerve allograft. Normal neurosensory function returned in this patient. As the state of the art advances with continued successful osseous and soft tissue reconstruction in the head and neck, we propose concomitant neurosensory functional reconstruction always be considered.

  4. Microsurgical anatomy of the infratentorial trabecular membranes and subarachnoid cisterns.

    Science.gov (United States)

    Vinas, F C; Dujovny, M; Fandino, R; Chavez, V

    1996-04-01

    The understanding of the anatomy of the subarachnoid cisterns and trabecular membranes is of paramount importance in the surgical treatment of pathology of the posterior fossa. Aneurysms, arteriovenous malformations, and some tumors should be approached through the subarachnoid space. The subarachnoid cisterns provide natural pathways to approach neurovascular and cranial nerve structures. The microsurgical anatomy of the infratentorial subarachnoid cisterns was studied in twenty adult brains, using the 'immersion technique'. Air was injected into the subarachnoid cisterns and brains were dissected under the operative microscope. Six main compartmental trabecular membranes were identified in the infratentorial level. They divide the subarachnoid space into six cisterns. Cisternal divisions and the disposition of the trabecular membranes were closely related to the vascular divisional patterns of the principal arteries. Thorough knowledge of the microsurgical anatomy of the subarachnoid space will aid neurosurgeons during the surgical approach of many vascular and tumoral lesions located in the posterior fossa.

  5. Cranial arachnoid membranes: some aspects of microsurgical anatomy.

    Science.gov (United States)

    Lü, Jian; Zhu, Xian-Li

    2007-07-01

    Although the arachnoid membranes have been known for more than 300 years, the anatomy of the arachnoid membranes has not been studied in detail. This study was performed to explore the microanatomical features of the cranial arachnoid membranes. The arachnoid membranes and cisterns were observed in eight Han Chinese adult human cadaveric brains with an operating microscope, without staining of intracranial structures or injection of colored material into blood vessels. Twenty seven arachnoid membranes and 21 subarachnoid cisterns were identified. The topographical features of each arachnoid membrane were described. On the basis of the arachnoid membranes we identified, the arachnoidal limits of the cisterns were discussed. The microsurgical anatomical research on the arachnoid membranes is a supplement to the anatomical study of the subarachnoid cisterns. The understanding of the topographical features of the arachnoid membranes is valuable to the reasonable dissection of the cisterns and the minimally invasive manipulations during microsurgical procedures.

  6. Multiple Factors Affecting Human Repregnancy after Microsurgical Vasovasostomy

    Institute of Scientific and Technical Information of China (English)

    黄明孔; 吴晓庆; 付成善; 邹平; 高晓平; 黄强

    1997-01-01

    To determine the factors which might affect the recover), of fertility after an accurate microsurgical vasovasostomy, we conducted a 3 year-follow-up study in 56 men after microsurgical vasovasostomy. Twenty-two variables as putative factors associated with recovery of fertility were measured. The results of Logistic regression and ather statistical analyses suggest that 8 factors including age of husband, age of wife, history of past pregnancies of current wife, number of vasovasostomies, serum FSH, LH and T before vasovasostomy, and sperm granuloma of vas nodule are of no significance in recovery of fertility, whereas 14 factors including years after vasectomy, sperm concentration, progressive motility, sperm motility, viability, normal morphology, sperm egg penetration rate, TAT and SIT before and after vasovasostomy, MAR, IBT adherent IgG and IgA after vasovasostomy are significantly, associated with repregnancy.

  7. Endovascular and microsurgical treatment of cerebral arteriovenous malformations: Current recommendations

    OpenAIRE

    Andrew Conger; Charles Kulwin; Lawton, Michael T; Cohen-Gadol, Aaron A.

    2015-01-01

    Background: Cerebral arteriovenous malformations (AVMs) can be a heterogeneous pathological entity whose management requires a complex decision-making process due to the risks associated with their treatment and natural history. Despite the recently published conclusions of the aborted Randomized Trial of Brain Unruptured AVMs (ARUBA) trial, the authors of this article believe multimodality intervention in general and microsurgical resection in particular continue to play a major role in the ...

  8. Postmastectomy lymphedema: long-term results following microsurgical lymph node transplantation

    National Research Council Canada - National Science Library

    Becker, Corinne; Assouad, Jalal; Riquet, Marc; Hidden, Geneviève

    2006-01-01

    Lymphedema complicating breast cancer treatment remains a challenging problem. The purpose of this study was to analyze the long-term results following microsurgical lymph node (LN) transplantation...

  9. Endovascular and microsurgical treatment of cerebral arteriovenous malformations: Current recommendations

    Science.gov (United States)

    Conger, Andrew; Kulwin, Charles; Lawton, Michael T.; Cohen-Gadol, Aaron A.

    2015-01-01

    Background: Cerebral arteriovenous malformations (AVMs) can be a heterogeneous pathological entity whose management requires a complex decision-making process due to the risks associated with their treatment and natural history. Despite the recently published conclusions of the aborted Randomized Trial of Brain Unruptured AVMs (ARUBA) trial, the authors of this article believe multimodality intervention in general and microsurgical resection in particular continue to play a major role in the management of carefully selected ruptured or unruptured AVMs. Methods: The authors provide an overview of their methodology for endovascular intervention and microsurgical resection and share their technical nuances for successful embolization and microsurgical resection of AVMs with special emphasis on complication avoidance. Results: The authors have achieved successful outcomes in embolization and resection of cerebral AVMs when using their methodology. Conclusions: These lesions are among the most technically difficult pathological entities handled by the cerebrovascular specialist, and an overview of technical concepts to help systematize this challenging and variable endeavor can improve the safety of their treatment. PMID:25883831

  10. Microsurgical Fenestration and Paraspinal Muscle Pedicle Flaps for the Treatment of Symptomatic Sacral Tarlov Cysts.

    Science.gov (United States)

    Potts, Matthew B; McGrath, Mary H; Chin, Cynthia T; Garcia, Roxanna M; Weinstein, Philip R

    2016-02-01

    Sacral Tarlov cysts are rare causes of sciatic and sacrococcygeal pain and neurologic deficits. Although several microsurgical treatments have been described, the optimal treatment has yet to be determined. We describe our initial experience with symptomatic lesions combining 1) cyst fenestration and imbrication and 2) filling the epidural space using vascularized paraspinous muscle flaps rotated into the cystic cavity. We retrospectively reviewed all consecutive cases of symptomatic giant sacral Tarlov cysts treated with microsurgery at our institution between 2003 and 2011. The main outcome measure was self-reported symptom relief. Postoperative imaging, surgical complications, and subsequent treatments were also recorded. Thirty-five patients were treated. Mean age was 52 years. All patients presented with a chief complaint of sacral-perineal pain. The mean cyst size was 3.6 cm (largest diameter). Follow-up beyond the initial hospital stay was available in 86% (median 8 months). Ninety-three percent reported improvement in pain at some point during the postoperative course but 50% of those developed recurrent pain symptoms. Postoperative imaging was available in 69% of the patients in whom 92% showed complete obliteration (25%) or reduction in cyst size (67%). The combination of microsurgical cyst fenestration and the use of vascularized muscle pedicle flaps to fill the cystic cavity and the epidural space results in obliteration or reduction in size of the majority of cysts and is associated with initial improvement in pain in most patients. However, delayed recurrence of pain was common with this technique. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Internal limiting membrane layer visualization and vitreoretinal surgery guidance using a common-path OCT integrated microsurgical tool

    Science.gov (United States)

    Liu, Xuan; Meisne, Eric; Han, Jae-Ho; Zhang, Kang; Gehlbach, Peter; Taylor, Russell; Kang, Jin U.

    2010-02-01

    Contemporary retinal microsurgery is performed by skilled surgeons through operating microscopes, utilizing free hand techniques and manually operated micro-instruments. One technically challenging procedure is the incising and peeling of the internal limiting membrane (ILM) while minimizing damage to the underlying retina. One strategy for minimizing damage is to improve visualization of the ILM layer. Here we present a preliminary evaluation of a prototype tool that integrates an ultra high resolution Fourier domain common path Optical Coherence Tomography (OCT) with an intelligent microsurgical instrument. The tool provides OCT guided visualization of the ILM layer at the point of tissue contact by the surgical tool. We have evaluated the imaging properties of the common path OCT system. The common path OCT system used in this study has a maximum imaging depth of 1.3mm and a sensitivity of 91dB. We have achieved an experimental axial resolution of 3μm in air and this appears to be sufficient to both identify the ILM and to perform surgical maneuvers. We scanned the single mode fiber probe using an intelligent microsurgical instrument to form B-Mode images. We imaged a porcine eye with both anterior eye segment and the vitreous removed. The image obtained show distinct functional layers of retina.

  12. Optimal training design for procedural motor skills: a review and application to laparoscopic surgery.

    Science.gov (United States)

    Spruit, Edward N; Band, Guido P H; Hamming, Jaap F; Ridderinkhof, K Richard

    2014-11-01

    This literature review covers the choices to consider in training complex procedural, perceptual and motor skills. In particular, we focus on laparoscopic surgery. An overview is provided of important training factors modulating the acquisition, durability, transfer, and efficiency of trained skills. We summarize empirical studies and their theoretical background on the topic of training complex cognitive and motor skills that are pertinent to proficiency in laparoscopic surgery. The overview pertains to surgical simulation training for laparoscopy, but also to training in other demanding procedural and dexterous tasks, such as aviation, managing complex systems and sports. Evidence-based recommendations are provided for facilitating efficiency in laparoscopic motor skill training such as session spacing, adaptive training, task variability, part-task training, mental imagery and deliberate practice.

  13. First investigation of spider silk as a braided microsurgical suture.

    Science.gov (United States)

    Kuhbier, Joern W; Reimers, Kerstin; Kasper, Cornelia; Allmeling, Christina; Hillmer, Anja; Menger, Björn; Vogt, Peter M; Radtke, Christine

    2011-05-01

    Inhibition of axonal outgrowth accompanied by neuroma formation appears in microsurgical nerve repair as reaction to common microsuture materials like silk, nylon, or polyglycolic acid. In contrast, recent findings revealed advantages of spider silk fibers in guiding Schwann cells in nerve regeneration. Here, we asked if we could braid microsutures from native spider silk fibers. Microsutures braided of native spider dragline silk were manufactured, containing either 2 × 15 or 3 × 10 single fibres strands. Morphologic appearance was studied and tensile strength and stress-strain ratio (SSR) were calculated. The constructed spider silk sutures showed a median thickness of 25 μm, matching the USP definition of 10-0. Maximum load and tensile strength for both spider silk microsutures were significantly more than 2-fold higher than for nylon suture; SSR was 1.5-fold higher. All values except elasticity were higher in 3 × 10 strand sutures compared to 2 × 15 strand sutures, but not significantly. In this pilot study, we demonstrate the successful manufacture of microsutures from spider silk. With regards to the mechanical properties, these sutures were superior to nylon sutures. As spider silk displays high biocompatibility in nerve regeneration, its usage in microsurgical nerve repair should be considered. Copyright © 2011 Wiley Periodicals, Inc.

  14. An optimized method of vessel dissection in establishment of the rat aortic transplantation model.

    Science.gov (United States)

    Luo, Ming; Qiu, Feng; Qiu, Jianxin; Liu, Yong; Fan, Yu; Guo, Yifeng

    2011-07-01

    The high demand for microsurgical skills in those without a strong microsurgery background limits the application of the rat aortic transplant model to transplantation research. In this study, we established a rat aortic transplant model using a hydrodissection technique as a minimal-touch technique in vessel dissection. Eighty male Sprague Dawley rats were randomly divided into two groups with equal numbers. In the experimental group, abdominal aortas were harvested using hydrodissection; in the control group, instrumental dissection was used. The harvested aortas were transplanted orthotopically. The mean harvesting and implanting time in the experimental group was significantly lower than that of the control group (11.8 ± 1.51 versus 23.8 ± 3.38 minutes, P Surgical complications in the control group included inferior vena cava injury (2/20), arterial vasospasm (3/20), and arterial wall hemorrhage (1/10). None of these complications were observed in the hydrodissection group. The overall frequency of surgical complications in the hydrodissection group was significantly lower than that in the control group ( P technique is a fast and safe method of vessel dissection. This technique requires less microsurgical skills and optimizes the establishment of the rat aortic transplant model. © Thieme Medical Publishers.

  15. Optimal Interpolation Framework for Evaluating the Skill and Error of Climate Field Reconstruction Methods

    Science.gov (United States)

    Kaplan, A.; Smerdon, J. E.; Evans, M. N.

    2010-12-01

    Current-generation climate field reconstruction (CFR) methods, which are used to estimate, e.g., surface temperature values (t) at a predetermined grid from a synchronously available vector of proxy values (p), seek solutions assuming that a linear transform (B) connects deviations of these variables from their respective means tm and pm: t-tm=B(p-p_m). The transform operator B here would be a standard linear regression matrix B=Ctp}C{pp-1 (with Ctp= and Cpp= being cross-covariance and covariance matrices for t and p respectively) if only these matrices could be robustly calculated from available data. As things usually stand, however, instrumental data sets of t available for computing its cross-covariance with p can never provide more than 100-150 annual samples. On the other hand, due to a relatively low signal-to-noise ratio of individual proxy records, their assemblies used in global reconstructions normaly include on the order of 100 records or more. Hence various methods for regularizing the inversion of Cpp are used: ridge regression, truncated total least squares, canonical correlation analysis, local regression, etc. Suppose, however, that the target climate field is Gaussian with a known covariance C: t ˜{N}(tm,C), while a proxy vector is obtained from it by a known linear transform H (``proxy forward model''), subject to a Gaussian error: p=Ht+\\varepsilon, \\varepsilon ˜{N}(0,R). In this case, Cpp=HCHT+R and Ctp=CHT, so that under the regression solution given above becomes an optimal interpolation (OI) solution hat {t}=CHT(HCH^T+R)-1p with error covariance Q=C-CHT(HCH^T+R)-1HC. Moreover, the posterior distribution of t conditional on p is [t|p] ˜ {N}(hat {t},Q). If available climate records were very long, the distinction between the sample regression estimate and the better structured OI solution would be immaterial: the covariances estimated from the available sample would produce a result approaching the OI solution. However, under the reality

  16. Radical microsurgical treatment of intramedullary spinal cord tumors

    Institute of Scientific and Technical Information of China (English)

    PENG Lin; QI Song-tao; CHEN Zhuang; FEN Wen-feng; FANG Lu-xiong; HUANG Li-jing; CHENG Jiang-peng

    2006-01-01

    Background The surgical treatment of intramedullary spinal cord tumor aims at complete removal and minimal postoperative deficit. This study was undertaken to evaluate the microsurgical features of intramedullary spinal cord tumors and the time for surgery and prognosis.Methods Twenty-one patients with intramedullary spinal cord tumor who had been treated at Nanfang Hospital,Guangzhou, China since 2000 were studied retrospectively. Fifteen patients were men and 6 women, aged 2-60 years (mean 29.28 years). Thirteen patients had the tumor in the cervical segments, 4 in medulla-cervical segments, 1 in cervicothoracic segment, and 3 in thoracic spine. All the patients underwent microsurgery for the tumor through posterior approaches by laminectomy. The tumor was exposed through dorsal myelotomy, then tumor plane was removed carefully from the entire rostrocaudal area. The dura was sutured routinely. In case of tumors occupying too many spinal segments, titanium strip was applied to reconstruct the vertebral plate and keep the spinal column stable. All the patients were subjected to MR imaging early after operation. Results Complete removal of the tumor was made in 15 patients, subtotal removal in 5, and partial resection in 1. Neurological recovery was related primarily to preoperative neurological conditions of the patients. Patients with minor neurological deficit showed stable sensory and motor function or minor loss in the early postoperative period, and neurological function tended to improve with time. But those with significant or long-standing deficit could hardly demonstrate any recovery. The dissection interface between the tumor and normal cord tissue was the most important factor influencing the extent of surgical removal.Conclusions Intramedullary spinal cord tumor mostly take place in cervical segments, with glioma as the commonest type. Microsurgery is the major treatment of choice, by which tumor plane could be totally resected. Excellent microsurgical

  17. Optimizing the number of steps in learning tasks for complex skills.

    NARCIS (Netherlands)

    Nadolski, Rob; Kirschner, Paul A.; Van Merriënboer, Jeroen

    2007-01-01

    Background. Carrying out whole tasks is often too difficult for novice learners attempting to acquire complex skills. The common solution is to split up the tasks into a number of smaller steps. The number of steps must be optimised for efficient and effective learning. Aim. The aim of the study is

  18. Microsurgical anatomy of the supratentorial arachnoidal trabecular membranes and cisterns.

    Science.gov (United States)

    Vinas, F C; Fandino, R; Dujovny, M; Chavez, V

    1994-12-01

    We examined the microsurgical anatomy of the supratentorial subarachnoid cisterns with a surgical microscope in 20 brains prepared using the immersion technique. The adult brains were immersed in Ringer's solution and air was injected into the subarachnoid cisterns while the brains remained submerged in solution. We identified nine trabecular membranes that limit the 15 cisterns. We specifically looked at the anatomical relationship between the supratentorial trabecular membranes and cisterns to their corresponding vessels and cranial nerves. The cistern divisions and the dispositions of trabecular membranes were closely related to the vascular division patterns of the principal brain arteries. A clear and thorough understanding of the neuroanatomical structures of the subarachnoid cisterns is important because they provide natural pathways to neurovascular and cranial nerve structures. These pathways allow access to intracranial arteries, veins, and nerves during microvascular procedures without disturbing surrounding important brain structures.

  19. 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.

  20. 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.

  1. Electronic database for documentation of microsurgical and endovascular treatment of intracranial aneurysms: technical note.

    Science.gov (United States)

    Gruber, A; Killer, M; Bavinzski, G; Richling, B

    2001-06-01

    The authors present an electronic database for the documentation and inter-group comparison of patients subjected to microsurgical and/or endovascular therapy of ruptured and unruptured intracranial aneurysms.

  2. Microsurgical third ventriculocisternostomy as an alternative to ETV: report of two cases.

    NARCIS (Netherlands)

    Lindert, E.J. van

    2008-01-01

    OBJECTIVE: To describe a microsurgical alternative to endoscopic third ventriculocisternostomy. METHODS: Two children with shunt-dependent hydrocephalus and multiple shunt revisions were considered candidates for third ventriculocisternostomy (TVS). Because of slit ventricles, an endoscopic approach

  3. Endoscope-assisted microsurgical transoral approach to the anterior craniovertebral junction compressive pathologies

    National Research Council Canada - National Science Library

    Visocchi, Massimiliano; Doglietto, Francesco; Della Pepa, Giuseppe Maria; Esposito, Giuseppe; La Rocca, Giuseppe; Di Rocco, Concezio; Maira, Giulio; Fernandez, Eduardo

    2011-01-01

    At the present time, an update to the classical microsurgical transoral decompression is strongly provided by the most recent literature dealing with the introduction of the endoscopy in spine surgery...

  4. Optimizing engagement in goal pursuit with youth with physical disabilities attending life skills and transition programs: an exploratory study.

    Science.gov (United States)

    Smart, Eric; Aulakh, Adeeta; McDougall, Carolyn; Rigby, Patty; King, Gillian

    2017-10-01

    Identify strategies youth perceive will optimize their engagement in goal pursuit in life skills and transition programs using an engagement framework involving affective, cognitive, and behavioral components. A qualitative descriptive design was used. Two semi-structured interviews were conducted with seven youth. The first was informed by a prior observation session, and the second occurred after the program ended and explored youths' perceptions of whether and how their engagement changed. Data were analyzed using thematic analysis. The analysis generated eight strategies youth considered effective. These were categorized under the three components of engagement. Affective strategies: (1) building a relationship on familiarity and reciprocity; and (2) guiding the program using youths' preferences and strengths. Cognitive strategies: (3) assisting youth to envision meaningful change; (4) utilizing youths' learning styles; and (5) promoting awareness of goal progress. Behavioral strategies: (6) ensuring youth access to a resource network; (7) providing youth multiple decision opportunities; and (8) enabling youth to showcase capabilities. Service providers together with youth are encouraged to consider the role of context and self-determination needs in order to optimize youth engagement in goal pursuit. Systematic approaches to studying engagement are necessary to learn how to maximize rehabilitation potential. Implications for Rehabilitation Service providers are encouraged to be aware of the nature of engagement strategies identified by youth. Comprehensive frameworks of engagement are essential to generate knowledge on the range of strategies service providers can use to engage clients in rehabilitation services. Strategies perceived by youth to optimize their engagement in goal pursuit in life skills and transition programs have subtle yet significant differences with strategies used in other rehabilitation settings like mental health and adult healthcare

  5. Structuring collaboration scripts for mastership skills: Optimizing online group play on classroom dilemmas in teacher education

    NARCIS (Netherlands)

    Hummel, Hans; Geerts, Walter; Slootmaker, Aad; Kuipers, Derek; Westera, Wim

    2014-01-01

    Serious games can facilitate workplace learning, for instance when collaboration on solving professional problems is involved. The optimal structure in collaboration scripts for such games has appeared to be a key success factor. Free collaboration does not systematically produce effective learning,

  6. Improving nursing home resident integrity by optimizing interpersonal communication skills in clinical staff.

    Science.gov (United States)

    Matusitz, Jonathan; Breen, Gerald-Mark; Zhang, Ning Jackie; Seblega, Binyam K

    2013-01-01

    In this article the authors discuss the prevalence of resident abuse and reported violations of care deficiencies and resident maltreatment in nursing homes in the United States. The number of nursing homes in the United States that are cited with abuse violations has increased in recent years. While the authors recognize that treatments (both positive and negative) received by residents are sometimes related to factors other than staff's lack of knowledge and poor attitudes, their purpose in this analysis is to enhance resident integrity through the improvement of staff interpersonal communication skills. In doing so, innovative strategies and specific interpersonal communication theories are examined as educational methods to confront and resolve care deficiencies and elevate and enrich residents' integrity, satisfaction, and outcomes.

  7. The Efficacy of the Enhanced Aussie Optimism Positive Thinking Skills Program in Improving Social and Emotional Learning in Middle Childhood

    Directory of Open Access Journals (Sweden)

    Jacqueline D Myles-Pallister

    2014-08-01

    Full Text Available The aim of the current study was to investigate the effects of the modified and enhanced Aussie Optimism Positive Thinking Skills Program (AO-PTS on Year 4 and 5 children’s social and emotional learning (SEL skills. AO-PTS is a universal-school based program that is implemented by class teachers as part of regular school curricula and was developed for the prevention of depression and anxiety. The study comprised a total of 683 Year 4 and 5 students from 10 private primary schools in Western Australia. Students were assessed on two subscales of emotional attribution at school whilst parents reported on their children’s externalizing and internalizing problems outside of school and at home. Two analyses were conducted: seven intervention schools were assessed at pre- and post-test (Analysis 1 and pre-post change in three intervention schools were compared to pre-post change in three matched control schools (Analysis 2. Results from Analysis 1 showed that the intervention children had increased in their overall emotional attribution accuracy and decreased in total difficulties and hyperactivity; Results from Analysis 2 revealed no intervention effect on emotional attribution accuracy or internalizing or externalizing problems. These findings suggest that the enhanced AO-PTS’s effects on SEL were not evident in the short-term period after intervention. The non-significant findings and future directions for AO-PTS research and program modification were discussed.

  8. The efficacy of the enhanced Aussie Optimism Positive Thinking Skills Program in improving social and emotional learning in middle childhood.

    Science.gov (United States)

    Myles-Pallister, Jacqueline D; Hassan, Sharinaz; Rooney, Rosanna M; Kane, Robert T

    2014-01-01

    The aim of the current study was to investigate the effects of the modified and enhanced Aussie Optimism Positive Thinking Skills Program (AO-PTS) on Year 4 and 5 children's social and emotional learning (SEL) skills. AO-PTS is a universal-school based program that is implemented by class teachers as part of regular school curricula and was developed for the prevention of depression and anxiety. The study comprised a total of 683 Year 4 and 5 students from 10 private primary schools in Western Australia. Students were assessed on two subscales of emotional attribution at school whilst parents reported on their children's externalizing and internalizing problems outside of school and at home. Two analyses were conducted: seven intervention schools were assessed at pre- and post-test (Analysis 1) and pre-post change in three intervention schools were compared to pre-post change in three matched control schools (Analysis 2). Results from Analysis 1 showed that the intervention children had increased in their overall emotional attribution accuracy and decreased in total difficulties and hyperactivity; Results from Analysis 2 revealed no intervention effect on emotional attribution accuracy or internalizing or externalizing problems. These findings suggest that the enhanced AO-PTS's effects on SEL were not evident in the short-term period after intervention. The non-significant findings and future directions for AO-PTS research and program modification were discussed.

  9. A New Microsurgical Technique to Correct Retinal Detachment

    Institute of Scientific and Technical Information of China (English)

    Wen Liu; Chunfang Li; Suying Huang; Qichong Wu

    2006-01-01

    Purpose: To evaluate the efficacy of a new technique to repair retinal detachments (RD) under the microscope. Methods: Thirty-six consecutive patients (36 eyes) who presented to our clinic with rhegmatogenous RD without severe proliferative vitreoretinopathy (≤ C1) were included. The sutures for buckling and/or encircling bands were preplaced according to the preoperative location of the breaks using a three-mirror contact lens. Drainage of subretinal fluid, retinal cryotherapy, buckling, locating the retinal breaks, and intravitreal gases injection were performed under surgical microscopy. The surgical effects were compared with those in 37 consecutive patients with rhegmatogenous RD who underwent surgery under binocular indirect ophthalmoscopy.Results: The simultaneous intraoperative observation of fundus details and the sclera through the microscope was excellent in all cases. The effect of retinal cryotherapy was clearly visible. Mild opacity of the refractive media did not interfere with observing cryotherapy and locating the breaks. Retinal reattachment was obtained in31 eyes (86%) during the primary surgery and in three eyes after a second surgery(94% total). The best-corrected visual acuity was <0.1 in 6 eyes (16.7%), 0.1~0.4 in 15 eyes (41.7%) and ≥ 0.5 in 15 eyes (41.7%). The results were similar to that of RD surgery performed under indirect ophthalmoscopy.Conclusions: This microsurgical procedure to correct RD is simple, convenient,reliable, provides an upright image, and facilitates good recovery similar to conventional RD surgery.

  10. Evaluation of 10-year Microsurgical Tubal Reversal after Tubal Sterilization

    Institute of Scientific and Technical Information of China (English)

    刘建华; 法韫玉; 罗冬英

    1996-01-01

    One thousand and twenty-nine women with microsurgical tubal reversal after tubal sterilization were followed up. The rate of intrauterine pregnancy was found to be 93. 29%. The rate of intrauterine pregnancy was the highest (73. 28 % ) in the first year after tubal reversal. In the firs tyear, the chance of pregnancy in the first 6 months was higher (54.81%) than that (40. 86%) in the second 6 months (P <0. 01), and the chance in the first 3 months was higher (37.41%) than that (27. 80%) in the second3 months (P<0. 01). The rates of ectopic pregnancy after tubal reversal in various stages were not significantly different (P >0. 05). The rate of intrauterine pregnancy was not related with the period from sterilization to tubal reversal. Early postoperative hydropertubation can only decrease the rate of intrauterine pregnancy. The rate of intrauterine pregnancy of the tubal reversal after Uchida’s method and clips tubal sterilization was higher than that after Pomeroy’s tubal ligation. The reanastomosis of isthmus and isthmus resulted in the highest rate of intrauterine pregnancy, so we think that Uchida’s or clips tubal sterilization in the isthmus of the tubal are ideal and reversible techniques at present.

  11. 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.

  12. Heteroparental blastocyst production from microsurgically corrected tripronucleated human embryos.

    Science.gov (United States)

    Escribá, María-José; Martín, Julio; Rubio, Carmen; Valbuena, Diana; Remohí, José; Pellicer, Antonio; Simón, Carlos

    2006-12-01

    To prove the efficiency of identification and removal of one of the surplus paternal pronuclei in dispermic IVF zygotes to obtain heteroparental blastocysts. Experimental. One hundred fourteen tripronucleated (3PN) embryos from conventional IVF. After informed and signed consent, the patients from Instituto Valenciano Infertilidad (IVI), Valencia, donated their abnormally fertilized embryos. Seventy-two embryos were diploidized by microsurgical removal of the pronucleus located at the farthest position to the second polar body. Forty-two 3PN embryos served as controls. Survival and correction rate; in vitro development up to the blastocyst stage; X, Y, and 18 chromosome determination by triple fluorescent in situ hybridization and, inheritance analysis for 10 polymorphic repeat regions using polymerase chain reaction (PCR) amplification and sequencing. Seventy-eight percent of 3PN zygotes (56/72) survived manipulation and eventually 51 zygotes had two pronuclei (71%). Forty-one percent of manipulated embryos progressed in vitro to the blastocyst stage (21/51). Fluorescent in situ hybridization analysis performed on eight manipulated embryos confirmed their diploid state; all four controls were triploid. Heteroparental inheritances were also confirmed in four of six manipulated embryos. Heteroparental blastocysts can be derived from corrected dispermic zygotes.

  13. Microsurgical Treatment of Meningiomas Invading the Sagittal or Transverse Sinuses

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To analyze our management strategy and results of treating patients affected by meningiomas invading the sagittalor transverse sinuses.METHODS Review of data from 35 patients with pathologically confirmed meningiomas(29 of the sagittal sinus and 6 of the transverse sinus)surgically treated between from July 1999 and June 2003, including clinical manifestations, mode of diagnosis and curative effect of microsurgery etc.For our surgical decision-making, meningiomas were classified into six types based on the degree of sinus involvement.RESULTS A Simpson's Grade I resection was achieved in 27 cases (77.1%), Grade Ⅱ in 6 (17.1%) and Grade Ⅲ in 2 (5.7%). No patients died after the operations. The recurrence rate in the study overall was 2.9%, with a follow-up period from 3 to 6 years.CONCLUSION Application of microsurgical techniques, protection of the sinus, avoidance of damages to the cerebral cortex, veins of the central sulcus, as well as other veins from the tumor, are the major factors for increasing the rate of total resection, reducing complications and improving the quality of life for the patients with meningiomas invading the sagittal or transverse sinuses.

  14. Fertility following microsurgical removal of the ampullary-isthmic junction in rabbits.

    Science.gov (United States)

    Eddy, C A; Antonini, R; Pauerstein, C J

    1977-10-01

    The role of the ampullary-isthmic junction (AIJ) in fertility was investigated in the rabbit by using microsurgical tuboplastic techniques. Microsurgical transection or resection of the AIJ failed to alter fertility significantly. Nine of ten rabbits which underwent unilateral transection of the AIJ became pregnant on the operated side and eight of the ten became pregnant on the unoperated control side. Of the ten rabbits which underwent unilateral AIJ resection, all became pregnant bilaterally. The results of this study indicate that the AIJ is not necessary for normal fertility in the rabbit.

  15. Microsurgical reconstruction of hepatic artery in A-A LDLT:124 consecutive cases without HAT

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To retrospectively investigate microsurgical hepatic artery(HA) reconstruction and management of hepatic thrombosis in adult-to-adult living donor liver transplantation(A-A LDLT).METHODS:From January 2001 to September 2009,182 recipients with end-stage liver disease underwent A-A LDLT.Ten of these patients received dual grafts.The 157 men and 25 women had an age range of 18 to 68 years(mean age,42 years).Microsurgical techniques and running sutures with back-wall first techniques were performed in all a...

  16. 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.

  17. Microsurgical resectability, outcomes, and tumor control in meningiomas occupying the cavernous sinus.

    Science.gov (United States)

    Nanda, Anil; Thakur, Jai Deep; Sonig, Ashish; Missios, Symeon

    2016-08-01

    OBJECTIVE Cavernous sinus meningiomas (CSMs) represent a cohort of challenging skull base tumors. Proper management requires achieving a balance between optimal resection, restoration of cranial nerve (CN) function, and maintaining or improving quality of life. The objective of this study was to assess the pre-, intra-, and postoperative factors related to clinical and neurological outcomes, morbidity, mortality, and tumor control in patients with CSM. METHODS A retrospective review of a single surgeon's experience with microsurgical removal of CSM in 65 patients between January 1996 and August 2013 was done. Sekhar's classification, modified Kobayashi grading, and the Karnofsky Performance Scale were used to define tumor extension, tumor removal, and clinical outcomes, respectively. RESULTS Preoperative CN dysfunction was evident in 64.6% of patients. CN II deficits were most common. The greatest improvement was seen for CN V deficits, whereas CN II and CN IV deficits showed the smallest degree of recovery. Complete resection was achieved in 41.5% of cases and was not significantly associated with functional CN recovery. Internal carotid artery encasement significantly limited the complete microscopic resection of CSM (p < 0.0001). Overall, 18.5% of patients showed symptomatic recurrence after their initial surgery (mean follow-up 60.8 months [range 3-199 months]). The use of adjuvant stereotactic radiosurgery (SRS) after microsurgery independently decreased the recurrence rate (p = 0.009; OR 0.036; 95% CI 0.003-0.430). CONCLUSIONS Modified Kobayashi tumor resection (Grades I-IIIB) was possible in 41.5% of patients. CN recovery and tumor control were independent of extent of tumor removal. The combination of resection and adjuvant SRS can achieve excellent tumor control. Furthermore, the use of adjuvant SRS independently decreases the recurrence rates of CSM.

  18. The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure.

    Science.gov (United States)

    Caspar, W; Campbell, B; Barbier, D D; Kretschmmer, R; Gotfried, Y

    1991-01-01

    The outcome in 119 patients who were operated on with a conventional standard lumbar discectomy procedure was retrospectively compared with that in 299 patients who were operated on with a microsurgical discectomy technique developed in Homburg/Saar, Federal Republic of Germany by the senior author (W.C.). All patients in this consecutive series had "virgin" lumbar radiculopathy evaluated and operated upon by two experienced surgeons at one institution. Determination of the final outcome was made objectively by an impartial third party using identical criteria for both groups, and with a patient self-evaluation form. The study looked at various pertinent aspects of the treatment course and at final outcome. The results in the microsurgical group were significantly favorable: fewer levels were explored: there was less operative blood loss and a decreased incidence of deep venous thrombosis, urinary tract infections, pulmonary emboli, and bladder catheterization; the time to full ambulation, discharge, and return to work was faster: and there was a decrease in change of occupation and a greater percentage of satisfactory final outcomes, as measured both objectively and subjectively. A description of the microsurgical technique used in this study, which differs significantly from existing microdisectomy techniques, is presented. The authors conclude that the microsurgical disectomy technique presented in this study is a safe and effective approach to the treatment of lumbar radiculopathy.

  19. Incidence and Type of Errors in Microsurgical Technique in Surgical Trainees.

    Science.gov (United States)

    Stone, Jill P; Doherty, Christopher C; Schrag, Christiaan H

    2016-09-01

    Background The purpose of our study was first to identify microsurgical errors and their incidence. Identifying these common errors and the theoretical approach to prevent or repair them may provide benefit to trainees in the laboratory setting and, ultimately, in the clinical setting. Methods Using a rat femoral artery anastomoses model for resident microsurgical training, direct staff observation with real-time feedback and error identification was employed. Types of microsurgical errors were recorded and instructor feedback relayed to five resident participants. Results Errors were cataloged into five main categories: insufficient approximation (26.1%), vessel backwall (21.7%), incomplete bites (19.6%), tissue tear (19.6%), and irregular widths (13.0%). Further subdivision of the incomplete bite error based on vessel layer violated was performed. Representative figures were created outlining these errors. Conclusions We present common microsurgical errors in trainees and a training model with synchronous feedback. Visual images were designed outlining these errors as an adjunct for teaching.

  20. A Comparative Analysis of 2 National Breast Reconstruction Surveys: Concerns Regarding Autologous and Microsurgical Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Raffi Gurunluoglu, MD, PhD, FACS

    2014-05-01

    Conclusions: Comparative data suggest that there are fewer high volume BR cases being performed by US plastic surgeons and that there has been a reduction among plastic surgeons in the use of microsurgical BR from 2010 to 2012. We believe that these findings may indicate early signs of the changes in BR trends in the US.

  1. Microsurgical Reconstruction of Traumatic Lower Extremity Defects in the Pediatric Population.

    Science.gov (United States)

    Momeni, Arash; Lanni, Michael; Levin, L Scott; Kovach, Stephen J

    2017-04-01

    Few reports focus exclusively on microsurgical reconstruction of traumatic lower extremity defects in children. Hence, the authors felt it prudent to contribute to this area of clinical research. The authors hypothesized that reconstructive success would be comparable to success rates reported in adults, and that young age or concerns regarding vessel size or behavior do not negatively impact surgical outcome. A retrospective review of microsurgical lower extremity reconstruction cases at two academic medical centers was performed. All pediatric patients who underwent microsurgical reconstruction of traumatic lower extremity defects between 1997 and 2012 were included for analysis. Forty flaps transferred in 40 patients with a mean age of 11.4 years (range, 1 to 17 years) were included for analysis. Muscle flaps were predominantly used [n = 23 (57.5 percent)]; however, there was a recent increase in use of fasciocutaneous flaps [n = 16 (40 percent)]. Postoperative complications were seen in 25 percent of patients, with a total flap loss rate of 5 percent. No donor-site complications were observed. The mean postoperative length of hospital stay was 12.9 days (range, 4 to 41 days), with patients returning to full weight-bearing after a mean of 2.6 months (range, 1 to 8 months). Microsurgical reconstruction of traumatic lower extremity defects in the pediatric population is safe. Concerns related to patient age, vessel size, or vessel behavior (i.e., vasospasm) should not detract from offering free flap reconstruction, as they do not negatively impact outcomes. Therapeutic, IV.

  2. Hydrocephalus Onset after Microsurgical or Endovascular Treatment for Acute Subarachnoid Hemorrhage. Retrospective Italian Multicenter Study

    Science.gov (United States)

    Gangemi, Michelangelo; Cavallo, Luigi Maria; Di Somma, Alberto; Mazzucco, Grazia Marina; Bono, Paolo Sebastiano; Ghetti, Giovanni; Zambon, Giampaolo

    2014-01-01

    Background Chronic shunt-dependent hydrocephalus is a complication of aneurysmal subarachnoid hemorrhage (aSAH). Its incidence and risk factors have been described while the hydrocephalus onset in terms of days after treatment (microsurgical or endovascular) has not been yet analyzed. Materials and Methods 45 patients, treated for aSAH in 4 Italian Neurosurgical Departments, were retrospectively analyzed. It was calculated the time that elapses between treatment and hydrocephalus onset in 36 patients. Results Of the 45 shunted patients, 15 (33.3%) were included in the microsurgical group (group A) and 30 (66.6%) were in the endovascular one (group B). There was no difference of the hydrocephalus onset between the two groups (24,1 days, group A vs. 27,7 days, group B). The presence of intracerebral hematoma (ICH) caused a delay in the hydrocephalus onset after endovascular treatment in terms of 11,5 days compared to microsurgical group as well the absence of vasospasm determined a delay of 13,7 days (not statistically significant). Conclusion No difference in terms of hydrocephalus onset after microsurgical or endovascular treatment has been demonstrated. Only the presence of ICH or the absence of vasospasm can cause a slight delay in the time of hydrocephalus onset in the endovascular series (not statistically significant). Long-term follow-up studies involving higher numbers of subjects are needed to better demonstrate this issue. PMID:24809036

  3. Microsurgically aided upper lip replantation – case report and literature review

    Science.gov (United States)

    Gustafsson, Jonas; Lidén, Mattias; Thorarinsson, Andri

    2016-01-01

    Abstract A case with a patient who suffered an upper lip amputation and a lower lip laceration due to dog bite is presented. The amputated segment was replanted using microsurgical technique. The operative technique and postoperative care is presented, as well as a review of the current literature on the subject. PMID:27713916

  4. 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...

  5. Spinal cord stimulation combined with microsurgical DREZotomy for pain due to syringomyelia.

    Science.gov (United States)

    Shu, Wei; Li, Yongjie; Tao, Wei; Hu, Yongsheng

    2016-10-01

    A 49-year-old man with lower extremity neuropathic pain thought to be caused by spinal cord syringomyelia was treated with a combination of using spinal cord stimulation, decompression of the syrinx, relief of arachnoid adhesions and microsurgical DREZotomy. The patient had significant pain relief and has stable neurological status at follow-up.

  6. [The anatomical x-ray validation of microsurgical treatment methods in intervertebral hernias of the lumbosacral spine].

    Science.gov (United States)

    Ogleznev, K Ia; Kagan, I I; Levoshko, L I

    1994-01-01

    The microsurgical anatomy of the lateral region of the lumbosacral region of the vertebral canal was studied in 15 human cadavers. The vertebral canal and intervertebral foramina were X-ray studied in 10 healthy subjects and in 50 patients with lumbar osteochondrosis. The morphological and X-ray findings were used in the development of microsurgical methods for removing lumbar discal hernias, which were employed in 40 patients with this abnormality. The control group included 50 patients with discal hernias who had been operated on by the conventional methods. The advantages of microsurgical methods have been indicated.

  7. Attitudes of Elementary School Teachers in Education System in Qazvin toward In-Service Education Role in Optimization of Administrators’ Skills

    OpenAIRE

    Mohammad Reza Karamipour; Naqi Kamali

    2014-01-01

    This study aimed to investigate the attitudes of elementary school teachers in education system in district 2, Qazvin toward in service education role in optimization of administrators skills. This was descriptive and survey research. The population consisted of all primary school teachers in public schools. Totally, 48 cases were randomly selected as sample. This study used a questionnaire to collect the data. The experts' opinion about the validity and reliability of questionnire was evalua...

  8. Music Training Program: A Method Based on Language Development and Principles of Neuroscience to Optimize Speech and Language Skills in Hearing-Impaired Children

    OpenAIRE

    Samaneh Sadat Dastgheib; Mina Riyassi; Maryam Anvari; Hamid Tayarani Niknezhad; Masumeh Hoseini; Mohsen Rajati; Mohammad Mahdi Ghasemi

    2013-01-01

    Introduction: In recent years, music has been employed in many intervention and rehabilitation program to enhance cognitive abilities in patients. Numerous researches show that music therapy can help improving language skills in patients including hearing impaired. In this study, a new method of music training is introduced based on principles of neuroscience and capabilities of Persian language to optimize language development in deaf children after implantation.    Materials and Methods: T...

  9. Designing evidence-based medicine training to optimize the transfer of skills from the classroom to clinical practice: applying the four component instructional design model.

    Science.gov (United States)

    Maggio, Lauren A; Cate, Olle Ten; Irby, David M; O'Brien, Bridget C

    2015-11-01

    Evidence-based medicine (EBM) skills, although taught in medical schools around the world, are not optimally practiced in clinical environments because of multiple barriers, including learners' difficulty transferring EBM skills learned in the classroom to clinical practice. This lack of skill transfer may be partially due to the design of EBM training. To facilitate the transfer of EBM skills from the classroom to clinical practice, the authors explore one instructional approach, called the Four Component Instructional Design (4C/ID) model, to guide the design of EBM training. On the basis of current cognitive psychology, including cognitive load theory, the premise of the 4C/ID model is that complex skills training, such as EBM training, should include four components: learning tasks, supportive information, procedural information, and part-task practice. The combination of these four components can inform the creation of complex skills training that is designed to avoid overloading learners' cognitive abilities; to facilitate the integration of the knowledge, skills, and attitudes needed to execute a complex task; and to increase the transfer of knowledge to new situations. The authors begin by introducing the 4C/ID model and describing the benefits of its four components to guide the design of EBM training. They include illustrative examples of educational practices that are consistent with each component and that can be applied to teaching EBM. They conclude by suggesting that medical educators consider adopting the 4C/ID model to design, modify, and/or implement EBM training in classroom and clinical settings.

  10. Experiences with microsurgical tissue transfers in elderly patients.

    Science.gov (United States)

    Ozkan, Omer; Ozgentas, H Ege; Islamoglu, Kemal; Boztug, Neval; Bigat, Zekiye; Dikici, M Bahadir

    2005-01-01

    The combination of advances in microsurgery and the improvement of anesthetic management with increased understanding of the physiology of preoperative and postoperative care has significantly raised the upper age limit for free-flap transfer in elderly patients. Despite pessimistic opinions regarding elderly patients who have poor recovery potential and decreased physiological reserves, the unique feature of free-tissue transfer is that it allows the transfer of well-vascularized tissue to defects in a single-stage procedure, and leads to improved quality of life. In this report, a retrospective analysis of 55 patients aged 50 and older who underwent microsurgical tissue transfer is presented. Hospital and our own records were used to review various parameters. The preoperative medical status of each patient was assessed using the American Society of Anesthesiologists (ASA) Classification of Physical Status. Each patient's preoperative medical records, age, sex, transferred tissue type, and length of operation were outlined. Postoperative recorded parameters were the fate of flaps and the short-term postoperative outcome, including surgical complications, medical morbidity, and death within 30 days of surgery. Fifty-eight microvascular tissue transfers were performed in 55 consecutive patients. The study comprised 38 male and 17 female patients, with a mean age of 64.8 years. ASA classification status was class 1 for 15 patients, class 2 for 26 patients, and class 3 for 14 patients. Twenty-five flaps were used for lower extremity reconstruction, 32 flaps were used for head and neck reconstruction, and 1 was used for breast reconstruction. The average operative time was 5.7 h, ranging between 2-13 h. There were 14 major medical complications, resulting in an overall medical complication rate of 25%. There were 3 deaths within 30 days postoperatively. Thus, the overall surgical mortality rate was 5.4%. The longer operation times were associated with the development

  11. 工业工程专业的优化方法技能教学研究%A Study of Teaching Optimization Skills in Industrial Engineering

    Institute of Scientific and Technical Information of China (English)

    张智聪; 胡开顺; 赵少勇; 李帅; 黄辉宇

    2012-01-01

    优化方法在工业工程专业应用广泛,其教学工作在工业工程教学体系中占有重要地位,而当前的优化方法的教学中普遍存在实践环节偏少等弊端。鉴于优化技能是涉及到多门课程的一种综合性的专业应用技能,提出工业工程专业的优化技能教学应该以实践与应用为主,理论教学服务于应用教学。主要围绕优化模型的建模技巧、应用软件教学和解决专业案例等方面培养学生运用优化原理与方法构建大规模优化模型的能力以及运用专业软件解决实际优化问题的能力。%Optimization methods, widely used in Industrial Engineering ( IE), whose teaching plays important role in industrial engineering teaching system, but the current Optimization methods have the problem of less practice. In view of optimization skills related to a more comprehensive application of professional skills, it is proposed that Optimization teaching should be based on practice and application, and theoretical teaching should serve applied teaching. To foster the students'capability of modeling large - scale optimization problems and solving them using software, this paper introduces techniques of modeling optimization problems, teaching optimization software and solving expertise problems.

  12. The PVC-rat and other alternatives in microsurgical training

    NARCIS (Netherlands)

    Remie, R

    2001-01-01

    The number of animals used in educational training programs in experimental microsurgery can be reduced by using artificial devices such as the anastomoses device and the MD PVC-Rat. Such in vitro methods allow development of technical skills, making the transition to in vivo models much easier.

  13. Factors Predicting Total Free Flap Loss after Microsurgical Reconstruction Following the Radical Ablation of Head and Neck Cancers

    OpenAIRE

    Fujioka, Masaki

    2013-01-01

    Background. With greater experience in microsurgical reconstruction, free tissue transfer has become common and reliable. However, total flap necrosis after microsurgical reconstruction is sometimes seen in patients who have undergone radical ablation of head and neck malignancies. We investigated factors predicting free flap loss in head and neck reconstruction. Methods. We reviewed the records of 111 free flap reconstructions carried out among 107 patients with head and neck cancer who requ...

  14. [Morphometric characteristics of human colon wall as anatomic basis for microsurgical anastomoses].

    Science.gov (United States)

    Konovalov, D Iu

    2007-01-01

    This article describes the morphometric characteristics and some peculiarities of microsurgical anatomy of human colon wall. The thickness of colon wall varied from 495 to 3501 microm in the areas between teniae and from 1103 to 4007 microm in the areas of teniae, the average values were equal to 1693+93.3 and 2602+85 microm, respectively. The width of teniae was 3.5-10.3 mm (6.2+0.3 mm on the average). The thickness of tunica muscularis along the colon prevailed over the thickness of other tunics and increased caudally, while the thickness of submucosa diminished. Marked variability and small thickness of both the colon wall and its layers, differences of these characteristics in the areas of teniae musculares and between them support the expediency of the application of microsurgical operative technique in the operations performed on the colon.

  15. Microsurgical reconstruction of hepatic ar ter y in living donor liver transplantation:experiences and lessons

    Institute of Scientific and Technical Information of China (English)

    Sheng Yan; Shu-Sen Zheng; Qi-Yi Zhang; Yu-Sheng Yu; Jiang-Juan He; Wei-Lin Wang; Min Zhang; Yan Shen; Jian Wu; Xiao Xu

    2009-01-01

    BACKGROUND: Hepatic artery (HA) reconstruction is one of the key steps for living donor liver transplantation (LDLT). The incidence of HA thrombosis has been reduced by the introduction of microsurgical techniques under a high resolution microscope or loupe. METHODS: We report our experience in 101 cases of HA reconstruction in LDLTs using the graft-artery-unclamp and posterior-wall-ifrst technique. The reconstructions were completed by either a plastic surgeon or a transplant surgeon. RESULTS: The rate of HA thrombosis was 2%(2/101). The risk factors for failed procedures appeared to be reduced by participation of the transplant surgeon compared with the plastic surgeon. For a graft with duplicate arteries, we considered no branches should be discarded even with a positive clamping test. CONCLUSIONS: HA reconstruction without clamping the graft artery is a feasible and simpliifed technique, which can be mastered by transplant surgeons with considerable microsurgical training.

  16. Carbon dioxide-laser microsurgical median glossotomy for resection of lingual dermoid cysts.

    Directory of Open Access Journals (Sweden)

    Kristien Corvers

    2016-07-01

    Full Text Available Dermoid cysts are epithelial-lined cavities with skin adnexae in the capsule. Only 7% present in the head and neck. Between 2004 and 2013, 4 patients with a lingual dermoid cyst underwent a microsurgical carbon dioxide (CO² laser resection via a median sagittal glossotomy approach. This approach is an elegant technique combining superior visualization, hemostasis, and little postoperative edema with good wound healing, allowing for perfect function preservation of the tongue.

  17. 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.

  18. Intraocular Microsurgical Forceps (20, 23, and 25 gauge Membrane Peeling Forces Assessment

    Directory of Open Access Journals (Sweden)

    Raul Velez-Montoya

    2013-01-01

    Full Text Available Background. To assess the peeling forces exerted by different calibers of microsurgical forceps on an experimental model of epiretinal membrane. Methods. A model of epiretinal membrane was constructed using thin cellulose paper and heptanes-isopropyl alcohol 1% mixture. The model was mounted on a force censoring device. Subsequently, flaps were created with three different microsurgical forceps of different calibers. We recorded the number of attempts, the duration of the event, and the pushing and the pulling forces during the peeling. The results were compared by a one-way ANOVA and a Fisher unprotected least significant difference test with an alpha value of 0.05 for statistically significance. Results. There was a statistical significant difference on the pulling and pushing forces between the 25 gauge (13.79 mN; −13.27 mN and the 23 (6.63 mN; −5.76 mN and 20 (5.02 mN; −5.30 mN gauge, being greater in the first (. There were no differences in the duration of all events, meaning that all the forces were measured within the same period of time. Conclusions. The 25 gauge microsurgical forceps exerted the greatest mechanical stress over our simulated epiretinal membrane model and required more attempts to create a surgical suitable flap. The clinical implication of this finding is still to be determined.

  19. A simple cost-effective method of microsurgical simulation training: the turkey wing model.

    Science.gov (United States)

    Bates, Benjamin J; Wimalawansa, Sunishka M; Monson, Benjamin; Rymer, Michael C; Shapiro, Ryan; Johnson, R Michael

    2013-11-01

    The rat femoral artery (RFA) anastomosis model has been the gold standard in microsurgical simulation training. While effective, live animal use requires animal use committee regulation and costly maintenance. Our institution's animal laboratory is remote to the hospital, limiting access by our busy surgical residents with their limited duty hours. We present an alternative convenient, cost-effective model. Ten frozen turkey wings were divided into distal and proximal segments. Vessel diameter, length, and anastomosis perfusion were assessed. Proximal brachial arteries ("humeral" segments) measured 8.85 ± 1.14 cm long with diameter 1.69 ± 0.27 mm. Distal brachial arteries ("forearm") measured 10.5 ± 2.06 cm long with diameter 1.25 ± 0.25 mm. An 8-lb box (~20 wings) cost $13.76. Separate use of the segments provides two training sessions with $0.35 per session effective cost. Our average cost for RFA microsurgical training sessions was $120 dollars for a single rat 2-hour session and $66 per rat if a maximum crate load of six rats was used. Besides significant cost, not all training programs are equipped to house, care for, and use rats in microsurgical training. We now use turkey wings for microvascular training. They are cheap, abundant, readily accessible for training, and consistent with tissue quality and vessel size approximating human systems. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Endovascular treatment of recurrent intracranial aneurysms following previous microsurgical clipping with the Pipeline Embolization Device.

    Science.gov (United States)

    Ding, Dale; Starke, Robert M; Evans, Avery J; Jensen, Mary E; Liu, Kenneth C

    2014-07-01

    The treatment of intracranial aneurysms with microsurgical clipping is associated with a very low rate of recurrence. However, in cases of aneurysm recurrence after previous clipping, microsurgical dissection due to adhesions and fibrosis may be challenging, and it may be difficult to safely occlude the recurrent lesion without the risk of significant morbidity. Flow-diverting stents have drastically changed the landscape of endovascular neurosurgery. We present two patients with large, recurrent supraclinoid internal carotid artery (ICA) aneurysms which were previously clipped 17 and 23 years ago at outside institutions. Both recurrent lesions were treated with the Pipeline Embolization Device (PED; ev3 Endovascular, Irvine, CA, USA) without radiographic or clinical complications. In the first patient, the 15 mm aneurysm significantly decreased in size at 6 month angiographic follow-up. The 21 mm aneurysm in the second patient was completely occluded 7 months following PED treatment. The moderate degree of in-stent stenosis present on initial follow-up imaging resolved on angiography 11 months post-treatment. The management of recurrent aneurysms after clipping is sparsely reported in the literature due to its infrequent occurrence. In carefully selected cases, flow-diverting stents may be used for complex aneurysms of the distal ICA, even for those which have recurred following microsurgical clipping.

  1. Application of a three-dimensional microsurgical video system for a rat femoral vessel anastomosis

    Institute of Scientific and Technical Information of China (English)

    Liu Jianfeng; Chen Bin; Ni Yong; Zhan Yongqiang; Gao Haibin

    2014-01-01

    Background The operating microscopes have been applied to modern surgery for nearly a century.However,generations of microsurgeons have to flex their necks and fix their eyes on the eyepieces of a microscope continually that leads to physical and mental fatigue during a long operation.Stereoscopic three-dimensional (3D) media provides more ergonomic working environment,subsequently,resulting better performance in tasks and more accurate judgment.In this study,an alternative method of magnification was analyzed using a three-dimensional microsurgical video system and compared with the traditional method under microscopy to evaluate the availability and feasibility of a 3D microsurgical video system for microvascular anastomosis.Methods Forty Sprague-Dawley rats were randomly divided into four groups with each of 10.In 20 rats,10 femoral artery anastomoses with a conventional microscope (arterial microscope group) were compared with that of 10 femoral artery anastomoses with a 3D microsurgical video system (arterial 3D group).For the other 20 rats,10 femoral vein anastomoses using a conventional microscope (venous microscope group) were compared with that of 10 femoral vein anastomoses using a 3D microsurgical video system (venous 3D group).The arterial and venous microscope groups were considered to be the control groups.The arterial and venous 3D groups were the experimental groups.The examined criteria were as follows:anastomotic time,patency right after the procedure and 10 days later,number of sutures,vessel caliber,and pathological features.Results There were no differences between the operating equipment with respect to vessel caliber,anastomotic time,patency rate,number of sutures,and pathological changes in either the small arteries or veins.The average arterial anastomotic time of the arterial microscope group and arterial 3D group was 34.21 and 33.87 minutes,respectively (P >0.05).The average venous anastomotic time of the venous microscope group and

  2. Developing the Model for Optimal Learning and Transfer (MOLT) Following an Evaluation of Outdoor Groupwork Skills Programmes

    Science.gov (United States)

    Cooley, Sam Joseph; Cumming, Jennifer; Holland, Mark J. G.; Burns, Victoria E.

    2015-01-01

    Purpose: This paper aims to evaluate the perceived efficacy of outdoor groupwork skills programmes for the undergraduate and postgraduate students, and the factors that influence its success. It also illustrates the use of Kirkpatrick's (1994) 4-level model of training evaluation as a framework for qualitative investigation of learning and…

  3. Optimizing Simulated Multidisciplinary Team Training of Pediatric Emergencies: An Evaluation of Prerequisites for Transfer of Skills to Clinical Practice

    Directory of Open Access Journals (Sweden)

    E. H. A. J. Coolen

    2015-01-01

    Full Text Available Introduction. Multidisciplinary simulation-based team training (STT provides a powerful training method to train technical and team skills during emergencies. Effectiveness of STT depends on transfer of learned skills to clinical practice. In this study we examined three important prerequisites to enhance transfer from STT into clinical practice, intervention readiness, realism, and performance self-efficacy. Methods. For the quantitative part of the study, 131 participants (pediatric nurses and physicians were asked to fill out an online questionnaire before and after training. For the qualitative part of the study we organized three one-hour focus group sessions in which participants were interviewed on attitude, realism, and self-efficacy. Results. Providing adequate preparation material and extensive debriefing of scenarios is important in creating this positive learning experience. The perspective of realism depends strongly on setting and learning goals. During STT team assembly and role playing can become more important to participants, while physical aspects become less important. Performance self-efficacy for all participants increases significantly (P<0.05 regarding team skills. Conclusions. STT can be a very positive multidisciplinary learning experience, which creates the possibility of enhancing confidence, skills, and team performance within the clinical context. STT combines three important prerequisites for transfer of training to take place.

  4. Developing the Model for Optimal Learning and Transfer (MOLT) Following an Evaluation of Outdoor Groupwork Skills Programmes

    Science.gov (United States)

    Cooley, Sam Joseph; Cumming, Jennifer; Holland, Mark J. G.; Burns, Victoria E.

    2015-01-01

    Purpose: This paper aims to evaluate the perceived efficacy of outdoor groupwork skills programmes for the undergraduate and postgraduate students, and the factors that influence its success. It also illustrates the use of Kirkpatrick's (1994) 4-level model of training evaluation as a framework for qualitative investigation of learning and…

  5. Optimism

    Science.gov (United States)

    Carver, Charles S.; Scheier, Michael F.; Segerstrom, Suzanne C.

    2010-01-01

    Optimism is an individual difference variable that reflects the extent to which people hold generalized favorable expectancies for their future. Higher levels of optimism have been related prospectively to better subjective well-being in times of adversity or difficulty (i.e., controlling for previous well-being). Consistent with such findings, optimism has been linked to higher levels of engagement coping and lower levels of avoidance, or disengagement, coping. There is evidence that optimism is associated with taking proactive steps to protect one's health, whereas pessimism is associated with health-damaging behaviors. Consistent with such findings, optimism is also related to indicators of better physical health. The energetic, task-focused approach that optimists take to goals also relates to benefits in the socioeconomic world. Some evidence suggests that optimism relates to more persistence in educational efforts and to higher later income. Optimists also appear to fare better than pessimists in relationships. Although there are instances in which optimism fails to convey an advantage, and instances in which it may convey a disadvantage, those instances are relatively rare. In sum, the behavioral patterns of optimists appear to provide models of living for others to learn from. PMID:20170998

  6. Optimization

    CERN Document Server

    Pearce, Charles

    2009-01-01

    Focuses on mathematical structure, and on real-world applications. This book includes developments in several optimization-related topics such as decision theory, linear programming, turnpike theory, duality theory, convex analysis, and queuing theory.

  7. Microsurgical management of complex fingertip injuries: comparison to conventional skin grafting.

    Science.gov (United States)

    Rose, E H; Norris, M S; Kowalski, T A

    1988-01-01

    In selected cases of severe fingertip injuries, an aggressive approach using microvascular and microneural techniques can yield functional results equal or superior to conventional methods of treatment in less severe injuries. A series of 20 patients were treated microsurgically from 1983 to 1986 for severe acute distal finger injuries or their early sequelae--five distal replantations, eight neurovascular free tissue transfers, and nine distal neurorrhaphies/nerve grafts with or without vascular conduit. Concurrently, 33 simpler tip avulsions were treated with full-thickness skin grafts for comparison. In the microsurgical series, one replant and the distal 1 cm of a free toe flap necrosed. Replants averaged two-point discrimination of 9.8 mm and pulp pinch 65 percent of normal; free toe transfers, two-point of 6 mm, pulp pinch 58 percent; distal nerve reconstruction, two-point 6 mm. Operating time per digit averaged 5.0 hours for replants, 4.3 hours for toe flaps, and 1.5 hours for nerve repair/grafts. All patients returned to full pre-injury employment within six months. None required revisional surgery for dysesthetic fingertips. In the conventional skin graft series, greater than six months follow-up is available in 17 patients. Average two-point was 7 mm (range: 3 to greater than 15 mm) and pulp pinch 83 percent of normal. There were seven poor results with cold intolerance, numbness, and paresthesias, three of which required revisional surgery. The data suggest that microsurgical management of fingertip injuries achieves results comparable to skin grafts, despite the greater complexity of the initial injury. This approach has resulted in fewer secondary tip revisions. Operative times are acceptable. Parameters of sensory return are similar, although pulp pinch is slightly less. Disability times are comparable to the average in major pulp losses. Of importance, final permanent partial factors of disability are diminished in rating, due to retained digital

  8. Microsurgical subtemporal approach to aneurysms on the P 2 segment of the posterior cerebral artery

    Directory of Open Access Journals (Sweden)

    Zhitao Jing

    2010-01-01

    Full Text Available Background: Aneurysms arising from the P 2 segment of the posterior cerebral artery (PCA are rare, accounting for less than 1% of all intracranial aneurysms. To date, few studies concerning the management of P 2 segment aneurysms have been reported. Objective: To review the microsurgical techniques and clinical outcomes of microsurgical treatment by different approaches in patients with aneurysms on the P 2 segment of the PCA. Materials and Methods: Forty-two patients with P2 segment aneurysms had microsurgical treatment by subtemporal approach. All the patients had drainage of cerebrospinal fluid for decompression, and indocyanine green (ICG angiography was used in 20 patients to assess the effect of clipping. Results: Of the 42 patients, 16 were operated by combined pterional-subtemporal approach. In 40 patients aneurysms were successfully treated by clipping the P 2 aneurysmal neck while preserving the parent artery. Two patients with giant aneurysms were treated using surgical trapping. Postoperatively, 41 patients had a good recovery. One patient after aneurysm trapping had ischemic infarction in the PCA tertiary and presented with hemiparesis and homonymous hemianopia. However, this patient recovered after three weeks of treatment. Conclusion: Subtemporal approach is the most appropriate approach to clip the aneurysms of the P 2 segment. It allows the neurosurgeon to operate on the aneurysms while preserving the patency of the parent artery. Gaint P 2 segment aneurysms can safely be treated by rapping of the aneurysm by combined subtemporal or pterional-subtemporal approach in experienced hands.ICG angiography will be an important tool in monitoring for the presence of residual aneurysm or perforating artery occlusion during aneurysm clipping. Preoperative lumbar drainage of cerebrospinal fluid may help to avoid temporal lobe damage.

  9. Recovery of spermatogenesis after microsurgical subinguinal varicocele repair in azoospermic men based on testicular histology

    Directory of Open Access Journals (Sweden)

    Sandro C. Esteves

    2005-12-01

    Full Text Available OBJECTIVE: Analyze whether testicular histologic patterns from a group of azoospermic men with varicocele is predictive of treatment outcome after subinguinal microsurgical varicocele repair. MATERIALS AND METHODS: Seventeen azoospermic men underwent bilateral open single testis biopsy and microsurgical subinguinal repair of clinical varicoceles. RESULTS: Histopathology of testicular biopsies revealed hypospermatogenesis (HYPO in 6 men, maturation arrest (MA in 5, and Sertoli cell-only (SCO in 6. Overall, presence of spermatozoa in the ejaculates was achieved in 47% (8/17 of men after varicocele repair, but only 35% (6/17 of them had motile sperm in their ejaculates. Only men with testicular histology revealing HYPO (5/6 or maturation arrest (3/5 had improvement after surgery. Median (25% - 75% percentile postoperative motile sperm count for both groups were 0.9 X 106/mL (0.1-1.8 X 106/mL and 0.7 X 106/mL (0.1-1.1, respectively (p = 0.87. The mean time for appearance of spermatozoa in the ejaculates was 5 months (3 to 9 months. One (HYPO of 8 (12.5% men who improved after surgery contributed to an unassisted pregnancy. Postoperative testicular biopsies obtained from patients who had no improvement after surgery revealed that testicular histology diagnosis remained unchanged. Successful testicular sperm retrieval for intracytoplasmic sperm injection (ICSI was achieved in 4 of 9 (44.4% individuals who did not improve after surgery, including 1 man with testicular histology exhibiting SCO. CONCLUSION: Microsurgical varicocele repair in nonobstructive azoospermic men with clinical varicoceles can result in sperm appearance in the ejaculate when hypospermatogenesis or maturation arrest is found on testicular histology diagnosis.

  10. Microsurgical thromboendarterectomy of the cavernous carotid artery--case report and surgical technique.

    Science.gov (United States)

    Fujitsu, K; Fujii, S; Tanaka, N; Kuwabara, T

    1990-10-01

    A 53-year-old male suffered a transient right hemiparesis and left monocular blindness. Angiography revealed 80% stenosis of the cavernous carotid artery. Microsurgical thromboendarterectomy was performed by a direct approach through Parkinson's triangle. During surgery, the carotid circulation was transiently trapped between the cervical and the supraclinoid segment and the trapped arterial lumen was irrigated with heparinized saline. Soft elastic lesion was easily removed. Cavernous carotid thromboendarterectomy through a direct approach is considered as a suitable operation for the solitary and localized stenotic lesions of the cavernous carotid artery, although this operation has not yet been reported to date.

  11. Music Training Program: A Method Based on Language Development and Principles of Neuroscience to Optimize Speech and Language Skills in Hearing-Impaired Children

    Directory of Open Access Journals (Sweden)

    Samaneh Sadat Dastgheib

    2013-03-01

    Full Text Available Introduction: In recent years, music has been employed in many intervention and rehabilitation program to enhance cognitive abilities in patients. Numerous researches show that music therapy can help improving language skills in patients including hearing impaired. In this study, a new method of music training is introduced based on principles of neuroscience and capabilities of Persian language to optimize language development in deaf children after implantation.    Materials and Methods: The candidate children are classified in three groups according to their hearing age and language development. The music training program is established and centered on four principles, as follows: hearing and listening to music (with special attention to boost hearing, singing, rhythmic movements with music and playing musical instruments.   Results: Recently much research has demonstrated that even after cochlear implant operation, a child cannot acquire language to the same level of detail as a normal child. As a result of this study music could compensate this developmental delay .It is known that the greater the area of the brain that is activated, the more synaptic learning and plasticity changes occur in that specific area. According to the principles of neural plasticity, music could improve language skills by activating the same areas for language processing in the brain.   Conclusion:  In conclusion, the effects of music on the human brain seem to be very promising and therapeutic in various types of disorders and conditions, including cochlear implantation.

  12. Music Training Program: A Method Based on Language Development and Principles of Neuroscience to Optimize Speech and Language Skills in Hearing-Impaired Children

    Directory of Open Access Journals (Sweden)

    Samaneh Sadat Dastgheib

    2013-03-01

    Full Text Available Introduction: In recent years, music has been employed in many intervention and rehabilitation program to enhance cognitive abilities in patients. Numerous researches show that music therapy can help improving language skills in patients including hearing impaired. In this study, a new method of music training is introduced based on principles of neuroscience and capabilities of Persian language to optimize language development in deaf children after implantation.    Materials and Methods: The candidate children are classified in three groups according to their hearing age and language development. The music training program is established and centered on four principles, as follows: hearing and listening to music (with special attention to boost hearing, singing, rhythmic movements with music and playing musical instruments.   Results: Recently much research has demonstrated that even after cochlear implant operation, a child cannot acquire language to the same level of detail as a normal child. As a result of this study music could compensate this developmental delay .It is known that the greater the area of the brain that is activated, the more synaptic learning and plasticity changes occur in that specific area. According to the principles of neural plasticity, music could improve language skills by activating the same areas for language processing in the brain.   Conclusion:  In conclusion, the effects of music on the human brain seem to be very promising and therapeutic in various types of disorders and conditions, including cochlear implantation.

  13. Music training program: a method based on language development and principles of neuroscience to optimize speech and language skills in hearing-impaired children.

    Science.gov (United States)

    Dastgheib, Samaneh Sadat; Riyassi, Mina; Anvari, Maryam; Tayarani Niknejad, Hamid; Hoseini, Masumeh; Rajati, Mohsen; Ghasemi, Mohammad Mahdi

    2013-01-01

    In recent years, music has been employed in many intervention and rehabilitation program to enhance cognitive abilities in patients. Numerous researches show that music therapy can help improving language skills in patients including hearing impaired. In this study, a new method of music training is introduced based on principles of neuroscience and capabilities of Persian language to optimize language development in deaf children after implantation. The candidate children are classified in three groups according to their hearing age and language development. The music training program is established and centered on four principles, as follows: hearing and listening to music (with special attention to boost hearing), singing, rhythmic movements with music and playing musical instruments. Recently much research has demonstrated that even after cochlear implant operation, a child cannot acquire language to the same level of detail as a normal child. As a result of this study music could compensate this developmental delay .It is known that the greater the area of the brain that is activated, the more synaptic learning and plasticity changes occur in that specific area. According to the principles of neural plasticity, music could improve language skills by activating the same areas for language processing in the brain. In conclusion, the effects of music on the human brain seem to be very promising and therapeutic in various types of disorders and conditions, including cochlear implantation.

  14. Microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach

    Institute of Scientific and Technical Information of China (English)

    XU Jian-guo; YOU Chao; CAI Bo-wen; JIANG Shu; SUN Hong; GUO Fu-you; YANG Yong-bo; WU Bo

    2005-01-01

    Background Craniopharyngioma of the third ventricle is difficult to treat and its therapeutic regimens and operative approaches have been controversial. This study was undertaken to probe indications for microsurgical resection of craniopharyngioma of the third ventricle via an improved transventricular approach, its surgical procedures and therapeutic effects, and prevention of postoperative complications.Methods Fifty-one patients with craniopharyngioma of the third ventricle were treated from January 2000 to October 2004 by an improved transventricular approach for removing the tumor via the interventricular foramen,the intermedius of the septum pellucidum or choroid fissure. Symptoms and signs of the patients, and results of imaging, operation, and follow-up were analyzed. Results Of the 51 patients who had received the improved transventricular resection, 4 underwent a combined approach with an entrance of the pterion. Forty patients (78.43%) underwent total resection and others subtotal resection, without an operative death. Epileptic seizures were found in 3 patients (5.88%) and subdural effusion in the operative field in 4 (7.84%). All patients showed good general conditions after operation, and follow-up for an average of 27.52 months showed relapse of the tumour in 8 patients (15.69%).Conclusions Microsurgical resection of craniopharyngioma of the third ventricle by an improved transventricular approach has advantages of operative safety and efficacy, lower mortality and disability, and less complications.

  15. 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

  16. 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.

  17. Microsurgical resection of tumors lateroventral and ventral to the high cervical spinal cord

    Institute of Scientific and Technical Information of China (English)

    LEI Peng; WU Yi; LI Zhi-yun; WANG Yu

    2005-01-01

    Background Since there are a complex anatomic structure and vital function in the high cervical spinal cord, it is difficult to remove the tumors lateroventral and ventral to the high cervical spinal cord. This clinical study was undertaken to analyze surgical approaches, manner of tumor resection and postoperative management. Methods Thirty-four patients underwent microsurgical excision of tumors lateroventral and ventral to the high cervical spinal cord by means of three approaches. The tumors comprised mostly Schwannoma and meningioma (88.24%, 30/34) in this group. Tumor volume varied from 3.0 cm×2.5 cm×2.0 cm to 12 cm×3.0 cm×2.5 cm. Of the 34 patients, 4 had dumbbell-shaped tumors growing outside the spinal canal and 7 tumors growing into the intracranium. Results The tumor was totally removed in 32 patients (94.1%). Follow-up for 7 months to 6.4 years (median 3.6 years) showed a recovery of a normal life or work ability in 30 (83.3%) patients. Conclusion Modified operative approaches and microsurgical techniques can raise the rate of total tumor removal and reduce the disability of patients.

  18. 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.

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Safety Resources About the Patient Education Program The Recovery Room Choosing Wisely Educational Programs Educational Programs Educational ... and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... with educational and simulation materials to learn and practice the skills needed for optimal postoperative recovery. The kit supports ... home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, ...

  1. 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.

  2. Early microsurgical treatment of ruptured anterior communicating aneurysms%破裂前交通动脉瘤的早期显微手术治疗

    Institute of Scientific and Technical Information of China (English)

    庄进学; 郑小强; 魏攀; 陈登奎; 陶传元; 邓聪颖; 宋朝理; 程宏炜; 李海龙; 薛峰; 张炜

    2012-01-01

    目的 总结破裂前交通动脉瘤早期显微手术治疗经验.方法 回顾分析我院2007年12月~2010年12月48例前交通动脉瘤破裂患者临床资料,包括临床分级、手术时间及疗效等.结果 24 h内手术12例,24 ~48 h手术30例,48~72 h手术6例,术中均成功夹闭动脉瘤颈;术后死亡3例,中等残废3例,1例轻微神经功能障碍,恢复良好11例,完全康复30例.结论 早期手术治疗前交通动脉瘤可明显降低再出血率及改善患者预后,术中颅压的控制、娴熟的显微操作技术及术后并发症的预防是成功的关键.%Objective To summarize the experiences of early microsurgical treatment of ruptured anterior communicating aneurysms ( ACA) . Methods Retrospective analyses of clinical data were made in 48 cases of ruptured ACA from December 2007 to December 2010, which included clinical grading, surgical time, and curative effects, etc. Results Twelve cases, 30 cases, and 6 cases received the surgical operation within 24 h, 24 to 48 h, and 48 to 72 h, respectively, and all the necks of aneurysm were successfully clipped. Three cases died postoperatively. There were 3 cases of moderate disability, 1 case of mild neurological dysfunction, 11 ones with good recovery, and 30 ones with complete recovery. Conclusion Early microsurgical treatment of ruptured anterior communicating aneurysms can dramatically reduce the rate of rehaemorrhagia and improve the prognosis. Control of intracranial pressure during the operation, refined micromanipulative skill, and the precaution of postoperative complications are keys for successful treatment.

  3. 松果体区肿瘤显微手术治疗及入路比较%Microsurgical treatment of pineal region tumor and comparison of approaches

    Institute of Scientific and Technical Information of China (English)

    陈传新; 虞正权; 王中; 孙雪波; 高薇; 毕永峰

    2013-01-01

    Objective To investigate the technique,approach and attention of surgical treatment for pineal region tumors.Methods The clinical characteristic,surgical approach and prognosis of 12 patients with pineal region tumors were analyzed retrospectively.Of 12 patients,suboccipital supratentorial approach were underwent in 7,transcallosal-interfornix approach in 3,infratentorial supracerebellar approach in 1 and lateral transventricular approach in 1.Results The tumors were totally resected in 11 patients.One patient died of postoperation complications.The follow up from 8 to 41 months showed 10 patients recovered well,one could care of himself and 1 died at three months after operation.Conclusion Mircrosurgical treatment is an effective method for pineal region tumors.Correct choice of microsurgical approach and skillful microsurgical technique are the key to the success of operation.%目的 探讨松果体区肿瘤外科治疗的方法、入路和注意事项.方法 回顾分析12例松果体区肿瘤直接手术患者的临床特点、手术及预后情况.12例患者中,枕下经小脑幕入路(Poppen入路)7例,经胼胝体-穹窿间入路3例,颞部侧脑室三角部入路1例,幕下小脑上入路(krause入路)1例.结果 肿瘤全切除11例.术后死于并发症1例;随访8个月至3.5年,10例恢复良好,1例生活基本自理,1例术后3月死亡.结论 松果体区肿瘤的手术治疗效果较好,选择合适的手术入路及体位,熟练的显微外科手术技巧是手术成功的关键.

  4. 颅咽管瘤显微手术治疗及术后并发症分析%Microsurgical treatment and analysis of postoperative complications for craniopharyngiomas

    Institute of Scientific and Technical Information of China (English)

    储卫华; 林江凯; 朱刚; 高伯元; 崔高宇; 孟辉; 吴南; 冯华

    2011-01-01

    Objective To investigate the microsurgical treatment and analysis of the postoperative complications for craniopharyngiomas. Methods Clinical data of 103 patients with craniopharyngioma undergoing microsurgical resection were analyzed retrospectively. The operation was performed via pterional approach in 76 cases, subfrontal approach in 16, transcallosal approach in 10 and transsphenoidal approach in 1. Results Total tumor removal was achieved in 65 cases, subtotal removal in 26 and partial removal in 12. Postoperatively diabetes insipidus occurred in 69 cases, epilepsy in 7, central high fever in 5, oculomotor nerve injury in 4, permanent hypopituitarism in 3. Two patients died within 1 month after operation. Sixty-seven patients were followed up for mean of 3.5 years, ranged from 2 months to 11 years. Normal work and life enjoyment were found in 52 patients, adiposity in 12, anterior pituitary hypofunction in 3. The tumors recurred in 11 cases and 6 patients died. Conelusions The choice of microsurgical approach for craniopharyngioma resection is based on the location, size and characteristic of the tumor, while pterional approach is appropriate for most patients. Skillful microsurgery, meticulous manipulation, and active management for postoperative complications are very important in reducing the fatality and disability rate and improving life quality.%目的 探讨显微手术切除颅咽管瘤的有效方法及术后并发症分析.方法 回顾性分析103例颅咽管瘤病人的临床资料.手术均在显微镜下进行,其中采取翼点人路76例,额下人路16例,纵裂胼胝体入路10例,经蝶入路1例.结果 肿瘤全切除65例,次全切除26例,大部分切除12例.术后出现尿崩69例,术后癫痫7例,中枢性高热5例,动眼神经损伤4例,垂体功能永久性低下3例;术后1月内死亡2例.随访67例,随访时间2个月~11年.平均3.5年.能基本正常学习生活52例,肥胖12例,垂体前叶功能低下3例,死亡6

  5. Coping and quality of life of patients following microsurgical treatment for breast cancer-related lymphedema.

    Science.gov (United States)

    Teo, Irene; Fingeret, Michelle Cororve; Liu, Jun; Chang, David W

    2016-12-01

    Breast cancer-related lymphedema is associated with numerous adverse outcomes. This study investigated the extent clinical factors, lymphedema symptoms, lymphedema-related appearance, and coping strategies predicted quality of life. Female patients who underwent microsurgical treatment for lymphedema (n = 54) participated. Lymphedema symptoms were associated with physical and functional well-being, but not emotional and social well-being. Clinical factors and lymphedema-related appearance were not significantly associated with quality of life. Compared to adaptive coping strategies, maladaptive coping strategies (e.g. denial, venting, self-blame) were more strongly associated with quality of life. This suggests psychosocial interventions aimed at modifying maladaptive coping behaviors can potentially improve quality of life for this patient population. © The Author(s) 2015.

  6. Lumbosacral dumb-bell neurilemmoma approached by microsurgical interlaminar foraminotomy. A case report.

    Science.gov (United States)

    Uchida, K; Baba, H; Maezawa, Y; Chen, Q; Imura, S

    1996-01-01

    The case history of a patient with a dumb-bell neurilemmoma arising from the L5 nerve root is described. The tumour extended into the outlet of the neural foramen at L5-S1 on the left and was also compressing the dural sac and the S1 nerve root. A limited laminotomy at L4-5 and L5-S1, with preservation of the neural arch, was followed by microsurgical medial foraminotomy at L5-S1 which allowed visualisation of the nerve root and enucleation of the tumour. The technique maintains stability of the posterior elements and spinal movement, and is recommended for the removal of this type of tumour.

  7. Use of indocyanine green angiography in microsurgical subinguinal varicocelectomy - lessons learned from our initial experience.

    Science.gov (United States)

    Cho, Chak-Lam; Ho, Kwan-Lun; Chan, Wayne Kwun-Wai; Chu, Ringo Wing-Hong; Law, In-Chak

    2017-07-20

    Microsurgical subinguinal varicocelectomy (MSV) is generally considered the gold standard nowadays in view of the lower risk of complications and recurrence. To achieve complete ligation of veins while preserving testicular artery (TA) during the procedure remains challenging despite the application of high power optical magnification and micro-Doppler ultrasonography. The use of intraoperative indocyanine green angiography (ICGA) with infrared fluorescence operative micro-scope in MSV potentially lowers the incidence of TA injury and shortens the learning curve of nov-ice surgeons. We present our initial experience in the application of the technique in nine patients and explore the potential of the new adjunct. Copyright® by the International Brazilian Journal of Urology.

  8. Microsurgical anatomy of the arachnoidal trabecular membranes and cisterns at the level of the tentorium.

    Science.gov (United States)

    Vinas, F C; Dujovny, M; Fandino, R; Chavez, V

    1996-08-01

    A clear and thorough understanding of the neuroanatomical structures of the subarachnoid cisterns is important because they provide natural pathways to intracranial arteries, veins, and nerves during microvascular procedures without disturbing surrounding important brain structures. Using a surgical microscope, we examined the microsurgical anatomy of the trabecular membranes and subarachnoid cisterns in 20 adult cadaver brains. The brains were immersed in Ringer's solution and air was injected into the subarachnoid cisterns while the brains remained submerged in solution. We identified seven trabecular membranes that limit six cisterns. We specifically looked at the anatomical relationship between the trabecular membranes and cisterns and their corresponding vessels and cranial nerves. The cistern divisions and the dispositions of trabecular membranes were closely related to the vascular division patterns of the principal brain arteries.

  9. Factor V Leiden associated with flap loss in microsurgical breast reconstruction.

    Science.gov (United States)

    Khansa, Ibrahim; Colakoglu, Salih; Tomich, David C; Nguyen, Minh-Doan; Lee, Bernard T

    2011-07-01

    Two cases are reported of flap loss following microsurgical perforator flap breast reconstruction in patients diagnosed with a factor V Leiden mutation. Factor V Leiden is the most common inherited cause of hypercoagulability, leading to an increased risk of thrombotic events. The first patient underwent a deep inferior epigastric artery perforator flap and then had recurrent arterial thrombosis both intraoperatively and postoperatively. This patient was subsequently diagnosed with a factor V Leiden mutation. The second patient had a known factor V Leiden mutation and underwent a superior gluteal artery perforator flap, which developed thrombosis and flap loss 2 days later. Preoperative assessment of a personal or family history of unexplained venous or arterial thrombosis should prompt suspicion of a factor V Leiden mutation. This mutation places patients at high risk for thromboembolic events in microvascular breast reconstruction, particularly when oral contraceptives or tamoxifen are used in conjunction. Copyright © 2011 Wiley-Liss, Inc.

  10. Genital self-amputation or the Klingsor syndrome: Successful non-microsurgical penile replantation.

    Science.gov (United States)

    El Harrech, Y; Abaka, N; Ghoundale, O; Touiti, D

    2013-10-01

    Self-mutilations of the external genitals in psychiatric patients also known as Klingsor syndrome is a rare urologic trauma. Men with religious conflicts, low self-esteem, unresolved transsexual issues and feelings of guilt are the most vulnerable. This condition requires immediate surgical intervention. Currently replantation involves meticulous microsurgery and has become the primary method for managing these patients. In this paper, we report a case of self amputation of penis in a patient with a psychiatric history significant for schizopfrenia. Because of the unavailability of a microscope in our department, a non-microsurgical replantation without microscopic magnification was attempted. After surgery, normal appearance and function including a good normal voiding, sensation, and erections were observed.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Genital self-amputation or the Klingsor syndrome: Successful non-microsurgical penile replantation

    Directory of Open Access Journals (Sweden)

    Y El harrech

    2013-01-01

    Full Text Available Self-mutilations of the external genitals in psychiatric patients also known as Klingsor syndrome is a rare urologic trauma. Men with religious conflicts, low self-esteem, unresolved transsexual issues and feelings of guilt are the most vulnerable. This condition requires immediate surgical intervention. Currently replantation involves meticulous microsurgery and has become the primary method for managing these patients. In this paper, we report a case of self amputation of penis in a patient with a psychiatric history significant for schizopfrenia. Because of the unavailability of a microscope in our department, a non-microsurgical replantation without microscopic magnification was attempted. After surgery, normal appearance and function including a good normal voiding, sensation, and erections were observed.

  13. [The reinnervation of a skin-fascia autograft after its microsurgical transplantation on neurovascular supports].

    Science.gov (United States)

    Pshenisnov, K P; Krivov, V A; Sidorov, V B

    1992-01-01

    The dynamics of the restoration of sensitivity of 40 free dermo-fascial grafts was studied: radial from the forearm, dorsal of the foot, deltoid, periscapular, and lateral graft of the upper arm. Effective degree of reinnervation of neurovascular grafts, a radial graft in particular, 12-18 months after a microsurgical operation was shown. The restoration of nerve connections of 63 grafts was appraised in dog experiments by means of a complex of histological and micromorphometric methods. The sources of nerve fiber growth from the sutured cutaneous nerve of the graft along the distribution of the paravasal nerve plexuses were identified. The rate of reinnervation of the graft from the adjoining tissues is determined by the characteristics of the recipient seat and the size of the graft.

  14. 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.

  15. Reversible meiotic abnormalities in azoospermic men with bilateral varicocele after microsurgical correction.

    Science.gov (United States)

    North, M O; Lellei, I; Rives, N; Erdei, E; Dittmar, A; Barbet, J P; Tritto, G

    2004-05-01

    Because of a possible relationship between microenvironmental disturbances and meiotic abnormalities and of a straight relationship between lower-quality semen in patient carrying a varicocele and first meiotic non-disjunction, bilateral bipolar testicular biopsies are realized according the thermic differential gradient described in varicocele. Systematic meiotic studies of multiple testicular biopsies from 65 azoospermic men with bilateral varicocele were done in a multi-centric study on microsurgical correction of bilateral varicocele with microthermic intra-operative evaluation using minimally invasive thermal microsensors (Betatherm 10K3MCD2). In the present study abnormal temperature raising, histomorphometric abnormalities (spermatocyte arrest) and meiotic abnormalities (class IIC) are strongly correlated. In the ten patients submitted to another testicular biopsy procedure six months after surgery for TESE, normal thermal differential is registered and no meiotic abnormalities recurrences are found.

  16. [Microsurgical resection of lumbar intraspinal tumors through paraspinal approach using percutaneous tubular retractor system].

    Science.gov (United States)

    Chunmei, Chen; Gangfeng, Cai; Rui, Wang; Weiqiang, Zhang; Yan, Chen; Feng, Li; Chunhua, Wang; Fan, Wang; Zhijie, Chen; Songsheng, Shi; Weizhong, Yang

    2015-04-07

    To evaluate the clinical outcomes and operative techniques of microsurgical resection of lumbar intraspinal tumors through paraspinal approach by percutaneous tubular retractor system. A retrospective study was conducted to analyze 21 patients with lumbar intraspinal tumors between November 2011 and February 2014, including Schwannoma (n = 19) and meningioma (n = 2) without lumbar instability on preoperative images. The length of tumors was 0.6-2.0 cm. Tracheal intubation anesthesia was performed prior to microsurgery using percutaneous tubular retractor system through paraspinal approach. Operative duration, blood loss volume, postoperative wound pain duration and hospital stay were analyzed. Creatine phosphokinase (CPK-MM) level was recorded at 1 day preoperatively, 1 day, 3 days and 5 days postoperatively. The scores of Japanese Orthopedic Association (JOA) and visual analog scale (VAS) were analyzed at 1 day preoperatively, 1, 3, 5 days and 6 months postoperatively to evaluate the function status of spinal cord. Computed tomography ( CT) three-dimensional reconstruction of lumbar vertebrae was performed at 1 week postoperatively. Magnetic resonance imaging ( MRI) plain scan and enhanced scan of lumbar vertebrae were conducted preoperatively, 1 week and 6 months postoperatively. Complete removal of tumors was achieved in all patients without the injuries of spinal cord or nerve root. Postoperative scores of JOA and VAS improved versus preoperative ones (P spinal instability was identified by CT three-dimensional reconstruction. And no spinal deformity occurred during a follow-up period of 6-28 months. Microsurgical resection of lumbar intraspinal tumors using percutaneous tubular retractor system through paraspinal approach minimizes the injuries of paraspinal muscles, facet joint, spinous process and ligaments. This technique offers the advantages of mini-invasiveness, shorter hospital stay, rapid recovery and preserved postoperative spinal stability.

  17. New predictive model for microsurgical outcome of intracranial arteriovenous malformations: study protocol

    Science.gov (United States)

    Tong, Xianzeng; Wu, Jun; Cao, Yong; Zhao, Yuanli; Wang, Shuo

    2017-01-01

    Introduction Although microsurgical resection is currently the first-line treatment modality for arteriovenous malformations (AVMs), microsurgery of these lesions is complicated due to the fact that they are very heterogeneous vascular anomalies. The Spetzler-Martin grading system and the supplementary grading system have demonstrated excellent performances in predicting the risk of AVM surgery. However, there are currently no predictive models based on multimodal MRI techniques. The purpose of this study is to propose a predictive model based on multimodal MRI techniques to assess the microsurgical risk of intracranial AVMs. Methods and analysis The study consists of 2 parts: the first part is to conduct a single-centre retrospective analysis of 201 eligible patients to create a predictive model of AVM surgery based on multimodal functional MRIs (fMRIs); the second part is to validate the efficacy of the predictive model in a prospective multicentre cohort study of 400 eligible patients. Patient characteristics, AVM features and multimodal fMRI data will be collected. The functional status at pretreatment and 6 months after surgery will be analysed using the modified Rankin Scale (mRS) score. The patients in each part of this study will be dichotomised into 2 groups: those with improved or unchanged functional status (a decreased or unchanged mRS 6 months after surgery) and those with worsened functional status (an increased mRS). The first part will determine the risk factors of worsened functional status after surgery and create a predictive model. The second part will validate the predictive model and then a new AVM grading system will be proposed. Ethics and dissemination The study protocol and informed consent form have been reviewed and approved by the Institutional Review Board of Beijing Tiantan Hospital Affiliated to Capital Medical University (KY2016-031-01). The results of this study will be disseminated through printed media. Trial registration

  18. Tarlov cysts: long-term follow-up after microsurgical inverted plication and sacroplasty.

    Science.gov (United States)

    Weigel, Ralf; Polemikos, Manolis; Uksul, Nesrin; Krauss, Joachim K

    2016-11-01

    Surgical treatment of Tarlov cysts is still a matter of debate. Published literature thus far includes mainly small case series with retrospective evaluation and short-term follow-up. We present a novel microsurgical technique that combines the decompression of the nerve fibers with the prevention of recurrence. The long-term follow-up is provided. The indication for surgery was incapacitating pain refractory to medical therapy for at least 6 months. The surgical technique consisted in microsurgical opening of the cyst, relief of CSF followed by secured inverted plication of the cyst wall, packing of remnant space with fat graft, and sacroplasty. Pain and neurological deficits were evaluated according to a modified Barrow National Institute score (BNI score, 0-5) and the Departmental Neuro Score (DNS score, 0-20). A total of 13 patients (9 women, 4 men) were operated and followed up to 14 years (mean FU 5.3 years). Mean age at surgery was 51.8 (±14) years. Pain and neurological deficits improved significantly in 11/13 patients (BNI score pre-OP 5 vs 3.1 ± 1.2 at 1-year-FU, and 2.8 ± 1.2 at last follow-up visit; DNS score pre-OP 5.5 ± 1.5 vs 2.8 ± 2.1 at 1-year follow-up, and 2.6 ± 2.2 at last follow-up visit. Two patients needed revision surgery due to reoccurrence of the cyst. One patient suffered deterioration of preexisting neurological deficit. The inverted plication technique combined with sacroplasty is a promising technique. It improves pain and neurological deficits on the long term in the majority of patients with symptomatic Tarlov cysts.

  19. Prevention of Depression and Anxiety Symptoms in Adolescents: 42 and 54 Months Follow-Up of the Aussie Optimism Program-Positive Thinking Skills.

    Directory of Open Access Journals (Sweden)

    Julie eJohnstone

    2014-05-01

    Full Text Available Anxiety and depression are the most commonly reported mental health problems amongst Australian children and adolescents. The Aussie Optimism Program: Positive Thinking Skills (AOP- PTS is a universal intervention program based on cognitive and behavioral strategies and aimed to prevent anxiety and depression in the middle primary school children aged 9-10 years old. 370 students randomly assigned to the intervention and control condition participated in the 42 and 54 months follow – up study. The intervention group received the AOP-PTS 10-week program and the control group received the regular Health Education curriculum. Students were assessed on anxiety, depression and attribution style at school whilst parents reported on their child’s externalizing and internalising problems at home. Results showed there were no significant reduction across groups in the depressive and anxiety symptoms, and attribution style at either 42 or 54 months follow-up. These findings suggest that AOP-PTS has short and medium term effects but were not sustained in longer term period. Future strategies to achieve the desirable outcomes in a longitudinal study are discussed.

  20. Prevention of Internalising Disorders in 9-10 year old children: Efficacy of the Aussie Optimism Positive Thinking Skills Program at 30-month follow-up

    Directory of Open Access Journals (Sweden)

    David eMorrison

    2013-12-01

    Full Text Available The Aussie Optimism: Positive Thinking Skills Program (AOPTP is a school-based prevention program aimed at addressing anxious and depressive symptoms in children aged 9-10 years. Nine-hundred and ten students from 22 Australian primary schools situated in low socio-economic areas were randomly assigned to either an intervention or control group, and assessed at a 30-month follow up. Those in the intervention group received the AOPTP program, where the control group continued to receive the regular health education course. Students completed self-report measures regarding their levels of depression, anxiety, and attribution style. Parents also reported on their children’s externalising and internalising problems outside of school. There were no significant differences between groups in regard to anxiety or depression, as well as no significant differences in attributional styles. Parents reported significantly less hyperactive behaviours from children in the intervention group. This finding suggests that AOP-PTS has the capacity to treat externalising problems at a medium term effect. The decrease in the externalising problems provides evidence of a partial medium term intervention effect. Future studies should continue to evaluate the program at a long term follow up.

  1. The Construction and Optimization of Teaching System of Clinical Skills for College of TCM%高等中医药院校临床技能教学体系的构建与优化

    Institute of Scientific and Technical Information of China (English)

    杨宇峰; 杨晓阳; 徐娜

    2015-01-01

    为提高我国高等中医药院校医学生临床基本技能水平,加强中医大学生临床综合思维能力和解决实际问题的临床操作能力是造就高素质中医学人才的关键。要从转变临床技能教育理念、优化实训课程建设体系、加强临床技能师资队伍建设和规范临床技能实训成果考核四个方面构建系统的中医临床技能教学体系,为实现高等中医院校培养医学人才的核心目标打下坚实基础。%In order to improve the level of medical basic clinical skills of higher TCM College Students in our country, to strengthen the college students of traditional Chinese medicine clinical comprehensive thinking ability and clinical skills to solve practical problems is the key to train high quality talents of Chinese medicine. To construct the system of TCM clinical skills teaching system should be changed from clinical skills education idea, training courses, strengthen the construction of system optimization of clinical skills of teachers team construction and speciifcation of clinical skill training achievements appraisal.

  2. Biportal neuroendoscopic microsurgical approaches to the subarachnoid cisterns. A cadaver study.

    Science.gov (United States)

    Fries, G; Reisch, R

    1996-12-01

    A preclinical cadaver study was performed to develop the technique of biportal neuroendoscopic dissection in the subarachnoid space of the basal cisterns and to test the feasibility, utility, and safety of this new technique. In 23 fresh post-mortem adult human cadavers and 2 formalin-fixed adult human head specimen a total of 33 biportal endomicrosurgical dissections into and within the basal cisterns were carried out. Following suction of cerebrospinal fluid from the subarachnoid space 0 degree-, 30 degrees-, and 70 degrees-lens-scopes (Aesculap AG, Tuttlingen, Germany) with outer diameters of 4.2 mm and trochars with outer diameters of 5 to 6.5 mm were introduced into the surgical field. 6 different endoscopic routes to the basal cisterns and a total of 10 different combinations of these approaches for biportal endoneurosurgery could be described, but it was found that not all of them were useful and safe. The transventricular approach to the prepontine cisterns through the foramen of Monro and the floor of the third ventricle, biportally combined with a subfrontal or a subtemporal approach, turned out to be not safe enough as it was accompanied by traumatization of the fornix at the interventricular foramen and of the hypothalamus at the level of the tuber cinereum due to relaxation and caudal shift of the brain following suction of cerebrospinal fluid to clear the basal cisterns for the subfrontal or subtemporal approaches. Useful and safe endomicrosurgical approaches to the basal cisterns were: 1st subfrontal, either epidural or intradural, 2nd subtemporal, either anterior or posterior, and 3rd frontal interhemispheric. Various biportal combinations of these approaches are estimated to be feasible, useful, and safe enough to be performed during microsurgical procedures in the operating room. The biportal endomicrosurgical strategy allows for effective and safe dissections within the subarachnoid spaces of the basal cisterns. The tip of the microinstruments as

  3. 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

  4. 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

  5. New and safe experimental model of radiation-induced neurovascular histological changes for microsurgical research.

    Science.gov (United States)

    Barrera-Ochoa, Sergi; Gallardo-Calero, Irene; Sallent, Andrea; López-Fernández, Alba; Vergés, Ramona; Giralt, Jordi; Aguirre-Canyadell, Marius; Velez, Roberto

    2017-04-01

    The aim is to create a new and safe experimental model of radiation-induced neurovascular histological changes with reduced morbidity and mortality for use with experimental microsurgical techniques. Seventy-two Sprague-Dawley rats (250-300 g) were divided as follows: Group I: control group, 24 rats clinically evaluated during six weeks; Group II: evaluation of acute side-effects (two-week follow-up period), 24 irradiated (20 Gy) rats; and Group III: evaluation of subacute side-effects (six-week follow-up period), 24 irradiated (20 Gy) rats. Variables included clinical assessments, weight, vascular permeability (arterial and venous), mortality and histological studies. No significant differences were observed between groups with respect to the variables studied. Significant differences were observed between groups I vs II-III regarding survival rates and histological changes to arteries, veins and nerves. Rat body weights showed progressive increases in all groups, and the mortality rate of the present model is 10.4% compared with 30-40% in the previous models. In conclusion, the designed model induces selective changes by radiotherapy in the neurovascular bundle without histological changes affecting the surrounding tissues. This model allows therapeutic experimental studies to be conducted, including the viability of microvascular and microneural sutures post radiotherapy in the cervical neurovascular bundle.

  6. [Microsurgical elimination of foot soft tissue defects with free vascularized flaps].

    Science.gov (United States)

    Moroz, V I; Iudenich, A A; Mikhaílov, I A; Kafarov, T G; Kuntsevich, G I

    1997-01-01

    The results of 40 microsurgical transplantations of complex flaps in 37 patients with cicatricial-ulcerous foot deformations are analysed. The surgery was indicated in cicatricial soft tissues defects, unhealing trophic ulcers, inability to use local tissues for plastic surgery. The scapular flap was used in 34 cases, thoraco-dorsal flap in 5 cases, deltoid flap in 1 case. It was necessary to increase the square of the scapular flap in case of a vast cicatricial soft tissue defect of the talocrural joint and dorsal surface of the foot and the sole. A special expander was used for this purpose. The importance of ultrasound methods for evaluation of the vessels supplying the sole, as well as the state of the microvascular anastomoses in postoperative period is stressed. The long-term results were followed up for 1.5 to 5 years in 29 of 37 patients. The good results was noted in 18 patients, satisfactory in 7 patients, complications (unhealed trophic ulcers) in 4 patients. The complications were caused by calcanel tuber deformation with osteophyte, osteomyelitis, inradically removed scars.

  7. 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.

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

    Science.gov (United States)

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

    2016-04-01

    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. We have searched for apps specifically helpful in the perioperative care of microsurgical breast reconstructive patients. 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. 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.

  9. Zygomatico-orbital artery as a recipient vessel for microsurgical head and neck reconstruction.

    Science.gov (United States)

    Higashino, Takuya; Sawamoto, Naoya; Hirai, Rintaro; Arikawa, Masaki

    2013-07-01

    The selection of recipient vessels in head and neck reconstruction is one of the key factors influencing its difficulty and outcome. We report a case of a microsurgical scalp reconstruction using the zygomatico-orbital artery as a recipient vessel.A 71-year-old woman had intractable skin ulcers on her head after neurosurgeries. Computed tomography angiography findings showed that the superficial temporal artery was obstructed and that the zygomatico-orbital artery ran forward and upward. She underwent scalp reconstruction using a free anterior lateral thigh flap. The zygomatico-orbital artery was dissected distally, cut, and turned over cranially. The diameter of the zygomatico-orbital artery was 1.2 mm. The blood flow through the zygomatico-orbital artery was sufficient. The thinned scalp area was excised, and some of the titanium devices and infectious tissues were removed. An anterior lateral thigh flap measuring 20 × 9 cm was harvested and transferred to the defect in the head. The discrepancy in calibers was within double, and the zygomatico-orbital artery fit the descending branch of the lateral circumflex femoral artery. The flap was transferred successfully.The zygomatico-orbital artery is one of the branches from the external carotid artery and supports the suprazygomatic territory. The zygomatico-orbital artery is present in 78% to 92% of people and originates from the superficial temporal artery and sometimes from the frontal branch of superficial temporal artery. The mean diameter of the zygomatico-orbital artery at origin is reported to be 1.20 mm. The zygomatico-orbital artery is another option as a recipient vessel in head and neck reconstruction.

  10. The role of the antisperm antibodies in male infertility assessment after microsurgical varicocelectomy.

    Science.gov (United States)

    Bozhedomov, V A; Lipatova, N A; Alexeev, R A; Alexandrova, L M; Nikolaeva, M A; Sukhikh, G T

    2014-11-01

    Antisperm antibodies (ASA) are a cause of male infertility. ASA are often found in varicocele patients. The study objective was to assess the ASA role in fertility recovery after varicocelectomy. The longitudinal study involved 99 patients with varicocele. Patients were examined according to the WHO recommendations; ASA level was measured using the direct method of Sperm MAR test: 66 patients were ASA-negative, 33 had MAR-IgG ≥ 10%. All patients underwent microsurgical varicocelectomy. Student's t-test, Wilcoxon test, Chi-squared test and signed rank test were used for data analysis. The retrospective analysis of all operated patients data showed that the patients without spermiogram improvement after varicocelectomy had higher ASA levels. 3 months after the surgery, the initially ASA-negative varicocele patients demonstrated 2.5 times increase in number of progressive motile spermatozoa in the ejaculate (p 0.05). The main outcome in this group was a favourable response to the surgery (ASA level decrease) vs. no reduction in autoimmune process. The improvement in the ASA-positive group was demonstrated in the patients with higher varicocele grade (median--2 vs. 1; p < 0.05) and lower ASA level (MAR-IgG = 48% vs. 92%; p < 0.01). The pregnancy rate within a year after surgery was 2.8 times more frequent in couples with ASA-negative men: 39% (25 of 65) in the ASA-negative group compared to 14% (4 of 28) in the ASA-positive group (p < 0.05). Thus, antisperm immune response decreases the varicocelectomy efficacy for reproductive function recovery: the higher percentage of ASA and lower grade of varicocele are associated with an unfavourable prognosis. © 2014 American Society of Andrology and European Academy of Andrology.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Microsurgical Treatment of 90 Cases of Petroclival Meningioma%90例岩斜区脑膜瘤的显微手术治疗

    Institute of Scientific and Technical Information of China (English)

    石磊; 卢明; 彭立辉; 陈静; 赵振宇

    2014-01-01

    life ,and 18 patients needed the care in life ,and 2 patients died .[Conclusion]Correct operation approach ,skillful microsurgical technique ,inten-sive postoperative observation and active treatment of complications are helpful to improve total resection rate of petroclival meningioma and decrease mortality and disability rate .

  13. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    Science.gov (United States)

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods.

  14. MICROSURGICAL RECONSTRUCTION OF SOFT TISSUES OF KNEE REGION IN ABSENCE OF LOCAL PLASTIC RESOURCES IN PREPARATION FOR ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    D. I. Kutyanov

    2013-01-01

    Full Text Available A new method of microsurgical reconstruction of soft tissues defects of a knee in the conditions of inability to form pedicled flaps of thigh and shin has been offered. Prefabricated pedicled fasciocutaneous donor flap of the thickness needed is created on the anterior and anterior-medial surface of the same thigh. The donor flap is based on the previously transplanted radial forearm fascial free flap. This method provides recreation of wholesome periarticular soft tissues, eradication of the local infection, increase of range of motion in the knee joint and possibility to fulfill in the future perspective total knee arthroplasty as well as any other surgical operations.

  15. Interpersonal Skills

    Directory of Open Access Journals (Sweden)

    Barakat NG

    2007-01-01

    Full Text Available INTRODUCTIONInterpersonal skills are becoming more and more a necessity in the medical profession. The expectation from health care professionals is beyond just knowledge of the medical facts. To practice medicine effectively, doctors need to develop interpersonal skills in communication, leadership, management, teaching and time management. All of these are vital tools and are becoming increasingly essential subjects in teaching both undergraduate students and postgraduate doctors. However, a degree of self-motivation and personal initiative is needed to develop these skills. In this article, I will give an overview on interpersonal skills and will be follow this by a series of articles, in future issues, dealing with these skills.

  16. Diagnosis and microsurgical treatment of Chiari malformation%Chiari畸形的临床诊断和显微手术治疗体会

    Institute of Scientific and Technical Information of China (English)

    丁晓东; 张远征

    2011-01-01

    目的 探讨Chiari畸形的诊断及显微外科处理方法.方法 回顾性分析50例Chiari畸形的临床资料,其中合并脊髓空洞30例,齿状突型颅底陷入3例.结果 50例术后平均随访35个月,按Tator疗效标准:优36例(72%);良12例(24%);差2例(4%).有效率96%.空洞缩小21例,消失7例.结论 有限的后颅窝减压及枕大池重建是治疗Chiari畸形的有效方法;合并齿状突型颅底陷入应先行口咽入路齿状突磨除术或许为较好的选择.%Objective To study the diagnosis and the microsurgical treatment for Chiari malformation( CM ).Methods The clinical data of 50 cases of Chiari malformation were analyzed retrospectively,30 cases were combinated with syringomyelia,3 with cranial basal invagination referred to dens of axis.Results 50 cases were followed up for an average 35 months.According to Tator's standard,the curative effect was excellent in 36,good in 12 and bad in 2 patients.The effective rate was 96%.The cavities in spinal cords reduced in 21 cases,disappeared in 7.Conclusion Limited posterior fossa decompression with reconstruction of cistern magna is a effective method for treatment of CM ; CM with cranial basilar invagination referred to dens of axis treated firstly by anterior decompression of odontoidectomy via oral approach may be an optimal selection.

  17. Impact of a Vascular Neurosurgery Simulation-Based Course on Cognitive Knowledge and Technical Skills in European Neurosurgical Trainees.

    Science.gov (United States)

    Zammar, Samer G; El Tecle, Najib E; El Ahmadieh, Tarek Y; Adelson, P David; Veznedaroglu, Erol; Surdell, Daniel L; Harrop, James S; Benes, Vladimir; Rezai, Ali R; Resnick, Daniel K; Bendok, Bernard R

    2015-08-01

    To assess microsurgical and diagnostic cerebral angiography modules and their corresponding objective assessment scales as educational tools for European neurosurgical residents at the European Association of Neurosurgical Societies Resident Vascular Neurosurgery course, which was held in Prague, Czech Republic, on September 2013. Microsurgical skills and cerebral angiography are fundamental skills in vascular neurosurgery. There is a need to develop a simulation-based curriculum focusing on these skills for neurosurgical trainees worldwide. The course consisted of 2 modules: microanastomosis and diagnostic cerebral angiography. In addition to an initial screening survey, each module was divided into 3 components: 1) a before didactic cognitive knowledge and technical skills testing, 2) a didactic lecture, and 3) an after didactic cognitive knowledge and technical skills testing. We compared the trainees' cognitive and technical scores from the before and after testing phases. Wilcoxon sum rank test was used to test statistical significance. The knowledge test median scores increased from 63% and 68% to 80% and 88% (P neurosurgery curriculum is feasible and may enhance resident knowledge and technical proficiency. Copyright © 2015. Published by Elsevier Inc.

  18. Longitudinal Treatment Outcomes of Microsurgical Treatment of Neurosensory Deficit after Lower Third Molar Surgery: A Prospective Case Series.

    Directory of Open Access Journals (Sweden)

    Yiu Yan Leung

    Full Text Available To prospectively evaluate the longitudinal subjective and objective outcomes of the microsurgical treatment of lingual nerve (LN and inferior alveolar nerve (IAN injury after third molar surgery.A 1-year longitudinal observational study was conducted on patients who received LN or IAN repair after third molar surgery-induced nerve injury. Subjective assessments ("numbness", "hyperaesthesia", "pain", "taste disturbance", "speech" and "social life impact" and objective assessments (light touch threshold, two-point discrimination, pain threshold, and taste discrimination were recorded.12 patients (10 females with 10 LN and 2 IAN repairs were recruited. The subjective outcomes at post-operative 12 months for LN and IAN repair were improved. "Pain" and "hyperaesthesia" were most drastically improved. Light touch threshold improved from 44.7 g to 1.2 g for LN repair and 2 g to 0.5 g for IAN repair.Microsurgical treatment of moderate to severe LN injury after lower third molar surgery offered significant subjective and objective sensory improvements. 100% FSR was achieved at post-operative 6 months.

  19. 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

    2013-01-15

    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.

  20. Microsurgical treatment of large acoustic neuroma%大型听神经瘤的显微手术治疗

    Institute of Scientific and Technical Information of China (English)

    宋建华; 方志敏; 陈建宁; 黄迢华; 姚正健; 陈建忠; 朱红仔; 康元宝

    2009-01-01

    目的 总结大型听神经瘤的显微手术经验.方法 回顾性分析经枕下-乙状窦后入路21例大型听神经瘤的显微手术.结果 本组病例全切或近全切18例(85.7%);大部分切除3例(14.3%);面神经解剖保留16例(76.2%);死亡1例(4.8%).结论 采用经枕下-乙状窦后入路显微久科技术切除大型听神经瘤是一种安全、有效的方法 .%Objective To summarize the experience in mierosurgical treatment of large acoustic neuroma.Methods 21 patients with large acoustic neuroma were analyzed retrospectively.Microsurgical resection via posterior appoach through the sigmoid sinus was undergone in all the patients.Result The tumors were totally or subtotally removed in 18 cases(85.7%)and partially removed in 3 cases(14.3%).Anatomical preservation of the facial nerve were achieved in 16 cases(76.2%).One patient(4.8%)died.Conclusions Microsurgical resection of large acoustic neuroma via posterior approach through the sigmoid sinus is safe and effective.

  1. Optimization modeling with spreadsheets

    CERN Document Server

    Baker, Kenneth R

    2015-01-01

    An accessible introduction to optimization analysis using spreadsheets Updated and revised, Optimization Modeling with Spreadsheets, Third Edition emphasizes model building skills in optimization analysis. By emphasizing both spreadsheet modeling and optimization tools in the freely available Microsoft® Office Excel® Solver, the book illustrates how to find solutions to real-world optimization problems without needing additional specialized software. The Third Edition includes many practical applications of optimization models as well as a systematic framework that il

  2. Optimizing the Teaching of Accounting Specialty in Higher Vocational Colleges Based on Skill Competition%以技能大赛为导向优化高职会计专业教学

    Institute of Scientific and Technical Information of China (English)

    张莲; 张莉

    2016-01-01

    To hold national vocational skill competitions is a system innovation of higher vocational educa-tion in our county.By carrying out various forms of skill competitions,classroom teaching and practice teaching are more closely combined together to lead the education and teaching reform in higher voca-tional colleges.Under this background,combining the problems existed in the present stage of the ac-counting professional teaching and research,it is of great significance to optimize the accounting profes-sional teaching in higher vocational colleges oriented by skill competitions.%举办全国高职院校技能大赛,是我国高职教育的一项制度创新。通过各种形式技能竞赛的开展,使课堂教学与实践教学更加紧密地结合起来,引领了高职院校的教育教学改革。正是在这种背景下,结合现阶段会计专业教学中存在的问题,研究以技能大赛为导向优化高职院校会计专业教学具有重要意义。

  3. Fertility and Pregnancy Outcome after Myoma Enucleation by Minilaparotomy under Microsurgical Conditions in Pronounced Uterus Myomatosus.

    Science.gov (United States)

    Floss, K; Garcia-Rocha, G-J; Kundu, S; von Kaisenberg, C S; Hillemanns, P; Schippert, C

    2015-01-01

    Introduction: Besides the typical complaints and symptoms, myomas can cause sterility, infertility and complications during pregnancy. Laparoscopic interventions reach their limits with regard to organ preservation and the simultaneous desire to have children in the removal of multiple and larger intramural myoma nodes. The aim of this study is to examine fertility status and pregnancy outcome after myoma removal by minilaparotomy (skin incision maximal 8 cm) in women with pronounced uterus myomatosus. Materials and Methods: This retrospective study makes use of the data from 160 patients with an average age of 34.6 years. Factors analysed include number, size and localisation of the myomas, complaints due to the myoma, pre- and postoperative gravidity, mode of delivery, and complications of birth. Results: Indications for organ-sparing myoma enucleation were the desire to have children (72.5 %), bleeding disorders (60 %) and pressure discomfort (36.5 %). On average 4.95 (SD ± 0.41), maximally 46 myomas were removed. The largest myoma had a diameter of 6.64 cm (SD ± 2.74). 82.5 % of the patients had transmural myomas, in 17.5 % the uterine cavity was inadvertently opened. On average the operating time was 163 minutes (SD ± 45.47), the blood loss 1.59 g/dL (SD ± 0.955). 60.3 % of the patients with the desire to have children became pregnant postoperatively. 75.3 % of the pregnancies were on average carried through to the 38th week (28.4 % vaginal deliveries, 71.6 % Caesarean sections). In the postoperative period there was one case of uterine rupture in the vicinity of a previous scar. Discussion: By means of the microsurgical "mini-laparotomy" even extensive myomatous uterine changes can, in the majority of cases, be operated in an organ-sparing manner with retention of the ability to conceive and to carry a pregnancy through to maturity of the infant. The risk for a postoperative uterine rupture in a subsequent pregnancy and

  4. 高位颈段椎管内神经鞘瘤显微手术治疗59例%Microsurgical treatment of neurilemmoma in upper cervical spinal canal: 59 cases report

    Institute of Scientific and Technical Information of China (English)

    王林; 傅先明; 牛朝诗; 钱若兵; 凌士营; 计颖; 汪业汉

    2011-01-01

    目的 探讨高位颈段神经鞘瘤显微手术技巧和疗效.方法从2004年1月至2007年12月,对59例均采用后正中入路显微手术治疗,采用德国产Laika显微镜下切除肿瘤,较大肿瘤不能完整切除时,用分块切除或囊内切除,术后常规颈托限制颈部活动,55例术后随访6个月~2年.结果 痊愈54例,症状改善5例,无死亡.55例随访6个月~2年,4例失访.35例术后3~12个月MR检查未见肿瘤残存或复发,42例术后6个月颈椎正侧位及张口位片检查未见脊柱骨性结构变形,脊柱稳定性好.结论 高位颈段神经鞘瘤一旦确诊,就应该及早显微手术治疗.手术安全、效果良好.%Objective To explore surgical techniques and curative effects of microsurgical treatment for neurilemmoma in upper cervical spinal canal. Methods From Jan. 2004 to Nov. 2007, 59 cases of schwannoma was resected through microoperation, the operation was conducted through a posteromedial approach, using German Laika microscope resection of the tumor, large tumors cannot complete resection,block or sac, resection postoperative neck activity conventional neck restrictions, with following observation of 6 months-2 years. Results A complete recovery was achieved in 54 cases, an improvement of symptoms was achieved in 5 cases, no death was encountered. Follow-up observations were carried out in 55 cases from 3 months-2 years (6.5 ± 1.5 months). MRI examinations 3-12 months after operation in 35 cases found no residual or recurrent tumor. X-ray radiography under anteroposterior, lateral, and open-mouth view 6 months after operation in 42 cases showed no spinal deformation and good vertebral stability. Conclusions As long as neurilemmoma in upper cervical spinal canal are diagnosed, a microsurgical treatment should be given as early as possible. Appropriate selection of surgical approach, skillful microsurgical techniques in accordance with pathological types of lesions, and principles of minimal

  5. A simple arteriotomy method for microsurgical end-to-side anastomoses: technical aspects of use in training and laboratory applications.

    Science.gov (United States)

    Dash, H; Kononov, A; Maloney, J; Browne, E

    1993-09-01

    An experiment was carried out to show the patency rates of microsurgical carotid artery bypasses with femoral artery grafts, using a single-cut arteriotomy in rats. A bypass was done on 127 Sprague-Dawley rats. Of these, 125 were patent after 20 min, and all of these were patent after the animals were sacrificed at 3 days, for a 98 percent patency rate. The method of performing the arteriotomies, as well as the bypass itself, is described. The benefits of using the end-to-side anastomosis are explained. The authors conclude that the single-cut arteriotomy is convenient and easy to perform. The end-to-side anastomosis is a worthwhile technique and should encourage the proficiency of every student of microsurgery.

  6. A deficit in optimizing task solution but robust and well-retained speed and accuracy gains in complex skill acquisition in Parkinson׳s disease: multi-session training on the Tower of Hanoi Puzzle.

    Science.gov (United States)

    Vakil, Eli; Hassin-Baer, Sharon; Karni, Avi

    2014-05-01

    There are inconsistent results in the research literature relating to whether a procedural memory dysfunction exists as a core deficit in Parkinson׳s disease (PD). To address this issue, we examined the acquisition and long-term retention of a cognitive skill in patients with moderately severe PD. To this end, we used a computerized version of the Tower of Hanoi Puzzle. Sixteen patients with PD (11 males, age 60.9±10.26 years, education 13.8±3.5 years, disease duration 8.6±4.7 years, UPDRS III "On" score 16±5.3) were compared with 20 healthy individuals matched for age, gender, education and MMSE scores. The patients were assessed while taking their anti-Parkinsonian medication. All participants underwent three consecutive practice sessions, 24-48h apart, and a retention-test session six months later. A computerized version of the Tower of Hanoi Puzzle, with four disks, was used for training. Participants completed the task 18 times in each session. Number of moves (Nom) to solution, and time per move (Tpm), were used as measures of acquisition and retention of the learned skill. Robust learning, a significant reduction in Nom and a concurrent decrease in Tpm, were found across all three training sessions, in both groups. Moreover, both patients and controls showed significant savings for both measures at six months post-training. However, while their Tpm was no slower than that of controls, patients with PD required more Nom (in 3rd and 4th sessions) and tended to stabilize on less-than-optimal solutions. The results do not support the notion of a core deficit in gaining speed (fluency) or generating procedural memory in PD. However, PD patients settled on less-than-optimal solutions of the task, i.e., less efficient task solving process. The results are consistent with animal studies of the effects of dopamine depletion on task exploration. Thus, patients with PD may have a problem in exploring for optimal task solution rather than in skill acquisition and

  7. MICROSURGICAL RECONSTRUCTION OF THE AERODIGESTIVE TRACT WITH COLONIC-ILEAL AUTOGENIC GRAFT IN PATIENTS WITH HYPOPHARYNX CANCER

    Directory of Open Access Journals (Sweden)

    M. V. Ratushny

    2014-01-01

    Full Text Available Study objective: development of the new method of reconstruction of upper section of the aerodigestive tract with the use of a microsurgical colonic-ileal autogenic graft that allows instant recovery of the food passage and voice function.A clinical case of successful treatment of a patient with locally distributed hypopharynx cancer is provided, regarding which microsurgical reconstruction of upper sections of the aerodigestive tract was performed with a free colonic-ileal autogenic graft at the surgical stage of therapy after laryngectomy with sleeve resection of the hypopharynx.The use of a colonic-ileal autogenic graft in the course of reconstruction of upper sections of the aerodigestive tract allowed instant recovery of both food passage and voice function for the patient after laryngectomy with sleeve resection of the hypopharynx.Conclusions:1. Application of this autogenic graft as a plastic material allows recovering both food passage and voice function instantly and completely with circular defects of upper sections of the aerodigestive tract.2. The ileocecal valve included into the structure of the combined autogenic graft prevents saliva and food aspiration into the trachea through the tracheo-oesophageal shunt.3. Mucous secretion of the autogenic graft has no aggressive action on the mucous membrane of the trachea, which allows implementation of the vocal rehabilitation plan.4. After the flap formation, there is no functional or aesthetic damage in the donor area.5. This reconstruction method cuts down the rehabilitation time significantly as well as decreases the patient’s disability level.

  8. Correlates of optimal behavior among child welfare-involved children: Perceived school peer connectedness, activity participation, social skills, and peer affiliation.

    Science.gov (United States)

    Merritt, Darcey H; Snyder, Susan M

    2015-09-01

    Understanding the association between children's behaviors and their perceptions regarding the quality of school friendships is useful for intervention strategies focusing on the interpersonal networks of children involved with the child welfare system. Rarely are measures of the strength of peer relationships assessed as a protective factor for maltreated children in the context of understanding their behaviors. This research investigates the link between these youth's expressed relational experiences and nonproblematic behavior. Analyses were conducted on 1,054 children (ages 11-17) from the National Survey of Child and Adolescent Well-Being II (NSCAW II) dataset. Utilizing a factored measure of perceived school friend connectedness, children's behaviors were predicted using Generalized Ordered Logistic regression analyses. Results demonstrated stronger school friend connectedness is a protective factor in that, children who perceive strong peer connections at school are more likely to classify below the problem behavior threshold than those with weaker peer connections. Further, children with increased social skills; fewer deviant peer affiliations; and those who take responsibility in part-time jobs and chores are more likely to display normative behaviors. Compared with all other types of maltreatment, physically abused children are significantly less likely to display behaviors below the problem range. Moreover, physical abuse has a negative impact on the protective nature of strong peer connections. Attention should be given to supporting children's perceived positive friendships, developing social skills, and encouraging participation in part-time jobs (e.g., babysitting, paper routes) as protective factors associated with nonproblematic behaviors, rather than problematic behaviors. Implications for service delivery are discussed. (c) 2015 APA, all rights reserved).

  9. Communication skills in palliative surgery: skill and effort are key.

    Science.gov (United States)

    Miner, Thomas J

    2011-04-01

    Excellence as a surgeon requires not only the technical and intellectual ability to effectively take care of surgical disease but also an ability to respond to the needs and questions of patients. This article provides an overview of the importance of communication skills in optimal surgical palliation and offers suggestions for a multidisciplinary team approach, using the palliative triangle as the ideal model of communication and interpersonal skills. This article also discusses guidelines for advanced surgical decision making and outlines methods to improve communication skills. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Job assignment with multivariate skills

    OpenAIRE

    Brilon, Stefanie

    2010-01-01

    This paper analyzes the job assignment problem faced by a firm when workers’ skills are distributed along several dimensions and jobs require different skills to varying extent. I derive optimal assignment rules with and without slot constraints, and show that under certain circumstances workers may get promoted although in their new job they are expected to be less productive than in their old job. This can be interpreted as a version of the Peter Principle which states that workers get prom...

  11. Motion-preserving wrist reconstruction using a microsurgical medial femur condylus bone graft and radio-scapho-lunate (RSL limited fusion after osteomyelitis following open distal radius fracture

    Directory of Open Access Journals (Sweden)

    Steinmann, Claudia

    2015-06-01

    Full Text Available This case presents the microsurgical management in the rare situation after sequestering osteomyelitis of the distal radius to achieve both bony stability and partially preserved wrist motion. A 38-year-old patient underwent after sequestrectomy microsurgical reconstruction using a medial femoral condyle as a prerequisite for simultaneous motion-preserving radio-scapho-lunate (RSL fusion. As a result, 11 months postoperatively, a good functional result was achieved with range of motion of 60° in extension/flexion and 40° in ulnar/radial deviation and grip strength of 12 kg correspondeding to 33% of the dominant contralateral side. Upper extremity usability as measured by Disability of Arm Shoulder and Hand (DASH questionnaire improved from preoperative 24 to after the reconstruction and enabled the patient to resume his work without pain.

  12. Long-term outcomes of microsurgical nasal replantation: review of the literature and illustrated 10-year follow-up of a pediatric case with full sensory recovery.

    Science.gov (United States)

    Marsden, Nicholas J; Kyle, Amanda; Jessop, Zita M; Whitaker, Iain S; Laing, Hamish

    2015-01-01

    We present a case of successful artery only total nose replantation in an 18-month-old child, with 10 years of follow-up and full sensory recovery despite no nerve repair. The common absence of veins for anastomosis does not prevent successful replant, as demonstrated with the use of Hirudo medicinalis use in this unique case. We comprehensively review the literature of this rare and complex injury and advocate microsurgical replantation where possible over other methods of nasal reconstruction.

  13. To Resect or Not to Resect: The Effects of Rib-Sparing Harvest of the Internal Mammary Vessels in Microsurgical Breast Reconstruction.

    Science.gov (United States)

    Wilson, Stelios; Weichman, Katie; Broer, P Niclas; Ahn, Christina Y; Allen, Robert J; Saadeh, Pierre B; Karp, Nolan S; Choi, Mihye; Levine, Jamie P; Thanik, Vishal D

    2016-02-01

    The internal mammary vessels are the most commonly used recipients for microsurgical breast reconstructions. Often, the costal cartilage is sacrificed to obtain improved vessel exposure. In an effort to reduce adverse effects associated with traditional rib sacrifice, recent studies have described less-invasive, rib-sparing strategies. After obtaining institutional review board's approval, a retrospective review of all patients undergoing microsurgical breast reconstruction at a single institution between November 2007 and December 2013 was conducted. Patients were divided into two cohorts for comparison: rib-sacrificing and rib-sparing internal mammary vessel harvests. A total of 547 reconstructions (344 patients) met inclusion criteria for this study. A total of 64.9% (n = 355) underwent rib-sacrificing internal mammary vessel harvest. Cohorts were similar in baseline patient characteristics, indications for surgery, and cancer therapies. However, patients undergoing rib-sparing reconstructions had significantly shorter operative times (440 vs. 476 minutes; p rib-sparing techniques had greater incidence of fat necrosis requiring excision (12.5 vs. 2.8%; p rib-sacrificing patients. Rib-sparing harvest of internal mammary vessels is a feasible technique in microsurgical breast reconstruction. However, given the significant increase in fat necrosis requiring surgical excision, the trend toward increased postoperative complications, and no significant difference in postoperative revision rates, the purported benefits of this technique may fail to outweigh the possible risks. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. 岩斜区肿瘤显微外科治疗手术入路选择 (附17例报告)%Microsurgical Treatment of Petroclival Tumor(Report of 17 Cases)Microsurgical Treatment of Petroclival Tumor(Report of 17 Cases)

    Institute of Scientific and Technical Information of China (English)

    孙涛; 黄德俊; 夏玉成; 李宗正; 田继辉; 刘吉庆; 李广兴

    2001-01-01

    目的:探讨岩斜区肿瘤外科治疗手术入路选择。方法:回顾性分析我院自1997年至2000年6月显微外科手术治疗的17例岩斜区肿瘤。12例肿瘤直径大于4cm。采用6种手术入路:颞下-小脑幕;天幕上下联合;颞下-乙状窦前;枕下乳突后;枕下远外侧;额眶颧入路。结果:肿瘤全切除12例(71%),术后恢复良好者11例(65%),术后新增颅神经损害6例(35%)。结论:选择和掌握适合的颅底手术入路,采用显微外科技术切除岩斜区肿瘤可取得满意效果。%Objective:To evaluate the advantages of choosing diverse surgicalapproaches for petroclival tumor.Methods:Seventeen cases with petroclival tumor treated under microsurgery were studied retrospectively.Twelve lesions were larger than 4cm in their largest diameter.According to the location of petroclival tumor,the following 6 approaches could be flexibly chosen and individually used:Subtemporal-transtentorial:Subtemporal-presigmoid;Suboccipital-retromastoid;Suboccipital-far lateral;Combined supra-and infratentorial;Frontoorbitozygomatic approaches.Results:Total removal of the tumor was achieved in 12 patients, favourable postoperative results showed in 11 cases and new postoperative injuries of cranial nerves occurred in 6 cases.Conclusion:The satisfactory outcome could be resulted by properly selecting and skillfully comprehending the operative approaches to cranial base lesions and by adopting the advanced microsurgical techniques.

  15. Leadership Skills

    Science.gov (United States)

    Parish, Thomas S.

    2006-01-01

    While this may not be a "complete list" of what leadership skills one needs to effectively lead in any/every situation, it should provide a great overview of many of the things s/he needs to do, at least initially.

  16. Coping Skills.

    Science.gov (United States)

    Library of Congress, Washington, DC. National Library Service for the Blind and Physically Handicapped.

    This annotated bibliography lists approximately 150 braille books and 300 audiocassettes of books which address coping skills for people in a variety of situations. All items listed are available in the network library collections provided by the National Library Service for the Blind and Physically Handicapped of the Library of Congress.…

  17. Microsurgical treatment for meningiomas of falcotentorinal junction%显微手术切除镰幕交界区脑膜瘤的临床分析

    Institute of Scientific and Technical Information of China (English)

    梅文忠; 游鸿海; 陈剑舞; 吴喜跃; 康德智

    2016-01-01

    Objective To explore the clinical features,differential diagnosis,preoperative imaging and microsurgical treatment skills/experiences of falcotentorinal meningiomas.Methods Nine patients with falcotentorinal meningiomas,admitted to and performed microsurgical resection in our hospital from January 2009 to October 2015,were chosen in our study.Preoperative examinations included MR imaging and CT angiography:the Galen's veins were totally occluded in two patients and stenosed of different degrees in 7 patients;3 patients had meningiomas at the above of Galen's veins,and 6 under the Galen's veins.Seven patients were resected via Poppen approachs,and 2 with considerable lateral extensions tumors were via bilateral Poppen approach.Results Simpson Grade Ⅰ-Ⅱ tumor resection was achieved in 7 patients and Grade Ⅲ in two patients.Postoperative complications included cortical blindness in two patients recovering within 3 months of follow-up,intracranial infection in one patient curing two weeks later;no postoperative death or severe disabilities were noted.Clinical follow-up was available in 9 patients for a period ranging from 0.5 to 7 years:7 patients enjoyed Simpson Grade Ⅰ-Ⅱ resection had no tumor recurrence and were self-reliable;in two patients with Simpson Grade Ⅲ resection,one accepted postoperative treatment of Gamma knife,another one without other treatment,and these two patients had no tumor progression in the 28 months of follow-up.Conclusion The microsurgery is preferred in the resection of falcotentorinal meningiomas,and sufficient preoperative imaging evaluation,reasonable operation concept,technique and experience of adept micromanipulation are the keys to the safe and effective removal of the tumors.%目的 探讨镰幕交界区脑膜瘤的临床、术前影像表现以及显微手术切除的疗效.方法 福建医科大学附属第一医院神经外科自2009年1月至2015年10月采取显微手术切除镰幕交界区脑膜瘤9例,术前均

  18. 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

    Full Text Available After surgical treatment for locally advanced oral tumors with resection of soft tissues, mucosal membrane, and facial skeletal structures, there are penetration combined defects, removal of which is a challenge for reconstructive surgeons. Mandibular repair is one of the problems in the correction of combined oral defects. Surgeons use different grafts to remove mandibular defects. One-flap transplantation does not always solve all reconstruction problems and ensure the repair of the mucosal membrane, a soft-tissue component, skin integuments, and facial skeleton.The authors describe a clinical case of successful single-stage correction of penetration combined orofacial defect after resection of the tongue, mouth floor, en bloc resection of the lower jaw and mental soft tissues, bilateral cervical supramyochoroidal lymphadenectomy, stage LCL CM mandibular defect formation after J. Boyd, by using two microsurgical autografts (a peroneal skin-muscle-skin autograft and a radial skin-fascia one in a 39-year-old female patient clinically diagnosed with carcinoma of the left mandibular alveolar ridge mucosa, Stage IVA (T4аN0M0.The Department of Microsurgery, P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, has gained experience in comprehensively correcting extensive combined maxillofacial defects with two or more grafts in 27 patients who underwent autografting with a total of 73 flaps. The most functionally incapacitating and life-incompatible defect was removed at Stage 1 of reconstructive treatment. Delayed reconstruction was made after a complex of specialized antitumor therapy and assessment of treatment results in the absence of progressive growth. A great problem during multi-stage defect correction is presented by the lack of recipient vessels after cervical lymphadenectomy, the presence of soft tissue scar changes, trismus, temporomandibular joint ankylosis, contractures and displacement of the edges of the

  19. 脉络膜前动脉起始处动脉瘤的显微手术治疗%Microsurgical clipping of aneurysm located at the proximal anterior choroidal artery

    Institute of Scientific and Technical Information of China (English)

    谢满意; 李中林; 朱玉辐; 陈晨; 冯力; 纪培志; 苗发安; 王子德

    2014-01-01

    Objective To summarize the diagnostic and surgical skills involved in the treatment of aneurysm located at the proximal anterior choroidal artery ( AChA) and how to prevent postoperative ischemic complication .Methods E-leven patients with aneurysm located at the proximal anterior choroidal artery were included who were admitted to our hos -pital from August 2007 to August 2013 and underwent microsurgical clipping .Then, preoperative diagnosis , surgical skills and preventive methods to avoid postoperative ischemic events were reviewed retrospectively .Results Among the eleven cases , eight were correctly diagnosed , while the other three were misdiagnosed as posterior communicating artery aneurysm before surgery .All the AChA aneurysms were clipped and two patients manifested infarction in the blood suppl -ying area of AChA.For GOS scores, nine cases had good recovery , one patient presented moderate disability , and one patient was reported severe disability .No bleeding case was reported during 3-24 months of follow-up visits.Conclu-sion It is of importance to recognize aneurysm and identify its relationship with surrounding vessels for microsurgical clipping and better prevention of postoperative ischemic events .%目的:总结脉络膜前动脉( AChA )起始处动脉瘤的诊断、手术治疗技巧、脑缺血等并发症防治。方法以2007年8月-2013年8月我科经显微手术治疗的11例脉络膜前动脉起始处动脉瘤患者临床资料为研究对象,对术前诊断、手术技巧、术后脑缺血并发症防治做回顾性分析。结果11例脉络膜前动脉瘤术前诊断正确8例,3例误诊为后交通动脉瘤。所有动脉瘤均顺利手术夹闭。术后出现脉络膜前动脉供血区梗塞2例。 GOS评分:恢复良好9例,中度残疾1例,重度残疾1例。术后随访3~24个月,无再出血病例。结论术中清晰显露瘤颈与周边血管关系,正确辨认、保护脉络膜前动脉对安全夹闭动

  20. Negotiating skills.

    Science.gov (United States)

    Hughes, G

    1996-01-01

    The Collins English Dictionary defines negotiation as "a discussion set up or intended to produce a "settlement or agreement." It is a skill everyone uses on a regular basis in daily life; often without realising. A plan to meet friends fo an evening meal for example involves agreeing a time and venue--this is negotiation. As it is the the process of coming to terms with the "other side" and trying to get the best deal possible it is necessary to accept the fact that a conflict of interest does exist. There is an atmosphere of uncertainty until the deal is completed and one side may gain and one may lose relative to their opening position. For this skill to be successfully applied when working with clinical management colleagues, a formal set of guidelines is necessary. In this article I highlight some of the problems which can arise and offer a systematic approach to this difficult but rewarding management activity. PMID:9091105

  1. Meta-heuristic ant colony optimization technique to forecast the amount of summer monsoon rainfall: skill comparison with Markov chain model

    Science.gov (United States)

    Chaudhuri, Sutapa; Goswami, Sayantika; Das, Debanjana; Middey, Anirban

    2014-05-01

    Forecasting summer monsoon rainfall with precision becomes crucial for the farmers to plan for harvesting in a country like India where the national economy is mostly based on regional agriculture. The forecast of monsoon rainfall based on artificial neural network is a well-researched problem. In the present study, the meta-heuristic ant colony optimization (ACO) technique is implemented to forecast the amount of summer monsoon rainfall for the next day over Kolkata (22.6°N, 88.4°E), India. The ACO technique belongs to swarm intelligence and simulates the decision-making processes of ant colony similar to other adaptive learning techniques. ACO technique takes inspiration from the foraging behaviour of some ant species. The ants deposit pheromone on the ground in order to mark a favourable path that should be followed by other members of the colony. A range of rainfall amount replicating the pheromone concentration is evaluated during the summer monsoon season. The maximum amount of rainfall during summer monsoon season (June—September) is observed to be within the range of 7.5-35 mm during the period from 1998 to 2007, which is in the range 4 category set by the India Meteorological Department (IMD). The result reveals that the accuracy in forecasting the amount of rainfall for the next day during the summer monsoon season using ACO technique is 95 % where as the forecast accuracy is 83 % with Markov chain model (MCM). The forecast through ACO and MCM are compared with other existing models and validated with IMD observations from 2008 to 2012.

  2. Leadership skills?

    Science.gov (United States)

    2016-09-01

    Senior executive leaders might be interested in applying for the NHS Leadership Academy's director programme, which is designed to 'stretch and challenge' those with an 'existing level of complex leadership skills'. The programme also offers an opportunity for participants to work with other leaders and other parts of the system to enhance inclusiveness. There are three cohorts a year, and the programme runs for a 12 months. Closing dates for applicants are 4 September 2016, 22 January 2017 and 21 May 2017.

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

    Science.gov (United States)

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

    2017-06-21

    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.

  4. The open access video collection project "Hernesniemi's 1001 and more microsurgical videos of Neurosurgery": A legacy for educational purposes.

    Science.gov (United States)

    Choque-Velasquez, Joham; Kozyrev, Danil A; Colasanti, Roberto; Thiarawat, Peeraphong; Intarakhao, Patcharin; Jahromi, Behnam Rezai; Hernesniemi, Juha

    2017-01-01

    Neurosurgical educational programs and courses are helpful to improve the quality of training. Moreover, nowadays, online activities may represent a very useful tool to globally enhance neurosurgical education. The "Hernesniemi's 1001 and more microneurosurgical videos" project aims to show the microsurgical style developed by the senior author and his TEAMs in more than 40 years of experience. More than 1100 high-definition videos of microneurosurgical operations performed by the senior author were carefully edited. These videos illustrate the philosophy of "simple, clean, fast and preserving the normal anatomy" while offering a step by step guide of different neurosurgical procedures. All the aforementioned material is well organized in an electronic videobook, freely available in Surgical Neurology International. The book also includes comments of great current neurosurgeons and writings of the authors and editors. We are sure that our project will be able to instill in and spread across the neurosurgical community the microneurosurgical style of the senior author, thus representing an efficient educational tool for surgeons all around the world.

  5. Foramen Magnum Dural Arteriovenous Fistula Treated by a Microsurgical Technique Combined with a Feeder Occlusion Using Transarterial Coil Embolization.

    Science.gov (United States)

    Hiramatsu, Ryo; Kuroiwa, Terumasa; Nozaki, Kazuhiko; Kuroiwa, Toshihiko

    2015-01-01

    The treatment of dural arteriovenous fistulas (DAVFs) at the foramen magnum remains controversial by reason that DAVFs appearing from the foramen magnum represent only a minority of spinal DAVFs. We present our treatment for an asymptomatic patient suffering from a foramen magnum DAVF. A 53-year-old man presented to our hospital with the complaint of a floating sensation. Although there was no subarachnoid hemorrhage or cerebral infarction on magnetic resonance imaging, a magnetic resonance angiography revealed a number of dilated veins and a large varix surrounding the medulla oblongata. Cerebral digital subtraction angiography (DSA) showed a foramen magnum DAVF fed by the neuromeningeal branch of the left ascending pharyngeal artery and occipital artery, draining into the posterior spinal vein. Occlusion of the fistula was achieved by a microsurgical technique combined with a feeder occlusion using transarterial coil embolization, without complications. We verified the complete occlusion on post-operative cerebral DSA. While this combined therapy was already established for the treatment of DAVFs, there were no reports of the combined therapy for foramen magnum DAVFs. This treatment was considered to be useful for foramen magnum DAVFs, especially those DAVFs at the foramen magnum with a number of dilated veins and a large varix.

  6. Microsurgical endoscopy-assisted anterior corpus callosotomy for drug-resistant epilepsy in an adult unresponsive to vagus nerve stimulation

    Directory of Open Access Journals (Sweden)

    Davide Nasi

    2016-01-01

    Full Text Available Because most of the corpus callosotomy (CC series available in literature were published before the advent of vagus nerve stimulation (VNS, the efficacy of CC in patients with inadequate response to VNS remains unclear, especially in adult patients. We present the case of a 21-year-old female with medically refractory drop attacks that began at the age of 8 years, which resulted in the patient being progressively unresponsive to vagus nerve stimulation implanted at the age of 14 years. Corpus callosotomy was recommended to reduce the number of drop attacks. However, the patient had only mild cognitive impairments and no neurological deficits. For this reason, we were forced to plan a surgical approach able to maximize the disconnection for good seizure control while, at the same time, minimizing sequelae from disconnection syndromes and neurosurgical complications because in such cases of long-lasting epilepsy the gyri cinguli and the arteries can be tenaciously adherent and dislocated with all the normal anatomy altered. In this scenario, we opted for a microsurgical endoscopy-assisted anterior two-thirds corpus callosotomy. The endoscopic minimally invasive approach proved to be quite adequate in this technically demanding case and confirmed that CC may offer advantages, with good results, even in adult patients with drop attacks who have had inadequate response to VNS.

  7. Microsurgical reconstruction of noma-related facial defects with folded free flaps: an overview of 31 cases.

    Science.gov (United States)

    Giessler, Goetz A; Fieger, Alexander; Cornelius, Carl-Peter; Schmidt, Andreas B

    2005-08-01

    Noma is primarily affecting children in underprivileged countries and results in disfiguring facial defects, loss of mandibular movement, and subsequent social disintegration. Plastic surgery in West Africa traditionally uses pedicled flaps. In large, complex, or central facial defects, though, pedicled flaps are apt to be too small or have a significant donor site morbidity. Since 1999, we have been using free microvascular flaps in Nigeria. In 5 Interplast missions, 31 patients (age 5-45 years, median 20 years, female to male ratio 18:13) underwent 31 free flap procedures in Nigeria, 27 of them for primary treatment. The operative time ranged from 3.75-8.75 hours (mean 5.5 hours). An external distractor/fixator to maintain mouth opening was mounted in 13 cases. All anastomoses were done with loupe magnification. Three flaps failed completely, 1 partly, and 4 patients showed minor wound infections. No donor-site complications occurred. Free flaps can be a suitable and safe closure for complex noma defects even in underprivileged circumstances, if patient profile and own microsurgical routine allows it. Patient disfigurement can be less than in pedicled flaps regarding the donor sites.

  8. 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.

  9. Microsurgical management of meningiomas in central sulcus region%中央沟区脑膜瘤的显微外科治疗

    Institute of Scientific and Technical Information of China (English)

    王军; 姚长义; 王运杰; 郭宗泽; 欧绍武; 邢德广

    2013-01-01

    Objective To explore the microsurgical outcome of meningiomas in central sulcus region.Methods A retrospective analysis of the clinical data and surgical results was performed in 42 meningiomas in central sulcus region.Results Of the 42 meningiomas in central sulcus region,total resection and sub-total resection were achieved in 36 and 6 cases,respectively.No death occurred postoperatively.Temporary motor or sensory disturbances occurred in 8 patients,all of which recovered within 2 weeks.All patients were followed up for about 3 to 60 months.10 cases out of 12 recovered from decreased muscle strength in limbs (or hemiparesis).One maintained his status and the other one suffered from deterioration.For the 10 patients with epilepsy preoperatively,systemic anti-epileptic therapy was administered and all of them were seizure free postoperatively.Of the 6 cases with tumor subtotally resected,2 cases suffered from tumor recurrence,one of which undertook second operation and the other one took radiotherapy.4 patients were lost during the follow up period.Conclusions Although meningiomas in central sulcus have close relationship with vessels of central sulcus,the superior sagittal snius and the central cortex,satisfactory clinical outcome can be achieved with perfect microsurgery skills.%目的 探讨中央沟区脑膜瘤显微外科手术的治疗效果.方法 对42例行显微外科手术治疗的中央沟区脑膜瘤患者的临床资料及手术效果进行分析总结.结果 36例全切(Simpon Ⅰ,Ⅱ级),6例次全切(SimponⅢ,Ⅳ级),无手术死亡病例.术后新发暂时性肢体肌力或感觉障碍8例,均于术后2周内恢复.随访3~60个月,术前已有肢体肌力障碍的12例中有10例于术后6个月内恢复正常,1例无变化,1例加重;术前有癫痫的10例患者,行系统抗癫痫治疗,术后均无癫痫发作;次全切病例中,2例有肿瘤再长,1例行二次手术,1例选择放疗.失访4例.结论 中央沟区脑膜瘤与中央沟静

  10. Students' perceptions on skills training in simulation.

    Science.gov (United States)

    Treadwell, I; Grobler, S

    2001-01-01

    The University of Pretoria implemented a problem-oriented undergraduate medical curriculum that emphasizes experiential learning and the mastering of practical skills. Students' experiences with acquiring practical skills in a skills laboratory and the impact that acquiring these skills has on their clinical practice were explored and described. A qualitative, investigative, descriptive and contextual design was used. Data were collected at focus-group discussions and analysed using Tesch's methodology. A literature control was conducted to identify similarities of and uniqueness in the research findings. Trustworthiness was established by utilizing Guba's model for the trustworthiness of qualitative research (Lincoln & Guba, 1981). The findings were that attitudes, knowledge and skills are interrelated and contribute to an enhanced process of learning. The interrelated learning process has a positive effect when students progress from the skills laboratory to clinical practice. Students made valuable recommendations that should contribute to the optimal use of the skills laboratory.

  11. Illinois Occupational Skill Standards: Machining Skills Cluster.

    Science.gov (United States)

    Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

    This document of skill standards for the machining skills cluster serves as a guide to workforce preparation program providers in defining content for their programs and to employers to establish the skills and standards necessary for job acquisition. These 67 occupational skill standards describe what people should know and be able to do in an…

  12. Validation of a chicken wing training model for endoscopic microsurgical dissection.

    Science.gov (United States)

    Kaplan, Daniel J; Vaz-Guimaraes, Francisco; Fernandez-Miranda, Juan C; Snyderman, Carl H

    2015-03-01

    To determine if training with a chicken wing model improves performance of endoscopic endonasal surgery (EES) with microvascular dissection. Randomized experimental study. A single-blinded randomized clinical trial of trainees with various levels of endoscopic experience was conducted to determine if prior training on a nonhuman model augments endoscopic skill and efficiency in a surrogate model for live surgery. Medical students, residents, and fellows were randomized to two groups: a control group that performed an endoscopic transantral internal maxillary artery dissection on a silicone-injected anatomical specimen, and an interventional group that underwent microvascular dissection training on a chicken wing model prior to performing the anatomic dissection on the cadaver specimen. Time to completion and quality of dissection were measured. A Mann-Whitney test demonstrated a significant improvement in time and quality outcomes respectively across all interventional groups, with the greatest improvements seen in participants with less endoscopic experience: medical students (P = .032, P = .008), residents and fellows (P = .016, P = .032). Prior training on the chicken wing model improves surgical performance in a surrogate model for live EES. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Response properties of whisker-associated primary afferent neurons following infraorbital nerve transection with microsurgical repair in adult rats.

    Science.gov (United States)

    Xiao, Bo; Zanoun, Rami R; Carvell, George E; Simons, Daniel J; Washington, Kia M

    2016-03-01

    The rodent whisker/trigeminal system, characterized by high spatial and temporal resolution, provides an experimental model for developing new therapies for improving sensory functions of damaged peripheral nerves. Here, we use controlled whisker stimulation and single-unit recordings of trigeminal ganglion cells to examine in detail the nature and time course of functional recovery of mechanoreceptive afferents following nerve transection with microsurgical repair of the infraorbital nerve (ION) branch of the trigeminal nerve in adult rats. Response measures include rapid vs. slow adaptation, firing rate, interspike intervals, latency, and angular (directional) tuning. Whisker-evoked responses, readily observable by 3 wk post-transection, recover progressively for at least the next 5 wk. All cells in transected animals, as in control cases, responded to deflections of single whiskers only, but topography within the ganglion was clearly disrupted. The time course and extent of recovery of quantitative response measures were receptor dependent. Cells displaying slowly adapting (SA) properties recovered more quickly than rapidly adapting (RA) populations, and for some response measures-notably evoked firing rates-closely approached or attained control levels by 8 wk post-transection. Angular tuning of RA cells was slightly better than control units, whereas SA tuning did not differ from control values. Nerve conduction times and refractory periods, examined separately using electrical stimulation of the ION, were slower than normal in all transected animals and poorly reflected recovery of whisker-evoked response latencies and interspike intervals. Results underscore the need for multiple therapeutic strategies that target different aspects of functional restitution following peripheral nerve injury. Copyright © 2016 the American Physiological Society.

  14. Rib-sparing and internal mammary artery-preserving microsurgical breast reconstruction with the free DIEP flap.

    Science.gov (United States)

    Kim, Hyungsuk; Lim, So-Young; Pyon, Jai-Kyong; Bang, Sa-Ik; Oh, Kap Sung; Lee, Jeong Eon; Nam, Seok Jin; Mun, Goo-Hyun

    2013-03-01

    Using an internal mammary artery as the recipient vessel in a free flap autologous breast reconstruction is common practice, but this vessel is often sacrificed for end-to-end anastomosis and is typically assessed by removing a costal cartilage segment. The authors studied the reliability of the end-to-side arterial anastomosis using a rib-sparing approach by comparing it with end-to-end anastomosis. The authors analyzed 100 consecutive medical records of patients who underwent autologous breast reconstruction with a free deep inferior epigastric artery perforator flap in which the internal mammary vessels were assessed using a rib-sparing technique. The study compared the complications between the two groups of end-to-side arterial anastomosis (50 cases) and end-to-end arterial anastomosis (50 cases). Exposure of the internal mammary artery using a rib-sparing technique was performed successfully in all 100 flaps. The second and third intercostal spaces were used in 46 and 54 cases, respectively. The mean width of the used intercostal space was 18.3 ± 2.4 mm in the end-to-side group and 18.3 ± 2.9 mm in the end-to-end group (p = 0.923). All flaps survived without partial or total necrosis. One case of venous insufficiency that required exploration occurred in the end-to-side group; the flap was totally saved with venous revision. There was no significant statistical difference between the end-to-side and end-to-end groups in all other variables, including mean flap ischemic time (p = 0.431) and fat necrosis (p = 0.339). The rib-sparing and internal mammary artery-preserving free deep inferior epigastric artery perforator flap transfer is an efficient and safe technique for microsurgical breast reconstruction.

  15. Biomechanange ical chof lumbar unilateral graded facetectomy and strategies of its microsurgical reconstruction: report of 23 cases

    Institute of Scientific and Technical Information of China (English)

    Zhou Yue; Luo Gang; Chu Tongwei; Wang Jian; Li Changqing; Zheng Wenjie; Zhang Zhengfeng; Hao Yong; Zhang Chao

    2008-01-01

    for microsurgical reconstruction, though the indications of the procedure should be carefully restricted.

  16. Microsurgical decompression of the median nerves for treating diabetic peripheral neuropathy in the upper limbs: A 21-month follow-up

    Institute of Scientific and Technical Information of China (English)

    Peng Lin; Li Zhang; Yanbing Yu; Xiaoli Xu; Jiang Liu; Fang Li; Jun Xu

    2007-01-01

    BACKGROUND: Peripheral nerve injured by abnormal glucose metabolism is compressed, which is an important etiological factor of diabetic peripheral neuropathy (DPN). Microsurgical decompression of peripheral nerve maybe effectively releases the symptoms of DPN.OBJECTIVE: To investigate the curative effects of microsurgical decompression of median nerves for treatment of DPN in upper limbs.DESIGN: Case-follow up observation.SETTING: Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital,Ministry of Health.PARTICIPANTS: Twelve patients with DPN in upper limbs (19 hands) who received treatment in the Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital, Ministry of Public Health between March 2004 and July 2006 were involved in this experiment. The involved patients, 5 male and 7 female, were aged 44 to 77 years, with DPN course of 6 months to 16 years. They all met 1999 WHO diabetic diagnosis criteria. Both two hands had symptom in 7 patients, and only one hand had symptom in 5 patients. Informed consents of detected items were obtained from all the patients, who also received 21 months of follow-up treatment.microscope, transverse carpal ligament was exposed. Subsequently, transverse carpal ligament, forearm superficial fascia and palmar aponeurosis were fully liberated, and then part of them was cut off. Connective tissue around median nerve, superficial flexor muscle of fingers, radial flexor, palmaris longus and other flexor tendons were completely loosened. Finally, epineurium was opened with microinstrument for neurolysis. After tourniquet was loosened, and bipolar coagulator was used to stop bleeding, and the incision distance of two normal points was 3 to 6 mm), nerve conduction velocity and action potential amplitude (short abductor muscle of thumb end Lat < 4.5 ms; Motor nerve conduction velocity of forearm > 50 m/s),etc. of all the patients were followed up.MAIN OUTCOME MEASURES: The

  17. Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.

    Science.gov (United States)

    Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

    2014-11-01

    This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field.

  18. The odontology victim identification skill assessment system.

    Science.gov (United States)

    Zohn, Harry K; Dashkow, Sheila; Aschheim, Kenneth W; Dobrin, Lawrence A; Glazer, Howard S; Kirschbaum, Mitchell; Levitt, Daniel; Feldman, Cecile A

    2010-05-01

    Mass fatality identification efforts involving forensic odontology can involve hundreds of dental volunteers. A literature review was conducted and forensic odontologists and dental educators consulted to identify lessons learned from past mass fatality identification efforts. As a result, the authors propose a skill assessment system, the Odontology Victim Identification Skill Assessment System (OVID-SAS), which details qualifications required to participate on the Antemortem, Postmortem, Ante/Postmortem Comparison, Field, and Shift Leader/Initial Response Teams. For each qualification, specific skills have been identified along with suggested educational pedagogy and skill assessment methods. Courses and assessments can be developed by dental schools, professional associations, or forensic organizations to teach and test for the skills required for dental volunteers to participate on each team. By implementing a system, such as OVID-SAS, forensic odontologists responsible for organizing and managing a forensic odontology mass fatality identification effort will be able to optimally utilize individuals presenting with proven skills.

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Skills Resources Educational Resources Educational Resources E-Learning Evidence-Based Decisions in Surgery Medical Student Resources ... Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for ...

  20. Microsurgical repairment of finger-tip defection%指端缺损的显微外科修复

    Institute of Scientific and Technical Information of China (English)

    王保山; 郑晓菊

    2009-01-01

    Objective To investigate the methods to repair the defection of finger tip.Methods During Feb.2004 to July 2008,in 98 cases,23 fingers were reconstructed with 2nd toe transfer which was reformed with digital flap or trilobed flap from 2nd toe,33 fingers were coverd with wrap around flap or half wrap around flap from great toe,or combined wrap around flap from great with pulp flap from 2nd toe,28fingers were repaired with fabular flap from great toe combined with tibial flap from 2nd flap,and 27 fingers were repaired with nail flap or enlarged nail flap from great toe. Results Vessel articulo took place in 5 cases,and all cases recovered with wonderful outward appearance Conclusion Microsurgical technic is an ideal method to repair the finger-tip defection.%目的 探讨手指远端各种缺损的修复方法. 方法 采用第二足趾趾动脉旋转"三叶皮瓣"修饰性再造23指:用(拇)甲瓣、半(拇)甲瓣、(拇)趾与第二足趾组织瓦合修复拇手指脱套伤33指;用(拇)趾腓侧及第二足趾胫侧皮瓣修复指腹缺损28指;(拇)趾趾甲或近侧带部分皮瓣修复指甲皮肤缺损27指.结果 临床修复98例111指,除5例出现血管危象,及时处理后恢复外,其它均一期成活,外形美观.结论 用显微外科技术修复拇手指远端的缺损,是理想的方法,达到了缺什么、补什么的理想目的 .

  1. Nelson 综合征的显微外科治疗%Microsurgical treatment of Nelson's syndrome

    Institute of Scientific and Technical Information of China (English)

    幸兵; 任祖渊; 苏长保; 王任直; 杨义; 胡尧飞

    2002-01-01

    Objective To discuss the etiology, diagnostic criteria and treatment of Nelson's syndrome.Methods Twenty-three patients with Nelson's syndrome who were treated in our department over the last 19 years were analyzed retrospectively. Removal of adenoma by the transsphenoidal approach was done in 21 patients and by transfrontal craniotomy in 2. The follow-up period ranged from six months to nine years.Results The incidence of Nelson's syndrome was 7.7% in a series of 300 patients with Cushing's disease treated by microsurgery in the same period. Hyperpigmentation was relieved and adrenocorticotropic hormone (ACTH) levels decreased in all patients after tumor excision. Eight patients with visual disturbance improved after surgery. The curative and remission rates were 56.5% and 26.1%, respectively. Conclusions Transsphenoidal microsurgical removal of pituitary ACTH adenoma is the first choice in the prevention and treatment of Nelson's syndrome. Regular follow-up examinations should be performed over a long time.%目的分析和探讨Nelson综合征的病因、诊断标准和治疗方法.方法 对我科手术治疗的23例病例进行回顾性研究.21例经蝶窦手术,2例经额开颅,随访时间半年~9年.结果 本组23例Nelson综合征,占同期手术治疗的库欣病的7.7%.垂体腺瘤切除后皮肤色素沉着减轻,血ACTH水平下降,8例视力视野障碍术后均改善,治愈率56.5%,缓解率26.1%.结论 经蝶窦垂体ACTH腺瘤切除是预防和治疗Nelson综合征的首选方法,术后应定期随访.

  2. Skill level, Cognitive Ability, Unemployment and Welfare

    DEFF Research Database (Denmark)

    Larsen, Birthe

    2004-01-01

    -biasedtechnological shocks increase unemployment, this may explain why themarket it-self cannot respond to this by making it sufficiently attractiveto acquire skills. Consequently, the trade-off in-between subsidizing educationand thereby reducing unemployment and optimizing welfare maybe eliminated. We analyse this issue...... in a simple educational model andnext in a search equilibrium model including a skill choice decision.Keywords: Education, subsidies, efficiency, unemployment.JEL codes: I20, J64....

  3. Experience of Microsurgical Resection of Acoustic Neuromas via Suboccipital Retrosigmoidal Approach: Report of 30 Cases%枕下乙状窦后入路切除听神经瘤30例体会

    Institute of Scientific and Technical Information of China (English)

    王旭辉; 华续明; 仲骏; 张文川; 李心远; 万亮; 李世亭

    2009-01-01

    背景与目的:听神经瘤是中枢神经系统常见的良性肿瘤之一,其治疗有几种不同的手术入路,但枕下乙状窦后入路应用最为广泛.本研究探讨经枕下乙状窦后入路治疗听神经瘤的显微外科技术及疗效.方法:回顾性分析30例听神经瘤患者临床资料,均经枕下乙状窦后入路行显微手术切除,术中显露横窦和乙状窦,放出枕大池脑脊液,再行显微镜下分离及切除肿瘤,分析显微手术过程及治疗效果.结果:术后无1例患者死亡,肿瘤总体全切率90.0%(27/30),次全切除3例,面神经解剖保留率为93.33%,面神经功能保留率为66.7%.结论:掌握桥小脑角区的解剖学特征、显微手术技巧以及电生理监测在听神经瘤切除和颅神经功能保护中具有重要意义.%BACKGROUND&OBJECTIVE: Acoustic neuroma is one of the most common benign tumors in central nervous system, and the main treatment is surgical resection via subocciipital retrosigmoid approach. In this study, we explored techniques and efficacy of suboccipital retrosigmoidal approach in the treatment of acoustic neuromas. METHODS: Records of 30 patients with acoustic neuromas treated via suboccipital retmsigmoidal approach were analyzed, retrospectively. RESULTS: No modality was observed. Among 30 patients, total resection was achieved in 27 cases and subtotal resection in 3 cases. Facial nerve was preserved in 28 cases anatomically and in 20 cases functionally, respectively. CONCLUSION: The anatomy of cerebellopontine, microsurgical skills and electrophysiological monitoring play important role in the removal of acoustic neuromas and cranial nerves protection.

  4. Microsurgical treatment of medial sphenoid ridge meningiomas%内侧型蝶骨嵴脑膜瘤的显微外科治疗

    Institute of Scientific and Technical Information of China (English)

    林恩; 许海雄; 方旭生; 郭骅

    2010-01-01

    Objective To discuss the microsurgical techniques and clinical efficacy of excision of medial sphenoid ridge meningiomas.Methods Eighteen patients with medial sphenoid ridge meningioma treated by microsurgical techniques were analyzed.Results Total removal(Grade Ⅰ,Ⅱ of Simpson system)was done in 12 cases and subtotal remove was in 6,without hemjplegia and mortality.Conclusions The dural attachment of the lesion should be dissected along the sphenoid wing first,in order to minimize blood loss and to facilitate orientating and exposing the supraclinoidal segment of ICA,and then the engulfing tumor should be dissected proximally to distally.Microsurgical techniques,identification and preservation of the important artery and cranial nerves during operation could be obtained.Because of the presence of interfacing arachnoid membrane in most of the cases,tumor should be removed with a vigorous attempt in the initial operation.%目的 探讨治疗内侧型蝶骨嵴脑膜瘤的显微神经外科的技巧和临床效果.方法 回顾性分析1993年至2008年应用显微神经外科技术治疗18例内侧型蝶骨嵴脑膜瘤患者的临床资料.结果 手术全切除(Simpson Ⅰ、Ⅱ级)12例,次全切除6例.术后无偏瘫及死亡.2例发生动眼神经麻痹;有8例视力改善.结论 尽早离断肿瘤基底并沿颈内动脉床突上段由近向远分离切除包绕的肿瘤是该术式技巧.充分利用显微技术辨别肿瘤与周围血管、神经的关系,注意保护穿通动脉,是手术成功的关键.

  5. IMPLEMENTASI TQM BERORIENTASI HARD SKILL DAN SOFT SKILL DALAM PEMBELAJARAN SEJARAH SMA DI KOTA SEMARANG

    Directory of Open Access Journals (Sweden)

    Cahyo Budi Utomo

    2011-10-01

    Full Text Available This study aims to introduce the implementation of hardskill and softskill oriented TQM in teacher’s learning of history in Senior High School in Semarang. The research model are structural fit model and significance of relationship between TQM implementation model, PDSA cycle, the model analysis of fish bone, continuous improvement , hard skills and soft skills and qualified history learning is the main target of research. Data was obtained from field studies using Likert scale questionnaire developed from the constructs and theoretical construct indicator. Analysis performed using software models SmartPLS. Implementation of PDSA cycle correlated 0879 to the implementation of fish bone analysis, correlates 0830 PDSA cycle to continuously improvement , while continuously improvement  correlated 0441 and 0749 against the hard skills to soft skills. Soft skills to hard skills correlate of 0329, while the correlation of hard skills to qualified history learning is at 0673. The developed qualityfied history learning need support from  the realization of the continuous (continuously improvement and optimal orientation of hard skills. Keywords: model, TQM, PDSA, the analysis of fish bone, hard skills, soft skills, learning the history of quality  Kajian ini bertujuan mengenalkan model implementasi TQM yang berorientasi pada hardskill dan softskill dalam pembelajaran sejarah di sekolah atas Semarang pada para guru. Sebagai model penelitian, model struktural fit dan signifikasi  dari korelasi antara model implementasi TQM, siklus PDSA, model analisis tulang ikan, perbaikan terus-menerus, hard skill dan soft skill, dan pembelajaran sejarah bermutu (PSB menjadi target utama penelitian. Data didapatkan dari studi lapangan menggunakan angket skala Likert yang dikembangkan dari konstruk dan indicator konstruk teoretis. Analisis menggunakan program SmartPLS. Implementasi siklus PDSA berkorelasi 0879 terhadap implementasi model analisis

  6. Microsurgical anatomy of the region of Dorello's canal%Dorello管区显微外科解剖学研究

    Institute of Scientific and Technical Information of China (English)

    朱国臣; 韩卉; 牛朝诗

    2001-01-01

    目的为临床Dorello管区手术提供显微解剖学基础。方法在手术显微镜下对15例(30侧)成人头颅标本Dorello管区结构进行观测。结果①Dorello管由Gruber韧带、岩尖及上斜坡外侧缘三者构成的一个骨纤维管道。Dorello管顶主要由Gruber韧带构成,Dorello管顶至底间最大垂直距离为2.14 mm±0.70 mm。②展神经经过Dorello管外1/3(56.7%)或中1/3(43.3%)。展神经伴行动脉为脑膜背侧动脉的分支,83.3%以单干形式经过展神经内侧。③展神经入海绵窦点距颈内动脉后升部后壁3.97 mm±1.83 mm,在Meckel腔内侧3.11 mm±0.95 mm。结论在Dorello管区展神经及其伴行动脉位置恒定,手术中应予保护。%Objective To provide microanatomic basis for direct microsurgical operation on the region of Dorello's canal. Methods The structures of the region of Dorellos canal were observed and measured on 30 sides of adult cadaverical heads under microscope. Results ①Dorello's canal was an osteofibrous canal composed of Gruber ligament, petrous apex and the lateral border of the upper part of clivus. The roof of Dorello's canal was mainly composed of Gruber ligament. The maximal distance from roof to bottom of Dorello's canal was 2.14 mm±0.70 mm. ②Abducens nerves passed through the lateral 1/3(56.7%) or intermedial 1/3(43.3%) of Dorello's canal to the cavernous sinus. The nutrient arteries of abducens nerves were originated from the dorsal meningeal arteries, and 83.3% of them traversed Dorello's canal by one stem, medially to abducens nerves. ③The point of abducens nerves entering cavernous sinus was 3.97 mm±1.83 mm posterior to the ascending portion of intracavernous carotid artery, 3.11 mm±0.95 mm medial to the Meckel's cave. Conclusion In the region of Dorello's canal, the positions of abducens nerves and their nutrient arteries are steady, and they should be protected during operation.

  7. 踝管综合征的显微手术治疗%Microsurgical Treatment in Tarsal Tunnel Syndrome

    Institute of Scientific and Technical Information of China (English)

    王换新; 吴学建; 李锦永; 程学锋

    2013-01-01

    Objective To investigate the causes of tarsal tunnel syndrome, and diagnosis and microsurgical treatment. Methods From March 2003 to June 2010, 21 cases of tarsal tunnel syndrome were treated, including 15 males and 6 females,in which the age range was from 20 to 56 years old, and treating time was durating from 2 years to the shortest 1 month. 21 patients had a history of trauma in Meases: 11 cases of ankle sprain, 3 fractures, 3 cases of ganglion cyst, 2 case of neurilemoma, and 2 lipoma. flexor support was fully open to expose the tarsal tunnel,and the pathological changes within the organization were observed. For example, the ganglion cyst, osteo-phyte formation were removed, and varicose vein ligation group was cut off, thickening of the plantar fascia was open for decompression. Nerve in lesions was reteased under the operating microscope. Results The patients were followed up,with the longest time of 3.5 years, the shortest time of 1 year,and an average of 2 years and 2 months. 17 patients recovered well, with normal sensory - motor; 3 cases feel back to normal and foot muscle partially restorated; 1 patient feels most of the recovery, and the foot muscle did not recover. Conclusion Tarsal tunnel syndrome is relatively rare, has not yet attracted the attention of clinicians, and is often misdiagnosed. Once it being diagnosed, when conservative treatment fails,dot tors should seize the opportunity to line neurolysis treatment.%目的 探讨踝管综合征的诊断及显微手术治疗.方法 2003年3月~ 2010年6月,采用显微外科技术治疗踝管综合征21例.男性15例,女性6例.患者年龄20~56岁,平均年龄35岁.病程最长2年,最短1个月.21例中14例有外伤史:11例踝关节扭伤;3例跟骨骨折.4例腱鞘囊肿;2例脂肪瘤,1例神经鞘瘤.手术方法:完全打开屈肌支持带,显露踝管,观察其内组织的病理变化情况.如腱鞘囊肿、骨赘形成予以切除,曲张静脉团予以结扎切断,跖筋膜增

  8. Beneficial effects following microsurgical decompression in an adult with congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele: an interesting case report.

    Science.gov (United States)

    Ghani, Imtiaz; Kroeber, Markus

    2012-08-01

    Case report. To report successful surgical therapy for spinal canal stenosis in an adult patient with congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele. A 65-year-old woman with a history of congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele presented with severe radicular pain and weakness in her left lower limb. The patient underwent microsurgical decompression at the level of L3/S1 on the left side. Postsurgery, the patient showed significant amount of pain relief and improvement in weakness in the left lower limb. Surgery for spinal canal stenosis in patients with severe thoraco-lumbar scoliosis can be effective in relieving radicular pain, weakness and numbness, and while not curative can greatly improve the quality of life.

  9. Microsurgical management of pediatric ependymomas of the fourth ventricle via the trans-cerebellomedullary fissure approach: A review of 26 cases

    Science.gov (United States)

    QIU, BO; WANG, YONG; WANG, WEI; WANG, CHAO; WU, PENGFEI; BAO, YIJUN; OU, SHAOWU; GUO, ZONGZE; WANG, YUNJIE

    2016-01-01

    In the present study, the microsurgical management of 26 ependymomas of the fourth ventricle in children via the trans-cerebellomedullary fissure (CMF) approach was reviewed and evaluated. Clinical data were obtained from 26 ependymomas of the fourth ventricle treated with microsurgery using the trans-CMF approach from March 2006 to September 2010 at the Department of Neurosurgery of The First Affiliated Hospital of China Medical University (Shenyang, China). These data were collected and analyzed. Suboccipital median posterior fossa craniotomy and trans-CMF approach were performed in all cases for the microsurgical removal of the tumors. An additional incision was performed in the inferior medullary velum of 5 patients, in order to obtain adequate exposure of the tumors. As a result, all tumors were well exposed during surgery. Gross total resection (GTR) was achieved in 22 cases, near total resection (NTR) in 3 cases and subtotal resection (STR) in 1 case. All excised tumors were pathologically confirmed. No mortality occurred intraoperatively, and no patient presented with mutism or any other surgery-related complications. One patient suffered from postoperative hydrocephalus and received ventriculoperitoneal shunting, which relieved the symptoms. Over the 3.0–7.5-year follow-up period (mean, 4.8 years), tumor relapse occurred in 1 case with GTR, 2 cases with NTR and 1 case with STR. In total, 3 patients succumbed to tumor relapse and 4 were lost to follow-up. According to the literature and the clinical experience of the present authors, the trans-CMF approach provides safe and sufficient access to the fourth ventricle without the requirement of an incision in the inferior vermis. This approach prevents damage to the normal cerebellum and improves the surgical outcome. Tumor removal, restoration of cerebrospinal fluid circulation and preservation of brainstem function are factors that should be taken into consideration during surgery. For patients with

  10. Patient-centered microsurgical management of gingival recession using coronally advanced flap with either platelet-rich fibrin or connective tissue graft: A comparative analysis

    Directory of Open Access Journals (Sweden)

    Archana Kumar

    2017-01-01

    Full Text Available Purpose: To evaluate autologous platelet-rich fibrin (PRF and autogenous connective tissue graft (CTG in gingival recession defects in conjunction with coronally advanced flap (CAF using a microsurgical technique. Materials and Methods: Forty-five Class I and II recession defects were randomly equally (n = 15 divided into three groups: Group I sites treated with CAF with PRF, Group II sites treated with CAF with CTG, and Group III sites treated with CAF alone using microsurgical approach. Parameters recorded were vertical gingival recession (VGR and horizontal gingival recession (HGR, % complete root coverage (CRC, patient comfort score (PCS, patient esthetic score (PES, and hypersensitivity score (HS at 10 days, 3 months, and 6 months. Results: CAF surgery alone and in combination with PRF or CTG are effective procedures to cover denuded roots with mean VGR values of 1.26 ± 0.70 mm (74.4%, 1.26 ± 0.59 mm (58%, and 1.06 ± 0.79 mm (53.3% for Groups I, II, and III, respectively. In terms of CRC achieved at 6 months, results showed that 100% CRC was obtained in 60% sites of Group I, 20% sites of Group II, and 27% sites of Group III. Patient response and acceptance for surgical treatment modality in terms of PCS and PES were highest for Group I (PRF and CAF followed by Group III and Group II, and there was decrease in HS for Group I (PRF and CAF while no significant changes in HS were observed for Group II and Group III. At the end of 6 months follow-up, there was a significant increase in gingival thickness measurements using transgingival probing in Group II, whereas nonsignificant changes were observed in Group I and Group III. Conclusions: A long-term multicenter randomized controlled clinical study may be necessary to evaluate the clinical outcome for autologous PRF in comparison to CTG and CAF alone.

  11. Does the use of arteriovenous loops increase complications rates in posttraumatic microsurgical lower extremity reconstruction?-A matched-pair analysis.

    Science.gov (United States)

    Momeni, Arash; Lanni, Michael A; Levin, Lawrence S; Kovach, Stephen J

    2017-06-28

    The use of arteriovenous (AV) loops in microsurgical lower extremity reconstruction is a controversial topic. The objective of the present study was to assess the impact of AV loops on complication rates following microsurgical reconstruction of posttraumatic lower extremity defects. Patients who underwent free flap coverage of posttraumatic defects in combination with an AV loop (Group 1) were identified and matched for age, body mass index (BMI), tobacco use, defect location, and flap type with patients who underwent reconstruction without vein grafts (Group 2). Outcomes of interest included complication rate and flap loss rate. Groups 1 and 2 consisted of 10 patients each with a mean age of 51 years (range, 21-79 years) and 47.3 years (range, 22-69 years), respectively (P = 0.596). No differences were noted regarding flap loss (P = 1.0), intraoperative (P = 0.474) or postoperative complication rate [surgical site infection (P = 1.0), bleeding (P = 1.0), delayed wound healing (P = 0.23), dehiscence (P = 0.58), and osseous non-union (P = 1.0)]. Only one flap loss was noted in Group 1. The only differences were increased operative time (P = 0.03) and increased length of stay (P = 0.009) in Group 1. Our results suggest that utilization of vein grafts with creation of AV loops followed by single-stage division and free flap transfer for reconstruction of posttraumatic lower extremity defects achieve reconstructive outcomes similar to those obtained in patients in whom no vein grafts are necessary. © 2017 Wiley Periodicals, Inc.

  12. 颅内破裂动脉瘤的早期显微手术治疗体会%Ruptured Intracranial Aneurysms Early Microsurgical Treatment Experience

    Institute of Scientific and Technical Information of China (English)

    刘世立

    2014-01-01

    目的:总结颅内破裂动脉瘤早期显微手术的临床经验。方法49例颅内破裂动脉瘤患者均早期(3 d内)采用显微神经外科手术进行治疗。其中48例行瘤颈夹闭,1例行动脉瘤包裹加固定术。结果术中动脉瘤破裂10例,9例得到完全夹闭,1例行包裹加固定术。术后随访1~6个月,恢复良好40例,留有残疾8例,死亡1例。结果颅内破裂动脉瘤一旦再次破裂预后差,早期显微手术治疗能有效防止再出血危险,并有利于防治脑血管痉挛。%Objective:Summary ruptured intracranial aneurysm microsurgery early clinical experience. Methods: 49 cases of patients with ruptured intracranial aneurysms were early (3d interior) using microsurgical nerve surgery for treatment. 48 of aneurysm neck clipping routine, a routine aneurysm parcellplus fixation. Results:Intraoperative aneurysm rupture in 10 cases, 9 cases ful y clipped a routine package plus fixation. 1-6 months postoperative fol ow-up, a good recovery in 40 cases, 8 cases of disability leave, and 1 died. Conclusion: Once again ruptured intracranial aneurysm rupture poor prognosis, early microsurgical treatment can prevent further bleeding risk, and have contributed to the prevention of cerebral vasospasm.

  13. Optimal admission to higher education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    2016-01-01

    that documents the relevance of theory and illustrates how to apply optimal admission procedures. Indirect gains from optimal admission procedures include the potential for increasing entire cohorts of students' probability of graduating with a higher education degree, thereby increasing the skill level...

  14. Optimal admission to higher education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    2016-01-01

    that documents the relevance of theory and illustrates how to apply optimal admission procedures. Indirect gains from optimal admission procedures include the potential for increasing entire cohorts of students' probability of graduating with a higher education degree, thereby increasing the skill level...

  15. A Randomized Control Trial Exploring the Effect of Mental Rehearsal and Cognitive Visualization on Microsurgery Skills.

    Science.gov (United States)

    Chadha, Priyanka; Hachach-Haram, Nadine; Shurey, Sandra; Mohanna, Pari-Naz

    2016-09-01

    Background Many factors are known to influence the performance of surgeons within the operating theater, including tiredness, previous experience, and stress levels. The effects of mental rehearsal and cognitive visualization on microsurgical skills have not been assessed. Methods Thirty-six subjects recruited from the Northwick Park Microsurgery Skills Course were randomized into three groups; (1) a control group (C) with no mental rehearsal script, (2) a visual anastomosis group (VA), with a detailed rat anastomosis script, and (3) a visual relaxation (VR) group with a relaxation script, unrelated to the anastomosis. Participants ran through relevant scripts from day 2 to 5 and were assessed through recorded arterial rat anastomosis, scored using the structured assessment of microsurgery skills. Results Results were analyzed by double-blinded assessors. No statistical significance was found on Monday and Tuesday (first day post intervention), p = 0.326 (VA vs. C) and p = 0.283 (VR vs. C). A statistically significant difference was noted at the end of day 4; p rehearsal in microsurgery may result in fewer complications from errors and thus lead to enhanced patient safety and better operative outcomes.

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Legislation Tracked by the College Quality Quality Quality Electronic Health Records (EHR) Incentive Program Physician Quality Reporting ... Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for ...

  17. Ostomy Home Skills Program

    Science.gov (United States)

    ... Surgery Resident Skills Curriculum ACS/APDS/ASE Resident Prep Curriculum ACS/ASE Medical Student Core Curriculum ACS/ ... Registry Trauma Education Trauma Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills ...

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Surgery Resident Skills Curriculum ACS/APDS/ASE Resident Prep Curriculum ACS/ASE Medical Student Core Curriculum ACS/ ... Registry Trauma Education Trauma Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills ...

  19. Teaching Reading Skills

    Institute of Scientific and Technical Information of China (English)

    刘恒

    2014-01-01

    Reading skills are very important part in language teaching and learning. This paper is written after attending lectures given by an Australian teacher named Rod Ellis focusing on how to teach reading skills using authentic materials.

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency ... Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for ...

  2. Ostomy Home Skills Program

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    Full Text Available ... You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency ... Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Stay Up to Date with ACS Association Management Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop/Donate ( 0 ) Items American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... AEI Consortium Quarterly ACS Chapter News The CoC Source Committee on Trauma News The Cutting Edge NAPBC ... login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement ...

  7. Ostomy Home Skills Program

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    Full Text Available ... About SSC SSC Membership Directory 2016 Annual Meeting Women's Committee Mentorship Program Outside Activities ACS Archives Contact ... login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement ...

  8. Optimally Stopped Optimization

    Science.gov (United States)

    Vinci, Walter; Lidar, Daniel A.

    2016-11-01

    We combine the fields of heuristic optimization and optimal stopping. We propose a strategy for benchmarking randomized optimization algorithms that minimizes the expected total cost for obtaining a good solution with an optimal number of calls to the solver. To do so, rather than letting the objective function alone define a cost to be minimized, we introduce a further cost-per-call of the algorithm. We show that this problem can be formulated using optimal stopping theory. The expected cost is a flexible figure of merit for benchmarking probabilistic solvers that can be computed when the optimal solution is not known and that avoids the biases and arbitrariness that affect other measures. The optimal stopping formulation of benchmarking directly leads to a real-time optimal-utilization strategy for probabilistic optimizers with practical impact. We apply our formulation to benchmark simulated annealing on a class of maximum-2-satisfiability (MAX2SAT) problems. We also compare the performance of a D-Wave 2X quantum annealer to the Hamze-Freitas-Selby (HFS) solver, a specialized classical heuristic algorithm designed for low-tree-width graphs. On a set of frustrated-loop instances with planted solutions defined on up to N =1098 variables, the D-Wave device is 2 orders of magnitude faster than the HFS solver, and, modulo known caveats related to suboptimal annealing times, exhibits identical scaling with problem size.

  9. Optimization and Optimal Control

    CERN Document Server

    Chinchuluun, Altannar; Enkhbat, Rentsen; Tseveendorj, Ider

    2010-01-01

    During the last four decades there has been a remarkable development in optimization and optimal control. Due to its wide variety of applications, many scientists and researchers have paid attention to fields of optimization and optimal control. A huge number of new theoretical, algorithmic, and computational results have been observed in the last few years. This book gives the latest advances, and due to the rapid development of these fields, there are no other recent publications on the same topics. Key features: Provides a collection of selected contributions giving a state-of-the-art accou

  10. Ostomy Home Skills Program

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    Full Text Available ... Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  11. School Leadership Skill Development

    Science.gov (United States)

    Weigel, Richard A.

    2013-01-01

    The purpose of this study was to investigate the relationship between what is currently understood about skills for school leadership and the need for a greater understanding of those skills. The importance of developing leadership skills to improve school performance and effectiveness is great. In the field of school leadership, most leaders…

  12. Assessing Skill Development

    Science.gov (United States)

    Mueller, Jon

    2008-01-01

    Most educators are familiar with instances of authentic assessment of "content" within the disciplines or of authentic assessment of "discipline-specific skills." In such authentic assessments, students apply the knowledge and skills of the discipline to situations or tasks that replicate real world challenges. The measurement of skills is…

  13. School Leadership Skill Development

    Science.gov (United States)

    Weigel, Richard A.

    2013-01-01

    The purpose of this study was to investigate the relationship between what is currently understood about skills for school leadership and the need for a greater understanding of those skills. The importance of developing leadership skills to improve school performance and effectiveness is great. In the field of school leadership, most leaders…

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... SSC About SSC SSC Membership Directory Annual Meeting ... Ostomy Pediatric Ostomy Ostomía Adulto Order Today Ostomy Home Skills Kit (login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement ...

  15. Ageing and skills

    DEFF Research Database (Denmark)

    Desjardins, Richard; Warnke, Arne Jonas

    of countries. Specifically, repeated measures will enable an analysis of whether there is skill gain and skill loss over the lifespan of cohorts and overtime between cohorts. This is especially important because age-skill profiles observed on the basis of a single cross-section are difficult to interpret...... the lifespan and over time....

  16. Pharmacists' and general practitioners' pharmacology knowledge and pharmacotherapy skills

    NARCIS (Netherlands)

    Keijsers, Carolina J P W; Leendertse, Anne J|info:eu-repo/dai/nl/30482061X; Faber, Adrianne; Brouwers, Jacobus R B J; de Wildt, Dick J; Jansen, Paul A F

    Understanding differences in the pharmacology knowledge and pharmacotherapy skills of pharmacists and physicians is vital to optimizing interprofessional collaboration and education. This study investigated these differences and the potential influence of work experience. The pharmacology knowledge

  17. Pharmacists' and general practitioners' pharmacology knowledge and pharmacotherapy skills

    NARCIS (Netherlands)

    Keijsers, Carolina J P W; Leendertse, Anne J|info:eu-repo/dai/nl/30482061X; Faber, Adrianne; Brouwers, Jacobus R B J; de Wildt, Dick J; Jansen, Paul A F

    2015-01-01

    Understanding differences in the pharmacology knowledge and pharmacotherapy skills of pharmacists and physicians is vital to optimizing interprofessional collaboration and education. This study investigated these differences and the potential influence of work experience. The pharmacology knowledge

  18. Evaluation of a number skills development programme | Pietersen ...

    African Journals Online (AJOL)

    Evaluation of a number skills development programme. ... It was concluded that the use of concrete educational material should be central in the ... in the use of educational equipment and also to create an optimal learning environment.

  19. 桡神经深支损伤的显微修复及疗效分析%THE EFFECTIVE ANALYSIS OF MICROSURGICAL REPAIR OF RADIAL NERVE DEEP BRANCH INJURY

    Institute of Scientific and Technical Information of China (English)

    李锦永; 胡洪良; 王换新; 程学锋

    2012-01-01

    Objective To investigate the effectiveness and surgical skills of microsurgical repair of radial nerve deep branch injury. Methods Between March 2001 and February 2011, 49 cases of radial nerve deep branch injury were treated by microsurgical technique. There were 40 males and 9 females with an average age of 32 years (range, 19-58 years), including 13 cases of knife-cut injury, 9 cases of electric-saw injury, 7 cases of dagger-stab injury, 6 cases of glass-cut injury, 5 cases of iatrogenic injury, 4 cases of Monteggia fracture, 3 cases of nailgun injury, and 2 cases of crush injury of the forearm complicated by fracture of the proximal radius. The disease duration ranged from 3 hours to 3 years and 8 months (mean, 4.9 months). The sites of injury were at front of supinator tube in 15 cases, in the supinator tube in 23 cases, and at back of supinator tube in 11 cases. One-stage repair was performed by end-to-end suture in 21 cases, including 9 cases of epineurial neurorrhaphy and 12 cases of perineurial neurorrhaphv; two-stage repair was performed in 28 cases, including 26 cases of sural nerve graft and 2 cases of neurolysis. Results Postoperative wounds primarily healed. All patients were followed up 21.5 months on average (range, 12-39 months). At last follow-up, in 21 cases of one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 13 cases, and level 4 in 8 cases; in 28 cases of two-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 2 cases, level 4 in 21 cases, level 3 in 4 cases, and level 2 in 1 case; and significant difference was found (Z=-5.340, P=0.000). In 9 cases undergoing epineurial neurorrhaphy at one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 3 cases, and level 4 in 6 cases; in 12 cases undergoing perineurial neurorrhaphy at one-stage repair, the muscle strength of the extensor pollicis longus was level 5 in 10 cases, and level 4 in 2 cases; and

  20. Promoting Team Leadership Skills in Doctoral Candidates

    Science.gov (United States)

    Suleiman, Mahmoud; Whetton, Danny

    2014-01-01

    Doctoral programs can serve as an optimal opportunity for candidates to engage in tasks and activities to transform them and their schools. The paradigm shifts in such preparation involve moving from sitting and getting to making and taking. Most importantly, it requires building leadership skills and styles necessary to bring about desired change…

  1. Functional flexibility good for skills development

    NARCIS (Netherlands)

    Houtman, I.L.D.

    2004-01-01

    Functional flexibility, making optimal use of the employee’s capacity to perform different tasks, is positively related to skills development and involvement in decision-making. It may lead to emotional exhaustion, however, if an imbalance exists, such as high job demands combined with a lack of

  2. Functional flexibility good for skills development

    NARCIS (Netherlands)

    Goudswaard, A.

    2004-01-01

    Making optimal use of the employee’s capacity to perform different tasks (‘functional flexibility’) is positively related to skills development and involvement in decision-making. It may lead to emotional exhaustion, however, if an imbalance exists, such as high job demands combined with a lack of

  3. Functional flexibility good for skills development

    NARCIS (Netherlands)

    Goudswaard, A.

    2004-01-01

    Making optimal use of the employee’s capacity to perform different tasks (‘functional flexibility’) is positively related to skills development and involvement in decision-making. It may lead to emotional exhaustion, however, if an imbalance exists, such as high job demands combined with a lack of a

  4. Critical Thinking Skills and Meaning in English Language Teaching

    Science.gov (United States)

    Masduqi, Harits

    2011-01-01

    Many ELT experts believe that the inclusion of critical thinking skills in English classes is necessary to improve students' English competence. Students' critical thinking skills will be optimally increased if meaning is prioritized in English lessons. Those two inter-related elements can be implemented when teachers do collaborative activities…

  5. Promoting Healthy Weight with "Stability Skills First": A Randomized Trial

    Science.gov (United States)

    Kiernan, Michaela; Brown, Susan D.; Schoffman, Danielle E.; Lee, Katherine; King, Abby C.; Taylor, C. Barr; Schleicher, Nina C.; Perri, Michael G.

    2013-01-01

    Objective: Although behavioral weight-loss interventions produce short-term weight loss, long-term maintenance remains elusive. This randomized trial examined whether learning a novel set of "stability skills" before losing weight improved long-term weight management. Stability skills were designed to optimize individuals' current satisfaction…

  6. Promoting Healthy Weight with "Stability Skills First": A Randomized Trial

    Science.gov (United States)

    Kiernan, Michaela; Brown, Susan D.; Schoffman, Danielle E.; Lee, Katherine; King, Abby C.; Taylor, C. Barr; Schleicher, Nina C.; Perri, Michael G.

    2013-01-01

    Objective: Although behavioral weight-loss interventions produce short-term weight loss, long-term maintenance remains elusive. This randomized trial examined whether learning a novel set of "stability skills" before losing weight improved long-term weight management. Stability skills were designed to optimize individuals' current…

  7. Critical Thinking Skills and Meaning in English Language Teaching

    Science.gov (United States)

    Masduqi, Harits

    2011-01-01

    Many ELT experts believe that the inclusion of critical thinking skills in English classes is necessary to improve students' English competence. Students' critical thinking skills will be optimally increased if meaning is prioritized in English lessons. Those two inter-related elements can be implemented when teachers do collaborative activities…

  8. Microsurgical removal of olfactory groove meningiomas%嗅沟脑膜瘤的显微外科治疗

    Institute of Scientific and Technical Information of China (English)

    梁日生; 周良辅; 毛颖; 张荣; 杨卫忠

    2011-01-01

    目的 探讨进一步提高嗅沟脑膜瘤治疗效果的有效方法.方法 应用显微神经外科技术治疗嗅沟脑膜瘤67例,其中首次发病57例,复发8例,二次复发2例.术中采用改良Derome入路12例,双侧额底入路28例,改良翼点入路21例,单侧额底入路6例.肿瘤切除包括附着硬膜、肿瘤基底增生破坏的骨质以及受累的副鼻窦黏膜,最后对缺损颅底做修补重建.结果 按照脑膜瘤切除的Simpson分级标准,肿瘤获Simpson Ⅰ类切除59例,Ⅱ类切除7例,Ⅳ类切除1例.术后并发脑脊液漏和颅内感染仅1例,经处理治愈.术后1个月内死亡2例(2.9%),死因分别为心衰和下丘脑损伤.47例(72.3%)患者随访1~10年,平均64个月.2例高龄患者死亡,其中1例死于肺炎,1例死因不详.45例生存患者中,复发3例,为Ⅱ类或Ⅳ类切除者,Ⅰ类切除者均无复发.除3例患者仍存在视力下降和2例患者一侧肢体轻瘫外,其余患者恢复良好,已恢复工作或能生活自理.结论 全切除肿瘤(Simpson Ⅰ类)应是嗅沟脑膜瘤的手术目的,特别是新发的病例.选择适当的手术入路是全切除肿瘤的根本保证.采用适当的带血管蒂材料修补、重建前颅底是手术治疗嗅沟脑膜瘤至关重要和必须做到的.%Objective To explore an effective method for further improving the surgical results of treatment of olfactory groove meningiomas.Methods 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.Results Simpson grade

  9. Teaching and Assessing Communication Skills in Medical Undergraduate Training.

    Science.gov (United States)

    Modi, Jyoti Nath; Anshu, -; Chhatwal, Jugesh; Gupta, Piyush; Singh, Tejinder

    2016-06-08

    Good communication skills are essential for an optimal doctor-patient relationship, and also contribute to improved health outcomes. Although the need for training in communication skills is stated as a requirement in the 1997 Graduate Medical Education Regulations of the Medical Council of India, formal training in these skills has been fragmentary and non-uniform in most Indian curricula. The Vision 2015 document of the Medical Council of India reaffirms the need to include training in communication skills in the MBBS curriculum. Training in communication skills needs approaches which are different from that of teaching other clinical subjects. It is also a challenge to ensure that students not only imbibe the nuances of communication and interpersonal skills, but adhere to them throughout their careers. This article addresses the possible ways of standardizing teaching and assessment of communication skills and integrating them into the existing curriculum.

  10. Elments constintute teachers’ teaching skills

    OpenAIRE

    Hoa, H.; Lам, P.

    2014-01-01

    Teachers’ pedagogical activities are constituted by many skills such as teaching skills, education skills, and skills of performing varied pedagogical ac- tivities. Each skill is formed from a variety of specifi c skills. Approaching teachers’ teaching skills based on pedagogical operation base can help us establish methods and develop skills for teachers. By doing so, we can assist teachers to enhance their teaching competence contributing to teaching quality improvement in schools

  11. Cognitive Skill in Medicine: An Introduction

    NARCIS (Netherlands)

    Cnossen, Fokie; Lanzer, Peter

    2015-01-01

    Cognition encompasses all processes from perception to action including attention and memory, reasoning, and decision making. Therefore, all skills (perceptual skills, motor skills, diagnosing skill, medical skills) are cognitive skills. Cognitive skills are supported by two types of knowledge:

  12. 手指皮肤缺损显微外科修复的方法及疗效%Clinical methods and effects of microsurgical repair of finger skin defect

    Institute of Scientific and Technical Information of China (English)

    卢建国; 杨庆达; 苏瑞鉴; 梁波; 梁大喜

    2015-01-01

    as tabatiere anatomique flap) ,the im-proved hand abdominal flap and the improved the first toe web free skin flap and so on. Results Excerpt 3 cases (4 fingers) were suffered with partial flap necrosis and cicatrized after changing dressing, 197 cases(316 fingers) were survived. 128 cases (215 fingers) achieved follow-up. The time of follow-up was 6~60 months. All the follow-up patients′flaps were good in shape and had no dysmorphia of scar contracture. The dialyneurg flap sensation and func-tion got right. The two point discrimination was 4~8mm. According to the criteria by Society of Hand Surgury of Chi-nese Medical Association, the results were excellent in 87 cases (157 fingers),good in 32 (45 fingers),and poor in 9 (13 fingers),and the excellent and good rate was 93. 0%. Conclusions The arteriae metacarpeae dorsales perfo-rator pedicle nutritional flap, the curtaneous nerve dorsum of hand nutritional flap,the index finger dorsal flap, the ar-teria digitals reverse island nutritional flap and the tabatiere anatomique flap can repair wound in the first operation and the dialyneury flap sensation get right. The cross finger flap and the improves hand abdominal flap need to do the second operation to cup the pedicle or separate finger. This method adds operation times and get anchylosis more easi-ly, because the affected extremity are exercise limit so long. But the abdominal flap can cover all fingers soft tissue defect in the first times, because the flaps area is enough. The improved the first toe web free skin flap can repair de-fect directly and do not need the second plastic operation and the dialyneury sensation get right. It requires high skill for microsurgical technique and is hard to popularize in basic level hospital.

  13. Microsurgical treatment of multiple intracranial aneurysms%颅内多发动脉瘤的显微手术治疗

    Institute of Scientific and Technical Information of China (English)

    梁春阳; 徐如祥; 沈春森; 戴宜武; 何江弘; 李运军; 罗永春

    2010-01-01

    Objective To explore the problems of microsurgical treatment of multiple intracranial aneurysms with regard to the indications,surgical timing,operative approaches and the prevention of complications, and improve their diagnoses and treatments. Methods We retrospectively reviewed the data of 33 patients with multiple intracranial aneurysms admitted to our hospital from Jan.2000 to Dec.2008 and their clinical manifestations,imaging features and microsurgical treatments were summarized. Results In the 33 cases of multiple intracranial aneurysms,the male-to-female sex ratio was 1:1.75 and the average age at onset of symptoms was 56.52.Twenty-four patients showed good postoperative prognosis(Glasgow Outcome Scale IV-V) with 2 deaths.Conclusion Individual treatment should be adopted in the treatment of differently localized multiple intracranial aneurysms with different sizes and clinical classifications,and the utilization of temporary blockade and ultrasound during the operation can improve the therapeutic effects and reduce the postoperative complication rates.%目的 探讨颅内多发动脉瘤手术治疗的适应证,手术时机及手术入路、并发症防治等问题,以提高诊断和治疗的水平. 方法 对北京军区总医院神经外科自2000年1月至2008年12月经手术治疗的颅内多发动脉瘤进行回顾性分析研究,总结其发病特点、临床表现及显微手术治疗方法等. 结果 本组颅内多发动脉瘤33例,男、女性别比为1:1.75,发病平均年龄56.52岁.术后良好(GOS IV~V级)24例,死亡2例. 结论 对于不同部位、大小、临床分级的颅内多发性动脉瘤,应采用个体化治疗措施;术中应用临时阻断、超声等辅助技术,对于提高术后疗效并减少手术并发症有重要作用.

  14. Long-term follow-up analysis of microsurgical clip ligation and endovascular coil embolization for dorsal wall blister aneurysms of the internal carotid artery.

    Science.gov (United States)

    Brown, Mason A; Guandique, Cristian F; Parish, Jonathan; McMillan, Aubrey C; Lehnert, Stephen; Mansour, Nassir; Tu, Michael; Bohnstedt, Bradley N; Payner, Troy D; Leipzig, Thomas J; DeNardo, Andrew J; Scott, John A; Cohen-Gadol, Aaron A

    2017-05-01

    Blister aneurysms at non-branching sites of the dorsal internal carotid artery (dICA) are fragile, rare, and often difficult to treat. The purpose of this study is to address the demographics, treatment modalities, and long-term outcome of patients treated for dICA blister aneurysms. A retrospective review of medical records identified all consecutive patients who presented with a blister aneurysm from 2002 to 2011 at our institution. Eighteen patients (M=7, F=11; mean age: 48.4±15.1years; range: 15-65years) harbored a total of 43 aneurysms, 25 of which were dorsal wall blister aneurysms of the ICA. Eleven (61.1%) patients presented with aneurysmal subarachnoid hemorrhage (aSAH), and 10 (55.6%) patients had multiple aneurysms at admission. Twelve patients had 18 aneurysms that were treated microsurgically. Five (41.7%) of these patients had a single recurrence that was retreated with subsequent repeat clip ligation. Six patients had 7 blister aneurysms that were treated with endovascularly. One (16.7%) of these patients had a single recurrence that was retreated with subsequent coil embolization. Postoperative vasospasm occurred in 8 (44.4%) patients, one of whom suffered from a stroke. This is one of the largest single-institution dICA blister aneurysm studies to date. There was no detected significant difference between microsurgical clip ligation and endovascular coil embolization in terms of surgical outcome. These blister aneurysms demonstrate a propensity to be associated with multiple cerebral aneurysms. Strict clinical and angiographic long-term follow-up may be warranted. Blister aneurysms are focal wall defects covered by a thin layer of fibrous tissue and adventitia, lacking the usual collagenous layer. Due to their pathologically thin vessel wall, blister aneurysms are prone to rupture. The management of these rare and fragile aneurysms presents a number of challenges. Here, we address the long-term outcome of patients treated for blister aneurysms at

  15. Microsurgical treatment for medial sphenoid wing meningiomas%内侧型蝶骨嵴脑膜瘤的显微外科手术治疗

    Institute of Scientific and Technical Information of China (English)

    王国军; 李新钢

    2012-01-01

    目的 探讨内侧型蝶骨嵴脑膜瘤的分型和疗效.方法 回顾性分析48例内侧型蝶骨嵴脑膜瘤的分型、显微手术及其预后.结果 所有患者均通过显微外科技术切除肿瘤.Simpson Ⅰ级切除6例,SimpsonⅡ级切除27例,SimpsonⅢ级切除15例.术后视力明显改善20例,6例视力改变不明显,2例出现患侧视力下降.死亡4例(8.3%).平均随访3.5年,随访期间肿瘤复发9例(18.75%).结论 Ⅰ型和Ⅱ型肿瘤全切率较高,而Ⅲ型肿瘤全切率较低;利用显微外科技术充分保护视神经、颈内动脉及其分支,能够提高肿瘤全切率和疗效.%Objective To explore the classification and effectiveness of microsurgical resection of medial sphenoid wing meningiomas. Methods Forty-eight patients with medial sphenoid wing meningiomas were retrospectively reviewed in the classification of meningiomas, microsurgery, and prognosis. Results All meningiomas were resected with micro-surgical treatment. Among them, Simpson grade I was resected in 6 patients, grade II in 27, and grade HI in 15. After operation, there were 20 patients with visual improvement, 6 without significant visual improvement, and 2 with visual decline. 4(8.3%) patients died. 9(18.75%) cases recurred during a mean follow-up period of 3. 5 years. Conclusions Total resection can be achieved in most Type I and Type II , but in a minority of Type M. Making full use of microsargical techniques in preservation of the optic nerve and internal carotid and its perforators can increase the effectiveness of operation.

  16. Research priorities in light of current trends in microsurgical training: revalidation, simulation, cross-training, and standardisation.

    Science.gov (United States)

    Nicholas, Rebecca Spenser; Madada-Nyakauru, Rudo N; Irri, Renu Anita; Myers, Simon Richard; Ghanem, Ali Mahmoud

    2014-05-01

    Plastic surgery training worldwide has seen a thorough restructuring over the past decade, with the introduction of formal training curricula and work-based assessment tools. Part of this process has been the introduction of revalidation and a greater use of simulation in training delivery. Simulation is an increasingly important tool for educators because it provides a way to reduce risks to both trainees and patients, whilst facilitating improved technical proficiency. Current microsurgery training interventions are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess the potential benefits of alternative models, particularly cross-training, a model now widely used in non-medical areas with significant benefits. Furthermore, with the proliferation of microsurgery training interventions and therefore diversity in length, cost, content and models used, appropriate standardisation will be an important factor to ensure that courses deliver consistent and effective training that achieves appropriate levels of competency. Key research requirements should be gathered and used in directing further research in these areas to achieve on-going improvement of microsurgery training.

  17. Teacher's communication skills

    OpenAIRE

    ZIKLOVÁ, Hana

    2010-01-01

    This diploma thesis concerns the area of self-presentation of a teacher and effective use of his communication skills. The thesis is divided into two parts. The first part is theoretical and presents basic concepts of social communication and defines communication skills essential for effective teaching. The practical part is partly based on the output of a questionnaire survey where the author probes knowledge of communication skills of students of pedagogical faculty and how they evaluate t...

  18. Communication skills in context: trends and perspectives.

    Science.gov (United States)

    van Dalen, Jan

    2013-09-01

    Doctor-patient communication has been well researched. Less is known about the educational background of communication skills training. Do we aim for optimal performance of skills, or rather attempt to help students become skilled communicators? An overview is given of the current view on optimal doctor-patient communication. Next we focus on recent literature on how people acquire skills. These two topics are integrated in the next chapter, in which we discuss the optimal training conditions. A longitudinal training design has more lasting results than incidental training. Assessment must be in line with the intended learning outcomes. For transfer, doctor-patient communication must be addressed in all stages of health professions training. Elementary insights from medical education are far from realised in many medical schools. Doctor-patient communication would benefit strongly from more continuity in training and imbedding in the daily working contexts of doctors. When an educational continuum is realised and attention for doctor-patient communication is embedded in the working context of doctors in training the benefits will be strong. Training is only a part of the solution. In view of the current dissatisfaction with doctor-patient communication a change in attitude of course directors is strongly called for. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... CME Accreditation CME Joint Providership Program Verification of Knowledge and Skills ... Practice Management Workshops Patients and Family Patient Education Patient Education ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Verification of Knowledge and Skills Resources Educational Resources Educational Resources E-Learning ... Practice Management Workshops Patients and Family Patient Education Patient Education ...

  1. Taxonomy of Trauma Leadership Skills : A Framework for Leadership Training and Assessment

    NARCIS (Netherlands)

    Leenstra, Nico F; Jung, Oliver C; Johnson, Addie; Wendt, Klaus W; Tulleken, Jaap E

    2016-01-01

    PURPOSE: Good leadership is essential for optimal trauma team performance, and targeted training of leadership skills is necessary to achieve such leadership proficiency. To address the need for a taxonomy of leadership skills that specifies the skill components to be learned and the behaviors by wh

  2. Taxonomy of Trauma Leadership Skills : A Framework for Leadership Training and Assessment

    NARCIS (Netherlands)

    Leenstra, Nico F; Jung, Oliver C; Johnson, Addie; Wendt, Klaus W; Tulleken, Jaap E

    2016-01-01

    PURPOSE: Good leadership is essential for optimal trauma team performance, and targeted training of leadership skills is necessary to achieve such leadership proficiency. To address the need for a taxonomy of leadership skills that specifies the skill components to be learned and the behaviors by wh

  3. Lymphatic microsurgical preventing healing approach (LYMPHA) for primary surgical prevention of breast cancer-related lymphedema: over 4 years follow-up.

    Science.gov (United States)

    Boccardo, Francesco; Casabona, Federico; De Cian, Franco; DeCian, Franco; Friedman, Daniele; Murelli, Federica; Puglisi, Maria; Campisi, Corrado C; Molinari, Lidia; Spinaci, Stefano; Dessalvi, Sara; Campisi, Corradino

    2014-09-01

    Breast cancer-related lymphedema (LE) represents an important morbidity that jeopardizes breast cancer patients' quality of life. Different attempts to prevent LE brought about improvements in the incidence of the pathology but LE still represents a frequent occurrence in breast cancer survivors. Over 4 years ago, Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) was proposed and long-term results are reported in this study. From July 2008 to December 2012, 74 patients underwent axillary nodal dissection for breast cancer treatment together with LYMPHA procedure. Volumetry was performed preoperatively in all patients and after 1, 3, 6, 12 months, and once a year. Lymphoscintigraphy was performed in 45 patients preoperatively and in 30 also postoperatively after at least over 1 year. Seventy one patients had no sign of LE, and volumetry was coincident to preoperative condition. In three patients, LE occurred after 8-12 months postoperatively. Lymphoscintigraphy showed the patency of lymphatic-venous anastomoses at 1-4 years after operation. LYMPHA technique represents a successful surgical procedure for primary prevention of arm LE in breast cancer patients.

  4. A microsurgical procedure for middle cerebral artery occlusion by intraluminal monofilament insertion technique in the rat: a special emphasis on the methodology.

    Science.gov (United States)

    Güzel, Aslan; Rölz, Roland; Nikkhah, Guido; Kahlert, Ulf D; Maciaczyk, Jaroslaw

    2014-01-01

    Although there are many experimental studies describing the methodology of the middle cerebral artery occlusion (MCAO) in the literature, only limited data on these distinct anatomical structures and the details of the surgical procedure in a step by step manner. The aim of the present study simply is to examine the surgical anatomy of MCAO model and its modifications in the rat. Forty Sprague-Dawley rats were used; 20 during the training phase and 20 for the main study. The monofilament sutures were prepared as described in the literature. All surgical steps of the study were performed under the operating microscope, including insertion of monofilament into middle cerebral artery through the internal carotid artery. After an extensive training period, we lost two rats in four weeks. The effects of MCAO were confirmed by the evidence of severe motor deficit during the recovery period, and histopathological findings of infarction were proved in all 18 surviving rats. In this study, a microsurgical guideline of the MCAO model in the rat is provided with the detailed description of all steps of the intraluminal monofilament insertion method with related figures.

  5. Energy metabolism during microsurgical transfer of human skeletal muscle assessed by high-pressure liquid chromatography and by 31P-nuclear magnetic resonance.

    Science.gov (United States)

    Lundberg, Jonas; Elander, Anna; Rakotonirainy, Olivier; Zetterlund, Therese; Fogdestam, Ingemar; Soussi, Bassam

    2002-01-01

    The effect of ischaemia and reperfusion on human skeletal muscle was studied during free vascularised muscle transfer. Muscle biopsy specimens were taken from patients having microsurgical muscle transfer, 18 cases (17 patients; 12 men, 5 women). The biopsies were taken three times: before transfer of the muscle (control), at maximum ischaemic time, and one hour after revascularisation. The biopsy specimens were analysed for purine nucleotides, by high-pressure liquid chromatography (HPLC), and by nuclear magnetic resonance (NMR) at 500 MHz. Phosphocreatine (PCr) recovered only partially (79%) and adenosine triphosphate (ATP) did not differ significantly from normal control after revascularisation and a mean ischaemic time of 114 minutes. NMR measurements showed an accumulation of glucose-6-phosphate (G-6-P) during the ischaemic period, indicating anaerobic metabolism. After three hours of ischaemia and one hour of reperfusion the PCr recovery was less than 60% (r = 0.7). The results confirm those of previous animal studies, which set three hours normothermic ischaemia as a safe limit for tissue preservation when transferring skeletal muscle. Longer ischaemic times may cause serious postoperative healing problems and reduced muscle function.

  6. Esthetic and functional reconstruction of the posttumoral interrupted mandible with double-barrel fibular free flap graft: rationale for a microsurgical and prosthodontic approach.

    Science.gov (United States)

    Paranque, Armand-Régis; Steve, Marc; Vazquez, Lydia; Bolleyn, Alain; Roze-Pellat, Marie-Andrée; Dohan Ehrenfest, David M

    2011-10-01

    Reconstruction after substantial osseous, cutaneous, and muscular tissue loss following a mandibular resection is a challenge. The use of a fibular free flap is an outstanding, but delicate, treatment option. These grafts, using the double-barrel technique, can achieve an almost complete reconstruction of the mandibular defect. The challenge posed by these treatments is to achieve an end result that is both functional and esthetically pleasing-an endeavor that requires a defined prosthetic plan prior to complete microsurgical reconstruction. Using a detailed clinical case, this article discusses the importance of planning the mandible reconstruction with double-barrel fibular graft in view of an implant-supported fixed partial denture. Immediate implant loading was even possible in this case. This approach allows improvement of the final esthetic and functional result of such a complex rehabilitation. Maxillofacial reconstructive surgery should seek to establish a near-as-normal anatomic situation that will allow a permanent implant rehabilitation that is both esthetic and durable.

  7. 大脑前动脉远端破裂动脉瘤的显微外科治疗%Microsurgical treatment for ruptured distal anterior cerebral artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    费小斌; 徐伟东; 那汉荣; 周新民; 潘鹤鸣; 高恒

    2013-01-01

    Objective To evaluate the clinical features and microsurgical strategies of ruptured distal anterior cerebral artery aneurysms ( DACAA). Methods 10 consecutive cases of ruptured DACAA operated from August 2006 to July 2011 were reviewed and followed up. According to Hunt-Hess classification, 2 belonged to grade Ⅰ, 2 gradeⅡ, 5 grade ⅢI and 1 grade Ⅳ. All patients were made definite diagnosis by 64 rows helical CT angiography ( CTA) or Digital Subtraction Angiography (DSA). The diameter of all DACAAs was between 3-16 mm. Pterional approach was selected for 3 cases with A2 aneurysm, 7 cases with A3 aneurysm underwent interhemispheric approach. Results 10 ruptured DACAAs were clipped through microsurgery in 10 cases. 2 cases carried multiple aneurysms. One middle cerebral artery bifurcation aneurysm was clipped through one-stage operation, the other fusiform basal artery aneurysm didn 't receive surgical treatment. According to Glasgow Outcome Scale, all cases were favorable except one death due to severe postoperative cerebral vasospasm. Conclusion Successful clinical management of DACAA depends on appropriate surgical approach and skilled microsurgery techniques.%目的 探讨破裂大脑前动脉远端动脉瘤的临床特征和显微外科治疗方法.方法 回顾性分析2006年8月~ 2011年7月经手术夹闭的10例患者的临床资料.术前Hunt-Hess分级Ⅰ级2例,Ⅱ级2例,Ⅲ级5例,Ⅳ级1例.64排CT血管造影(CTA)或脑血管造影(DSA)确诊.瘤体直径在3~16 mm之间,位于A2段3个,采用翼点入路;A3段7个,采用经大脑纵裂间入路.结果 10例患者的动脉瘤均经显微手术成功夹闭.2例为多发动脉瘤,其中1例大脑中动脉分叉处动脉瘤一期予以夹闭,另1例基底动脉梭形动脉瘤未予治疗.9例患者治疗效果满意,无明显神经功能缺损和其他并发症,1例术后并发严重脑血管痉挛死亡.按照GOS预后评分,9例恢复良好,1例死亡.结论 采用合适的手术入路和

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with educational and simulation ...

  9. learning and soft skills

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard

    2000-01-01

    Learning of soft skills are becoming more and more necessary due to the complexe development of modern companies and their environments. However, there seems to be a 'gap' between intentions and reality regarding need of soft skills and the possiblities to be educated in this subject in particular...

  10. learning and soft skills

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard

    2000-01-01

    Learning of soft skills are becoming more and more necessary due to the complexe development of modern companies and their environments. However, there seems to be a 'gap' between intentions and reality regarding need of soft skills and the possiblities to be educated in this subject in particular...

  11. Development in teaching skills

    NARCIS (Netherlands)

    van de Grift, W.; van der Wal, M.; Torenbeek, M.

    2011-01-01

    Teaching skills are observed in samples of primary schools in the Netherlands, Belgium, Germany, Slowakia, Croatia and Scotland. A sequential level of difficulty in teaching skills has been observed. Activities in the domains 'ensuring a safe and stimulating environment' and 'efficient lesson organi

  12. Testing Skills in Vertebrates

    Science.gov (United States)

    Funk, Mildred Sears; Tosto, Pat

    2007-01-01

    In this article, the authors present a project that gives students examples of basic skills that many vertebrate species develop as they grow and function in their ecosystem. These activities involve information gathering about surroundings, learning how to use objects, and tracking and searching skills. Different vertebrate species may acquire…

  13. Your skills are important

    CERN Document Server

    2004-01-01

    An ambitious project to compile a skills database, known as the Skills and Talents Inventory (STI), was launched at the beginning of this year. The STI is a vital tool for various aspects of human resources management. The Weekly Bulletin has interviewed Mr Andre John Naudi, CERN's Director of Finance and Human Resources, who was the initiator of the project.

  14. Development in teaching skills

    NARCIS (Netherlands)

    van de Grift, W.; van der Wal, M.; Torenbeek, M.

    2011-01-01

    Teaching skills are observed in samples of primary schools in the Netherlands, Belgium, Germany, Slowakia, Croatia and Scotland. A sequential level of difficulty in teaching skills has been observed. Activities in the domains 'ensuring a safe and stimulating environment' and 'efficient lesson

  15. On Range of Skill

    DEFF Research Database (Denmark)

    Hansen, Thomas Dueholm; Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2008-01-01

    size (and doubly exponential in its depth). We also provide techniques that yield concrete bounds for unbalanced game trees and apply these to estimate the Range of Skill of Tic-Tac-Toe and Heads-Up Limit Texas Hold'em Poker. In particular, we show that the Range of Skill of Tic-Tac-Toe is more than...

  16. Electromechanical Technician Skills Questionnaire.

    Science.gov (United States)

    Anoka-Hennepin Technical Coll., Minneapolis, MN.

    This document contains test items to measure the job skills of electromechanical technicians. Questions are organized in four sections that cover the following topics: (1) shop math; (2) electricity and electronics; (3) mechanics and machining; and (4) plumbing, heating, ventilation and air conditioning, and welding skills. Questions call for…

  17. Measuring internet skills

    NARCIS (Netherlands)

    Deursen, van A.J.A.M.; Dijk, van J.A.G.M.

    2010-01-01

    Research that considers Internet skills often lacks theoretical justifications and does not go beyond basic button knowledge. There is a strong need for a measurement framework that can guide future research. In this article, operational definitions for measuring Internet skills are proposed, applie

  18. Testing Skills in Vertebrates

    Science.gov (United States)

    Funk, Mildred Sears; Tosto, Pat

    2007-01-01

    In this article, the authors present a project that gives students examples of basic skills that many vertebrate species develop as they grow and function in their ecosystem. These activities involve information gathering about surroundings, learning how to use objects, and tracking and searching skills. Different vertebrate species may acquire…

  19. Development in teaching skills

    NARCIS (Netherlands)

    van de Grift, W.; van der Wal, M.; Torenbeek, M.

    2011-01-01

    Teaching skills are observed in samples of primary schools in the Netherlands, Belgium, Germany, Slowakia, Croatia and Scotland. A sequential level of difficulty in teaching skills has been observed. Activities in the domains 'ensuring a safe and stimulating environment' and 'efficient lesson organi

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal ... UOAA). The skills kit contains: A booklet with information on the ... and home management. A DVD with demonstration of each skill Stoma ...

  1. Innovation and Academic Skills

    DEFF Research Database (Denmark)

    Nielsen, René Nesgaard

    2006-01-01

    Literature on skill-biased technological and organisational change has established that these kinds of changes are positively related with demand for highly skilled (and highly educated) labour. Most of the literature is based on the hypothesis that technological and organisational change cause...... a larger demand for highly skilled labour (see e.g. Abramovitz and David 1996; Bresnahan 1999), but it has also been argued that ample supply of highly skilled labour may affect technological change (Acemoglu 2002), and that the relationship is likely to be complementary and interdependent (Caroli and Van...... will be written on an assumption of a positive relationship between innovation and use of academic skills subject to a continuing importance of practical know-how and non-formal learning processes. Confronting this assumption with Danish empirics, interesting research questions arise. Danish empirics thus show...

  2. Teaching Professional Engineering Skills

    DEFF Research Database (Denmark)

    Andersson, Niclas; Andersson, Pernille Hammar

    2010-01-01

    Engineering education aims at providing students with sufficient disciplinary knowledge of science and engineering principles in order for them to become successful engineers. However, to fulfil their roles as professional engineers, students also need to develop personal and interpersonal skills......, as well as professional skills, in order to implement and apply their theoretical and technical knowledge in a real context. CDIO constitutes a comprehensive approach to engineering education in which these additional skills represent fundamental principles besides the predominant technical knowledge....... The implementation of professional skills as well as personal and interpersonal skills in engineering teaching must be done, however, without reducing the existing curriculum of technical disciplines and still allow for the continuous acquisition of new technical knowledge. The general purpose of this study...

  3. Ageing and skills

    DEFF Research Database (Denmark)

    Desjardins, Richard; Warnke, Arne Jonas

    The relationship between ageing and skills is becoming an important policy issue, not least in the context of population ageing. Data from the Programme for the International Assessment of Adult Competencies (PIAAC) will potentially add considerably to the understanding of the relationship between...... ageing and foundation skills. In particular, the fact that data from the 1994-1998 International Adult Literacy Survey (IALS) and the 2003-2007 Adult Literacy and Lifeskills Survey (ALL) will be linked with PIAAC offers a unique opportunity to examine trends over time at the cohort level for a wide range...... of countries. Specifically, repeated measures will enable an analysis of whether there is skill gain and skill loss over the lifespan of cohorts and overtime between cohorts. This is especially important because age-skill profiles observed on the basis of a single cross-section are difficult to interpret...

  4. Cognitive Skills in Medicine: An Introduction

    NARCIS (Netherlands)

    Cnossen, Fokie

    2015-01-01

    Cognition encompasses all processes from perception to action including attention and memory, reasoning, and decision making. Therefore, all skills (perceptual skills, motor skills, diagnosing skill, medical skills) are cognitiveskills. Cognitive skills are supported by two types of knowledge:

  5. “互联网+”技能竞赛与会计实训融合式教学优化思考%Thinking of Teaching Optimization in Integration of “Internet + ”Skills Contest and Accounting Practice

    Institute of Scientific and Technical Information of China (English)

    邓莹; 殷明

    2016-01-01

    会计技能竞赛受到越来越多高校的重视,而且在提高会计专业教学质量方面起到了积极的作用,文章试利用互联网+优势,对会计技能竞赛与会计实训融合式教学优化进行思考,进而提出会计实训教学改革的具体措施。%More and more colleges and universities attaches great attention to accounting skills competition,which plays a posi-tive role in improving teaching quality of accounting.This paper tries to take advantage of Internet+,and makes some thinking of teaching optimization;in integration of “Internet+”skills contest and accounting practice and thus puts forward concrete measures for reform of accounting practice teaching.

  6. Optimal immigration, education and growth in the long run.

    Science.gov (United States)

    Shea K--; Woodfield, A E

    1996-01-01

    "The paper extends Manning's model on education and balanced growth to include labour immigration. Each immigration unit is assumed to consist of one skilled worker and some unskilled members. The optimal immigration policy which maximizes the per capita steady-state consumption of the host country is derived. We show that optimal immigration policy can reduce the steady-state skilled labour ratio. More interesting still, contrary to the widespread belief that immigration of skilled workers hurts local skilled workers, it is the unskilled local workers whose interests are threatened by optimal immigration policy." excerpt

  7. Teaching antenatal counseling skills to neonatal providers.

    Science.gov (United States)

    Stokes, Theophil A; Watson, Katie L; Boss, Renee D

    2014-02-01

    Counseling a family confronted with the birth of a periviable neonate is one of the most difficult tasks that a neonatologist must perform. The neonatologist's goal is to facilitate an informed, collaborative decision about whether life-sustaining therapies are in the best interest of this baby. Neonatologists are trained to provide families with a detailed account of the morbidity and mortality data they believe are necessary to facilitate a truly informed decision. Yet these complicated and intensely emotional conversations require advanced communication and counseling skills that our current fellowship-training strategies are not adequately providing. We review educational models for training neonatology fellows to provide antenatal counseling at the threshold of viability. We believe that training aimed at teaching these skills should be incorporated into the neonatal-perinatal medicine fellowship. The optimal approaches for teaching these skills remain uncertain, and there is a need for continued innovation and outcomes-based research.

  8. Trismus Secondary Release Surgery and Microsurgical Free Flap Reconstruction After Surgical Treatment of Head and Neck Cancer.

    Science.gov (United States)

    Chang, Yang-Ming; Deek, Nidal Farhan Al; Wei, Fu-Chan

    2016-10-01

    This article addresses trismus following head and neck cancer ablation and free flap reconstruction whether or not radiotherapy has been utilized. The focus is to achieve durable and favorable outcomes and avoid untoward results. To aid surgeons in fulfilling these goals, key factors, including adequate release surgery, optimal free flap selection and reconstruction, long-lasting results, and the untoward outcomes specific to trismus release and reconstruction surgery and how to avoid them have been investigated and discussed based on the authors' experience in this surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Wages and Skills Utilization: Effect of Broad Skills and Generic Skills on Wages in Singapore

    Science.gov (United States)

    Ramos, Catherine R.; Ng, Michael Chi Man; Sung, Johnny; Loke, Fiona

    2013-01-01

    Many people go for training to upgrade their skills which is hoped to pave the way for better pay. But what are the kinds of skills that really affect wages? Employers have emphasized the value of generic skills such as interpersonal and communication skills, teamwork and problem solving. Does possession of these skills translate to at least the…

  10. CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY

    Energy Technology Data Exchange (ETDEWEB)

    BERGMAN, T. B.; STEFANSKI, L. D.; SEELEY, P. N.; ZINSLI, L. C.; CUSACK, L. J.

    2012-09-19

    THE CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY WAS CONDUCTED TO DEVELOP AN OPTIMAL SEQUENCE OF REMEDIATION ACTIVITIES IMPLEMENTING THE CERCLA DECISION ON THE CENTRAL PLATEAU. THE STUDY DEFINES A SEQUENCE OF ACTIVITIES THAT RESULT IN AN EFFECTIVE USE OF RESOURCES FROM A STRATEGIC PERSPECTIVE WHEN CONSIDERING EQUIPMENT PROCUREMENT AND STAGING, WORKFORCE MOBILIZATION/DEMOBILIZATION, WORKFORCE LEVELING, WORKFORCE SKILL-MIX, AND OTHER REMEDIATION/DISPOSITION PROJECT EXECUTION PARAMETERS.

  11. Culinary Life Skills Recipe Guide

    OpenAIRE

    Seberry, Dermot

    2010-01-01

    A book of recipes designed to teach men in rehab, the life skills to cook in their home. Designed to develop domestic skills, social skills and achievement of a FETAC accredited award towards a culinary qualification.

  12. Manipulator Design and Operation for a Six-Degree-of-Freedom Handheld Tremor-Canceling Microsurgical Instrument.

    Science.gov (United States)

    Yang, Sungwook; MacLachlan, Robert A; Riviere, Cameron N

    2015-04-01

    This paper presents the design and actuation of a six-degree-of-freedom (6-DOF) manipulator for a handheld instrument, known as "Micron," which performs active tremor compensation during microsurgery. The design incorporates a Gough-Stewart platform based on piezoelectric linear motor, with a specified minimum workspace of a cylinder 4 mm long and 4 mm in diameter at the end-effector. Given the stall force of the motors and the loading typically encountered in vitreoretinal microsurgery, the dimensions of the manipulator are optimized to tolerate a transverse load of 0.2 N on a remote center of motion near the midpoint of the tool shaft. The optimization yields a base diameter of 23 mm and a height of 37 mm. The fully handheld instrument includes a custom-built optical tracking system for control feedback, and an ergonomic housing to serve as a handle. The manipulation performance was investigated in both clamped and handheld conditions. In positioning experiments with varying side loads, the manipulator tolerates side load up to 0.25 N while tracking a sinusoidal target trajectory with less than 20 μm error. Physiological hand tremor is reduced by about 90% in a pointing task, and error less than 25 μm is achieved in handheld circle-tracing.

  13. Floorball game skills (evaluation criteria)

    OpenAIRE

    Chlumský, Marek

    2013-01-01

    Title: Playing skills in floorball (evaluation criteria). Target: To create a list of playing skills which an ideal player should demonstrate. Find and verify the evaluation criteria of these skills and inspire trainers to develop these skills in the best way. Methods: Informal interviews, individually structured interviews, analysis and verification of data, pilot testing. Results: Defined playing skills in floorball, developed scale of values of floorball playing skills, creation of exercis...

  14. What is Skilled Coping?

    DEFF Research Database (Denmark)

    Høffding, Simon

    2014-01-01

    The paper uses a phenomenological analysis of interviews with a professional string quartet to critique the notion of ‘skilled coping’ as used by Hubert Dreyfus. According to Dreyfus, skilled coping is a way of being and acting in which one is immersed in one’s actions such that one is not thinking......-called skilled coping, rather than a distinct phenomenon, is a series of connected mental phenomena that span highly reflective stances as well as trance-like states of absorption. Therefore, I point out that Dreyfus’s problematic usage in fact prevents us from appreciating the phenomenological complexity...

  15. Presentation skills for nurses.

    Science.gov (United States)

    Foulkes, Mark

    2015-02-20

    This article emphasises the importance of effective presentation skills. Such skills allow nurses to share knowledge and expertise and to communicate clearly in a range of workplace scenarios. Nurses are increasingly being asked to present in formal and informal situations, such as conferences, poster presentations, job interviews, case reports and ward-based teaching. This article explores the principles underpinning the development of these skills, discusses the situations in which they could be applied and demonstrates how nurses might improve and develop as presenters.

  16. Rethinking generic skills

    Directory of Open Access Journals (Sweden)

    Roy Canning

    2013-10-01

    Full Text Available The paper provides a critical analysis of the notion of generic or transversal skillscontained with European Union policy discourses. The author presents a conceptualframework that challenges the idea that generic skills are universal, transferable andautonomous. An alternative analysis is put forward that argues the case forcontextualising skills and knowledge within particular understandings and cultures thatare more collective than individualistic in nature. The arguments are framed withinwider cross-disciplinary debates in linguistics, geosemiotics and social-cultural theoryand build upon an earlier paper exploring core skills in the UK (Canning, 2007.

  17. Improve your communication skills

    CERN Document Server

    Barker, Alan

    2016-01-01

    Excellent communication skills are vital in today's workplace. Whether keeping the interest of a large audience, impressing a potential employer or simply winning the argument at an important meeting, sounding the part is key. This fourth edition of Improve Your Communication Skills is full of practical advice on all aspects of verbal and non-verbal communication. It gives vital tips on improving conversations and building rapport with colleagues, learning the skills of persuasion, and writing effective emails, letters and reports. This editionincludes new information focusing on communicating across borders and virtual teams and a new chapter on managing difficult conversations."

  18. 试论基于实现“体面就业”的职业技能开发政策体系的完善%On the Optimization of Vocational Skill Develepment Policy System Based on the Realization of“Getting a Decent Job”

    Institute of Scientific and Technical Information of China (English)

    徐向平

    2013-01-01

    The development of vacational skill is the core means of enhancing labor productivity, which is a very imporant premise to promote the economic and social development and realize getting a decent job. Lower qulity by vacational skill process may result in a vicious circle of lower education level, lower labor productivity and lower labor income for the whole society, thus losing the cornerstone of the realization of getting a decent job;therefore, in order to make the economic society step into a virtuous circle with higher labor productivity, decent jobs and higher labor income, an optimized and efficient policy system should be established by the state to take concrete and effective measures to strengthen the development of vocational skills and to improve the citizens’uptrend channel based on the enhancement of vocational skills.%  职业技能开发是增强劳动生产力的核心手段,而劳动生产力的提高则是促进经济社会发展、实现“体面就业”的重要前提。职业技能加工品质不高的直接后果是经济社会发展陷入低教育水平、低劳动生产力和低劳动收入的恶性循环,整个社会将丧失实现“体面就业”的基石。经济社会要步入较高劳动生产力、体面就业以及较高劳动收入的良性发展循环,国家需要完善有效的政策体系,采取切实措施加强职业技能开发,改善国民基于增强职业技能的上升通道。

  19. Skill development in experimental courses

    National Research Council Canada - National Science Library

    Bagán, Héctor; Sayós, Rosa; García, José Francisco

    2015-01-01

    ..., promoting reflexive learning and developing generic skills. This study presents different ways of developing and evaluating some important general skills, settle on four specific objectives: 1...

  20. Microsurgical treatment of type Ⅰ diastematomyelia in 75 children%75例儿童脊髓纵裂Ⅰ型的显微外科治疗

    Institute of Scientific and Technical Information of China (English)

    崔志强; 修波; 孙振兴; 萧凯; 段虹宇

    2012-01-01

    Objective To evaluate the therapeutic effect of microsurgicaltreatment for childrenwith type Ⅰ diastematomyelia.Methods The clinical data of 75 cases including neurological examination,MRI and three dimensional CT reconstruction were collected.The microsurgical treatment of type Ⅰ diastematomyeliawas performed in all patients.Neurological examination,high-speed bone drill and microscope were used during operation.Electrophysiological examination was performed before and after surgery.The microsurgical treatment of Lipoma Tethered cord syndromewas performed in all cases and the therapeutic effectiveness after operation was analyzed according to clinical symptoms,urodynamicalexamination and electrophysiological examination inthe patients.Results According to Cheng -bin grading system,the short term effects were assessedas following:recovery in 7 cases,excellent in 24,effeetive in 40 and ineffective in 4.The markedly effective rate was 94.6%.There were significant differences in urodynamicalexamination between presurgery and postsurgery.There was significant difference in electrophysiologicalexamination between presurgery and postsurgery.Conclusions The microsurgery should be performed on tethered cord syndrome as soon as possible.The application of intraoperative neuroelectrophysiological monitoring and high-speed bone drill can be used for type Ⅰ diastematomyeliain children.%目的 通过对75例儿童脊髓纵裂I型临床资料分析,评价其显微外科治疗疗效.方法 患者术前均行神经系统检查、MRI检查以及CT检查,并经显微外科手术治疗,手术中综合运用电生理检测、气动磨钻及显微镜等设备.手术前后相应地应用尿动力学,神经电生理等检查方法.术后疗效根据临床症状、尿动力学和神经电生理等结果进行对比评定.结果 根据程斌等提出的临床疗效:本组75例患儿中,术后疗效优(痊愈)1例,良(显效)30例,可(有效)40例,差(无效)4例,总有效率94.6

  1. Microsurgical treatment of spinal cord congenital tumors%椎管内先天性肿瘤的显微外科治疗

    Institute of Scientific and Technical Information of China (English)

    黄忻涛; 万大海; 王宏勤; 马宁; 薛乃照; 赵学明; 郝解贺; 王振宇

    2016-01-01

    Objective:To characterize the microsurgical treatment of spinal cord congenital tumors and explore the experiences of pa-tients who have undergone the treatment. Methods:The clinical data of 50 patients with spinal cord congenital tumors (from August 2010 to August 2015) were analyzed retrospectively. The characteristics of different types of tumor and surgical techniques were dis-cussed. Results:The age of patients with spinal cord congenital tumors is relatively young. Most tumors are located in the lumbar and sacral regions. In the 50 cases, total tumor removal was achieved in 11 cases, subtotal in 9, partial in 29, and cyst fistulation in 1. We al-so found 10 cases of epidermoid cyst, 8 cases of dermoid cyst, 13 cases of mature teratoma, 9 cases of lipoma (2 of angiolipoma), 4 cases of intestinal cyst, 3 cases of arachnoid cyst, 1 case of glial ependymal cyst, 1 case of hamartoma, and 1 case without pathological diagnosis. The postoperative complications included 1 case of meningitis and 1 case of incision infection. Of the 50 cases, 39 have been followed up from 3 months to 2 years. Recurrence was observed in 3 cases. Conclusion:Spinal cord congenital tumors could be revealed and removed satisfactorily with fewer surgical complications through microsurgical treatment.%目的:探讨椎管内先天性肿瘤的特点及显微外科治疗体会。方法:回顾性分析山西医科大学第一医院2010年8月至2015年8月50例椎管内先天性肿瘤患者的临床资料,对不同类型肿瘤的特点、术中技巧等问题进行探讨。结果:椎管内先天性肿瘤患者发病年龄较轻,大部分位于腰骶部。50例患者中,肿瘤全切11例,近全切9例,大部分切除29例,囊肿造瘘1例。病检表皮样囊肿10例、皮样囊肿8例、成熟畸胎瘤13例、脂肪瘤9例(血管脂肪瘤2例)、肠源性囊肿4例、蛛网膜囊肿3例、胶质室管膜囊肿1例、错构瘤1例、未获得病理诊断1例。手术并

  2. A-level skills

    Science.gov (United States)

    Downie, Neil A.

    2016-12-01

    In reply to the Graduate Careers article "Taking the long view" (October 2016 pp48–50), in which Patrick White and Emma Smith suggest that talk of a skills shortage in science, technology, engineering and mathematics (STEM) is overblown.

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Skills Resources Educational Resources Educational Resources E-Learning Evidence-Based Decisions in Surgery Medical Student Resources ... Scholars in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry Trauma Education ...

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Skills Resources Educational Resources Educational Resources E-Learning Evidence-Based Decisions in Surgery Medical Student Resources ... College of Surgeons Collections Highlights Research Surgical History Group Icons in Surgery Archives Catalog Contact Us Careers ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Skills Resources Educational Resources Educational Resources E-Learning Evidence-Based Decisions in Surgery Medical Student Resources ... Emergency Preparedness Rural Trauma Team Development Course Trauma Evaluation and Management Trauma CME Nora Institute Nora Institute ...

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Skills Resources Educational Resources Educational Resources E-Learning Evidence-Based Decisions in Surgery Medical Student Resources So You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency ...

  7. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Patients Medical Professionals Skills Programs Find a Treatment Center Patient Safety Resources About the Patient Education ... Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of ...

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and Emergency Preparedness Rural Trauma Team Development Course Trauma Evaluation and Management Trauma CME Nora ...

  9. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education ... Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and ...

  10. On English Reading Skills

    Institute of Scientific and Technical Information of China (English)

    钱芬

    2008-01-01

    Reading is one of the four important skills in English learning.It is also a skill that the students need to possess to support independent and self-directed learning.With the development of society,science and technology develop at hish speed and the competition in the society become sharp.Reading is a way for students to be more knowledgeable and successful.So,it becomes more and more important to speed up their reading in order to acquire as much information as possible.Thus,fostering a good English reading habit is essential,and being able to adopt different reading skills for different reading materials and purposes will also help to read more effectively.The paper mainly concenls some basic English reading skills.

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Resources in Surgical Education ACS Fundamentals of Surgery Curriculum Transition to Practice Program ACS/APDS Surgery Resident Skills Curriculum ACS/APDS/ASE Resident Prep Curriculum ACS/ASE ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Surgical Patient Safety Nora Institute for Surgical Patient Safety Advanced Skills Course for Rural Surgeons Support the Work of the Nora Institute Featured Articles Nora Institute ...

  13. On Range of Skill

    DEFF Research Database (Denmark)

    Hansen, Thomas Dueholm; Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2008-01-01

    is a small number, but only gave heuristic arguments for this. In this paper, we provide the first methods for rigorously estimating the Range of Skill of a given game. We provide some general, asymptotic bounds that imply that the Range of Skill of a perfectly balanced game tree is almost exponential in its...... size (and doubly exponential in its depth). We also provide techniques that yield concrete bounds for unbalanced game trees and apply these to estimate the Range of Skill of Tic-Tac-Toe and Heads-Up Limit Texas Hold'em Poker. In particular, we show that the Range of Skill of Tic-Tac-Toe is more than...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... CME Accreditation CME Joint Providership Program Verification of Knowledge and Skills Resources Educational Resources Educational Resources E-Learning Evidence-Based Decisions in Surgery Medical Student Resources So You Want to Be a Surgeon ...

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... SESAP SESAP Sampler SRGS ACS Fundamentals of Surgery Curriculum Transition to Practice Program ACS/APDS Surgery Resident Skills Curriculum ACS/APDS/ASE Resident Prep Curriculum Medical Student ...

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Liability Surgeons as Advocates Surgeons and Bundled Payment Models Surgeons as Institutional Employees Our Changing Health Care ... DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample ...

  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education ... Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and ...

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Improvement Program Mentoring for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program ... Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure in Trauma Advanced Trauma ...

  19. Skilled Nursing Facility PPS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 4432(a) of the Balanced Budget Act (BBA) of 1997 modified how payment is made for Medicare skilled nursing facility (SNF) services. Effective with cost...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... Nurses (CETN), and the United Ostomy Associations of America (UOAA). The skills kit contains: A booklet with ...

  2. Comparative evaluation of recession coverage with sub-epithelial connective tissue graft using macrosurgical and microsurgical approaches: A randomized split mouth study

    Directory of Open Access Journals (Sweden)

    Uditi Jindal

    2015-01-01

    Full Text Available Aims: The aim was to compare the recession coverage outcomes when done macrosurgically and microsurgically. Background: Increasing interest in esthetics and the related problems such as hypersensitivity and root caries have favored the development of many root coverage procedures. Recession coverage up to a certain extent has solved these problems, but these procedures need good maintenance after the surgery for long-term benefits. With increasing advances in the field of recession coverage, microscope has added another dimension in undertaking the surgical procedure. Materials and Methods: Thirty Miller′s Class I and II recession were treated using the sub-epithelial connective tissue graft from the palate. In 15 sites, the graft was placed at the recipient site with unaided eye (Group A and in other 15 sites the graft was placed using surgical microscope (Group B. Clinical evaluation was done at baseline, 12 weeks and 24 weeks postoperatively using plaque index, gingival index, vertical recession (VR, probing depth, clinical attachment level (CAL, width of attached gingiva, papilla height (PH and width, malalignment index (MI and esthetic appearance. Statistical Analysis Used: Paired and unpaired Student′s t-test along with Wilcoxon Z-test were used to analyze the results and probability of P < 0.05 were accepted to reject the null hypothesis. Pearson correlation was used to correlate two parameters such as VR and CAL and MI and VR. Results: Both the techniques demonstrated predictable mean root coverage (Group A 61.78% and Group B 67.58% at 6 months postsurgery. CAL gain was slightly better in Group B patients when compared to Group A patients. A moderate positive correlation for Group A while a mild correlation in Group B was seen between the MI and VR. Conclusion: The use of the microscope enhances the results, but obtaining an expertise in using needs a lot of practice. The periodontal healing by both techniques should be evaluated

  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.

  4. What Is the Ideal Free Flap for Soft Tissue Reconstruction? A Ten-Year Experience of Microsurgical Reconstruction Using 334 Latissimus Dorsi Flaps From a Universal Donor Site.

    Science.gov (United States)

    Kim, Jeong Tae; Kim, Sang Wha; Youn, Seungki; Kim, Youn Hwan

    2015-07-01

    Microsurgical free tissue transfer is regarded as the best available method of tissue reconstruction for intractable defects. The ideal soft tissue flap is thought to be the anterolateral thigh flap. On the basis of 334 procedures involving the latissimus dorsi (LD) flap, we discuss the advantages of the LD flap over the current universal option, and we aimed to establish whether the LD could also gain universal status in all reconstructive fields.Three hundred thirty-four reconstructive procedures using the LD flap were performed in 322 patients between September 2002 and July 2012. In accordance with defect characteristics, we performed 334 procedures using flaps, which included the LD muscle flap with skin graft, the myocutaneous flap, the muscle-sparing flap, the perforator flap, the chimeric flap, and the 2-flap technique using the serratus anterior branch.Flap-related complications occurred in 21 patients (6.3%), including total and partial flap failure. In 253 cases, the donor site was closed primarily, and in the remaining cases, we used split-thickness skin grafts. Donor-site complications occurred in 20 cases (6%). In 11 of the 182 cases, no suitable perforators were identified during surgery.The advantages of the LD as a donor site include the possibility of various harvesting positions without position change, versatility of components, availability of muscle to fill extensive defects, and presence of thick fascia to enable full abdominal reconstruction. On the basis of our experience, we concluded that this flap has the potential to be used as widely as, or in preference to, the anterolateral thigh flap in most reconstructive areas.

  5. Entrepreneurial Integration Skills

    DEFF Research Database (Denmark)

    Bauer, Florian; Schriber, Svante; King, David R.

    2016-01-01

    effect relationships by investigating the effect of integration related decisions on intermediate goals. Additionally, we argue that entrepreneurial integration skills, or proactivity under ambiguity, are needed to keep pace with the dynamism inherent in acquisition integration. Based on primary data...... on 116 acquisitions, we find that entrepreneurial integration skills can display both advantages and disadvantages. While it helps to realize expected and serendipitous synergies, it can also trigger employee uncertainty due to decreased transparency. In supplementary analysis, we show measures...

  6. Interpersonal Skills Summary Report

    Science.gov (United States)

    2013-08-01

    training . Behavior Therapy, 8(2), 222-228. 2 2 Meloy, J. R. (1980). The effect of assertiveness training on the personality construct extraversion ...guidelines for the relative effectiveness of different training methods for acquiring and transferring skills involved in complex task domains. Broadly...the current report seeks to provide an update regarding the current state of the science on interpersonal skills (IPS) training . Specifically, this

  7. Teaching Receptive Skills

    Institute of Scientific and Technical Information of China (English)

    Russell Stannard

    2005-01-01

    @@ Many ELT practitioners believe that listening is one of the most important skills that can be developed. The argument is that if students can develop their listening skills they can begin to learn themselves, they can become autonomous and learn in the way many native speakers learn their first language through hearing. When I teach listening in the class I think there are six main considerations that underpin my approach.

  8. optimal control

    Directory of Open Access Journals (Sweden)

    L. I. Rozonoer

    1999-01-01

    Full Text Available Necessary and sufficient conditions for existence of optimal control for all initial data are proved for LQ-optimization problem. If these conditions are fulfilled, necessary and sufficient conditions of optimality are formulated. Basing on the results, some general hypotheses on optimal control in terms of Pontryagin's maximum condition and Bellman's equation are proposed.

  9. Open knot-tying skills: residents skills assessed

    NARCIS (Netherlands)

    van Empel, P.J.; Verdam, M.G.E.; Huirne, J.A.; Bonjer, H.J.; Meijerink, W.J.; Scheele, F.

    2013-01-01

    Aim: Open knot-tying and suturing skills are fundamental surgical skills, founding many alternative knot-tying techniques. It is therefore mandatory for residents to possess adequate basic open knot-tying skills. The aim of this study was to compare an objective assessment of open knot-tying skills

  10. Contribution of Oral Language Skills, Linguistic Skills, and Transcription Skills to Chinese Written Composition among Fourth-Grade Students

    Science.gov (United States)

    Yeung, Pui-sze; Ho, Connie Suk-han; Chan, David Wai-ock; Chung, Kevin Kien-hoa

    2013-01-01

    The present study aimed to investigate the contribution of oral language skills, linguistic skills, and transcription skills to Chinese written composition among Grade 4 students in Hong Kong. Measures assessing verbal working memory, oral language skills, linguistic skills (i.e., syntactic skills and discourse skills), transcription skills (i.e.,…

  11. Contribution of Oral Language Skills, Linguistic Skills, and Transcription Skills to Chinese Written Composition among Fourth-Grade Students

    Science.gov (United States)

    Yeung, Pui-sze; Ho, Connie Suk-han; Chan, David Wai-ock; Chung, Kevin Kien-hoa

    2013-01-01

    The present study aimed to investigate the contribution of oral language skills, linguistic skills, and transcription skills to Chinese written composition among Grade 4 students in Hong Kong. Measures assessing verbal working memory, oral language skills, linguistic skills (i.e., syntactic skills and discourse skills), transcription skills (i.e.,…

  12. Let your communication skills equal your clinical skills.

    Science.gov (United States)

    Demarais, Ann; Baum, Neil

    2012-01-01

    Relating effectively with patients is among the most valued skills of clinical care. Honing your communication skills is an art that every physician needs to learn and understand. In this era of increased volume of patients there is a tendency to lose sight of the importance of having good communication skills. This article will review 11 suggestions for letting your communication skills equal your clinical skills.

  13. Relationship between literacy skills and self-reported health in the Nordic countries.

    Science.gov (United States)

    Lundetræ, Kjersti; Gabrielsen, Egil

    2016-12-01

    This study investigated the association between literacy skills and self-reported health among Danish ( n = 7284), Finnish ( n = 5454), Norwegian ( n = 4942) and Swedish ( n = 4555) participants aged 16-65 years. Logistic regression models were used to assess the association between literacy skills and self-reported health after adjusting for sex, age and educational level. Nordic participants aged 16-65 years with literacy skills at the lowest level reported sub-optimal health more often (28-37%) than those with literacy skills at the highest level (7-9%). After adjusting for sex, age and educational level, the likelihood of reporting sub-optimal health was 1.99-3.24 times as high for those with literacy skills at the lowest level as for those with literacy skills at the highest level. These results suggest that poor literacy skills increase the likelihood of experiencing poor health in the Nordic countries, even after controlling for educational level.

  14. Employability Skills Assessment Tool Development

    Science.gov (United States)

    Rasul, Mohamad Sattar; Rauf, Rose Amnah Abd; Mansor, Azlin Norhaini; Puvanasvaran, A. P.

    2012-01-01

    Research nationally and internationally found that technical graduates are lacking in employability skills. As employability skills are crucial in outcome-based education, the main goal of this research is to develop an Employability Skill Assessment Tool to help students and lecturers produce competent graduates in employability skills needed by…

  15. Mathematical Skills and Motor Life Skills in Toddlers: Do Differences in Mathematical Skills Reflect Differences in Motor Skills?

    Science.gov (United States)

    Reikerås, Elin; Moser, Thomas; Tønnessen, Finn Egil

    2017-01-01

    This study examines possible relations between early mathematical skills and motor life skills in 450 toddlers aged two years and nine months. The study employs baseline data from the longitudinal Stavanger Project--The Learning Child. The children's mathematical skills and motor life skills were assessed by structured observation in the natural…

  16. Digital literacy and safety skills

    NARCIS (Netherlands)

    Sonck, N.; Livingstone, S.; Kuiper, E.; de Haan, J.

    2011-01-01

    Children’s digital skills were assessed by asking 25,000 European 9-16 year old internet users about their online activities, skills and self-efficacy. The range of digital skills and online activities are linked. But many younger (11-13 year old) children lack key critical and safety skills. Also,

  17. Digital literacy and safety skills

    NARCIS (Netherlands)

    Sonck, N.; Livingstone, S.; Kuiper, E.; de Haan, J.

    2011-01-01

    Children’s digital skills were assessed by asking 25,000 European 9-16 year old internet users about their online activities, skills and self-efficacy. The range of digital skills and online activities are linked. But many younger (11-13 year old) children lack key critical and safety skills. Also,

  18. Microsurgical treatment of large acoustic neuromas%大型听神经瘤的显微手术

    Institute of Scientific and Technical Information of China (English)

    陈晓雷; 朱风仪; 赵春生; 周明卫; 骆慧; 刘宁

    2008-01-01

    Objective To explore the skill of mien)surgical removal and preservation and functional recovery of facial nerve for large acoustic neuromas.Methods The clinical data of 82 consecutive patients with large acoustic neuromas operated upon through the suboccipital retrosigmoid approach were retrospectively reviewed.The cases with HB grade Ⅲ - Ⅵ of facial nerve were divided randomly into two groups,the one group was given conventional therapy and the other group was given Kabato rehabilitation training.Results In those cases,acoustic neuromas were totally removed in 77 (93.9%),subtotally removed in 5.Facial nerve was kept anatomically intact in 78 cases of the patients (95.1%).Recovery of facial nerve function was faster and more effective in the training group than that in the un-training group.During the follow-up ranging from 6 months to 3 years,among 5 cases of subtotally resection,2 cases relapsed.Three patients in our series complained of chronic headache postoperatively.No patient long time coma or died.Conclusion The goal of large acoustic neuromas treatment should be total removal in one stage and preservation of facial nerve function,as they determine a patient's quality of life.Kabat rehabilitation training is the effective method of functional recovery of facial nerve after operation.%目的 报道大型听神经瘤显微手术切除、面神经解剖保留及功能恢复的临床效果.方法 采用枕下乙状窦后入路切除大型听神经瘤82例,并将术后面神经功能HB分级为Ⅲ~Ⅵ级者随机分为2组,分别予Kabato康复训练和常规治疗,对其临床资料进行回顾性总结.结果 肿瘤全部切除77例(93.9%),次全切除5例.面神经解剖保留78例(95.1%),术后训练组面神经功能恢复较快,且显效率和有效率均明显高于非训练组.随访6个月~3年,次全切除5例中复发2例,3例患者出现慢性头痛,无长期昏迷、死亡病例.结论 全切除肿瘤的同时保留面神经功能,是大

  19. Teacher’s Interpersonal skills

    Institute of Scientific and Technical Information of China (English)

    孙雪莲

    2011-01-01

    Teacher’s interpersonal skills play a significant role in the teaching quality and students’ improvement.Interpersonal skill is complicate and involves a great deal of skills.Due to the limited space,the paper only gives a description of the core skills which are key to teachers in the teaching and learning process.This paper is divided into three parts:what interpersonal skills are important to teachers,why these skills are important and how teachers can develop these skills to improve their teaching and students’ learning.In the first part,understanding others,self-presentation,communicating,and influencing by persuading or power were found to be the most important skills in related research and literature.The second part discusses the importance of interpersonal skills both from teacher’s teaching quality and students’ learning outcome.The last part of the paper lists some suggestions on how to improve teacher’s interpersonal skills.

  20. Soft skills and dental education.

    Science.gov (United States)

    Gonzalez, M A G; Abu Kasim, N H; Naimie, Z

    2013-05-01

    Soft skills and hard skills are essential in the practice of dentistry. While hard skills deal with technical proficiency, soft skills relate to a personal values and interpersonal skills that determine a person's ability to fit in a particular situation. These skills contribute to the success of organisations that deal face-to-face with clients. Effective soft skills benefit the dental practice. However, the teaching of soft skills remains a challenge to dental schools. This paper discusses the different soft skills, how they are taught and assessed and the issues that need to be addressed in their teaching and assessment. The use of the module by the Faculty of Dentistry, University of Malaya for development of soft skills for institutions of higher learning introduced by the Ministry of Higher Education, Malaysia.

  1. Training a sophisticated microsurgical technique: interposition of external jugular vein graft in the common carotid artery in rats.

    Science.gov (United States)

    Schleimer, Karina; Grommes, Jochen; Greiner, Andreas; Jalaie, Houman; Kalder, Johannes; Langer, Stephan; Koeppel, Thomas A; Jacobs, Michael; Kokozidou, Maria

    2012-11-11

    Neointimal hyperplasia is one the primary causes of stenosis in arterialized veins that are of great importance in arterial coronary bypass surgery, in peripheral arterial bypass surgery as well as in arteriovenous fistulas.(1-5) The experimental procedure of vein graft interposition in the common carotid artery by using the cuff-technique has been applied in several research projects to examine the aetiology of neointimal hyperplasia and therapeutic options to address it. (6-8) The cuff prevents vessel anastomotic remodeling and induces turbulence within the graft and thereby the development of neointimal hyperplasia. Using the superior caval vein graft is an established small-animal model for venous arterialization experiment.(9-11) This current protocol refers to an established jugular vein graft interposition technique first described by Zou et al., (9) as well as others.(12-14) Nevertheless, these cited small animal protocols are complicated. To simplify the procedure and to minimize the number of experimental animals needed, a detailed operation protocol by video training is presented. This video should help the novice surgeon to learn both the cuff-technique and the vein graft interposition. Hereby, the right external jugular vein was grafted in cuff-technique in the common carotid artery of 21 female Sprague Dawley rats categorized in three equal groups that were sacrificed on day 21, 42 and 84, respectively. Notably, no donor animals were needed, because auto-transplantations were performed. The survival rate was 100 % at the time point of sacrifice. In addition, the graft patency rate was 60 % for the first 10 operated animals and 82 % for the remaining 11 animals. The blood flow at the time of sacrifice was 8±3 ml/min. In conclusion, this surgical protocol considerably simplifies, optimizes and standardizes this complicated procedure. It gives novice surgeons easy, step-by-step instruction, explaining possible pitfalls, thereby helping them to gain

  2. Communication as a core skill of palliative surgical care.

    Science.gov (United States)

    Miner, Thomas J

    2012-03-01

    Excellence as a surgeon requires not only the technical and intellectual ability to effectively take care of surgical disease but also an ability to respond to the needs and questions of patients. This article provides an overview of the importance of communication skills in optimal surgical palliation and offers suggestions for a multidisciplinary team approach, using the palliative triangle as the ideal model of communication and interpersonal skills. This article also discusses guidelines for advanced surgical decision making and outlines methods to improve communication skills.

  3. Skills for life of rural teenagers: cognitive and social skills

    Directory of Open Access Journals (Sweden)

    Marisol Morales Rodríguez

    2013-12-01

    Full Text Available A life skills-based approach allows to develop psychosocial skills in adolescents; specifically, cognitive and social skills play a fundamental role. Thus arises the objective of the present study, strengthen self-efficacy and coping, cognitive skills and social skills in high school adolescents in rural area, through the implementation of two programs of psycho-educational intervention. It is based on a quantitative methodology, pre-experimental design of descriptivo-correlacional scope; participating 96 adolescents. The results highlight an improvement in social skills; In addition to finding partnership between advanced social skills and self-efficacy, as well as active coping with social skills; there were changes in self-efficacy and coping. It is concluded that the program was effective in improving social skills of teenagers; however, it requires more time for the improvement of cognitive abilities, given the conditions of a rural area.

  4. Skill Gap Analysis for Improved Skills and Quality Deliverables

    Directory of Open Access Journals (Sweden)

    Mallikarjun Koripadu

    2014-10-01

    Full Text Available With a growing pressure in identifying the skilled resources in Clinical Data Management (CDM world of clinical research organizations, to provide the quality deliverables most of the CDM organizations are planning to improve the skills within the organization. In changing CDM landscape the ability to build, manage and leverage the skills of clinical data managers is very critical and important. Within CDM to proactively identify, analyze and address skill gaps for all the roles involved. In addition to domain skills, the evolving role of a clinical data manager demands diverse skill sets such as project management, six sigma, analytical, decision making, communication etc. This article proposes a methodology of skill gap analysis (SGA management as one of the potential solutions to the big skill challenge that CDM is gearing up for bridging the gap of skills. This would in turn strength the CDM capability, scalability, consistency across geographies along with improved productivity and quality of deliverables

  5. Treatment of localized gingival recession using the free rotated papilla autograft combined with coronally advanced flap by conventional (macrosurgery and surgery under magnification (microsurgical technique: A comparative clinical study

    Directory of Open Access Journals (Sweden)

    Suraj Pandey

    2013-01-01

    Full Text Available Background: The aim of the present study was to evaluate and compare the conventional (macro-surgical and microsurgical approach in performing the free rotated papilla autograft combined with coronally advanced flap surgery in treatment of localized gingival recession. Materials and Methods: A total of 20 sites from 10 systemically healthy patients were selected for the study. The selected sites were randomly divided into experimental site A and experimental site B by using the spilt mouth design. Conventional (macro-surgical approach for site A and micro-surgery for site B was applied in performing the free rotated papilla autograft combined with coronally advanced flap. Recession depth (RD, recession width (RW clinical attachment level (CAL. and width of keratinized tissue (WKT. were recorded at baseline, 3 months and 6 months post-operatively. Results: Both (macro- and microsurgery groups showed significant clinical improvement in all the parameters (RD, RW, CAL and WKT. However, on comparing both the groups, these parameters did not reach statistical significance. Conclusion: Both the surgical procedures were equally effective in treatment of localized gingival recession by the free rotated papilla autograft technique combined with coronally advanced flap. However, surgery under magnification (microsurgery may be clinically better than conventional surgery in terms of less post-operative pain and discomfort experienced by patients at the microsurgical site.

  6. 松果体区肿瘤显微手术治疗相关因素分析%Analysis of related factors in the microsurgical treatment of pineal region tumors

    Institute of Scientific and Technical Information of China (English)

    张治元; 王汉东; 史继新; 杭春华; 成惠林; 樊友武; 潘云曦

    2011-01-01

    Objective To analysis the related factors in the microsurgical treatment of pineal region tumors. Methods The clinical data of 69 patients with pineal region tumors performed microsurgery were analyzed retrospectively. The tumors and the texture, blood supply, pathology in pineal region and the relationship with microsurgery were analyzed. Results The tumors were totally removed in 43 cases, subtotal in 19 and partial in 7. Conclusion The microsurgical difficulty and degree of resection are closely related to the size, texture, blood supply and pathology of pineal region tumors.%目的 分析松果体区肿瘤显微手术治疗的相关因素.方法 回顾性分析显微手术治疗69 例松果体区肿瘤的临床资料,探讨松果体区肿瘤大小、质地、血供及病理类型与显微手术的关系.结果 肿瘤全切除43 例,次全切除19 例,部分切除7 例.结论 松果体区肿瘤的大小、质地、血供、病理类型与显微手术难度和切除程度密切相关.

  7. Microsurgical treatment for huge acoustic neuromas (with 65 cases report)%显微手术治疗大型听神经瘤(附65例报告)

    Institute of Scientific and Technical Information of China (English)

    孙胜玉; 黄伟; 马辉; 夏鹤春

    2011-01-01

    Objective To observe the effect of microsurgical treatment for huge acoustic neuromas. Method 65 huge acoustic neurinomas were removed through subcccipital retresigmoid approach. The path and function of facial nerve were monitored by electromyographic monitoring. Results 60 (92.3%)acoustic neurinomas were totally removed. Facial nerves were kept anatomic intact completely during the operation in 58 patients ( 89. 2% ). Conclusions Micresurgical treatment for huge acoustic neuromas is effective. The key point for successful surgey is mastering the anatomical features of cerebellopontine angle region, microsurgical technology and neurophysiological monitoring.%目的 观察显微手术治疗大型听神经瘤的效果.方法 大型听神经瘤65例,采用经枕下乙状窦后入路显微手术切除,术中应用肌电监测判断面神经的走行及功能.结果 本组肿瘤全切60例,术中保留面神经58例.结论 显微手术可有效治疗大型听神经瘤;熟悉桥小脑角局部解剖、手术入路、显微手术技巧及术中面神经的电生理监测等是手术成功的关键.

  8. 创新理念下排球垫球教学方法的优化与实证研究%On the Optimization of the Teaching Method for Volleyball Digging Skill and Empirical Study under the Guidance of the Innovative Concept

    Institute of Scientific and Technical Information of China (English)

    孙正

    2014-01-01

    Through literature review,seeking advice from the experts,and analysis of personal experience,and under the guidance of the innovative concept,also considering the learning reality of students,the traditional teaching methods for volleyball digging skills are integrated and optimized into a set of combined strategy for teaching the volleyball digging skills, namely a combined use of the three teaching methods:the goal setting method,the integrated method of both the small group teaching method and guided learning teaching method and the self assessment method.Experimental results show that the ex-perimental class students excel the controlled class in the number of digging,the level of digging,the fighting capability,which indicate a significant difference,showing that the combined use of the three methods is effective in improving the students’dig-ging skills and the classroom teaching efficiency.%通过查阅文献资料,听取专家意见以及个人经验总结,基于创新理念下,结合学生学习的实际,对传统的垫球教学方法进行了优化整合,总结出一套垫球教学方法组合方略,即目标设置法、小群体教学法与学导教学法的整合、自我评价法三种方法的组合运用。实验结果显示:实验班的学生在垫球数量、垫球技术水平、比赛水平上均高于对照班,呈现显著性差异,说明这三种方法的组合运用可以提高学生的垫球水平和课堂教学效益。

  9. Robot skills for manufacturing

    DEFF Research Database (Denmark)

    Pedersen, Mikkel Rath; Nalpantidis, Lazaros; Andersen, Rasmus Skovgaard

    2016-01-01

    Due to a general shift in manufacturing paradigm from mass production towards mass customization, reconfigurable automation technologies, such as robots, are required. However, current industrial robot solutions are notoriously difficult to program, leading to high changeover times when new...... products are introduced by manufacturers. In order to compete on global markets, the factories of tomorrow need complete production lines, including automation technologies that can effortlessly be reconfigured or repurposed, when the need arises. In this paper we present the concept of general, self......-asserting robot skills for manufacturing. We show how a relatively small set of skills are derived from current factory worker instructions, and how these can be transferred to industrial mobile manipulators. General robot skills can not only be implemented on these robots, but also be intuitively concatenated...

  10. Innovation and Academic Skills

    DEFF Research Database (Denmark)

    Nielsen, René Nesgaard

    2006-01-01

    , different authors within systems of innovation literature emphasise the continuing relevance of practical know-how and non-formal learning processes based on learning-by-doing, -using, and -interacting (see e.g. Lundvall 1992). Combining insights from these two streams of literature, my thesis...... will be written on an assumption of a positive relationship between innovation and use of academic skills subject to a continuing importance of practical know-how and non-formal learning processes. Confronting this assumption with Danish empirics, interesting research questions arise. Danish empirics thus show......Literature on skill-biased technological and organisational change has established that these kinds of changes are positively related with demand for highly skilled (and highly educated) labour. Most of the literature is based on the hypothesis that technological and organisational change cause...

  11. Development and Optimization Skills of Simple Particle Image Velocimetry Technology%简易粒子图像测速(PIV)技术开发与优化技巧

    Institute of Scientific and Technical Information of China (English)

    柯森繁; 石小涛; 王恩慧; 何慧灵; 胡晓; 王志强; 饶冬伟; 樊后龑

    2016-01-01

    粒子图像测速( PIV)技术是一种瞬态流动平面二维速度场测试技术,在细部流场实测领域得到重视,但是成熟的PIV产品价格高昂。鉴于此,介绍了一种简易的PIV装置,主要由高速摄像机、激光发射器、柱面透镜和示踪粒子构成,以较低成本即可基本实现商业用PIV产品的功能。为了验证简易PIV性能,设计了PIV简易装置,采用Fluent软件模拟,并结合PIV技术对比分析了简易PIV装置的优缺点,同时对影响结果的粒径大小和粒子跟随性进行了优化。结果表明,简易PIV装置适宜选用玉米粉作为示踪粒子,并需要根据示踪粒子跟随性所能达到的最大进口水流速度选择高速摄像机的帧率,最终能够较好地实现流场实测,进而达到对PIV技术进行开发和优化的目的,其分析结果将为后续研究者提供参考。%As a measurement technique of instantaneous 2-D velocity flow field, particle image velocimetry ( PIV) has received much attention in detailed flow field measurement , but mature product of PIV is still expensive .In view of this, we introduce a simple device which consists of high-speed digital camera, laser transmitter, cylindrical lens and tracer particle .The fuctions of business PIV product can be achieved with low cost .To verify the simple PIV performance in this paper , we designed a simple device and analyzed the advantages and disadvantages of this simple device by software Fluent .Furthermore , we optimized the particle size and the tracking performance of parti-cle.Results show that corn flour particle is suitable as the tracer particle of this simple device .Moreover, we should choose the frame rate of high-speed digital camera according to the maximum inlet water velocity which the tracking performance of tracer particle can reach .During this process , we can get a better flow field measurement , and de-velope and optimize the PIV technique .The analysis

  12. Dynamic Optimization

    Science.gov (United States)

    Laird, Philip

    1992-01-01

    We distinguish static and dynamic optimization of programs: whereas static optimization modifies a program before runtime and is based only on its syntactical structure, dynamic optimization is based on the statistical properties of the input source and examples of program execution. Explanation-based generalization is a commonly used dynamic optimization method, but its effectiveness as a speedup-learning method is limited, in part because it fails to separate the learning process from the program transformation process. This paper describes a dynamic optimization technique called a learn-optimize cycle that first uses a learning element to uncover predictable patterns in the program execution and then uses an optimization algorithm to map these patterns into beneficial transformations. The technique has been used successfully for dynamic optimization of pure Prolog.

  13. Skills, Stakes, and Clout

    DEFF Research Database (Denmark)

    Vanhuysse, Pieter

    2015-01-01

    but no longer Central Europe. Reviewing decade-long evidence on subsidized, high-quality early childhood education pilot programs, I argue that such programs are a tested tool for marrying economic efficiency with social justice (equality of opportunity). I conclude by reflecting on which human skills...... are likely to be valued in the Second Machine Age. And I recommend policies, including new schemes to compensate for the way in which Europe's existing core-periphery divide is being (self-)perpetuated through periphery-to-core brain drain of highly skilled young Europeans....

  14. Engineering and design skills

    DEFF Research Database (Denmark)

    Schrøder, Anne Lise

    2006-01-01

    In various branches of society there is focus on the need for design skills and innovation potential as a means of communicating and handling constant change. In this context, the traditional idea of the engineer as a poly-technician inventing solutions by understanding the laws of nature....... This leads to considering the fundamental skills of the engineering practice as basic abilities to see the structures and dynamics of the world, to model it, and to create new solutions concerning practical as well as theoretical matters. Finally, it is assumed that the essence of engineering “bildung...

  15. TEACHING INTERPERSONAL SKILLS

    DEFF Research Database (Denmark)

    Andersson, Niclas

    2009-01-01

    knowledge and skills in teamwork, leadership, and communications are highly required. Thus, the practice of interpersonal skills need to be implemented in engineering teaching, not only in terms of learning objectives, but realised in practical teaching activities and as an integrated part...... of the social interaction in a small group of students and thus facilitates communication and teamwork operation. Students find the Social Risk Analysis being easy to apprehend and meaningful in engineering teaching, and most significantly, they perceive that the Social Risk Analysis facilitates the work...

  16. Hard skills or soft skills? Findings about importance of various skills in work

    OpenAIRE

    Niva, Anu

    2016-01-01

    Getting a job requires many things: hard skills, soft skills, the right attitude and motivation. To develop the degree programme in Business Information Systems in Oulu university of Applied Sciences (Oulu UAS), three surveys were conducted, to study importance of skills and knowledge in professional life: a graduate career survey in 2013, an employer survey in 2014, and a student survey in 2015. According to the results, readiness for change, learning skills and basic ICT skills seem to be t...

  17. Stochastic optimization

    CERN Document Server

    Schneider, Johannes J

    2007-01-01

    This book addresses stochastic optimization procedures in a broad manner. The first part offers an overview of relevant optimization philosophies; the second deals with benchmark problems in depth, by applying a selection of optimization procedures. Written primarily with scientists and students from the physical and engineering sciences in mind, this book addresses a larger community of all who wish to learn about stochastic optimization techniques and how to use them.

  18. Selective Optimization

    Science.gov (United States)

    2015-07-06

    consider a probabilistically-constrained portfolio optimization problem [16] to determine a minimum cost distribution of a unit investment among n assets...present a branching technique (Section 5). Through computational experiments on the probabilistic portfolio optimization problem (3) and an optimal ...at one. 15 DISTRIBUTION A: Distribution approved for public release. 6.2 Probabilistic Portfolio Optimization The first class of instances we test

  19. Microsurgical treatment for posterior communicating artery aneurysms%后交通动脉瘤的显微手术治疗

    Institute of Scientific and Technical Information of China (English)

    谢飞; 孙鸿; 毛伯镛; 游潮; 贺民; 刘翼; 毛庆

    2011-01-01

    Objective To review experience with microsurgical treatment for posterior communicating artery (PCoA) aneurysms. Methods Clinical data of 108 patients with PCoA aneurysms treated by microsurgery through the pterional approach were analyzed retrospectively, including clipping of aneurysmal neck in 107 cases and wrapping of aneurysm in 1. Aneurismal incision and the indocyanine green angiography were routinely performed after the clipping. Results Total clipping of aneurysmal neck in 107 cases and wrapping of aneurysm in 1. Intraoperatively intracranial aneurysm burst ruptured in 18 patients. Preoperative hydrocephalus occurred in 11 cases, and improved in 6 and no significantly improved in S postoperatively. The postoperative GOS scores were as follows: 4 to 5 scores in 93 patients, 2 to 3 in 11 and 1 (death) in 4. Eighty-four patients were followed up for 6 to 12 months, and there was no residual aneurysm or recurrence. Conclusions Microsurgery is an ideal method for treatment of PCoA aneurysms. Intraoperatively aneurysmal incision and the indocyanine green angiography are useful in judging the clipping effect.%目的 总结显微手术治疗后交通动脉瘤的经验.方法 回顾性分析108例后交通动脉瘤病人的临床资料,采用翼点入路显微手术治疗,行瘤颈夹闭术107例,动脉瘤包裹术1例.瘤颈夹闭后术中常规切开瘤体并行吲哚菁绿荧光血管造影.结果 动脉瘤颈完全夹闭107例,动脉瘤包裹1例.术中动脉瘤破裂18例.术前脑积水11例,术后改善6例,无明显改善5例.术后GOS评分:4~5分93例,2~3分11例,1分(死亡)4例.84例获随访6~12个月,无动脉瘤残留及复发.结论 显微手术是治疗后交通动脉瘤的理想方法,术中常规切开瘤体并行吲哚菁绿荧光血管造影可有效判断夹闭效果.

  20. 纯岛叶低级别胶质瘤的显微外科治疗%Microsurgical treatment of purely insular low grade gliomas

    Institute of Scientific and Technical Information of China (English)

    赵建华; 冯继; 裴玉芳; 冯三平; 陈兴河; 江涛

    2011-01-01

    Objective To investigate microsurgical method and outcome for purely insular low grade gliomas. Methods The clinical data of 17 patients with purely insular low grade glioma, which was located at the left insula in 8 and right insula in 9, were analyzed retrospectively. All the tumors were removed via pterional transsylvian approach. Results Complete removal of the tumor was achieved in 12 patients and subtotal removal in 5. The diagnosis was established by postoperative pathological analysis, including 8 astrocytomas, 4 oligodendrogliomas and 5 oligoastrocytomas. There was no operative mortality. Early postoperative complications such as hemiplegia occurred in 2 patients and aphasia in 2. Seventeen patients were followed up for 6 to 12 months, hemiparesis occurred in 1 patient, mild aphasia in 1 and no tumor recurrence was found. Conclusions Microsurgery via pterional transsylvian approach is a safe and effective means for purely insular low grade gliomas. The good understanding of the insular anatomy is helpful for resection of insular low grade gliomas to the full extent and alleviation of neurological disorders of patients after operation.%目的 探讨纯岛叶低级别胶质瘤的显微手术方法及疗效.方法 回顾性分析17例纯岛叶低级别胶质瘤病人的临床资料.其中肿瘤位于左侧岛叶8例,右侧岛叶9例,均采用翼点外侧裂入路手术切除肿瘤.结果 肿瘤全切除12例,近全切除5例.病理结果:星形细胞瘤8例,少枝胶质细胞瘤4例,少枝星形细胞瘤5例.无手术死亡,术后早期发生偏瘫、失语各2例.随访17例,时间6~12个月,均未见肿瘤复发,轻偏瘫1例,轻度失语1例.结论 应用显微外科技术经翼点外侧裂入路治疗纯岛叶低级别胶质瘤安全、有效.了解岛叶解剖有助于最大程度切除岛叶低级别胶质瘤,减少病人术后神经功能障碍.

  1. Library Skills Workbook.

    Science.gov (United States)

    Miller, Constance; And Others

    This self-paced library skills workbook provides incoming students with an introduction to the physical arrangement and use of the university libraries. Divided into two sections, the first contains explanations of the catalogs, classification system, and various library resources. The second consists of practical exercises keyed to the…

  2. State Skill Standards: Photography

    Science.gov (United States)

    Howell, Frederick; Reed, Loretta; Jensen, Capra; Robison, Gary; Taylor, Susan; Pavesich, Christine

    2007-01-01

    The Department of Education has undertaken an ambitious effort to develop statewide skill standards for all content areas in career and technical education. The standards in this document are for photography programs and are designed to clearly state what the student should know and be able to do upon completion of an advanced high-school program.…

  3. Measuring Skills and Behavior.

    Science.gov (United States)

    Ludeman, Kate

    1991-01-01

    Customized skills assessments can perform a number of functions: help training departments demonstrate their effectiveness; provide a foundation for career development programs; reinforce company values; add feedback from the bottom up for performance evaluation; provide a concentrated focus for customer service improvement; and serve as a…

  4. Competing Auctions of Skills

    DEFF Research Database (Denmark)

    Kennes, John; le Maire, Christian Daniel

    The model of competing sellers McAfee (1993) is applied to a labor market environment with heterogeneous workers, who differ by outside option and skill type, and heterogeneous firms, who differ by the amount of output produced when matched to each possible worker tyoe. We derive both a static...

  5. Hearing poorly with skill

    DEFF Research Database (Denmark)

    Day, Dennis

    2012-01-01

    This paper offers an account of ongoing research into hearing. I offer a characterization of 'skil- led practitioners' from an Ethnomethodological perspective. The skilled practitioner in question is a generic 'hard of hearing' person. The ambition is that such a characterization, both in its...

  6. Develop your presentation skills

    CERN Document Server

    Theobald, Theo

    2016-01-01

    Going beyond handling nerves and presenting PowerPoint slides, the third edition of "Develop Your Presentation Skills "offers practical advice on developing a captivating presentation, constructing compelling content, and boosting self-confidence. The book includes three new chapters on delivering a "stripped down"presentation, using new media to engage with the audience, and handling being asked to present on short notice."

  7. Improving Teachers' Verbal Skills.

    Science.gov (United States)

    Albrecht, Kay

    1992-01-01

    Suggests strategies center directors can use to improve teachers' verbal interactions with children. Directors can help teachers (1) understand child growth and development; (2) understand that what they say matters; (3) hear themselves talking to children; and (4) develop their observation skills. Directors can also share good models with…

  8. Competing Auctions of Skills

    DEFF Research Database (Denmark)

    Kennes, John; le Maire, Christian Daniel

    The model of competing sellers McAfee (1993) is applied to a labor market environment with heterogeneous workers, who differ by outside option and skill type, and heterogeneous firms, who differ by the amount of output produced when matched to each possible worker tyoe. We derive both a static...

  9. EMBODIMENT OF CAPOEIRA SKILLS

    Directory of Open Access Journals (Sweden)

    Urska Habjan

    2015-09-01

    Full Text Available This article is the result of twenty-one months of fieldwork among the capoeiristas in Brazil, primarily in the city of Salvador, between 2003 and 2013. The fieldwork methodology was based on participant observation. It also included conducting interviews and informal conversations, listening to life stories of locals, and writing a diary. My personal experiences within capoeira and the improvement of my own skills enabled me to better grasp what capoeira is about. By participating, I more fully understood the corporeal strain and pleasure involved in this particular embodied practice. The socio-economic situation of Brazilian society based on racial and gender discrimination enhances the cultivation of capoeiristic habitus and dictates the need for the acquisition of capoeiristic skills and attitudes in order to cope with, understand, and live within an unequal world. Capoeiristic habitus consists of knowledge, attitudes and skills enabling capoeiristas to stay in tune with the environment of lurking danger, to face with an ambiguous, unstable and uncertain environment. Capoeiristic habitus can be embodied early in life or learnt and acquired as a by-product of capoeira training. But it remains important whether the environment in which a capoeirista practises tolerates or inhibits the cultivation of capoeiristic skills.

  10. Hearing poorly with skill

    DEFF Research Database (Denmark)

    Day, Dennis

    2012-01-01

    This paper offers an account of ongoing research into hearing. I offer a characterization of 'skil- led practitioners' from an Ethnomethodological perspective. The skilled practitioner in question is a generic 'hard of hearing' person. The ambition is that such a characterization, both in its...... making and its final state, may be an intrinsic part of design practices concerning the development of hearing aids....

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry Trauma Education Trauma Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure in ... Scope of Practice Pediatric Issues ...

  12. Thinking-Skills Strategy.

    Science.gov (United States)

    Cummings, Alysa

    1991-01-01

    Describes discovery learning, a teaching method that encourages students to use inductive reasoning. Students explore and experiment using the skill or idea being taught; they determine rules, make generalizations, and discover concepts. The teacher acts as coach, advisor, and reinforcer. A student page offers a discovery learning game on capital…

  13. Teaching Presentation Skills

    Science.gov (United States)

    Baker, William H.; Thompson, Michael P.

    2004-01-01

    Effective teaching of presentation skills focuses on the most important element of the presentation--the message itself. Some instructors place the heaviest emphasis on the messenger (the presenter) and focus their presentation feedback on all the presenter is doing wrong--saying "um," gesturing awkwardly, and so forth. When students receive this…

  14. Negotiation Skill Development Exercise

    Science.gov (United States)

    Benson, Gregory E.; Chau, Ngan N.

    2017-01-01

    Conflict occurs naturally in all marketing related activities. When such conflict is handled well through proper negotiation, it helps solve problems and build stronger, deeper relationships between the negotiating parties. Nevertheless, many students feel uneasy about negotiating, yet they know it is a crucial skill that needs to be developed.…

  15. Scaffolding Reading Comprehension Skills

    Science.gov (United States)

    Salem, Ashraf Atta Mohamed Safein

    2017-01-01

    The current study investigates whether English language teachers use scaffolding strategies for developing their students' reading comprehension skills or just for assessing their comprehension. It also tries to demonstrate whether teachers are aware of these strategies or they use them as a matter of habit. A questionnaire as well as structured…

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ...

  17. Building Science Process Skills

    Science.gov (United States)

    DeFina, Anthony V.

    2006-01-01

    A well-designed and executed field trip experience serves not only to enrich and supplement course content, but also creates opportunities to build basic science process skills. The National Science Education Standards call for science teachers "to design and manage learning environments that provide students with the time, space, and resources…

  18. Counseling Skills for Teachers

    Science.gov (United States)

    Kottler, Jeffrey A.; Kottler, Ellen

    2006-01-01

    By necessity, today's teachers do much more than deliver instruction. In the classroom, on the playground, or even in the parking lot, teachers are often called upon to respond quickly and appropriately to students' social and emotional needs, drawing from instinct more than anything else. In this second edition of "Counseling Skills for…

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry Trauma Education Trauma Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure in ... Scope of Practice Pediatric Issues ...

  20. Skill in Expert Dogs

    Science.gov (United States)

    Helton, William S.

    2007-01-01

    The motor control of novice participants is often cognitively demanding and susceptible to interference by other tasks. As people develop expertise, their motor control becomes less susceptible to interference from other tasks. Researchers propose a transition in human motor skill from active control to automaticity. This progression may also be…

  1. Listening Skills Handbook.

    Science.gov (United States)

    Decatur Public Schools District 61, IL.

    Defining listening as the active and conscious process of hearing, recognizing, and interpreting or comprehending language, this guide provides numerous activities to promote the listening skills of primary and intermediate grade students. Specifically, the activities described seek to develop (1) the ability of young students to listen…

  2. Organisational skills and tools.

    Science.gov (United States)

    Wicker, Paul

    2009-04-01

    While this article mainly applies to practitioners who have responsibilities for leading teams or supervising practitioners, many of the skills and tools described here may also apply to students or junior practitioners. The purpose of this article is to highlight some of the main points about organisation, some of the organisational skills and tools that are available, and some examples of how these skills and tools can be used to make practitioners more effective at organising their workload. It is important to realise that organising work and doing work are two completely different things and shouldn't be mixed up. For example, it would be very difficult to start organising work in the middle of a busy operating list: the organisation of the work must come before the work starts and therefore preparation is often an important first step in organising work. As such, some of the tools and skills described in this article may need to be used hours or even days prior to the actual work taking place.

  3. Maine's Employability Skills Program

    Science.gov (United States)

    McMahon, John M.; Wolffe, Karen E.; Wolfe, Judy; Brooker, Carrie

    2013-01-01

    This Practice Report describes the development and implementation of the "Maine Employability Skills Program," a model employment program developed by the Maine Division for the Blind and Visually Impaired (DBVI). The program was designed to support the efforts of the chronically unemployed or underemployed. These consumers were either…

  4. Otologic Skills Training

    DEFF Research Database (Denmark)

    Wiet, Gregory J; Sørensen, Mads Sølvsten; Andersen, Steven Arild Wuyts

    2017-01-01

    This article presents a summary of the current simulation training for otologic skills. There is a wide variety of educational approaches, assessment tools, and simulators in use, including simple low-cost task trainers to complex computer-based virtual reality systems. A systematic approach...

  5. Analysis of Prospective Mathematics Teachers’ Basic Teaching Skills (a Study of Mathematics Education Departement Students’ Field Experience Program at STKIP Garut)

    Science.gov (United States)

    Rahayu, D. V.

    2017-02-01

    This study was intended to figure out basic teaching skills of Mathematics Department Students of STKIP Garut at Field Experience Program in academic year 2014/2015. This study was qualitative research with analysis descriptive technique. Instrument used in this study was observation sheet to measure basic teaching mathematics skills. The result showed that ability of content mastery and explaining skill were in average category. Questioning skill, conducting variations skill and conducting assessment skill were in good category. Managing classroom skill and giving motivation skill were in poor category. Based on the result, it can be concluded that the students’ basic teaching skills weren’t optimal. It is recommended for the collegians to get lesson with appropriate strategy so that they can optimize their basic teaching skills.

  6. Optimizing motivation and attention for motor performance and learning.

    Science.gov (United States)

    Lewthwaite, Rebecca; Wulf, Gabriele

    2017-08-01

    We review three lines of recent research at an intersection of motor learning and sport psychology as they relate to motor skill acquisition: enhanced expectancies, autonomy support, and external attentional focus. Findings within these lines of research have been integrated into a new theory, the OPTIMAL (Optimizing Performance through Intrinsic Motivation and Attention for Learning) theory (i.e., OPTIMAL theory, Wulf and Lewthwaite, 2016), and have been applied in motor skill acquisition and performance. Implications range from more effective skill development in children and novice performers to athletes and performers in many fields, including clinical rehabilitation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Employment Social Skills: What Skills Are Really Valued?

    Science.gov (United States)

    Agran, Martin; Hughes, Carolyn; Thoma, Colleen A.; Scott, LaRon A.

    2016-01-01

    Although social skills have long been recognized as essential in promoting employees' employability (e.g., maintaining employment), there has been little research about work-related social skills for the last two decades. A systematic replication of Salzberg, Agran, and Lignugaris/Kraft's investigation of critical social skills was conducted.…

  8. Illinois Occupational Skill Standards: Metal Stamping Skills Cluster.

    Science.gov (United States)

    Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

    These skill standards, developed through a consortium of educational and industry partners in Illinois, serve as guides to workforce preparation program providers to define content for their programs and to employers to establish the skills and standards necessary for job acquisition and performance. The skill standards include the following…

  9. Skills Labs: workshop EMERGO toolkit

    NARCIS (Netherlands)

    Kurvers, Hub; Slootmaker, Aad

    2009-01-01

    Kurvers, H. J., & Slootmaker, A. (2009). Skills Labs: workshop EMERGO toolkit. Presentation given at project members of Skills Labs. March, 31, 2009 and April, 24, 2009, Heerlen, The Netherlands: Open University of the Netherlands.

  10. Skilled nursing or rehabilitation facilities

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features ... facility. Who Needs to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may ...

  11. 手术时机对小骨窗显微手术治疗高血压脑出血患者预后的影响%The influence of operation time on prognosis of patients with hypertensive intracerebral hemorrhage undergoing small skull window micro-surgical operation

    Institute of Scientific and Technical Information of China (English)

    施鹏; 鲍波; 邵珠平

    2015-01-01

    目的 探究小骨窗显微手术治疗高血压脑出血的最佳手术时机.方法 连续纳入2010年6月至2014年6月来我院神经外科高血压脑出血发病24 h内接受小骨窗显微手术治疗患者.前瞻性队列研究方法进行研究设计,根据入院接受手术时间分为对照组(>6h)27例及研究组(≤6h) 31例.两组患者均全麻下进行小骨窗开颅显微手术.术后1周内检测死亡、并发症及再出血例数.手术前后对患者进行GOS评分,手术后1周及半年对患者进行随访,并进行ADL评分及WHOQOL-BREF评分.结果 术前两组GOS评分无统计学差异(P>0.05),术后研究组患者GOS评分显著高于对照组(P<0.05).术后1周,两组ADL评分无统计学差异(P>0.05);术后半年,研究组患者ADL评分显著高于对照组(P<0.05).术后1周,两组WHOQOL-BREF评分无统计学差异(P>0.05);术后半年,研究组患者WHOQOL-BREF评分显著高于对照组(P<0.05).通过多重线性回归发现,在校正性别、年龄、术前GOS评分后,手术时机与术后GOS评分呈线性关系,发病到手术的时间越短,其术后GOS评分越高(P<0.05).结论 发病到手术的时间越短,患者术后预后越好,在发病后6h内进行手术能够显著提高患者的预后,促进日常生活活动功能的恢复,提高患者的生存质量,具有重要意义.%Objective To explore the optimal operation time of small skull window micro-surgical operation in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods Consecutively included patients with HICH who underwent small skull window micro-surgical operation within 24 h admitted in department of neurosurgery of our hospital from June 2010 to June 2014.The study was designed with prospective cohort study method.According to the operation time,all patients were divided into control group (more than 6 h,27 cases) and study group (within 6 h,31 cases).Under general anesthesia,patients in both groups underwent small skull

  12. Life skills and children's characterstrengths

    DEFF Research Database (Denmark)

    Ledertoug, Mette Marie; Linder, Anne

    Psychologist Anne Linder and Psychologist and PhDstudent Mette Marie Ledertoug focus in ‘Life skills and Childrens’ Character Strengths’ on improving life skills for children and adolescents by adopting a strengths-based approach combining a theoretical foundation based on VIA strengths...... a combination of characterstrengths and these strategies can improve life skills....

  13. Stochastic Reinforcement Benefits Skill Acquisition

    Science.gov (United States)

    Dayan, Eran; Averbeck, Bruno B.; Richmond, Barry J.; Cohen, Leonardo G.

    2014-01-01

    Learning complex skills is driven by reinforcement, which facilitates both online within-session gains and retention of the acquired skills. Yet, in ecologically relevant situations, skills are often acquired when mapping between actions and rewarding outcomes is unknown to the learning agent, resulting in reinforcement schedules of a stochastic…

  14. Training of Component Reading Skills.

    Science.gov (United States)

    Fiedorowicz, Christina A. M.

    1986-01-01

    Eight reading-disabled boys with subskill deficits in either oral reading, associative skills, or sequential skills received skill specific computer-assisted instruction emphasizing accuracy and speed of response for two and a half months. Comparison with controls indicated marked improvement which generalized to achievement measures of word…

  15. Physical Attractiveness and Counseling Skills.

    Science.gov (United States)

    Vargas, Alice M.; Borkowski, John G.

    1982-01-01

    Searched for interaction between quality of counseling skills (presence or absence of empathy, genuineness, and positive regard) and physical attractiveness as determinants of counseling effectiveness. Attractiveness influenced perceived effectiveness of counselor's skill. Analyses of expectancy data revealed that only with good skills did…

  16. Computational Skills for Biology Students

    Science.gov (United States)

    Gross, Louis J.

    2008-01-01

    This interview with Distinguished Science Award recipient Louis J. Gross highlights essential computational skills for modern biology, including: (1) teaching concepts listed in the Math & Bio 2010 report; (2) illustrating to students that jobs today require quantitative skills; and (3) resources and materials that focus on computational skills.

  17. Physical Attractiveness and Counseling Skills.

    Science.gov (United States)

    Vargas, Alice M.; Borkowski, John G.

    1982-01-01

    Searched for interaction between quality of counseling skills (presence or absence of empathy, genuineness, and positive regard) and physical attractiveness as determinants of counseling effectiveness. Attractiveness influenced perceived effectiveness of counselor's skill. Analyses of expectancy data revealed that only with good skills did…

  18. Communication skills training of undergraduates.

    Science.gov (United States)

    Ali, Abrar Ashraf

    2013-01-01

    To assess the adequacy or deficiency of relevant communication skills needed in clinical practice among students of King Edward Medical University and identify the need of developing curriculum for communication skills. Sequential mixed method design using survey questionnair and in-depth interviews. King Edward Medical University, Lahore, from March - September 2010. Final year students consented to participate in the survey questionnaire regarding communication skills needed in clinical practice selected on the basis of random stratified sampling technique. The questioned aspects include communication skills, supervised training, breaking bad news, counselling and written communication skills. In the second qualitative phase, volunteers who had passed final year were selected on the basis of non-probability purposive sampling technique for recording in-depth interviews. Qualitative data was analyzed with content analysis after identifying themes and trends from the data. Only 20% students had clarity of communication skills training, 28% believed that their learning was supervised, 20% believed training was structured, 28% were confident about handling difficult situations, 15% could effectively break bad news, and 22% were confident in written communication skills. In the interviews 70% felt that their peers had average skills in handling difficult situations like breaking bad news and counselling, 60% believed that communication skills program was non-existent and 100% agreed that patient turnover is a strength for the institute and structured training would improve their communication skills performance. The communication skills of the studied group were inadequate to address special situations. This presses need for developing a communication skills training program.

  19. Employability Skills. At a Glance

    Science.gov (United States)

    Wibrow, Bridget

    2011-01-01

    In a competitive workforce it is not just having the right qualification or technical skills that will land an individual a job; it could very well be their interpersonal skills. How someone communicates is often the first impression an employer has of a possible worker. Yet, it is precisely communication skills that employers feel applicants are…

  20. Nonlinear optimization

    CERN Document Server

    Ruszczynski, Andrzej

    2011-01-01

    Optimization is one of the most important areas of modern applied mathematics, with applications in fields from engineering and economics to finance, statistics, management science, and medicine. While many books have addressed its various aspects, Nonlinear Optimization is the first comprehensive treatment that will allow graduate students and researchers to understand its modern ideas, principles, and methods within a reasonable time, but without sacrificing mathematical precision. Andrzej Ruszczynski, a leading expert in the optimization of nonlinear stochastic systems, integrates t

  1. On Thanslation Skill

    Institute of Scientific and Technical Information of China (English)

    贾艳

    2010-01-01

    @@ 1.Introduction Before state doing a thanslation job,what comes to your mind?yes,It's the principle of thanslation If som cone wants to become a good thanslator or to thanslate an ariticle,It's the most important thing that you should keep in mind all the time.It will help you thanslate the article better.If not you will not thanslate the article best.And also you need to know the thanslation skills,it will help you thanslate the article without too much barriers.then how you should make these skills into practice.the more you use them,the better you article will be!Now let us first talk the principles.

  2. Language as skill

    DEFF Research Database (Denmark)

    Chater, Nick; McCauley, Stewart M.; Christiansen, M. H.

    2016-01-01

    occurs on-line. These properties are difficult to reconcile with the 'abstract knowledge' viewpoint, and crucially suggest that language comprehension and production are facets of a unitary skill. This viewpoint is exemplified in the Chunk-Based Learner, a computational acquisition model that processes...... incrementally and learns on-line. The model both parses and produces language; and implements the idea that language acquisition is nothing more than learning to process. We suggest that the Now-or-Never bottleneck also provides a strong motivation for unified perception-production models in other domains......Are comprehension and production a single, integrated skill, or are they separate processes drawing on a shared abstract knowledge of language? We argue that a fundamental constraint on memory, the Now-or-Never bottleneck, implies that language processing is incremental and that language learning...

  3. Engineering and design skills

    DEFF Research Database (Denmark)

    Schrøder, Anne Lise

    2006-01-01

    In various branches of society there is focus on the need for design skills and innovation potential as a means of communicating and handling constant change. In this context, the traditional idea of the engineer as a poly-technician inventing solutions by understanding the laws of nature...... concept of diagrammatic reasoning to some extent incarnates the very method of engineering and design. On this background, it is argued how the work field and techniques of the engineer and the engineering scientist could be characterized in a broader creative context of learning and communication....... This leads to considering the fundamental skills of the engineering practice as basic abilities to see the structures and dynamics of the world, to model it, and to create new solutions concerning practical as well as theoretical matters. Finally, it is assumed that the essence of engineering “bildung...

  4. Skills, Stakes, and Clout

    DEFF Research Database (Denmark)

    Vanhuysse, Pieter

    2015-01-01

    I ask why and how early human capital investment may boost the future foundations of European welfare states. Regarding the material circumstances of young adults and very young children, and educational outcomes such as PISA results in mathematics, reading, writing and problem solving, the years...... but no longer Central Europe. Reviewing decade-long evidence on subsidized, high-quality early childhood education pilot programs, I argue that such programs are a tested tool for marrying economic efficiency with social justice (equality of opportunity). I conclude by reflecting on which human skills...... are likely to be valued in the Second Machine Age. And I recommend policies, including new schemes to compensate for the way in which Europe's existing core-periphery divide is being (self-)perpetuated through periphery-to-core brain drain of highly skilled young Europeans....

  5. Training generalized spatial skills.

    Science.gov (United States)

    Wright, Rebecca; Thompson, William L; Ganis, Giorgio; Newcombe, Nora S; Kosslyn, Stephen M

    2008-08-01

    Spatial transformation skills are an essential aspect of cognitive ability. These skills can be improved by practice, but such improvement has usually been specific to tasks and stimuli. The present study investigated whether intensive long-term practice leads to change that transcends stimulus and task parameters. Thirty-one participants (14 male, 17 female) were tested on three cognitive tasks: a computerized version of the Shepard-Metzler (1971) mental rotation task (MRT), a mental paper-folding task (MPFT), and a verbal analogies task (VAT). Each individual then participated in daily practice sessions with the MRT or the MPFT over 21 days. Postpractice comparisons revealed transfer of practice gains to novel stimuli for the practiced task, as well as transfer to the other, nonpracticed spatial task. Thus, practice effects were process based, not instance based. Improvement in the nonpracticed spatial task was greater than that in the VAT; thus, improvement was not merely due to greater ease with computerized testing.

  6. Optimal semelparity.

    Directory of Open Access Journals (Sweden)

    James W Vaupel

    Full Text Available Semelparous organisms have a simple life cycle characterized by immediate death after reproduction. We assume that semelparous life histories can be separated into a juvenile non-reproductive period followed by an adult period during which reproduction is possible. We derive formulae for the optimal age and size at reproduction and for the optimal size of the offspring (e.g., seeds. Our main contribution is to determine the conditions under which the optimal size of the offspring does not depend on the optimal size at reproduction and vice versa.

  7. Website Optimization

    CERN Document Server

    King, Andrew

    2008-01-01

    Remember when an optimized website was one that merely didn't take all day to appear? Times have changed. Today, website optimization can spell the difference between enterprise success and failure, and it takes a lot more know-how to achieve success. This book is a comprehensive guide to the tips, techniques, secrets, standards, and methods of website optimization. From increasing site traffic to maximizing leads, from revving up responsiveness to increasing navigability, from prospect retention to closing more sales, the world of 21st century website optimization is explored, exemplified a

  8. REINFORCEMENT SKILL DALAM PEMBELAJARAN PAI (Studi Kasus di SMA Bukit Barisan Padang)

    OpenAIRE

    Misra Misra

    2012-01-01

    The purpose of the study is to describe positive contribution of Reinforcement Skill to make-up of productive behaviour and creativity of student and to investigate supplementary factor and his resistor.Result of research depict that theoretically learn have applied skill reinforcement in course of study but not yet optimal fully, precisely or as according to what expected. Special at study of PAI applying of skill reinforcement enough give positive contribution to creativity and improvement ...

  9. Cultivating strategic thinking skills.

    Science.gov (United States)

    Shirey, Maria R

    2012-06-01

    This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author presents an overview of strategic leadership and offers approaches for cultivating strategic thinking skills.

  10. Intermediate Family Therapy Skills

    OpenAIRE

    2001-01-01

    The field of marriage and family therapy (MFT) has prospered since its beginnings nearly 50 years ago. In order to keep the field current and competitive with other related professions, empirical research is necessary. Although there has been an upsurge of research on the effectiveness and specialty areas of MFT, one area has been overlooked: skills. THe empirical research that has been performed has focused its attention on beginning therapists. The current research took the next step in...

  11. Develop your leadership skills

    CERN Document Server

    Adair, John

    2016-01-01

    "Develop Your Leadership Skills "is John Adair s most accessible title on leadership. Full of exercises and checklists, it can help boost confidence levels and guide and inspire anyone on their journey to becoming a leader of excellence. Acknowledged as a world expert, John Adair offers stimulating insights into recognizing and developing individual leadership qualities, acquiring personal authority, and mastering core leadership functions such as planning, communicating and motivating. The new edition includes summary points for each chapter.

  12. BUILD UP Skills Danmark

    DEFF Research Database (Denmark)

    Forsingdal, Charlotte Vartou; Lauridsen, Vagn Holk; Hougaard, Karsten Frøhlich

    opfyldelsen af 2020-målene, skal de rette kompetencer inden for energief-fektivitet og brug af vedvarende energi være til stede blandt de udførende i bygge- og an-lægsbranchen. Det er på denne baggrund, at Europa-Kommissionen har igangsat Build Up Skills projektet på tværs af Europa. Formålet med denne...

  13. NONTECHNICAL SKILLS IN ANAESTHESIOLOGY

    Directory of Open Access Journals (Sweden)

    D.S.DIVEKAR

    2009-06-01

    Full Text Available Crucial role of Non technical skills (NTS in the dynamic environment of day to day anaesthetic practice is emerging. Rather than mere acceptance, efforts are being made world over to identify & assess them to overcome their negative effects by structured taxonomy both in real time & simulated conditions. Reduction in anaesthetic accidental mishaps & near misses is the prime concern from the point of patient safety & towards that end training & education have a pivotal role.

  14. Communication and presentation skills

    OpenAIRE

    Lorencová, Ivana

    2014-01-01

    This bachelor thesis deals with individual factors of communication and basic presentations skills. The theoretical part specifies the basic elements of verbal and non-verbal communication and basic factors connected with preparation and realisation of a presentation. The practical part of the thesis comprises an analysis of impacts of speaker's visual and other communication influences over an audience. The results are applied to a Multimedia Display exhibition taking place during the bachel...

  15. Arabic Learning Skill

    OpenAIRE

    Muh. Barid Nizaruddin Wajdi

    2016-01-01

    There are some factors influencing teaching and learning of foreign language. In teaching Arabic, for example, linguistic factors, such as Phonology, Grammatical rules, Morphology, and Vocabulary. Non linguistic factor also influences teaching and learning Arabic, for example, teaching aids, teaching method, age and environment. Teaching method in Arabic is one of the important factor. This article discusses about the Arabic learning skills, and how influenced Arabic teaching

  16. Arabic Learning Skill

    Directory of Open Access Journals (Sweden)

    Muh Barid Nizaruddin Wajdi

    2016-07-01

    Full Text Available There are some factors influencing teaching and learning of foreign language. In teaching Arabic, for example, linguistic factors, such as Phonology, Grammatical rules, Morphology, and Vocabulary. Non linguistic factor also influences teaching and learning Arabic, for example, teaching aids, teaching method, age and environment. Teaching method in Arabic is one of the important factor. This article discusses about the Arabic learning skills, and how influenced Arabic teaching

  17. Facilitation skills for trainers

    Directory of Open Access Journals (Sweden)

    F. Cilliers

    2000-06-01

    Full Text Available This research aims to develop the facilitation skills of trainers. Facilitation is defined form the Person-Centered approach, as providing an opportunity for the trainee to experience personal growth and learning. A facilitation skills workshop was presented to 40 trainers, focussing on enhancing selfactualisation, its intra and inter personal characteristics, and attending and responding behaviour. Measurement with the Personal Orientation Inventory and Carkhuff scales, indicate enhanced cognitive, affective and conative sensitivity and interpersonal skills. A post-interview indicates the trainers experienced empowerment in dealing with the providing of opportunities for growth amongst trainees, in all kinds of training situations. Recommendations are made to enhance facilitation development amongst trainers. Opsomming Hierdie navorsing poog om die fasiliteringsvaardighede van opieiers te ontwikkel. Fasilitering word gedefinieer vanuit die Persoonsgesentreerde benadering as die beskikbaarstelling van 'n geleentheid om persoonlike groei en leer te ervaar. 'n Fasiliteringsvaardighede werkswinkel is aangebied vir 40 opieiers, met die fokus op die stimulering van selfaktualisering, die intra en interpersoonlike kenmerke daarvan, en aandagskenk- en responderings- gedrag. Meting met die Persoonlike Orientasievraelys en die Carkhuff skale, dui op n toename in kognitiewe, affektiewe en konatiewe sensitiwiteit en interpersoonlike vaardighede. n Post-onderhoud dui op die opleier se ervaarde bemagtiging in die beskikbaarstelling van groeigeleenthede vir opleidelinge, in all tipe opleidingsituasies. Aanbevelings word gemaak om die ontwikkeling van fasiliteringsvaardighede by opleiers te verhoog.

  18. Facilitation skills for nurses

    Directory of Open Access Journals (Sweden)

    F Cilliers

    2000-09-01

    Full Text Available Using the pcrson-centered approach, facilitation in this study was conceptualised as providing opportunities for personal growth in the patient, and operationalised in a skills workshop for 40 nurses from different hospitals in Gauteng. The first objective was to evaluate the workshop and the second to ascertain its effect on the participant’s experienced performance. A combined quantitative and qualitative research design was used. The quantitative measurement (Personal Orientation Inventory, Carkhuff scales indicated that the workshop stimulated self-actualisation in terms of intrapersonal awareness, and the interpersonal skills of respect, realness, concreteness, empathy, as well as in terms of attending and responding behaviour. The qualitative measurement (a semi-structured interview indicated that the participants were able to empower patients to find their own answers to difficult personal questions. The alternative hypothesis was accepted, namely that this workshop in facilitations skills significantly enhanced the intra- and interpersonal characteristics associated with self-actualisation and the facilitation of growth in patients. The findings highlighted the difference between the two roles of instructor and facilitator, and recommendations to this effect were formulated.

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Committee on Health Care Disparities Overview Committee on Health Care Disparities Overview Why Optimal Access Matters NIH-ACS Symposium ... Articles in Press About ACS Member Login Contact ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Publications Optimal Access Resources Members Contact Us Publications ACS Publications ACS Catalog About the ACS Catalog About the ... Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in the News Stay Up to Date ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... Search Relevant Publications Optimal Access Resources Members Contact Us Publications ACS Publications ACS Catalog About the ACS ...

  2. Design Principles for Support in Developing Students' Transformative Inquiry Skills in Web-Based Learning Environments

    Science.gov (United States)

    Pedaste, Margus; Sarapuu, Tago

    2014-01-01

    The aim of this explorative study was to find the factors limiting sixth-grade learners' outcomes in acquiring skills related to the transformative inquiry learning processes as well as to analyse the interrelations between inquiry skills in order to develop an optimal support system for designing Web-based inquiry learning environments. A…

  3. The Effects of Modified Games on the Development of Gross Motor Skill in Preschoolers

    Science.gov (United States)

    Lestari, Indah; Ratnaningsih, Tri

    2016-01-01

    Gross motor skills on children must be optimized much earlier since it plays important role not only on their interaction process but also in supporting other multiple developments. One of the means in developing child's motor skill is by providing innovative games i.e. modified games including game format, game timing, and game sequence. The…

  4. Procedural Skills Education – Colonoscopy as a Model

    Directory of Open Access Journals (Sweden)

    Maitreyi Raman

    2008-01-01

    Full Text Available Traditionally, surgical and procedural apprenticeship has been an assumed activity of students, without a formal educational context. With increasing barriers to patient and operating room access such as shorter work week hours for residents, and operating room and endoscopy time at a premium, alternate strategies to maximizing procedural skill development are being considered. Recently, the traditional surgical apprenticeship model has been challenged, with greater emphasis on the need for surgical and procedural skills training to be more transparent and for alternatives to patient-based training to be considered. Colonoscopy performance is a complex psychomotor skill requiring practioners to integrate multiple sensory inputs, and involves higher cortical centres for optimal performance. Colonoscopy skills involve mastery in the cognitive, technical and process domains. In the present review, we propose a model for teaching colonoscopy to the novice trainee based on educational theory.

  5. Optimizing the operating theatre environment.

    Science.gov (United States)

    Wong, Shing W; Smith, Richard; Crowe, Phil

    2010-12-01

    The operating theatre is a complex place. There are many potential factors which can interfere with surgery and predispose to errors. Optimizing the operating theatre environment can enhance surgeon performance, which can ultimately improve patient outcomes. These factors include the physical environment (such as noise and light), human factors (such as ergonomics), and surgeon-related factors (such as fatigue and stress). As individual factors, they may not affect surgical outcome but in combination, they may exert a significant influence. The evidence for some of these working environment factors are examined individually. Optimizing the operating environment may have a potentially more significant impact on overall surgical outcome than improving individual surgical skill.

  6. Surgeons' non-technical skills.

    Science.gov (United States)

    Yule, Steven; Paterson-Brown, Simon

    2012-02-01

    The importance of non-technical skills to surgical performance is gaining wide acceptance. This article discusses the core cognitive and social skills categories thought to underpin medical knowledge and surgical expertise, and describes the rise of non-technical skill models of assessment in surgery. Behavior rating systems such as NOTSS (Non-Technical Skills for Surgeons) have been developed to support education and assessment in this regard. We now understand more about these critical skills and how they impact surgery. The challenge in the future is to incorporate them into undergraduate teaching, postgraduate training, workplace assessment, and perhaps even selection.

  7. Essential Math Skills for Engineers

    CERN Document Server

    Paul, Clayton R

    2011-01-01

    Just the math skills you need to excel in the study or practice of engineering Good math skills are indispensable for all engineers regardless of their specialty, yet only a relatively small portion of the math that engineering students study in college mathematics courses is used on a frequent basis in the study or practice of engineering. That's why Essential Math Skills for Engineers focuses on only these few critically essential math skills that students need in order to advance in their engineering studies and excel in engineering practice. Essential Math Skills for Engineers features con

  8. Improved sub-seasonal meteorological forecast skill using weighted multi-model ensemble simulations

    Science.gov (United States)

    Wanders, Niko; Wood, Eric F.

    2016-09-01

    Sub-seasonal to seasonal weather and hydrological forecasts have the potential to provide vital information for a variety of water-related decision makers. Here, we investigate the skill of four sub-seasonal forecast models from phase-2 of the North American Multi-Model Ensemble using reforecasts for the period 1982-2012. Two weighted multi-model ensemble means from the models have been developed for predictions of both sub-seasonal precipitation and temperature. By combining models through optimal weights, the multi-model forecast skill is significantly improved compared to a ‘standard’ equally weighted multi-model forecast mean. We show that optimal model weights are robust and the forecast skill is maintained for increased length of time and regions with a low initial forecast skill show significant skill after optimal weighting of the individual model forecast. The sub-seasonal model forecasts models show high skill over the tropics, approximating their skill at monthly resolution. Using the weighted approach, a significant increase is found in the forecast skill for dry, wet, cold and warm extreme events. The weighted mean approach brings significant advances to sub-seasonal forecasting due to its reduced uncertainty in the forecasts with a gain in forecast skill. This significantly improves their value for end-user applications and our ability to use them to prepare for upcoming extreme conditions, like floods and droughts.

  9. Microsurgical Treatment of Mooren's Ulcer

    Institute of Scientific and Technical Information of China (English)

    Hanping Xie; Jiaqi Chen; Xiangming Gong; Chunmao Feng; Longshan Chen; Yuesheng Lin

    2000-01-01

    Objective: To evaluate effect of microsurgery of lamellar keratoplasty (LKP) on Mooren's corneal ulcer.Methods: The effect, postoperative astigmatism, postoperative vision, ulcer recurrence of postoperation, and surgical complications of two groups of consecutive Mooren's ulcer inpatients treated respectively by non-microsurgery of LKP and microsurgery of LKP were analyzed.Results:There were significant differences of the effect, postoperative astigmatism,postoperative vision, ulcer recurrence of postoperation, and surgical complications between the two groups. The effect and postoperative vision of the microsurgery-treated groupwerebetterthanthoseofthenon-microsurgery-treatedgroup. The postoperative astigmatism, ulcer recurrence of postoperation, and surgical complications of the microsurgery-treated group were less than those of the nonmicrosurgery-treated group.Conclusion: Microsurgery of LKP of Mooren's corneal ulcer can greatly improve the ulcer healing and postoperative vision, and reduce the surgical complication and the ulcer recurrence of postoperation. Eye Science 2000; 16:56 ~ 60.

  10. 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....

  11. Medicinsk Optimering

    DEFF Research Database (Denmark)

    Birkholm, Klavs

    2010-01-01

    En undersøgelse af anvendelsen af medicin til optimering af koncentration, hukommelse og følelsestonus. Efterfulgt af etiske overvejelser og anbefalinger til det politiske system......En undersøgelse af anvendelsen af medicin til optimering af koncentration, hukommelse og følelsestonus. Efterfulgt af etiske overvejelser og anbefalinger til det politiske system...

  12. Business Students' Perceptions of Necessary Skills.

    Science.gov (United States)

    Davis, Lajuan; Riley, Monica; Fisher, Diane J.

    2003-01-01

    Business education students (n=100) rated 14 job skills identified by the Secretary's Commission on Necessary Skills. The top characteristic identified was interpersonal skills followed by critical thinking. Other skills included teamwork, problem solving, computer literacy, and multitasking. (JOW)

  13. 垂体Rathke囊肿的诊断和显微手术治疗%Diagnosis and microsurgical treatment of Rathke's cleft cysts

    Institute of Scientific and Technical Information of China (English)

    连伟; 任祖渊; 苏长保; 王任直; 杨义; 马文斌; 陆菁菁

    2002-01-01

    Objective To discuss the diagnosis and surgical treatment of Rathke's cleft cysts. Methods Forty-one cases of Rathke's cleft cysts verified by microsurgery and pathological results were retrospectively analyzed. Sixteen of them were male and 25 were female. The mean age was 32.8 years. The duration of symptoms was 20.6 months in average. The main clinical manifestations included headache (62.5%), pituitary dysfunctions (55%) and visual disturbance (32%). Computed tomography (CT) and magnetic resonance imaging (MRI) showed cystic mass in the area of sella turcica. Thirty-nine cases underwent microsurgical treatment by transsphenoid approach and 2 cases by craniotomy. In the operation, the contents of the cysts were removed or drained off, and the cyst walls were partially resected and kept open. Results Only 7 cases were correctly diagnosed prior to operation. Post-operative follow-up period ranged from 3 months to 8 years. Headache was completely relieved. Pituitary dysfunction was improved in 55% and visual disturbance in 75%. There was no recurrence. Conclusion It is difficult to establish the correct diagnosis of Rathke's cleft cysts before operation. The MRI signals often vary and show no specificity. Transsphenoidal microsurgery is an effective treatment for the Rathke's cleft cysts since it can relieve the symptoms and give a confirmed diagnosis.%目的分析和讨论垂体Rathke囊肿的诊断和手术治疗.方法回顾分析41例经手术和病理证实的垂体Rathke囊肿的病例,男性16例,女性25例,平均年龄32.8岁,平均病程为20.6个月.主要临床表现包括头痛(62.5%)、垂体功能紊乱(55%)、视功能障碍(32%)等.CT及MRI检查发现鞍区囊性肿物.39例采用经口鼻蝶窦入路显微外科手术,2例采用开颅手术,切除部分囊壁,敞开囊腔,清除囊肿内容物.结果术前正确诊断为垂体Rathke囊肿的仅为7例,术后随诊3月至8年,头痛患者的症状全部缓解,垂体功能紊乱患者55%得

  14. Microsurgical anatomy and clinical significance of temporal branches of facial nerve%面神经颞支的显微解剖及其临床意义

    Institute of Scientific and Technical Information of China (English)

    孙永强; 杨雯雯; 梁宪斌

    2011-01-01

    目的 为防止涉及颞区的颅底手术损伤面神经颞支提供显微解剖学依据.方法 选用福尔马林固定的成人头颅标本20侧,应用颞下-耳前-颞下窝入路,在手术显微镜下模拟手术人路,解剖观察面神经颞支的分支数目、走行层次,测量颞支与所选标志点的关系.结果 ①面神经颞支越过颧弓时分为2~4支,其中85%为3支.②颞支距耳屏尖距离:最后支16.32±2.43mm,最前支31.30±2.64mm.③在颧弓上面神经颞支走行于颞浅筋膜深面.结论 面神经颞支在耳屏尖前颧弓表面16.32~31.30mm范围内较集中,相关手术应避免损伤.在颞深筋膜深层与颞肌之间分离颞肌可保护面神经颞支免受损伤.%Objective To provide anatomical basis for the preservation of the temporal branches of the facial nerve under operation on temporal region. Methods Ten adult cadaveric heads (20 sides) fixed in 10% formalin were examined using microsurgical techniques and instruments, including the operating microscope. Subtemporal - preauricular infratemporal fossa was selected to study. The number of the temporal branches of the facial nerve and its distribution were observed. The distances between the temporal branches and marking point selected were measured. Results ①The number of the temporal branches was 2 ~4 acrossing the zygomatic arch, and about 85% was 3.②The distances from the apex of tragus to the most posterior temporal branch, most anterior temporal branch were (16. 32 ±2. 43) mm, (31. 30 ±2. 64) mm, respectively. ③They ran between the superficial temporal fascia and the superficial layer of the deep temporal fascia after acrossing the zygomatic arch. Conclusions The temporal branches of the facial nerve cross zygomatic arch at the distance of 16. 32 ~ 31. 30mm before the tragus. It is safe to dissect in the plane between the deep layer of the deep temporal fascia and the temporal muscle.

  15. Topology Optimization

    DEFF Research Database (Denmark)

    A. Kristensen, Anders Schmidt; Damkilde, Lars

    2007-01-01

    . A way to solve the initial design problem namely finding a form can be solved by so-called topology optimization. The idea is to define a design region and an amount of material. The loads and supports are also fidefined, and the algorithm finds the optimal material distribution. The objective function...... dictates the form, and the designer can choose e.g. maximum stiness, maximum allowable stresses or maximum lowest eigenfrequency. The result of the topology optimization is a relatively coarse map of material layout. This design can be transferred to a CAD system and given the necessary geometrically...... refinements, and then remeshed and reanalysed in other to secure that the design requirements are met correctly. The output of standard topology optimization has seldom well-defined, sharp contours leaving the designer with a tedious interpretation, which often results in less optimal structures. In the paper...

  16. Dispositional Optimism

    Science.gov (United States)

    Carver, Charles S.; Scheier, Michael F.

    2014-01-01

    Optimism is a cognitive construct (expectancies regarding future outcomes) that also relates to motivation: optimistic people exert effort, whereas pessimistic people disengage from effort. Study of optimism began largely in health contexts, finding positive associations between optimism and markers of better psychological and physical health. Physical health effects likely occur through differences in both health-promoting behaviors and physiological concomitants of coping. Recently, the scientific study of optimism has extended to the realm of social relations: new evidence indicates that optimists have better social connections, partly because they work harder at them. In this review, we examine the myriad ways this trait can benefit an individual, and our current understanding of the biological basis of optimism. PMID:24630971

  17. Capitalizing on Speaking Skill of EFL Learners for the Language Literacy

    Directory of Open Access Journals (Sweden)

    Fauzia Hasan Siddiqui

    2014-03-01

    Full Text Available This study aims at grabbing the attention of EFL /ESL teachers, trainers, and administrators towards the importance of teaching speaking skill to enhance overall language proficiency of EFL learners. Comprehensive research done in the field of applied linguistics and English Language Teaching (ELT establishes a positive correlation of speaking skill with the overall language proficiency. Despite this obvious significance of speaking skill in language learning process, it has not gained sufficient attention in the ELT or the assessments in Oman.  Relying on the available literature on the importance of the speaking skill and its effective role in enhancing other language macro skills (listening, reading, and writing, this exploratory research analyzes the currents status of speaking skill in ELT and assessments at the General Foundation Programme (GFP in Oman. As many GFP’s have IELTS (International English Language Testing System  exam as their programme exit examination, the study begins with measuring the correlation of speaking skill grades with other macro skill in order to accentuate the positive impact of speaking skill on other language skills. Secondly, it presents the statistics of time devoted to teaching and weights that speaking skill hold in the GFP in Oman. Finally, the study suggests the ways to optimize speaking skill opportunities to create successful literacy experience among adult EFL learners.

  18. Prevention and management of intraoperative rupture of anterior communicating aneurysms during microsurgical clipping%前交通动脉瘤显微夹闭术中动脉瘤破裂的预防及处理

    Institute of Scientific and Technical Information of China (English)

    许州; 陈谦学; 田道锋; 吴立权

    2011-01-01

    目的 总结前交通动脉瘤显微夹闭术中动脉瘤破裂的预防及处理.方法 回顾性分析89例采用显微手术夹闭的前交通动脉瘤病人的临床资料,其中15例发生术中动脉瘤破裂.结果 动脉瘤术中破裂的发生率为16.85%,15例术中破裂的动脉瘤均成功夹闭.随访15例,时间6个月,术后GOS评分:恢复良好8例,轻度残疾5例,重度残疾2例.结论 载瘤动脉的显露与合理的临时阻断,脑池的充分开放以及动脉瘤破裂出血后保持术野的清晰可以有效预防和处理前交通动脉瘤术中破裂的发生.%Objective To review the prevention and management of intraoperative rupture of anterior communicating aneurysms during microsurgical clipping. Methods The clinical data of 89 patients with anterior communicating aneurysms who underwent microsurgical clipping were analyzed retrospectively, 15 of whom suffered intraoperative rupture of aneurysms. Results The rate of intraoperative aneurysm rupture was 16.85%. All the ruptured aneurysms were clipped successfully. Fifteen patients were followed up for 6 months, and GOS revealed that 8 patients recovered well, 5 had mild disability and 2 severe disability. Conclusions The exposure and rational temporary occlusion of the parent artery, complete open of the cistern and keeping the surgical field clear are effective to prevent and manage intraoperative rupture of anterior communicating aneurysms.

  19. Leadership and Administrative Skills for Optimal Universal Basic ...

    African Journals Online (AJOL)

    DR Nneka

    This is true for the basic schools which have become quite complex and relatively difficult to ... careful analysis of the resources provided for it and the desired objectives of the system. It usually ..... Ocho, L. O. & Okeke, B. S. (Eds). Dynamics of ...

  20. Teaching Skills through Literature

    Directory of Open Access Journals (Sweden)

    Saleh Ahmed Saif Abdulmughni

    2016-03-01

    Full Text Available This study tries to investigate the contributory factors in the success and failure in teaching of the four language skills through teaching of literature because literature is critically and crucially relevant to the evolution of a literary sensibility. The basic end of literature is to read which develops reading skills and to reinterpret the dynamics of a given society. In this process the language skills are actually manifested. Literature, if we deconstruct the term involves two stages of reading; one that is the text, and second; the subsequent evaluation which entails the ability to break the text and trace the possibilities of meanings. This cannot be done without a proper perspective of the literary and linguistic mind, and the very act of interpretation amply appropriates reading skills. Literature fundamentally helps to develop the spirit of inquiry and the variety of thoughts involved in the representation of the text and; therefore, the study of literature enhances the ability to think beyond what you have been provided with and also to be equipped with a quizzical bent of mind that seeks to establish the competence to question what is read as a matter of literary text. This makes the learner naturally acquire the language from the literary context and consequently develop the language skills. Teaching of language through literature has been a tested method as literary texts are so complete with vocabulary, the terrain of thoughts, the diversity of human encounters and the complexity of experiences. In the process of deconstructing a text, one comes across umpteen shades of thoughts conceived and delivered in a compressed form. Also the decoding of the language given its symbolic structure greatly enhances the prospects of independent thinking and writing. In this way the written skills are widely developed. A text is a bundle of thoughts clad in a complicated web of linguistic sophistication, and the sophistry alone suffices to

  1. Skill-based Syllabus for Teaching Basic Writing Skills

    Institute of Scientific and Technical Information of China (English)

    秦苏芳

    2009-01-01

    Writing is an important skill that students should grasp in learning English, but the teaching and learning of writing is a difficult task. To teach freshmen with little knowledge of writing is extremely difficult. However, the skill-based syllabus is of great usefulness. It enables students to master the very basic writing skill, which helps them to keep pace with the writing requirements assigned by the textbooks, and to improve their overall writing skills so as to fulfill the requirements by the national College English Curriculum.

  2. Decadal prediction skill in the GEOS-5 forecast system

    Science.gov (United States)

    Ham, Yoo-Geun; Rienecker, Michele M.; Suarez, Max J.; Vikhliaev, Yury; Zhao, Bin; Marshak, Jelena; Vernieres, Guillaume; Schubert, Siegfried D.

    2014-01-01

    A suite of decadal predictions has been conducted with the NASA Global Modeling and Assimilation Office's (GMAO's) GEOS-5 Atmosphere-Ocean general circulation model. The hind casts are initialized every December 1st from 1959 to 2010, following the CMIP5 experimental protocol for decadal predictions. The initial conditions are from a multi-variate ensemble optimal interpolation ocean and sea-ice reanalysis, and from GMAO's atmospheric reanalysis, the modern-era retrospective analysis for research and applications. The mean forecast skill of a three-member-ensemble is compared to that of an experiment without initialization but also forced with observed greenhouse gases. The results show that initialization increases the forecast skill of North Atlantic sea surface temperature compared to the uninitialized runs, with the increase in skill maintained for almost a decade over the subtropical and mid-latitude Atlantic. On the other hand, the initialization reduces the skill in predicting the warming trend over some regions outside the Atlantic. The annual-mean atlantic meridional overturning circulation index, which is defined here as the maximum of the zonally-integrated overturning stream function at mid-latitude, is predictable up to a 4-year lead time, consistent with the predictable signal in upper ocean heat content over the North Atlantic. While the 6- to 9-year forecast skill measured by mean squared skill score shows 50 % improvement in the upper ocean heat content over the subtropical and mid-latitude Atlantic, prediction skill is relatively low in the subpolar gyre. This low skill is due in part to features in the spatial pattern of the dominant simulated decadal mode in upper ocean heat content over this region that differ from observations. An analysis of the large-scale temperature budget shows that this is the result of a model bias, implying that realistic simulation of the climatological fields is crucial for skillful decadal forecasts.

  3. Portfolio Optimization

    OpenAIRE

    Frajtova-Michalikova, Katarina; Spuchľakova, Erika; Misankova, Maria

    2015-01-01

    In this paper Portfolio Optimization techniques were used to determine the most favorable investment portfolio. In particular, stock indices of three companies, namely Microsoft Corporation, Christian Dior Fashion House and Shevron Corporation were evaluated. Using this data the amounts invested in each asset when a portfolio is chosen on the efficient frontier were calculated. In addition, the Portfolio with minimum variance, tangency portfolio and optimal Markowitz portfolio are presented.

  4. Communication skills in psychiatry training.

    Science.gov (United States)

    Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L; Levin, Tomer; Kissane, David; Cohen, Martin; Loughland, Carmel

    2015-08-01

    Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  5. Does your Robot have Skills?

    OpenAIRE

    Bøgh, Simon; Nielsen, Oluf Skov; Pedersen, Mikkel Rath; Krüger, Volker; Madsen, Ole,

    2012-01-01

    This article presents a unifying terminology for task-level programming of highly flexible mobile manipulators in industrial environments. With a terminology of tasks and object-centered skills, industrial applications are analyzed in the logistic and assistive domains. The analysis shows that many tasks can actually be solved with a small library of predefined building blocks, called skills. In logistics domains, it can be exploited that the sequences of skills needed to solve specific tasks...

  6. Taking Lawyering Skills Training Seriously

    OpenAIRE

    Binder, David A.; Bergman, Paul

    2003-01-01

    The lawyering skills so thoroughly explored in Gary Bellow and Bea Moulton's The Lawyering Process continue to be a major focus of clinical legal education. Distinguishing between case-centered and skill-centered clinical programs, this essay explores whether clinical courses provide a sufficient foundation for students to "transfer" the lawyering skills they are exposed to in law school to the practice of law. Drawing on the recent work of educational researchers and medical school educators...

  7. Developing a Research Skill Set

    OpenAIRE

    You, Y. Nancy; Bednarski, Brian

    2014-01-01

    The recent decades have witnessed a significant expansion in the diversity of career paths within academic surgery. Although the skills for providing exemplary surgical care and for maintaining a strong work ethic are the foundations of an academic surgeon, deliberate career planning and organized acquisition of research skills contribute to the success of an academic career. In this article, we identify a set of core academic skills and propose a framework for acquiring them. We also describ...

  8. Intraregional migration of skilled manpower.

    Science.gov (United States)

    Martinez Pizarro, J

    1993-08-01

    This is an analysis of the migration of skilled manpower among the countries of Latin America. "The author reviews its causes, possible implications, the characteristics of these flows of skilled migrants, and the relationship between what is to be observed in some countries and the official attitude adopted by their Governments. This examination suggests that the emigration of skilled human resources, regardless of their destination, is invariably a loss for developing countries owing to [migrants] high social value and economic cost." excerpt

  9. Improving the training process of highly skilled bodybuilders in the preparatory period, general preparatory phase

    Directory of Open Access Journals (Sweden)

    Olexandr Tyhorskyy

    2015-08-01

    Full Text Available Purpose: to improve the method of training highly skilled bodybuilders during the general preparatory phase. Material and Methods: the study involved eight highly skilled athletes, members of the team of Ukraine on bodybuilding. Results: comparative characteristics of the most commonly used methods of training process in bodybuilding. Developed and substantiated the optimal method of training highly skilled bodybuilders during the general preparatory phase of the preparatory period, which can increase body weight through muscle athletes component. Conclusions: based on studies, recommended the optimum method of training highly skilled bodybuilders depending on mezotsykles and microcycles general preparatory phase

  10. Development of scales for psychosocial skills in physical education and life skills

    OpenAIRE

    杉山, 佳生; 渋倉, 崇行; 西田, 保; 伊藤, 豊彦; 佐々木, 万丈; 磯貝, 浩久

    2010-01-01

    In this paper, we developed scales for psychosocial skills in physical education and life skills (psychosocial skills in daily life) that can be used to evaluate any enhancements in psychosocial skills in physical education classes and their transfer to life skills. Nine items common to both psychosocial skills in physical education and life skills, which included decision-making and problem-solving skills (3 items), communication and interpersonal skills (4 items), and emotion and stress cop...

  11. Optimizing the Long-Term Retention of Skills: Structural and Analytic Approaches to Skill Maintenance

    Science.gov (United States)

    1990-07-01

    which the students used ( Swokowski , 1986). The choice of categories was further constrained by a decision to test only information which pertained to...Cognitive Science, 8, 387-412. Swokowski , E.W. (1986). Fundamentals of Aljebra and Trigonometry, Sixth Edition. Boston: Prindle, Weber, & Schmidt. E-17

  12. Getting Skills Right: Assessing and Anticipating Changing Skill Needs

    Science.gov (United States)

    OECD Publishing, 2016

    2016-01-01

    Digitalisation, globalisation, demographic shifts and other changes in work organisation are constantly reshaping skill needs. This can lead to persistent skill shortages and mismatch which are costly for individuals, firms and society in terms of lost wages and lower productivity and growth. These costs can be reduced through better assessment…

  13. Parent-implemented behavioral skills training of social skills.

    Science.gov (United States)

    Dogan, Rebecca K; King, Melissa L; Fischetti, Anthony T; Lake, Candice M; Mathews, Therese L; Warzak, William J

    2017-09-20

    Impairment in social skills is a primary feature of Autism Spectrum Disorders (ASDs). Research indicates that social skills are intimately tied to social development and negative social consequences can persist if specific social behaviors are not acquired. The present study evaluated the effects of behavioral skills training (BST) on teaching four parents of children with ASDs to be social skills trainers. A nonconcurrent multiple baseline design across parent-child dyads was employed and direct observation was used to assess parent and child behaviors Results demonstrated substantial improvement in social skills teaching for all participants for trained and untrained skills. Ancillary measures of child performance indicated improvement in skills as well. High levels of correct teaching responses were maintained at a 1 month follow-up. This study extends current literature on BST while also providing a helpful, low-effort strategy to modify how parents can work with their children to improve their social skills. © 2017 Society for the Experimental Analysis of Behavior.

  14. Skill analysis part 3: improving a practice skill.

    Science.gov (United States)

    Price, Bob

    In this, the third and final article in a series on practice skill analysis, attention is given to imaginative ways of improving a practice skill. Having analysed and evaluated a chosen skill in the previous two articles, it is time to look at new ways to proceed. Creative people are able to be analytical and imaginative. The process of careful reasoning involved in analysing and evaluating a skill will not necessarily be used to improve it. To advance a skill, there is a need to engage in more imaginative, free-thinking processes that allow the nurse to think afresh about his or her chosen skill. Suggestions shared in this article are not exhaustive, but the material presented does illustrate measures that in the author's experience seem to have potential. Consideration is given to how the improved skill might be envisaged (an ideal skill in use). The article is illustrated using the case study of empathetic listening, which has been used throughout this series.

  15. Resilience: a transversal occupational skill for current organizations

    Directory of Open Access Journals (Sweden)

    María del Rosario Piñeros-Botero

    2013-12-01

    some studies related to deal the resilience from the transverse occupational skills and the MCclelland approach TO KNOW TO BE AND TO KNOW TO DO, as a structural base for behavior and performance of people. Finally we propose an organizational resilience model that presents its functionality and categorization of profiles in occupational and individual skills that allow encouraging cultural and organizational behavior by means of optimization strategies to current organizations. The term organizations, is going to be used to talk about an industry or enterprise of any kind or financial sector.

  16. Improving Pathologists' Communication Skills.

    Science.gov (United States)

    Dintzis, Suzanne

    2016-08-01

    The 2015 Institute of Medicine report on diagnostic error has placed a national spotlight on the importance of improving communication among clinicians and between clinicians and patients [1]. The report emphasizes the critical role that communication plays in patient safety and outlines ways that pathologists can support this process. Despite recognition of communication as an essential element in patient care, pathologists currently undergo limited (if any) formal training in communication skills. To address this gap, we at the University of Washington Medical Center developed communication training with the goal of establishing best practice procedures for effective pathology communication. The course includes lectures, role playing, and simulated clinician-pathologist interactions for training and evaluation of pathology communication performance. Providing communication training can help create reliable communication pathways that anticipate and address potential barriers and errors before they happen.

  17. Migrant Labor, Unemployment and Optimal Growth

    Directory of Open Access Journals (Sweden)

    Ioana Viasu

    2015-03-01

    Full Text Available One of the arguments against migrant labor is that it has negative ef- fect on the employment of domestic labor. The question is now if the immigration has also negative effects on the other variables of the econ- omy. To examine these effects we develop an optimal growth model with migration and unemployment and then we analyze these effects, restricting our analysis to the steady state. We introduce a simplify- ing hypothesis concerning the skill level of human capital. We assume that the average skill level of domestic employed labor differs from the average skill level of migrant labor, but the two kinds of labor grow at the same constant rate. We prove that the immigration process could have both positive and negative effects on consumption, human capital and physical capital, depending on the skill level of the migrant labor. The numerical simulations confirm our theoretical results.

  18. Unconstrained Optimization

    DEFF Research Database (Denmark)

    Frandsen, P. E.; Jonasson, K.; Nielsen, Hans Bruun

    1999-01-01

    This lecture note is intended for use in the course 04212 Optimization and Data Fitting at the Technincal University of Denmark. It covers about 25% of the curriculum. Hopefully, the note may be useful also to interested persons not participating in that course. The aim of the note is to give...... an introduction to algorithms for unconstrained optimization. We present Conjugate Gradient, Damped Newton and Quasi Newton methods together with the relevant theoretical background. The reader is assumed to be familiar with algorithms for solving linear and nonlinear system of equations, at a level corresponding...

  19. Unconstrained Optimization

    DEFF Research Database (Denmark)

    Frandsen, P. E.; Jonasson, K.; Nielsen, Hans Bruun

    1999-01-01

    This lecture note is intended for use in the course 04212 Optimization and Data Fitting at the Technincal University of Denmark. It covers about 25% of the curriculum. Hopefully, the note may be useful also to interested persons not participating in that course. The aim of the note is to give...... an introduction to algorithms for unconstrained optimization. We present Conjugate Gradient, Damped Newton and Quasi Newton methods together with the relevant theoretical background. The reader is assumed to be familiar with algorithms for solving linear and nonlinear system of equations, at a level corresponding...

  20. Assessing Trainee Surgeons’ Nontechnical Skills

    DEFF Research Database (Denmark)

    Spanager, Lene; Konge, Lars; Dieckmann, Peter

    2015-01-01

    BACKGROUND: Trainee surgeons would benefit from regular, formative assessments to ensure they learn the nontechnical aspects of surgical performance. Non-Technical Skills for Surgeons in Denmark (NOTSSdk) is a tool to assess surgeons' nontechnical skills (NTS) during an operation. The aims...

  1. Especial Skills in Experienced Archers.

    Science.gov (United States)

    Nabavinik, Mahdi; Abaszadeh, Ali; Mehranmanesh, Mehrab; Rosenbaum, David A

    2017-09-05

    Especial skills are skills that are distinctive by virtue of massive practice within the narrow contexts in which they are expressed. In the first demonstration of especial skills, Keetch, Schmidt, Lee, and Young (2005) showed that experienced basketball players are better at shooting baskets from the foul line, where they had massive amounts of practice, than would expected from their success at other locations closer to or farther from the basket. Similar results were obtained for baseball throwing. The authors asked whether especial skills hold in archery, a sport requiring less movement. If the emergence of especial skills depends on large-scale movement, one would expect archery to escape so-called especialism. But if the emergence of especial skills reflects a more general tendency for highly specific learning, experienced archers should show especial skills. The authors obtained evidence consistent with the latter prediction. The expert archers did much better at their most highly practiced distance than would be expected by looking at the overall function relating shooting score to distance. We offer a mathematical model to account for this result. The findings attest to the generality of the especial skills phenomenon.

  2. Knowledge and Skills for PISA

    DEFF Research Database (Denmark)

    Dohn, Nina Bonderup

    2007-01-01

    to the claims of PISA, PISA is not an assessment of the ‘knowledge and skills for life' of students, but only of ‘knowledge and skills in assessment situations'. Even this latter form of assessment is not fully reliable, however, because of problems at the level of concrete test items and because of an inherent...

  3. The Fundamental Skills Training Project

    Science.gov (United States)

    2003-08-01

    Computers in Human Behavior . 1. 59-74. Slavin, R. E. (1990). Cooperative learning and the gifted: Who benefits? Journal for the... Computers in Human Behavior , 15, 243-254. ISIS Scores on Design Experiment Subscale (Skills Test) By Skill Level 1997-1998 0% 10% 20% 30% 40% 50...word problem solving. Computers in Human Behavior , 15, 243-254. ________________________________________________________________________

  4. Key Findings for Interpersonal Skills

    Science.gov (United States)

    2013-12-04

    2005). Beyond difference and domination? Intercultural communication in legal contexts. Intercultural discourse and communication . The essential...trainable and consequential to warfighters in being good strangers. These key skills include observing and adapting to variation in communicative norms...warfighters in being good strangers. These key skills include observing and adapting to variation in communicative norms; allowing civilian

  5. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  6. Evidence for Multiple Rhythmic Skills.

    Directory of Open Access Journals (Sweden)

    Adam Tierney

    Full Text Available Rhythms, or patterns in time, play a vital role in both speech and music. Proficiency in a number of rhythm skills has been linked to language ability, suggesting that certain rhythmic processes in music and language rely on overlapping resources. However, a lack of understanding about how rhythm skills relate to each other has impeded progress in understanding how language relies on rhythm processing. In particular, it is unknown whether all rhythm skills are linked together, forming a single broad rhythmic competence, or whether there are multiple dissociable rhythm skills. We hypothesized that beat tapping and rhythm memory/sequencing form two separate clusters of rhythm skills. This hypothesis was tested with a battery of two beat tapping and two rhythm memory tests. Here we show that tapping to a metronome and the ability to adjust to a changing tempo while tapping to a metronome are related skills. The ability to remember rhythms and to drum along to repeating rhythmic sequences are also related. However, we found no relationship between beat tapping skills and rhythm memory skills. Thus, beat tapping and rhythm memory are dissociable rhythmic aptitudes. This discovery may inform future research disambiguating how distinct rhythm competencies track with specific language functions.

  7. Knowledge and Skills for PISA

    DEFF Research Database (Denmark)

    Dohn, Nina Bonderup

    2007-01-01

    to the claims of PISA, PISA is not an assessment of the ‘knowledge and skills for life' of students, but only of ‘knowledge and skills in assessment situations'. Even this latter form of assessment is not fully reliable, however, because of problems at the level of concrete test items and because of an inherent...

  8. Integrating Writing and Negotiation Skills.

    Science.gov (United States)

    Lawrence, Carolena Lyons

    2002-01-01

    Describes an assignment in which students must integrate writing and negotiation skills with proposal development. Notes that many students have been able to share their problem-solving skills by implementing their proposal at their workplace. Notes students liked the opportunity to select a topic of interest to them. (SG)

  9. Communication Skills Training for Divorcees.

    Science.gov (United States)

    Avery, Arthur W.; Thiessen, Jake D.

    1982-01-01

    Examined the effects of a weekend communication skills training program for divorced persons. Subjects in the experimental group (N=13) received interpersonal skills training, while the control group (N=14) received no training. Results indicated experimentals significantly increased their perceived level of social support, self-disclosure and…

  10. Evidence for Multiple Rhythmic Skills.

    Science.gov (United States)

    Tierney, Adam; Kraus, Nina

    2015-01-01

    Rhythms, or patterns in time, play a vital role in both speech and music. Proficiency in a number of rhythm skills has been linked to language ability, suggesting that certain rhythmic processes in music and language rely on overlapping resources. However, a lack of understanding about how rhythm skills relate to each other has impeded progress in understanding how language relies on rhythm processing. In particular, it is unknown whether all rhythm skills are linked together, forming a single broad rhythmic competence, or whether there are multiple dissociable rhythm skills. We hypothesized that beat tapping and rhythm memory/sequencing form two separate clusters of rhythm skills. This hypothesis was tested with a battery of two beat tapping and two rhythm memory tests. Here we show that tapping to a metronome and the ability to adjust to a changing tempo while tapping to a metronome are related skills. The ability to remember rhythms and to drum along to repeating rhythmic sequences are also related. However, we found no relationship between beat tapping skills and rhythm memory skills. Thus, beat tapping and rhythm memory are dissociable rhythmic aptitudes. This discovery may inform future research disambiguating how distinct rhythm competencies track with specific language functions.

  11. PIAAC Skills and Economic Inequality

    Science.gov (United States)

    Pena, Anita Alves

    2016-01-01

    Mixed findings characterize the literature on skills and economic distributions within and across countries. The Programme for the International Assessment of Adult Competencies (PIAAC) offers new, internationally comparable data on literacy, numeracy, and digital problem-solving skills that can be combined with wage information. This paper…

  12. Risk, Balanced Skills and Entrepreneurship

    NARCIS (Netherlands)

    C. Hsieh; S.C. Parker; M.C. van Praag

    2015-01-01

    This paper proposes that risk aversion encourages individuals to invest in balanced skill profiles, making them more likely to become entrepreneurs. By not having taken this possible linkage into account, previous research has underestimated the impacts both of risk aversion and balanced skills on t

  13. SKILL SELECTIVITY IN TRANSATLANTIC MIGRATION

    NARCIS (Netherlands)

    Juif, Dácil

    2015-01-01

    The skill composition of European migrants to the New World and their contribution to the human capital and institutional formation in destination countries are popular topics in economic history. This study assesses the skill composition of 19th century transatlantic migrants to Cuba.

  14. Skilled up and Having Fun

    Science.gov (United States)

    Goldsworthy, Anne

    2013-01-01

    Many teachers seem to have followed the "dunking theory." That is, they dunk their children in a variety of investigations and hope that through their practical work they will absorb a thorough understanding of enquiry skills. Children seem to have quite a good natural waterproof coating when it comes to absorbing scientific skills through…

  15. Business Management Occupations: Skill Standards.

    Science.gov (United States)

    Vocational Technical Education Consortium of States, Decatur, GA.

    This report organizes the information provided by 77 individuals in business management occupations in 12 states into skills inventories for persons in these jobs. The skills inventories contain the following sections: (1) occupation-specific knowledge (communication, mathematics, science); (2) workplace behaviors (work ethics, interpersonal…

  16. Business Financial Occupations: Skill Standards.

    Science.gov (United States)

    Vocational Technical Education Consortium of States, Decatur, GA.

    This report organizes the information provided by 71 individuals in finance-related occupations in 11 states into skills inventories for persons in these jobs. The skills inventories contain the following sections: (1) occupation-specific knowledge (communication, mathematics, science); (2) workplace behaviors (work ethics, interpersonal…

  17. Instruction of Competent Psychomotor Skill

    Science.gov (United States)

    Olson, Valerie Dong

    2008-01-01

    Instruction of competent psychomotor skill necessitates an eclectic approach. The principles of learning, complemented with learning styles and sensory modalities preferences, provide a background for teaching physical skills. The use of the psychomotor domain of Bloom's Taxonomy as a map and corresponding behavioral objectives foster the mastery…

  18. Epilepsy, language, and social skills.

    Science.gov (United States)

    Caplan, Rochelle

    2017-10-04

    Language and social skills are essential for intrapersonal and interpersonal functioning and quality of life. Since epilepsy impacts these important domains of individuals' functioning, understanding the psychosocial and biological factors involved in the relationship among epilepsy, language, and social skills has important theoretical and clinical implications. This review first describes the psychosocial and biological factors involved in the association between language and social behavior in children and in adults and their relevance for epilepsy. It reviews the findings of studies of social skills and the few studies conducted on the inter-relationship of language and social skills in pediatric and adult epilepsy. The paper concludes with suggested future research and clinical directions that will enhance early identification and treatment of epilepsy patients at risk for impaired language and social skills. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Interactive Teaching in Interpersonal Skills

    DEFF Research Database (Denmark)

    Christensen, Jørgen Erik; Karhu, Markku; Christensen, Cecillia

    2013-01-01

    Engineers are very much part of the ongoing globalization and they are encountering problems of cross-disciplinary nature. Team working skills respecting other peoples’ qualifications are required so therefore interpersonal skills are becoming more and more important, including communications...... skills, leadership and awareness. Consequently, educational programs for teaching engineers should work with the fact that the capability of communicating with people with different background competences is important, nevertheless the engineering education has traditionally focused on technical skills...... to the CDIO (conceive, design, implement and operate) approach in the autumn of 2008. The CDIO pedagogy encouraged to develop an interactive course in interpersonal skills, where the students have to take an active part in the exercises as well as involve themselves in the interactive communication process...

  20. Interactive Teaching in Interpersonal Skills

    DEFF Research Database (Denmark)

    Christensen, Jørgen Erik; Karhu, Markku; Christensen, Cecillia

    2013-01-01

    Engineers are very much part of the ongoing globalization and they are encountering problems of cross-disciplinary nature. Team working skills respecting other peoples’ qualifications are required so therefore interpersonal skills are becoming more and more important, including communications...... to the CDIO (conceive, design, implement and operate) approach in the autumn of 2008. The CDIO pedagogy encouraged to develop an interactive course in interpersonal skills, where the students have to take an active part in the exercises as well as involve themselves in the interactive communication process...... skills, leadership and awareness. Consequently, educational programs for teaching engineers should work with the fact that the capability of communicating with people with different background competences is important, nevertheless the engineering education has traditionally focused on technical skills...

  1. Developing a research skill set.

    Science.gov (United States)

    You, Y Nancy; Bednarski, Brian

    2014-06-01

    The recent decades have witnessed a significant expansion in the diversity of career paths within academic surgery. Although the skills for providing exemplary surgical care and for maintaining a strong work ethic are the foundations of an academic surgeon, deliberate career planning and organized acquisition of research skills contribute to the success of an academic career. In this article, we identify a set of core academic skills and propose a framework for acquiring them. We also describe specific career paths within academic surgery and provide an overview of the opportunities for acquiring specific skill sets. The development of an academic career is challenging, and firm knowledge of the personal motivations will sustain and endure the time needed for acquiring the needed skills.

  2. Communication skills training in orthopaedics.

    Science.gov (United States)

    Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

    2008-06-01

    Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

  3. [Development of skill scale for communication skill measurement of pharmacist].

    Science.gov (United States)

    Teramachi, Hitomi; Komada, Natsuki; Tanizawa, Katsuya; Kuzuya, Yumi; Tsuchiya, Teruo

    2011-04-01

    To purpose of this study was to develop a pharmacist communication skill scale. A 38 items scale was made and 283 pharmacists responded. The original questionnaire consisted of 38 items, with 1-5 graded Likert scale. Completed responses of 228 pharmacists data were used for testing the reliability and the validity of this scale. The first group of items from the original questionnaire were 38, and finally 38 original items were chosen for investigation of content validity, correlation coefficient and commonality. From factor analysis, four factors were chosen among the 31 items as follows: patient respect reception skill, problem discovery and solution skill, positive approach skill, feelings processing skill. The correlation coefficient between this original scale and the KiSS-18 (Social Skill) received high score (r=0.694). The reliability of this scale showed high internal consistency (Cronbach α coefficient=0.951), so the result of test for the validity of this scale supports high content validity. Thus we propose adoption of pharmacist communication skill scale to carry a brief eponymous name as TePSS-31. The above findings indicate that this developed scale possess adequate validity and reliability for practical use.

  4. Optimal transport

    CERN Document Server

    Eckmann, B

    2008-01-01

    At the close of the 1980s, the independent contributions of Yann Brenier, Mike Cullen and John Mather launched a revolution in the venerable field of optimal transport founded by G Monge in the 18th century, which has made breathtaking forays into various other domains of mathematics ever since. The author presents a broad overview of this area.

  5. Topology optimization

    DEFF Research Database (Denmark)

    Bendsøe, Martin P.; Sigmund, Ole

    2007-01-01

    Taking as a starting point a design case for a compliant mechanism (a force inverter), the fundamental elements of topology optimization are described. The basis for the developments is a FEM format for this design problem and emphasis is given to the parameterization of design as a raster image...

  6. Valuing skill differences : Perceived skill complementary and dyadic helping behavior in teams

    NARCIS (Netherlands)

    Oosterhof, A.; van der Vegt, G.S.; Van de Vliert, E.; Sanders, K.

    2009-01-01

    This article reports effects of perceived skill dissimilarity and perceived skill complementarity on dyadic helping behavior using a cross-lagged panel study. Specifically, the authors hypothesize that perceived skill dissimilarity is negatively related, whereas perceived skill complementarity is po

  7. Valuing Skill Differences: Perceived Skill Complementarity and Dyadic Helping Behavior in Teams

    NARCIS (Netherlands)

    Oosterhof, Aad; Vegt, van der Gerben S.; Vliert, van de Evert; Sanders, Karin

    2009-01-01

    This article reports effects of perceived skill dissimilarity and perceived skill complementarity on dyadic helping behavior using a cross-lagged panel study. Specifically, the authors hypothesize that perceived skill dissimilarity is negatively related, whereas perceived skill complementarity is po

  8. Valuing skill differences : Perceived skill complementary and dyadic helping behavior in teams

    NARCIS (Netherlands)

    Oosterhof, A.; van der Vegt, G.S.; Van de Vliert, E.; Sanders, K.

    2009-01-01

    This article reports effects of perceived skill dissimilarity and perceived skill complementarity on dyadic helping behavior using a cross-lagged panel study. Specifically, the authors hypothesize that perceived skill dissimilarity is negatively related, whereas perceived skill complementarity is po

  9. 显微松解术治疗儿童脊髓栓系综合征疗效分析%Microsurgical release of tethered spinal cord in pediatric patients: analysis on therapeutic effects

    Institute of Scientific and Technical Information of China (English)

    贺晓生; 陈伟; 李娜; 费舟; 刘卫平; 屈延; 李兵

    2012-01-01

    目的 总结分析儿童脊髓栓系的显微松解手术效果.方法 西安西京医院2007年1月至2011年12月收治脊髓圆锥和马尾部神经症状患儿80例.MRI显示全部病例伴有腰骶椎板缺如、脊髓低位、终丝增粗、脊髓末端占位.接受脊髓栓系松解手术(包括脊膜膨出囊和腰骶椎管内病变切除),28例患儿术中获得脊髓圆锥和马尾神经电生理监测,术后对67例患儿随访.结果 患儿术后住院期内自述症状缓解或减轻者69% (55/80).大、小便异常的患儿中,术后改善者占62%(40/65);下肢感觉、运动以及发育和营养症状40例中,18例术后早期下肢感觉功能好转(45%),11例运动障碍出现改善(28%).随访时大小便功能较术前明显改善者占79% (45/57);下肢感觉和运动障碍较术前明显改善者占63% (22/35);术中接受脊髓圆锥和马尾神经电生理监测的患儿,比未接受监测者,自评症状改善率明显增加.结论 显微分离技术和神经电生理监测手段,是保障松解手术效果的关键因素.%Objective To summarize and analyze the therapeutic effects of microsurgical release on pediatric patients with tethered spinal cord.Methods Eighty hospitalized patients with conus and cauda equina symptoms were included in this study.Their MRI showed lumbosacral laminectomy defect,spinal low,terminal filament thickening and spinal cord end mass.All cases received microsurgical release operation including resection of the meningocele sac and lumbosacral intraspinal lesion.Among which,28 patients underwent the electrophysiological monitoring for the functions of conus and cauda equine in operation.Post - operational follow - up were obtained for 67 cases.Results The 69% children self - evaluated an alleviation and mitigation for their symptoms.The 62% cases improved in the cases with abnormality of defecation and urination.Among those with sensory,motor,lower extremities development and nutrition

  10. 单鼻孔经蝶入路显微手术治疗垂体瘤46例%Microsurgical endonasal transsphenoidal approach for 46 patients with pituitary adenomas

    Institute of Scientific and Technical Information of China (English)

    杨登峰

    2013-01-01

    Objective To explore the effect of microsurgical endonasal transsphenoidal approach on the treatment of pituitary adenomas.Methods The clinical data of 46 cases with pituitary adenomas treated through microsurgical endonasal transsphenoidal approach were retrospectively analyzed.The relevant endocrine index and MRI were checked during the follow-up and the clinical effect and complication were analyzed.Results 38 cases achieved follow-up.There were 32 (84.2%) cases of total resection and 6 (15.8%) cases of subtotal resection.28 patients (93.3%) had vision improved in 30 patients with decreased vision before operation.24 patients(75.0%) got normal menstruation in 32 patients with menstrual disorder.4 patients (57.1%) got better in 7 patients with acromegaly.12 patients(75.0%) got normal endocrine in 16 hyper-prolactin patients.4 patients(57.1%) got normal growth hormone in 7 patients with somatotrophinomas.There was one postoperative death.12 cases (24.4%) suffered postoperative insipidus in 45 patients.Cerebrospinal rhinorrhea occurred in 3 patients(6.7%,3/45) postoperatively.Postoperative hyperglycemia occurred in 9 cases (20.0%,9/45).Conclusion Microsurgical endonasal transsphenoidal approach provides the first choice for operation of pituitary adenomas,which is effective and safe with reliable effect.%目的 探讨显微镜单鼻孔经蝶入路手术治疗垂体瘤的疗效.方法 回顾性分析46例患者的临床资料,采用显微镜单鼻孔经蝶窦入路治疗垂体瘤,随访中复查相关内分泌指标及MRI检查,统计其疗效及并发症结果.结果 随访38例,其中肿瘤全切除者32例(84.2%),次全切除者6例(15.8%);视力改善者28例(93.3%,28/30),月经及泌乳逐步好转者24例(75.0%,24/32),肢体肥大好转者4例(57.1%,4/7);内分泌指标改善:催乳激素12例(75.0%,12/16),生长激素4例(57.1%,4/7).并发症:死亡1例,尿崩12例(24.4%,11/45),脑脊液鼻漏3例(6.7%,3/45),

  11. Effects of microsurgical free flap transfer on oral and maxillofacial reconstruction%游离皮瓣移植修复口腔颌面部缺损的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    翟沁凯; 王绪凯; 卢利; 孙长伏; 谭学新; 秦兴军; 黄绍辉

    2011-01-01

    Objective To analyze the clinical value of microsurgical free flap transfers for oral and maxillofacial region reconstruction.Methods One hundred and sixty-eight consecutive microsurgical free flap transfers performed on patients who had oral and maxillofacial defects from premodinantly surgical procedure due to carcinoma from March 2006 to August 2010 were reviewed.Concerning data include 90 free radial forearm flap,31 free fibular flap,39 anterolateral thigh flap and 8 latissmus dorsi musculocutaneous flap.Observe the microsurgical free plap survival rate and complication postoperatively.Results The overall success rate of flap was 97.6%(164/168).The overall complication rate was 6.5% (11/168).The flap crisis rate was 5.4% (9/168)including the vessel thrombosis rate 66.7% (6/9), and the flap salvage rate was 55.6% (5/9).Survival rate of radial forearm free flap,anterolateral thigh flap,fibular flap and latissmus dorsi musculocutaneous flap were 97.8% ,97.4% ,96.8%, 100% respectively.The features and functions of patients were mainly satisfactory after 2 ~ 2.5 years' follow-ups.Conclusions Mierosurgieal free flap transfer for oral and maxiilofaeial region defects is safe and reliable.The free radial forearm flap was most commonly used, followed by anterolateral thigh flap,fibular free flap and latissimus dorsi flap.%目的 探讨游离皮瓣在修复口腔颌面部缺损中的临床应用价值.方法 选择2006年03月-2010年08月中国医科大学口腔医学院口腔颌面外科用游离皮瓣修复口腔颌面部缺损病例168例,前臂游离皮瓣90例,股前外侧游离皮瓣39例,腓骨肌皮瓣31例,背阔肌皮瓣8例.术后观察皮瓣成活率和并发症.结果 成功164(97.6%)例,失败4例,患者出现术后早期局部并发症6.5%(11/168),术后皮瓣危象发生率为5.4%(9/168),其中静脉血栓形成66.7%(6/9),手术探查抢救成功率55.6%(5/9),前臂桡侧皮瓣成活率97.8%(88/90);股前外侧皮瓣成活率97

  12. Europe's Skill Challenge: Lagging Skill Demand Increases Risks of Skill Mismatch. Briefing Note

    Science.gov (United States)

    Cedefop - European Centre for the Development of Vocational Training, 2012

    2012-01-01

    The main findings of Cedefop's latest skill demand and supply forecast for the European Union (EU) for 2010-20, indicate that although further economic troubles will affect the projected number of job opportunities, the major trends, including a shift to more skill-intensive jobs and more jobs in services, will continue. Between 2008 and 2010…

  13. Two Thinking Skills Assessment Approaches: "Assessment of Pupils' Thinking Skills" and "Individual Thinking Skills Assessments"

    Science.gov (United States)

    Burke, Lynsey A.; Williams, Joanne M.

    2012-01-01

    This paper is linked to a previous paper outlining an evaluation of a thinking skills intervention (Burke & Williams, 2008). Following extensive requests for the assessment tools used in the intervention, this short paper presents the development and potential uses of two thinking skills assessment tools. The aim of the paper is simply to make…

  14. Two Thinking Skills Assessment Approaches: "Assessment of Pupils' Thinking Skills" and "Individual Thinking Skills Assessments"

    Science.gov (United States)

    Burke, Lynsey A.; Williams, Joanne M.

    2012-01-01

    This paper is linked to a previous paper outlining an evaluation of a thinking skills intervention (Burke & Williams, 2008). Following extensive requests for the assessment tools used in the intervention, this short paper presents the development and potential uses of two thinking skills assessment tools. The aim of the paper is simply to make…

  15. Skill versus luck: A motivational analysis of gambling involvement.

    Science.gov (United States)

    Chantal, Y; Vallerand, R J

    1996-12-01

    The purpose of the present investigation was to test the skill/luck distinction among gambling games by comparing the motivations underlying participation in a skill (horse racing) and a luck (lottery) betting activity. Predictions were made using Self-Determination Theory (Deci & Ryan, 1985, 1991). It was predicted that self-determined motivations (intrinsic motivation and identified regulation) would be more prominent for the skill game because it is conducive to optimal challenges, fun, and self-involvement. Conversely, the non self-determined forms of motivation (especially external regulation) should be more important for the game of luck because the luck dimension precludes true involvement of the self and orients the individual towards material gains. Results from a hierarchical discriminant function analysis, with 120 gamblers predominantly involved in one of the two betting activities, supported these hypotheses. These results highlight the relevance of a motivational analysis for a better understanding of the inherent properties of gambling games.

  16. EVA Skills Training

    Science.gov (United States)

    Parazynski, Scott

    2012-01-01

    Dr. Parazynski and a colleague from Extravehicular Activity (EVA), Robotics, & Crew Systems Operations (DX) worked closely to build the EVA Skills Training Program, and for the first time, defined the gold standards of EVA performance, allowing crewmembers to increase their performance significantly. As part of the program, individuals had the opportunity to learn at their own rate, taking additional water time as required, to achieve that level of performance. This focus on training to one's strengths and weaknesses to bolster them enabled the Crew Office and DX to field a much larger group of spacewalkers for the daunting "wall of EVA" required for the building and maintenance of the ISS. Parazynski also stressed the need for designers to understand the capabilities and the limitations of a human in a spacesuit, as well as opportunities to improve future generations of space. He shared lessons learned (how the Crew Office engaged in these endeavors) and illustrated the need to work as a team to develop these complex systems.

  17. Skills Development and Transfer Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Mutshena, M.T.; Nkuna, K.K. [Pebble Bed Modular Reactor Pty (Ltd), P O Box 9394, Centurion, 0046 (South Africa); South African Young Nuclear Professionals Society (South Africa); Thugwane, S.J. [South African Young Nuclear Professionals Society (South Africa); Rasweswe, M.A. [South African Young Nuclear Professionals Society (South Africa); Nuclear Energy Cooperation of South Africa, P O Box 582, PRETORIA 0001 (South Africa)

    2008-07-01

    South Africa as a developing country is faced with numerous challenges amongst them is the shortage of skills in the working environment. Skills shortage has been aggravated by the retirement of the ageing skilled workforce and emigration of most experienced professionals to first world countries. Some professionals once they acquire the experience they opt out for a consultative business. This leaves a gap or void in the industries which can results into poor performance and quality, lessening of business standards and loosing competition. This challenge need to be attended to, because it will lead to hiring of consultants in most jobs or having many young and less experienced professionals and new graduates filling these gaps. The South African Young Nuclear Professionals Society (SAYNPS) has developed a strategic plan to serve as a guideline on how these challenges mentioned above can be addressed [1]. The proposed strategy will be aligned with skills development in the line of work and should get support from the nuclear Industry. Young professionals and recent graduates are the most affected people who lack skills and shall benefit from these programmes. In order for skill development and transfer to be accomplished there should be a Skill Development and Transfer Strategy and procedures to be followed. (authors)

  18. The health literacy skills framework.

    Science.gov (United States)

    Squiers, Linda; Peinado, Susana; Berkman, Nancy; Boudewyns, Vanessa; McCormack, Lauren

    2012-01-01

    Although there are a variety of models and frameworks that describe factors that are associated with health literacy skills, few illustrate the full pathway from development and moderators of health literacy skills, their application, and the outcomes that result all in one framework or model. This article introduces the Health Literacy Skills conceptual framework that does encompass this full continuum. To develop the framework, the authors reviewed and built upon existing health literacy frameworks. The Health Literacy Skills framework hypothesizes the relations between health literacy and health-related outcomes and depicts how health literacy functions at the level of the individual. The framework also reflects how factors external to the individual (e.g., family, setting, community, culture, and media) influence the constructs and relations represented in the framework. The framework is organized into 4 primary components: (a) factors that influence the development and use of health literacy skills; (b) health-related stimuli; (c) health literacy skills needed to comprehend the stimulus and perform the task; and (d) mediators between health literacy and health outcomes. Previous theoretical frameworks lend support to the proposed causal pathways it illustrates. The authors hope this conceptual framework can serve as a springboard for further discussion and advancement in operationalizing this complex construct. The Health Literacy Skills framework could also be used to guide the development of interventions to improve health literacy. Future research should be conducted to fully test the relations in the framework.

  19. Quantifying Cricket Fast Bowling Skill.

    Science.gov (United States)

    Feros, Simon A; Young, Warren B; O'Brien, Brendan J

    2017-09-27

    To evaluate the current evidence regarding the quantification of cricket fast bowling skill. Studies that assessed fast bowling skill (bowling speed and accuracy) were identified from searches in SPORTDiscus (EBSCO) in June 2017. The reference lists of identified papers were also examined for relevant investigations. Sixteen papers matched the inclusion criteria, and discrepancies in assessment procedures were evident. Differences in: test environment, pitch and cricket ball characteristics, the warm-up prior to test, test familiarisation procedures, permitted run-up lengths, bowling spell length, delivery sequence, test instructions, collection of bowling speed data, collection and reportage of bowling accuracy data were apparent throughout the literature. The reliability and sensitivity of fast bowling skill measures has rarely been reported across the literature. Only one study has attempted to assess the construct validity of their skill measures. There are several discrepancies in how fast bowling skill has been assessed and subsequently quantified in the literature to date. This is a problem, as comparisons between studies are often difficult. Therefore, a strong rationale exists for the creation of match-specific standardised fast bowling assessments that offer greater ecological validity while maintaining acceptable reliability and sensitivity of the skill measures. If prospective research can act on the proposed recommendations from this review, then coaches will be able to make more informed decisions surrounding player selection, talent identification, return to skill following injury, and the efficacy of short- and long-term training interventions for fast bowlers.

  20. Making predictions skill level analysis

    Science.gov (United States)

    Katarína, Krišková; Marián, Kireš

    2017-01-01

    The current trend in the education is focused on skills that are cross-subject and have a great importance for the pupil future life. Pupils should acquire different types of skills during their education to be prepared for future careers and life in the 21st century. Physics as a subject offers many opportunities for pupils' skills development. One of the skills that are expected to be developed in physics and also in other sciences is making predictions. The prediction, in the meaning of the argument about what may happen in the future, is an integral part of the empirical cognition, in which students confront existing knowledge and experience with new, hitherto unknown and surprising phenomena. The extent of the skill is the formulation of hypotheses, which is required in the upper secondary physics education. In the contribution, the prediction skill is specified and its eventual levels are classified. Authors focus on the tools for skill level determination based on the analysis of pupils` worksheets. Worksheets are the part of the educational activities conducted within the Inquiry Science Laboratory Steelpark. Based on the formulation of pupils' prediction the pupils thinking can be seen and their understanding of the topic, as well as preconceptions and misconceptions.