[Abstracts of VIII Young Scientists Conference dedicated to 55th anniversary of Central Research Institute of Dentistry and Maxillofacial Surgery 'Modern scientific achievements in dentistry and maxillofacial surgery'].
Abstracts of VIII Young Scientists Conference dedicated to 55th anniversary of Central Research Institute of Dentistry and Maxillofacial Surgery 'Modern scientific achievements in dentistry and maxillofacial surgery'. Therapeutic stomatology. Surgical dentistry. Maxillofacial surgery. Orthopedic stomatology. Orthodontics. Organization of dental care.
Full Text Available Abstract Background Although regulatory compliance in academic research is enforced by law to ensure high quality and safety to participants, its implementation is frequently hindered by cost and logistical barriers. In order to decrease these barriers, we have developed a Web-based application, Duke Surgery Research Central (DSRC, to monitor and streamline the regulatory research process. Results The main objective of DSRC is to streamline regulatory research processes. The application was built using a combination of paper prototyping for system requirements and Java as the primary language for the application, in conjunction with the Model-View-Controller design model. The researcher interface was designed for simplicity so that it could be used by individuals with different computer literacy levels. Analogously, the administrator interface was designed with functionality as its primary goal. DSRC facilitates the exchange of regulatory documents between researchers and research administrators, allowing for tasks to be tracked and documents to be stored in a Web environment accessible from an Intranet. Usability was evaluated using formal usability tests and field observations. Formal usability results demonstrated that DSRC presented good speed, was easy to learn and use, had a functionality that was easily understandable, and a navigation that was intuitive. Additional features implemented upon request by initial users included: extensive variable categorization (in contrast with data capture using free text, searching capabilities to improve how research administrators could search an extensive number of researcher names, warning messages before critical tasks were performed (such as deleting a task, and confirmatory e-mails for critical tasks (such as completing a regulatory task. Conclusion The current version of DSRC was shown to have excellent overall usability properties in handling research regulatory issues. It is hoped that its
The objects of the Association journal shall be the advancement of the science and art of surgery and the promotion of friendship and exchange of ideas between surgeons in the constituent countries of The Association of Surgeons of East Africa (ASEA) and The College of Surgeons of East, Central and Southern Africa ...
Author Guidelines. Instructions for Authors. The East and Central African Journal of Surgery will consider new manuscripts on clinical research, surgical technique, surgical practice, trauma, critical care, as well as clinical reviews, editorials, brief communications, and letters of interest to readers in Africa and globally.
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Focus and Scope. The journal's objects are the advancement of the science and art of surgery and exchange of ideas among surgeons in the constituent countries of The Association of Surgeons of East Africa (ASEA) and The College of Surgeons of East, Central and Southern Africa (COSECSA).
Editorial - East and Central African Journal of Surgery: The Canadian connection. Jonathan Meakins, Edward W Archibald, James Waddell. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE ...
Principal Contact. Prof. Ignatius Kakande Editor-in-Chief Association of Surgeons of East Africa. East and Central African Journal of Surgery. P.O. Box 7051. Kampala. Uganda. Alternative email: email@example.com. Phone: +256 772 501 745. Email: firstname.lastname@example.org ...
Miller, Jeffrey W; Vu, Dien N; Chai, Paul J; Kreutzer, Janet H; John, J Blaine; Vener, David F; Jacobs, Jeffrey P
A central venous catheter located in the jugular or subclavian vein provides rapid, reliable vascular access for pediatric heart surgery. However, intravascular catheters are associated with vessel injury. Stenosis or thrombosis of central veins in the upper body can lead to 'superior vena cava syndrome' with markedly elevated venous pressures in the head and neck, causing facial swelling and headaches. This complication may be especially serious for patients with superior cavopulmonary (Glenn) or total cavopulmonary (Fontan) circulation. The authors hypothesized that upper body central line placement would be associated with a low risk of venous thrombosis or stenosis. A three-year retrospective review of infant and univentricular cardiac procedures at a single institution was performed. Two hundred and thirty-five consecutive cardiac surgical patients central lines are routinely placed by the anesthesiologist after induction of anesthesia for pediatric cardiac surgery at the study institution. The major exception is existing central venous access via an umbilical vein or femoral vein. Patients central line [Cook Medical polyurethane, no antibiotic or heparin coating]. Those over two years of age received a 5.0-French, 8-cm triple lumen central line [Cook Medical polyurethane, no antibiotic or heparin coating]. A retrospective review of charts, hospital reports, echocardiographic studies, and cardiac catheterization studies was performed. The combined population of infants central lines were inserted. A total of 158 right internal jugular vein catheters were placed. Two left internal jugular lines, two left subclavian lines, and nine right subclavian lines were placed in this population after failure to obtain right internal jugular access. Due to the small sample size (N = 13), the central lines not placed in the right internal jugular vein were excluded from further review. Two cases with right internal jugular venous lines were excluded due to death (without
Central Line-associated Bloodstream Infection (CLABSI); Central Venous Catheter Associated Bloodstream Infection; Heart; Surgery, Heart, Functional Disturbance as Result; Congenital Heart Disease; Newborn; Infection
The present thesis was designed to evaluate the qualitative and quantitative aspects of plastic surgery research by means of a bibliometric citation analysis of plastic surgical presentations and publications. Citations to such published work provides an indication of the impact and the relevance of
A. M. Batyrshina
Full Text Available Objective: to study hemodynamic changes and the development rate of adaptive reactions in patients with hypokinetic circulation during lung resections varying in volumes. Subjects and methods. Thirty-eight patients with hypo-kinetic circulation, who had undergone sublobar resections, lobectomies, and pneumonectomies, were examined. The values of hemodynamics and gas exchange were recorded at the basic surgical stages and in the early postoperative period (on days 1, 3, 7, and 10. Results. When the patient is placed in the lateral position, the lung is switched off, or the surgical pneumothorax is less than 10—12%, cardiac index changes generally fail to give rise to the decompensation of adaptive processes in the cardiovascular system if the volume of a surgical intervention does not exceed that of sublobar resections or lobectomies. A 15% or more change in cardiac index during controlled lung collapse even with the minimum volume of surgery is indicative of the breakdown of physiological adaptation processes and may manifest itself through the symptoms of cardiorespiratory decompensation in both intra- and postoperative periods. Conclusion. The patients with baseline poor, hypokinetic circulation need not only adequate preoperative estimation of central hemodynamic values, but also continuous intraoperative monitoring of the basic parameters of central hemodynamics. The magnitude of a reduction in cardiac index is prognostically important at the stage of one-lung ventilation during surgical pneumothorax. Key words: hypokinetic circulation, thoracic cancer surgery, central hemodynamic monitoring.
Full Text Available Background and objective Fast track surgery (FTS is a systematical method to accelerate the recovery of surgical patients by reducing the physical and mental trauma stress of them. The research is to investigate the feasibility of FTS application in lung cancer surgery. Methods A total of 80 cases of lung cancer patients with single leaf lobotomy resection were randomized into two groups. While the experimental group was treated with the conception of FTS, and the control group was treated with the traditional methods. The incident rate of post-operation pain degrees, telecasts, pleural effusion, the post-operation time stay in hospital time and the total cost during hospitalization in two groups were compared respectively. Results In FTS group: the VAS score of post-operation pain at 1 h, 6 h, 12 h, 24 h and 48 h all significantly decreased compared to the traditional therapy group. The incidence rate of telecast was 10.53%. The incidence rate of pleural effusion was 26.31%. The length of stay after operation was (4±1 d and the total cost was RMB 15 600±7 600. In the control group, the above values were 77.78%, 33.33%, 22.22%, (9±1 d, RMB 23 600±5 400, respectively. The post operation pain (VAS method of FTS group was remarkablely below the control group. There has significant difference of the incident rate of telecasts, stay time in hospital and the total cast in two groups (P < 0.05. No significant difference was observed in the incident rate of pleural effusion. Conclusion The new methods of FTS can apparently accelerates recovery after lung cancer resection, reduces complications, shorten timestay in hospital and cut down the total cost.
Herrick, Rick; Horton, William; Olsen, Timothy; McKay, Michael; Archie, Kevin A; Marcus, Daniel S
XNAT Central is a publicly accessible medical imaging data repository based on the XNAT open-source imaging informatics platform. It hosts a wide variety of research imaging data sets. The primary motivation for creating XNAT Central was to provide a central repository to host and provide access to a wide variety of neuroimaging data. In this capacity, XNAT Central hosts a number of data sets from research labs and investigative efforts from around the world, including the OASIS Brains imaging studies, the NUSDAST study of schizophrenia, and more. Over time, XNAT Central has expanded to include imaging data from many different fields of research, including oncology, orthopedics, cardiology, and animal studies, but continues to emphasize neuroimaging data. Through the use of XNAT's DICOM metadata extraction capabilities, XNAT Central provides a searchable repository of imaging data that can be referenced by groups, labs, or individuals working in many different areas of research. The future development of XNAT Central will be geared towards greater ease of use as a reference library of heterogeneous neuroimaging data and associated synthetic data. It will also become a tool for making data available supporting published research and academic articles. Copyright © 2015 Elsevier Inc. All rights reserved.
Community centrality is a growing requirement of social science. The field's research practices are increasingly expected to conform to prescribed relationships with the people studied. Expectations about community centrality influence scholarly activities. These expectations can pressure social scientists to adhere to models of community involvement that are immediate and that include community-based co-investigators, advisory boards, and liaisons. In this context, disregarding community centrality can be interpreted as failure. This paper considers evolving norms about the centrality of community in social science. It problematises community inclusion and discusses concerns about the impact of community centrality on incremental theory development, academic integrity, freedom of speech, and the value of liberal versus communitarian knowledge. Through the application of a constructivist approach, this paper argues that social science in which community is omitted or on the periphery is not failed science, because not all social science requires a community base to make a genuine and valuable contribution. The utility of community centrality is not necessarily universal across all social science pursuits. The practices of knowing within social science disciplines may be difficult to transfer to a community. These practices of knowing require degrees of specialisation and interest that not all communities may want or have.
Bernemann, Inga; Kersting, Markus; Prokein, Jana; Hummel, Michael; Klopp, Norman; Illig, Thomas
Biobanks are the basis for a substantial part of biomedical research. The development, establishment and operation of biobanks are connected to a broad range of aspects, mainly concerning the preparation, storage, usage and dissemination of samples and associated data, in addition to the social and public involvement of these processes. These complex requirements can often only be managed in large centralized biobanks. In recent years, centralized clinical biobanks have been established in several university clinics in Germany. Similar activities take place in other European countries and worldwide. This article highlights the requirements and main tasks of centralized clinical biobanks: high-quality pre-analytics and sample storage, the creation of professional IT structures, data protection, ethical issues, in addition to quality and project management.
A peripherally inserted central catheter line, inserted the day before surgery, decreases the time from induction to incision for spinal deformity surgery and safely provides central venous access during surgery: a pilot study.
Stuedemann, Anne E; Schwend, Richard M; Thomas, Valorie K; Leamon, Julia M; Lightner, Tammy S
be $4710 per patient. When planning central vascular access for a pediatric spine patient, placing central access the day before surgery can decrease the time from induction to incision, therefore decreasing time under general anesthesia, potentially improving patient safety, and overall value. Prospective research into the use of PICC lines in pediatric spinal fusion surgery is planned. Level III.
Editorial - East and Central African Journal of Surgery: The Canadian connection · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Jonathan Meakins, Edward W Archibald, James Waddell ...
Palliative care or End-of-life care in terminally-ill patients requires multi-displinary approach and therefore, different modalities of treatment. The aim of palliative care is to improve the quality of life and make the subject as comfortable as possible. Palliative cancer surgery is a branch of surgical oncology which relieves the ...
Most cancer patients require surgery for preventive, diagnostic or therapeutic purposes of cure or palliation. (i) Prevention of cancer e.g.. • Orchidopexy in cryptorchidism reduces risk of testicular cancer. (10% risk of cancer). • Prophylactic mastectomy in high risk individuals for Breast cancer. (BRCA 1 & 2 has 40-80% risk of.
Sluis, P.C. van der; Schreuder, H.W.B.; Merks, B.T.; Kruger, A.E. Boeken; Verheijen, R.; Hillegersberg, R. van
In the University Medical Center Utrecht, the Netherlands, robot-assisted surgical procedures are performed weekly within the departments of Surgery, Gynaecology and Urology. Training for robot-assisted minimally invasive surgical procedures can be divided into two parts: system training and
Conclusion: The quality and quantity of vascular surgery research in the GCC countries should be improved to answer important local questions related to vascular diseases. This needs better strategic planning and more collaboration between various institutions.
Sand, Ane Ahrenkiel
Some five years ago, DTU switched from decentralized research registration, where researchers entered their publications into the DTU research repository themselves to centralized research registration, whereby library staff upload academic publications to the repository on behalf of the research......Some five years ago, DTU switched from decentralized research registration, where researchers entered their publications into the DTU research repository themselves to centralized research registration, whereby library staff upload academic publications to the repository on behalf...
Sand, Ane Ahrenkiel
Some five years ago, DTU switched from decentralized research registration, where researchers entered their publications into the DTU research repository themselves to centralized research registration, whereby library staff upload academic publications to the repository on behalf of the research......Some five years ago, DTU switched from decentralized research registration, where researchers entered their publications into the DTU research repository themselves to centralized research registration, whereby library staff upload academic publications to the repository on behalf...
Bouwense, S.A.W.; Ali, U. Ahmed; Broek, R.P. Ten; Issa, Y.; Eijck, C.H. van; Wilder-Smith, O.H.G.; Goor, H. van
BACKGROUND: Chronic abdominal pain is common in chronic pancreatitis (CP) and may involve altered central pain processing. This study evaluated the relationship between pain processing and pain outcome after pancreatic duct decompression and/or pancreatic resection in patients with CP. METHODS:
Central Asia. Asie centrale. Read more about Harnessing big data to meet the Sustainable Development Goals – Building capacity in the Global South. Language English. Read more about Grants and awards: Gender equality and scaling digital innovation. Language English. Read more about Community access ...
Zhu, Victor Zhang; Tuggle, Charles Thompson; Au, Alexander Francis
The use of "Big Data" in plastic surgery outcomes research has increased dramatically in the last 5 years. This article addresses some of the benefits and limitations of such research. This is a narrative review of large database studies in plastic surgery. There are several benefits to database research as compared with traditional forms of research, such as randomized controlled studies and cohort studies. These include the ease in patient recruitment, reduction in selection bias, and increased generalizability. As such, the types of outcomes research that are particularly suited for database studies include determination of geographic variations in practice, volume outcome analysis, evaluation of how sociodemographic factors affect access to health care, and trend analyses over time. The limitations of database research include data which are limited only to what was captured in the database, high power which can cause clinically insignificant differences to achieve statistical significance, and fishing which can lead to increased type I errors. The National Surgical Quality Improvement Project is an important general surgery database that may be useful for plastic surgeons because it is validated and has a large number of patients after over a decade of collecting data. The Tracking Operations and Outcomes for Plastic Surgeons Program is a newer database specific to plastic surgery. Databases are a powerful tool for plastic surgery outcomes research. It is critically important to understand their benefits and limitations when designing research projects or interpreting studies whose data have been drawn from them. For plastic surgeons, National Surgical Quality Improvement Project has a greater number of publications, but Tracking Operations and Outcomes for Plastic Surgeons Program is the most applicable database for plastic surgery research.
Litton, E; Silbert, B; Ho, K M
Optimising perioperative haemodynamic status may reduce postoperative complications. In this prospective prevalence study, we investigated the associations between standard haemodynamic parameters and a low central venous oxygen saturation (ScvO2) in patients after major surgery. A total of 201 patients requiring continuous arterial and central venous pressure monitoring after major surgery were recruited. Simultaneous arterial and central venous blood gases, haemodynamic and biochemical data and perfusion index were obtained from patients at a single time-point within 24 hours of surgery. A low ScvO2 (central venous pressure, haemoglobin concentrations, arterial pH and lactate concentrations, arterial oxygen (PaO2) and carbon dioxide tensions (PaCO2) were all associated with a low ScvO2 in the univariate analyses. In the multivariate analysis, only a higher perfusion index (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.78 to 0.98), PaO2 (OR 0.98 per mmHg increment, 95% CI 0.97 to 0.99) and PaCO2 (OR 0.88 per mmHg increment, 95% CI 0.82 to 0.95) and a lower central venous pressure (OR 1.14 per mmHg increment, 95% CI 1.04 to 1.25) were significantly associated with a reduced risk of a low ScvO2, all in a linear fashion. In conclusion, PaO2, PaCO2, perfusion index and central venous pressure were significant predictors of a low ScvO2 in patients after major surgery including cardiac surgery.
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East and Central African Journal of Surgery Volume 15 Number 2. July/August 2010. ECAJS. Page 54. Duration of symptoms ranged from 4 weeks to 109 weeks with a median of 8 weeks. None of our patients have family history of pancreatic cancer. Only eleven (11.5%) have previous history of diabetic mellitus (DM) before ...
Dec 2, 2006 ... East And Central African Journal of Surgery Volume 11 Number 2. December 2006. 3. Problem Based Learning at .... promotes the teaching of concepts and principles needed by students to understand their case. ... principles of PBL, the learning expected of students in this pedagogy, as well as aspects.
Kocum, Aysu; Sener, Mesut; Calıskan, Esra; Bozdogan, Nesrin; Atalay, Hakan; Aribogan, Anis
To evaluate the clinical success rate, safety, and usefulness for intraoperative central venous pressure monitoring, and the intravenous access of the supraclavicular subclavian vein approach when compared with the infraclavicular subclavian vein approach and the internal jugular vein approach for central venous catheterization during open-chest cardiac surgery. A prospective, randomized, single-center study. A university hospital. One hundred ninety-five patients scheduled for open-chest cardiac surgery. The study population consisted of patients for whom central vein catheterization was intended during cardiac surgery. Patients were randomized to 3 groups according to the route of central vein catheterization: the supraclavicular group: the supraclavicular approach for the subclavian vein (n = 65); the infraclavicular group: the infraclavicular approach for the subclavian vein (n = 65); and the jugular group: the internal jugular vein approach (n = 65). After the induction of anesthesia, central venous catheterization was performed according to the assigned approach. The success rates for the assigned approach were 98%, 98%, and 92% for the supraclavicular, infraclavicular, and jugular groups, respectively (p > 0.05). The success rates in the first 3 attempts in patients who were catheterized successfully according to the assigned approach were 96%, 100%, and 96% for the supraclavicular, infraclavicular, and jugular groups, respectively (p > 0.05). There was no difference among groups in catheter insertion time (p > 0.05). After sternal retraction, central venous pressure trace loss and difficulty in fluid infusion were significantly more frequent in the infraclavicular group (21%) when compared with the supraclavicular (3%) and jugular groups (0%) (p = 0.01). There was no difference among groups in terms of catheter malposition, complications during catheterization, and rate of catheter-related infection. The supraclavicular approach for subclavian vein
Full Text Available Student research society of clinic of children surgery of Donetsk National Medical university named after M. Gorkyi exists since 1968. Our student research society has two main directions in activity of the students — theoretical and practical ones, and both of them are presented during meetings of research society. During a spring semester the student scientific conference is carried out. The best works are represented on University, Ukrainian and international student conferen-ces. The obligatory form of activity in student research society is the immediate involvement in diagnostic and medical manipulations. The enhancement of activity of student research society allows increase learning efficiency of children surgery students at Higher Medical School.
Zochios, Vasileios; Gilhooly, Michael; Fenner, Simon
The subclavian vein is thought to be the most appropriate route for central venous access in major maxillofacial surgery. Evidence suggests that left-sided central venous catheters should lie below the carina and be angulated at less than 40 degrees to superior vena cava wall. This reduces perforation risk. With this in mind we audited our current practice for placement of central venous catheters for major maxillofacial surgery. The criteria against which we compared our practice were: 1) all catheter tips should lie below the carina and 2) the angle of the distal 1 cm of the catheter should be no more than 40 degrees to the superior vena cava wall. Left subclavian central venous catheters placed on a weekly operating list between September 2005 and August 2008 were identified retrospectively: 83 patients were identified; 22 were excluded. The angle of the central venous catheter tip and distance from the carina were measured on the first post-procedure chest-X ray. All central venous catheters used were 16 cm long. 82% of the catheter tips were located above the carina while 61% were angulated at greater than 40 degrees ; 11% of central venous catheters met both standards; 14% of central venous catheters placed by a consultant and 12% of catheters placed by a trainee met both standards. 89% of the central venous catheters were not correctly placed. The majority of central venous catheter tips above the carina were at an adverse angle to the superior vena cava wall. We suggest that for left subclavian central lines, 20 cm catheters be used.
Oomens, M.A.E.; Heijmans, M.W.; Forouzanfar, T.
The risk of bias is important in the interpretation of the results of research. The aim of this review was to evaluate the risk of bias in randomised controlled trials (RCTs) in oral and maxillofacial surgery (OMFS) over a 10-year period. We searched databases of publications for RCTs published
Chopra, Karan; Swanson, Edward W; Susarla, Srinivas; Chang, Sarah; Stevens, W Grant; Singh, Devinder P
Objective measures of research productivity depend on how frequently a publication is cited. Metrics such as the Hirsch index (h-index; total number of publications h that have at least h citations) allow for an objective measurement of the scientific impact of an author's publications. The purpose of this study was to assess and compare the h-index among aesthetic plastic surgery fellowship directors to that of fellowship directors in craniofacial surgery and microsurgery. We conducted a cross-sectional study of all fellowship directors in aesthetic surgery, craniofacial surgery, and microsurgery in the United States and Canada. The gathered data were categorized as bibliometric (h-index, i10-index, total number of publications, total number of citations, maximum citations for a single work, and number of self-citations) and demographic (gender, training background). Descriptive statistics were computed. The sample was composed of 30 aesthetic surgeons (93% male), 33 craniofacial surgeons (97% male), and 32 microsurgeons (94% male). The mean h-index was 13.7 for aesthetics, 16.9 for craniofacial, and 12.4 for microsurgery. There were no significant differences for any of the bibliometric measures between the three subspecialties, despite the fact that academic rank and years in practice were significantly different. As measured by the h-index, there is a high level of academic productivity among fellowship directors, regardless of subspecialty area. Unlike other plastic surgery subspecialties however, the h-index of aesthetic plastic surgeons is not correlated to academic rank, revealing a discrepancy between perceptions of aesthetic plastic surgery and its actual academic impact. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: email@example.com.
Ziyaeifard, Mohsen; Alizadehasl, Azin; Aghdaii, Nahid; Sadeghi, Ali; Azarfarin, Rasoul; Masoumi, Gholamreza; Golbargian, Ghodrat
Heparinized saline solution is used to prevent occlusion in the arterial catheters and central venous pressure monitoring catheters. Even at low dose, heparin administration can be associated with serious complications. Normal saline solution can maintain patency of arterial catheters and central venous pressure monitoring catheters. The current study aimed to compare the efficacy of normal saline with that of heparinized one to maintain patency of arterial and central venous catheters after cardiac surgery. In the current randomized controlled trial, 100 patients, with an age range of 18 - 65 years of valve and coronary artery surgery were studied in Rajaie heart center, Tehran, Iran. Patients were randomized to receive either heparinized saline (n = 50) or normal saline flush solutions (n = 50). In the study, arterial catheters and central venous pressure monitoring catheters were daily checked for any signs of occlusion in three postoperative days as primary end-point of the study. According to the information obtained from the study, four (8%) arterial catheters in the saline group (P value: 0.135) and three (6%) arterial catheters in the heparin group (P value = 0.097) were obstructed. Statistical analysis showed that the incidence of obstruction and changes in all other parameters between the two groups during the three-day follow-up was not significant (all P values > 0.05). It seems that there is no difference in the use of heparinized and normal saline solutions to prevent catheter occlusion of arterial and central venous pressure.
Roginsky, V V; Ivanov, A L; Ovtchinnikov, I A; Khonsari, R H
The Central Institute for Stomatology and Maxillo-facial Surgery in Moscow is one the main centers for the treatment of pediatric head and neck tumors in the territory of the former Soviet Union. A series of 33 patients presenting with cherubism (24 children and 9 of their parents) is presented. The authors discuss the atypical clinical presentations, the relevant associated anomalies and the different treatment strategies. They report the first case of cherubism associated with gingival hypertrophy without neurological signs.
Salamati, Payman; ashraf Eghbali, Ali; Zarghampour, Manijeh
The present study was conducted with the aim of identifying and evaluating the internal and external factors, affecting the Sina Trauma and Surgery Research Center, affiliated to Tehran University of Medical Sciences and propose some of related strategies to senior managers. We used a combined quantitative and qualitative methodology. Our study population consisted of personnel (18 individuals) at Sina Trauma and Surgery Research Center. Data-collection tools were the group discussions and the questionnaires. Data were analyzed with descriptive statistics and SWOT (Strength, Weakness, Opportunities and Threats) analysis. 18 individuals participated in sessions, consisting of 8 women (44.4%) and 10 men (55.6%). The final scores were 2.45 for internal factors (strength-weakness) and 2.17 for external factors (opportunities-threats). In this study, we proposed 36 strategies (10 weakness-threat strategies, 10 weakness-opportunity strategies, 7 strength-threat strategies, and 9 strength-opportunity strategies). The current status of Sina Trauma and Surgery Research Center is threatened weak. We recommend the center to implement the proposed strategies.
Businger, Adrian; Kaderli, Reto; Sommer, Christoph; Furrer, Markus; Villiger, Peter
Networks are known to improve performance and create synergies. A research network can provide a significant advantage for all parties involved in research in surgery by systematically tracking the outcome of a huge number of patients over a long period of time. The aim of the present study was to investigate the experiences of surgeons with respect to research activities, to evaluate the opinions of surgeons with regard to the development of a national network for research in the field of surgery in Switzerland and to obtain data on how such a network should be designed. An anonymous postal survey of board-certified surgeons practising in Switzerland was conducted during summer 2007. The questionnaire included questions related to research activities, the desire to develop a national research network and the design and potential advantages of such a network. Qualitative analyses were performed using Mayring's content analysis. A total of 337 out of 749 (45%) questionnaires were returned. In all, 156/337 (46.3%) surgeons were engaged in research activities. During the past five years, 212/337 (62.9%) of the participants had participated at least in one multi-centre study. Out of 337, 88 (26.1%) surgeons were members of an established research association in Switzerland. Interest in a national surgical research network was reported by 266 (78.9%) participants. The reported advantages were "power" (53.1%), "teamwork effects" (23.7%), "efficiency" (12.2%) and "quality aspects" (8.0%). The most frequently named design proposal was based on a clinic for coordinating research, while the younger participants also suggested a web-based platform. Due to the significant interest of participants, the establishment of a national research network should be considered. An established clinic for coordinating research alongside an additional web-based platform to target young surgeons could function as an umbrella organisation.
West and Central African Research and Education Networking (WACREN). For universities and research centres around the world, the Internet has become an important resource for teaching, learning and research. But, African universities have always faced important challenges to accessing cheap and reliable bandwidth ...
Franke, Thomas; Gruetz, Romanus; Dickmann, Frank
The current situation at many university medical centers regarding the management of biomedical research imaging data leaves much to be desired. In contrast to the recommendations of the German Research Foundation (DFG) and the German Council of Sciences and Humanities regarding the professional management of research data, there are commonly many individual data pools for research data in each institute and the management remains the responsibility of the researcher. A possible solution for this situation would be to install local central repositories for biomedical research imaging data. In this paper, we developed a scenario based on abstracted use-cases for institutional research undertakings as well as collaborative biomedical research projects and analyzed the functional requirements that a local repository would have to fulfill. We determined eight generic categories of functional requirements, which can be viewed as a basic guideline for the minimum functionality of a central repository for biomedical research imaging data.
Abdullah, Fizan; Ortega, Gezzer; Islam, Saleem; Barnhart, Douglas C; St Peter, Shawn D; Lee, Steven L; Glynn, Loretto; Teitelbaum, Daniel H; Arca, Marjorie J; Chang, David C
Outcomes research in pediatric surgery can be defined as the analysis of pediatric surgical outcomes and their predictors at different levels in the health care delivery system. The objectives of this article are to understand the differences between outcomes research and clinical trials as well as to gain familiarity with public multispecialty and specialty-specific databases. The utility of outcomes research extends to benchmarking the quality of care, refinement of management strategies, patient education, and marketing. Assessment of the integration of a new surgical technique into the health care system is best determined by examining a population-based registry, whereas comparative efficacy of surgical procedures is best assessed by randomized clinical trials. In the first part of this 2-part series, an overview and brief outline of available resources for outcomes research in pediatric surgery are reviewed. In part 2, a template is presented on how to structure and design an outcomes research question. Copyright Â© 2011 Elsevier Inc. All rights reserved.
Yazgan, Serpil; Ayar, Orhan; Akdemir, M. Orcun; Uğurbas, Suat Hayri
Abstract Non-arteritic anterior ischaemic optic neuropathy (NAION) results from the ischaemia of the anterior part of the optic nerve. Postoperative NAION is especially related to spinal surgeries, cardiovascular surgeries, and head-neck surgical procedures. This paper reports a rare case with simultaneous bilateral NAION and unilateral central retinal artery occlusion after hip prosthesis surgery. A 63-year-old woman had sudden visual loss in both eyes after hip prosthesis surgery. Fundus examination revealed bilateral optic disc oedema and macular paleness, and dot-blot haemorrhage around the optic disc suggesting central retinal artery occlusion in the left eye. Sudden simultaneous loss of vision may appear after non-ocular surgical procedures. In this case, anaemia due to excessive blood loss and prolonged hypotension during hip prosthesis surgery was the probable cause of anterior ischaemic optic neuropathy and unilateral central retinal artery occlusion. PMID:27928309
Esmaeilivand, Masoumeh; Khatony, Alireza; Moradi, Gholamreza; Najafi, Farid; Abdi, Alireza
Arterial blood sampling, used to assess patients in acute conditions, may result in complications such as thrombosis and embolism. However, it can be replaced by venous blood sampling, but there is a dearth of information on this. To assess the correlation and agreement between the arterial and central venous blood gases analyses in patients undergoing elective Coronary Artery Bypass Graft (CABG) surgery. In this cross-sectional study, 100 ICU patients undergoing elective CABG surgery were recruited. 2 mm arterial and a 2 mm venous blood samples were obtained from each patient's arterial and central venous lines, respectively. To predict Arterial Blood Gas (ABG) values based on central Venous Blood Gas (VBG) values, the linear regression analysis was used and for evaluating their agreement Bland-Altman method was used. In total of 200 samples were obtained. The mean and Standard Deviation (SD) of age was 58.9±9.1 years and 51% of the participants were female. There was a strong correlation between ABG and central VBG values regarding pH, partial Pressure of Carbon Dioxide (PCO2), Bicarbonate (HCO3) and Base Excess (BE) (r= 0.73, r=0.74, r=0.67 and r=0.71, respectively; panalysis showed an excellent agreement between all the variables (panalysis cannot replace ABG analysis in measuring exact PO2 status, necessitating arterial sampling in some matters, but with respect to the accuracy of pulse oximetry measurements in determining the exact PO2 status, for the rest of the indices a central VBG rather than an ABG can be utilised for determining patient's acid-base status. Particularly in patients who are hospitalised for a long time and have a central venous catheter in place like patients who have undergone CABG, thus reducing the risk and need for invasive arterial sampling.
Markel, Troy A; Rescorla, Frederick J
Resident Research (RR) has been a presumed requirement for pediatric surgery fellowship candidates. We hypothesized that: 1) pediatric surgery leaders would no longer feel that RR was necessary for fellowship candidates, 2) the type of study performed would not impact a program's opinion of candidates, and 3) the timing of RR could be altered for those interested in a research career. An anonymous survey was sent to pediatric surgery fellowship program directors (PDs). Sixty-three percent responded, and answers were compared via Chi square analysis with ppediatric surgery fellowship candidates. Seventy-five percent had no preference between one or two years of research (p=0.0005), 79% placed no heavier weight on basic or clinical research (psurgery may not be necessary. Pediatric surgery candidates who partake in RR are not penalized for their choice of study. Increasing efficiency of training is important in today's era of medical training. Copyright © 2015 Elsevier Inc. All rights reserved.
Sharifi, Reza J; Closmann, James J; Pogrel, M Anthony
This article presents a case involving a 16-year-old boy who came to the Tripler Army Medical Center Oral and Maxillofacial Surgery with a central giant cell granuloma (CGCG) on the anterior mandible. Initial management consisted of surgical curettage and intralesional injection of corticosteroids. Upon completion of steroid therapy, there was clinical and radiographic evidence of remission; however, radiographic evidence of lesion recurrence was seen at a six-month follow-up visit. The CGCG was retreated with curettage and five months of systemic injections of calcitonin, both of which failed. The lesion was most likely an aggressive form of CGCG that progressed despite conservative therapy, with destruction of hard and soft tissues, root resorption, tooth displacement, and paraesthesia in the anterior mandible. The authors present a treatment algorithm with comprehensive management involving surgical resection, reconstruction, orthodontics, and orthognathic surgery with prosthodontic considerations.
Adkinson, Joshua M; Casale, Mia T; Kim, John Y S; Khavanin, Nima; Gutowski, Karol A; Gosain, Arun K
Plastic surgery research using large databases has increased dramatically over the past 20 years. With the magnitude and breadth of information available in these databases, researchers are able to more easily answer a wide variety of research questions. This study sought to provide a comprehensive comparative analysis of the relevant databases for plastic surgery research. Database information, data collection methods, acquisition details, and variable availability were collected for 19 large databases. Examples of potential future research utility were ascribed to each database based on this comprehensive analysis. With a greater understanding of the content, strengths, and limitations of these databases, researchers will be better equipped to select the most appropriate database to answer a specific research question.
Baulig, Werner; Dullenkopf, Alexander; Kobler, Andreas; Baulig, Barbara; Roth, Hans Rudolf; Schmid, Edith R
Continuous assessment of central venous oxygen saturation (S(cevox)O(2)) with the CeVOX device (Pulsion Medical Systems, Munich, Germany) was evaluated against central venous oxygen saturation (S(cv)O(2)) determined by co-oximetry. In 20 cardiac surgical patients, a CeVOX fiberoptic probe was introduced into a standard central venous catheter placed in the right internal jugular vein and advanced 2-3 cm beyond the catheter tip. After in vivo calibration of the probe, S(cevox)O(2), S(cv)O(2), mixed venous oxygen saturation (S(mv)O(2)) haemoglobin (Hb), body temperature, heart rate, central venous and mean arterial pressure, and cardiac index were assessed simultaneously at 30 min intervals during surgery and at 60 min intervals during recovery in the intensive care unit. Agreement between S(cevox)O(2), and S(cv)O(2) was determined by Bland-Altman analysis. Simple regression analysis was used to assess the correlation of S(cevox)O(2), and S(cv)O(2) to Hb, body temperature and haemodynamic parameters. Values of S(cevox)O(2) and S(cv)O(2) (84 data pairs during surgery and 106 in the intensive care unit) ranged between 45-89% and 43-90%, respectively. Mean bias and limits of agreement of S(cevox)O(2) and S(cv)O(2) were -0.9 (-7.9/+6.1)% during surgery and -1.2 (-10.5/+8.1)% in the intensive care unit. In 37.9% of all measured data pairs, the difference between S(cevox)O(2) and S(cv)O(2) was beyond clinically acceptable limits (> or =1 s.d.). Mean bias was significantly influenced by cardiac index. Sensitivity and specificity of S(cevox)O(2) to detect substantial (> or =1 s.d.) changes in S(cv)O(2) were 89 and 82%, respectively. In adult patients during and after cardiac surgery, the current version of the CeVOX device might not be the tool to replace S(cv)O(2) determined by co-oxymetry, although sensitivity and specificity of S(cevox)O(2 )to predict substantial changes in S(cv)O(2) were acceptable.
Kolesar, Tiffany A; Bilevicius, Elena; Kornelsen, Jennifer
This study examined the altered patterns of functional connectivity in task-positive resting state networks in failed back surgery syndrome (FBSS) patients compared to healthy controls using functional magnetic resonance imaging (fMRI). This work stems from a previous study in which alterations in the task-negative default mode network were investigated. Participants underwent a 7-minute resting state fMRI scan in which they lay still, with eyes closed, in the absence of a task. Scanning took place at the National Research Council's 3Tesla MRI magnet in Winnipeg, Canada. Fourteen patients with FBSS and age- and gender-matched controls participated in this study. Three patients were removed from the analyses due to image artefact (n=1) and effective pain treatment (n=2). Eleven patients (5 female, mean age 52.7 years) and their matched controls were included in the final analyses. Resting state fMRI data were analyzed using an independent component analysis, yielding three resting state networks of interest: the salience network (SN), involved in detection of external stimuli, central executive network (CEN), involved in cognitions, and sensorimotor network (SeN), involved in sensory and motor integration. Analysis of Variance contrasts were performed for each network, comparing functional connectivity differences between FBSS patients and healthy controls. Alterations were observed in all three resting state networks, primarily relating to pain and its processing in the FBSS group. Specifically, compared to healthy controls, FBSS patients demonstrated increased functional connectivity in the anterior cingulate cortex within the SN, medial frontal gyrus in the CEN, and precentral gyrus within the SeN. FBSS patients also demonstrated decreased functional connectivity in the medial frontal gyrus in the SeN compared to healthy controls. Interestingly, we also observed internetwork functional connectivity in the SN and SeN. FBSS is associated with altered patterns of
Lilley, Elizabeth J; Cooper, Zara; Schwarze, Margaret L; Mosenthal, Anne C
Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet, these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care. Surgical patients would likely benefit from early palliative care delivered alongside surgical treatment to promote goal-concordant decision making and to improve patients' physical, emotional, social, and spiritual well-being and quality of life. To date, evidence to support the role of palliative care in surgical practice is sparse and palliative care research in surgery is encumbered by methodological challenges and entrenched cultural norms that impede appropriate provision of palliative care. The objective of this article was to describe the existing science of palliative care in surgery within three priority areas and expose specific gaps within the field. We propose a research agenda to address these gaps and provide a road map for future investigation.
Arnrich, Bert; Walter, Jörg; Albert, Alexander; Ennker, Jürgen; Ritter, Helge
For many new medical research questions in heart surgery comprehensive and large data bases are essential. We discuss typical challenges for the integration of real-time and legacy data stored in multiple unconnected hospital information systems (HIS). Furthermore the HIS are often operated by autonomous departments whose data base structures are subject to occasional modifications. We present a solution which integrates and consolidates all research relevant data in a data mart without imposing any considerable operational or maintenance contract liability risk for the existing HIS. The problems of partial consistency and partial redundancy in the data are discussed. The data mart system serves multiple purposes: beside clinical reporting and quality assessment, the preparation steps for comprehensive studies are enormously simplified.
Saluja, Saurabh; Nwomeh, Benedict; Finlayson, Samuel R G; Holterman, AiXuan L; Jawa, Randeep S; Jayaraman, Sudha; Juillard, Catherine; Krishnaswami, Sanjay; Mukhopadhyay, Swagoto; Rickard, Jennifer; Weiser, Thomas G; Yang, George P; Shrime, Mark G
Global surgery is an emerging academic discipline that is developing in tandem with numerous policy and advocacy initiatives. In this regard, academic global surgery will be crucial for measuring the progress toward improving surgical care worldwide. However, as a nascent academic discipline, there must be rigorous standards for the quality of work that emerges from this field. In this white paper, which reflects the opinion of the Global Academic Surgery Committee of the Society for University Surgeons, we discuss the importance of research in global surgery, the methodologies that can be used in such research, and the challenges and benefits associated with carrying out this research. In each of these topics, we draw on existing examples from the literature to demonstrate our points. We conclude with a call for continued, high-quality research that will strengthen the discipline's academic standing and help us move toward improved access to and quality of surgical care worldwide. Copyright © 2017. Published by Elsevier Inc.
This grant will assist the Educational Research Network for West and Central Africa (ERNWACA) by providing funding for succession planning, recruiting a regional coordinator (to be based in Mali) and strengthening the Network's ... IDRC partner the World Economic Forum is building a hub for inclusive growth solutions.
Full Text Available Abstract Background Several systematic reviews and meta-analyses populate the literature on the effectiveness of laparoscopic surgery for colorectal cancer. The utility of this body of work is unclear. The objective of this study was to synthesize all such systematic reviews in terms of clinical effectiveness, to appraise their quality, and to determine whether areas of duplication exist across reviews. Methods Systematic reviews comparing laparoscopic and open surgery for colorectal cancer were identified using a comprehensive search protocol (1991 to 2008. The primary outcome was overall survival. The methodological quality of reviews was appraised using the Assessment of Multiple Systematic Reviews (AMSTAR instrument. Abstraction and quality appraisal was carried out by two independent reviewers. Reviews were synthesized, and outcomes were compared qualitatively. A citation analysis was carried out using simple matrices to assess the comprehensiveness of each review. Results In total, 27 reviews were included; 13 reviews included only randomized controlled trials. Rectal cancer was addressed exclusively by four reviews. There was significant overlap between review purposes, populations and, outcomes. The mean AMSTAR score (out of 11 was 5.8 (95% CI: 4.6 to 7.0. Overall survival was evaluated by ten reviews, none of which found a significant difference. Three reviews provided a selective meta-analysis of time-to-event data. Previously published systematic reviews were poorly and highly selectively referenced (mean citation ratio 0.16, 95% CI: 0.093 to 0.22. Previously published trials were not comprehensively identified and cited (mean citation ratio 0.56, 95% CI: 0.46 to 0.65. Conclusions Numerous overlapping systematic reviews of laparoscopic and open surgery for colorectal cancer exist in the literature. Despite variable methods and quality, survival outcomes are congruent across reviews. A duplication of research efforts appears to exist
Swiatek, Peter R; Chung, Kevin C; Mahmoudi, Elham
Following a practical project management method is essential in completing a research project on time and within budget. Although this concept is well developed in the business world, it has yet to be explored in academic surgical research. Defining and adhering to a suitable workflow would increase portability, reusability, and therefore efficiency of the research process. In this article, the authors briefly review project management techniques. The authors specifically underline four main steps of project management-definition and organization, planning, execution, and evaluation-using practical examples from their own multidisciplinary plastic surgery research team.
Swiatek, Peter R.; Chung, Kevin C.; Mahmoudi, Elham
Following a practical project management method is essential in completing a research project on time and within budget. Although this concept is well developed in the business world, it has yet to be explored in academic surgical research. Defining and adhering to a suitable workflow would increase portability, reusability, and therefore, efficiency of the research process. In this article, we briefly review project management techniques. We specifically underline four main steps of project management: (1) definition and organization, (2) planning, (3) execution, and (4) evaluation, using practical examples from our own multidisciplinary plastic surgery research team. PMID:26710037
Joshua Smith, Jesse; Patel, Ravi K; Chen, Xi; Tarpley, Margaret J; Terhune, Kyla P
Many residents supplement general surgery training with years of dedicated research, and an increasing number at our institution pursue additional degrees. We sought to determine whether it was worth the financial cost for residency programs to support degrees. We reviewed graduating chief residents (n = 69) in general surgery at Vanderbilt University from 2001 to 2010 and collected the data including research time and additional degrees obtained. We then compared this information with the following parameters: (1) total papers, (2) first-author papers, (3) Journal Citation Reports impact factors of journals in which papers were published, and (4) first job after residency or fellowship training. The general surgery resident training program at Vanderbilt University is an academic program, approved to finish training 7 chief residents yearly during the time period studied. Chief residents in general surgery at Vanderbilt who finished their training 2001 through 2010. We found that completion of a degree during residency was significantly associated with more total and first-author publications as compared with those by residents with only dedicated research time (p = 0.001 and p = 0.017). Residents completing a degree also produced publications of a higher caliber and level of authorship as determined by an adjusted resident impact factor score as compared with those by residents with laboratory research time only (p = 0.005). Degree completion also was significantly correlated with a first job in academia if compared to those with dedicated research time only (p = 0.046). Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic
Kandarakis, Artemios; Soumplis, Vasileios; Karampelas, Michalis; Koutroumanos, Ioannis; Panos, Christos; Kandarakis, Stylianos; Karagiannis, Dimitrios
To evaluate the effect of routine phacoemulsification in corneal viscoelastic properties determined by corneal hysteresis (CH) and central corneal thickness (CCT) and to explore the impact of phaco energy on the above parameters. Forty-one eyes of 41 patients undergoing cataract surgery were enrolled in this prospective study. CH and CCT were measured preoperatively, 1 day and 1 week postoperatively. CCT measurement was performed using a non-contact optical pachymeter followed by ocular response analyzer (ORA) examination. Intraoperatively ultrasound time, average phaco power and effective phaco time (EPT) were recorded. Mean CH was 10.05±1.86 mmHg preoperatively, 8.25±1.85 mmHg 1 day and 9.12±1.37 mmHg 1 week postoperatively (pcorneal alterations following cataract surgery resulted in a statistical change in CH and CCT. These two parameters responded in a different manner that clearly demarcates their different nature. On the first postoperative day, CCT increase was correlated at a statistically significant level with intraoperative EPT. This correlation was not found with CH reduction. Other factors, besides cornea oedema or phacoemulsification energy, could be responsible for this CH modification. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.
Full Text Available Farming communities were established in many parts of central Europe Between approximately 5600 and 4500 BC. Although these communities have been studied for over a century, much more remains to be learned about them. This article will provide an overview of the history of this research, some important recent discoveries, and a sense of the ongoing debate about the origins of these agricultural communities.
Desai, Shamit S., E-mail: firstname.lastname@example.org [Northwestern Memorial Hospital, Department of Radiology (United States); Konanur, Meghana [Northwestern University Feinberg School of Medicine (United States); Foltz, Gretchen [Mallinckrodt Institute of Radiology at Washington University, Interventional Radiology (United States); Malaisrie, S. Chris [Northwestern Memorial Hospital, Department of Cardiothoracic Surgery (United States); Resnick, Scott, E-mail: email@example.com [Northwestern University Feinberg School of Medicine, Department of Radiology, Interventional Radiology, Northwestern Memorial Hospital (United States)
PurposeEntrapment of central venous catheters (CVC) at the superior vena cava (SVC) cardiopulmonary bypass cannulation site by closing purse-string sutures is a rare complication of cardiac surgery. Historically, resternotomy has been required for suture release. An endovascular catheter release approach was developed.Materials and MethodsFour cases of CVC tethering against the SVC wall and associated resistance to removal, suggestive of entrapment, were encountered. In each case, catheter removal was achieved using a reverse catheter fluoroscopically guided over the suture fixation point between catheter and SVC wall, followed by the placement of a guidewire through the catheter. The guidewire was snared and externalized to create a through-and-through access with the apex of the loop around the suture. A snare placed from the femoral venous access provided concurrent downward traction on the distal CVC during suture release maneuvers.ResultsIn the initial attempt, gentle traction freed the CVC, which fractured and was removed in two sections. In the subsequent three cases, traction alone did not release the CVC. Therefore, a cutting balloon was introduced over the guidewire and inflated. Gentle back-and-forth motion of the cutting balloon atherotomes successfully incised the suture in all three attempts. No significant postprocedural complications were encountered. During all cases, a cardiovascular surgeon was present in the interventional suite and prepared for emergent resternotomy, if necessary.ConclusionAn endovascular algorithm to the “entrapped CVC” is proposed, which likely reduces risks posed by resternotomy to cardiac surgery patients in the post-operative period.
Kacel, Myriam; Sierra, Adeline; Dreyfus, Elsa; Giorgi, Roch; François, Nicole; Catani, Jacques; Lehucher-Michel, Marie-Pascale
In August 2005, a series of complaints, with a strong media coverage, occurred among the staff of the surgery suite of an hospital in Marseilles during a maintenance work period. A study realized during this period of time concluded that the complaints were due to a collective phenomenon provoked by a acute discomfort among the staff. No triggering mechanism was identified till then. In order to found a relevant factor that could explain the complaints, we performed a retrospective investigation some time after the events with the aim of reducing the auto-suggestive phenomenon. Six months after the events, a questionnaire was submitted to each person of the 109 medical and paramedic staff working at central surgery suite during the maintenance work period. Subjects were asked about age, gender, disorder description, medical history, work place and work conditions during the event period. The study counted 98 persons with 31 physicians and 67 paramedic staff having replied to the questionnaire. Sixty-nine persons (70,4%) plead showing up symptoms. Multifactorial analysis found that female gender (OR=4,21; IC=1,23-14,38) and perception of particular odours (OR=8,81: IC=2,52-30,78) increased the probability of the occurrence of symptoms. A significant increase (p=0,03) of felt disorders was evidenced among the staff working in the sanitizing room. Disorders were less frequent for persons working in the operating room (p=0,04) and were strongly decreased for smokers (OR=0,25; IC=0,07-0,89). No complaint was recorded six months after the events. Considering the work places and conditions, peracetic acid appears as the most plausible etiologic agent of the reported disorders. As a consequence, hospitals, especially during maintenance work periods, must be sensitized to the involvement of the occupational physician in order to avoid the social and financial cost of such crisis.
... Disease Lookup > COPD > Diagnosing and Treating COPD Surgery Chronic obstructive pulmonary disease (COPD) includes two separate lung problems, emphysema and chronic bronchitis. Some people with COPD have ...
Weinrich, Malte; Scheingraber, Stefan; Stephan, Bernhard; Weiss, Christel; Kayser, Anna; Kopp, Berit; Schilling, Martin K
Measurement of central venous oxygen saturation has become a surrogate parameter for fluid administration, blood transfusions and treatment with catecholamines in (early) goal directed therapy in the treatment of acute septic patients. These strategies are not easily transferred to the postoperative management of abdominal surgery due to the different conditions in surgical patients. A study population of 15 patients (8 females/7 males) underwent elective major abdominal surgery: 6 gastrectomies, 5 major liver resections and 4 lower anterior rectum resections. Surgery was performed for primary or secondary malignancy. The patients' age was 65.4+/-12.7 (mean+/-standard deviation, range 44-84, median 62) years. Blood samples were taken intraoperatively from indwelling central venous lines as well as from draining veins at the surgical site. Blood gas analyses to determine the oxygen saturations were performed immediately. All patients were operated in standardized general anesthesia including epidural analgesia and in a balanced volume status. Central venous oxygen saturations and oxygen saturations in blood from the draining veins of the surgical site showed a wide range with high intra- and interindividual differences intraoperatively. Overall, at most time points no correlation between the two oxygen saturations could be detected in three operation types. A significant correlation was only observed at one time point during liver resections. Our results show a lack of correlation between central venous oxygen saturations and oxygen saturations in the draining veins of the surgical site during major abdominal surgery. Measurement of central venous oxygen saturations does not seem to be a good surrogate for the local oxygen supply in the field of interest in major abdominal surgery even under standardized conditions.
Andres Cibils; Mark Petersen; Shad Cox; Michael Rubio
Description: New Mexico State University's Corona Range and Livestock Research Center (CRLRC) is located in a pinon-juniper (PJ)/grassland ecotone in the southern Basin and Range Province in south central New Mexico. A number of research projects conducted at this facility revolve around soil, plant, livestock, and wildlife responses to PJ woodland management. The...
Manchikanti, Laxmaiah; Helm, Standiford; Pampati, Vidyasagar; Racz, Gabor B
The increase in the number of interventions for the management of chronic pain and associated escalation of healthcare costs has captured the attention of health policymakers, in no small part due to the lack of documentation of efficacy, cost-effectiveness, or cost utility analysis. A recent cost utility analysis of caudal epidural injections in managing chronic low back pain of various pathologies showed a high cost utility with improvement in quality of life years, competitive with various other modalities of treatments. However, there are no analyses derived from high-quality controlled studies related to the cost utility of percutaneous adhesiolysis in the treatment of post-lumbar surgery syndrome or lumbar central spinal stenosis. This analysis is based on 2 previously published controlled studies. To assess the cost utility of percutaneous adhesiolysis procedures in managing chronic low back and lower extremity pain secondary to post-lumbar surgery syndrome and lumbar central spinal stenosis. A private, specialty referral interventional pain management center in the United States. Two controlled studies were conducted assessing the clinical effectiveness of percutaneous adhesiolysis for post-lumbar surgery syndrome and lumbar central spinal stenosis in an interventional pain management setting utilizing contemporary interventional pain management practices. A cost utility analysis was performed with direct payment data for a total of 130 patients in treatment groups over a 2-year period. Various outcome measures were included with significant improvement, defined as at least 50% improvement with reduction in pain and disability status. The results of 2 controlled studies of low back pain with 60 and 70 patients and a 2-year follow-up with the actual reimbursement data showed cost utility for 1 year of quality-adjusted life year (QALY) of USD $2,652 for post-lumbar surgery syndrome and USD $2,649 for lumbar central spinal stenosis. The results of this
Weiler, Carly P.
As a research facility, the Glenn Research Center (GRC) trusts and expects all the systems, controlling their facilities to run properly and efficiently in order for their research and operations to occur proficiently and on time. While there are many systems necessary for the operations at GRC, one of those most vital systems is the Central Process Systems (CPS). The CPS controls operations used by GRC's wind tunnels, propulsion systems lab, engine components research lab, and compressor, turbine and combustor test cells. Used widely throughout the lab, it operates equipment such as exhausters, chillers, cooling towers, compressors, dehydrators, and other such equipment. Through parameters such as pressure, temperature, speed, flow, etc., it performs its primary operations on the major systems of Electrical Dispatch (ED), Central Air Dispatch (CAD), Central Air Equipment Building (CAEB), and Engine Research Building (ERB). In order for the CPS to continue its operations at Glenn, a new contract must be awarded. Consequently, one of my primary responsibilities was assisting the Source Evaluation Board (SEB) with the process of awarding the recertification contract of the CPS. The job of the SEB was to evaluate the proposals of the contract bidders and then to present their findings to the Source Selecting Official (SSO). Before the evaluations began, the Center Director established the level of the competition. For this contract, the competition was limited to those companies classified as a small, disadvantaged business. After an industry briefing that explained to qualified companies the CPS and type of work required, each of the interested companies then submitted proposals addressing three components: Mission Suitability, Cost, and Past Performance. These proposals were based off the Statement of Work (SOW) written by the SEB. After companies submitted their proposals, the SEB reviewed all three components and then presented their results to the SSO. While the
Full Text Available Central venous catheters (CVC are used commonly in clinical practice. Incidences of CVC-related right atrial thrombosis (CRAT are variable, but, when right atrial thrombus is present, it carries a mortality risk of 18% in hemodialysis patients and greater than 40% risk in nonhemodialysis patients. Different pathogenic mechanisms have been postulated for the development of CRAT, which includes mechanical irritation of the myocardial wall, propagation of intraluminal clot, hypercoagulability, and hemodynamics of right atria. Presentation of CRAT may be asymptomatic or may be associated with one of the complications of CRAT like pulmonary embolism, systemic embolism, infected thrombi, or hemodynamic compromise. There are no established treatment guidelines for CRAT. We describe an interesting case of a 59-year-old asymptomatic male successfully treated with open heart surgery after failure of medical treatment for a large CRAT discovered during a preoperative evaluation for a kidney transplant. Our case underscores that early detection of CRAT may carry a favorable prognosis as opposed to waiting until catastrophic complications arise. It also underscores the importance of transesophageal echocardiography in the detection of thrombus and perhaps guides clinicians on which treatment modality to be used according to the size of the thrombus.
Methods: This was a retrospective review of record charts of patients' hearing status before surgery and between 18 – 24 months after surgery using the pure tone average derived according to the guidelines of the Committee on Hearing and Equilibrium of the American Academy of. Otolaryngology Head and Neck Surgery ...
Han, W.; Brust, J.
Near real-time satellite data is critical to many research and development activities of atmosphere, land, and ocean processes. Acquiring and managing huge volumes of satellite data without (or with less) latency in an organization is always a challenge in the big data age. An organization level data repository is a practical solution to meeting this challenge. The STAR (Center for Satellite Applications and Research of NOAA) Central Data Repository (SCDR) is a scalable, stable, and reliable repository to acquire, manipulate, and disseminate various types of satellite data in an effective and efficient manner. SCDR collects more than 200 data products, which are commonly used by multiple groups in STAR, from NOAA, GOES, Metop, Suomi NPP, Sentinel, Himawari, and other satellites. The processes of acquisition, recording, retrieval, organization, and dissemination are performed in parallel. Multiple data access interfaces, like FTP, FTPS, HTTP, HTTPS, and RESTful, are supported in the SCDR to obtain satellite data from their providers through high speed internet. The original satellite data in various raster formats can be parsed in the respective adapter to retrieve data information. The data information is ingested to the corresponding partitioned tables in the central database. All files are distributed equally on the Network File System (NFS) disks to balance the disk load. SCDR provides consistent interfaces (including Perl utility, portal, and RESTful Web service) to locate files of interest easily and quickly and access them directly by over 200 compute servers via NFS. SCDR greatly improves collection and integration of near real-time satellite data, addresses satellite data requirements of scientists and researchers, and facilitates their primary research and development activities.
... and impairs lung function. People need to stop smoking several weeks before surgery so that the defense mechanisms of the respiratory system can recover. Doctors' evaluations The surgeon does a ...
Full Text Available Because of the rapid improving of corneal refractive surgery with laser, its characteristics such as safety, stability, availability and predictability have already been proved by clinical practice. Laser in situ keratomileusis(LASIK, epipolis laser in situ keratomileusis(Epi-LASIK, femtosecond laser in situ keratomileusis(FS-LASIKand small incision lenticule extraction(SMILEare the main operational methods. SMILE has gradually been being accepted by young and middle-aged with its minimal invasive and little post-surgery complications. Dry eye syndrome is one of the most common complications that may affect the visual effect of the surgery. Specialists and patients have paid more attention to dry eye disease after corneal refractive surgery. According to clinical and experimental researches, the basic condition of ocular surface before surgery, the application of drugs in or after the surgery, the type of refractive surgery that operator choose, as well as the damage and reinnervation of corneal nerve all play important roles in post-surgery dry eye. This article reviews the pathogen of dry eye disease after surgery and the prevalence of dry eye after surgery.
Silvestre, Jason; Wu, Liza C; Lin, Ines C; Serletti, Joseph M
An increasing number of women are entering the medical profession, but plastic surgery remains a male-dominated profession, especially within academia. As academic aspirations and advancement depend largely on research productivity, the authors assessed the number of articles authored by women published in the journal Plastic and Reconstructive Surgery. Original articles in Plastic and Reconstructive Surgery published during the years 1970, 1980, 1990, 2000, 2004, and 2014 were analyzed. First and senior authors with an M.D. degree and U.S. institutional affiliation were categorized by gender. Authorship trends were compared with those from other specialties. Findings were placed in the context of gender trends among plastic surgery residents in the United States. The percentage of female authors in Plastic and Reconstructive Surgery increased from 2.4 percent in 1970 to 13.3 percent in 2014. Over the same time period, the percentage of female plastic surgery residents increased from 2.6 percent to 32.5 percent. By 2014, there were more female first authors (19.1 percent) than senior authors (7.7 percent) (p plastic surgery had fewer female authors than other medical specialties including pediatrics, obstetrics and gynecology, general surgery, internal medicine, and radiation oncology (p plastic surgery is encouraging but lags behind advances in other specialties. Understanding reasons for these trends may help improve gender equity in academic plastic surgery.
Funk, L M; Gunnar, W; Dominitz, J A; Eisenberg, D; Frayne, S; Maggard-Gibbons, M; Kalarchian, M A; Livingston, E; Sanchez, V; Smith, B R; Weidenbacher, H; Maciejewski, Matthew L
In 2016, the Veterans Health Administration (VHA) held a Weight Management State of the Art conference to identify evidence gaps and develop a research agenda for population-based weight management for veterans. Included were behavioral, pharmacologic, and bariatric surgery workgroups. This article summarizes the bariatric surgery workgroup (BSWG) findings and recommendations for future research. The BSWG agreed that there is evidence from randomized trials and large observational studies suggesting that bariatric surgery is superior to medical therapy for short- and intermediate-term remission of type 2 diabetes, long-term weight loss, and long-term survival. Priority evidence gaps include long-term comorbidity remission, mental health, substance abuse, and health care costs. Evidence of the role of endoscopic weight loss options is also lacking. The BSWG also noted the limited evidence regarding optimal timing for bariatric surgery referral, barriers to bariatric surgery itself, and management of high-risk bariatric surgery patients. Clinical trials of pre- and post-surgery interventions may help to optimize patient outcomes. A registry of overweight and obese veterans and a workforce assessment to determine the VHA's capacity to increase bariatric surgery access were recommended. These will help inform policy modifications and focus the research agenda to improve the ability of the VHA to deliver population-based weight management.
Shen, Jie; Song, Diyu; Wang, Xiaoyu; Wang, Changjiang; Zhang, Shuming
To summarize the research progress of peripheral nerve surgery assisted by Da Vinci robotic system. The recent domestic and international articles about peripheral nerve surgery assisted by Da Vinci robotic system were reviewed and summarized. Compared with conventional microsurgery, peripheral nerve surgery assisted by Da Vinci robotic system has distinctive advantages, such as elimination of physiological tremors and three-dimensional high-resolution vision. It is possible to perform robot assisted limb nerve surgery using either the traditional brachial plexus approach or the mini-invasive approach. The development of Da Vinci robotic system has revealed new perspectives in peripheral nerve surgery. But it has still been at the initial stage, more basic and clinical researches are still needed.
Utilizing the American Board of Surgery in-training exam in a Rwandan surgical residency program: Alignment of exam topics with the University of Rwanda general surgery curriculum · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Jennifer Rickard, F Ntirenganya, ...
Cardiac Surgery: One year experience of cardiac surgery at Muhimbili National Hospital, Dar es Salaam- TANZANIA · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. ETM Nyawawa, EV Ussiri, P Chillo, T Waane, E Lugazia, U Mpoki, R Luchemba, B Wandwi, ...
Background: Prediction of complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction in surgery. The physiological and operative severity score for the ...
Background: The concept of day case surgery puts into efficient utilisation scarce resources to derive numerous social and ... investment in establishing such facility through suboptimal utilisation. Patients and Methods ... All the patients were evaluated and counseled for surgery at the out patient clinic with informed consent ...
Background: Success in the management of neonatal surgical emergencies depends on prompt diagnosis, adequate resuscitation, good nursing care, safe anaesthesia and competent surgery. Considering that centres for paediatric surgery are few in the developing world, an added requirement is application of the ...
Violi, Vincenzo; Costi, Renato; De Bernardinis, Massimo; Roncoroni, Luigi
The association between hospital high volumes and good outcomes after complex surgery has given rise to a worldwide controversial debate. Important and unsolved questions have followed, both theoretical and practical, which could have repercussions on health care and health economic policies, such as the centralization/regionalization of major surgical procedures.We read a recent study on the impact of surgery volumes on short-term outcomes after colon cancer resection in Emilia Romagna, Italy, the same geographic area where we operate. Ten issues were submitted to critical analysis and many sources of planning and methodology bias were identified, which, in our opinion, paradigmatically led to unreliable results, inadequate statistical analysis and deceptive conclusions. Despite the authors' admitted awareness of their study's limits, their conclusive message was, surprisingly, that centralization of colon cancer surgery should be substantially encouraged.Unrecognized, systemic biases may easily turn into cognitive biases, into logical short cuts which could confuse healthcare policy-makers. The volume-outcome relationship, in which a direct causal link has never been demonstrated, should not be used as a reliable measure of quality, rather than less implementable process indicators, to address centralization policies.A disregarded negative consequence of centralization could be that non-high-volume centres, after a further progressive workload decrease and depletion in resources and surgical skills, will have to cope with patients in bad general condition and at high risk, who must be treated in emergency or cannot anyway afford the move for age, indigence or severe co-morbidities. Thus, centralization policies might disadvantage the weak segments of the population, thereby moving towards an iniquitous health service.
Full Text Available The Central Asian vortex (CAV is an important synoptic-scale system that causes rainstorms, short-term heavy precipitation, hail, and sustained low temperatures in Xinjiang. This paper summarizes the current research conducted on the CAV since the 1960s. The objective definition of the CAV has been revised and a deep and shallow CAV classification proposed. Two high-frequency areas of deep CAV activity are the Kazakhstan hills (Sayan mountains and the eastern area of the Aral Sea (Tashkent; events mostly occur in summer and 40% cause strong rainfall. In addition, two high-frequency activity areas of the shallow CAV are located in the west and south of the Pamirs Plateau and mostly occur in spring; 23.2% of occurrences cause strong rainfall. The western and eastern water vapor transport relates to westerlies and a strong low-level easterly jet stream (LLEJ extending from Gansu to Xinjiang, respectively, and water vapor over the Tibetan Plateau transports even more northwards and enters Xinjiang. The deep CAV has an obvious cold core structure down to 300 hPa. The conversion terms from eddy available potential energy (AE to eddy kinetic energy (KE and eddy kinetic energy inflow (BKE from the open atmospheric region boundaries are the main sources of KE which cause rapid development of the CAV. The anomalous anti-cyclone center over the northeast Atlantic is the fountain of Rossby wave energy dispersion; Rossby waves propagate from the northeast Atlantic to eastern Europe (Urals (EEU, and then continuously propagate to Central Asia causing development of the CAV. The CAV requires further study to characterize the meso-scale system structure and evolution characteristics. In addition, physical modeling of the severe convective weather occurring under the CAV is required to determine the critical impacts of this severe convective weather and enable forecasting and early-warning indexes.
Schneider, M; Werner, J; Weitz, J; Büchler, M W
The structural organization of research facilities within a surgical university center should aim at strengthening the department's research output and likewise provide opportunities for the scientific education of academic surgeons. We suggest a model in which several independent research groups within a surgical department engage in research projects covering various aspects of surgically relevant basic, translational or clinical research. In order to enhance the translational aspects of surgical research, a permanent link needs to be established between the department's scientific research projects and its chief interests in clinical patient care. Importantly, a focus needs to be placed on obtaining evidence-based data to judge the efficacy of novel diagnostic and treatment concepts. Integration of modern technologies from the fields of physics, computer science and molecular medicine into surgical research necessitates cooperation with external research facilities, which can be strengthened by coordinated support programs offered by research funding institutions.
Sand, L; Lundin, S; Rizell, M; Wiklund, J; Stenqvist, O; Houltz, E
To reduce blood loss during liver surgery, a low central venous pressure (CVP) is recommended. Nitroglycerine (NG) with its rapid onset and offset can be used to reduce CVP. In this study, the effect of NG on portal and hepatic venous pressures (PVP and HVP) in different body positions was assessed. Thirteen patients undergoing liver resection were studied. Cardiac output (CO), mean arterial pressure (MAP) and CVP were measured. PVP and HVP were measured using tip manometer catheters at baseline (BL) in horizontal position; during NG infusion, targeting a MAP of 60 mmHg, with NG infusion and the patient placed in 10 head-down position. NG infusion reduced HVP from 9.7 ± 2.4 to 7.2 ± 2.4, PVP from 12.3 ± 2.2 to 9.7 ± 3.0 and CVP from 9.8 ± 1.9 to 7.2 ± 2.1 mmHg at BL. Head-down tilt during ongoing NG resulted in increases in HVP to 8.2 ± 2.1, PVP to 10.7 ± 3 and CVP to 11 ± 1.9 mmHg. CO at BL was 6.3 ± 1.1, which was reduced by NG to 5.8 ± 1.2. Head-down tilt together with NG infusion restored CO to 6.3 ± 1.0 l/min. NG infusion leads to parallel reductions in CVP, HVP and PVP at horizontal body position. Thus, CVP can be used to guide NG dosage and fluid administration at horizontal position. NG infusion can be used to reduce HVP. Head-down tilt can be used during NG infusion to improve both blood pressure and CO without substantial increase in liver venous pressure. In head-down tilt, CVP dissociates from HVP and PVP. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Lee, Soo Eon; Jahng, Tae-Ahn; Kim, Ki-Jeong; Hyun, Seung-Jae; Kim, Hyun Jib; Kawaguchi, Yoshiharu
There has been a marked increase in spine surgery in the 21st century, but there are no reports providing quantitative and qualitative analyses of research by Korean spine surgeons. The study goal was to assess the status of Korean spinal surgery and research. The number of spine surgeries was obtained from the Korean National Health Insurance Service. Research articles published by Korean spine surgeons were reviewed by using the Medline/PubMed online database. The number of spine surgeries in Korea increased markedly from 92,390 in 2004 to 164,291 in 2013. During the 2000-2014 period, 1982 articles were published by Korean spine surgeons. The annual number of articles increased from 20 articles in 2000 to 293 articles in 2014. There was a positive correlation between the annual spine surgery and article numbers (particles with Oxford levels of evidence 1, 2, and 3. The mean five-year impact factor (IF) for article quality was 1.79. There was no positive correlation between the annual IF and article numbers. Most articles (65.9%) were authored by neurosurgical spine surgeons. But spinal deformity-related topics were dominant among articles authored by orthopedics. The results show a clear quantitative increase in Korean spinal surgery and research over the last 15years. The lack of a correlation between annual IF and published article numbers indicate that Korean spine surgeons should endeavor to increase research value. Copyright © 2016 Elsevier Ltd. All rights reserved.
Zarzaur, Ben L; Valsangkar, Nakul; Feliciano, David F; Koniaris, Leonidas G
More than 75% of respondents to an Eastern Association for the Surgery of Trauma survey felt that barriers to research had increased and that acute care surgeon (ACS) academic productivity had decreased. Recent data confirm this impression and show lower academic productivity of junior ACS faculty compared with peers in other general surgical fields. The purpose of this study was to determine if early career acute care surgery research scholarships are associated with improved ACS academic productivity. Faculty data at the Top 55 National Institutes of Health (NIH)-funded departments of surgery (Top 55) were obtained using SCOPUS, NIH, department, and professional society databases. Academic productivity was measured using total publications, citations, and the Hirsch index. Scholarship recipients from the American Association for the Surgery of Trauma and Eastern Association for the Surgery of Trauma were identified. A total of 4,101 surgical faculty (8.3% ACS) who belong to the Top 55 NIH-funded departments of surgery and 85 scholarship recipients were identified. After merging, 34 scholarship recipients (40%) were current faculty at a Top 55 NIH-funded department of surgery, and 24 of those (71%) were ACS faculty. Scholarship recipients had higher median total publications compared with nonrecipients at assistant and associate ranks but not at full professor rank. For all ranks, scholarship recipients were more likely to have NIH funding compared with nonrecipients (33% vs. 11%, p Research scholarships granted by acute care surgery professional organizations remain largely among ACS faculty in Top 55 NIH-funded departments of surgery. Among junior ACS faculty, recipients are associated with increased academic productivity and NIH funding. To fill the academic productivity gap among junior ACSs, professional organizations should consider increasing research funding scholarships for promising investigators.
Methods: We reviewed all cases of emergency non-obstetric abdominal surgery performed on pregnant women ..... COMPLICATIONS. FREQUENCY. PERCENTAGE. Non. Anaemia. Wound Infection. Prolonged Ileus. Pelvic Abscess. Anastomotic Leak. Wound Dehiscence. 28. 10. 8. 18 ... caesarean section while others had.
Surgery of traumatic peripheral arterial injury with delayed transfer during the Ethio-Eritrean War - 1997-2000 · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Mohammed Kedir, Abebe Bekele ...
Keller, B A; Farmer, D L
Myelomeningocele, more commonly known as spina bifida, is the most common neural tube defect worldwide. In the United States, it is the primary cause of lifelong childhood paralysis with approximately four children born daily with this devastating disease. To minimize damage to the exposed spinal cord and prevent ascending central nervous system infections, postnatal closure of the spinal defect has been the standard of care for decades. Research into the mechanism of spinal cord injury in those with spina bifida revealed that damage continues to accrue during the gestational period. Prenatal defect closure via in utero surgery was proposed to prevent this early deterioration of the spinal cord, and early animal research demonstrated that prenatal repair was feasible and promising. This paved the way for the first human prenatal repairs in the mid-to-late 1990s. Following the promising outcomes observed during the first human cases, a randomized controlled trial, the Management of Myelomeningocele Study (MOMS), was conducted comparing postnatal repair of spina bifida to prenatal repair. The MOMS trial demonstrated that to those undergoing prenatal repair of spina bifida had a decreased need for ventriculoperitoneal shunting and improved lower extremity motor function. With the success of the MOMS trial, in utero repair is now considered the standard of care in those who meet the criteria for prenatal repair. This review will provide an overview of spina bifida and its impact, highlight the historical changes in care, describe the early research and theory that made prenatal repair an option, discuss the clinical experiences with human fetal repair and briefly touch on future research directions for those with myelomeningocele.
Terra, Ricardo Mingarini
Literature suggests that, for thymectomy in myasthenia or resection of thymic tumors, minimally invasive surgery is equivalent to open surgery with regard to long-term outcomes. However, it could bring some benefits in the immediate results as complication rate or length-of-stay. There are doubts about the worldwide adoption of the method, though. In Latin America, the implementation of video-assisted thoracic surgery (VATS) started in the 1990s, but it progressed slowly. The main barriers were associated costs and training. Thymic surgery poses a bigger challenge due to its rarity, so just a few reports mention the use of the method in the region. Nonetheless, in recent years we observe a faster dissemination of the method both in number and in complexity of the procedures performed. Confirming this fact, half of the patients registered in the Brazilian Society of Thoracic Surgery database in the last 2 years as undergoing resection of thymic tumors, underwent a minimally invasive procedure. Although promising, robotic surgery is still in its early days in Latin America.
Full Text Available This article suggests that qualitative research group dynamics shape university researchers' capacities for expertly enacting ethical practices. Specifically, I assert that when research participants become the researchers, both university-based and community-based members of the research group have opportunities to deeply experience each other's life worlds. By spending time together as researchers, we can then develop ethical expertise that is fluid, unconscious, and implicitly appropriate for the community in which the research is being conducted. URN: urn:nbn:de:0114-fqs0503367
Central Asia. Asie centrale. Read more about Bourses de l'International Crisis Group. Language French. Read more about Crisis Group Fellowship Program. Language English. Read more about Arab Democracy Barometer. Language English. Read more about Baromètre de la démocratie dans le monde arabe. Language ...
Central Asia. Asie centrale. Read more about Information Society Innovation Fund Asia. Language English. Read more about Information Society Innovation Fund Asia (ISIF Asia). Language French. Read more about Liens entre le savoir et l'innovation dans les services de gestion des déchets solides de trois municipalités ...
Central Asia. Asie centrale. Read more about Migration, Rural Poverty and Community Natural Resource Management in Cambodia. Language English. Read more about Migration, pauvreté rurale et gestion communautaire des ressources naturelles au Cambodge. Language French. Read more about Diffusion libre du ...
Dorneles de Andrade, Daniela
Brazil has the second highest rate of cosmetic surgery worldwide, provided in a large number of public and private clinics and hospitals, especially in the southeast. This qualitative field research in Rio de Janeiro included participant observation and in-depth interviews with 18 women cosmetic surgery patients, 10 key informants (e.g. psychologists and sociologists) and 12 plastic surgeons. Fifteen of the women were either pre- or post-operative; three had not decided whether to have surgery. When asked about their motivations and expectations of the surgery, the majority of the women said they wanted to be "normal". Most of the surgeons said they acted as empathic companions from decision-making through surgery and beyond. Many of the key informants were critical of what was happening to medical ethics in relation to cosmetic surgery. With the growth in a consumer culture, they saw ethics in medicine becoming more bendable and subject to the "law" of the market. The cult of the body has become a mass phenomenon and taken on an important social dimension in a society where norms and images are broadcast widely by the media. The trend towards body-modification by cosmetic surgery at an early age is increasing dramatically. What demands critical thinking and further investigation are the consequences of cosmetic surgery for physical and mental health. Copyright 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
Maia Nogueira, Renato Luiz; Osterne, Rafael Lima Verde; Cavalcante, Roberta Barroso; Abreu, Ricardo Teixeira
Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Stricker, Paul A; Lin, Elaina E; Fiadjoe, John E; Sussman, Emily M; Pruitt, Eric Y; Zhao, Huaqing; Jobes, David R
Massive hemorrhage during craniofacial surgery is common and often results in hypovolemia and hypotension. We conducted this study to assess the effect of the addition of routine central venous pressure (CVP) monitoring on the incidence of intraoperative hypotension and to evaluate the relationship between CVP and hypotension in this population. Data from our prospective craniofacial perioperative registry for children 6 to 24 months of age undergoing cranial vault reconstruction with CVP monitoring were compared with data from a historical cohort without CVP monitoring. The incidence and duration of hypotension in the 2 cohorts were compared. In the cohort of subjects with CVP monitoring who experienced hypotension, CVP at the onset of hypotension (T0) was compared with CVP 5 minutes before (T-5) and 5 minutes after (T+5) the onset of hypotension and with the baseline CVP. The amount of time spent at various CVP levels below the baseline, and the associated incidence of hypotension were also determined. Data from 57 registry subjects were compared with data from 115 historical cohort subjects. The median total duration of hypotension in subjects experiencing hypotension was 278 seconds in the CVP cohort versus 165 seconds in the historical cohort; the median difference was 98 seconds (95% confidence interval [CI], -45 to 345 seconds). The incidence of hypotension was 18% in the CVP cohort versus 21% in the historical cohort; the difference in the incidence of hypotension was -3% (95% CI, -10% to 15%). Analysis using a linear mixed effects model showed a significant decrease in CVP from T-5 to T0 (95% CI, -0.9 to -2.2 mm Hg), a significant increase in CVP from T0 to T+5 (95% CI, 1.0-2.4 mm Hg), no significant difference in CVP between T-5 and T+5 (95% CI, -0.9 to 0.9 mm Hg), and a significant decrease in CVP from baseline to T0 (95% CI, -3.4 to -2.1 mm Hg). CVP at T0 was less than the baseline CVP in 97% of hypotensive episodes. When all cases were examined, CVP
Kourkouta, Stella; Bailey, Graham C
A case of a symptomatic maxillary central incisor that underwent periradicular regenerative surgery with a successful long-term clinical and radiographic outcome is presented. A 52-year old woman was referred to the Endodontology Clinic, UCL Eastman Dental Institute and Hospital, London, UK, in 2004 for swelling and discoloration of the maxillary right central incisor. There was a history of trauma 21 years previously. The tooth was endodontically treated 5 years before the referral. At presentation, there was diffuse facial swelling/erythema and a periodontal probing depth of 11 mm on the midfacial surface with bleeding on probing and purulent exudate. Endodontic retreatment was completed along with subgingival debridement. Reassessment at 6 weeks showed persistent purulent exudate and a probing depth up to 13 mm facially. Periradicular surgery was performed for the purposes of surgical exploration, apical resection and root-end filling with mineral trioxide aggregate, and guided tissue regeneration using a bone xenograft and collagen membrane. Histopathology confirmed the presence of a radicular cyst. Clinical and radiographic evaluation, including cone-beam computed tomographic imaging, at 7 years postoperatively showed a probing depth up to 3 mm and hard tissue formation apically, interproximally, and partly facially on the root surface. In this case of a combined endodontic-periodontic lesion in a maxillary central incisor, regenerative periradicular surgery led to the resolution of the defect, significant attachment gain, and a stable clinical and radiographic outcome after 7 years of follow-up. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Full Text Available This paper is a response to our recognition that approaches to equity and consumer involvement in research differed in emphasis between our researchers and jurisdictions. Whilst we shared common aspirations we varied in our priorities between equity groups and methods to represent consumer interests. New Zealand has a historical focus on equity for indigenous Maori and shares with Canada concern about enduring inequalities that affect people’s lives.
Juhl, Gitte Irene; Jensen, Troels Staehelin; Nørholt, Svend Erik
BACKGROUND: Surgical removal of third molars may carry a risk of developing persistent orofacial pain, and central sensitization appears to play an important role in the transition from acute to chronic pain. AIM: The aim of this study was to investigate sensitization (primarily central sensitiza......BACKGROUND: Surgical removal of third molars may carry a risk of developing persistent orofacial pain, and central sensitization appears to play an important role in the transition from acute to chronic pain. AIM: The aim of this study was to investigate sensitization (primarily central...... impacted third molar. RESULTS: Central sensitization for at least one week was indicated by significantly increased pain intensity evoked by intraoral repetitive pinprick and electrical stimulation (p
Jensen, T.S.; Norholt, S.E.; Svensson, P.
Background: Surgical removal of third molars may carry a risk of developing persistent orofacial pain, and central sensitization appears to play an important role in the transition from acute to chronic pain. Aim: The aim of this study was to investigate sensitization (primarily central sensitiza......Background: Surgical removal of third molars may carry a risk of developing persistent orofacial pain, and central sensitization appears to play an important role in the transition from acute to chronic pain. Aim: The aim of this study was to investigate sensitization (primarily central...... impacted third molar. Results: Central sensitization for at least one week was indicated by significantly increased pain intensity evoked by intraoral repetitive pinprick and electrical stimulation (p
Lysanova, G.; Soja, A. J.
Minusinskaya basin, the area under research, is situated in the south of Central Siberia and is an agrarian region, which differs from another territories of Siberia. The territory provides for foodstuff not only its population but another regions as well. Nature-climate conditions favour the development of agriculture and cattle-breeding. Complex geographical study of rural lands, which is implemented by two approaches: a natural and industrial system block is necessary for rational use of agrolandscapes. Agrolandscapes are objects for rationalization of land management in agricultural regions. From our point of view application of a landscape map as a base for working out of agrolandscape map (Fig. 1a) and a map of agronatural potential of geosystems (Fig. 2), gives an opportunity to take stock of reserves of agricultural lands not only in quantitative but qualitative respects and also to determine the ways of optimal transformation of arable lands depending on nature conditions of regions and their development. Landscape maps that reflect differentiation of not only natural formations, changed by anthropogenious influence and also natural analogues, concern to a number of important tools of planning for optimal land use. The main principles of working out of typological landscape map of a medium scale aroused from targets and tasks of agrolandscape estimation of the territory . The landscape map was worked out according to V.A. Nikolaev's methodology : types of landscapes correlated with types of lands use, composition of cereals in rotation of crops, agro-techniques, crop capacity, climate indices, etc. Existing natural-agricultural systems are shown in the map. Their characteristics includes information about natural and agricultural blocks. Agronatural potential had been calculated by summarize estimations of its component parts. As a result of these calculations 30 arable agrolandscapes, marked out into the landscape map, were joined according to summ
Momeni, Arash; Becker, Axel; Bannasch, Holger; Antes, Gerd; Blümle, Anette; Stark, G Björn
Financial and other competing interests have recently received increasing attention. In particular clinical research in plastic surgery attracts for-profit organizations, thus, explaining the increasing number of financial sponsorships. However, research articles often lack sufficient description of study design as well as disclosure of the source of funding. Furthermore, debate exists whether industry funding influences research findings and is leading to pro-industry results. A hand search was conducted identifying all randomized controlled (RCT) and controlled clinical trials (CCT) in 4 plastic surgery journals (Plastic and Reconstructive Surgery, British Journal of Plastic Surgery, Annals of Plastic Surgery, and Aesthetic Plastic Surgery) between 1990 and 2005. Subsequently, the influence of financial support on study outcome was analyzed. A total of 10,476 original articles were analyzed, resulting in the identification of 346 clinical trials which meet the Cochrane criteria for RCTs and CCTs. One hundred eighty-three trials and 163 studies were found to be RCTs and CCTs, respectively. Hereof, only 70 trials (20.2%) reported on grant support. Of these, 42 trials (60%) were supported by the industry. Depending on the topic addressed marked differences were detected regarding grant support. Studies with a focus on reconstructive plastic surgery were supported by the industry and by public institutions in almost equal shares (18 trials vs. 15 trials), whereas aesthetic surgical topics were predominantly funded by the industry (13 trials vs. 6 trials). Industry-funded trials reported more often statistically significant differences between treatment arms (28 trials vs. 16 trials). Authors' conclusions were found to be positively associated with financial competing interests. However, trial funding is rarely declared in the plastic surgery literature. Thus, the quality of reporting needs to be improved to be able to investigate these relationships in greater detail
Haahr, M. E.; Hansen, D. L.; Fisher, P. M.
The cerebral serotonin (5-HT) system shows distinct differences in obesity compared with the lean state. Here, it was investigated whether serotonergic neurotransmission in obesity is a stable trait or changes in association with weight loss induced by Roux-in-Y gastric bypass (RYGB) surgery. In ...
Background: An epidemiological study on the traumatic haemoperitoneum cases that underwent surgery over a 7 years period from January 1999 to December 2005 was carried out in the Surgical Department of Butare University Hospital, Rwanda. The main aim of our study was to determine the epidemiological character, ...
mortality rate measures the quality of life and health care in a country, success of neonatal surgery is an audit of health delivery by any institution. The challenges .... Kruger, C.: The missing link: neonatal care in rural communities. Bull World Health Organ. 2002; 80(a): Editorial. 6. Hadley G. P., Mars, M.: Improving Neonatal.
Cervical myelopathy from traditional bonesetters' treatment of spinal injury. O.E. Idowu1,2, O.C. Idika2, R.A. Apemiye2. Neurosurgery Division, Department of Surgery, 1Lagos State University College of Medicine and 2Lagos. State University Teaching Hospital, Ikeja, Lagos, Nigeria. Correspondence to: Dr. O.E. Idowu, ...
Hager, A; Loge, K; Kutschan, A; Wiegand, W
Intraocular irrigating solutions remain for several hours beyond the actual time of surgery in the eye. The irrigating solution ought to resemble biochemically aqueous humor and vitreous and offer protection for sensitive structures of the eye, such as the corneal endothelium. Impairment of the corneal endothelium may lead to corneal oedema and biomechanical alterations of the cornea. 54 eyes after pars-plana vitrectomy (PPV) in elective macular surgery were evaluated by measuring corneal thickness (CCT) using ultrasound pachymetry (20 MHz) and corneal hysteresis (CH) using the ocular response analyser (Reichert Ophthalmic Instruments, Buffalo, NY, USA). Measurements were performed not earlier than 2 weeks prior to surgery and 1 to 3 days after surgery. Results were compared to a control group (n = 39) and to 101 eyes after clear cornea cataract extraction (KAT). The two groups (PPV and KAT) did not differ with respect to age (p = 0.555). Corneal thickness has increased significantly in both groups (p corneal hysteresis decreased significantly postoperatively (p corneal thickness but also by biomechanical parameters such as corneal hysteresis.
was evaluated in Mulago Hospital in. Kampala. Uga. Patients and Methods. This was a prospective descriptive study conducted over a period of 6-months in. Mulago Hospital, Kampala, Uganda. The study population consisted of 76 patients aged 13 years and above admitted for elective or emergency surgery. Day-care ...
Results: Abdominal trauma accounted for 14.23% of the 836 trauma admissions seen over the study period. Fifty two ... with abdominal trauma to the department of surgery of Mbarara Regional Referral Hospital between 1st of August 2005 to 31st ... road, 13.4% on high way and 9.2% on urban road. Injuries sustained at ...
Surgery on neonates, late referral, emergency laparotomy, infective indication, intraperitoneal soiling, inanition, and postoperative abdominal distension owing to protracted ileus that occurred in different combinations were predictive of burst abdomen in these cases. Conclusion: The prevalence of burst abdomen is high ...
http://www.bioline.org.br/js 142. Gastric Cancer Diagnosis and Treatment guidelines 2008: Uganda Cancer Working Group. M. Galukande M, A. Luwaga2, J. Jombwe1, J. Fualal1, J. Kigula-Mugamba2, A. Kanyike2,. A. Gakwaya1. 1Surgery Department, Faculty of Medicine, Makerere University. 2Radiotherapy department ...
Assessment of Parental Distress and Psychiatric Morbidity Before Elective Surgery in a Lagos Teaching Hospital · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. RI Osuoji, AO Coker, OM William, O Ajai, 22-28 ...
tract diseases and biliary surgery, and despite advances in the antibiotic therapy such complications still continue to .... 12 patients were bile culture positive and only 1 patient developed urinary tract infection. While patients who ... with complicated gall bladder disease in B (+) group compared to B (-) group. Moreover the.
pain, drooling of saliva and minimal blood loss. There was no difficulty in breathing. There was neither a previous history of similar incidence nor history suggestive of mental derangements. She had no history of previous hospital admission, surgery or blood transfusion. She was the only child of deceased parents, and lives ...
... of instances, such as pain and nausea and vomiting. Table 1. Hospital Admissions by Specialty. Specialty. Number of Patients. Number of Admissions. GI. 21,287. 20. Ophthalmology. 25,200. 8. Ear, Nose and Throat. 7,413. 15. General Surgery. 12,044. 31. Orthopaedics. 16,061. 30. Gynaecology. 1,172. 3. Podiatry. 2,525.
Patients studied included cases of sepsis de novo and septic complications of semi-elective or emergency abdominal surgery. Results: Out of a total of 691 cases of generalized septic peritonitis seen between 1989 and 2003,. 170 patients met the criteria and formed the basis of this study. Their ages ranged from 3 days to.
Carol Kerven; Bernd Steimann; Chad Dear; Laurie Ashley
Abstract This paper synthesizes research findings on contemporary mountain pastoralism in Kyrgyzstan and Tajikistan, based on a longer review characterizing mountain agropastoralism in Central Asia...
Stechemesser, B; Jacob, D A; Schug-Paß, C; Köckerling, F
Despite the high frequency of hernia surgery procedures and continuous improvements, thanks to new hernia meshes and fixation techniques, in Germany, for example, the recurrence rate and rate of chronic inguinal pain after inguinal surgery are more than 10% far too high. Introduction of a hernia register in Denmark led to a significant reduction in the recurrence rate. The aim of a hernia registry as an application-oriented outcome research tool is to monitor and evaluate (concomitant research) how the knowledge gleaned from evidence-based science is implemented in the everyday clinical setting and, ultimately, investigate its effectiveness (outcome research). The new Internet-based English- and German-language registry for the entire spectrum of inpatient and outpatient hernia surgery is designed to improve the quality of patient care and provide valid data on outcome research. Via the Internet, all relevant patient data (comorbidities, previous operations, staging, specific surgical technique, medical devices used, perioperative complications and follow-up data) can be entered into the registry database. The participating hospitals and surgeons can at any time view their own data by means of an evaluation statistics tool. The outcome research project Herniamed focuses on inguinal hernias, umbilical hernias, incisional hernias, epigastric hernias, parastomal hernias and hiatus hernias. The online-based outcome research registry meets the most stringent data protection criteria. With the Internet-based English- and German-language hernia register, a new instrument is now available for outcome research in hernia surgery.
Pitak-Arnnop, P; Sader, R; Hervé, C; Dhanuthai, K; Bertrand, J-Ch; Hemprich, A
This retrospective observational study investigated the frequency of reporting ethical approval and informed consent in recently published oral and maxillofacial surgery (OMS) research involving human subjects. All research involving human subjects published in the International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, British Journal of Oral and Maxillofacial Surgery, and Journal of Cranio-Maxillofacial Surgery during January to June 2005-2007 were analysed for disclosure of ethical approval by a local ethical committee and obtaining informed consent from the subjects. 534 articles were identified; ethical approval was documented in 118 (22%) and individual patient consent in 135 (25%). 355 reports (67%) did not include a statement on ethical approval or informed consent and only 74 reports (14%) disclosed statements of both. Ethical documentation in retrospective and observational studies was scant; 12% of randomised controlled trials and 38% of non-random trials did not report both of ethical protections. Most recent OMS publications involving humans failed to mention ethical review or subjects' consent. Authors must adhere to the international research ethics guidelines and journal instructions, while editors should play a gatekeeper role to protect research participants, uphold scientific integrity and maintain public trust in the experimental process and OMS profession.
Abbott, Daniel E; Martin, Grace; Kooby, David A; Merchant, Nipun B; Squires, Malcolm H; Maithel, Shishir K; Weber, Sharon M; Winslow, Emily R; Cho, Clifford S; Bentrem, David J; Kim, Hong Jin; Scoggins, Charles R; Martin, Robert C; Parikh, Alexander A; Hawkins, William G; Ahmad, Syed A
Several groups have defined pancreatic surgery quality metrics that identify centers delivering quality care. Although these metrics are perceived to be associated with good outcomes, their relationship with actual outcomes has not been established. A national cadre of pancreatic surgeons was surveyed regarding perceived quality metrics, which were evaluated against the Central Pancreas Consortium (CPC) database to determine actual performance and relationships with long-term outcomes. The most important metrics were perceived to be participation in clinical trials, appropriate clinical staging, perioperative mortality, and documentation of receipt of adjuvant therapy. Subsequent analysis of 1399 patients in the CPC dataset demonstrated that a R0 retroperitoneal and neck margin was obtained in 79% (n = 1109) and 91.4% (n = 1278) of cases, respectively. 74% of patients (n = 1041) had >10 lymph nodes harvested, and LN positivity was 65% (n = 903). 76% (n = 960) of eligible patients (surgery first approach) received adjuvant therapy within 60 days of surgery. Multivariate analysis demonstrated margin status, identification of >10 lymph nodes, nodal status, tumor grade and delivery of adjuvant therapy within 60 days to be associated with improved overall survival. These analyses demonstrate that systematic monitoring of surgeons' perceived quality metrics provides critical prognostic information, which is associated with patient survival. Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
Jun 21, 2016 ... Building consensus on youth violence prevention and citizen security in Central America. IDRC's efforts in negotiation and coalition building contributed to a high-level dialogue that engaged high-level officials and reaffirmed their c. View more Building consensus on youth violence prevention and citizen ...
Full Text Available Using voxel-wise degree centrality (DC, as measured by resting-state fMRI, we aimed to study alterations in the brain functional networks in patients with primary angle-closure glaucoma (PACG and to reveal the plastic trajectories of surgery.A total of 23 preoperative PACG patients (49.48 ± 14.37 years old were recruited to undergo a resting-state fMRI scan, and 9 of them were rescanned 3 months after surgery. All PACG patients underwent a complete ophthalmologic examination, including intraocular pressure (IOP, retinal nerve fiber layer (RNFL thickness, vertical cup to disc ratio (V C/D, and average cup to disc ratio (A C/D. Another 23 gender- and age-matched healthy controls (48.18 ± 9.40 years old underwent scanning once for comparison. The group difference in DC was calculated in each voxel, and the correlations between the DC value and each of the clinical variables were analyzed in the PACG patients.Preoperative PACG (pre-PACG patients showed significantly decreased DC in the bilateral visual cortices but increased DC in the left anterior cingulate cortex (ACC and caudate (p < 0.05, corrected compared with the controls. Statistical analysis showed a significantly negative correlation between DC in the bilateral visual cortices and the IOP score and between DC in the anterior cingulate cortex (ACC and both the A C/D and V C/D scores in the pre-PACG patients. Three months after surgery, these postoperative PACG (post-PACG patients showed a significantly increased DC in both the bilateral visual cortices and the left precentral gyrus compared with the pre-PACG patients.Our results suggest that PACG may contribute to decreased functional centrality in the visual system and to increased degree centrality in cognition-emotional processing regions. Alterations in visual areas seem to parallel the cup to disc ratio, but not the duration of angle closure. The changes of functional centrality in PACG patients after operation may reveal the
Full Text Available Background and Aims: There is limited data on the impact of perioperative fluid therapy guided by dynamic preload variables like stroke volume variation (SVV on outcomes after abdominal surgery. We studied the effect of SVV guided versus central venous pressure (CVP guided perioperative fluid administration on outcomes after major abdominal surgery. Material and Methods: Sixty patients undergoing major abdominal surgeries were randomized into two equal groups in this prospective single blind randomized study. In the standard care group, the CVP was maintained at 10-12 mmHg while in the intervention group a SVV of 10% was achieved by the administration of fluids. The primary end-points were the length of Intensive Care Unit (ICU and hospital stay. The secondary end points were intraoperative lactate, intravenous fluid use, requirement for inotropes, postoperative ventilation and return of bowel function. Results: The ICU stay was significantly shorter in the intervention group as compared to the control group (2.9 ± 1.15 vs. 5.4 ± 2.71 days. The length of hospital stay was also shorter in the intervention group, (9.9 ± 2.68 vs. 11.96 ± 5.15 days though not statistically significant. The use of intraoperative fluids was significantly lower in the intervention group than the control group (7721.5 ± 4138.9 vs. 9216.33 ± 2821.38 ml. Other secondary outcomes were comparable between the two groups. Conclusion: Implementation of fluid replacement guided by a dynamic preload variable (SVV versus conventional static variables (CVP is associated with lesser postoperative ICU stay and reduced fluid requirements in major abdominal surgery.
Zhan, R; Zhu, Y; Shen, Y; Shen, J; Tong, Y; Yu, H; Wen, L
A post-operative central nervous system infection (PCNSI) is a dangerous complication after cranial surgery. Although a large number of neurosurgical procedures are performed in hospitals in China, PCNSI-related data from this country are rarely reported. To address this issue, we examined the incidence of PCNSI after cranial surgery, the potential risk factors, and the offending etiologic agents in a large Chinese population. The medical records and post-operative courses for patients >16 years of age who underwent elective or emergency cranial surgeries between May 2010 and May 2012 and who survived for >7 days were reviewed retrospectively. Pre-operative data, surgery-related records, and post-operative variables were evaluated as risk factors for PCNSI after cranial surgery. Among 1,470 surgeries, 1,340 were craniotomies and 130 involved the cerebrospinal fluid (CSF). There were 109 patients with PCNSIs, resulting in a total infection rate of 7.4 %. The dominant Gram-positive organism isolated (Staphylococcus aureus) was the most common pathogen isolated. Based on multivariate analysis, the risk of PCNSI was increased by a CSF leak [odds ratio (OR), 3.545; 95 % confidence interval (CI), 2.053-6.122; p China. CSF leakage, CSF drainage of any kind, subsequent short-term surgery, and surgery duration were major risk factors, indicating that surgery-focused management might be the most effective way to minimize the risk for PCNSI after cranial surgery.
Full Text Available INTRODUCTION: Neuroimaging studies suggest that obese people might show hyperactivity of brain areas regarding reward processing, and hypoactivity of brain areas concerning cognitive control, when exposed to food cues. Although the effects of bariatric surgery on the central nervous system and eating behavior are well known, few studies have used neuroimage techniques with the aim of investigating the central effects of bariatric surgery in humans. OBJECTIVES: This paper systematically and critically reviews studies using functional neuroimaging to investigate changes on the patterns of activation of central areas related to the regulation of eating behavior after bariatric surgery. METHOD: A search on the databases Medline, Web of Science, Lilacs and Science Direct on Line, was conducted in February 2013, using the keywords "Neuroimaging", "Positron-Emission Tomography", "Magnetic Resonance Imaging", "Gastric Bypass", "Gastroplasty", "Jejunoileal Bypass", "Bariatric Surgery". RESULTS: Seven manuscripts were included; the great majority studied the central effects of Roux en Y gastric bypass, using positron emission tomography or functional magnetic resonance. CONCLUSIONS: Bariatric surgery might normalize the activity of central areas concerned with reward and incentive salience processing, as the nucleus accumbens and mesencephalic tegmental ventral area, as well as circuitries processing behavioral inhibition, as the dorsolateral prefrontal cortex.
Fan, Guoxin; Zhou, Zhi; Zhang, Hailong; Gu, Xin; Gu, Guangfei; Guan, Xiaofei; Fan, Yunshan; He, Shisheng
Robot-assisted surgery operations are being performed more frequently in the world these years. In order to have a macroscopic view of publication activities about robotic surgery, the first bibliometric analysis was conducted to investigate the publication distributions of robotic surgery. The original articles about robotic surgery were extracted from the Science Citation Index Expanded (SCI-E) on Web of Science and analyzed concerning their distributions. We also explored the potential correlations between publications of different countries and their Gross Domestic Product (GDP). The total number of original articles retrieved from SCI-E was 3362 from 1994 to 2015. The number of original articles published in the last decade has a burgeoning increase of 572.87% compared with that published in the former decade. The leading country was USA who have published 1402 pieces of articles (41.701%), followed by Germany with 342 (10.173%). The journal published the highest number of original articles was Journal of Endourology with 237 (7.049%), followed by Surgical Endoscopy and Other Interventional Techniques (188, 5.592%). There was strong correlations between publication numbers and GDP of different countries (r(2) = 0.889, p research activities has the potential to guide future trend in the field of robotic surgery. There is a skyrocket trend of robotic surgery in medical research over the last two decades, and countries with high GDP tend to make more contributions to the medical field of robotic surgery. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
Alawi, S A; Bohr, S; Stromps, J P; Alharbi, Z; Pallua, N
In plastic surgery, a broad spectrum of research activity has been performed over the past decade. However, compared with other medical fields, there seems to be a lack of central coordination in the individual research areas. Also no comprehensive, periodical assessment has been undertaken to date. This study aims to provide an overview of German research activity in plastic surgery departments affiliated to medical universities. We performed a 5-year interval (01/2010-12/2014) survey of PubMed-listed publications of plastic surgery departments in German university hospitals. For each university (n=11), statistical analyses of the following parameters were performed: distribution of research fields, number of publications, annual cumulative impact sum (IS) and impact factor (IF). For the above-mentioned period, a total of n=904 publications were analysed. Ranking among academic departments was as follows: number of publications: 1. Medizinische Hochschule Hannover 178 (annual average x̅=36/median x͂=34; 2. University Hospital of Erlangen 115 (x̅=23/x͂=23); 3. Bergmannsheil Bochum 90 (x̅=18/x͂=19). The annual impact sum (IS) averaged 33.51 (SD 11.088, p<0.05); separated IS: 1. Medizinische Hochschule Hannover x̅=74.66, x͂=62.22, 2. University Hospital of Erlangen x̅=53.24, x͂=50.84, 3. University Hospital RWTH Aachen x̅=46.12, x͂=44.67. The average impact factor per publication was: 1.98 (SD 0.31, p<0.05); separated IF: 1. University Hospital RWTH Aachen x̅=2.76, x͂=2.79; 2. University Hospital of Erlangen x̅=2.34, x͂=2.46; 3. Medizinische Hochschule Hannover x̅=2.08, x͂=2.05. The analysed publications were distributed as follows: 43% reviews, 20% cell biology/tissue engineering, 10% reconstruction, 27% others (including wound healing, vessel/nerve research, hand surgery, burn, aesthetics, oncology). Based on this comprehensive analysis, it seems that a periodical assessment of current research activity would be useful for the future. Data
Santangelo, Michele; Esposito, Anna; Tammaro, Vincenzo; Calogero, Armando; Criscitiello, Carmen; Roberti, Giuseppe; Candida, Maria; Rupealta, Niccolò; Pisani, Antonio; Carlomagno, Nicola
Conventional pancreatic resections for pancreatic neck and body diseases include pancreaticoduodenectomy, distal pancreatectomy with or without splenectomy, and total pancreatectomy. Recent studies have reported encouraging results of non-traditional pancreatic resections, including central pancreatectomy (CP), for central pancreatic disease. This surgical approach offers the potentials of low postoperative morbidity and preservation of metabolic functions. This study performs a systematic review on CP. A comprehensive literature search was conducted, for the period 1992-2015, on three worldwide databases: PubMed, Scopus, ISI-Web of Knowledge. We focused on indications, morbidity and mortality of this surgical procedure. The review shows that CP is particularly suitable for small-medium size diseases localized into the pancreatic body. This procedure is associated with an increased postoperative morbidity but an excellent postoperative pancreatic function. CP is a safe and effective procedure when performed following the right indications. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.
Levene, R Z
The relationship between Snellen visual acuity and central visual field loss as determined by the Humphrey 10-degree test was examined in 96 glaucomatous eyes of 79 patients. The severity of the field defect was determined by the number of affected quadrants, defined as a sensitivity loss of at least 10 decibels from normal at the most central point of 1.4-degree eccentricity. The decrease in median acuity was gradual, one-half line per quadrant for one and two affected quadrants, and an additional one and one-half line to two lines for three and four quadrants. Loss of acuity was disproportionate when both temporal quadrants were affected. The major source of error was difficulty with fixation. One type, a prolonged fixation shift, was not related to short-term fixation losses. There was a significant correlation between acuity and foveal threshold over a wide range of both variables. Sudden visual loss from additional optic nerve damage was studied retrospectively in 96 eyes with advanced glaucoma and a central field defect. A frequency of 3% for any loss of visual acuity and a frequency of 1% for a loss to 20/200 or worse were noted. There were no apparent predictive factors.
Full Text Available Background: Central venous (CV catheters play an essential role in the management of critically ill patients in the Intensive Care Unit (ICU. CV lines are, however, allied to catheter-associated blood stream infections. Bacterial colonization of CV lines is deemed the main cause of catheter-associated infection. The purpose of our study was to compare bacterial colony counts in the catheter site before CV line insertion in two groups of post-cardiac surgery patients: a group receiving Sanosil (an antiseptic agent composed of H2 O2 and silver and a control group.Methods: This interventional prospective double-blinded clinical trial recruited the patients in three post-cardiac surgeryICUs of a heart center. The participants were divided into interventional (113 patients and control (136 patients groups. Sanosil was added to the routine preparation procedure (Chlorhexidine bath one day before and scrub with Povidone-Iodine just before the CV line insertion. After the removal of the CV lines, the catheters tips were sent for culture and evaluation of colony counts.Results: Catheter colonization occurred in 55 (22.1% patients: 26 (23% patients in the Sanosil group and 29 (21.3% in the control group; there was no significant statistical difference between the two groups (p value = 0.75, RR = 1.05, 95%CI:0.76-1.45. The most common organism having colonized in the cultures of the catheter tips was staphylococcus epidermis:20 cases in the control group and 16 cases in the intervention group.Conclusion: Catheter colonization frequently occurs in post-cardiac surgery patients. However, our results did not indicate the effectiveness of adding Sanosil to the routine preparation procedure with respect to reducing catheter bacterial colonization.
Ratti, Francesca; Cipriani, Federica; Reineke, Raffaella; Catena, Marco; Paganelli, Michele; Comotti, Laura; Beretta, Luigi; Aldrighetti, Luca
Central venous pressure (CVP) is used as a marker of cardiac preload to control intraoperative blood loss in open hepatectomies, while its reliability in laparoscopy is less certain. The aim of this randomized prospective trial was to evaluate the outcome of laparoscopic resections performed with stroke volume variation (SVV) or CVP monitoring. All candidates for laparoscopic liver resection were assigned randomly to SVV or to CVP groups. Outcome was evaluated included conversion rate, cause of conversion, intraoperative blood loss, need for transfusions, length of surgery and postoperative results. Ninety consecutive patients were enrolled: both SVV and CVP groups included 45 patients each and were comparable in terms of patient and disease characteristics. A reduced rate of conversion was recorded in the SVV compared to the CVP group (6.7% and 17.8% respectively, p = 0.02). Blood loss was lower in the SVV group (150 mL), compared to the CVP group (300 mL, p = 0.04). Morbidity, mortality, length of stay and functional recovery were comparable. On multivariate analysis, lesion location, extent of hepatectomy and type of cardiac preload monitoring were associated significantly to risk of conversion. SVV monitoring in laparoscopic liver surgery improves intraoperative outcome, thus enhancing the benefits of the minimally-invasive approach and fast-track protocols. Copyright © 2015 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
Full Text Available Aims and Objectives: We evaluated the factors which affect patient satisfaction and their expectations toward “surgery first” and conventional orthognathic surgery. Materials and Methods: Questionnaires consisting of 17 questions were given to the subjects postoperatively who had undergone Le fort 1 maxillary superior impaction for skeletal gummy smile correction with conventional orthognathic surgery and “surgery first” approach. Eleven-point rating scale based on a (visual analog scale; 0 = poor; 10 = excellent were used to answer six questions. Ten closed-form questions were also included as well as one open question for “further remarks.” Results: Nineteen patients (12 females, 07 males; mean age, 23.4 ± 4.9 [standard deviation] years gave their consent to participate in the study. The intention to undergo surgery only for esthetics was noted in 42.11% of patients; only improvement of chewing function in 21.05% and both in 36.84%. Conclusion: The most common factor for patient satisfaction after “surgery first” and conventional orthognathic surgery was facial esthetics, but masticatory function and even psychological aspects should be considered equally when planning surgery. The patient satisfaction was more in “surgery first” than conventional orthognathic surgery. The timing of treatment and immediate results are important factors toward patient satisfaction.
E-commerce in Asia has been receiving considerable attention as a result of the proliferation of Internet connectivity and technologies in the region. In response to this trend, Canada's International Development Research Centre ( IDRC ) commissioned four studies to investigate the various economic, social, methodological ...
Information and communication technologies have long promised to provide quality education, improve health care, allow open government, and solve environmental issues. To realize this potential and influence policy-making and program design, the Singapore Internet Research Centre, supported by IDRC, created an ...
Read more about Alternative Measure of Wellbeing: Bhutan's Gross National Happiness 2010. Language English. Read more about Mekong Economic Research Network (MERN). Language English. Read more about Technologies omniprésentes et accès au savoir (A2K). Language French. Read more about Pervasive ...
van Raan, Anthony F. J.
This article presents an overview of measuring science based on a bibliometric methodology. The 2 main lines of this methodology are discussed. First, the measurement of research performance is addressed, including aspects such as interdisciplinarity, collaboration, and knowledge users. It is demonstrated that advanced bibliometric methods are an…
Language English. Read more about Diaspora Impact on the Capacity for Recovery from Conflict and Crisis. Language English. Read more about Migration, Gender and Social Justice : Connecting Research and Practice Networks. Language English. Read more about Migrations, sexospécificités et justice sociale : faire le ...
Following on a pilot project in Ghana and Mali (102772), this research project proposes to analyze, evaluate and compare the process of decentralization underway in ... The study will be carried out by multidisciplinary teams constituted at the national level under the administrative coordination of ROCARE and the technical ...
Researchers from Canada and India funded by IDRC have found that filtering water through sari-cloth before purifying it in the sun's heat makes polluted water safe to drink. Polluted water is often the only source of drinking water for many low-income households in India. To kill the germs, people pour water into clear plastic ...
Read more about Development Research to Empower All Mongolians through Information Communication Technology - DREAM IT. Language English. Read more about DREAM IT, un programme de recherche aux fins d'autonomisation de tous les Mongols grâce aux TIC. Language French. Read more about Advancing ...
Nakajo, Akihiro; Arima, Hideo; Hirata, Munetsugu; Yamashita, Yoshie; Shinden, Yoshiaki; Hayashi, Naoki; Kawasaki, Yota; Arigami, Takaaki; Uchikado, Yasuto; Mori, Shinichiro; Mataki, Yuko; Sakoda, Masahiko; Kijima, Yuko; Uenosono, Yoshikazu; Maemura, Kosei; Natsugoe, Shoji
Endoscopic thyroidectomy is a well-established surgical technique that is mainly performed for benign thyroid disease. We considered that endoscopic surgery could also be widely indicated for the treatment of thyroid cancer. We herein describe our new bidirectional approach of video-assisted neck surgery (BAVANS) for complete central node dissection in endoscopic thyroid cancer surgery. BAVANS involves two different directional pathways to the cervical lesion. Before lymph node dissection, we perform endoscopic thyroidectomy via a conventional gasless precordial or axillary approach. After thyroidectomy, the surgeon repositions by the head of the patient and inserts three ports in front of the upper neck lesion in the submandibular area to approach the paratracheal lesion from an overhead-to-caudal direction. BAVANS allows for an excellent craniocaudal view and easy access to the peritracheal lymph nodes. Sixteen patients with papillary thyroid cancer underwent BAVANS and progressed satisfactorily after surgery. Of those patients, eight underwent total or near total thyroidectomy, and five patients underwent bilateral central node dissection. The average number of retrieved lymph nodes with unilateral central node dissection was nine, which was higher than that achieved with conventional open surgery. All patients began oral intake within 5 h after surgery. Postoperative Horner syndrome occurred in one patient. No other complications were noted. BAVANS is a very effective surgical procedure that many endoscopic surgeons can perform safely and easily. It has both a cosmetic advantage and excellent curability in endoscopic thyroid cancer surgery. © 2016 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.
During the 19th, and for most of the 20th century, malignant tumors were removed by mutilating radical anatomic dissection. Advances such as anesthesia, asepsis, and blood transfusion made possible increasingly more radical operations. There was no scientific rationale for the operations being performed. Surgery in the 20th century was dominated by the principles of William S. Halsted, who contended that the bloodstream was of little significance as a route of tumor cell dissemination; a tumor was autonomous of its host; and cancer was a local-regional disease that spread in an orderly fashion based on mechanical considerations. Halsted believed that both the extent and nuances of an operation influenced patient outcome and that inadequate surgical skill was responsible for the failure to cure. A new surgical era arose in 1957, when cancer surgery began to be influenced by laboratory and clinical research, with results contrary to Halstedian principles. A new hypothesis resulted in a scientific basis for cancer surgery. Clinical trials supported the thesis that operable cancer is a systemic disease and that variations in local-regional therapy are unlikely to substantially affect survival. Complex host-tumor relationships were shown to affect every aspect of cancer and, contrary to Halsted's thesis, the bloodstream is of considerable importance in tumor dissemination. Clinical trials also have shown that less radical surgery is justified. Studies have shown that improved survival can be achieved with systemic therapy after surgery. Such therapy can reduce both the incidence of distant disease and the tumor recurrence at the tumor site after minimal surgery. The use of systemic therapy in patients who have no identifiable metastatic disease is a drastic departure from previous strategies. New technological innovations resulting from engineering research have improved the quality of life of patients by eliminating the need for some surgical procedures. Because cancer
Maragh-Bass, Allysha C; Appelson, Jessica R; Changoor, Navin R; Davis, W Austin; Haider, Adil H; Morris, Megan A
Over the past 2 decades, researchers have recognized the value of qualitative research. Little has been done to characterize its application to surgery. We describe characteristics and overall prevalence of qualitative surgical research. We searched PubMed and CINAHL using "surgery" and 7 qualitative methodology terms. Four researchers extracted information; a fifth researcher reviewed 10% of abstracts for inter-rater reliability. A total of 3,112 articles were reviewed. Removing duplicates, 28% were relevant (N = 878; κ = 0.70). Common qualitative methodologies included phenomenology (34.3%) and grounded theory (30.2%). Interviews were the most common data collection method (81.9%) of patients (64%) within surgical oncology (15.4%). Postdischarge was the most commonly studied topic (30.8%). Overall, 41% of studies were published in nursing journals, while 8% were published in surgical journals. More than half of studies were published since 2011. Results suggest qualitative surgical research is gaining popularity. Most is published in nonsurgical journals, however, utilizing only 2 methodologies (phenomenology, grounded theory). The surgical journals that have published qualitative research had study topics restricted to a handful of surgical specialties. Additional surgical qualitative research should take advantage of a greater variety of approaches to provide insight into rare phenomena and social context. Copyright © 2016 Elsevier Inc. All rights reserved.
Block, Ernest F J; Rudloff, Beth; Noon, Charles; Behn, Bruce
There is a national loss of access to surgeons for emergencies. Contributing factors include reduced numbers of practicing general surgeons, superspecialization, reimbursement issues, emphasis on work and life balance, and medical liability. Regionalizing acute care surgery (ACS), as exists for trauma care, represents a potential solution. The purpose of this study is to assess the financial and resources impact of transferring all nontrauma ACS cases from a community hospital (CH) to a trauma center (TC). We performed a case mix and financial analysis of patient records with ACS for a rural CH located near an urban Level I TC. ACS patients were analyzed for diagnosis, insurance status, procedures, and length of stay. We estimated physician reimbursement based on evaluation and management codes and procedural CPT codes. Hospital revenues were based on regional diagnosis-related group rates. All third-party remuneration was set at published Medicare rates; self-pay was set at nil. Nine hundred ninety patients were treated in the CH emergency department with 188 potential surgical diseases. ACS was necessary in 62 cases; 25.4% were uninsured. Extrapolated to 12 months, 248 patients would generate new TC physician revenue of >$155,000 and hospital profits of >$1.5 million. CH savings for call pay and other variable costs are >$100,000. TC operating room volume would only increase by 1%. Regionalization of ACS to TCs is a viable option from a business perspective. Access to care is preserved during an approaching crisis in emergency general surgical coverage. The referring hospital is relieved of an unfavorable payer mix and surgeon call problems. The TC receives a new revenue stream with limited impact on resources by absorbing these patients under its fixed costs, saving the CH variable costs.
Full Text Available Objective To report our experiences of direct cortical stimulation in surgery of gliomas located in eloquent areas. Methods Clinical data of 157 patients with gliomas underwent awake craniotomy with the direct electrical stimulation for functional mapping of the eloquent areas were analysed retrospectively. Results Negative cortical stimulation was found in 4 patients, and positive cortical stimulation was achieved in 153 patients (97.45% . Four hundred and ninty -six cortical sites in 139 patients were detected for motor response by direct electrical stimulation, 70 sites in 21 patients for sensory, 112 sites in 91 patients for language (such as counting and naming. The positive areas of counting disturbance were mainly seen at the lower part of left precentral gyri operculum of left inferior frontal gyri, triangular part of left inferior frontal gyri, posterior part of left middle frontal gyri, and posterior part of left superior frontal gyri. Postoperative MRI showed 92 patients (58.60% achieved total resection, 55 cases (35.03% subtotal and 10 cases (6.37% partial. One hundred and ten patients (70.06% were diagnosed as having low grade glimas, including 71 cases of astrocytoma, 26 cases of oligodendroglioma, and 13 cases of mixed astro ? oligodendroglioma, 47 patients (29.94% were high grade gliomas, including 19 cases of glioblastoma, 15 cases of anaplastic astrocytoma, and 13 cases of anaplastic oligodendroglioma. After operation 53 patients (33.76% occurred transient postoperative paralysis, 39 patients (24.84% transient language disturbance and 4 patients (2.55% permanent neurological deficits. Conclusion Intraoperative direct electrical stimulation is a reliable, precise and safety method for functional mapping of the eloquent areas. This technique allows us to achieve 'maximal safety resection' in glioma surgery．
Mommaerts, Maurice Y; Foster, Murray E; Gundlach, Karsten K H
Not many randomised controlled trials are published in surgical journals, especially those on maxillo-facial surgery. There appears to be some uncertainty on how to perform such studies. Accordingly this paper offers some information on how to plan, pursue and publish a well conducted case-control study, or the more powerful randomised control trial. The main section describes how to define a relevant clinical question, and a research protocol, the way to implement the study, and it helps to find funding for such research. It also explains the various study designs, gives a very short introduction to statistics and on how to appraise the results achieved, and it advises on writing and submitting the resultant manuscript. This paper offers a guide for young colleagues who wish to perform a study, write a paper and achieve publication in one of our leading speciality journals. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Gourash, William F; Lockhart, Joan Such; Kalarchian, Melissa A; Courcoulas, Anita P; Nolfi, David
Bariatric surgery research, often longitudinal, bears the challenge of maintaining retention and decreasing attrition of participants to avoid bias. To explore factors influencing the retention and attrition for bariatric surgical research participants. Databases searched included: PubMed, CINAHL, Scopus, and others. As a secondary aim, studies reporting on retention/attrition factors in clinical follow-up visits were included. Of the 1145 articles retrieved, 44 met inclusion criteria, and underwent qualitative analysis. Four descriptive articles focused on longitudinal research participation and 40 on clinical follow-up visits. Willingness to participate in research was high (92%) and decreased with more invasive procedures or extra visits. A large observational longitudinal study presented 24-month retention/attrition data (92% for some data and 66% visit completion) and the retention strategies employed. One study indicated that research follow-up possibly increased clinical follow-up and another demonstrated a higher retention by increasing compensation. No consistent, modifiable demographic or psychosocial variables associated or predictive of retention or attrition in clinical follow-up were identified. Research on factors related to participant retention and attrition is sparse. It is essential for studies to document retention/attrition data. Existing research has demonstrated a patient willingness to participate in research and that retention strategies have been successful in the short term. Further research should explore the motivations, perspectives and attitudes of bariatric surgical research participants regarding participation and explore predictors to develop evidence-based retention strategies. Research has yet to identify consistent and modifiable demographic or psychosocial variables predictive of clinical follow-up, possibly due to the heterogeneity of follow-up across studies. Further investigation into follow-up definition, content
Lukman Olajide Abdur-Rahman
Full Text Available Background and Objective: Advances in laparoscopy are making the service accessible even in resource-poor countries where adaptations are made to meet local challenges. We report our experience in the provision of laparoscopy service to children at a tertiary health center in North-central Nigeria. Methods: A team of pediatric surgeons, anesthetists, and nurses collaborated to provide service and train other personnel. A prospective collection of data on biodata, diagnoses, procedure, and outcome over an effective period of 36 months of laparoscopy intervention of the 54 months between September 2009 and February 2014 was done. Consent, which also included the possibility of conversion to open was obtained from the parents of the patients. Results: A total of 73 patients aged 2 weeks to 16 years with a male: female ratio of 3 to 1 had laparoscopy done during the period. Fifty-two (71.2% procedures were therapeutic, and 21 (28.8% cases were done as emergency. Laparoscopic appendectomy was the most commonly performed procedure 25 (34.3%, followed by laparoscopic orchidopexy 17 (23. 3%, and diagnostic laparoscopy for disorders of sexual differentiation in 13 (17.8%. The length of stay in hospital postoperative was 1-3 days with a mean of 1.34 0.45 days. The complications recorded included hemorrhage, in a case of infantile hypertrophic pyloric stenosis due to failed electrocautery, one port site burns injury from diathermy dissection, and two periport pain postoperation. There was no mortality recorded. Conclusion: Pediatric laparoscopic service is gaining recognition in our practice in spite of poor resources, incessant industrial actions, and apathy from support staff. The outcomes are encouraging as the patients had minimal morbidities. Skills are improved through practice and retraining and manpower, and instruments are being expanded through our collaboration and training.
Nasser, Bana; Tageldein, Mohmad; AlMesned, Abdulrahman; Kabbani, Mohammad
Red blood cell transfusion is common in critically ill children after cardiac surgery. Since the threshold for hemoglobin (Hb) transfusion need is not well defined, the threshold Hb level at which dependent critical oxygen uptake-to-delivery (VO2-DO2) status compensation is uncertain. To assess the effects of blood transfusion on the oxygen extraction ratio (O2ER) and central venous oxygen saturation (ScvO2) to identify a critical O2ER value that could help us determine the critical need for blood transfusion. Prospective, observational cohort study. Cardiac Surgical Intensive Care Unit at Prince Sultan Cardiac Center in Qassim, Saudi Arabia. Between January 2013 and December 2015, we included all children with cardiac disease who underwent surgery and needed a blood transfusion. Demographic and laboratory data with physiological parameters before and 1 and 6 hours after transfusion were recorded and O2ER before and 6 hours after transfusion was computed. Cases were divided into two groups based on O2ER: Patients with increased O2ER (O2ER > 40%) and normal patients without increased O2ER (O2ER transfusion. Changes in O2ER and ScvO2 following blood transfusion. Of 103 patients who had blood transfusion, 75 cases had normal O2ER before transfusion while 28 cases had increased O2ER before transfusion. Following blood transfusion, O2ER and ScvO2 improved in the group that had increased O2ER before transfusion, but not in the group that had normal O2ER before transfusion. The clinical and hemodynamic indicators O2ER and ScvO2 may be considered as markers that can indicate a need for blood transfusion. The limitation of this study is the small number of patients that had increased O2ER before transfusion. There were few available variables to assess oxygen consumption.
Sun, Jianzhong; Ding, Ren; Ma, Tai; Shi, Xiaobing; Bao, Chaolu; Guan, Huapeng
Worldwide research contributions have allowed the field of fracture surgery to progress. However, to the best of our knowledge, no studies have documented the main characteristics of publications from different countries. The present study aimed to determine the quantity and quality of worldwide research in fracture surgery. The Web of Science database was searched to identify fracture articles published between 2005 and 2014. The contributions of countries were evaluated based on paper and citation numbers, and the research output of each country was adjusted according to population size. A total of 19,423 papers on the topic of fracture surgery were identified worldwide, and the total number of publications from 2005 to 2014 had significantly increased by 1.82-fold (Pincome countries (gross national income per capita ≥$12,736), 13.25% by middle-income countries ($1,046-12,735) and 0.11% by low-income countries (≤$1,045). The United States contributed the highest number of publications (33.34%), followed by the United Kingdom (9.03%), Germany (8.42%), China (5.58%) and Japan (4.18%). Furthermore, the United States ranked first according to total citations (72,640). Articles from Sweden achieved the highest average citations per paper (15.63), followed by Australia (12.84) and Canada (12.44). When the number of publications were adjusted for population size, Switzerland was the first (56.39), followed by Austria (35.43) and the Netherlands (30.68). In conclusion, the number of publications in fracture surgery increased from 2005 to 2014, and the majority of fracture papers were published by high-income countries, while few papers were published by low-income countries. The United States was the most prolific country, but based on population size, a number of smaller countries in Europe may be relatively more prolific.
Musculoskeletal research has brought about revolutionary changes in our ability to perform high precision surgery in joint replacement procedures. Recent advances in computer assisted surgery as well better materials have lead to reduced wear and greatly enhanced the quality of life of patients. The new surgical techniques to reduce the size of the incision and damage to underlying structures have been the primary advance toward this goal. These new techniques are known as MIS or Minimally Invasive Surgery. Total hip and knee Arthoplasties are at all time high reaching 1.2 million surgeries per year in the USA. Primary joint failures are usually due to osteoarthristis, rheumatoid arthritis, osteocronis and other inflammatory arthritis conditions. The methods for THR and TKA are critical to initial stability and longevity of the prostheses. This research aims at understanding the fundamental mechanics of the joint Arthoplasty and providing an insight into current challenges in patient specific fitting, fixing, and stability. Both experimental and analytical work will be presented. We will examine Cementless total hip arthroplasty success in the last 10 years and how computer assisted navigation is playing in the follow up studies. Cementless total hip arthroplasty attains permanent fixation by the ingrowth of bone into a porous coated surface. Loosening of an ingrown total hip arthroplasty occurs as a result of osteolysis of the periprosthetic bone and degradation of the bone prosthetic interface. The osteolytic process occurs as a result of polyethylene wear particles produced by the metal polyethylene articulation of the prosthesis. The total hip arthroplasty is a congruent joint and the submicron wear particles produced are phagocytized by macrophages initiating an inflammatory cascade. This cascade produces cytokines ultimately implicated in osteolysis. Resulting bone loss both on the acetabular and femoral sides eventually leads to component instability. As
Kerven, Carol; Steimann, Bernd; Dear, Chad; Ashley, Laurie
This paper synthesizes research findings on contemporary mountain pastoralism in Kyrgyzstan and Tajikistan, based on a longer review characterizing mountain agropastoralism in Central Asia. We focus here on the principal issues that have been emphasized over the past two decades in policy, programs, and projects regarding pastoralism in Central Asia's mountains. We conclude that this emphasis has largely been driven by two unproven orthodoxies about The extent and causes of pasture degra...
Li, Qiang; Zeng, Yanjun; Tang, Xiaoying
In spite of some good successes and excellent researches of nickel-titanium shape memory alloy (NiTi-SMA) in reconstructive surgery, there are still serious limitations to the clinical applications of NiTi alloy today. The potential leakage of elements and ions could be toxic to cells, tissues and organs. This review discussed the properties, clinical applications, corrosion performance, biocompatibility, the possible preventive measures to improve corrosion resistance by surface/structure modifications and the long-term challenges of using SMAs.
Okusanya, Olugbenga T; Madajewski, Brian; Segal, Erin; Judy, Brendan F; Venegas, Ollin G; Judy, Ryan P; Quatromoni, Jon G; Wang, May D; Nie, Shuming; Singhal, Sunil
Fluorescence guided surgery (FGS) is a developing field of surgical and oncologic research. Practically, FGS has shown useful applications in urologic surgery, benign biliary surgery, colorectal cancer liver metastasis resection, and ovarian cancer debulking. Most notably in in cancer surgery, FGS allows for the clear delineation of cancerous tissue from benign tissue. FGS requires the utilization of a fluorescent contrast agent and an intraoperative fluorescence imaging device (IFID). Currently available IFIDs are expensive, unable to work with multiple fluorophores, and can be cumbersome. This study aims to describe the development and utility of a small, cost-efficient, and interchangeable IFID made from commercially available components. Extensive research was done to design and construct a light-weight, portable, and cost-effective IFID. We researched the capabilities, size, and cost of several camera types and eventually decided on a near-infrared (NIR) charged couple device (CCD) camera for its overall profile. The small portable interchangeable imager of fluorescence (SPIIF) is a "scout" IFID system for FGS. The main components of the SPIIF are a NIR CCD camera with an articulating light filter. These components and a LED light source with an attached heat sink are mounted on a small metal platform. The system is connected to a laptop by a USB 2.0 cable. Pixielink © software on the laptop runs the system by controlling exposure time, gain, and image capture. After developing the system, we evaluated its utility as an IFID. The system weighs less than two pounds and can cover a large area. Due to its small size, it is easily made sterile by covering it with any sterile plastic sheet. To determine the system's ability to detect fluorescent signal, we used the SPIIF to detect indocyanine green under ex and in-vivo conditions and fluorescein under ex-vivo conditions. We found the SPIIF was able to detect both ICG and fluorescein under different depths of a
Orkin, Bruce A; Poirier, Jennifer; Kowal-Vern, Areta; Chan, Edie; Ohara, Karen; Mendoza, Brian
Objective - To determine whether residents with one or more years of dedicated research time (Research Residents, RR) improved their ABSITE scores compared to those without (Non-Research Residents, N-RR). A retrospective review of general surgery residents' ABSITE scores from 1995 to 2016 was performed. RR were compared to N-RR. Additional analysis of At Risk (AR) v Not At Risk residents (NAR) (35th percentile as PGY1-2) was also performed. Cohort - 147 residents (34 RR and 113 N-RR). There were no differences in initial ABSITE scores (p = 0.47). By definition, the AR group had lower scores than NAR. Overall, post-research RR v PGY-4 N-RR scores did not differ (p = 0.84). Only the AR residents improved their scores (p = 0.0009 v NAR p = 0.42), regardless of research group (p = 0.70). Protected research time did not improve residents' ABSITE scores, regardless of initial scores. At Risk residents improved regardless of research group status. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available Background Breast reconstruction refers to the rebuilding of a woman’s breast usingautologous tissue or prosthetic material to form a natural-looking breast. It is increasinglyoffered to women undergoing mastectomy for breast cancer. However, there is no systematicanalysis available for the expanding area of research on breast reconstruction.Methods A bibliometric method was used to obtain a view of the scientific production aboutbreast reconstruction by data extracted from the Institute for Scientific Information (ISI.Specific parameters were retrieved from the ISI. Articles about breast reconstruction wereanalyzed to obtain a view of the topic’s structure, history, and document relationships usingHistCite software. Trends in the most influential publications and authors were analyzed.Results The number of articles was constantly increasing. Most highly cited articles describedthe methods of flap construction in the surgery. Other highly cited articles discussed thepsychological or emotional aspects of breast reconstruction, skin sparing mastectomy, andbreast reconstruction in the irradiated breast.Conclusions This was the first breast reconstruction scientometric analysis, representing thecharacteristics of papers and the trends of scientific production. A constant increase in thenumber of breast reconstruction papers and also the increasing number of citations showsthat there is an increasing interest in this area of medical science. It seems that most of theresearch in this field is focused on the technical aspects of surgery.
Wang, Bin; Du, Zhi-Peng; Qiu, Nian-Cun; Liu, Miao-E; Liu, Sheng; Jiang, Dao-Zhen; Zhang, Wei; Qiu, Ming
The aim of this study was to evaluate the efficacy of carbon nanoparticles in identifying lymph nodes and promoting parathyroid gland function recovery after thyroid carcinoma surgery along with central lymph node dissection. A total of 231 patients who underwent thyroid carcinoma surgery combined with central lymph node dissection were divided into two groups: the CN group (intraoperative carbon nanoparticles injections) and the control group (no injection). Datas were collected respectively on the pre-operative, 1st, 7th and 30th postoperative days and monthly thereafter. While the pathological results (e.g. amount of incidental removed parathyroid glands and lymph nodes dissected), complications (e.g. rates of vocal cord paralysis, the neuromuscular symptoms, hypocalcemia and hypoparathyroidism), as well as follow-up outcomes of the serum Ca2+ and PTH levels were gathered and measured to be included in. In regard to the results of the pathological tests, the control group had a relatively higher incidence of incidental parathyroidectomy when compared to the CN group (P 0.05). Carbon nanoparticles play a key role in accurately identifying lymph nodes, reducing mistaken excision of parathyroid glands, accelerating rapid recovery of parathyroid function during thyroid carcinoma surgery with central lymph node dissection, without increasing the probability of postoperative complications. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
Sánchez Ares, Rocío
Feminist action research interrogates gendered dynamics in the development of a collective consciousness. A group of immigrant Latina women (Latinas) from the Caribbean and Central America employed community-based theater as an instrument to mobilize diverse audiences against discriminatory practices and policies. Based on their theater work, I…
Seifried, Maria; Höh, Helmut
Background The collection of pre-, peri- and postoperative data took place between 2005 and 2008, based on a contract between the social insurance company, AOK Mecklenburg-Vorpommern, and the outpatient cataract surgeons/centers in Mecklenburg-Vorpommern, Germany. The purpose of the contract was the monitoring of quality of cataract surgery in the outpatient healthcare system. Materials and Methods We analysed 2952 datasets of 2952 eyes, remaining after exclusion of 109 datasets because of lack of plausibility and missing data (initially 3058 eyes with surgery in our centre). Visual acuity (VA), refraction, comorbidities and further data were correlated to patient satisfaction with cataract surgery. Results The average age of our patients was 74.5 years (Cataracta senilis 96.51%) and they had a mean VA increase from decimal 0.4 ± 0.2 (LogMAR 0.5 ± 0.3) to 0.8 ± 0.3 (LogMAR 0.2 ± 0.2). The target refraction was reached by 78.9% (respectively 49.9%) of the eyes within ± 1.0 D (respectively ± 0.5 D). Factors correlating with a positive overall satisfaction of the patients with surgery were the postoperative increase of VA (Spearman, r = 0.404, p = 0.01), the absence of comorbidities (Spearman, r = - 0.168, p = 0.01) and absence of perioperative complications (Spearman, r = - 0.104, p = 0.01). 1.7% of our patients were dissatisfied despite an increase of VA ≥ 0.1, no comorbidities and no complications. We found the biggest percentage of not satisfied patients without objective reason (Patient-reported Outcome Measure negative/Clinical Outcome Measure positive, PROM-/COM+ 3.9%) in the sector of improvement of reading abilities. Conclusion With a not preselected patient cohort, we reached internationally comparable visual, refractive and satisfaction results. The overall satisfaction with cataract surgery is high. The majority of our patients (84.2%) were PROM+ combined with COM+ (VA increase ≥ 0
Kayaoglu, M. Naci
Action research is characterized by a new paradigm of empowering teachers to monitor their own practices in a more autonomous manner with a vision of challenging and improving their own techniques of teaching through their own participatory research. Yet in spite of this apparently radical shift in the function of the teacher from the constant…
Cucchetti, Alessandro; Mazzotti, Federico; Pellegrini, Sara; Cescon, Matteo; Maroni, Lorenzo; Ercolani, Giorgio; Pinna, Antonio Daniele
The Hirsch index (h-index) is recognized as an effective way to summarize an individual's scientific research output. However, a benchmark for evaluating surgeon scientists in the field of hepatic surgery is still not available. A total of 3,251 authors who published between 1949 and 2011 were identified using the Scopus identification number. The h-index, the total number of cited document, the total number of citations, and the scientific age were calculated for each author using both Scopus and Google Scholar. The median h-index was 6 and the median scientific age, assessed with Google Scholar, was 19 years. The numbers of cited documents, numbers of citations, and h-indexes obtained from Scopus and Google Scholar showed good correlation with one another; however, the results from the 2 databases were modified in different ways by scientific age. By plotting scientific age against h-index percentiles an h-index growth chart for both Scopus database and Google Scholar was provided. This analysis provides a first benchmark to assess surgeon scientists' productivity in the field of liver surgery. Copyright © 2013 Elsevier Inc. All rights reserved.
Vernal, Ditte Lammers; Stenstrøm, Anne Dorte; Staal, Nina
The objective of this study is to assess (1) the concordance and validity of schizophrenia register diagnoses among children and adolescents (early onset schizophrenia = EOS) in the Danish Psychiatric Central Research Register (DPCRR), and (2) the validity of clinical record schizophrenia diagnoses...... in inpatient settings, EOS diagnoses are reliable and valid for register-based research. Schizophrenia diagnosed in children and adolescents in outpatient settings were found to have a high number of false-positives, both due to registration errors and diagnostic practice. Utilizing this knowledge......, it is possible to reduce the number of false-positives in register-based research of EOS....
Uggerby, Peter; Østergaard, Søren Dinesen; Røge, Rasmus
INTRODUCTION: The Danish Psychiatric Central Research Register (DPCRR) has been used extensively for research purposes during the past decades. The aim of this study was to investigate the validity of the International Classification of Diseases (ICD)-10 schizophrenia diagnosis in the DPCRR...... all 300 case records, the validity of the schizophrenia diagnosis was 89.7%. CONCLUSION: According to this assessment of patient case records, the diagnosis of schizophrenia in the DPCRR has a high validity and is well-suited for research. FUNDING: Aalborg Psychiatric Hospital funded the study...
Jankowski, Katherine R B; Flannelly, Kevin J
The three measures of central tendency are discussed in this article: the mode, the median, and the mean. These measures of central tendency describe data in different and important ways, in relation to the level of measurement (nominal, ordinal, interval, or ratio) used to obtain the data. The results of published research studies, thought experiments, and graphs of frequency and percentage distributions of data are used as examples to demonstrate and explain the similarities and differences among these summary measures of data. The examples include the application of nominal, ordinal, interval, and ratios scales to measure pain, anxiety, chaplaincy services, religious behaviors, and treatment-related preferences, and their respective measures of central tendency. Examples of unimodal and bimodal distributions, and differences in the relative locations of the median and mean in symmetrical and skewed distributions are also presented and discussed.
Bialke, Martin; Rau, Henriette; Thamm, Oliver C; Schuldt, Ronny; Penndorf, Peter; Blumentritt, Arne; Gött, Robert; Piegsa, Jens; Bahls, Thomas; Hoffmann, Wolfgang
In most research projects budget, staff and IT infrastructures are limiting resources. Especially for small-scale registries and cohort studies professional IT support and commercial electronic data capture systems are too expensive. Consequently, these projects use simple local approaches (e.g. Excel) for data capture instead of a central data management including web-based data capture and proper research databases. This leads to manual processes to merge, analyze and, if possible, pseudonymize research data of different study sites. To support multi-site data capture, storage and analyses in small-scall research projects, corresponding requirements were analyzed within the MOSAIC project. Based on the identified requirements, the Toolbox for Research was developed as a flexible software solution for various research scenarios. Additionally, the Toolbox facilitates data integration of research data as well as metadata by performing necessary procedures automatically. Also, Toolbox modules allow the integration of device data. Moreover, separation of personally identifiable information and medical data by using only pseudonyms for storing medical data ensures the compliance to data protection regulations. This pseudonymized data can then be exported in SPSS format in order to enable scientists to prepare reports and analyses. The Toolbox for Research was successfully piloted in the German Burn Registry in 2016 facilitating the documentation of 4350 burn cases at 54 study sites. The Toolbox for Research can be downloaded free of charge from the project website and automatically installed due to the use of Docker technology.
Melendez, Mark M; Xu, Xiaoti; Sexton, Thomas R; Shapiro, Marc J; Mohan, Eugene P
The selection criteria for surgical residents applying for residency differ among programs nationwide. Factors influencing this selection process have not been well defined, and research in particular has not been evaluated fully. This study aimed to evaluate the relative importance of basic science and clinical research in the selection criteria used by program directors (PDs). A web-based survey consisting of 11 questions was sent to PDs using the list server of the Association of Program Directors in Surgery. Respondents were asked to rank selection factors using a 1-to-5 scoring system, with 5 as most important. Their responses were recorded and tabulated. University-based teaching hospital. The survey went to 251 accredited general surgery residency programs in the United States. Overall, 134 (53.3%) of the surveys were returned, representing 61 university-based programs, 57 community-based programs with university affiliation, and 16 community-based programs without university affiliation. In total, 120 PDs (89.5%) considered basic or clinical research almost always or all the time when evaluating applicants to their general surgery program. Another 73 PDs (54.5%) gave basic science and clinical research equal importance. Another 40 PDs (29.9%) rarely or never credited research unless it had been published as an abstract or paper. In ranking research, 11 (8.2%) respondents gave it the 5 score. Most respondents (n = 93; 69.4%) gave it the 3 score. An applicant's interview and interest in surgery were the factors considered most important by 93 (69.4%) and 78 (58.2%), respectively, of the PDs. Basic science and clinical research constituted an important but secondary criterion for resident selection by PDs into general surgery residency programs. PDs perceived the primary factors for residency selection to be the interview, demonstrated interest in surgery, AOA membership, letters of recommendation, and USMLE Step I scores.
Hoffmann, Henry; Kettelhack, Christoph
Enhanced recovery after surgery (ERAS) or fast-track surgery is a perioperative and postoperative care concept initiated in the early 1990s aiming to reduce the length of hospital stays following elective abdominal surgery. Twenty treatment items defined in the Consensus Guidelines established in 2009 were included in this concept. The success of ERAS depends highly on multidisciplinary teamwork and patient compliance. Several ERAS items and their impact on perioperative and postoperative care have recently been discussed. In this connection, translational research topics triggered increasing interest in ERAS and new impulses aimed at improving the ERAS concept. We thus reviewed the surgical literature to highlight the role of translational research items in ERAS. A literature search of Medline®, PubMed® and the Cochrane Database was performed. Two investigators independently reviewed the abstracts and appropriate articles were included in this review. Articles have been selected. The advantages of the ERAS concept over conventional postoperative care were established by four meta-analyses and several reviews. But, due to the lack of standardization of the protocols, the level of evidence is still low. The implementation of ERAS into clinical practice is furthermore hampered by the poor compliance with ERAS protocols and remains a challenge for the future. Moreover, recent trials challenge the role of some ERAS items, e.g. epidural anesthesia. Translational research trials investigating stress, immune and inflammatory response after surgery, new analgesic concepts, goal-directed fluid therapy and new drugs and substances to improve the outcome of ERAS provide first promising data but still need to be integrated in the ERAS concept. The Consensus Guidelines for ERAS are subject to the constant evolution of treatment strategies and implementation of translational research findings. Improvement of the compliance with ERAS protocols in surgical clinics and updating
Taro, Trisa; Yao, Caroline; Ly, Stephanie; Wipfli, Heather; Magee, Kathleen; Vanderburg, Richard; Magee, William
An estimated two billion people worldwide lack access to adequate surgical care. Addressing surgical disparities requires both immediate relief efforts and long-term investments to improve access to care and surgical outcomes, train the next generation of surgical professionals, and expand the breadth of formative research in the field. While models exist for establishing short-term surgical missions in low- and middle-income countries, far less focus has been placed on models for multi-institutional partnerships that support the development of sustainable solutions. In 2011, the Global Surgery Partnership (GSP) was founded by an established children's hospital (Children's Hospital Los Angeles), an academic medical center (University of Southern California), and a nonprofit organization (Operation Smile) to build oral cleft surgical capacity in resource-poor settings through education, research, and service. Leveraging the strengths of each partner, the GSP supports three global health education programs for public health graduate students and surgical residents, including the Tsao Fellowship in Global Health; has initiated two international research projects on cleft lip and palate epidemiology; and has built upon Operation Smile's service provision. As of January 2015, Tsao fellows had operated on over 600 patients during 13 missions in countries including China, Vietnam, Mexico, and India. The GSP plans to conduct a formal evaluation and then to expand its programs. The GSP encourages other global health organizations and academic and medical institutions to engage with each other. The partnership described here provides a basic model for structuring collaborations in the global health arena.
He, Xingrong; Yang, Yongqiang; Wu, Weihui; Wang, Di; Ding, Huanwen; Huang, Weihong
In order to simplify the distal femoral comminuted fracture surgery and improve the accuracy of the parts to be reset, a kind of surgery orienting model for the surgery operation was designed according to the scanning data of computer tomography and the three-dimensional reconstruction image. With the use of DiMetal-280 selective laser melting rapid prototyping system, the surgery orienting model of 316L stainless steel was made through orthogonal experiment for processing parameter optimization. The technology of direct manufacturing of surgery orienting model by selective laser melting was noted to have obvious superiority with high speed, precise profile and good accuracy in size when compared with the conventional one. The model was applied in a real surgical operation for thighbone replacement; it worked well. The successful development of the model provides a new method for the automatic manufacture of customized surgery model, thus building a foundation for more clinical applications in the future.
Full Text Available Age-related macular degeneration(AMDand cataract are the most common causes of low vision worldwide. Nowadays, there is still a controversy about whether cataract surgery should be taken in patients combined with AMD and when should the surgery be taken. The aim of this review is to assess the influence of cataract surgery on the occurrence and development of AMD, to analyze the risk factors, to explore the occasion of cataract surgery in patients with AMD, and joint with anti-vascular endothelial growth factor(VEGFtreatment, also including the development and application of intraocular lens. It helps to avoid and postpone the development and progression of macular degeneration after cataract surgery and get good visual outcome.
Full Text Available The aim of this research was to assess the content and composition of the pollutants emitted by domestic central heating boilers equipped with an automatic underfeed fuel delivery system for the combustion chamber. The comparative research was conducted. It concerned fuel properties, flue gas parameters, contents of dust (fl y ash and gaseous substances polluting the air in the flue gases emitted from a domestic CH boiler burning bituminous coal, pellets from coniferous wood, cereal straw, miscanthus, and sunflower husks, coniferous tree bark, and oats and barley grain. The emission factors for dust and gaseous air pollutants were established as they are helpful to assess the contribution of such boilers in the atmospheric air pollution. When assessing the researched boiler, it was found out that despite the development in design and construction, flue gases contained fly ash with a significant EC content, which affected the air quality.
Knowles, C H; Grossi, U; Horrocks, E J; Pares, D; Vollebregt, P F; Chapman, M; Brown, S; Mercer-Jones, M; Williams, A B; Yiannakou, Y; Hooper, R J; Stevens, N; Mason, J
This manuscript forms the final of seven that address the surgical management of chronic constipation (CC) in adults. The content coalesces results from the five systematic reviews that precede it and of the European Consensus process to derive graded practice recommendations (GPR). Summary of review data, development of GPR and future research recommendations as outlined in detail in the 'introduction and methods' paper. The overall quality of data in the five reviews was poor with 113/156(72.4%) of included studies providing only level IV evidence and only four included level I RCTs. Coalescence of data from the five procedural classes revealed that few firm conclusions could be drawn regarding procedural choice or patient selection: no single procedure dominated in addressing dynamic structural abnormalities of the anorectum and pelvic floor with each having similar overall efficacy. Of one hundred 'prototype' GPRs developed by the clinical guideline group, 85/100 were deemed 'appropriate' based on the independent scoring of a panel of 18 European experts and use of RAND-UCLA consensus methodology. The remaining 15 were all deemed uncertain. Future research recommendations included some potential RCTs but also a strong emphasis on delivery of large multinational high-quality prospective cohort studies. While the evidence base for surgery in CC is poor, the widespread European consensus for GPRs is encouraging. Professional bodies have the opportunity to build on this work by supporting the efforts of their membership to help convert the documented recommendations into clinical guidelines. © 2017 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.
Reddy, Brian; Pagel, Christina; Vuylsteke, Alain; Gerrard, Caroline; Nashef, Sam; Utley, Martin
Severe post-operative bleeding can lead to adverse outcomes for cardiac surgery patients and is a relatively common complication of cardiac surgery. One of the most effective drugs to prevent such bleeding, aprotinin, has been withdrawn from the market due to concerns over its safety. Alternative prophylactic drugs which can be given to patients to prevent bleeding can result in significant side effects and are expensive. For this reason it is difficult to make a clinical or economic case for administering these drugs to all cardiac surgery patients, and the prevailing view is that their use should be targeted at patients considered to be at relatively high risk of post-operative bleeding. However, there is currently no objective method for identifying such patients. Over the past 7 years, a team of clinicians and researchers at Papworth Hospital has collected data concerning post-operative blood loss for each cardiac surgery patient, totalling 11,592 consecutive records. They approached a team of operational researchers (MU, ACP, BR) with extensive experience of developing clinical risk models with the aim of devising a risk stratification scheme that could potentially be used to identify a cohort of higher risk patients. Such patients could be treated with the available prophylactic drugs or recruited to studies to evaluate new interventions. This paper is intended to describe the Operational Research process adopted in the development of this scheme. A concise description of the scheme and its clinical interpretation is published elsewhere.
CONFIABILIDAD DE LOS CÁLCULOS ESPECIALES DE LA OXIGENACIÓN DE MUESTRAS VENOSAS CENTRALES EN CIRUGÍA CARDÍACA / Reliability of the special calculations of oxygenation from central venous samples in cardiac surgery
Pedro A. Hidalgo Menéndez
Full Text Available Resumen Introducción y objetivos: Diferentes mecanismos se implican en la captación, transporte, entrega y utilización del oxígeno en los organismos vivos, y cada uno de ellos puede afectarse en el enfermo grave. El propósito de este trabajo fue conocer la confiabilidad de los cálculos especiales de la oxigenación, procedentes de muestras venosas centrales. Método: Se realizó un estudio prospectivo con 22 pacientes a los que se les practicó cirugía cardíaca, en los que se compararon los cálculos especiales obtenidos de muestras venosas centrales con los venosos-mixtos. Resultados: Se encontró correlación estadística significativa entre la diferencia arteriovenosa de oxígeno, el cortocircuito y la saturación venosa de hemoglobina oxigenada. Sin embargo, se halló un bajo por ciento de fiabilidad al aplicarles los criterios protocolizados; pero fue factible mediante ecuaciones de regresión, lograr una corrección altamente significativa (p < 0,01, que elevó la fiabilidad a más del 90 %. Conclusiones: Las muestras venosas centrales constituyen una alternativa recomendable para obtener cálculos especiales de la oxigenación durante la cirugía cardíaca. / Abstract Introduction and Objectives: Different mechanisms are involved in the uptake, transportation, delivery and utilization of oxygen in living organisms, and each of them may be affected in the severely ill patient. The purpose of this study was to determine the reliability of the special calculations of oxygenation, from central venous samples. Methods: A prospective study was performed on 22 patients who underwent cardiac surgery, and in which special calculations obtained from central venous samples were compared to mixed-venous samples calculations. Results: A statistically significant correlation among the arteriovenous oxygen difference, the shunt and the venous hemoglobin oxygen saturation was found. However, a small percentage of reliability was found when
Hume, Keith M; Giladi, Aviram M; Chung, Kevin C
Federal research funding is decreasing, forcing specialty organizations to have an increasingly important position in developing and fostering research. As the research and innovation arm of the American Society of Plastic Surgeons, The Plastic Surgery Foundation has a key role in supporting promising plastic surgery research. Understanding the grant review process and factors that contribute to funding well-written grant funding applications is essential for aspiring academic surgeons. All research grant applications submitted to The Plastic Surgery Foundation in 2012 and 2013 were evaluated. Each reviewer comment was assessed independently by two study team members and classified into key weakness categories. The chi-square test was used to compare results between funded and unfunded grants. Linear regression identified which critique elements corresponded to changes in scores, and logistic regression identified elements that predicted funding. The authors analyzed 1764 comments from 240 applications. Of these, 55 received funding. Funded grants had significantly fewer reviewer comments in four of five weakness categories. As expected, funded grants received better (lower) scores. Concerns in the categories of plan for execution and other elements/grantsmanship significantly affected score and odds of funding. Ensuring that a grant addresses all required elements is important for receiving a low reviewer score. Our study demonstrates that plan for execution and grantsmanship influence reviewer scoring more than others. Investigators must clearly address items associated with conducting their experiments and performing the analysis. Investigators must also give equal attention to elements of overall quality and completeness to optimize chances of funding.
Bragato, Pier Luigi; Costa, Giovanni; Gallo, Antonella; Gosar, Andrej; Horn, Nikolaus; Lenhardt, Wolfgang; Mucciarelli, Marco; Pesaresi, Damiano; Steiner, Rudolf; Suhadolc, Peter; Tiberi, Lara; Živčić, Mladen; Zoppé, Giuliana
The region of the Central and Eastern Europe is an area characterised by a relatively high seismicity. The active seismogenic structures and the related potentially destructive events are located in the proximity of the political boundaries between several countries existing in the area. An example is the seismic region between the NE Italy (FVG, Trentino-Alto Adige and Veneto), Austria (Tyrol, Carinthia) and Slovenia. So when a destructive earthquake occurs in the area, all the three countries are involved. In the year 2001 the Agencija Republike Slovenije za Okolje (ARSO) in Slovenia, the Department of Mathematics and Geoscience of the University of Trieste (DMG), the OGS (Istituto Nazionale di Oceanografia e di Geofisica Sperimentale) in Italy and the Zentralanstalt für Meteorologie und Geodynamik (ZAMG) in Austria signed an agreement for the real-time seismological data exchange in the Southeastern Alps region. Soon after the Interreg IIIa Italia-Austria projects "Trans-National Seismological Networks in the South-Eastern Alps" and "FASTLINK" started. The main goal of these projects was the creation of a transfrontier network for the common seismic monitoring of the region for scientific and civil defense purposes. During these years the high quality data recorded by the transfrontier network has been used, by the involved institutions, for their scientific research, for institutional activities and for the civil defense services. Several common international projects have been realized with success. The instrumentation has been continuously upgraded, the installations quality improved as well as the data transmission efficiency. In the 2013 ARSO, DMG, OGS and ZAMG decided to name the cooperative network "Central and Eastern European Earthquake Research Network - CE3RN". The national/regional seismic networks actually involved in the CE3RN network are: • Austrian national BB network (ZAMG - OE) • Friuli Veneto SP network (OGS - FV) • Friuli VG
Kageyama, Ikuo; Yoshimura, Ken; Satoh, Yoshihide; Nanayakkara, Chinthani D; Pallegama, Ranjith W; Iwasaki, Shin-Ichi
We coordinated anatomy and physiology lectures and practicals to facilitate an integrated understanding of morphology and function in a basic medical science program for dental students and to reduce the time spent on basic science education. This method is a means to provide the essential information and skills in less time. The overall impression was that the practice of joint central nervous system lectures and practicals was an efficient method for students, which suggests that joint lectures might also be useful for clinical subjects. About two-thirds of students felt that the joint anatomy and physiology lecture on the central nervous system was useful and necessary in understanding the relationship between morphology and function, at least for this subject. One-third of students were neutral on the effectiveness of this method. However, the survey results suggest that improvements are needed in the method and timing of joint lectures and practicals. The present teaching approach can be further improved by conducting combined lectures in which the form and function of anatomic structures are presented by the relevant departments during the same lecture. Finally, joint lecturers and practicals offer an opportunity to increase student understanding of the importance of new research findings by the present authors and other researchers.
Manchikanti, Laxmaiah; Falco, Frank J E; Pampati, Vidyasagar; Cash, Kimberly A; Benyamin, Ramsin M; Hirsch, Joshua A
In this era of escalating health care costs and the questionable effectiveness of multiple interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine, and has an influence coverage decisions. Even though multiple cost effectiveness analysis studies have been performed over the years, extensive literature is lacking for interventional techniques. Cost utility analysis studies of epidural injections for managing chronic low back pain demonstrated highly variable results including a lack of cost utility in randomized trials and contrasting results in observational studies. There has not been any cost utility analysis studies of epidural injections in large randomized trials performed in interventional pain management settings. To assess the cost utility of caudal epidural injections in managing chronic low back pain secondary to lumbar disc herniation, axial or discogenic low back pain, lumbar central spinal stenosis, and lumbar post surgery syndrome. This analysis is based on 4 previously published randomized trials. A private, specialty referral interventional pain management center in the United States. Four randomized trials were conducted assessing the clinical effectiveness of caudal epidural injections with or without steroids for lumbar disc herniation, lumbar discogenic or axial low back pain, lumbar central spinal stenosis, and post surgery syndrome. A cost utility analysis was performed with direct payment data for a total of 480 patients over a period of 2 years from these 4 trials. Outcome included various measures with significant improvement defined as at least a 50% improvement in pain reduction and disability status. The results of 4 randomized controlled trials of low back pain with 480 patients with a 2 year follow-up with the actual reimbursement data showed cost utility for one year of quality-adjusted life year (QALY) of $2,206 for disc herniation, $2,136 for axial or discogenic pain without
Grova, Monica M; Yang, Anthony D; Humphries, Misty D; Galante, Joseph M; Salcedo, Edgardo S
The surgical community commonly perceives a decline in surgical and patient care skills among residents who take dedicated time away from clinical activity to engage in research. We hypothesize that residents perceive a decline in their skills because of dedicated research time. UC Davis Medical Center, Sacramento, CA, an institutional tertiary care center. General surgery residents and graduates from UC Davis general surgery residency training program, who had completed at least 1 year of research during their training. A total of 35 people were asked to complete the survey, and 19 people submitted a completed survey. Participants were invited to complete an online survey. Factors associated with the decline in skills following their research years were examined. All statistical analyses were performed with IBM SPSS Statistics software. A total of 19 current or former general surgery residents responded to the survey (54% response rate). Overall, 42% described their research as "basic science." Thirteen residents (68%) dedicated 1 year to research, while the remainder spent 2 or more years. Basic science researchers were significantly more likely to report a decrease in clinical judgment (75% vs. 22%, p = 0.013) as well as a decrease in patient care skills (63% vs. 0%, p = 0.002). Residents who dedicated at least 2 years to research were more likely to perceive a decline in overall aptitude and surgical skills (100% vs. 46%, p = 0.02), and a decline in patient care skills (67% vs. 8%, p = 0.007). Most residents who dedicate time for research perceive a decline in their overall clinical aptitude and surgical skills. This can have a dramatic effect on the confidence of these residents in caring for patients and leading a care team once they re-enter clinical training. Residents who engaged in 2 or more years of research were significantly more likely to perceive these problems. Further research should determine how to keep residents who are interested in academics
The article describes empirical findings regarding the perceptions of the Hungarian central civil service on outsourcing and other forms of cooperation. The findings summarized in this article are part of a vast empirical research effort that took place in 2014 – shortly after the wave of a comprehensive centralization that affected the entire corpus of Hungarian public administration from the local level to the ministerial level. The complete research design consisted of qualitative and quan...
Full Text Available This research seeks to explain the existence of Shia community at Pancuran village, in Salatiga, Central Java, Indonesa, and how their strategies to survive in the midst society in that region. To obtain data on the Shia community at Pancuran, Salatiga, it was done through in-depth interviews, and observations are preceded by a close observation prior to the study. This research also examines some relevant literatures and documents to the research problem as the secondary data. The theory of religious freedom and cultural identity of religious pluralism in the Shia community are used to describe and to analyze the problem of research based on the obtained data. The results show that the Shia community in Salatiga is not discriminated, and they can live in Salatiga freely along with other religious communities and Salatiga society at large. This is supported by an inclusive attitude among Shia community and society Salatiga in building relationships and communication with people of other faiths. Local knowledge possessed by people of Salatiga can be a social capital for implementing inter-religious harmony.
Adams, Swann Arp; Heiney, Sue P; Brandt, Heather M; Wirth, Michael D; Khan, Samira; Johnson, Hiluv; Davis, Lisa; Wineglass, Cassandra M; Warren-Jones, Tatiana Y; Felder, Tisha M; Drayton, Ruby F; Davis, Briana; Farr, Deeonna E; Hébert, James R
Use of community-based participatory research (CBPR) approaches is increasing with the goal of making more meaningful and impactful advances in eliminating cancer-related health disparities. While many reports have espoused its advantages, few investigations have focused on comparing CBPR-oriented recruitment and retention. Consequently, the purpose of this analysis was to report and compare two different CBPR approaches in two cancer prevention studies. We utilized frequencies and Chi-squared tests to compare and contrast subject recruitment and retention for two studies that incorporated a randomized, controlled intervention design of a dietary and physical activity intervention among African Americans (AA). One study utilized a de-centralized approach to recruitment in which primary responsibility for recruitment was assigned to the general AA community of various church partners whereas the other incorporated a centralized approach to recruitment in which a single lay community individual was hired as research personnel to lead recruitment and intervention delivery. Both studies performed equally well for both recruitment and retention (75 and 88 % recruitment rates and 71 and 66 % retention rates) far exceeding those rates traditionally cited for cancer clinical trials (~5 %). The de-centralized approach to retention appeared to result in statistically greater retention for the control participants compared to the centralized approach (77 vs. 51 %, p recruitment and retention rates of AA populations. We further note lessons learned and challenges to consider for future research opportunities.
Saleh S. Baeesa
Full Text Available Purpose. The purpose of our study is to evaluate the level of evidence (LOE of spine surgery publications in the Arab countries and compare it with standard international literature in spine surgery and to determine the stand of the Arab nations academic production with that of the global one. Methods. An online search using “PubMed” and “Google Scholar” was carried out, using search terms related to spine surgery such as “Spine surgery,” “Scoliosis,” “Herniated disc.” Each article was reviewed and graded by two reviewers using Oxford Centre for Evidence-Based Medicine (OCEBM Levels of Evidence scale. Results. We have identified 434 articles that met the inclusion criteria; 56% were level IV studies. The most common study design was case reports (42%. The number of Arab countries with publications in spine surgery was 18 countries. The country with the highest rate of publications was Egypt (26%. The quantity of the published studies increased from 151 in (2000–2008 to 283 in (2009–2015. There is statistical significance between high and low LOE articles (p=0.0007. Conclusion. We have observed that LOE has not changed significantly over the period of 15 years and that much of the publications are of a low LOE (levels III and IV. We, herein, emphasize the need for spine surgeons in the Arab countries to conduct studies of higher LOE.
Gwilym, S E; Oag, H C L; Tracey, I; Carr, A J
Impingement syndrome in the shoulder has generally been considered to be a clinical condition of mechanical origin. However, anomalies exist between the pathology in the subacromial space and the degree of pain experienced. These may be explained by variations in the processing of nociceptive inputs between different patients. We investigated the evidence for augmented pain transmission (central sensitisation) in patients with impingement, and the relationship between pre-operative central sensitisation and the outcomes following arthroscopic subacromial decompression. We recruited 17 patients with unilateral impingement of the shoulder and 17 age- and gender-matched controls, all of whom underwent quantitative sensory testing to detect thresholds for mechanical stimuli, distinctions between sharp and blunt punctate stimuli, and heat pain. Additionally Oxford shoulder scores to assess pain and function, and PainDETECT questionnaires to identify 'neuropathic' and referred symptoms were completed. Patients completed these questionnaires pre-operatively and three months post-operatively. A significant proportion of patients awaiting subacromial decompression had referred pain radiating down the arm and had significant hyperalgesia to punctate stimulus of the skin compared with controls (unpaired t-test, p shoulder pain associated with impingement. Also, if patients had relatively high levels of central sensitisation pre-operatively, as indicated by higher levels of punctate hyperalgesia and/or referred pain, the outcome three months after subacromial decompression was significantly worse.
Hammarström, Anne; Johansson, Klara; Annandale, Ellen; Ahlgren, Christina; Aléx, Lena; Christianson, Monica; Elwér, Sofia; Eriksson, Carola; Fjellman-Wiklund, Anncristine; Gilenstam, Kajsa; Gustafsson, Per E; Harryson, Lisa; Lehti, Arja; Stenberg, Gunilla; Verdonk, Petra
Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (i.e., a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper.
Sigmundsson, Freyr Gauti; Jönsson, Bo; Strömqvist, Björn
A register cohort study. To evaluate outcome of surgery for lumbar spinal stenosis without concomitant degenerative spondylolisthesis according to predominance of pain and to analyze the role of spinal fusion in conjunction with decompression in patients with predominant back pain (BP) or leg pain (LP). Predominance of BP is associated with inferior outcome of surgery for central spinal stenosis. It is unknown if using spinal fusion improves outcomes. In a register study of 9051 patients, we studied outcome of surgery in terms of BP and LP visual analogue scale, function (the Oswestry Disability Index and self-estimated walking distance), health-related quality of life (Short-Form 36 and EuroQol), and patient satisfaction. Outcome was analyzed for 4 groups at 1- and 2-year follow-ups; preoperative BP was equal to or worse than LP and decompression, preoperative BP was equal to or worse than LP and decompression and fusion, preoperative BP was less than LP and decompression, preoperative BP was less than decompression and fusion. Patients with concomitant fusion were younger and had higher BP and Oswestry Disability Index scores and lower preoperative EuroQol. Predominant BP was associated with inferior outcome in terms of pain, health-related quality of life, and function. Patients most often satisfied (69%) were patients with BP less than LP treated with decompression and fusion and the least satisfied group was patients with BP equal to or worse than LP treated with decompression (54%). Fusion was not only associated with higher EuroQol at 1-year follow-up for patients with predominant BP, but also associated with increased LP at 2-year follow-up in patients with predominant LP. Patients with predominant BP experienced small gains in the physical component summary with fusion. Predominance of BP is associated with inferior outcome. Using spinal fusion improves unadjusted outcome but the benefit is small and not clinically significant and generally disappears in
Full Text Available The paper reviews recent literature on the specifics of adoption of International Financial Reporting Standards (IFRS by the new EU members from the Central and Eastern Europe. Despite being members of the EU or OECD, the transition to a standard developed economy has not yet finished. The first part of the paper presents macroeconomic statistics and capital market data, which underline a unique economic structure of the region (relative unimportance of capital markets for raising capital, strong dependence on foreign direct investments combined with the lacks in institutional environment. Under such conditions, the economic consequences of IFRS adoption can be unpredictable and adverse. The second part of the paper analyses the reflection of specifics of the IFRS adoption in the CEE region in research studies covered by the Thomson Reuters’ Web of Science database. The analysis reveals (a cross-country disproportion in the research coverage of the area; (b relatively low coverage of the IFRS research focusing on these transition countries in top journals.
Full Text Available Aim: We aimed to assess the clinical outcomes of our department of cardiac surgery which was newly introduced in Hitit University Corum Education and Research Hospital. Material and Method: Between November 2012 and November 2013, a total of 110 open-heart surgeries were performed. Ten out of these (9.1% were emergency operations for acute ST elevation myocardial infarction Off-pump technique was used in 31 (29.2% patients and cardiopulmonary bypass was used in 75 (70.8%. A total of 106 patients received coronary artery bypass grafting, 1 received mitral reconstruction, 1 received Bentall procedure, 1 received tricuspid valve repair, 1 received mitral valve replacement, 1 received aortic valve replacement with aortic root enlargement and 1 received aortic supracoronary graft replacement. Results: Hospital mortality occurred in 1 (0.9% patient. Four patients (3.6% who were on dual antiaggregants underwent a revision for bleeding on the day of the operation. Morbidities occurred in 3 (2.7% patients. Atrial fibrillation occurred in 11 (10% patients and the normal sinus rhythm was achieved by amiodarone. Intraaortic balloon counterpulsation was used in 5 (4.5% patients. Discussion: The newly introduced cardiac surgery department of the Hitit University Corum Education and Research Hospital, which provides tertiary care to a wide rural community, serves with low morbidity and mortality.
Güngel, Hülya; Eren, Mümin Hakan; Pınarcı, Eylem Yaman; Altan, Ciğdem; Baylançiçek, Deniz Oygar; Kara, Necip; Gürsel, Tanıl; Yegenoğlu, Yildiz; Susever, Serdar
To report an outbreak of Fusarium solani endophthalmitis after uneventful cataract surgeries performed on the same day in the same operating room. Nine patients underwent phacoemulsification at 4th Clinic of Beyoglu Eye Training and Research Hospital in Istanbul. Cefuroxime axetyl was injected intracamerally from the same vial to all patients at the end of surgery. All patients developed acute postoperative endophthalmitis. Presentation, cultural studies, treatment, clinical responses and risk factors were evaluated. Cultural and DNA sequence findings revealed F. solani. Antifungal therapy was begun and pars plana vitrectomy, intraocular lens and capsule extraction were performed. Corneal involvement was correlated with old age and systemic disease. Fusarium solani should be considered in acute postoperative endophthalmitis. This infection can be controlled with early and aggressive combined antifungal and surgical treatment. The patients with corneal involvement had poor prognosis. It is important to use solutions prepared separately for each patient. © 2011 Blackwell Verlag GmbH.
Moore, Malcolm A; Aitmurzaeva, Gulmira; Arsykulov, Zhetkergen A; Bozgunchiev, Maratbek; Dikanbayeva, Saule Alkeeva; Igisinov, Gulnara; Igisinov, Nurbek; Igisinov, Saginbek; Karzhaubayeva, Sholpan; Oyunchimeg, Dondov; Oyunsuren, Tsendsuren; Soipova, Mashhura; Tumubaatar, T
Central Asia, the Urals, Siberia and Mongolia cover an immense section of Asia and although relatively sparsely populated the total inhabitants number well in excess of 100 million. Furthermore, there is an increasing tendency for urbanization of the populations, which in many cases are growing. The ethnic make-up is diverse, with various degrees of admixture of Russians to the Turkish, Mongolian and other indigenous peoples of the region, and there is evidence of major variation in the burden of different cancers among the groups, although oesophageal and gastric neoplasias are relatively prevalent in common. Clearly there is a need for cooperation for cancer and other chronic disease prevention and the presence of Russian as a shared language of science, commerce and industry means that there should be no major communication difficulties. However, collaborative efforts at present are limited and the research output is low, even in the non-English literature. Here we focus on published work from the individual countries, as assessed by PubMed searches using the country name with cancer, cardiovascular, metabolic syndrome and diabetes as search terms, with an especial focus on epidemiology, environmental carcinogenicity and screening. One major aim is to identify active groups with an interest in participation in a regional meeting and collaborative research, so that a coordinated approach to granting agencies can be made to fund such a collective endeavour.
Full Text Available AIM: To evaluate the outcome of high oxygen permeable contact lens used after photorefractive keratectomy(PRKsurgery.METHODS: Totally 95 patients(190 eyesafter PRK were included. Patients were randomly assigned to wear high oxygen permeable contact lens in one eye and normal lens in the fellow eye after surgery. The subjective symptoms and corneal epithelial status after PRK were evaluated. Uncorrected visual acuity(UCVAand haze were assessed at 6 months after PRK.RESULTS: Complaints of blurred vision, pain and photophobia were statistically more among the normal lens group than high oxygen permeable contact lens group(PPP=0.35. There was no difference in UCVA and haze 6 months after surgery(P=0.55. CONCLUSION: High oxygen permeable contact lens can significantly produce less the corneal irritated symptoms, reduce the discomfort feeling and promote healing of corneal epithelium after PRK.
Fernando P. Secin
Introduction. The objective is to determine the clinical and experimental evidences of the renal responses to warm and cold ischemia, kidney tolerability, and available practical techniques of protecting the kidney during nephron-sparing surgery. Materials and methods. Review of the English and non-English literature using MEDLINE, MD Consult, and urology textbooks. Results and discussion. There are three main mechanisms of ischemic renal injury, including persistent vasoconstriction with an ...
Full Text Available AIM: To evaluate the efficacy and safety of limbal relaxing incision(LRIfor correcting corneal astigmatism during implantable collamer lens(ICLsurgery.METHODS: A total of 185 eyes of 105 patients with high myopia and corneal keratometric astigmatism were included in the study. ICL surgery with concomitant relaxing incision was performed in 105 eyes of 60 patients in LRIs group(Group A. Eighty eyes of 45 patients only underwent ICL surgery were in control group(Group B. All patients undergone ophthalmic examination that included uncorrected visual acuity(UCVA, best-corrected visual acuity(BCVA, Pentacam analysis system to observe the changes of corneal astigmatism before and 1wk, 1 and 3mo after surgery.RESULTS: Respectively comparing UCVA between two groups in 1 and 3mo postoperatively, the P values were considered statistically significant(PP values were considered no statistically significant(P>0.05. Preoperative corneal astigmatism was 1.52±0.55D in group A and 1.48±0.57D in group B, there was no statistically significant difference(P>0.05. One week postoperatively, the astigmatism was 0.55±0.41D in group A and 1.20±0.48D in group B. One month postoperatively, the astigmatism was 0.60±0.38D in group A and 0.93±0.47D. Three months postoperatively, the astigmatism was 0.51±0.32D in group A and 0.96±0.40D in group B. The difference between the two groups were statistically significant(PPPCONCLUSION: LRIs performed during ICL surgery appeared to be an effective and safer procedure to reduce pre-existing corneal astigmatism and improve UCVA as well as the visual quality.
Full Text Available Abstract Background When evaluating health technologies with insufficient scientific evidence, only innovative potentials can be assessed. A Regional policy initiative linking the governance of health innovations to the development of clinical research has been launched by the Region of Emilia Romagna Healthcare Authority. This program, aimed at enhancing the research capacity of health organizations, encourages the development of adoption plans that combine use in clinical practice along with experimental use producing better knowledge. Following the launch of this program we developed and propose a method that, by evaluating and ranking scientific uncertainty, identifies the moment (during the stages of the technology's development where it would be sensible to invest in research resources and capacity to further its evaluation. The method was developed and tested during a research project evaluating robotic surgery. Methods A multidisciplinary panel carried out a 5-step evaluation process: 1 definition of the technology's evidence profile and of all relevant clinical outcomes; 2 systematic review of scientific literature and outline of the uncertainty profile differentiating research results into steady, plausible, uncertain and unknown results; 3 definition of the acceptable level of uncertainty for investing research resources; 4 analysis of local context; 5 identification of clinical indications with promising clinical return. Results Outputs for each step of the evaluation process are: 1 evidence profile of the technology and systematic review; 2 uncertainty profile for each clinical indication; 3 exclusion of clinical indications not fulfilling the criteria of maximum acceptable risk; 4 mapping of local context; 5 recommendations for research. Outputs of the evaluation process for robotic surgery are described in the paper. Conclusions This method attempts to rank levels of uncertainty in order to distinguish promising from hazardous
Ballini, Luciana; Minozzi, Silvia; Negro, Antonella; Pirini, Giampiero; Grilli, Roberto
When evaluating health technologies with insufficient scientific evidence, only innovative potentials can be assessed. A Regional policy initiative linking the governance of health innovations to the development of clinical research has been launched by the Region of Emilia Romagna Healthcare Authority. This program, aimed at enhancing the research capacity of health organizations, encourages the development of adoption plans that combine use in clinical practice along with experimental use producing better knowledge. Following the launch of this program we developed and propose a method that, by evaluating and ranking scientific uncertainty, identifies the moment (during the stages of the technology's development) where it would be sensible to invest in research resources and capacity to further its evaluation. The method was developed and tested during a research project evaluating robotic surgery. A multidisciplinary panel carried out a 5-step evaluation process: 1) definition of the technology's evidence profile and of all relevant clinical outcomes; 2) systematic review of scientific literature and outline of the uncertainty profile differentiating research results into steady, plausible, uncertain and unknown results; 3) definition of the acceptable level of uncertainty for investing research resources; 4) analysis of local context; 5) identification of clinical indications with promising clinical return. Outputs for each step of the evaluation process are: 1) evidence profile of the technology and systematic review; 2) uncertainty profile for each clinical indication; 3) exclusion of clinical indications not fulfilling the criteria of maximum acceptable risk; 4) mapping of local context; 5) recommendations for research.Outputs of the evaluation process for robotic surgery are described in the paper. This method attempts to rank levels of uncertainty in order to distinguish promising from hazardous clinical use and to outline a research course of action
Wollschläger, U.; Baeßler, C.; de Rooij, G. H.; Dietrich, P.; Fleckenstein, J. H.; Frenzel, M.; Klotz, S.; Lausch, A.; Martini, E.; Musolff, A.; Oswald, S.; Pause, M.; Reinstorf, F.; Rode, M.; Samaniego-Eguiguren, L.; Vogel, H.-J.; Werban, U.; Zacharias, S.
The Bode river catchment in the TERENO Harz/Central German Lowland Observatory is the central study area for water-related research at the Helmholtz Centre for Environmental Research - UFZ. As integral part of the TERENO observation network of the Helmholtz Association, an integrated monitoring and research concept joining hydrological, atmospheric, biodiversity-related, and soil physical research is currently being implemented. The observation concept has been designed following a nested catchment monitoring approach comprising highly instrumented, intensive research sites as smallest units. We present an overview of the Schäfertal-Catchment, one of the intensive research sites within the Bode Hydrological Observatory. The central research goal is the long-term investigation of the catchment water budget and the feedbacks with climatic, pedological, geological, and ecological drivers. In this context three main research packages have been defined: (i) monitoring and modelling of water fluxes from the point to the catchment scale, (ii) soil-landscape-modelling, and (iii) investigation of biodiversity and ecosystem functioning. Within the Schäfertal several technologies for soil hydrological monitoring are combined in order to observe meso-scale vadose zone hydrological processes. In this presentation, the general research concept as well as conceptual approaches for the different specific research hypotheses are described. First results of ongoing monitoring activities are presented and discussed.
Vera, J.; Mulugeta, L.; Nelson, E. S.; Raykin, J.; Feola, A.; Gleason, R.; Samuels, B.; Myers, J. G.
INTRODUCTION: Current long-duration missions to the International Space Station and future exploration-class missions beyond low-Earth orbit, such as to Mars and asteroids, expose astronauts to increased risk of Visual Impairment and Intracranial Pressure (VIIP) syndrome . It has been hypothesized that the headward shift of cerebral spinal fluid (CSF) and blood in microgravity may cause significant elevation of intracranial pressure (ICP), which in turn induces VIIP syndrome through biomechanical pathways [1, 2]. However, there is insufficient evidence to confirm this hypothesis. In this light, we are developing lumped-parameter models of fluid transport in the central nervous system (CNS) as a means to simulate the influence of microgravity on ICP. The CNS models will also be used in concert with the lumped parameter and finite element models of the eye described in the realted IWS abstracts submitted by Nelson et al., Feola et al. and Ethier et al. METHODS: We have developed a nine compartment CNS model (Figure 1) capable of both time-dependent and steady state fluid transport simulations, based on the works of Stevens et al. . The breakdown of compartments within the model includes: vascular (3), CSF (2), brain (1) and extracranial (3). The boundary pressure in the Central Arteries [A] node is prescribed using an oscillating pressure function PA(t) simulating the carotid pulsatile pressure wave as developed by Linninger et al. . For each time step, pressures are integrated through time using an adaptive-timestep 4th and 5th order Runga-Kutta solver. Once pressures are found, constitutive equations are used to solve for flowrates (Q) between each compartment. In addition to fluid flow between the different compartments, compliance (C) interactions between neighboring compartments are represented. We are also developing a second CNS model based on the works of Linninger et al.  which takes a more granular approach to represent the interactions of the
Full Text Available Maintaining healthy forests is the major objective for the Forest Service scientists and managers working for the U.S. Department of Agriculture. Air pollution, specifically ozone (O3 and nitrogenous (N air pollutants, may severely affect the health of forest ecosystems in the western U.S. Thus, the monitoring of air pollution concentration and deposition levels, as well as studies focused on understanding effects mechanisms, are essential for evaluation of risks associated with their presence. Such information is essential for development of proper management strategies for maintaining clean air, clean water, and healthy ecosystems on land managed by the Forest Service. We report on two years of research in the central Sierra Nevada of California, a semi-arid forest at elevations of 1100–2700 m. Information on O3 and N air pollutants is obtained from a network of 18 passive samplers. We relate the atmospheric N concentration to N concentrations in streams, shallow soil water, and bulk deposition collectors within the Kings River Experimental Watershed. This watershed also contains an intensive site that is part of a recent Forest Service effort to calculate critical loads for N, sulfur, and acidity to forest ecosystems. The passive sampler design allows for extensive spatial measurements while the watershed experiment provides intensive spatial data for future analysis of ecosystem processes.
Full Text Available Flowering plants consists of more than 300.000 species around the world, out of which a small percentage has been sufficiently investigated from phytochemical and biological activity aspects. Plant diversity of the Balkans is very rich, but still poorly investigated. The aim of this paper is survey of current status and trends in research of wild-growing aromatic plants from Central Balkans. Many aromatic plants are investigated from morphological, physiological, ecological, systematic and phytochemical aspects. However, traditionally used medicinal and aromatic plants can also be considered from applicative aspects, concerning their health effects, and from wide range of usage in cosmetics, and as food, agrochemical and pharmaceutical products. In order to achieve all planned objectives, following methodology has been applied: field research, taxonomic authentication and, comparative biologically assayed phytochemical investigations. The total herbal extracts, postdistillation waste (deodorized extracts, essential oils and individual compounds of some autochthonous plants have been considered as potential source of antibacterial, antifungal, anti-biofilm, antioxidant and cytotoxic agents. In this manuscript, composition of essential oils and extracts were evaluated in a number of species, from the Apiaceae, Lamiaceae, Rosaceae and Asteraceae families. Extracts which were rich in phenols mostly of flavonoids, often showed high antioxidant potential. Also, phenolic compounds identified in essential oils and extracts were mostly responsible for expected antimicrobial activity. Current worldwide demand is to reduce or, if possible, eliminate chemically synthesized food additives. Plant-produced compounds are becoming of interest as a source of more effective and safe substances than synthetically produced antimicrobial agents (as inhibitors, growth reducers or even inactivators that control growth of microorganisms. Many different pathogens have
Chua, Su Jen; Akande, Valentine A; Mol, Ben Willem J
Surgery remains an acceptable treatment modality for tubal infertility despite the rise in usage of in vitro fertilisation (IVF). Estimated livebirth rates after surgery range from 9% for women with severe tubal disease to 69% for those with mild disease; however, the effectiveness of surgery has not been rigorously evaluated in comparison with other treatments such as IVF and expectant management (no treatment). Livebirth rates have not been adequately assessed in relation to the severity of tubal damage. It is important to determine the effectiveness of surgery against other treatment options in women with tubal infertility because of concerns about adverse outcomes, intraoperative complications and costs associated with tubal surgery, as well as alternative treatments, mainly IVF. The aim of this review was to determine the effectiveness and safety of surgery compared with expectant management or IVF in improving the probability of livebirth in the context of tubal infertility (regardless of grade of severity). We searched the following databases in October 2016: the Cochrane Gynaecology and Fertility (CGF) Group trials register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO; as well as clinical trials registries, sources of unpublished literature and reference lists of included trials and related systematic reviews. We considered only randomised controlled trials to be eligible for inclusion, with livebirth rate per participant as the primary outcome of interest. We planned that two review authors would independently assess trial eligibility and risk of bias and would extract study data. The primary review outcome was cumulative livebirth rate. Pregnancy rate and adverse outcomes, including miscarriage rate, rate of ectopic pregnancy and rate of procedure-related complications, were secondary outcomes. We planned to combine data to calculate
Park, Joshua S; Lee, Christopher; Rogers, Jason M; Sun, Ho-Hyun; Liu, Yuan F; Elo, Jeffrey A; Inman, Jared C
The study aimed to provide precise measurements of anterior mandibular structural anatomy and to explore potential osteotomies for genioglossal advancement. Cone beam computed tomography was used to analyze 33 randomly selected patients undergoing surgery for obstructive sleep apnea (OSA) between 2014 and 2016 at an academic surgical hospital. The locations of relevant mandibular structures were measured and statistical modeling was performed. Mean horizontal distances from midline to the mental foramina and the roots of the canine, lateral incisor, and central incisor were 22.11 ± 1.92, 13.56 ± 3.01, 6.19 ± 1.58, and 2.04 ± 0.87 mm, respectively. Mean vertical distances from the inferior border of the mandible were 15.15 ± 1.77, 17.11 ± 3.28, 20.48 ± 3.10, and 21.81 ± 3.49 mm, respectively. The superior border of the genial tubercle was 15.63 ± 2.75 mm, and the inferior border was 6.87 ± 3.29, from the inferior border of the mandible. The angle of decline of the best-fit line through the important structures was about 18° from the occlusion plane at the midline. A straight line estimating the mental foramen, canine, lateral incisor, and central incisor tooth roots crosses at a mean of 22.3-22.6 mm above the inferior border of the mandible at the midline and has an angle of decline of about 18°. Potential osteotomies made parallel to and below this line result in tradeoffs between maximizing capture of the genioglossus muscle attachment and risk of dental/neurovascular injury.
Horowitz, Carol R; Arniella, Agueda; James, Sherline; Bickell, Nina A
It is important to teach community members about the causes, magnitude and effects of health disparities that affect them, and to partner with them to develop, test and disseminate programs that they can sustain to improve health. East and Central Harlem are two underserved, predominantly minority, inner-city communities whose residents have disproportionately high morbidity and mortality from chronic conditions. We developed an approach to educate and work together with Harlem residents to study health disparities, and to use peer-led classes to improve chronic disease management and outcomes. Researchers and community leaders formed a community-based research core ("Core") with funds from a large health disparities grant. We then assembled a community advisory board and partnered with them to start a community newsletter to explain the causes of local health disparities and suggest ways to eliminate them. Together, we also began to create a self-sustaining cadre of community-based peer educators to teach culturally acceptable chronic disease self-management skills. The recruited board consists of 33 leaders of community-based health and social service organizations, religious institutions, and tenant organizations, as well as local activists. We produced and distributed our first educational newsletter to more than 4,000 community leaders, members and community-based organizations. We also adapted an existing chronic disease self-management program for the Harlem population and developed strategies to recruit peer educators and sustain their efforts in the future. To help them attain expertise in teaching chronic disease self-management, the board selected four individuals to become master peer-education trainers. The board then helped recruit more than 60 community members and leaders for our first two peer-education courses. Researchers, clinicians and community leaders worked together to disseminate knowledge about health disparities and a peer
Full Text Available In surgery with a master-slave type of surgical robot, an anisometric interface is often used. The working range of the master side is limited, so repositioning is required. Any repositioning from the master side will disturb the robot's operation. In this study, an operation interface is proposed that uses only the operator's force input for translational directions. A force sensor is used to detect this input. A gimbal mechanism is mounted on the sensor which allows for rotation. The rotation accounts for the operator's input rotation, and as a result the mechanism can now match the input. This allows the operator to concentrate on the slave side and control the robot without repositioning. The authors developed the proposed interface to control the pneumatically driven slave robot. The block transfer experiments confirmed that the proposed interface has nearly the same performance as conventional interfaces.
Full Text Available The limitations of the current methods of quantifying the surgical movements of facial bones inspired this study. The aim of this study was the assessment of the accuracy and reproducibility of directly landmarking of 3D DICOM images (Digital Imaging and Communications in Medicine to quantify the changes in the jaw bones following surgery. The study was carried out on plastic skull to simulate the surgical movements of the jaw bones. Cone beam CT scans were taken at 3mm, 6mm, and 9mm maxillary advancement; together with a 2mm, 4mm, 6mm and 8mm "down graft" which in total generated 12 different positions of the maxilla for the analysis. The movements of the maxilla were calculated using two methods, the standard approach where distances between surface landmarks on the jaw bones were measured and the novel approach where measurements were taken directly from the internal structures of the corresponding 3D DICOME slices. A one sample t-test showed that there was no statistically significant difference between the two methods of measurements for the y and z directions, however, the x direction showed a significant difference. The mean difference between the two absolute measurements were 0.34±0.20mm, 0.22±0.16mm, 0.18±0.13mm in the y, z and x directions respectively. In conclusion, the direct landmarking of 3D DICOM image slices is a reliable, reproducible and informative method for assessment of the 3D skeletal changes. The method has a clear clinical application which includes the analysis of the jaw movements "orthognathic surgery" for the correction of facial deformities.
Full Text Available The most recent research studies into the long-term landscape evolution of the Abruzzo area, carried out over the last twenty years at the “G. d’Annunzio” University of Chieti-Pescara, are based on an integrated approach incorporating structural geology and geomorphology and, in particular, the geomorphometry of topographic and hydrographic aspects, geological and structural-geomorphological surveys and mapping supported by morpho-stratigraphic and chronological constraints. The geomorphological analyses have allowed us to outline the main stages of geomorphological evolution and to identify the factors that have contributed to the landscape shaping of the Apennine Chain, the Adriatic Piedmont and the fluvial plains and coastal sectors, up to the Tremiti islands. In the Apennine Chain, landscape evolution — in a ridge, valley and basin system — is connected to the regional uplift, local tectonic subsidence and local base level variations, which have led to changes in the drainage systems, from exoreic to endorheic (in the intermontane basins and then to exoreic again. In the Adriatic Piedmont, landscape shaping is connected to uplifting and eustatic sea-level fluctuations, which have induced the formation of a structure-controlled drainage system and the shaping of systems of entrenched alluvial fans and large consequent river valleys, with flights of river terraces. In the coastal Adriatic area — composed of a coastal plain-coastal slope system (northern and southern coast and of a cliffed rocky coast (central coast, Tremiti interrupted by river valleys — landscape shaping is the result of selective erosion due to the interaction between marine geomorphic processes and slope processes connected to Late Quaternary eustatic fluctuations.
Hay, John; Yeh, Kenneth B; Dasgupta, Debanjana; Shapieva, Zhanna; Omasheva, Gulnara; Deryabin, Pavel; Nurmakhanov, Talgat; Ayazbayev, Timur; Andryushchenko, Alexei; Zhunushov, Asankadyr; Hewson, Roger; Farris, Christina M; Richards, Allen L
Central Asia is a vast geographic region that includes five former Soviet Union republics: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. The region has a unique infectious disease burden, and a history that includes Silk Road trade routes and networks that were part of the anti-plague and biowarfare programs in the former Soviet Union. Post-Soviet Union biosurveillance research in this unique area of the world has met with several challenges, including lack of funding and resources to independently conduct hypothesis driven, peer-review quality research. Strides have been made, however, to increase scientific engagement and capability. Kazakhstan and Kyrgyzstan are examples of countries where biosurveillance research has been successfully conducted, particularly with respect to especially dangerous pathogens. In this review, we describe in detail the successes, challenges, and opportunities of conducting biosurveillance in Central Asia as exemplified by our recent research activities on ticks and tick-borne diseases in Kazakhstan and Kyrgyzstan.
Full Text Available Central Asia is a vast geographic region that includes five former Soviet Union republics: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. The region has a unique infectious disease burden, and a history that includes Silk Road trade routes and networks that were part of the anti-plague and biowarfare programs in the former Soviet Union. Post Soviet Union biosurveillance research in this unique area of the world has met with several challenges, including lack of funding and resources to independently conduct hypothesis driven, peer-review quality research. Strides have been made, however, to increase scientific engagement and capability. Kazakhstan and Kyrgyzstan are examples of countries where biosurveillance research has been successfully conducted, particularly with respect to especially dangerous pathogens. In this review we describe in detail the successes, challenges and opportunities of conducting biosurveillance in Central Asia as exemplified by our recent research activities on ticks and tick-borne diseases in Kazakhstan and Kyrgyzstan.
Ding, Sa; Yang, Jianhua; Lu, Wei; Duan, Zhipeng
The central heating is a major way of warming in northeast China in winter, however, the traditional heating method is inefficient, intensifying the energy consumption. How to improve the heating efficiency and reduce energy waste attracts more and more attentions in our country. In this paper, the mathematical model of heat transfer station temperature control system was established based on the structure of central heating system. The feedforward-feedback control strategy was used to overcome temperature fluctuations caused by the pressurized heating exchange system. The genetic algorithm was used to optimize the parameters of PID controller and simulation results demonstrated that central heating temperature achieved well control effect and meet stabilization requirements.
Fan, Guoxin; Han, Ruoshuang; Zhang, Hailong; He, Shisheng; Chen, Zhengqi
MINI: The time trend for the number of minimally invasive spine surgery articles showed a significant increase over time with an average of 93.23 articles per year. Among all related journals, Spine published the largest number of articles in minimally invasive spine surgery research and was the most popular one in the top five countries. Bibliometric analysis. This study aimed to reveal the characteristics of world productivity in the field of minimally invasive spine surgery (MISS) research and to provide a general picture for surgeons and researchers. Significant growth has been observed in the field of MISS research in recent years. However, bibliometric studies concerning the quantity and quality of articles published in MISS journals are scarce. All the data concerning MISS in this study originate from the Web of Science (Thomson Reuters, New York, NY) without restrictions. All selected literates were evaluated in the following aspects: publication year, publication journals, author, times cited, Web of Science category, countries/territories. A total number of 2051 articles were published worldwide. The articles published during 2000 to 2015 are more than 11.28 times when compared to those published before 2000. The United States published the largest number of articles (855/2051, 41.7%), followed by Germany (245/2051, 11.9%), South Korea (160/2051, 7.8%), China (147/2051, 7.2%), and Japan (108/2051, 5.2%) and had the highest total citations (16,626). Additionally, the United States had the highest average citations per article (12.14), followed by Japan (11.98), Germany (11.19), South Korea (11.04), and China (10.95). High-income countries published 98.73% of articles, upper-middle-income countries published 0.24% of articles, and middle-income countries published 1.03% of articles. The time trend for the number of MISS articles showed a significant increase over time with an average of 93.23 articles per year. The United States was the most productive
Mohr-Jensen, C; Koch, S Vinkel; Briciet Lauritsen, M
OBJECTIVE: To validate the diagnosis of hyperkinetic disorders (HD) in the Danish Psychiatric Central Research Registry (DPCRR) for children and adolescents aged 4 to 15 given in the years 1995 to 2005. METHOD: From a total of 4568 participants, a representative random subsample of n=387 patients...
Pascal, Christophe; Beltrami, Hugo; Daly, Stephen; Juhlin, Christopher; Kukkonen, Ilmo; Long, Mike; Rath, Volker; Renner, Joerg; Schwarz, Gerhard; Sundberg, Jan
The scientific drilling project "Collisional Orogeny in the Scandinavian Caledonides" (COSC), supported by ICDP and the Swedish Research Council, involves the drilling of two boreholes through carefully selected sections of the Paleozoic Caledonian orogen in Central Sweden. COSC-1, the first of the two planned boreholes, was drilled and fully cored down to 2.5 km depth during spring and summer 2014 near the town of Åre. The COSC working group is organised around six thematic teams including us, the geothermal team. The major objectives of the COSC geothermal team are: a) to contribute to basic knowledge about the thermal regime of Palaeozoic orogenic belts, ancient shield areas and high heat-producing plutons; b) to refine knowledge on climate change at high latitudes (i.e. Scandinavia), including historical global changes, recent palaeoclimate development (since last ice age) and expected future trends; c) to determine the vertical variation of the geothermal gradient, heat flow and thermal properties down to 2.5 km, and to determine the required corrections for shallow (< 1 km) heat flow data; d) to explore the geothermal potential of the Åre-Järpen area; e) to explore to what degree the conductive heat transfer is affected by groundwater flow in the uppermost crust and f) to evaluate the heat generation input and impact from the basement and the alum shales. To reach these targets the following tasks were carried out or are planned: 1) heat flow predictions from shallow boreholes; 2) geophysical logging; 3) analyses of logs and well tests; (3) determination of rock thermal properties on core samples; 4) determination of heat generation rates from radiometric and geochemical studies; 5) fracture characterisation for permeability and convective heat flow estimations; 6) analysis of convective signals; 7) analysis of paleoclimatic signals; 8) heat flow modelling and evaluation of geothermal potential and 9) Fennoscandia heat flow map compilation. The purpose of
Full Text Available Abstract Background In the years 2003–2005 research was carried out concerning ethno-medicine in the high Molise (central- southern Italy, a region that has been the object of very little investigation from the ethnobotanical point of view. Upper Molise is a continuation of the mountain profiles of the Abruzzi Appenines: a series of hills, steep slopes and deep fluvial valleys making communications difficult. Primordial traditions (e.g. harvest feasts are typical of the region. Methods Field data were collected through open interviews in the field. These were conducted on both an individual and group level, fresh plants gathered from surrounding areas being displayed. In other cases, individual interviews were conducted by accompanying the person involved to the places where they perform their activities (for example, in the woods with woodcutters, kitchen gardens and fields with housewives, pastures with shepherds, etc.. In total 54 individuals were interviewed. Results Data of 70 taxa belonging to 39 families were gathered. Among the species, 64 are used in human therapy, 5 as insect repellents, 11 in veterinary medicine, 1 to keep eggs and cheeses and 4 for magic purposes. The most important findings in ethno-medicine relate to the lichen Lobaria pulmonaria (L. Hoffm. (wounds and to some vascular plant species: Asplenium trichomanes L. and Ceterach officinarum Willd. (to regularize menstruation, Cyclamen hederifolium (chilblains, Centaurium erythraea Rafn. and Pulmonaria apennina Cristof. & Puppi (bruises, while in the ethno-veterinary field, we have Valeriana officinalis L. (wounds sustained by mules. Also worthy of note, given the isolation of the area, is the number of plants used to protect foodstuffs from parasites, among which Allium sativum L. and Capsicum frutescens L. Conclusion The research revealed a deep-rooted and widespread habit of husbanding the family's resources. Whilst isolation and snowfalls contributed to the widespread
Aiello Bowles Erin J
Full Text Available Abstract Background Common measures of surgical quality are 30-day morbidity and mortality, which poorly describe breast cancer surgical quality with extremely low morbidity and mortality rates. Several national quality programs have collected additional surgical quality measures; however, program participation is voluntary and results may not be generalizable to all surgeons. We developed the Breast Cancer Surgical Outcomes (BRCASO database to capture meaningful breast cancer surgical quality measures among a non-voluntary sample, and study variation in these measures across providers, facilities, and health plans. This paper describes our study protocol, data collection methods, and summarizes the strengths and limitations of these data. Methods We included 4524 women ≥18 years diagnosed with breast cancer between 2003-2008. All women with initial breast cancer surgery performed by a surgeon employed at the University of Vermont or three Cancer Research Network (CRN health plans were eligible for inclusion. From the CRN institutions, we collected electronic administrative data including tumor registry information, Current Procedure Terminology codes for breast cancer surgeries, surgeons, surgical facilities, and patient demographics. We supplemented electronic data with medical record abstraction to collect additional pathology and surgery detail. All data were manually abstracted at the University of Vermont. Results The CRN institutions pre-filled 30% (22 out of 72 of elements using electronic data. The remaining elements, including detailed pathology margin status and breast and lymph node surgeries, required chart abstraction. The mean age was 61 years (range 20-98 years; 70% of women were diagnosed with invasive ductal carcinoma, 20% with ductal carcinoma in situ, and 10% with invasive lobular carcinoma. Conclusions The BRCASO database is one of the largest, multi-site research resources of meaningful breast cancer surgical quality data
Blank, Madeleine M; Chen, Lilian; Papageorge, Marianna; Driscoll, Daniel; Graham, Roger; Chatterjee, Abhishek
Cost-analysis research can influence healthcare policies and practices. There is inherent bias depending on the chosen cost perspective (hospital, third-party payer, societal), and conclusions can change based on the perspective used. These perspectives may or may not be well declared or justified when performing cost-analysis research. The goal of this study was to perform a literature review of cost-analysis research in the Plastic Surgery literature to determine the prevalence of studies declaring and justifying their perspective, and to inform the reader on why such declarations are important in understanding potential bias. A systematic review was completed to retrieve cost-utility and cost-effectiveness research within the scope of Plastic Surgery. The search was limited to English-language studies in North America and Europe published between 2006 and 2016. Articles were selected using predefined data fields and specific inclusion criteria. A total of 2304 abstracts were identified, of which 47 met inclusion criteria. Seventy-two percent of studies (n = 34) declared a cost perspective. Of the studies that identified a cost perspective, 32% incorrectly identified the cost perspective. Only 49% of all studies (n = 23) both accurately declared and justified their chosen perspective. Only half of studies correctly declare their cost perspective and justify why the perspective was chosen. Not doing so potentially hides bias from the reader. Future efforts when performing cost-analysis studies should require a clear declaration and justification of the cost perspective taken. A table of our recommendations for reporting cost perspective is provided. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Smith, Justin S; Shaffrey, Christopher I; Sansur, Charles A; Berven, Sigurd H; Fu, Kai-Ming G; Broadstone, Paul A; Choma, Theodore J; Goytan, Michael J; Noordeen, Hilali H; Knapp, Dennis R; Hart, Robert A; Donaldson, William F; Polly, David W; Perra, Joseph H; Boachie-Adjei, Oheneba
Retrospective review of a prospectively collected database. Our objective was to assess the rates of postoperative wound infection associated with spine surgery. Although wound infection after spine surgery remains a common source of morbidity, estimates of its rates of occurrence remain relatively limited. The Scoliosis Research Society prospectively collects morbidity and mortality data from its members, including the occurrence of wound infection. The Scoliosis Research Society morbidity and mortality database was queried for all reported spine surgery cases from 2004 to 2007. Cases were stratified based on factors including diagnosis, adult (≥ 21 years) versus pediatric (scoliosis, and type of kyphosis for both adult and pediatric patients. Factors associated with increased rate of infection included revision surgery (P spine surgeons, is an inherent potential complication. These data provide general benchmarks of infection rates as a basis for ongoing efforts to improve safety of care.
Ranucci, Marco; Isgrò, Giuseppe; De La Torre, Teresa; Romitti, Federica; De Benedetti, Donatella; Carlucci, Concetta; Kandil, Hassan; Ballotta, Andrea
Mixed venous oxygen saturation and central venous oxygen saturation are considered possible indicators of the adequacy of oxygen delivery with respect to the oxygen needs of critically ill adult and pediatric patients. The present study was aimed at validating the accuracy of a new technology (Pediasat central venous catheter) in providing a continuous measurement of the central venous oxygen saturation in pediatric patients. A prospective observational study. Thirty pediatric patients (age, 6 days-9 years) undergoing cardiac operations. Data obtained with the Pediasat during and after the operation were compared with simultaneously collected venous blood samples analyzed with standard laboratory techniques. A clinical research hospital. None. A Bland and Altman analysis was performed on 30 matched sets of data collected before cardiopulmonary bypass, during cardiopulmonary bypass, and during the intensive care unit stay. Before cardiopulmonary bypass, there was a bias of 0.003, with lower and upper limits of agreement, -5.84 and 5.84 (percentage error, 17.3%). During cardiopulmonary bypass, the bias was 0.57 and lower and upper limits of agreement were -7.7 and 8.7 (percentage error, 23.2%). At 2 hours after the arrival in the intensive care unit, the bias was -0.6 and the lower and upper limits of agreement were -8 and 6.8 (percentage error, 20.3%). Because of the minimal bias and the acceptable value of percentage error, the Pediasat may be considered as an accurate tool for the continuous measurement of the central venous oxygen saturation in neonates and pediatric patients during and after cardiac operations.
Han, Jesse T; Egbert, Mark A; Dodson, Thomas B; Susarla, Srinivas M
Pursuing promotion in academic rank and seeking funded research opportunities are core elements of academic practice. Our purpose was to assess whether formal research training influences academic rank or National Institutes of Health (NIH) funding among full-time academic oral and maxillofacial surgeons (OMSs). We performed a cross-sectional study of full-time academic OMSs in the United States. The primary predictor variable was completion of formal research training, defined as a research fellowship or advanced non-clinical doctoral research degree (PhD, DMSc, DPH, DPhil, ScD). The outcomes measures were current academic rank and successful acquisition of NIH funding (yes vs no). Other study variables included MD degree, clinical fellowship training, years since training completion, and Hirsch index (H-index), a measure of academic productivity. We computed the descriptive, bivariate, and multiple regression models and set P ≤ .05 as significant. A total of 299 full-time academic OMSs were included in the study sample. Of the 299 OMSs, 41 (13.7%) had had formal research training. Surgeons with formal research training had a greater mean interval since completion of training (P = 0.01) and had a greater mean H-index (P = 0.02). Formal research training was not associated with academic rank (P = .10) but was associated with an increased likelihood of receiving NIH funding (P academic OMSs, those with formal research training had greater success with obtaining NIH funding. However, formal research training did not appear to influence an OMS's current academic rank. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Kuretzki, Carlos Henrique; Campos, Antônio Carlos Ligocki; Malafaia, Osvaldo; Soares, Sandramara Scandelari Kusano de Paula; Tenório, Sérgio Bernardo; Timi, Jorge Rufino Ribas
The use of information technology is often applied in healthcare. With regard to scientific research, the SINPE(c) - Integrated Electronic Protocols was created as a tool to support researchers, offering clinical data standardization. By the time, SINPE(c) lacked statistical tests obtained by automatic analysis. Add to SINPE(c) features for automatic realization of the main statistical methods used in medicine . The study was divided into four topics: check the interest of users towards the implementation of the tests; search the frequency of their use in health care; carry out the implementation; and validate the results with researchers and their protocols. It was applied in a group of users of this software in their thesis in the strict sensu master and doctorate degrees in one postgraduate program in surgery. To assess the reliability of the statistics was compared the data obtained both automatically by SINPE(c) as manually held by a professional in statistics with experience with this type of study. There was concern for the use of automatic statistical tests, with good acceptance. The chi-square, Mann-Whitney, Fisher and t-Student were considered as tests frequently used by participants in medical studies. These methods have been implemented and thereafter approved as expected. The incorporation of the automatic SINPE (c) Statistical Analysis was shown to be reliable and equal to the manually done, validating its use as a research tool for medical research.
Full Text Available AIM:To evaluate the changes of corneal high-order aberration(including Coma, Spab, RMShafter laser in situ keratomileusis(LASIKwith femtosecond laser, sub-Bowman keratomileusis(SBKand laser epithelial keratomileusis(LASEK.METHODS: Of 82 myopic patients(164 eyes, 31 patients(62 eyeswere treated by FS-LASIK, 31 patients(62 eyeswere treated by SBK, 20 patients(40 eyeswere treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery.RESULTS: 1Vision: The uncorrected visual acuity of the three groups had no differences(P>0.05. 2Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly(P0.05. The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS-LASIK was smaller than the other two groups, with statistical significance(P0.05.CONCLUSION: Compared with SBK and LASEK,FS-LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.
Full Text Available AIM:To explore cataract surgery complication of the anterior chamber injection 0.1mL dexamethasone for uveitis complicated cataract patients. METHODS: The experimental group was injected 0.1mL dexamethasone to anterior chamber at the end of phacoemulsification(Phaco+intraocular lens(IOLimplantation, while the control group did not. And the different postoperative inflammation between them was observed. RESULTS: The differences of visual acuity between the two groups on the first two days after operation were statistically significant(P<0.05. The postoperative corneal edema and anterior chamber flare between the two groups in the first day were different(P<0.05. And the percentage of the experimental group postoperative visual acuity improved was higher than that of the control group. CONCLUSION: It can reduce short-term postoperative inflammation, improve visual acuity earlier and do not impact the short-term postoperative intraocular pressure that uveitis complicated cataract was injected 0.1mL dexamethasone to anterior chamber at the end of Phaco+IOL.
Anthony Michael Jarc
Full Text Available Classic studies in human sensorimotor control use simplified tasks to uncover fundamental control strategies employed by the nervous system. Such simple tasks are critical for isolating specific features of motor, sensory, or cognitive processes, and for inferring causality between these features and observed behavioral changes. However, it remains unclear how these theories translate to complex sensorimotor tasks or to natural behaviors. Part of the difficulty in performing such experiments has been the lack of appropriate tools for measuring complex motor skills in real-world contexts. Robot-assisted surgery (RAS provides an opportunity to overcome these challenges by enabling unobtrusive measurements of user behavior. In addition, a continuum of tasks with varying complexity – from simple tasks such as those in classic studies to highly complex tasks such as a surgical procedure – can be studied using RAS platforms. Finally, RAS includes a diverse participant population of inexperienced users all the way to expert surgeons. In this perspective, we illustrate how the characteristics of RAS systems make them compelling platforms to extend many theories in human neuroscience, as well as, to develop new theories altogether.
Gong, Zhi; Peng, Dailiang; Wen, Jingyi; Cai, Zhanqing; Wang, Tiantian; Hu, Yuekai; Ma, Yaxin; Xu, Junfeng
Central Asia is a typical arid area, which is sensitive and vulnerable part of climate changes, at the same time, Central Asia is the Silk Road Economic Belt of the core district, the warm-humid climate change will affect the production and economic development of neighboring countries. The average annual precipitation, average anneal temperature and evapotranspiration are the important indexes to weigh the climate change. In this paper, the annual precipitation, annual average temperature and evapotranspiration data of every pixel point in Central Asia are analyzed by using long-time series remote sensing data to analyze the trend of warm and humid conditions. Finally, using the model to analyzed the distribution of warm-dry trend, the warm-wet trend, the cold-dry trend and the cold-wet trend in Central Asia and Xinjiang area. The results showed that most of the regions of Central Asia were warm-humid and warm-dry trends, but only a small number of regions showed warm-dry and cold-dry trends. It is of great significance to study the climatic change discipline and guarantee the ecological safety and improve the ability to cope with climate change in the region. It also provide scientific basis for the formulation of regional climate change program. The first section in your paper
Beppu, Takaaki; Inoue, Takashi; Nishimoto, Hideaki; Nakamura, Shinichi; Nakazato, Yoichi; Ogasawara, Kuniaki; Ogawa, Akira
Primary granulomatous angiitis of the central nervous system (CNS) is extremely rare. Its preoperative diagnosis is difficult as the condition displays nonspecific features on routine neuroimaging investigations. In this paper, the authors report findings of magnetic resonance (MR) spectroscopy and fractional anisotropy (FA) with diffusion tensor MR imaging in a case of granulomatous angiitis of the CNS. A 30-year-old man presented with morning headaches and grand mal seizures. An MR image revealed a mass resembling glioblastoma in the right temporal lobe. Magnetic resonance spectroscopy showed a high choline/creatine (Cho/Cr) ratio indicative of a malignant neoplasm, accompanied by a slight elevation of glutamate and glutamine. The FA value was very low, which is inconsistent with malignant glioma. The mass was totally removed surgically. Histologically, the peripheral lesion of the mass consisted of a rough accumulation of fat granule cells, infiltration of inflammatory cells, and distribution of capillary vessels. Some vessels within the lesion were replaced by granulomas. The histological diagnosis was granulomatous angiitis of the CNS. The MIB-1-positive rate of the granuloma was approximately 5%. Both MR spectroscopy and FA were unable to accurately diagnose granulomatous angiitis of the CNS prior to surgery; however, elevated Cho/Cr and glutamate and glutamine shown by MR spectroscopy may indicate the moderate proliferation potential of the granuloma and the inflammatory process, respectively, in this condition. Although the low FA value in the present case enabled the authors to rule out a diagnosis of glioblastoma, FA values in inflammatory lesions require careful interpretation.
Chan, John K; Gardner, Austin B; Taylor, Katie; Blansit, Kevin; Thompson, Caroline A; Brooks, Rebecca; Yu, Xinhua; Kapp, Daniel S
To evaluate the hospital and patient factors associated with robotic surgery for endometrial cancer in the United States. Data was obtained from the Nationwide Inpatient Sample from the year 2010. Chi-squared and multivariate analyses were used for statistical analysis. Of the 6560 endometrial cancer patients who underwent surgery, the median age was 62 (range: 22 to 99). 1647 (25%) underwent robotic surgery, 820 (13%) laparoscopic, and 4093 (62%) had open surgery. The majority was White (65%). Hospitals with 76 or more hysterectomy cases for endometrial cancer patients per year (4% of hospitals in the study) performed 31% of all hysterectomies and 40% of all robotic hysterectomies (probotic surgery compared to 15% of Hispanics, 12% of Blacks, and 11% of Asians (probotic surgery more than patients with low or middle incomes (probotic surgery compared to only 14% of Medicaid patients and 12% of uninsured patients (probotic surgeries for endometrial cancer were performed at a small number of high-volume hospitals in the United States. Socioeconomic status, insurance type, and race were also important predictors for the use of RS. Further studies are warranted to better understand the barriers to receiving minimally invasive surgery. Copyright © 2015. Published by Elsevier Inc.
Van Deun, Jan; Mestdagh, Pieter; Agostinis, Patrizia; Akay, Özden; Anand, Sushma; Anckaert, Jasper; Martinez, Zoraida Andreu; Baetens, Tine; Beghein, Els; Bertier, Laurence; Berx, Geert; Boere, Janneke|info:eu-repo/dai/nl/371593050; Boukouris, Stephanie; Bremer, Michel; Buschmann, Dominik; Byrd, James B; Casert, Clara; Cheng, Lesley; Cmoch, Anna; Daveloose, Delphine; De Smedt, Eva; Demirsoy, Seyma; Depoorter, Victoria; Dhondt, Bert; Driedonks, Tom A P; Dudek, Aleksandra; Elsharawy, Abdou; Floris, Ilaria; Foers, Andrew D; Gärtner, Kathrin; Garg, Abhishek D; Geeurickx, Edward; Gettemans, Jan; Ghazavi, Farzaneh; Giebel, Bernd; Kormelink, Tom Groot|info:eu-repo/dai/nl/31413137X; Hancock, Grace; Helsmoortel, Hetty; Hill, Andrew F; Hyenne, Vincent; Kalra, Hina; Kim, David; Kowal, Joanna; Kraemer, Sandra; Leidinger, Petra; Leonelli, Carina; Liang, Yaxuan; Lippens, Lien; Liu, Shu; Lo Cicero, Alessandra; Martin, Shaun; Mathivanan, Suresh; Mathiyalagan, Prabhu; Matusek, Támas; Milani, Gloria; Monguió-Tortajada, Marta; Mus, Liselot M; Muth, Dillon C; Németh, Andrea; Nolte-'t Hoen, Esther N M; O'Driscoll, Lorraine; Palmulli, Roberta; Pfaffl, Michael W; Primdal-Bengtson, Bjarke; Romano, Erminia; Rousseau, Quentin; Sahoo, Susmita; Sampaio, Natalia; Samuel, Monisha; Scicluna, Benjamin; Soen, Bieke; Steels, Anneleen; Swinnen, Johannes V; Takatalo, Maarit; Thaminy, Safia; Théry, Clotilde; Tulkens, Joeri; Van Audenhove, Isabel; van der Grein, Susanne|info:eu-repo/dai/nl/412755211; Van Goethem, Alan; van Herwijnen, Martijn J|info:eu-repo/dai/nl/313936021; Van Niel, Guillaume; Van Roy, Nadine; Van Vliet, Alexander R; Vandamme, Niels; Vanhauwaert, Suzanne; Vergauwen, Glenn; Verweij, Frederik; Wallaert, Annelynn; Wauben, Marca|info:eu-repo/dai/nl/112675735; Witwer, Kenneth W; Zonneveld, Marijke I|info:eu-repo/dai/nl/338042202; De Wever, Olivier; Vandesompele, Jo; Hendrix, An
We argue that the field of extracellular vesicle (EV) biology needs more transparent reporting to facilitate interpretation and replication of experiments. To achieve this, we describe EV-TRACK, a crowdsourcing knowledgebase (http://evtrack.org) that centralizes EV biology and methodology with the
Susarla, Srinivas M; Dodson, Thomas B; Lopez, Joseph; Swanson, Edward W; Calotta, Nicholas; Peacock, Zachary S
Academic promotion is linked to research productivity. The purpose of this study was to assess the correlation between quantitative measures of academic productivity and academic rank among academic oral and maxillofacial surgeons. This was a cross-sectional study of full-time academic oral and maxillofacial surgeons in the United States. The predictor variables were categorized as demographic (gender, medical degree, research doctorate, other advanced degree) and quantitative measures of academic productivity (total number of publications, total number of citations, maximum number of citations for a single article, I-10 index [number of publications with ≥ 10 citations], and h-index [number of publications h with ≥ h citations each]). The outcome variable was current academic rank (instructor, assistant professor, associate professor, professor, or endowed professor). Descriptive, bivariate, and multiple regression statistics were computed to evaluate associations between the predictors and academic rank. Receiver-operator characteristic curves were computed to identify thresholds for academic promotion. The sample consisted of 324 academic oral and maxillofacial surgeons, of whom 11.7% were female, 40% had medical degrees, and 8% had research doctorates. The h-index was the most strongly correlated with academic rank (ρ = 0.62, p research activity.
Arkhangel' skij, I.A.; Sokolov, D.D.; Kalinin, V.F.; Nikiforov, V.S.
The main tasks are considered in the scope of the Central Scientific-Research Institute for Information and Technological and Economic Studies on Nuclear Science and Technology. (TsNIIAtominform). The institute coordinates scientific research and information activity of information agencies of all the USSR organizations engaged in nuclear science and technology, excercises a centralized completion of their libraries, develops and puts into practice the most progressive methods for the information servicing. The institute is a national INIS center of the USSR. Here a system for the automatic information dissemination has been successfully elaborated and employed. Much of the institute activity is given to the estimation and analysis of information and to the determination of tendencies in the nuclear science and technology development. A conclusion is drawn to the effect that TsNIIAtominform, within 15 years of its existence, has formed as a center ensuring functioning of the system of scientific and technical information on nuclear science and technology.
A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury and Central Cord Syndrome: Recommendations on the Timing (≤24 Hours Versus >24 Hours) of Decompressive Surgery
Tetreault, Lindsay A.; Wilson, Jefferson R.; Aarabi, Bizhan; Anderson, Paul; Arnold, Paul M.; Brodke, Darrel S.; Burns, Anthony S.; Chiba, Kazuhiro; Dettori, Joseph R.; Furlan, Julio C.; Hawryluk, Gregory; Holly, Langston T.; Howley, Susan; Jeji, Tara; Kalsi-Ryan, Sukhvinder; Kotter, Mark; Kurpad, Shekar; Marino, Ralph J.; Martin, Allan R.; Massicotte, Eric; Merli, Geno; Middleton, James W.; Nakashima, Hiroaki; Nagoshi, Narihito; Palmieri, Katherine; Singh, Anoushka; Skelly, Andrea C.; Tsai, Eve C.; Vaccaro, Alexander; Yee, Albert; Harrop, James S.
Objective: To develop recommendations on the timing of surgical decompression in patients with traumatic spinal cord injury (SCI) and central cord syndrome. Methods: A systematic review of the literature was conducted to address key relevant questions. A multidisciplinary guideline development group used this information, along with their clinical expertise, to develop recommendations for the timing of surgical decompression in patients with SCI and central cord syndrome. Based on GRADE, a strong recommendation is worded as “we recommend,” whereas a weak recommendation is presented as “we suggest.” Results: Conclusions from the systematic review included (1) isolated studies reported statistically significant and clinically important improvements following early decompression at 6 months and following discharge from inpatient rehabilitation; (2) in one study on acute central cord syndrome without instability, a marginally significant improvement in total motor scores was reported at 6 and 12 months in patients managed with early versus late surgery; and (3) there were no significant differences in length of acute care/rehabilitation stay or in rates of complications between treatment groups. Our recommendations were: “We suggest that early surgery be considered as a treatment option in adult patients with traumatic central cord syndrome” and “We suggest that early surgery be offered as an option for adult acute SCI patients regardless of level.” Quality of evidence for both recommendations was considered low. Conclusions: These guidelines should be implemented into clinical practice to improve outcomes in patients with acute SCI and central cord syndrome by promoting standardization of care, decreasing the heterogeneity of management strategies, and encouraging clinicians to make evidence-informed decisions. PMID:29164024
Andersen, Bent; Binnerup, S.; Bijl, L. van der; Villholth, K.G.; Drews, M.; Strand, I.F.; Henrichs, T.; Larsen, Niels; Timmermann, T.; Moseholm, L.
The report proposes five key research themes under the heading 'Future climate and climate adaptation' which can support the Danish climate adaptation efforts. These themes underpin climate adaptation in the light of research needs identified by the research environments and sectors under the government's strategy on adaptation to climate change in Denmark from March 2008. The paper has been prepared within the framework of RESEARCH2015-proposal by the Ministry of Science, Technology and Innovation in order to bring about the knowledge and tools that are demanded by sectors and authorities to implement the government's climate adaptation strategy. This concept paper for research themes is a thorough, holistic and inter-sectoral suggestion for future research priorities in climate adaptation with anchoring in both the research community as well as in the political-administrative system. The five key themes are; 1. Models and climate adaptation; 2. Communities and climate adaptation; 3. Construction and climate adaptation; 4. Landscape and climate adaptation; 5. Climate adaptation in the coastal zone. The overall research needs over a 5 year period is estimated at 700 million DKK, of which 85 million DKK yearly can be estimated to be financed primarily through national basic funds and research council funds. Research is assumed to be coupled to external financing, for which the EU's 7th Framework Program and the Nordic excellence and innovation program in the energy, climate and environment will be significant sources.
Full Text Available Currently, acquired immunodeficiency syndrome (AIDS and syphilis are widely epidemic all over the world, which has seriously jeopardized public health security. In China, studies on human immunodeficiency virus (HIV-associated central nervous system (CNS damage and neurosyphilis are increasing. This paper reviews related literatures on HIV-associated CNS infection and neurosyphilis, and summarizes the epidemiological characteristics, pathogenesis, clinical features, diagnosis and treatment strategies, so as to provide new clues for further exploration into clinical diagnosis and treatment. DOI: 10.3969/j.issn.1672-6731.2016.07.003
device enables sheet and film casting of both petrochemical and biodegradable starch -based polymers. A list of the C RP-supported projects undertaken by...Identification Technologies. The laboratory’s state-of-the-art research in packaging (durability, biodegradability , smart materials, electronic tracking, etc...compression effects from stacking packaged items during warehousing and transshipment. Extruder for plastic resin applications. This extruding
Beck Jørgensen, T.; Rutgers, M.R.
This article provides the introduction to a symposium on contemporary public values research. It is argued that the contribution to this symposium represent a Public Values Perspective, distinct from other specific lines of research that also use public value as a core concept. Public administration
Written by leading experts in the field, this monograph provides homotopy theoretic foundations for surgery theory on higher-dimensional manifolds. Presenting classical ideas in a modern framework, the authors carefully highlight how their results relate to (and generalize) existing results in the literature. The central result of the book expresses algebraic surgery theory in terms of the geometric Hopf invariant, a construction in stable homotopy theory which captures the double points of immersions. Many illustrative examples and applications of the abstract results are included in the book, making it of wide interest to topologists. Serving as a valuable reference, this work is aimed at graduate students and researchers interested in understanding how the algebraic and geometric topology fit together in the surgery theory of manifolds. It is the only book providing such a wide-ranging historical approach to the Hopf invariant, double points and surgery theory, with many results old and new. .
Nambuanyi, Lekunze Ransom; Midtvåge, Runa; Hiranandani, Vanmala Sunder
Uganda is burdened with rising poverty, malnutrition and food insecurity. While most Ugandans depend on agriculture for their livelihoods, it is important to recognize that access to and control over resources by women and climate factors are central to the question of food security in Uganda....... However, a review of the literature demonstrates that policy options have poorly understood these interlinkages or tended to undermine them, especially the extent that these policies and programs put the necessary attention on the role of women farmers in food security. This paper presents part of a work...... in progress of a research project that seeks to investigate the interrelated effects of agricultural practices, access to and control over resources, as well as climate change on women’s food security in the urban and peri-urban areas of central Uganda. The paper not only considers how to turn...
Ma, A D; Kessler, C M; Al-Mondhiry, H A B; Gut, R Z; Cooper, D L
Acquired haemophilia (AH) is a rare disorder caused by autoantibodies against factor VIII. The Hemostasis & Thrombosis Research Society (HTRS) Registry was used to monitor the safety of recombinant FVII (rFVIIa). This study aims to report data from the HTRS Registry regarding safety and efficacy of rFVIIa for haemostatic management of surgeries and other invasive procedures in patients with AH. For each rFVIIa-treated procedure, the initial dose, total dose, average infused dose, number of doses and treatment duration were calculated. Efficacy was assessed on a 4-point scale. Of 166 registered patients with AH, 37 patients underwent 58 procedures [30 (51%) rFVIIa-treated]. The median (range) age of all patients undergoing procedures was 70 (13-93) years; for rFVIIa-treated patients, 74 (28-89) years. Approximately 67% (39/58) of all procedures were elective. Overall, the most common procedures were endoscopy (12) and central venous access device (10); rFVIIa was used preoperatively (11), postoperatively (13) and during six follow-up procedures during ongoing postoperative rFVIIa treatment. The median (range) initial dose was 90.0 (44-187) μg kg(-1) preoperatively and 106.0 (56-270) μg kg(-1) postoperatively. For rFVIIa-treated episodes with a reported outcome, 20 (91%) were rated excellent/good or no additional agents used and 2 (9%) were rated as poor/ineffective requiring a switch to another bypassing agent. No thromboembolic events were reported. Adequate haemostasis was provided for 91% of rFVIIa-treated procedures at doses largely conforming to the package insert. No safety concerns were reported. © 2015 John Wiley & Sons Ltd.
Zeynep EKMEKCİ BAL
Full Text Available In this study, bread consumption statuses of families living in the central district of Tokat province were identified. Data were obtained from 272 consumers in November 2012. According to the findings, the amount of per capita bread consumption is 291.95 g which is lower than the national average consumption. The most frequently consumed bread type of families was loaf bread with 70.59%. Consumers were mainly purchased bread from supermarkets (80.51% and oven (25.37%. More than half of consumers think that the quality of bread sold in the market is insufficient. Several families cannot consume a significant portion of bread purchased during the day; they re-used some of the staled bread and wasted the rest of staled bread. Measures should be taken to prevent the waste of bread. The quality of the bread produced should be increased and a necessary care for hygiene should be taken during production and sales stages.
Molinillo; Lasanta; Garcia-Ruiz
/ Plant succession and pasture resources have been studied in abandoned fields of the central Spanish Pyrenees, in an environment severely affected by strong demographic pressure in the past. Several hydromorphological features (runoff and sediment yield) were also analyzed for different environments of the abandoned fields, in order to forecast the effects of their reclamation and transformation into areas for livestock use. The availability and accessibility of pastures as well as soil and water conservation is related to the process of colonization of Genista scorpius. Under a dense shrub cover both runoff and sediment yield are strongly controlled. As the shrub cover becomes open, sediment yield and runoff increase greatly. A dense herbaceous cover yields high runoff coefficients but moderate soil losses. From the results obtained, the possibility of abandoned field reclamation by means of selective clearing of scrub is discussed.KEY WORDS: Abandoned fields; Plant succession; Degraded environments; Soil erosion; Runoff; Spanish Pyrenees
Su, Yi; Wang, Feifeng; Lu, Yufeng; Huang, Huimin; Xia, Xiaofei
This paper is based on affine function equation of the grid and OPF problem, discusses the equivalent of some inequality constraints variables optimizing. Further, we propose the model of injection current and set up the constraint sensitivity index of affine characteristics. The index can be used to identify the central point voltage and effective inequality of the system automatically. And then we can know how to compensate reactive power of the corresponding generator node and control the voltage to ensure the quality of the system voltage. When checking the effective inequalities we introduce cross-solving method of power flow. This provide a different idea for solving the power flow. The paper uses the results of the IEEE5 node examples to illustrate the validity and practicality of the proposed method.
The global biomedical research enterprise is driving substantial advances in medicine and healthcare. Yet it appears that the enterprise is rather wasteful, falling short of its true innovative potential. Suggested reasons are manifold and involve various stakeholders, such that there is no single remedy. In the present paper, I will argue that laboratories are the basic working units of the biomedical research enterprise and an important site of action for corrective intervention. Keeping laboratories relatively small will enable better training and mentoring of individual scientists, which in turn will yield better performance of the scientific workforce. The key premise of this argument is that people are at the heart of the successes and failures of biomedical research, yet the human dimension of science has been unduly neglected in practice. Renewed focus on the importance of laboratories and their constituent scientists is one promising approach to reducing waste and increasing efficiency within the biomedical research enterprise.
Derek R. Hall
Full Text Available Within the context of tourism development in the countries of contemporary Central and Eastern Europe, this paper briefly discusses the challenges for industry and key issues for researchers within six broad topic areas. These are: climate change adaptation and mitigation; integration with sustainable development strategies; coping with globalization; differentiation/ uniqueness; innovation; and collaboration / partnership / networking. Practical cases are drawn from Western European experience to exemplify potential opportunities, and recent published research is identified to inform fruitful research directions. It is concluded that challenges and issues are similar across Europe, and that those relating to climate change adaptation and mitigation are, in the wider context, the most important to understand and address.
The detail design (DD) of research experiment hardware for the collector subsystem (heliostats) to support the 10 MW/sub e/ Pilot Plant preliminary design (PD) is presented. Additionally, test plans for assembly, integration, and array tests are presented, along with results of completed component/material tests. Research experiment DD and tests described were planned to provide design verification and supporting data, with hardware which either duplicates, or closely simulates the Pilot Plant PD baseline. (WHK)
Lopez, Joseph; Ameri, Afshin; Susarla, Srinivas M; Reddy, Sashank; Soni, Ashwin; Tong, J W; Amini, Neda; Ahmed, Rizwan; May, James W; Lee, W P Andrew; Dorafshar, Amir
It is currently unknown whether formal research training has an influence on academic advancement in plastic surgery. The purpose of this study was to determine whether formal research training was associated with higher research productivity, academic rank, and procurement of extramural National Institutes of Health (NIH) funding in plastic surgery, comparing academic surgeons who completed said research training with those without. This was a cross-sectional study of full-time academic plastic surgeons in the United States. The main predictor variable was formal research training, defined as completion of a postdoctoral research fellowship or attainment of a Doctor of Philosophy (PhD). The primary outcome was scientific productivity measured by the Hirsh-index (h-index, the number of publications, h that have at least h citations each). The secondary outcomes were academic rank and NIH funding. Descriptive, bivariate, and multiple regression statistics were computed. A total of 607 academic surgeons were identified from 94 Accreditation Council for Graduate Medical Education-accredited plastic surgery training programs. In all, 179 (29.5%) surgeons completed formal research training. The mean h-index was 11.7 ± 9.9. And, 58 (9.6%) surgeons successfully procured NIH funding. The distribution of academic rank was the following: endowed professor (5.4%), professor (23.9%), associate professor (23.4%), assistant professor (46.0%), and instructor (1.3%). In a multiple regression analysis, completion of formal research training was significantly predictive of a higher h-index and successful procurement of NIH funding. Current evidence demonstrates that formal research training is associated with higher scientific productivity and increased likelihood of future NIH funding. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
... Loss Featured Resource Find an Endocrinologist Search Bariatric Surgery September 2017 Download PDFs English Espanol Editors Durga ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese ...
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Duran, Felicia Angelica [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Security Systems Analysis Dept.; Waymire, Russell L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Security Systems Analysis Dept.
Sandia National Laboratories (SNL) is providing training and consultation activities on security planning and design for the Korea Hydro and Nuclear Power Central Research Institute (KHNPCRI). As part of this effort, SNL performed a literature review on computer security requirements, guidance and best practices that are applicable to an advanced nuclear power plant. This report documents the review of reports generated by SNL and other organizations [U.S. Nuclear Regulatory Commission, Nuclear Energy Institute, and International Atomic Energy Agency] related to protection of information technology resources, primarily digital controls and computer resources and their data networks. Copies of the key documents have also been provided to KHNP-CRI.
Ball, Chad G.; Keaney, Marilyn A.; Chun, Rosaleen; Groleau, Michelle; Tyssen, Michelle; Keyte, Jennifer; Broderick, Timothy J.; Kirkpatrick, Andrew W.
BackgroundMultiple nations are actively pursuing manned exploration of space beyond low-earth orbit. The responsibility to improve surgical care for spaceflight is substantial. Although the use of parabolic flight as a terrestrial analogue to study surgery in weightlessness (0 g) is well described, minimal data is available to guide the appropriate delivery of anesthesia. After studying anesthetized pigs in a 0 g parabolic flight environment, our group developed a comprehensive protocol describing prolonged anesthesia in a parabolic flight analogue space surgery study (PFASSS). Novel challenges included a physically remote vivarium, prolonged (>10 h) anesthetic requirements, and the provision of veterinary operating room/intensive care unit (ICU) equivalency on-board an aircraft with physical dimensions of laboratory sessions were conducted with combinations of anesthetic, pre-medication, and induction protocols on Yorkshire-cross specific pathogen-free (SPF) pigs. Several constant rate infusion (CRI) intravenous anesthetic combinations were tested. In each regimen, opioids were administered to ensure analgesia. Ventilation was supported mechanically with blended gradients of oxygen. The best performing terrestrial 1 g regime was flight tested in parabolic flight for its effectiveness in sustaining optimal and prolonged anesthesia, analgesia, and maintaining hemodynamic stability. Each flight day, a fully anesthetized, ventilated, and surgically instrumented pig was transported to the Flight Research Laboratory (FRL) in a temperature-controlled animal ambulance. A modular on-board surgical/ICU suite with appropriate anesthesia/ICU and surgical support capabilities was employed. ResultsThe mean duration of anesthesia (per flight day) was 10.28 h over four consecutive days. A barbiturate and ketamine-based CRI anesthetic regimen supplemented with narcotic analgesia by bolus administration offered the greatest prolonged hemodynamic stability through an IV route
Full Text Available Three newly synthesized benzamides by the Department of Pharmaceutical Chemistry of the Faculty of pharmacy from the University of Medicine and Pharmacy „Carol Davila” Bucharest were tested in order to determine whether these new molecules have similar effects on the central nervous system as those already in therapeutic use belonging to the same chemical group, such as tiapride (neuroleptic or lidocaine (local anaesthetic. Tests were carried out on NMRI mice which were given new compounds, conventionally named I5C, I14C, and II5C in a dose of 1/20 of the lethal dose 50% (LD50, as previously determined. They received this treatment daily for 21 days. The evasive–investigating capacity of mice was determined using the platform test, and the motor activity using an Activity cage device. The results have shown that compounds I5C and II5C decrease the investigation capacity of the mice; and compound I5C inhibits motor activity, while II5C stimulates it. Thus we concluded that only compounds I5C and II5C have a neuroleptic potential that might be investigated further.
Study of the cadaver is integral to both medical education and research, but how is cadaveric material to be obtained in the 21st-century world? Historical precedents are of little assistance, built as they are on the most unethical of practices, including body snatching and murder. This constitutes a major challenge for modern ...
Full Text Available Abstract Antegrade selective cerebral perfusion in conjunction with hypothermia attenuate postoperative neurological injury, which in turn still remains the main cause of mortality and morbidity following aortic arch surgery. Hypothermic circulatory arrest however could be a useful tool during arch surgery, surgery for chronic thromboembolic disease, air on the arterial line during CPB, during cavotomy for extraction of renal cell carcinoma with level IV extension, or when dealing with difficult trauma to the SVC or IVC. Cerebral protective effects with hypothermic procedures including inhibition of neuron excitation, and discharge of excitable amino acids, and thereby, prevention of an increase in intercellular calcium ions, hyperoxidation of lipids in cell membranes, and free radical production. The authors are briefly discussing the fundamental principles of using hypothermia as an adjunct tool of the cardiothoracic surgeon's practice. The relationship between temperature, flow, metabolic requirements and adverse effects is addressed.
Di Canio, D.G.; Treytl, W.J.; Jur, F.A.; Watson, C.D.
The results of a study to examine the line focus central receiver alternative for solar thermal generation of electric power on a commercial scale are presented. The baseline concept consists of the following elements: (1) a solar collector (heliostat) whose geometry is the equivalent of a focused parabolic cylinder. The heliostat reflecting surface is composed of an array of flexible rectangular mirror panels supported along their long edges by a framework which rotates about an axis parallel to the ground plane. The mirror panels in one section (18.3 meters by 3.05 meters (60 feet by 10 feet)) are defocused in unison by a simple mechanism under computer control to achieve the required curvature. Two sections (110 meters/sup 2/(591 feet/sup 2/)) are controlled and driven in elevation by one control/drive unit. (2) A linear cavity receiver, composed of 61-meter (200-foot) sections supported by towers at an elevation of 61 meters (200 feet). Each section receives feedwater and produces turbine-rated steam. The cavity is an open cylinder 1.83 meters (6 feet) in inside diameter, with a 1.22 meter (4 foot) aperture oriented at 45 degrees to the collector field. (3) Heliostat control, consisting of a local controller at each heliostat module which communicates with a master control computer to perform elevation tracking and focal length adjustment. The control logic is open-loop, with sun position computer by the master computer with an algorithm. Image sensors, mounted above and below the receiver aperture, are used to monitor the collector field and provide feedback to the master computer for detection of misaligned heliostats. (WHK)
Beauchamp, C J
This chapter has provided a rudimentary example of an exploratory/descriptive case study, utilizing phenomenological methods of data analysis. As discussed in the previous chapter, clearly delineated methods for case studies are not prevalent in the same way that other research methods are. The clear and fundamental design of this case study was purposeful as a demonstration of the utility of the method in day-to-day nursing. The aesthetic quality of the case study method is its simplicity of design. It is critical to note that the simplicity does not decrease the rigor or scientific merit of the process or outcome; in fact, an opposite argument could be made. The reporting style utilized was traditional so that the method could be clearly understood and compared to other research methods.
Rison, Richard A
Case reports are a time-honored, important, integral, and accepted part of the medical literature. Both the Journal of Medical Case Reports and the Case Report section of BioMed Central Research Notes are committed to case report publication, and each have different criteria. Journal of Medical Case Reports was the world's first international, PubMed-listed medical journal devoted to publishing case reports from all clinical disciplines and was launched in 2007. The Case Report section of BioMed Central Research Notes was created and began publishing case reports in 2012. Between the two of them, thousands of peer-reviewed case reports have now been published with a worldwide audience. Authors now also have Cases Database, a continually updated, freely accessible database of thousands of medical case reports from multiple publishers. This informal editorial outlines the process and mechanics of how and when to write a case report, and provides a brief look into the editorial process behind each of these complementary journals along with the author's anecdotes in the hope of inspiring all authors (both novice and experienced) to write and continue writing case reports of all specialties. Useful hyperlinks are embedded throughout for easy and quick reference to style guidelines for both journals.
Gbolagade Benjamin Adesiji
Full Text Available To understand the technology generating practices among universities and research institutes in north central zone of Nigeria, this study examined sources of funds for technology generating activities, compared agro-technology generating practices and identified constraining factors hindering technology generating practices. One hundred and fifty-two academic staff were randomly selected from universities and one hundred and thirty-six respondents were drawn from research institutes. Validated questionnaires with reliability coefficient of r = 0.92 were used to elicit data. Data were analyzed using descriptive statistics, Likert-scale, T-test and Factor analysis. Majority (93.4% of universities’ respondents used their personal funds to generate new technology compared to their counterparts in research institutes. The most widely employed mechanism for generating agricultural technologies was joint radio programmes (mean = 3.38 while the least was biotechnology (mean = 2.57. Major areas of differences in technology generation between the two institutions were the physical distance (t = 13.54; P < 0.05, farmers participation in field research trials (t = 8.50; P < 0.05, farmers co-finance of adaptive research trials (t = 3.77; P < 0.05 and adequate research facilities and incentives to workers (t = 2.05; P < 0.05. Factors constraining technology generation for universities were poor access to knowledge and information on new innovation (r = 0.815 while for research institutes it was limited physical resources (ICT, Telephone (r = 0.801. It was recommended therefore that respondents should look into options of writing alternate fund proposals and submitting to a wider range of funding bodies. Governance of innovation could be strengthened through the formation of a formal technological linkage advisory council.
Jackson, O. [Caribbean Infra-Tech, Inc., St. Croix (Virgin Islands (U.S.))
Programme for Belize (PFB), a non-governmental organization which owns and manages the Rio Bravo Conservation and Management Area (RBCMA), a 229,000 acre section of subtropical rainforest in northwestern Belize, is developing a series of research and eco-tourism developments as sustainable development projects. Guided by a comprehensive Sustainable Infrastructure Plan completed by Caribbean Infra-Tech, Inc. (CIT) in 1995, PFB adopted an organizational goal of implementing 100% green renewable energy-based utilities for their two major development sites: La Milpa and Hill Bank stations. To date, PFB has constructed or installed over 20 kW of standalone PV power, sustainable water supply systems, recycling waste treatment systems, and a model sustainable Dormitory and Bath House facility in the RBCMA. In addition, a Resource Conservation and Management Program (RCMP), which is to guide ongoing visitor orientation, staff training, and sustainable systems operations and maintenance, is now being prepared for immediate implementation. In this paper, the design and technical performance of the solar (PV) electric power plants, PV water pumping, solar water heating and other green utility systems will be assessed.
Rossetto, Marta; Ciccarino, Pietro; Lombardi, Giuseppe; Rolma, Giuseppe; Cecchin, Diego; Della Puppa, Alessandro
The role of surgery on central area metastasis remains unclear, and outcome data are still controversial. The aim of our study is to analyze the predictive value of clinical and surgical data on motor and functional outcome of patients, taking into account new emerging data on boundary irregularity of brain metastasis. We retrospectively analyzed 47 consecutive patients who underwent surgery assisted by neurophysiologic monitoring for a solitary metastasis in central area between 2010 and 2013. Inclusion criteria were as follows: good functional status (Karnofsky Performance Status (KPS) ≥70), controlled systemic disease, and absence of extra-cranial dissemination. At 1-month follow up, motor and functional outcomes were compared with preoperative clinical status, response to corticosteroids, extent of tumor resection, boundary irregularity, and size of tumor. Gross total resection was achieved in 93.6% of cases. In preoperative symptomatic patients, motor outcome (according to Medical Research Council grading scale) improved in 55.5% and worsened in 16.7%, while functional outcome (according to KPS score) improved in 50% and worsened in 14.2% of cases. No worsening occurred in preoperative asymptomatic patients. Motor outcome resulted to be not correlated with preoperative deficits, tumor volume, or preoperative response to corticosteroid treatment. Remarkably, motor outcome and extent of surgical resection appeared strongly correlated with tumor boundary irregularity (p < 0.05). Surgery with neurophysiologic monitoring on motor area metastasis can improve functional and motor condition in selected patients. Tumor volume does not represent a limit in surgery. The high correlation between clinical outcome, resection rate, and tumor boundary irregularity strengthens a new belief on the infiltrative growing pattern of brain metastasis. Motor function was evaluated according to Medical Research Council grading scale (Ott et al. 2014) while functional status was
The goal of the Annals of African Surgery is to provide a medium for the exchange of current information between surgeons in the African region. The journal embraces surgery in all its aspects; basic science, clinical research, experimental research, surgical education. It will assist surgeons in the region to keep abreast of ...
Aslakson, Rebecca A; Schuster, Anne L R; Lynch, Thomas J; Weiss, Matthew J; Gregg, Lydia; Miller, Judith; Isenberg, Sarina R; Crossnohere, Norah L; Conca-Cheng, Alison M; Volandes, Angelo E; Smith, Thomas J; Bridges, John F P
Patient-centered outcomes research (PCOR) methods and social learning theory (SLT) require intensive interaction between researchers and stakeholders. Advance care planning (ACP) is valuable before major surgery, but a systematic review found no extant perioperative ACP tools. Consequently, PCOR methods and SLT can inform the development of an ACP educational video for patients and families preparing for major surgery. The objective is to develop and test acceptability of an ACP video storyline. The design is a stakeholder-guided development of the ACP video storyline. Design-thinking methods explored and prioritized stakeholder perspectives. Patients and family members evaluated storyboards containing the proposed storyline. The study was conducted at hospital outpatient surgical clinics, in-person stakeholder summit, and the 2014 Maryland State Fair. Measurements are done through stakeholder engagement and deidentified survey. Stakeholders evaluated and prioritized evidence from an environmental scan. A surgeon, family member, and palliative care physician team iteratively developed a script featuring 12 core themes and worked with a medical graphic designer to translate the script into storyboards. For 10 days, 359 attendees of the 2014 Maryland State Fair evaluated the storyboards and 87% noted that they would be "very comfortable" or "comfortable" seeing the storyboard before major surgery, 89% considered the storyboards "very helpful" or "helpful," and 89% would "definitely recommend" or "recommend" this story to others preparing for major surgery. Through an iterative process utilizing diverse PCOR engagement methods and informed by SLT, storyboards were developed for an ACP video. Field testing revealed the storyline to be highly meaningful for surgery patients and family members.
... has had a previous neck operation (thyroid surgery, parathyroid surgery, spine surgery, carotid artery surgery, etc.) and/or who has had a suspected invasive thyroid cancer should have their vocal cord function evaluated routinely before surgery. This is necessary to ...
This paper summarizes research related to the 2012 record drought in the central United States conducted by members of the NASA Energy and Water cycle Study (NEWS) Working Group. Past drought patterns were analyzed for signal coherency with latest drought and the contribution of long-term trends in the Great Plains low-level jet, an important regional circulation feature of the spring rainy season in the Great Palins. Long-term changes in the seasonal transition from rainy spring into dry summer were also examined. Potential external forcing from radiative processes, soil-air interactions, and ocean teleconnections were assessed as contributors to the intensity of the drought. The atmospheric Rossby wave activity was found to be a potential source of predictability for the onset of drought. A probabilistic model was introduced and evaluated for its performance in predicting drought recovery in the Great Plains.
Stage I-IIIC right colonic cancer treated with complete mesocolic excision and central vascular ligation: quality of surgical specimen and long term oncologic outcome according to the plane of surgery.
Siani, L M; Pulica, C
Complete removal of mesocolon "as an envelope" (complete mesocolic excision, CME) with central vascular ligation and apical node dissection (CVL) in the surgical management of right sided colonic cancer is a novel technique focused on resection of the colon surrounded by its intact primitive dorsal mesentery containing the tumors and all the routes of initial cancerous diffusion; our aim was to evaluate quality of surgical specimens and the relative impact on long-term oncologic outcome when compared to less radical planes of surgery. Data were collected in 159 staged I-IIIC right sided colon cancers operated on with the concept of CME and CVL, between 2008 and 2013. Morbidity and mortality were 37.7% and 1.9% respectively. Overall and disease free survival were 80.5% and 69.8% at five years. Mesocolic, intramesocolic and muscolaris-mucosa planes of resection were achieved in 64.7%, 22.6% and 12.5% of cases, respectively: mesocolic plane of surgery impacted significantly on R0 resection rate (98%), CRMCRMCRM<1 mm of 72.2%, 86.1% and 13.8%, respectively. Stratifying patients for stage of disease, CME with CVL significantly improved survival in stage II, IIIA/B and in a subgroup of IIIC patients, with not metastatically involved apical nodes. CME with CVL follows the oncologic principle based on resection of the primitive embryological mesenterium as an intact envelope, along with central lymphadenectomy up to the apical nodes, translating in higher surgical specimens quality and significant impact on locoregional control and overall survival when compared to less radical planes of surgery.
Full Text Available Research work on the adverse effects of noise on annoyance in adults is well documented in Western Europe, but there is a knowledge gap concerning this type of research in Central and Eastern Europe (CEE, South-East Europe (SEE, and Newly Independent States (NIS. The objective of this review was to present findings and to propose future research directions for the studies on the effects of environmental noise on annoyance in adults conducted in these countries. After systematic search in accessible databases, scientific journals, conference proceedings, international and national reports in English and other languages, the authors identified 29 papers to be included to this review: 24 papers related to annoyance due to road traffic noise and 5 papers related to annoyance from other noise sources. In most of the identified studies, a cross-sectional design prevailed and the evaluations were mainly performed subjectively. The lack of recent annoyance studies related to railway and aircraft traffic noise was identified. Only two studies from NIS countries used noise exposure data for the evaluation of population annoyance according to the European Environmental Noise Directive (END. Capacity building in CEE, SEE, and NIS countries is necessary to acquire the "know-how" on how to implement and use the different scenarios for evaluating population annoyance by environmental noise, depending on the availability and suitability of noise exposure data. Particular attention should be given to the possible use of END noise exposure data, where applicable.
Full Text Available Many reviews have documented the adverse effects of noise on children′s health, but the international scientific community was previously unfamiliar with noise research in Central and Eastern Europe (CEE, South-East Europe (SEE, and Newly Independent States (NIS. The aim of this review was to present studies on the effects of noise on children′s health, conducted in aforementioned countries in the second half of the 20 th century, interpret their findings, and criticize their methodology and results wherever possible. This review focused on 30 papers published in national journals in the period from 1965 to 2000. By design, 22 studies were observational and cross-sectional, and eight studies were experimental. The outcomes under the study included auditory changes, stress reactions, sleep disturbances, school performance, upright posture, and vegetative functions. Researchers from CEE, SEE, and NIS were the pioneers in the assessment of noise-induced changes of vegetative functions and blood pressure of children in urban areas, as well as of infants exposed to noise in incubators. Future research should focus on intervention studies and follow-up of children′s health in relation to noise exposure.
Marina O. Leibman
Full Text Available The research station "Vaskiny Dachi" on the Yamal Peninsula was established in 1988. Activities aimed at monitoring of permafrost and related environmental features under a relatively low level of nature disturbances caused by gas field development. Cryogenic processes that may affect the environment and their structures have been of primary interest. Landslides are the most common cryogenic processes in Central Yamal in general and also in the proximity of the station. Field surveys of numerous landslides, analysis of their dependence on climatic parameters and their fluctuations resulted in novel classification of cryogenic landslides based on mechanisms of their development. Dating by radiocarbon and dendrochronology allows the separation of cycles of landslide activation. Cryogenic landslides control the development of other processes, such as thermal erosion, river channel erosion and thermokarst. It also affects topography, vegetation pattern, geochemistry of vegetation, ground water and soils. As a result, permafrost parameters, specifically active layer depth and ground temperature, moisture and ice content in the active layer, depend indirectly on landsliding. Monitoring within the framework of the main programs of the International Permafrost Association, such as Circumarctic Active Layer Monitoring (CALM, since 1993 and Thermal State of Permafrost (TSP, since 2011, play an important role among the research activities. From the collected data one can conclude that ground temperature increased on average by about 1 °C since the 1990s. At the same time, active layer fluctuations do not exactly follow the air temperature changes. Spatial changes in ground temperature are controlled by the redistribution of snow which is resulting from strong winds characteristic for tundra environments and the highly dissected relief of Central Yamal. Temporal variations rather depend on air temperature fluctuations but the rate differs in various
Full Text Available Countries from South-East Europe (SEE, Central and Eastern Europe (CEE and Newly Independent States (NIS are in the process of harmonization with European environmental noise legislation. However, research work on noise and health was performed in some countries independently of harmonization process of adoption and implementation of legislation for environmental noise. Aim of this review is to summarize available evidence for noise induced sleep disturbance in population of CEE, SEE and NIS countries and to give directions for further research work in this field. After a systematic search through accessible electronic databases, conference proceedings, PhD thesis, national reports and scientific journals in English and non-English language, we decided to include six papers and one PhD thesis in this review: One paper from former Yugoslavia, one paper from Slovakia, one paper from Lithuania, two papers from Serbia and one paper, as also one PhD thesis from The Former Yugoslav Republic of Macedonia. Noise exposure assessment focused on road traffic noise was mainly performed with objective noise measurements, but also with noise mapping in case of Lithuanian study. Sleep disturbance was assessed with the questionnaire based surveys and was assumed from dose-effect relationship between night-time noise indicator (Lnight for road traffic noise and sleep disturbance (for Lithuanian study. Although research evidence on noise and sleep disturbance show to be sufficient for establishing dose response curves for sleep disturbance in countries where studies were performed, further research is needed with particular attention to vulnerable groups, other noise sources, development of laboratory research work and common methodology in assessment of burden of diseases from environmental noise.
Ristovska, Gordana; Lekaviciute, Jurgita
Countries from South-East Europe (SEE), Central and Eastern Europe (CEE) and Newly Independent States (NIS) are in the process of harmonization with European environmental noise legislation. However, research work on noise and health was performed in some countries independently of harmonization process of adoption and implementation of legislation for environmental noise. Aim of this review is to summarize available evidence for noise induced sleep disturbance in population of CEE, SEE and NIS countries and to give directions for further research work in this field. After a systematic search through accessible electronic databases, conference proceedings, PhD thesis, national reports and scientific journals in English and non-English language, we decided to include six papers and one PhD thesis in this review: One paper from former Yugoslavia, one paper from Slovakia, one paper from Lithuania, two papers from Serbia and one paper, as also one PhD thesis from The Former Yugoslav Republic of Macedonia. Noise exposure assessment focused on road traffic noise was mainly performed with objective noise measurements, but also with noise mapping in case of Lithuanian study. Sleep disturbance was assessed with the questionnaire based surveys and was assumed from dose-effect relationship between night-time noise indicator (Lnight ) for road traffic noise and sleep disturbance (for Lithuanian study). Although research evidence on noise and sleep disturbance show to be sufficient for establishing dose response curves for sleep disturbance in countries where studies were performed, further research is needed with particular attention to vulnerable groups, other noise sources, development of laboratory research work and common methodology in assessment of burden of diseases from environmental noise.
Ayah, Richard; Jessani, Nasreen; Mafuta, Eric M
Local health systems research (HSR) provides policymakers and practitioners with contextual, evidence-based solutions to health problems. However, producers and users of HSR rarely understand the complexities of the context within which each operates, leading to the "know-do" gap. Universities are well placed to conduct knowledge translation (KT) integrating research production with uptake. The HEALTH Alliance Africa Hub, a consortium of seven schools of public health (SPHs) in East and Central Africa, was formed to build capacity in HSR. This paper presents information on the capacity of the various SPHs to conduct KT activities. In 2011, each member of the Africa Hub undertook an institutional HSR capacity assessment using a context-adapted and modified self-assessment tool. KT capacity was measured by several indicators including the presence of a KT strategy, an organizational structure to support KT activities, KT skills, and institutional links with stakeholders and media. Respondents rated their opinions on the various indicators using a 5-point Likert scale. Averages across all respondents for each school were calculated. Thereafter, each school held a results validation workshop. A total of 123 respondents from all seven SPHs participated. Only one school had a clear KT strategy; more commonly, research was disseminated at scientific conferences and workshops. While most respondents perceived their SPH as having strong institutional ties with organizations interested in HSR as well as strong institutional leadership, the organizational structures required to support KT activities were absent. Furthermore, individual researchers indicated that they had little time or skills to conduct KT. Additionally, institutional and individual links with policymakers and media were reported as weak. Few SPHs in Africa have a clear KT strategy. Strengthening the weak KT capacity of the SPHs requires working with institutional leadership to develop KT strategies designed
... You are here Home » Disorders » All Disorders Central Cord Syndrome Information Page Central Cord Syndrome Information Page What research is being done? Our understanding of central cord syndrome has increased greatly in recent decades as ...
Scheer, Justin K; Sethi, Rajiv K; Hey, Lloyd A; LaGrone, Michael O; Keefe, Malla; Aryan, Henry E; Errico, Thomas J; Deviren, Vedat; Hart, Robert A; Lafage, Virginie; Schwab, Frank; Daubs, Michael D; Ames, Christopher P
An electronic survey administered to Scoliosis Research Society (SRS) membership. To characterize surgeon practices and views regarding the use of two attending surgeons for adult spinal deformity (ASD) surgery. The use of two experienced attending surgeons can decrease the operative time, estimated blood loss, and perioperative complication rates. However, the current practice patterns for the use of two attending surgeons remains unknown. An electronic, 27-question survey regarding single/dual attending surgeons was administered to the SRS membership. Determinants included: surgeon/practice demographics, assistant type/level of training, and questions regarding use of two attending surgeons. Overall reporting and comparisons between groups were made: US versus international, academic versus private practice, and experience 15 years. A total of 199 surgeons responded from 27 different countries. Overall and between the groups, the respondents significantly reported believing that two attending spine surgeons improves safety, decreases complications, and improves outcomes (P < 0.01). Approximately, 67.3% reported using a second attending ≤25% of the time (33.2% do not), and 24.1% use one ≥51% of the time (similar between groups); 51.1% that have a second attending feel it's limited by reimbursement and access concerns and 71.9% have difficulty getting the second attending reimbursed. 72.3% use a second attending for ALL of the following reasons (no difference between groups): "it's safer/reduces complications," "it decreases operative time," "it decreases blood loss," "it results in improved outcomes," "it's less work and stress for me." If reimbursement was equal/assured for a second attending, 67.5% would use one "more often" or "always." The respondents feel that having a second attending surgeon improves patient care, however most do not use one often. Reasons include reimbursement/access concerns and the majority would use one if reimbursement was
... Heel Spur Surgery: Based on the condition and the nature of the disease, heel surgery can provide relief of pain ... Prior to surgery, the podiatrist will review your medical history and medical conditions. Specific diseases, illnesses, allergies, ...
... Foot Health Awareness Month Diabetes Awareness When is Foot Surgery Necessary? Many foot problems do not respond ... restore the function of your foot. Types of Foot Surgery Bunion Surgery: There are many different types ...
Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... computer station and directs the movements of a robot. Small surgical tools are attached to the robot's ...
... Staying Safe Videos for Educators Search English Español Plastic Surgery KidsHealth / For Teens / Plastic Surgery What's in ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...
Anderson, Cynthia D; Goe, W. Richard; Weng, Chih-Yuan
Spatial statistics, econometric modeling, and other quantitative research methods provide the dominant approach to conducting research in regional science. This paper contends that a deeper understanding of many regional development processes can be gained by employing mixed method research designs that combine quantitative research methods with qualitative methods. This is illustrated through an analysis of change in the working poor in the North Central region of the U.S. during the post-19...
Lunsford, M. Leigh; Rowell, Ginger Holmes; Goodson-Espy, Tracy
We applied a classroom research model to investigate student understanding of sampling distributions of sample means and the Central Limit Theorem in post-calculus introductory probability and statistics courses. Using a quantitative assessment tool developed by previous researchers and a qualitative assessment tool developed by the authors, we…
... CM Jr, et al. Emerging technology in surgery: Informatics, robotics, electronics. In: Sabiston Textbook of Surgery: The ... Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2018 Mayo Foundation for ...
Laparoscopic Surgery has been rightly described as the "dawn of a new era" in surgery. It has come to stay and has altered permanently the practice and teaching of surgery as we used to know it. It is not about. "new gadgets" but a new way of practicing an old art surgery. ~ The surgical world has moved on and.
http://creativecommons.org/licenses/by-nc-nd/4.0. The bariatric surgery patient for non-bariatric surgery. B Dayaa*. aSpecialist Anaesthesiologist, Inkosi Albert Luthuli Central Hospital, Durban. *Corresponding author: Bhavika Daya, e-mail: firstname.lastname@example.org. Table II: Co-morbidities frequently found in obese patients.
The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...
The Flat-Plate Solar Array Project, managed by the Jet Propulsion Laboratory for the US Department of Energy, has focused on advancing technologies relevant to the design and construction of megawatt-level central-station systems. Photovoltaic modules and arrays for flat-plate central-station or other large-scale electric power production facilities require the establishment of a technical base that resolves design issues and results in practical and cost-effective configurations. The Central Station Research Forum addressed design, qualification and maintenance issues related to central-station arrays derived from the engineering and operating experiences of early applications and parallel laboratory research activities. Technical issues were examined from the viewpoint of the utility engineer, architect-engineer and laboratory researcher. The forum included presentations on optimum source-circuit designs, module insulation design for high system voltages, array safety, structural interface design, measurements and array operation and maintenance. The Research Forum focused on current capabilities as well as design difficulties requiring additional technological thrusts and/or continued research emphasis. Session topic summaries highlighting major points during group discussions, identifying promising technical approaches or areas of future research, are presented.
The Use of the Ratio between the Veno-arterial Carbon Dioxide Difference and the Arterial-venous Oxygen Difference to Guide Resuscitation in Cardiac Surgery Patients with Hyperlactatemia and Normal Central Venous Oxygen Saturation
Full Text Available Background: After cardiac surgery, central venous oxygen saturation (ScvO 2 and serum lactate concentration are often used to guide resuscitation; however, neither are completely reliable indicators of global tissue hypoxia. This observational study aimed to establish whether the ratio between the veno-arterial carbon dioxide and the arterial-venous oxygen differences (P(v−aCO 2 /C(a−vO 2 could predict whether patients would respond to resuscitation by increasing oxygen delivery (DO 2 . Methods: We selected 72 patients from a cohort of 290 who had undergone cardiac surgery in our institution between January 2012 and August 2014. The selected patients were managed postoperatively on the Intensive Care Unit, had a normal ScvO 2 , elevated serum lactate concentration, and responded to resuscitation by increasing DO 2 by >10%. As a consequence, 48 patients responded with an increase in oxygen consumption (VO 2 while VO 2 was static or fell in 24. Results: At baseline and before resuscitative intervention in postoperative cardiac surgery patients, a P(v−aCO 2 /C(a−vO 2 ratio ≥1.6 mmHg/ml predicted a positive VO 2 response to an increase in DO 2 of >10% with a sensitivity of 68.8% and a specificity of 87.5%. Conclusions: P(v−aCO 2 /C(a−vO 2 ratio appears to be a reliable marker of global anaerobic metabolism and predicts response to DO 2 challenge. Thus, patients likely to benefit from resuscitation can be identified promptly, the P(v−aCO 2 /C(a−vO 2 ratio may, therefore, be a useful resuscitation target.
Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...
... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ...
Berlev, I V; Nekrasova, E A; Urmancheeva, A F; Ulrikh, E A; Mikaya, N A; Guseinov, K D; Saparov, A B; Trifanov, Yu N; Sidoruk, A A
For the period from September 2010 to September 2014 there were operated 513 patients with endometrial cancer using laparoscopic installation the Karl Storz company. 304 patients (59.2%) underwent hysterectomy with appendages, 209 (40.8%)--hysterectomy with appendages and pelvic lymphadenectomy, including 11 patients (2.2%) with the addition of omentectomy in serous and serous-papillary forms of endometrial cancer. The average age of patients was 58.4 years (44-75 years). Body mass index over 25.0 was determined in 456 patients (88.9%), of whom 183 patients (35.6%) had an excess of body weight, in 159 (31.0%)--obesity of I degree, in 79 (15.5%)--obesity of II degree and in 35 patients (6.8%)--obesity of III degree. There were no reported complications during surgery. The postoperative period in the majority of patients was characterized by the minimal complications and absence of contraindications for adjuvant radiotherapy. During follow-up period there were registered 4 relapses: in 1 patient with serous--papillary form of endometrial cancer during the first year after surgery--in the form of dissemination of tumor in the abdomen and pelvis; in 3 patients--in the form of a cytological detection of glandular cancer cells in vaginal stump. As a result, regardless of age and comorbidities, laparoscopy allows performing to endometrial cancer patients the entire volume of planned radical surgery with minimum damage and with minimal risk of intra- and postoperative complications, favorable and accelerated rehabilitation period.
Ben-Peshat, Malka; Sitton, Shoshana
We present here the findings of an ethno-visual research study involving the creation of a mental map of images, artifacts and practices in Tel Aviv's New Central Bus Station. This huge and complex building, part bus station, part shopping mall, has become a stage for multicultural encounters and interactions among diverse communities of users.…
... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...
... anesthesia with sedation, so you are asleep and pain-free during surgery. Turbinoplasty: A tool is placed in ... anesthesia with sedation, so you are asleep and pain-free during surgery. Radiofrequency or laser ablation: A thin ...
... cavity, particularly after trauma Surgery to remove small balloon-like tissues (blebs) that cause lung collapse ( pneumothorax ) ... this surgery include: Failure of the lung to expand Injury to the lungs or blood vessels Need ...
Tomassini, Giuseppe; Bernasconi, Elisa; Giudice, Giuseppe
This paper describes the anaesthesiological course of patients cared by an independent multi skills Day Surgery Unit during four years activity from 2004 to 2007. This method of caring surgical patients, continuously expanding, calls for regular audits where the anaesthetist plays a major role in selecting patients, in choosing and applying the most suitable anaesthesia technique, in managing any postoperative complications, and discharging the patient. All this contributes to minimising the patient's discomfort, to a quick recovery, and to minimise all inconvenience that may invalidate the service provided. Our experience includes 13,014 surgical procedures performed by seven specialised Operative Units. The analysis of our case records shows we have established an adequate organisation model and achieved a high quality standard of care in connection with high volumes of activity.
ofSurgery,. University College Hospital, Ibadan, Nigeria. SUMMARY. Laparoscopic Surgery has been rightly described as the "dawn of a new era" in surgery. It has come to stay and ... gases (CO2 and N20) require special devices for delivery to regulate ... wound, not to talk of the cosmetics that also makes the technique ...
... Donât rely on surgery to change your life in a huge way. Make sure any doctor you consider is qualified for the surgery youâre considering and is certified by the American Board of Plastic Surgery. Some doctors wonât ...
provide correct nipple areolar complex position and shape. PLASTIC SURGERY. T Jay, K Segwapa. Department of Plastic and Reconstructive Surgery Sefako Makgatho Health Science University, Pretoria South-Africa. Corresponding author: T Jay (email@example.com). Background: In surgery for gynaecomastia, excision ...
Zatloukal, Jan; Pradl, Richard; Kletecka, Jakub; Skalicky, Tomas; Liska, Vaclav; Benes, Jan
BACKGROUNDː Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODSː Patients undergoing resections of two or more liver segments were equally randomized to absolute fluid restriction (AR, N.=17) or relative volume redistribution group (RR, N.=17). The ease of reaching low CVP, blood loss, morbidity and mortality were assessed. Besides, the effect of Pringle maneuver and utility of stroke volume variation (SVV) were analyzed. RESULTSː Both methods of CVP reduction were equally effective (0.7±0.9 vs. 0.9±1.0 protocolized steps in the AR and RR group; P=0.356) and safe (no difference in observed blood loss, intraoperative hemodynamic parameters, lactate levels, morbidity and mortality). Patients in the AR group received smaller amount of fluids in the pre-resection period (120 (100-150) vs. 600 (500-700) mL; P10% with 81.4% sensitivity and 77.1% specificity. Reduced blood loss and transfusion rate was observed when Pringle maneuver was used. CONCLUSIONSː In our study, absolute fluid restriction and relative volume redistribution seemed to be equally effective and safe methods of lowering CVP in patients undergoing liver resection. According to our data high SVV might be considered as a low CVP replacement. Pringle maneuver reduced blood loss and transfusion requirement.
Elharram, Malik; Dinh, Trish; Lalande, Annie; Ge, Susan; Gao, Sophie; Noël, Geoffroy
As health care delivery increasingly requires providers to cross international borders, medical students at McGill University, Canada, developed a multidirectional exchange program with Haiti and Rwanda. The program integrates surgery, pathology, anatomy, research methodology, and medical education. The aim of the present study was to explore the global health value of this international training program to improve medical education within the environment of developing countries, such as Haiti and Rwanda, while improving sociocultural learning of Canadian students. Students from the University of Kigali, Rwanda and Université Quisqueya, Haiti, participated in a 3-week program at McGill University. The students spanned from the first to sixth year of their respective medical training. The program consisted of anatomy dissections, surgical simulations, clinical pathology shadowing, and interactive sessions in research methodology and medical education. To evaluate the program, a survey was administered to students using a mixed methodology approach. Common benefits pointed out by the participants included personal and professional growth. The exchange improved career development, sense of responsibility toward one's own community, teaching skills, and sociocultural awareness. The participants all agreed that the anatomy dissections improved their knowledge of anatomy and would make them more comfortable teaching the material when the returned to their university. The clinical simulation activities and shadowing experiences allowed them to integrate the different disciplines. However, the students all felt the research component had too little time devoted to it and that the knowledge presented was beyond their educational level. The development of an integrated international program in surgery, pathology, anatomy, research methodology, and medical education provided medical students with an opportunity to learn about differences in health care and medical education
Yen, Yung-Chieh; Huang, Chih-Kuan; Tai, Chi-Ming
Purpose of review Bariatric surgery has been consistently shown to be effective in long-term marked weight loss and in bringing significant improvement to medical comorbidities such as metabolic syndrome. Empirical data suggest a high prevalence of psychiatric disorders among bariatric surgery candidates. In this review, we focus on the studies published recently with a high impact on our understanding of the role of psychiatry in bariatric surgery. Recent findings This article reviews the specific psychopathologies before surgery, changes in psychopathologies after surgery, suicide risk related to bariatric surgery, factors associated with weight loss, and recommendations for presurgical and postsurgical assessment and management. Research indicates a decrease in certain psychiatric symptoms after weight loss with bariatric surgery. However, the risk of suicide and unsuccessful weight loss in some bariatric surgery patients make monitoring following surgery as important as careful assessment and management before surgery. Specific considerations for youth and older populations and future potential research foci are discussed. Summary Recent publications suggest new directions for psychiatric evaluation and interventions for bariatric surgery patients. Future research on outcomes of specific populations, effectiveness of psychopharmacotherapy, and underlying pathophysiology are warranted for the advancement of treating bariatric surgery patients. PMID:25036421
Yamada, Satoshi; Oki, Koichi; Itoh, Yoshiaki; Kuroda, Satoshi; Houkin, Kiyohiro; Tominaga, Teiji; Miyamoto, Susumu; Hashimoto, Nobuo; Suzuki, Norihiro
Despite the common practice of surgery and antiplatelet therapy for the prevention of recurrent stroke in patients with moyamoya disease, the benefit of these treatments is controversial. We analyzed the stroke recurrence rate in the Registry Study of Research Committee on Moyamoya Disease in Japan funded by the Health, Labor and Welfare Ministry of Japan. An annual follow-up study of the registered cases was continued for 10 years. The rate of recurrent stroke, including cerebral infarction and hemorrhage but not transient ischemic attack and seizure, was evaluated with Kaplan-Meier analysis. The proportion of childhood-onset cases decreased in recently registered cases (within 10 years, n = 541) compared to remote cases (> 10 years, n = 735). Among types at disease onset in adult-onset cases, intracerebral hemorrhage decreased recently. In recent cases, the rate of subsequent cerebral hemorrhage was much higher in the hemorrhagic group (10.9 ± 3.3%/5 years) than in the ischemic group (2.0 ± .9%/5 years). The recurrence rate of cerebral infarction was lower in the surgery group (1.8 ± .9%/5 years) than in the nonsurgery group (3.8 ± 2.2%/5 years). In the adult-onset ischemic group, the proportion of surgically treated patients increased and their recurrence rate was lower than that of nonsurgery patients. In the ischemic group, the rate of cerebral infarction was not significantly different between the antiplatelet subgroup and the non-antiplatelet subgroup, whereas the rate of cerebral hemorrhage was higher in the non-antiplatelet subgroup than in the antiplatelet subgroup. Our results suggest revascularization surgery may suppress recurrent ischemic attacks in patients with moyamoya disease. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Bougatf, Nina; Bendl, Rolf; Debus, Jürgen
Our overall objective is the utilization of heterogeneous and distributed radio-oncological data in retrospective clinical trials. Previously, we have successfully introduced a central research database for collection of heterogeneous data from distributed systems. The next step is the integration of image analysis tools in the standard retrieval process. Hence, analyses for complex medical questions can be processed automatically and facilitated immensely. In radiation oncology recurrence analysis is a central approach for the evaluation of therapeutic concepts. However, various analysis steps have to be performed like image registration, dose transformation and dose statistics. In this paper we show the integration of image analysis tools in the standard retrieval process by connecting them with our central research database using a service-oriented approach. A concrete problem from recurrence analysis has been selected to prove our concept exemplarily. We implemented service-oriented data collection and analysis tools to use them in a central analysis platform, which is based on a work flow management system. An analysis work flow has been designed that, at first, identifies patients in the research database fulfilling the inclusion criteria. Then the relevant imaging data is collected. Finally the imaging data is analyzed automatically. After the successful work flow execution, the results are available for further evaluation by a physician. As a result, the central research database has been connected successfully with automatic data collection and image analysis tools and the feasibility of our service-oriented approach has been demonstrated. In conclusion, our approach will simplify retrospective clinical trials in our department in future.
The Flat Plate Solar Array Project, focuses on advancing technologies relevant to the design and construction of megawatt level central station systems. Photovoltaic modules and arrays for flat plate central station or other large scale electric power production facilities require the establishment of a technical base that resolves design issues and results in practical and cost effective configurations. Design, qualification and maintenance issues related to central station arrays derived from the engineering and operating experiences of early applications and parallel laboratory reserch activities are investigated. Technical issues are examined from the viewpoint of the utility engineer, architect/engineer and laboratory researcher. Topics on optimum source circuit designs, module insulation design for high system voltages, array safety, structural interface design, measurements, and array operation and maintenance are discussed.
Giri, Purushottam A; Bangal, Vidyadhar B; Phalke, Deepak B
Health research training is an essential component of medical education and a vital exercise to help develop physician research skills. This study was carried out to assess the knowledge, attitude, and practices towards health research amongst the postgraduate students of Pravara Institute of Medical Sciences University of central India. A cross-sectional study was carried out from August to October 2012. A total of 116 postgraduate students were interviewed. Knowledge, attitude, and practices related to health research were assessed using a predesigned, pretested and validated questionnaire. Results were analyzed in the form of percentage and proportions whenever appropriate. In present study, the concept of research hypothesis was known to only 18.9% of the postgraduate students, whereas 17.2 and 21.5% students knew the full form of MEDLARS and MEDLINE respectively. Majority (91.4%) students believed that patient outcome improves with continued medical research and 70.7% are willing to participate in workshop for research methodology. Lack of time due to vast curriculum of postgraduate subjects (59.5%), lack of research curriculum (25%), and inadequate facilities (25.8%) were stated as major obstacles for pursuing research. Postgraduate students have inadequate knowledge, but have positive attitudes towards health research. Postgraduate training and research facilities at the institution need to undergo major transformation in order to encourage meaningful research by postgraduate trainees.
Effect of intraoperative transesophageal Doppler-guided fluid therapy versus central venous pressure-guided fluid therapy on renal allograft outcome in patients undergoing living donor renal transplant surgery: a comparative study.
Srivastava, Divya; Sahu, Sandeep; Chandra, Abhilash; Tiwari, Tanmay; Kumar, Sanjay; Singh, P K
Transesophageal Doppler (TED)-guided intraoperative fluid therapy has shown to noninvasively optimize intravascular volume and reduce postoperative morbidity. The aim of this study was to compare the effects of Doppler-guided intraoperative fluid administration and central venous pressure (CVP)-guided fluid therapy on renal allograft outcome and postoperative complications. A prospective nonrandomized active controlled study was conducted on end-stage renal disease patients scheduled for living donor renal transplant surgery. 110 patients received intraoperative fluid guided by corrected flow time (FTc) and variation in stroke volume values obtained by continuous TED monitoring. Data of 104 patients in whom intraoperative fluid administration was guided by CVP values were retrospectively obtained for a control. The amount of intraoperative fluid given in the study group (12.20 ± 4.24 ml/kg/h) was significantly lower than in the controls (22.21 ± 4.67 ml/kg/h). The amount of colloid used was also significantly less and fewer recipients were seen to require colloid (69 vs 85%). The mean arterial pressures were comparable throughout. CVP reached was 7.18 ± 3.17 mmHg in the study group. It was significantly higher in the controls (13.42 ± 3.12 mmHg). The postoperative graft function and rate of dysfunction were comparable. Side-effects like postoperative dyspnoea (4.8 vs 0%) and tissue edema (9.6 vs 2.7%) were higher in the controls. FTc-guided intraoperative fluid therapy achieved the same rate of immediate graft function as CVP-guided fluid therapy but used a significantly less amount of fluid. The incidence of postoperative complications related to fluid overload was also reduced. The use of TED may replace invasive central line insertions in the future.
Wex, T; Kuester, D; Meyer, F
Experimental medicine has evolved tremendously in the last few years. In particular, the introduction of novel techniques, in-vitro models, knock-out/transgenic animals and high-through put analytical methodologies have resulted in a deeper understanding of cellular pathophysiology and diseases. The daily clinical management has benefited by the introduction of biomarkers and targeted therapies. This development has been accompanied by increasing specialisation across all fields of research and medicine. Therefore, clinical-translational research requires a team of competent partners nowadays. The visceral surgeon can contribute significantly to these projects. The present review highlights several aspects of translational research and put chances and potential pitfalls into perspective in context with the work of the visceral surgeon. Georg Thieme Verlag KG Stuttgart · New York.
Türkoğlu, Emir Alper, E-mail: firstname.lastname@example.org [Ağrı İbrahim Çeçen University, Faculty of Pharmacy, Department of Pharmaceutical Technology, Ağrı (Turkey); Ağrı İbrahim Çeçen University, Central Research and Application Laboratory, Ağrı (Turkey); Kurt, Murat, E-mail: email@example.com; Tabay, Dilruba, E-mail: firstname.lastname@example.org [Ağrı İbrahim Çeçen University, Central Research and Application Laboratory, Ağrı (Turkey)
Ağrı İbrahim Çeçen University built a central research and application laboratory (CRAL) in the east of Turkey. The CRAL possesses 7 research and analysis laboratories, 12 experts and researchers, 8 standard rooms for guest researchers, a restaurant, a conference hall, a meeting room, a prey room and a computer laboratory. The CRAL aims certain collaborations between researchers, experts, clinicians and educators in the areas of biotechnology, bioimagining, food safety & quality, omic sciences such as genomics, proteomics and metallomics. It also intends to develop sustainable solutions in agriculture and animal husbandry, promote public health quality, collect scientific knowledge and keep it for future generations, contribute scientific awareness of all stratums of society, provide consulting for small initiatives and industries. It has been collaborated several scientific foundations since 2011.
Türkoǧlu, Emir Alper; Kurt, Murat; Tabay, Dilruba
Aǧrı İbrahim Çeçen University built a central research and application laboratory (CRAL) in the east of Turkey. The CRAL possesses 7 research and analysis laboratories, 12 experts and researchers, 8 standard rooms for guest researchers, a restaurant, a conference hall, a meeting room, a prey room and a computer laboratory. The CRAL aims certain collaborations between researchers, experts, clinicians and educators in the areas of biotechnology, bioimagining, food safety & quality, omic sciences such as genomics, proteomics and metallomics. It also intends to develop sustainable solutions in agriculture and animal husbandry, promote public health quality, collect scientific knowledge and keep it for future generations, contribute scientific awareness of all stratums of society, provide consulting for small initiatives and industries. It has been collaborated several scientific foundations since 2011.
Yin, Yong; Chen, Jinhu; Sun, Tao; Ma, Changsheng; Lu, Jie; Liu, Tonghai; Wang, Ruozheng
Intensity-modulated radiotherapy (IMRT) has played an important role in breast cancer radiotherapy after breast-preservation surgery. Our aim was to study the dosimetric and implementation features/feasibility between IMRT and intensity-modulated arc radiotherapy (Varian RapidArc, Varian, Palo Alto, CA). The forward IMRT plan (f-IMRT), the inverse IMRT, and the RapidArc plan (RA) were generated for 10 patients. Afterward, we compared the target dose distribution of the 3 plans, radiation dose on organs at risk, monitor units, and treatment time. All 3 plans met clinical requirements, with RA performing best in target conformity. In target homogeneity, there was no statistical significance between RA and IMRT, but both of homogeneity were less than f-IMRT's. With regard to the V(5) and V(10) of the left lung, those in RA were higher than in f-IMRT but were lower than in IMRT; for V(20) and V(30), the lowest was observed in RA; and in the V(5) and V(10) of the right lung, as well as the mean dose in normal-side breast and right lung, there was no statistically significance difference between RA and IMRT, and the lowest value was observed in f-IMRT. As for the maximum dose in the normal-side breast, the lowest value was observed in RA. Regarding monitor units (MUs), those in RA were higher than in f-IMRT but were lower than in IMRT. Treatment time of RA was 84.6% and 88.23% shorter than f-IMRT and IMRT, respectively, on average. Compared with f-IMRT and IMRT, RA performed better in target conformity and can reduce high-dose volume in the heart and left lung-which are related to complications-significantly shortening treatment time as well. Compared with IMRT, RA can also significantly reduce low-dose volume and MUs of the afflicted lung. Copyright © 2012 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
A.L.A. Kerver (Anton)
markdownabstractThis thesis presents a novel anatomy mapping tool named Computer Assisted Surgical Anatomy Mapping (CASAM). It allows researchers to map complex anatomy of multiple specimens and compare their location and course. Renditions such as safe zones or danger zones can be visualized,
Adomßent, Maik; Fischer, Daniel; Godemann, Jasmin; Otte, Insa; Rieckmann, Marco; Timm, Jana-Michaela; Herzig, Christian
Management education for sustainable development, sustainable consumption in higher education institutions, and higher education for sustainable development in Central and Eastern Europe can be considered as three highly relevant emerging areas in research on higher education for sustainable development. The transformation of management education to meet the increasing societal demands for responsible business has been reinforced in the light of the current economic situation. In this context...
Nájera Morrondo, Rafael
The "Instituto de Salud Carlos III" is the Central Public Health Laboratory in Spain with an important component of scientific research in health related areas, such as cancer, cardiovascular diseases, infectious diseases and environmental health. The article describes the development of the Public Health Institutes. arising from the introduction and development of scientific and laboratory based medicine and the introduction of vaccination and sanitation with the control of water and food. At about the same time, the discoveries in microbiology and immunology were produced, being the research activities incardinated with the practical advances in the control of products. To cope with the practical needs, Institutions were created with the responsibility of providing smallpox vaccine but incorporating very soon production of sera and other vaccines and water and sanitation control and foods control. At the same time. colonization of countries specially in Africa, South East Asia and explorations in Central America confront the Europeans with new diseases and the need of laboratories where to study them. These circumstances gave rise to the birth of the Central Public Health Laboratories and the National institutes of Health at the beginning of the XX century in many countries. In Spain, the Spanish Civil War was a breaking point in the development of such an institution that finally was reinvented with the creation of the Instituto de Salud Carlos III, in 1986, incorporating research and epidemiological surveillance and control of diseases and also the responsibilities of the Food and Drug Control, lately separated from it.
Full Text Available With the proposal to search for universal cooperation in the field of Medicinal Chemistry, the IUPAC group has elaborated a line of work divided into two phases: a- An Awareness of the true situation of Medicinal Chemistry in the different geographic areas of the world; b- A proposal of actions as to achieve more effective cooperation. This first report presents and discusses the actual situation in South and Central America as well as in sub-Saharan Africa.
McGoldrick, D M; Majeed, M; Achakzai, A A; Redmond, H P
Inadvertent parathyroidectomy is a recognised complication of thyroid surgery. We aimed to investigate the incidence of and risk factors for inadvertent parathyroidectomy during thyroid surgery, in our patient cohort. A retrospective review of the records of all patients undergoing thyroid surgery in our institution between January 2012 and December 2014 was performed. Medical records, laboratory investigations and histopathology reports were evaluated. Patient demographics, indication for surgery, surgery performed, final pathology, incidental parathyroidectomy and post-operative hypocalcaemia were recorded. Univariate analysis using the Fisher's exact test was performed. Two hundred and thirty procedures were included: 147 hemi-thyroidectomies and 83 total thyroidectomies. Central neck dissection was also performed in 13 cases. The most common indication for surgery was indeterminate cytology (81 cases). Post-operatively, malignant disease was reported in 52 cases (22.6%). Inadvertent parathyroidectomy occurred in 40 cases (17.3%). There was a statistically significant increased risk of inadvertent parathyroidectomy with malignant disease (p = 0.001) and after central neck dissection (p = 0.013) but no difference was seen between hemi- and total thyroidectomies (p = 0.47), gender (p = 1.00) or with increasing age (p = 1.00). Hypocalcaemia occurred in four cases and was transient in three. Inadvertent parathyroidectomy is a potential risk during thyroid surgery but post-operative hypocalcaemia as a result is rare. Malignancy and more extensive surgery appear to carry an increased risk for this complication.
Full Text Available ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ...
The Nigerian Journal of Surgery publishes original articles, special articles (by invitation), reviews, case reports, correspondences and notes. Materials cited for publication will include scientific research papers read at the meetings of the Nigerian Surgical Research Society, and of the Association of Surgeons of Nigeria and ...
... for Educators Search English Español Weight Loss Surgery (Bariatric Surgery) KidsHealth / For Parents / Weight Loss Surgery (Bariatric Surgery) ... or bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...
Koen C. Mertens
Full Text Available Ample research is conducted on ICT, automation and robotics in agriculture and related environmental issues. ICT and Robotics innovations are rapidly emerging and have the ability to revolutionize future farming through their major impacts on productivity and profitability. Unfortunately human and financial resources and efforts are fragmented and limited. This led to the creation of the ICT-AGRI ERA-NET that provides a central structured framework. Its main objective is to strengthen and coordinate European research regarding ICT and robotics in agriculture. Besides the creation of the Meta Knowledge Base (MKB, a common European research agenda will be developed and common research calls are launched. The Meta Knowledge Base (http://db-ictagri.eu is attempting to map all relevant research and development within the selected research area. To accomplish the mapping, two types of information are collected: research profiles and research postings. To organize the postings, a three-dimensional task-technology oriented framework was designed. The results indicated that the three axes: task, technology and scope seemed insufficient to describe the whole research area. Therefore, an improved framework was developed. By extending the task-technology oriented framework with a process-control–information system, a useful framework was designed.
. 2012 ... This study reviewed health facility maternal mortality trends, causes and distribution in Central Region of Kenya, 2008-2012. Methods: We ..... Central Bureau of statistics (Kenya), Ministry of Health (Kenya), and ORC ...
BI-annual report of Central Laboratory for Radiological Protection, Warsaw, shows its activities in 1994-1995. The general information and organization of CLOR have been performed in the opening part of the report. The second part contains extended abstracts of scientific activities especially in: environmental radioactivity monitoring, supervision and control of the users of radioactive sources, dosimetry problems, calibration and standardization of dosimetric equipment, radiobiology and radiological hazard assessment. The report also includes the full list of publications of CLOR scientific staff issued in the period of 1994-1995.
Wisniewska, Lidia M; Dohan Ehrenfest, David M; Galindo-Moreno, Pablo; Segovia, Jesus D; Inchingolo, Francesco; Wang, Hom-Lay; Fernandes-Cruz, Manuel
In dentistry and oral and maxillofacial surgery, the development of implantable biomaterials and the understanding of their molecular, cellular and pharmaceutical aspects are currently major fields of research and education, with a considerable impact on the daily clinical practice and the evolution of therapeutic strategies. In the era of globalized economy of knowledge and science, this scientific domain needs the development of global cooperation and a paradigm evolution in the organizational culture of the dental sciences and related dental industry. Despite political pressure and theoretical efforts, the internationalization of higher education and research today in dentistry and biomaterials remains in general quite superficial and mostly dependent on the efforts of a few leaders of internationalization working through their personal networks, as it was assessed through the FAST scores (Fast Assessment Screening Test) calculated in various dental schools and groups worldwide through the ISAIAS program (Intercultural Sensitivity Academic Index &Advanced Standards). Cooperation in a multipolar multicultural community requires the development of strong intercultural competences, and this process remains limited in most institutions. These limits of international scientific cooperation can be observed through different markers, particularly the difficult and limited production of ISO standards (International Organization for Standardization) and the relatively low SCIENTI scores (Scientific Cooperation Internationalization Effort &Network Test &Index) of the specialized dental literature, particularly in comparison to the most significant medical literature. However, as an analytical tool to assess the scientific international cooperation effort between fields and periods, the SCIENTI screening system also highlighted a significant increase of the internationalization effort in the last years in the best dental biomaterials publications. Finally, an
Weaver, Allison; Steele, Scott
Over the past few decades, robotic surgery has developed from a futuristic dream to a real, widely used technology. Today, robotic platforms are used for a range of procedures and have added a new facet to the development and implementation of minimally invasive surgeries. The potential advantages are enormous, but the current progress is impeded by high costs and limited technology. However, recent advances in haptic feedback systems and single-port surgical techniques demonstrate a clear role for robotics and are likely to improve surgical outcomes. Although robotic surgeries have become the gold standard for a number of procedures, the research in colorectal surgery is not definitive and more work needs to be done to prove its safety and efficacy to both surgeons and patients. PMID:27746895
Of the three most dreaded disease in the United States, heart disease, cancer and stroke, cancer is the most feared. According to public opinion polls, Americans fear cancer more than war. For over a hundred years scientists have probed for the cause of cancer in the hope of defeating this disease or at least improving the ...
level mathematics course in algebra, calculus and coordinate geometry (to support the physics) as well as an interesting course on comparative religions from the .... only a rudimentary understanding, have given in- valuable advice. The improved quality of the jour- nal is due to the constructive criticism of the re- viewers.
been won against smallpox, poliomyelitis, whooping cough, diphtheria and measles. These no longer reach epidemic proportions in Africa as they did 30 years ago. But against a background of over- population, war and malnutrition, malaria and the diarrhoea1 diseases take an increasing toll of African children. In the cities ...
Training for what by the year 2000? Earlier this month a medical politician announced that his country's health reforms programme was moving towards the goal of the Alma Ata declaration of "Health for all by the year 2000". On that same clay the Teaching Hospital had no antibiotics or ferrous sulphate in the pharmacy and ...
Nakagawara, Van B; Wood, Kathryn J; Montgomery, Ron W
...., myopia, hyperopia, astigmatism) with corrective surgery. Prior Federal Aviation Administration research studies have shown that the number of civil airmen with refractive surgery continues to increase...
Full Text Available Research aimed at contributing to the further development of integrated water resources management needs to tackle complex challenges at the interface of nature and society. A case study in the Cuvelai-Etosha Basin in Namibia has shown how semi-arid conditions coinciding with high population density and urbanisation present a risk to people’s livelihoods and ecosystem health. In order to increase water security and promote sustainable water management, there is a requirement for problem-oriented research approaches combined with a new way of thinking about water in order to generate evidence-based, adapted solutions. Transdisciplinary research in particular addresses this issue by focusing on the problems that arise when society interacts with nature. This article presents the implementation of a transdisciplinary research approach in the above-mentioned case study. The concept of social-ecological systems (SES plays a key role in operationalising the transdisciplinary research process. Application of the SES concept helps to outline the problem by defining the epistemic object, as well as structure the research process itself in terms of formulating research questions and developing the research design. It is argued here that the SES concept is not merely useful, but also necessary for guiding transdisciplinary sustainability research and implementation. The study from Namibia clearly demonstrates that the introduction of technological innovations such as rainwater and floodwater harvesting plants requires a social-ecological perspective. In particular this means considering questions around knowledge, practices and institutions related to water resources management and includes various societal innovations alongside technologies on the agenda.
Roberson, Donna W; Neil, Janice A; Pories, Mary Lisa; Rose, Mary Ann
Despite the fact that bariatric surgery is the most effective intervention for morbid obesity, only a fraction of obese patients, even after undergoing evaluation for surgery, decide to undergo the surgery. Opting out by patients is fairly common yet little is known about factors that lead a patient to decide to undergo surgery. The purpose of this qualitative study was to identify factors that "tipped the scales" in the patient's experience leading to a decision to move ahead with surgery. The study was carried out in the bariatric surgical clinic of a southeastern regional medical center. This qualitative descriptive study utilized semistructured interviews with patients (n = 24) at the time of their "decision visit" to determine the factors related to their positive decision to move forward. A modification of Colaizzi's procedural steps of analysis was used to extract, organize, and analyze data for central themes. Two main factors leading participants to decide to move ahead with bariatric surgery were their own worsening health issues and low energy levels that limited their activities. Participants also noted additional factors that impacted their "tipping point" such as financial considerations and family influences. The decision to move ahead with bariatric surgery is influenced by many factors to which this research provides additional insight. Further research is warranted to fully understand this phenomenon and develop appropriate outreach and educational approaches. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Full Text Available Two species of spurdog of the genus Squalus occur in the Gulf of Gabès (southern Tunisia, central Mediterranean: the longnose spurdog Squalus blainvillei (Risso, 1827 and a short-snout spurdog of the Squalus megalops-cubensis group. Morphometric and meristic data as well as a genetic analyses (DNA inter-simple sequence repeat markers and molecular barcoding methods support the assignation of this short-snout spurdog to Squalus megalops (Macleay, 1881. Squalus megalops occurs commonly in temperate and tropical Australian waters, and is also thought to occur in the eastern Atlantic, southern Indian Ocean and western North Pacific although these records need to be confirmed. Our study confirms that it occurs in the Mediterranean Sea. Populations of both S. blainvillei and S. megalops are described based on Tunisian material.
Shaffrey, Ellen; Smith, Justin S; Lenke, Lawrence G; Polly, David W; Chen, Ching-Jen; Coe, Jeffrey D; Broadstone, Paul A; Glassman, Steven D; Vaccaro, Alexander R; Ames, Christopher P; Shaffrey, Christopher I
Retrospective review of prospectively collected databases. To compare 2 approaches for assessment of mortality associated with spine surgery. The Scoliosis Research Society collects morbidity and mortality data from its members. Previously, this included details for all spine cases and all complications. To reduce time burden and improve compliance, collection was changed to focus on a few major complications (death, neurological deficit, and blindness) for specific deformity diagnoses (scoliosis, spondylolisthesis, and kyphosis) and only for cases with complications. Data were extracted from the Scoliosis Research Society from 2004-2007 (detailed system) and 2009-2011 (simplified system). As an anchor for comparison, mortality rates were compared between the systems. Between 2009 and 2011, the number of deformity cases reported were 87,162, with 131 deaths (1.50/1000 cases). The mean age of these 131 patients was 50, mean American Society of Anesthesiologists grade was 2.8, 10% were smokers, and 18% had diabetes. Rates of death (per 1000 cases) were: idiopathic scoliosis (0.4), congenital scoliosis (1.3), neuromuscular scoliosis (3.6), other scoliosis (3.1), spondylolisthesis (0.6), and kyphosis (4.7). Common causes of mortality included respiratory (48), cardiac (32), sepsis (12), organ failure (9), and blood loss (7). Compared with the detailed system, the simplified system had greater surgeon compliance (79% vs. 62%, P < 0.001), greater number of deformity cases per reporting surgeon per year (139 vs. 90, P < 0.001), and modest but significantly lower mortality rates (1.50 vs. 1.80/1000 cases; P < 0.001). Causes of death were comparable between the 2 systems. On the basis of the simplified collection system, the rate of mortality for spinal deformity surgery was 1.50 per 1000 cases. Compared with the detailed system, the simplified system had significantly improved compliance and similar mortality rates. Although the simplified system is limited by less data
Comparison of AFRRI (Armed Forces Radiobiology Research Institute) and ETCA (Etablissement Technique Central de l’Armament) Dosimetry Measurements at AFRRI TRIGA (Training Research Isotopes General Atomic) Reactor
TECHNICAL REPORT Comparison of AFRRI and ETCA dosimetry measurements at AFRRI TRIGA reactor M. Dooley G. H. Zeman DEFENSE NUCLEAR AGENCY ARMED...Research Institute (AFRRI) TRIGA (Training Research Isotopes General Atomic) reactor on 10-12 September 1985. The purpose of the experiment was to...anthropomorphic dosimetry phantom (a Incite cylinder 30 cm in diameter and 60 cm tall) in exposure room 1 of the AFRRI TRIGA reactor. As reference
Inverso, Gino; Chuang, Sung-Kiang; Kaban, Leonard B
The purpose of this study was to review outcomes of the Oral and Maxillofacial Surgery (OMS) Foundation's funding awards to members of the OMS department at Massachusetts General Hospital (MGH) in terms of projects completed, abstracts presented, peer-reviewed publications, and career trajectories of recipients. Data were collected from MGH and OMS Foundation records and interviews with award recipients. Primary outcome variables included 1) number of awards and award types, 2) funding amount, 3) project completion, 4) number of presented abstracts, 5) conversion from abstracts to publications, 6) number of peer-reviewed publications, 7) career trajectories of awardees, and 8) additional extramural funding. Eleven Student Research Training Awards provided $135,000 for 39 projects conducted by 37 students. Of these, 34 (87.2%) were completed. There were 30 student abstracts presented, 21 peer-reviewed publications, and a publication conversion rate of 58.8%. Faculty research awards comprised $1,510,970 for 22 research projects by 12 faculty members and two research fellows. Of the 22 funded projects, 21 (95.5%) were completed. There were 110 faculty and research fellow abstracts presented and 113 peer-reviewed publications, for a publication conversion rate of 93.8%. In the student group, 17 of 37 (45.9%) are enrolled in or are applying for OMS residencies. Of the 10 students who have completed OMS training, 3 (30%) are in full-time academic positions. Of the 12 faculty recipients, 9 (75%) remain in OMS academic practice. During this time period, the department received $9.9 million of extramural foundation or National Institutes of Health funding directly or indirectly related to the OMS Foundation grants. The results of this study indicate that 90.2% of projects funded by the OMS Foundation have been completed. Most projects resulted in abstracts and publications in peer-reviewed journals. These grants encouraged students to pursue OMS careers and aided OMS
Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...
... above-the-knee splint or lightweight plaster or fiberglass splint instead. Bracing may be used after the ... level. Potential Complications Complications from rodding surgery include risks related to: General anesthesia, Fractures during the procedure, ...
... if the seizure occurs during a bath or swimming Brain damage from prolonged seizures Sudden death, a ... a candidate for epilepsy surgery, your pre-surgical evaluation may include: Baseline electroencephalogram (EEG). In this test, ...
R. van Valen (Richard)
markdownabstractThis thesis describes the efforts to reduce complications during and after cardiac surgery and to enhance the quality of patient care during the in-hospital stay after surgery. Several important topics for daily patient care will be addressed. In light of this goal, the scope and
Stoneham, M; Murray, D; Foss, N
National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...
Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín
Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.
Full Text Available ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ...
Barrett, Nicole; Colón-Ramos, Uriyoán; Elkins, Allison; Rivera, Ivonne; Evans, W Douglas; Edberg, Mark
Latinos consume more sugary drinks and less water than other demographic groups. Our objective was to understand beverage choice motivations and test promotional concepts that can encourage Central American Latino urban youth to drink more water. Two rounds of focus group discussions were conducted (n = 10 focus groups, 61 participants, 6-18 years old). Data were transcribed verbatim and analyzed using inductive and deductive coding approaches. Youth motivations for drinking water were shaped by level of thirst, weather, energy, and perceptions of health benefits. Youth were discouraged from drinking water due to its taste and perceptions of the safety and cleanliness of tap water. Youth beverage preference depended on what their friends were drinking. Availability of water versus other beverages at home and other settings influenced their choice. Promotional materials that included mixed language, informative messages about the benefits of drinking water, and celebrities or athletes who were active, energized, and drinking water were preferred. A promotional campaign to increase water consumption among these Latino youth should include bicultural messages to underscore the power of water to quench true thirst, highlight the health benefits of drinking water, and address the safety of tap water.
Lopatto, David; Hauser, Charles; Jones, Christopher J.; Paetkau, Don; Chandrasekaran, Vidya; Dunbar, David; MacKinnon, Christy; Stamm, Joyce; Alvarez, Consuelo; Barnard, Daron; Bedard, James E. J.; Bednarski, April E.; Bhalla, Satish; Braverman, John M.; Burg, Martin; Chung, Hui-Min; DeJong, Randall J.; DiAngelo, Justin R.; Du, Chunguang; Eckdahl, Todd T.; Emerson, Julia; Frary, Amy; Frohlich, Donald; Goodman, Anya L.; Gosser, Yuying; Govind, Shubha; Haberman, Adam; Hark, Amy T.; Hoogewerf, Arlene; Johnson, Diana; Kadlec, Lisa; Kaehler, Marian; Key, S. Catherine Silver; Kokan, Nighat P.; Kopp, Olga R.; Kuleck, Gary A.; Lopilato, Jane; Martinez-Cruzado, Juan C.; McNeil, Gerard; Mel, Stephanie; Nagengast, Alexis; Overvoorde, Paul J.; Parrish, Susan; Preuss, Mary L.; Reed, Laura D.; Regisford, E. Gloria; Revie, Dennis; Robic, Srebrenka; Roecklien-Canfield, Jennifer A.; Rosenwald, Anne G.; Rubin, Michael R.; Saville, Kenneth; Schroeder, Stephanie; Sharif, Karim A.; Shaw, Mary; Skuse, Gary; Smith, Christopher D.; Smith, Mary; Smith, Sheryl T.; Spana, Eric P.; Spratt, Mary; Sreenivasan, Aparna; Thompson, Jeffrey S.; Wawersik, Matthew; Wolyniak, Michael J.; Youngblom, James; Zhou, Leming; Buhler, Jeremy; Mardis, Elaine; Leung, Wilson; Shaffer, Christopher D.; Threlfall, Jennifer; Elgin, Sarah C. R.
In their 2012 report, the President's Council of Advisors on Science and Technology advocated "replacing standard science laboratory courses with discovery-based research courses"--a challenging proposition that presents practical and pedagogical difficulties. In this paper, we describe our collective experiences working with the…
Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...
Rahman, Luthfur; Muirhead-Allwood, Sarah K
Publications are considered to indicate academic achievement and can lead to various rewards, including job opportunities and research funding. Recent years have seen a rising trend in the number of articles published, multiple authorship, and internationalization of the biomedical literature. The goal of this study was to analyze the trends in authorship over the past 50 years to determine whether the orthopedic literature parallels trends seen in other areas of the biomedical literature. We performed an observational study with analysis of the number of authors and geographic origin of articles published in the Journal of Bone and Joint Surgery British Volume (JBJS) and Clinical Orthopaedics and Related Research (CORR). We analyzed 2776 articles (CORR, n=1809; JBJS, n=967) published between 1958 and 2008 at 10-year intervals. There has been a significant increase in the mean number of authors per article from 1.638 to 4.08 (P<.0001) and 1.633 to 4.540 (P<.0001) for CORR and JBJS, respectively between 1958 and 2008. There has been a significant increase in the international contribution to both journals (P<.0001). The number of countries contributing to articles increased from 5 to 39 and from 17 to 33 for CORR and JBJS, respectively. These findings are similar to other areas of the biomedical literature. The reasons for this proliferation are multifactorial, including multicenter trials and inappropriate authorship. Guidelines for authorship and preparation of manuscripts from the International Committee of Medical Journal Editors or from individual journals are widely available, and every effort should be made to adhere to them to prevent inappropriate authorship proliferation in the future. Copyright 2010, SLACK Incorporated.
Beeton, J.M.; Mandel, R.D.
Temporal and spatial patterns of landscape evolution strongly influence the temporal and spatial patterns of the archaeological record in drainage systems. In this geoarchaeological investigation we took a basin-wide approach in assessing the soil stratigraphy, lithostratigraphy, and geochronology of alluvial deposits and associated buried soils in the Cottonwood River basin of east-central Kansas. Patterns of landscape evolution emerge when stratigraphic sequences and radiocarbon chronologies are compared by stream size and landform type. In the valleys of high-order streams (???4th order) the Younger Dryas Chronozone (ca. 11,000-10,000 14C yr B.P.) was characterized by slow aggradation accompanied by pedogenesis, resulting in the development of organic-rich cumulic soils. Between ca. 10,000 and 4900 14C yr B.P., aggradation punctuated by soil formation was the dominant process in those valleys. Alluvial fans formed on the margins of high-order stream valleys during the early and middle Holocene (ca. 9000-5000 14C yr B.P.) and continued to develop slowly until ca. 3000-2000 14C yr B.P. The late-Holocene record of high-order streams is characterized by episodes of entrenchment, rapid aggradation, and slow aggradation punctuated by soil development. By contrast, the early and middle Holocene (ca. 10,000-5000 14C yr B.P.) was a period of net erosion in the valleys of low-order streams. However, during the late Holocene small valleys became zones of net sediment storage. Consideration of the effects of these patterns of landscape evolution on the archaeological record is crucial for accurately interpreting that record and searching for buried archaeological deposits dating to specific cultural periods. ?? 2011 Wiley Periodicals, Inc. ?? 2011 Wiley Periodicals, Inc..
Full Text Available A survey was conducted to record the butterfly diversity, status and occurrence of butterfly species in the Tropical Forest Research Institute campus area of 109 hectare within Jabalpur city from June 2008 to May 2009. A total of 62 species of butterflies belonging to 47 genera of 5 families viz., Papilionidae (5 species, Pieridae (9 species, Nymphalidae (25 species, Lycaenidae (16 species and Hesperiidae (7 species were recorded. Of the total 65 species, 24 (37% were commonly occurring, 16 (26% were very common, 2 (3% were not rare, 17 (26% were rare and 6 (8% were very rarely occurring. Of these eight species are listed in the Indian Wildlife (protection Act 1972. The observations support the importance of the Tropical Forest Research Institute campus which provides a habitat and valuable resources for butterflies.
The African Journal of Paediatric Surgery aims to promote research, post- graduate training and further education among Paediatric surgeons, Paediatric Surgical Trainees and paramedical personnel in the surgery of newborn infants and children particularly in Africa and other tropical regions of the world.AJPS welcomes ...
PARMA JR.,EDWARD J.
Production of the molybdenum-99 isotope at the Annular Core Research Reactor requires highly enriched, uranium oxide loaded targets to be irradiated for several days in the high neutron-flux region of the core. This report presents the safety analysis for the irradiation of up to seven Cintichem-type targets in the central region of the core and compares the results to the Annular Core Research Reactor Safety Analysis Report. A 19 target grid configuration is presented that allows one to seven targets to be irradiated, with the remainder of the grid locations filled with aluminum ''void'' targets. Analyses of reactor, neutronic, thermal hydraulics, and heat transfer calculations are presented. Steady-state operation and accident scenarios are analyzed with the conclusion that the reactor can be operated safely with seven targets in the grid, and no additional risk to the public.
Diana, M; Marescaux, J
Proficiency in minimally invasive surgery requires intensive and continuous training, as it is technically challenging for unnatural visual and haptic perceptions. Robotic and computer sciences are producing innovations to augment the surgeon's skills to achieve accuracy and high precision during complex surgery. This article reviews the current use of robotically assisted surgery, focusing on technology as well as main applications in digestive surgery, and future perspectives. The PubMed database was interrogated to retrieve evidence-based data on surgical applications. Internal and external consulting with key opinion leaders, renowned robotics laboratories and robotic platform manufacturers was used to produce state-of-the art business intelligence around robotically assisted surgery. Selected digestive procedures (oesophagectomy, gastric bypass, pancreatic and liver resections, rectal resection for cancer) might benefit from robotic assistance, although the current level of evidence is insufficient to support widespread adoption. The surgical robotic market is growing, and a variety of projects have recently been launched at both academic and corporate levels to develop lightweight, miniaturized surgical robotic prototypes. The magnified view, and improved ergonomics and dexterity offered by robotic platforms, might facilitate the uptake of minimally invasive procedures. Image guidance to complement robotically assisted procedures, through the concepts of augmented reality, could well represent a major revolution to increase safety and deal with difficulties associated with the new minimally invasive approaches. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.
Pareek, Manan; Schauer, Philip R; Kaplan, Lee M
The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown the superio......The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown...... the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity...
Jun 6, 2013 ... Cost effectiveness of using surgery versus skeletal traction in management of femoral shaft fractures at Thika level 5 hospital, Kenya ... physiotherapy costs. The data was compiled and analyzed using SPSS version 16. Person's chi .... odds ratio and logistic regression. Results. Socio demographics of study ...
Apr 22, 2014 ... Introduction: The use of coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB) or without CPB technique (off-pump) can be associated with ... Published in partnership with the African Field Epidemiology Network (AFENET). ..... injury and acute respiratory distress syndrome after.
Jul 10, 2013 ... 1Department of Periodontics, Sri Sai college of dental surgery, Vikarabad, AP, India, 2Department of Periodontics, Kamineni institute of dental ..... 12. James L Holly. Inflammation and Cardiovascular Risk: is there a role for anti-inflammatory therapy. 2008. Texas. The. Examiner. Google Scholar. 13. Glurich I ...
Aug 25, 2010 ... 100%. UDT: undescended testis. Table 2: The indications and number of day case procedures/surgery in children. Diagnosis. Type of procedure number. %. Intact prepuce/phimosis. Circumcision. 231. 79.7. Redundant prepuce/skin bridge. Re-do-circumcision. 14. 4.8. Undescended testis/horizontal testes.
Sep 11, 2015 ... However, various internal and external factors influence utilization of day surgery services globally. Internal factors focus on management aspects such as scheduling and turn-around time, ensuring optimum utilization of operating rooms. While, external factors include: patient awareness, attitude of doctors ...
Oct 25, 2013 ... prior gastric surgery, patients on current parenteral or enteral nutritional support , those with malabsoprtion syndrome, use of B12 supplements (oral or parenteral), vegetarians, proton pump inhibitors. Informed written consent was taken from all participants and approval from ethical committee combined ...
Shrimp Trap Report data collected by NOAA research vessel Townsend Cromwell from 1980 to 1989 in the Central and Western Pacific Ocean and chartered fishing vessel Pesquedot in 1984 in waters off Guam
National Oceanic and Atmospheric Administration, Department of Commerce — Shrimp trapping operations were conducted by NOAA research vessel Townsend Cromwell from 1980 to 1989 in the Central and Western Pacific Ocean to determine...
Amphibian surgery has been especially described in research. Since the last decade, interest for captive amphibians has increased, so have the indications for surgical intervention. Clinicians should not hesitate to advocate such manipulations. Amphibian surgeries have no overwhelming obstacles. These patients heal well and tolerate blood loss more than higher vertebrates. Most procedures described in reptiles (mostly lizards) can be undertaken in most amphibians if equipment can be matched to the patients' size. In general, the most difficult aspect would be the provision of adequate anesthesia. Copyright © 2016 Elsevier Inc. All rights reserved.
Desrochers, André; Anderson, David E
A wide variety of disorders affecting the intestinal tract in cattle may require surgery. Among those disorders the more common are: intestinal volvulus, jejunal hemorrhage syndrome and more recently the duodenal sigmoid flexure volvulus. Although general principles of intestinal surgery can be applied, cattle has anatomical and behavior particularities that must be known before invading the abdomen. This article focuses on surgical techniques used to optimize outcomes and discusses specific disorders of small intestine. Diagnoses and surgical techniques presented can be applied in field conditions. Copyright © 2016 Elsevier Inc. All rights reserved.
Naseri, Ayman; McLeod, Stephen D
To review recent contributions addressing the challenge of intraocular lens (IOL) calculation in patients undergoing cataract extraction following corneal refractive surgery. Although several articles have provided excellent summaries of IOL selection in patients wherein prerefractive surgery data are available, numerous authors have recently described approaches to attempt more accurate IOL power calculations for patients who present with no reliable clinical information regarding their refractive history. Additionally, results have been reported using the Scheimpflug camera system to measure corneal power in an attempt to resolve the most important potential source of error for IOL determination in these patients. IOL selection in patients undergoing cataract surgery after corneal refractive surgery continues to be a challenging and complex issue despite numerous strategies and formulas described in the literature. Current focus seems to be directed toward approaches that do not require preoperative refractive surgery information. Due to the relative dearth of comparative clinical outcomes data, the optimal solution to this ongoing clinical problem has yet to be determined. Until such data are available, many cataract surgeons compare the results of multiple formulas to assist them in IOL selection for these patients.
Wang, Jay Ching Chieh; Hathorn, Iain; Habib, Al-Rahim; Chang, Estelle; Javer, Amin R
There is a need to find an animal model to study new medications to improve mucosal wound healing after functional endoscopic sinus surgery (FESS). Current literature suggests swine as a potential candidate. The lack of information correlating swine computer tomography (CT) and endoscopic sinonasal anatomy prompted us to investigate them in the domestic and Yucatan swine to determine their feasibility as models to test new medications and drug-embedded stents applied using FESS techniques. Two domestic pig heads and 2 Yucatan pig heads were imaged using helical thin slice (1 mm) CT. Two rhinologists analyzed the images and performed endoscopy on the swine. Particular attention was given to accessing the frontal sinus and suturing stents to the nasal septum using standard endoscopic instruments. CT confirmed that swine sinonasal anatomy is largely similar to human, with all major sinuses present. The middle and inferior turbinates of swine arise from a single uniturbinate. The superior turbinates contain large concha bullosa. Unlike human, swine nasal septum is bone anteriorly and cartilage posteriorly. The frontal sinus ostia, regardless of head size, were consistently around 10 cm from the nasal aperture. On endoscopy, domestic swine frontal sinus ostia were easily accessible for topical medication deposition. Silastic splints can be sutured to the domestic swine septum through the posterior cartilaginous portion, allowing for studies involving medication-eluting material. The narrower nasal cavity of Yucatan pigs prohibited endoscopic maneuvers. Domestic swine, but not Yucatan, are a feasible model for future sinonasal research using standard FESS instruments. © 2013 ARS-AAOA, LLC.
Sivakumar, Venkatasubramanian; Swaminathan, Gopalaraman; Rao, Paruchuri Gangadhar; Ramasami, Thirumalachari
Ultrasound is a sound wave with a frequency above the human audible range of 16 Hz to 16 kHz. In recent years, numerous unit operations involving physical as well as chemical processes are reported to have been enhanced by ultrasonic irradiation. There have been benefits such as improvement in process efficiency, process time reduction, performing the processes under milder conditions and avoiding the use of some toxic chemicals to achieve cleaner processing. These could be a better way of augmentation for the processes as an advanced technique. The important point here is that ultrasonic irradiation is physical method activation rather than using chemical entities. Detailed studies have been made in the unit operations related to leather such as diffusion rate enhancement through porous leather matrix, cleaning, degreasing, tanning, dyeing, fatliquoring, oil-water emulsification process and solid-liquid tannin extraction from vegetable tanning materials as well as in precipitation reaction in wastewater treatment. The fundamental mechanism involved in these processes is ultrasonic cavitation in liquid media. In addition to this there also exist some process specific mechanisms for the enhancement of the processes. For instance, possible real-time reversible pore-size changes during ultrasound propagation through skin/leather matrix could be a reason for diffusion rate enhancement in leather processing as reported for the first time. Exhaustive scientific research work has been carried out in this area by our group working in Chemical Engineering Division of CLRI and most of these benefits have been proven with publications in valued peer-reviewed international journals. The overall results indicate that about 2-5-fold increase in the process efficiency due to ultrasound under the given process conditions for various unit operations with additional benefits. Scale-up studies are underway for converting these concepts in to a real viable larger scale operation. In
Kessel, Line; Andresen, Jens; Erngaard, Ditte
The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...... performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery...
Federal Laboratory Consortium — The ASR services for NHLBI research animals include: animal model development, surgery, surgical support, post-operative care as well as technical services such as...
body temperature to derive an equation for the purpose of predicting mortality in damage control surgery. It was shown to ... equation to have 100% positive predictive value (PPV) for both datasets and 24% sensitivity. The aim of the study was to .... predictive systems assess average, and not individual, risk. Increasing the ...
Background: The management of cystic lymphangiomas is and challenging. Of all the available modalities of treatment, surgery remains the gold standard but it is associated with significant morbidity and mortality. Method: Retrospective analysis of 28 cases of cystic lymphangioma seen at the. Obafemi Awolowo University ...
At Surgery she had a floating gall bladder with the fundus at the left side of __the porta hepatis due to adhesions attached to the Hartmann ' s pouch. A choiecystectomy was performed, then a choledochotomy was madci in etwcen 2 stay sutures of 3—0 silk” The. Chi) stones were removed with. Dcsjardin forceps, irrigation ...
Key words: Palliative surgery, transposition, great arteries. Introduction. Transposition 'ol' the great arteries (TGA) was first observed by Sterro in 1672l and was subsequently described by Morgagni. (1761) 2 and Baille (r797). '1 in this severe congenital cyanotic heart disease, the aorta arises from the right ventricle and the ...
Thorstensson, Carina; Lohmander, L; Frobell, Richard
ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in...
examination of the abdomen at four specific locations: the right upper quandrant, left upper quadrant, suprapubic area. Role of focused assessment with sonography for trauma as a screening tool for blunt abdominal trauma in young children after high energy trauma. PAEDIATRIC SURGERY. W Tummers,1 J van Schuppen ...
services at public hospitals across the country are currently delivered by IMGs.6 Although some IMGs wish to stay on in the hope of entering ... accredited by the Health Professions Council of South Africa. (HPCSA), the national regulatory authority for medical licensing. The general surgery registrar programme lasts for a.
within surgical societies, where mentors and role models have a significant impact on ..... al.12 suggested that although women have high self-efficacy in surgery, they .... Ling M, Young CJ, Shepherd HL, Mak C, Saw RPM. Workplace bullying ...
intraperitoneal space, and infrequently at other sites.2-13. The traditional operative approach is an open surgical one to drain the cysts and remove their germinal layer by either controlled evacuation of the cystic cavity or resectional surgery. Since the first laparoscopic treatment of hydatid disease was described in 1992,14 ...
of shock and who require “damage control” surgery are more likely to suffer a worse outcome, particularly when multiple physiological derangements .... Gun shot. 13. 15. Shot gun. 0. 1. Level of injury. Infrarenal. 11. 7. 0.248. Juxtarenal. 2. 7. Suprarenal. 2. 1. Retrohepatic. 2. 2. Trauma scores. RTS (mean). 7.28. 6.44. 0.095.
Connors, G. Patrick
Arthroscopic surgery (or microsurgery) is a significant breakthrough in treating knee injuries. Its applications range from basic diagnosis to arthroscopic menisectomy, although its use in some procedures is still highly controversial. Many surgeons perform the diagnostic procedure, but follow this with the conventional surgical approach.…
A career in missionary surgery offers professional challenge, much opportunity, and high job satisfaction. Preparation, financial support, job requirements, and difficulties are issues to be considered. However, these are secondary in the context of seeing needy people made whole physically and spiritually. Copyright 2010 Elsevier Inc. All rights reserved.
Addictive behaviour is as prevalent in Germany as in other western countries, but in contrast to some European countries and the United States, very little money was given to this research field. Change came in the early 1990s, when the German government started to launch specific grants for addiction research. The first chair in addiction research was created in 1999 (Karl Mann) at the Central Institute of Mental Health Mannheim (CIMH; University of Heidelberg). The recruitment of a pre-clinical alcohol researcher as head of the department of psychopharmacology followed (Rainer Spanagel). This 'addiction research cluster' collaborates with several research groups at the CIMH (such as genetics). We inaugurated a clinical trial network which now comprises up to 20 treatment centres throughout Germany. Like most authors, we found effect sizes of different treatment modalities more in the low to moderate range, perhaps because of the heterogeneity of large patient samples. Therefore, we concentrated upon the biological basis of addiction in order to define more homogeneous 'subtypes' of patients for a better match with existing treatments. Results concerning genetics and neuroimaging (both animal and human) are promising, and could move our field towards a more personalized treatment approach. Our funding has been extended over the years, including involvement in several large European grants. We are studying substance-related problems as well as so-called 'behavioural addictions'. As a natural consequence of this development, we are deeply involved both in informing the general public on addiction issues as well as in counselling policy makers in Germany. © 2010 The Author, Addiction © 2010 Society for the Study of Addiction.
Sudduth, Kenneth A; Jang, Gab-Sue; Lerch, Robert N; Sadler, E John
In situ methods for estimating water quality parameters would facilitate efforts in spatial and temporal monitoring, and optical reflectance sensing has shown potential in this regard, particularly for chlorophyll, suspended sediment, and turbidity. The objective of this research was to develop and evaluate relationships between hyperspectral remote sensing and lake water quality parameters-chlorophyll, turbidity, and N and P species. Proximal hyperspectral water reflectance data were obtained on seven sampling dates for multiple arms of Mark Twain Lake, a large man-made reservoir in northeastern Missouri. Aerial hyperspectral data were also obtained on two dates. Water samples were collected and analyzed in the laboratory for chlorophyll, nutrients, and turbidity. Previously reported reflectance indices and full-spectrum (i.e., partial least squares regression) methods were used to develop relationships between spectral and water quality data. With the exception of dissolved NH, all measured water quality parameters were strongly related ( ≥ 0.7) to proximal reflectance across all measurement dates. Aerial hyperspectral sensing was somewhat less accurate than proximal sensing for the two measurement dates where both were obtained. Although full-spectrum calibrations were more accurate for chlorophyll and turbidity than results from previously reported models, those previous models performed better for an independent test set. Because extrapolation of estimation models to dates other than those used to calibrate the model greatly increased estimation error for some parameters, collection of calibration samples at each sensing date would be required for the most accurate remote sensing estimates of water quality. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.
Berry, Margaret E.; Lundstrom, Scott C.; Slate, Janet L.; Muhs, Daniel R.; Sawyer, David A.; VanSistine, D. Paco
The Greater Platte River Basin area spans a central part of the Midcontinent and Great Plains from the Rocky Mountains on the west to the Missouri River on the east, and is defined to include drainage areas of the Platte, Niobrara, and Republican Rivers, the Rainwater Basin, and other adjoining areas overlying the northern High Plains aquifer. The Greater Platte River Basin contains abundant surficial deposits that were sensitive to, or are reflective of, the climate under which they formed: deposits from multiple glaciations in the mountain headwaters of the North and South Platte Rivers and from continental ice sheets in eastern Nebraska; fluvial terraces (ranging from Tertiary to Holocene in age) along the rivers and streams; vast areas of eolian sand in the Nebraska Sand Hills and other dune fields (recording multiple episodes of dune activity); thick sequences of windblown silt (loess); and sediment deposited in numerous lakes and wetlands. In addition, the Greater Platte River Basin overlies and contributes surface water to the High Plains aquifer, a nationally important groundwater system that underlies parts of eight states and sustains one of the major agricultural areas of the United States. The area also provides critical nesting habitat for birds such as plovers and terns, and roosting habitat for cranes and other migratory birds that travel through the Central Flyway of North America. This broad area, containing fragile ecosystems that could be further threatened by changes in climate and land use, has been identified by the USGS and the University of Nebraska-Lincoln as a region where intensive collaborative research could lead to a better understanding of climate change and what might be done to adapt to or mitigate its adverse effects to ecosystems and to humans. The need for robust data on the geologic framework of ecosystems in the Greater Platte River Basin has been acknowledged in proceedings from the 2008 Climate Change Workshop and in draft
Mansour, Ahmad M; Hamam, Rola
The operating room is a place of surgical intervention with its accompanying bodily and cognitive strain on the performers. Stress in the operating room may lead to the onset of central serous chorioretinopathy as reported hereby in a retina surgeon and is labeled as operating room central serous chorioretinopathy. The same operator performed the optical coherence tomography scans on one retina surgeon. A masked observer estimated the maximal height of the subretinal fluid. Central serous chorioretinopathy recurred four times over a 1-year period 1 -2 days after a stressful day in the operating room, especially when cases were done under topical or subtenon anesthesia for cataract surgery, vitreous surgery or combined surgeries with complex ocular and medical problems and inability for anesthesia team to intervene. Stress management allowed resolution of subretinal fluid between 3 and 4 weeks. Adopting this strategy, no further attacks were documented by optical coherence tomography for 5 years. (1) This is one of a few optical coherence tomography documentation of resolution of central serous chorioretinopathy within 3-4 weeks of its occurrence and its recurrence induced by stress in the operating room; (2) Unassisted topical anesthesia required in patients with complex medical and ocular problems causes more cognitive stress than when surgery is carried under assisted local or general anesthesia (partly due to unexpected ocular or bodily movements); and (3) the available evidence suggests that those overcommitted surgeons (type A personality) may very well be most susceptible to burnout and central serous chorioretinopathy.
Wang, Jin; Lu, Yuan-qiang
Chinese surgery journals are of small international impact which does not measure up to the state of development of surgery in China and they can not adequately publish Chinese researches to the world. To improve the visibility of Chinese surgery journals, this article suggests developing more English surgery journals, extending a co-operation with famous publishers, employing overseas experts as editorial committee and making more use of the Internet.
Full Text Available ... Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the ... Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the ...
Full Text Available ... and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the extent of ... and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the extent of ...
Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ...
Full Text Available ... and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the soft tissues ... and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the soft tissues ...
Lateral epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... Soon after surgery, severe pain will decrease, but you may have mild soreness for 3 to 6 months.
Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...
Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...
Full Text Available ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ...
Full Text Available ... Corrective Jaw Surgery Dental and Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures ...
Kjærgaard Larsen, Marie; Thygesen, Torben Henrik
The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... to sex, age, and somatosensory change. High satisfaction and improvement in facial esthetic after OS were seen. Young patients (16-25 years) and men indicated a higher degree of satisfaction than old (>25 years) patients and women. The use of social media seems to be an interesting platform...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...
Full Text Available With continued advances in medical robotic technology and global telecommunications, the concept of remote telerobotic surgery continues to develop. The ultimate goal of an experienced specialist operating remotely using a robot controlled by high-speed audiovisual connections has been shown to be feasible but is limited by local resources and a lack of evidence from randomised controlled trials. This article looks at the development of this exciting field and its impact on modern urology.
Mar 2, 2015 ... Using a critical leadership theory framework, we conducted a qualitative ... or basic science research career (Socio-Behavioral Research, ... AITRP was to develop HIV research leaders at the University of ..... Wellcome-Trust.
Beget, J. E.; Sturm, M.
Three different permafrost sites near the University of Alaska-Fairbanks in central Alaska are utilized for student field studies and class laboratory exercises and research projects. The Fox Permafrost Tunnel (FPT) is managed by the Army Corps of Engineers and was drilled more than 40 years ago through a section of frozen ground containing multiple ice-wedges, ice lenses, cave ice, and other periglacial features. This site lies 25 km from the UAF campus and has been used for decades by University of Alaska classes conducting fieldtrips in classes ranging from introductory Geology to graduate class in permafrost and permafrost engineering. Since permafrost rapidly thaws and degrades when exposed at the surface, the Fox Tunnel is kept below freezing, allowing hundreds of students to see a wide variety of periglacial features and frozen ground in a subsurface mine. The Pewe Permafrost Preserve was established in the 1980s, and is owned managed by the University of Alaska. The site preserves a 40-m-high surface exposure of yedoma, loess, paleosols, tephras and fossil permafrost features recording climate changes and permafrost history during the last 4 MA. The site lies only 10 km from the UAF cmapuss, and more than 30 student research projects have been carried out there on permafrost history, paleomagnetism, isotope geochemistry, geophysics, and climate history. In 2011 the Cold Regions Research Laboratory (CRRL) completed a new Permfrost Tunnel near Fox Alaska, 25 km from UAF, With support from NSF, researchers and engineering, geology and geophsycis students are now involved in stratigraphic and geochronologic work as part of a graduate class on periglacial geology designed to establish the age and climate history of this new permafrost site. The three permafrost permafrost sites near UAF comprise a unique set of field sites for permafrost studies and provide unparalleled opportunities for student fieldwork on permafrost.
Baros, B; Djuric, B
Conservative resection is applied in cases with central localisation of the tumour in the surrounding lymph nodes are not affected by the malignant process. This surgery is of great importance for patients with restricted respiratory function if pneumonectomy is contraindicated or is performed under enhanced risk. A total of 29 surgeries were performed on the bronchial system. Blood vessel resection was simultaneously done in two of the cases. Frozen section biopsy was obligatorily performed. In one case atelectasis was an early complication that was resolved by bronchoaspiration. In a thirty-day long postoperative period one (3.4%) of the patients died because of profound intrathoracic bleeding.
Caroline Sarah Zuijdwijk
Full Text Available Background/Objective: Diabetes Research Education and Management (DREAM Trust (DT is a charitable organisation that offers free insulin and healthcare to children and youth with type 1 diabetes (T1D in central India. We systematically describe DT's model of care and evaluate medical and sociodemographic factors influencing glycaemic control in this resource-poor setting. Methods: Study of DT patients diagnosed with T1D <16 years old and followed at DT ≥1 year. Participants completed an interview, retrospective chart review and prospective haemoglobin A1c (HbA1c measurements. Uni- and multi-variate linear regressions determined factors associated with HbA1c. Percentage of underweight patients (as proxy for glycaemic control was compared at presentation to DT versus time of interview. Results: A total of 102 DT patients (51% female completed the interview and chart review. 74 had HbA1c measured. Median HbA1c was 10.4% (90.2 mmol/mol. In multivariate regression, higher HbA1c was independently associated with higher insulin dose/kg (P < 0.001 and holding a below the poverty line certificate (P = 0.004. There was no association between HbA1c and age, sex, caste, religion or experience of stigma. However, the psychosocial burden of T1D (expressed as concern about others learning about the diagnosis, and worry about the future, and experience of stigma were substantial. Percentage of patients with underweight body mass index was significantly lower at the time of study vs. presentation to DT (P = 0.005. Conclusions: The DT charitable programme overcomes social status, gender inequalities and experience of social stigma to provide life-saving treatment to children with T1D in central India. Glycaemic control remains inadequate however, with children living in extreme poverty most at risk.
Gurinović, M; Witthöft, C M; Tepšić, J; Ranić, M; Hulshof, P J M; Hollman, P C; Porubska, J; Gohar, A; Debeljak-Martačić, J; Petrović-Oggiano, G; Novaković, R; Glibetić, M; Oshaug, A
Capacity development (CD) in food and nutrition is much more than formal training and includes human resource development, and organisational, institutional and legal framework development with the aim of enhancing nutrition-relevant knowledge and skills to support infrastructural development. The goal of the European Food Information Resource (EuroFIR) Network of Excellence has been to develop and integrate food composition data throughout Europe. EuroFIR joined forces in CD with the United Nations (UN) University and UN System Standing Committee on Nutrition, the Network for Capacity Development in Nutrition in Central and Eastern Europe, the Central and Eastern European Countries Food Data Systems network and with the Middle East and North African Capacity Building Initiative. The aim of this paper is to discuss an inventory of the status of food composition databases (FCDBs) and the training needs of compilers in non-EuroFIR countries in Central and Eastern Europe (CEE) and in the Middle East and North Africa (MENA), and to present the CD achieved through EuroFIR and other network collaborations. Two online questionnaires were created addressing the FCDB status and specific training needs in countries of the targeted regions. Data were collected during 2006-2008 and then analysed. Subsequently, CD activities were organised. Contacts were established in 19 CEE and 7 MENA countries, of which several had national food composition tables, but no electronic versions. Education, training, workshops, networking and the sharing of experiences were uniformly requested. Subsequently, CD activities in EuroFIR were organised focussing on food composition courses, exchange visits, workshops and individual training for PhD students, junior scientists and other staff categories, as well as conferences linked to food composition research and food information. To facilitate CD activities, EuroFIR has signed a Memorandum of Understanding with the Czech Republic, Hungary
Full Text Available The Earth’s Critical Zone (CZ is a thin living layer connecting atmosphere and geosphere, including aquifers. Humans live in the CZ and benefit from the vital supporting services it provides. However, the CZ is increasingly impacted by human activities including land and resource use, pollution and climate change. Recent interest in uniting the many disciplines studying this complex domain has initiated an international network of research infrastructure platforms that allow access to the CZ in a range of geologic settings. In this paper a new such infrastructure platform associated with the Collaborative Research Center AquaDiva is described, that uniquely seeks to combine CZ research with detailed investigation of the functional biodiversity of the subsurface. Overall, AquaDiva aims to test hypotheses about how water connects surface conditions set by land cover and land management to the biota and biogeochemical functions in the subsurface. With long-term and continuous observations, hypotheses about how seasonal variations and extreme events at the surface impact subsurface processes, community structure and function, are tested. AquaDiva has established the Hainich Critical Zone Exploratory (CZE in central Germany in an alkaline geological setting of German Triassic Muschelkalk formations. The Hainich CZE includes specialized monitoring wells to access the vadose zone and two main groundwater complexes in limestone and marlstone parent materials along a ~6 km transect spanning forest, pasture and agricultural land uses. Initial results demonstrate fundamental differences in the biota and biogeochemistry of the two aquifer complexes that trace back to the land uses in their respective recharge areas. They also show the importance of antecedent conditions on the impact of precipitation events on responses in terms of groundwater dynamics, chemistry and ecology. Thus we find signals of surface land use and events can be detected in the
Küsel, Kirsten; Totsche, Kai; Trumbore, Susan; Lehmann, Robert; Steinhäuser, Christine; Herrmann, Martina
The Earth's Critical Zone (CZ) is a thin living layer connecting atmosphere and geosphere, including aquifers. Humans live in the CZ and benefit from the vital supporting services it provides. However, the CZ is increasingly impacted by human activities including land and resource use, pollution and climate change. Recent interest in uniting the many disciplines studying this complex domain has initiated an international network of research infrastructure platforms that allow access to the CZ in a range of geologic settings. In this paper a new such infrastructure platform associated with the Collaborative Research Center AquaDiva is described, that uniquely seeks to combine CZ research with detailed investigation of the functional biodiversity of the subsurface. Overall, AquaDiva aims to test hypotheses about how water connects surface conditions set by land cover and land management to the biota and biogeochemical functions in the subsurface. With long-term and continuous observations, hypotheses about how seasonal variations and extreme events at the surface impact subsurface processes, community structure and function, are tested. AquaDiva has established the Hainich Critical Zone Exploratory (CZE) in central Germany in an alkaline geological setting of German Triassic Muschelkalk formations. The Hainich CZE includes specialized monitoring wells to access the vadose zone and two main groundwater complexes in limestone and marlstone parent materials along a ~6 km transect spanning forest, pasture and agricultural land uses. Initial results demonstrate fundamental differences in the biota and biogeochemistry of the two aquifer complexes that trace back to the land uses in their respective recharge areas. They also show the importance of antecedent conditions on the impact of precipitation events on responses in terms of groundwater dynamics, chemistry and ecology. Thus we find signals of surface land use and events can be detected in the subsurface CZ. Future
... venous catheter (KATHeter), also known as a central line or CVC, is long, soft, thin, hollow tube ... into a large vein (blood vessel). A central line is much like an intravenous (IV) catheter that ...
Madu, Assumpta A; Ali, Tofik
The Residency Review Committee Ophthalmology of the Accreditation Council for Graduate Medical Education has recently established guidelines pertaining to the minimum operative requirements for training ophthalmology residents in refractive surgery. Despite being one of the most frequently performed ophthalmic surgical procedures, there is a paucity of literature on residency training in refractive surgery. Moreover, the literature indicates that only half of training programs offer surgical exposure to trainees. The purpose of this article is to review recent research on training ophthalmology residents in refractive surgery and offer an approach to incorporating laser refractive surgery curriculum in residency education. Kwon et al. performed a national survey to evaluate current trends in resident laser in-situ keratomileusis (LASIK) training in the USA. The result shows that 54% of respondents had resident-performed LASIK surgery with 9.1% of surveyed programs not offering any LASIK experience. In addition, residents in the study performed a mean of 4.4 LASIK surgeries (range 1-10) during residency training starting during the second year. The data emerging from the survey show that refractive surgery experience is fundamental to the education of the ophthalmology resident. Although the demand for refractive surgery continues to gain pace with millions of such procedures performed worldwide, only a little over half of ophthalmology residency programs offer residents the opportunity to gain surgical experience. With the current mandate, programs must now look for strategies to provide laser refractive surgical experience to residents.
Full Text Available The term "robot" was coined by the Czech playright Karel Capek in 1921 in his play Rossom′s Universal Robots. The word "robot" is from the check word robota which means forced labor.The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK, FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc. redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System ® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist ® . It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naοve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions.
Winkler von Mohrenfels, C; Salgado, J P; Khoramnia, R
Refractive surgery has become more and more popular in the past years. One of the most severe complications is iatrogenic keratectasia. The purpose of this article is to review the current knowledge about iatrogenic keratectasia. METHOD. A literature research (Medline) using the key words keratectasia, complication after refractive surgery and cross-linking was carried out. Apart from this, our own data from partially unpublished studies have been used. Since the first publication of keratectasia in 1998 more and more cases of keratectasia have been published. The main risk factor is a preoperative irregular topography. But also thin corneas, deep ablations, thin residual stromal beds and young patients age at the time of the laser surgery are further risk factors. Although preoperative examinations before refractive surgery are becoming more and more accurate and the inclusion criteria for laser ablation have become stricter, iatrogenic keratectasia still occurs. Therefore longer follow-up visits should be performed over a longer period to diagnose keratectasia in an early stage and to provide therapy. © Georg Thieme Verlag KG Stuttgart · New York.
Abstract. Background: It has been suggested that the prolonged pain and hyperalgesia occurring after an injury is due to central sensitization in the spinal cord. N- methyl D- Aspirate. (NMDA) receptors are activated by glutamate and aspartate and have been implicated in the wind-up phenomenon of centrai sensitization.
29 oct. 2013 ... 1Laboratoire central de Biologie, Etablissement hospitalier spécialisée en Gynécologie Obstétrique, Sidi Bel Abbés, Algérie, 2Département de biologie, Faculté des sciences, Université Djillali Liabes, Sidi Bel Abbes, Algérie. &Corresponding author: Fatima Beddek, Biologiste de laboratoire, Laboratoire ...
27 janv. 2014 ... principale de l'Hôpital Central de Yaoundé. Cette étude a inclus 66 patientes qui ont subi chacune une échographie doppler couleur entre la. 18ième et 30ième semaine de gestation, précisant le type d'insertion du cordon ombilical sur le placenta. A l'accouchement, un examen macroscopique du ...
The research was aimed at improving the current practice of radiation safety training of radiographers and was, therefore, considered action research. The processes of action and research was integrated because the teaching activities and assessment were developed after the Delphi survey and aligned with the ...
of the Western Cape (UWC), Cape Town, South Africa the students are exposed to research in various modules where they are trained in epidemiology, research methods and literature appraisal. In addition, they personally conduct a research project, performing relevant statistical analyses. The relevant modules for.
May 13, 2015 ... Systems (SEEDS)-INDEPTH Network Accra, Ghana, 3KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research-. Coast, Kilifi, Kenya, 4Population Health Sciences/Research Support Unit, Faculty of Health Sciences, Aga Khan University- East Africa, Nairobi,. Kenya ...
Full Text Available The YMCA in Central European Countries as One of the Ways of Americanising Central Europe after the First World War (Base of Information and Methodological Approaches zo Researching the Issue The YMCA is essentially an organisation uniting people of Christian faith. The basis of its work was the so-called “Four-way program”, which included religious (spiritual, educational and physical education activities. This organisation was established in London in 1844, having been formed by sales clerk George Williams. The YMCA began to spread rapidly throughout Great Britain. From here it spread to France and subsequently to Holland and Germany. It particularly flourished in the United States of America and came to Czechoslovakia from there after the First World War. Here, the YMCA began to establish military and later student residences. It played an important role in developing basketball, volleyball and other sports. It significantly contributed to the rise of permanent summer camps. It also brought a new view of the world, emerging from American Protestantism. The basic method we have decided to use is the comparative method. Using this classic method of historical research, it is necessary to compare the extent to which the YMCA organisation contributed to the “Americanisation” of national cultures of observed countries and how much it influenced young people. Due to the anticipated inequality and imbalance of sources, the method of probing will have to be used to assess individual regions. Unpublished archive materials as well as magazines and news reports from the period, which have not been systematically researched as yet, will be used as sources of information. YMCA ve středoevropských zemích jako jedna z cest amerikanizace střední Evropy po 1. světové válce (informační báze a metodologické přístupy k řešení problému YMCA je v první řadě organizace sdružující lidi křesťanského vyznání. Základem její pr
Starzy?ska, Anna; Paw?owska, Anita; Renkielska, Dorota; Michaj?owski, Igor; Sobjanek, Micha?; B?a?ewicz, Izabela; W?odarkiewicz, Adam
Introduction Oral leukoplakia (OL) is the most common potentially malignant lesion of the oral cavity. Aim The purpose of the study was clinical and epidemiological analysis of patients with OL diagnosed and treated in the Department of Maxillofacial and Oral Surgery, Medical University of Gdansk, comparison of effectiveness of treatment methods, defining whether van der Waal level of OL influences treatment effectiveness, correlation between localization of OL and treatment effectiveness, an...
Kijima, Yuko; Koriyama, Chihaya; Fujii, Teruhiko; Hirokaga, Kouichi; Ishigure, Kiyoshi; Kaneko, Tomoyo; Kayano, Shuji; Miyamoto, Sachio; Sagara, Yasuaki; Sakurai, Takashi; Sakurai, Teruhisa; Sotome, Keiichi; Ueo, Hiroaki; Wakita, Kazuyuki; Watatani, Masahiro
Immediate volume replacement using a free dermal fat graft (FDFG) has been proven safe with early postoperative benefits. The aims of the present study were to clarify adequate indications and risk factors associated with operative morbidity. A multi-institutional analysis of partial mastectomy with immediate volume replacement with FDFG was undertaken in 14 hospitals specializing in breast cancer treatment. Clinical and oncological variables were analyzed to identify factors associated with postoperative complications. A total of 262 cases were analyzed. Considering the observation period and overlap of patients, 13 (5.4%) out of 242 patients had complications within 1 month of surgery while 7 (4.6%) out of 151 patients developed complications 1-12 months after surgery. Two hundred and eleven out of 242 patients were statistically examined using a multivariate analysis, which revealed that the weight of resected breast tissue, size of implanted FDFG (cranio-caudal length), and weight of implanted FDFG were associated with a higher likelihood of postoperative complications. Immediate breast volume replacement using a FDFG after breast cancer surgery should be done for selected patients with breast cancer to avoid postoperative complications. The prospective and larger investigations are warranted for the establishment of appropriate guidelines.
Gurinović, Mirjana; Milešević, Jelena; Kadvan, Agnes; Nikolić, Marina; Zeković, Milica; Djekić-Ivanković, Marija; Dupouy, Eleonora; Finglas, Paul; Glibetić, Maria
In order to meet growing public health nutrition challenges in Central Eastern European Countries (CEEC) and Balkan countries, development of a Research Infrastructure (RI) and availability of an effective nutrition surveillance system are a prerequisite. The building block of this RI is an innovative tool called DIET ASSESS & PLAN (DAP), which is a platform for standardized and harmonized food consumption collection, comprehensive dietary intake assessment and nutrition planning. Its unique structure enables application of national food composition databases (FCDBs) from the European food composition exchange platform (28 national FCDBs) developed by EuroFIR (http://www.eurofir.org/) and in addition allows communication with other tools. DAP is used for daily menu and/or long-term diet planning in diverse public sector settings, foods design/reformulation, food labelling, nutrient intake assessment and calculation of the dietary diversity indicator, Minimum Dietary Diversity-Women (MDD-W). As a validated tool in different national and international projects, DAP represents an important RI in public health nutrition epidemiology in the CEEC region. Copyright © 2016 Elsevier Ltd. All rights reserved.
Klailova, Michelle; Hodgkinson, Chloe; Lee, Phyllis C
Gorilla tourism, widely perceived as a lucrative industry, is propelled by strong market demand with programs in five countries and for three of four gorilla subspecies. Human presence may negatively affect wild gorillas, potentially lowering immunity and increasing the likelihood of acquiring human-borne disease. Yet, behavioral impacts of humans on wild gorilla behavior remain largely unexplored, particularly for western lowland gorillas. We evaluate the impact of tourist presence, human observer numbers (tourists, trackers, and researchers), and human observer distance on the behavior of one habituated gorilla group at Bai Hokou, Central African Republic. Behavioral data were collected for more than 12 months from January 2007. Of silverback aggressive events, 39% (N=229) were human directed, but 65% were low-level soft barks. Adult females, and one in particular, were responsible for the highest number of aggressive events toward humans. Humans maintained closer proximity to the silverback when tourists were present, although tourist numbers had no significant impact on overall group activity budgets or rates of human-directed aggression. However, as research team size increased, group feeding rates decreased. Close observer-silverback distance correlated with a decrease in his feeding rates and an increase in human monitoring. He directed less aggression toward observers at distances >10 m, although observers spent 48.5% of time between 6 and 10 m of the silverback. We discuss gorilla personality as a factor in human-directed aggression. We explore whether the current 7 m distance limit governing gorilla tourism, based on disease transmission risks, is sufficient considering the potential behavioral stressor of close human presence. We recommend increasing minimum observation distance to >10 m where possible, decreasing observer group sizes, particularly after a visit consisting of maximum numbers and restricting tourist access to 1 visit/day. 2010 Wiley
Catanzarite, Tatiana; Tan-Kim, Jasmine; Whitcomb, Emily L; Menefee, Shawn
Work-related musculoskeletal disorders (WMSDs) are prevalent among surgeons and may result in practice modification. We aimed to perform a comprehensive review of the English-language literature regarding ergonomic risk, prevalence of WMSDs, and unique ergonomic considerations by route of surgery. Multiple searches were performed of PubMed and University library resources to access English-language publications related to surgeon ergonomics. Combinations of keywords were used for each mode of surgery, including the following: "ergonomics," "guidelines," "injury," "operating room," "safety," "surgeon," and "work-related musculoskeletal disorders." Each citation was read in detail, and references were reviewed. Surgeon WMSDs are prevalent, with rates ranging from 66% to 94% for open surgery, 73% to 100% for conventional laparoscopy, 54% to 87% for vaginal surgery, and 23% to 80% for robotic-assisted surgery. Risk factors for injury in open surgery include use of loupes, headlamps, and microscopes. Unique risks in laparoscopic surgery include table and monitor position, long-shafted instruments, and poor instrument handle design. In vaginal surgery, improper table height and twisted trunk position create injury risk. Although robotic surgery offers some advantages, it remains associated with trunk, wrist, and finger strain. Surgeon WMSDs often result in disability but are under-reported to institutions. Additionally, existing research tools face limitations in the operating room environment. Work-related musculoskeletal disorders are prevalent among surgeons but have received little attention owing to under-reporting of injury and logistical constraints of studying surgical ergonomics. Future research must aim to develop objective surgical ergonomics instruments and guidelines and to correlate ergonomics assessments with pain and tissue-level damage in surgeons with WMSDs. Ergonomics training should be developed to protect surgeons from preventable, potentially career
... basic and clinical research into many disorders. Additional Reading Active at Any Size! Binge Eating Disorder Dieting ... See more about obesity research at NIDDK . Next: Definition & Facts This content is provided as a service ...
Focus and Scope. The goal of the Annals of African Surgery is to provide a medium for the exchange of current information between surgeons in the African region. The journal embraces surgery in all its aspects; basic science, clinical research, experimental research, surgical education. It will assist surgeons in the region ...
... heart surgery that is becoming more common is robotic-assisted surgery. For this surgery, a surgeon uses a computer ... surgeon always is in total control of the robotic arms; they don't move on their own. Who Needs Heart Surgery? Heart surgery is used to treat many heart ...
Role of surgery in patients with recurrent, metastatic, or unresectable locally advanced gastrointestinal stromal tumors sensitive to imatinib: a retrospective analysis of the Spanish Group for Research on Sarcoma (GEIS).
Rubió-Casadevall, Jordi; Martinez-Trufero, Javier; Garcia-Albeniz, Xabier; Calabuig, Silvia; Lopez-Pousa, Antonio; Del Muro, Javier Garcia; Fra, Joaquin; Redondo, Andrés; Lainez, Nuria; Poveda, Andrés; Valverde, Claudia; De Juan, Ana; Sevilla, Isabel; Casado, Antonio; Andres, Raquel; Cruz, Josefina; Martin-Broto, Javier; Maurel, Joan
Recurrent, metastatic, and locally advanced gastrointestinal stromal tumors (GISTs) can be treated successfully with imatinib mesylate. Surgery for residual disease has been suggested for nonrefractory metastatic GISTs to reduce the probability of resistant recurrent clones, although no randomized Phase III trial has been performed to answer the question about its benefit. We carried out an analysis of the outcome of patients with recurrent unresectable locally advanced or metastatic imatinib-sensitive priamary GIST in 14 institutions in Spain. We compared two cohorts: treated or not treated with surgery after partial response or stabilization by imatinib. Data were obtained from the online GIST registry of the Spanish Group for Research in Sarcomas. Selected patients were then divided into two groups: group A, treated initially only with imatinib, and group B, treated additionally with metastasectomy. Baseline characteristics between groups were compared, and univariate and multivariate analysis for progression-free survival and overall survival (OS) were performed. Analysis was undertaken in 171 patients considered nonrefractory to imatinib. The median follow-up time was 56.6 months. Focusing on OS, the Eastern Cooperative Oncology Group performance status different than 0, extent of disease limited to one metastatic organ, and comparison between groups A or B achieved statistical difference in the multivariate analysis. Median survival was 59.9 months in group A and 87.6 months in group B. Based in its benefit in OS, our study supports surgery of metastatic disease in GIST patients who respond to imatinib therapy.
In May of 1999, the American Academy of Arts and Sciences hosted a conference on ways to improve the scientific quality of educational research. In medicine, thanks to work 40 years ago by 2 researchers, Howard Hyatt and Frederick Mosteller, the commitment of medical professionals to base their diagnoses and prescriptions on clinical trials in…
Results. Three emergent themes were identified from the results of this study: a lack of standardised guidelines for nurse academics to effectively supervise postgraduate research; the pressure that nurse academics experience regarding postgraduate research supervision; other demanding roles of an academic, such as a ...
first time, on the findings of a research study on the implementation of field trips in a management module in the BPharm curriculum and to conclude whether this intervention changed pharmacy students' perception of the module. Method. A mixed-method sequential exploratory research design was followed,.
Apr 29, 2016 ... Anonymity of respondents was assured by concealing their identity and research data was kept confidential for research purposes only. The study was conducted by full adherence of the ..... Samwel K. Misoi, Richard K. Rotich, Anthony K. Mwanthi and George. M. Mwita for their moderation throughout the ...
An interview guide approach was implemented in face-to-face in-depth interviews ... Dependability of the data collected was ensured through an audit trail. The main researcher and supervisor served as peer ....  A growing body of research reports that students with high academic resilience and self-efficacy are more ...
Research. 108 September 2017, Vol. 9, No. 3 AJHPE. Methods. This is a qualitative descriptive study that explored nursing students' experiences. ..... Challenges and lessons learned. Clin. Simulation Nursing 2013;9(5):e157-e162. https://doi.org/10.1016/j.ecns.2011.11.011. 12. Creswell JW. Research Design. 4th ed.
Rietveld, Toni; van Hout, Roeland
In this tutorial we review current practice in the analysis of data obtained in designs involving two dependent samples and evaluate two conventional statistics: the t test for paired samples and its non-parametric alternative, the Wilcoxon Signed Ranks test (WSR). It is a sequel to our tutorial on the analysis of designs with two independent samples on the basis of non-count data (Rietveld & van Hout, 2015). The frequency with which these statistics are used is assessed on the basis of publications on disordered communication in Clinical Linguistics & Phonetics, Journal of Communication Disorders and Journal of Speech, Language and Hearing Research for the time interval 2006-2015. We conclude with a number of recommendations for the analysis and presentation of data. Researchers should more consistently present the relevant characteristics of their data (means, medians, SD, skewness, tailedness, outliers etc.) and explicitly consider the assumptions that apply to their statistical methods, such as correlations between data obtained on two occasions, interactions between participants and treatment, and the symmetry of difference scores, many of which are hardly ever reported or even tested. Two recommendations are particularly relevant. First, the WSR is not a proper test for central tendencies as a replacement of the conventional t test for paired samples whenever assumptions about the dependent variable are in doubt. Second, researchers should choose statistical procedures on the basis of the null hypothesis (H0) to be tested and not primarily on the basis of the type of data (ordinal or interval). Two relevant H0's in the field of speech-language pathology are: (1) μ1=μ2 (the mean obtained in condition 1 is equal to the mean in condition 2) and (2) p=0.5, which says: the probability to obtain (for instance) higher scores in condition 2 than in condition 1 is 0.5. We recommend the permuted t test for paired samples to test the first H0 and the permuted Brunner
Vaccarelli, Alessandro; Ciccozzi, Chiara; Fiorenza, Arianna
the action-research "Outdoor training and citizenship between children from L'Aquila", carried out from 2014 to 2015 in some schools situated in the municipality of L'Aquila, aimed to answer to the needs emerged in reference to the social and psychological problems among children during the period after the L'Aquila earthquake occurred in 2009. In particular, the article provides documentary evidence about the results regarding the parts related to the study of resilience (cognitive objective) and of social relations (objective tied to the educational intervention), five years after the earthquake. the pedagogical research team, in close cooperation with the Cartography Laboratory of the University of L'Aquila and with the Grupo de Innovación Educativa Areté de la Universidad Politécnica de Madrid, has worked according to the research-action methodology, collecting secondary data and useful data to check the effectiveness of the educational actions put in place in order to promote resilient behaviours and to activate positive group dynamics. the study has been developed in 4 primary schools of the L'Aquila and has involved 83 children from 8 to 12 years. A control group made by 55 subjects, homogeneous for sex and age, has been identified in the primary schools of Borgorose, a little town near Rieti (Central Italy). data about the abilities of resilience and about the response to the stress have been collected in the first phase of the study with the purpose to outline the initial situation and develop an appropriate educational intervention. The comparison with the control group made by 55 subjects who were not from L'Aquila allowed to check that, 5 years after the disaster, the context of life produces a meaningful discrepancy in terms of responses to the stress and to the ability of resilience, and this fact is definitely negative for children from L'Aquila. On the other hand, data related to social relations allowed to verify how the educational intervention
Essig, Harald; Rana, Majeed; Kokemueller, Horst; Zizelmann, Christoph; von See, Constantin; Ruecker, Martin; Tavassol, Frank; Gellrich, Nils-Claudius
As a prerequisite in navigation-assisted surgery, a three-dimensional image data set with registration marker is necessary. Often patients are presented, not being aware of facing a computer-assisted surgical intervention (CAS), with an already performed computed tomography (CT) data set without marker. The aim of this study was to evaluate the accuracy of a new method which allows performing CAS by enhancing the initial markerless data set with a marked subvolume gained by cone beam (CBCT) scan. Therefore four registration markers are inserted and afterwards the patient is strongly limited to the field of interest scanned by CBCT scan (marked data set). Superimposed with the initial data set, a data set with reference markers and with full information is obtained. Registration procedure was performed with group A (25 patients, superimposed marked CBCT scan) and group B (25 patients, initially marked CT scan) using BrainLab® navigation by two observers and overall system accuracy was measured using the registration landmarks and additional intraoperative landmarks (tooth cusps). Adequate image quality assumed, no significant difference between group A and B was detected. Enhancing an initially performed data set with registration marker by using a marked subvolume could improve the workflow for navigation-assisted surgery due to the availability of cone beam scan technology, provide excellent resolution with reduced metal artifacts nearby dental restorations, and reduce radiation dose for the patient. Regarding the advantages of the new method which allows performing CAS by enhancing the initial markerless data set with a marked subvolume gained by cone beam (CBCT) scan, this technique will play a major part in navigation-assisted surgery and will address widespread general methodological solutions that are of great interest in multidisciplinary treatment. Copyright © 2013 John Wiley & Sons, Ltd.
Starzyńska, Anna; Pawłowska, Anita; Renkielska, Dorota; Michajłowski, Igor; Sobjanek, Michał; Błażewicz, Izabela; Włodarkiewicz, Adam
Oral leukoplakia (OL) is the most common potentially malignant lesion of the oral cavity. The purpose of the study was clinical and epidemiological analysis of patients with OL diagnosed and treated in the Department of Maxillofacial and Oral Surgery, Medical University of Gdansk, comparison of effectiveness of treatment methods, defining whether van der Waal level of OL influences treatment effectiveness, correlation between localization of OL and treatment effectiveness, and defining the optimal OL therapeutic method. Among 55 911 patients diagnosed and treated in the Department in the years 1999-2009, 204 people with OL were selected (104 women, 100 men, average age: 58.1 years). Treatment and observation period of 6 months was completed by 178 (87.25%) patients. Seventy-four patients were treated with cream containing 0.05% tretinoin. Sixty-three patients underwent cryosurgery, and 41 surgery. Control visits were made in week 2, 4, 6 and 8 and 6 months after completed treatment. Three hundred and twenty lesions of OL were diagnosed. According to van der Waal classification, the largest group of patients was classified into stage I and II. The percentage of totally cured patients was 90.07%. There were no statistic differences in effectiveness between surgical and cryosurgical treatment. Evaluation of OL treatment methods depends on localization of the lesions and its stage of progression. The effectiveness of treatment with locally applied tretinoin is smaller in comparison to surgery and cryosurgery. It allows to reduce the number and size of OL lesions, what makes it possible to reduce the number of ablative procedures.
Research in Biological and Medical Sciences, Including Biochemistry, Communicable Disease and Immunology, Internal Medicine, Nuclear Medicine, Physiology, Psychiatry, Surgery and Veterinary Medicine. Volume 2
surgery, or blood banking. In addition evidence is presented in support of steroids being of benefit in shock therapy. 863 MMMiimmM kteUÜM i 1 lüii...out- weigh the benefits if the work were to be pursued. Work on the synthesis of potential hypoxanthine-guaninephosphori- bosyl transferase...south and 18 Km west of Altamira (3° 22’ S, 52° 23’ W). Four types of forest were sampled in this site; acai swamp, low1 and, sidehill
Full Text Available ... surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on ... without straining Chronic mouth breathing Sleep apnea (breathing problems when sleeping, including snoring) Your dentist, orthodontist and ...
Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...
... also be robotically assisted in certain cases. During robotic surgery, the surgeon watches a 3-D monitor and ... weeks after surgery. Those who undergo laparoscopic or robotic surgery may return to full activity sooner — as early ...
... 3 or 4 small cuts in the belly. Robotic surgery is similar to laparoscopic surgery, except that the ... Elsevier Saunders; 2011:560. Richstone L, Scherr DS. Robotic and laparoscopic surgery. In: Wein AJ, Kavoussi LR, Partin AW, Peters ...
Full Text Available ... Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures ...
... medlineplus.gov/ency/article/007649.htm Surgery for pancreatic cancer To use the sharing features on this page, ... surgeries are used in the surgical treatment of pancreatic cancer. Whipple procedure: This is the most common surgery ...
... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... minimally invasive techniques (laparoscopic surgery). The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric ...
Full Text Available ... Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral ...
... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Glaucoma Education Center Pediatric Ophthalmology Education Center Oculofacial Plastic ... Center Laser Surgery Education Center Redmond Ethics Center ...
... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Glaucoma Education Center Pediatric Ophthalmology Education Center Oculofacial Plastic ... Center Laser Surgery Education Center Redmond Ethics Center ...
... heart disease Gastric bypass surgery Laparoscopic gastric banding Obesity Obstructive sleep apnea - adults Type 2 diabetes Patient Instructions Getting out of bed after surgery Weight-loss surgery - after - what to ask your doctor Weight- ...
... Y gastric bypass; Gastric bypass - Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass Patient Instructions Bathroom safety - adults Gastric bypass surgery - discharge Laparoscopic gastric banding - discharge ...
Full Text Available ... Do Who We Are News Videos Contact Find a Surgeon What We Do Administration of Anesthesia Administration ... Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries ...
Li, Nan; Wang, Jing; Wang, Xue-lian; Chang, Chong-wang; Ge, Shun-nan; Gao, Li; Wu, He-ming; Zhao, Hai-kang; Geng, Ning; Gao, Guo-dong
Opiate addiction remains intractable in a large percentage of patients, and relapse is the biggest hurdle to recovery because of psychological dependence. Multiple studies identify a central role of the nucleus accumbens (NAc) in addiction; several studies note decreased addictive behavior after interventions in this area. Based on animal experiments, our institute started the clinical trial for the treatment of drug addicts' psychological dependence by making lesions in the bilateral NAc with stereotactic surgery from July 2000. The short-term outcomes were encouraging and triggered rapid application of this treatment in China from 2003 to 2004. However, lack of long-term outcomes and controversy eventually led to halting the surgery for addiction by the Ministry of Health of China in November 2004 and a nationwide survey about it later. Our institute had performed this surgery in 272 patients with severe heroin addiction. The follow-up study showed that the 5-year nonrelapse rate was 58% and the quality of life was significantly improved. Patients had several kinds of side effects, but the incidence rate was relatively low. The patients gradually recovered more than 5 years after the surgery. The side effects did not severely influence an individual's life or work. Nationwide surgery showed that the nonrelapse rate was 50% in the sample of 150 cases, from 1167 patients overall who underwent stereotactic surgery in China. Although sometimes accompanied by neuropsychological adverse events, stereotactic ablation of NAc may effectively treat opiate addiction. Lesion location has a significant impact on treatment efficacy and requires further study. Because ablation is irreversible, the NAc surgery for addiction should be performed with cautiousness, and deep brain stimulation (DBS) is an ideal alternative. Copyright © 2013 Elsevier Inc. All rights reserved.
Sep 9, 2015 ... Traumatology, Umraniye Research and Education Hospital, 34899 ... This is an Open Access article distributed under the terms of the Creative Commons .... and major complication such as pain, seroma, dog ears, widening of.
that should promote basic capabilities and functionings as well as academic achievement. ... for development and wellbeing on an educational, personal and social level. ... Research indicates that academic stressors, living circumstances, working conditions and where students undertake leisure activities affect.
Aug 28, 2015 ... Ethiopia, 2Bahir Dar Regional Health Research Laboratory Center, Department ... of Public Health, 4Institute of Medical Microbiology and Epidemiology of Infectious .... active ingredient x 10,000 dilution rate of product): 0.1%.
Nov 14, 2011 ... Background: For many women in Kenya, their husbands act as ... and researching whether men are translating this knowledge into action ..... older participants, and participants with multiparous wives, reflecting personal.
Jeysen, Zivan Yogaratnam; Gerard, Laden; Levant, Guvendik; Cowen, Mike; Cale, Alex; Griffin, Steve
We have previously conducted and reported on the primary endpoint of a clinical study which demonstrated that hyperbaric oxygen (HBO2) preconditioning consisting of two 30-minute intervals of 100% oxygen at 2.4 atmospheres absolute (ATA) prior to coronary artery bypass graft (CABG) surgery leads to an improvement in left ventricular stroke work (LVSW) 24 hours following CABG. In that study, 81 patients were randomized to treatment with HBO2 (HBO2; n = 41) or routine treatment (Control Group; n = 40) prior to surgery. The objective of this manuscript is to further report on the result of the exploratory secondary endpoints from that study, specifically the effects of HBO2 preconditioning on biomarkers of myocardial protection. Intraoperative right atrial biopsies were assessed, via an Enzyme Linked ImmunoSorbent Assay (ELISA), for the expression of eNOS and HSP72. In this study, no significant differences were observed between the groups with respect to the quantity of myocardial eNOS and HSP72. However, in the HBO2 Group, following ischemia and reperfusion, the quantities of myocardial eNOS and HSP72 were increased. This suggests that HBO2 preconditioning in this group of patients may be capable of inducing endogenous cardioprotection following ischemic reperfusion injury (IRI).
Longchamp, Alban; Harputlugil, Eylul; Corpataux, Jean-Marc; Ozaki, C Keith; Mitchell, James R
Dietary restriction (DR) is best known for extending lifespan in experimental model organisms, but also increases resistance to a variety of clinically relevant stressors, including those associated with surgery. Extended periods of DR, lasting months to years, are required for optimal longevity benefits in rodents, but short-term dietary preconditioning (less than 1 week) remarkably protects from acute injury. Here, we discuss recent advances in our understanding of the mechanistic basis of short-term DR and fasting in the context of surgical stress resistance, including upstream amino acid sensing by the GCN2 and mTORC1 pathways, and downstream effector mechanisms including increased insulin-dependent prosurvival signaling and elevated endogenous hydrogen sulfide production. We also review the current trend in preoperative nutrition away from preoperative fasting and towards carbohydrate loading. Finally, we discuss the rationale for the nonmutually exclusive use of brief DR or pharmacological DR mimetics to precondition against the stress and potential complications of surgery. © 2017 S. Karger AG, Basel.
Baffaut, Claire; John Sadler, E; Ghidey, Fessehaie; Anderson, Stephen H
Starting in 1971, stream flow and climatologic data have been collected in the Goodwater Creek Experimental Watershed, which is part of the Central Mississippi River Basin (CMRB) Long-Term Agroecosystem Research (LTAR) site. Since 1992, water quality and socio-economic data have complemented these data sets. Previous modeling efforts highlighted the challenges created by the presence of a claypan. Specific changes were introduced in the Soil and Water Assessment Tool (SWAT) (i) to better simulate percolation through and saturation above the claypan and (ii) to simulate the spatial and temporal distributions of the timing of field operations throughout the watershed. Our objectives were to document the changes introduced into the code, demonstrate that these changes improved simulation results, describe the model's parameterization, calibration, and validation, and assess atrazine [6-chloro--ethyl-'-(1-methylethyl)-1,3,5-triazine-2,4-diamine] management practices in the hydrologic context of claypan soils. Model calibration was achieved for 1993 to 2010 at a daily time step for flow and at a monthly time step for water quality constituents. The new percolation routines ensured correct balance between surface runoff and groundwater. The temporal heterogeneity of atrazine application ensured the correct frequency of daily atrazine loads. Atrazine incorporation by field cultivation resulted in a 17% simulated reduction in atrazine load without a significant increase in sediment yields. Reduced atrazine rates produced proportional reductions in simulated atrazine transport. The model can be used to estimate the impact of other drivers, e.g., changing aspects of climate, land use, cropping systems, tillage, or management practices, in this context. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.
Lauszus, Finn F; Petersen, Astrid C; Neumann, Gudrun
OBJECTIVE: To describe the outcome of adult granulosa cell tumor (AGCT) with respect to initial clinical findings, methods of surgery, and perioperative treatment. STUDY DESIGN: Retrospective follow-up study. Setting: All hospitals in Jutland. Sample: 163 women diagnosed with AGCT. Methods: Follo...... with similar survival compared to extensive surgery, but with advancing age conservative surgery increased the risk of relapse and death....
Off-pump coronary artery bypass - discharge; OPCAB - discharge; Beating heart surgery - discharge; Bypass surgery - heart - discharge; CABG - discharge; Coronary artery bypass graft - discharge; Coronary artery ...
Holst, Mette; Rasmussen, Henrik H; Irtun, Oivind
This review addresses recent relevant advances to clinical nutrition regarding gastrointestinal disease surgery. Medline Ovid, EMBASE and Central were searched systematically in April 2014. Inclusion criteria were randomized controlled trials, non-randomized controlled trials and observational studies evaluating nutritional support in gastrointestinal surgery published within 5 years. The review included 56 relevant studies. Themes were: nutrition screening and risk factors predict outcome; preoperative nutritional support; shortening fasting periods and including carbohydrate solutions; early nutrition after surgery; immune modulating nutrition; synbiotics, growth hormone, omega-3 and oral, enteral and parenteral nutrition in combination. Screening for nutritional risk is profound, with special focus on dietary intake in the past week. Age and severity of disease need to be included in the screening system. Patients at severe nutritional risk benefit from nutritional therapy before surgery. New standards are developing quickly and clinical guidelines on surgery should include updated knowledge within clinical nutrition.
Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos
Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Agyei3. 1 Tain District Hospital, Nsawkaw, BrongAhafo Region (BAR); Ghana. 2 Regional Health Directorate, Sunyani, BAR; Ghana. 3 Kintampo Health Research Centre, Kintampo, BAR; Ghana. Corresponding author: Michael Adjei Rockson ...
Full Text Available Security and perfect vision and fewer complications are our goals in cataract surgery, and hard-nucleus cataract surgery is always a difficulty one. Many new studies indicate that micro-incision phacoemulsification in treating hard nucleus cataract is obviously effective. This article reviews the evolution process of hard nuclear cataract surgery, the new progress in the research of artificial intraocular lens for microincision, and analyse advantages and disadvantages of various surgical methods.
Procopiuc, Livia; Tudor, Ştefan; Mănuc, Mircea; Diculescu, Mircea; Vasilescu, Cătălin
Minimally invasive surgery for gastric cancer is a relatively new research field, with convincing results mostly stemming from Asian countries. The use of the robotic surgery platform, thus far assessed as a safe procedure, which is also easier to learn, sets the background for a wider spread of minimally invasive technique in the treatment of gastric cancer. This review will cover the literature published so far, analyzing the pros and cons of robotic surgery and highlighting the remaining study questions. PMID:26798433
Nov 6, 2013 ... 1University of Botswana, Gaborone, Botswana, 2Research Institute for Humanity and Nature, Kyoto, Japan, 3School of Public Health, University of the Western Cape, Bellville, South Africa, 4Japan Overseas Christian Medical Co-operative Services, C/o Roman Catholic Archdiocese of Tabora,. Private Bag ...
212-218. [http:// dx.doi.org/10.1207/s15430421tip4104_2]. 22. Pepper C. 'There's a lot of learning going on but NOT much teaching!': Student perceptions of problem-based learning in science. Higher Education Research & Development 2010 ...
Mar 24, 2017 ... 26 March 2017, Vol. 9, No. 1 AJHPE. Research were distributed among varying levels of advancement within the EM training programme (Table 1). Responses to the qualitative section of the survey were categorised into major themes, providing insight into the overall acceptability of small-group education.
Research. December 2017, Vol. 9, No. 4 AJHPE 189. Community-based education (CBE) is a learning approach that enables students to acquire skills by means of ... of CBE include early contact with the community, improved teamwork of ... A descriptive cross-sectional survey was conducted at the University of Zimbabwe.
Aug 6, 2015 ... permanent contraceptive methods and women's education (AOR=1.72, 95%CI = 1.02 - 3.05), women's occupation (AOR = 2.01, 95% CI = 1.11 -. 3.58), number of live .... NGO's and presence of different Medias in the area. The result of this .... Social and Behavior Change Communication. Research Brief.
Jan 27, 2016 ... (SD) age of the male subjects was 38.4(14.9) years and that of the females was 40.8(13.9) years (p> 0.05). The overall ... Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net) ... Trained research assistants administered questionnaires and obtained the ...
YouTube, TED and other podcast websites. Other researchers have also documented their procedures. Corl et al. describe the basic process of producing a podcast, and Jham et al. list a number of universities actively doing podcasts. Besides the lecture podcasts, we have also captured numerous clinical.
Jan 5, 2015 ... Methods: this was a descriptive cross-sectional study conducted in Talensi district in the Upper East Region of Ghana. Systematic random ..... 14. Saunders MNK, Lewis P and Thornhill A. Research methods for business students. FT Prentice Hall. (2003); 3rd Edition. Harlow. Google Scholar. 15. Allen K ...
Feb 17, 2012 ... Organizational Behaviour and Human Decision Processes. 2000; 50: 79-211. 13. Montano DE and Kasprzyk D. The Theory of Reasoned Action and the Theory of Planned Behaviour Glanz, K Lewis, FM Rimer, BK eds. Health Behaviour and Health Education, Theory, Research and Practice: Jossy Bass ...
Apr 15, 2016 ... 1National Reference Center in Neonatology and Nutrition, Children's Hospital, University Hospital, Rabat, Morocco, 2Research Team on Health and ... This is an Open Access article distributed under the terms of the Creative Commons .... were globally performed in older mothers with a mean age of 31.5.
the standard of future practice. Therefore, it is imperative for healthcare educators to understand the issues students face in their everyday fieldwork practice and equip them to deal with these ethical issues. Objectives. The objective of this research was to determine the issues that students face in their fieldwork practice and ...
Jan 15, 2015 ... diagnosed cases with FNAB as either benign or malignant when correlated with histology were 95% and 100% respectively. Conclusion: FNAB is ... foot). This study was conducted in compliance with the guidelines of the Helsinki declaration on biomedical research in human subjects. Confidentiality of the ...
Dec 16, 2015 ... of this policy, there is need to monitor the implementation progress, identify the challenges and mitigate them and determine better strategies for implementation .... Ethical Considerations: ethical Clearance to carry out the research ... 10% of the respondents reported that the government was doing enough ...
Received: 03/12/2014 - Accepted: 15/01/2015 - Published: 13/03/2015. Abstract. Introduction: ... Studies have called on the need for further additional research to establish how supportive supervision in health systems should be best carried out effectively .... male to female medical practitioners in Kenya stood at 60% and.
Jun 9, 2015 ... The authors sincerely thank the staff of Clinical Research Education,. Networking and Consultancy (CRENC), Douala Cameroon for statistical analysis, data interpretation and assistance in drafting the manuscript. Tables and figures. Table 1: Characteristics (socio-demographic and clinical) of women.
Oct 29, 2013 ... mosquito-borne diseases, however, limited research has been documented on infections with dengue. This study ... presence of antibodies against dengue virus 2 (denv-2) in a cross-section of febrile out-patients visiting three selected hospitals to assess the level .... treatments prescribed was recorded.
May 10, 2017 ... (Approval number B/874), Joint Research Ethics Committee, Health Studies Office and the Manicaland Directorate Institutional Review Board. Written informed .... parasites, but without any features of severe malaria between. September ..... T-lymphocytes, impairment of antibody formulation and atrophy of.
Apr 14, 2016 ... Methods: A mixed methods study was conducted using both .... Methods. Study design: A mixed method cross-sectional design using both quantitative and qualitative research methods as described by. Hanson et al  was employed. ..... Musheke M, Ntalasha H, Gari S, McKenzie O, Bond V, Martin-.
Aug 25, 2011 ... euthanasia were also queried. Data was analyzed using Epidata, SPSS 16.0 and Microsoft Excel. Results: Thirty-eight (97.4%) of thirty-nine institutions reported using animals for education and/or research. Thirty (76.9%) institutions reported using analgesics or anesthetics on a regular basis. Thirteen ...
Apr 28, 2016 ... Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net). Research .... interstitial compartment and may lead to distal tubular damage, some with attendant nephrogenic diabetes ..... Model Summary R=0.861, R2=0.742, Standard error of estimate=0.046, p<0.001.
Jan 30, 2015 ... Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net). Research. Open Access ... compartment syndrome [4,5]. According to the literature, incidence ... fed into a multiple regression model to assess the odds ratio. Results. Between March 2012 and March 31, ...
1 AJHPE 43. Research. Patient-centredness requires pharmacists to view their patients as individuals with unique experiences. Each patient in their social context responds uniquely to ... To determine the prevalence of the 16 different Myers-Briggs Type Indicator®(MBTI®) communication styles, and compare them with.
The mixed-methods approach was selected as the most appropriate research design for data collection and analysis. The use of multiple data collection instruments and sources provided a broader perspective and deeper understanding of the core concepts of the evaluation from the perspective of multiple sources. Results ...
During Phase I of the mixed-methods research design, data were collected by means of a nominal group technique. Nominal group discussions were held with the class leaders to identify possible themes/ topics to describe the perceptions of health sciences students with regard to. CBE and SL. These themes and topics ...
than student assessment.[12,13] One needs to ... Cut scores for students' assessments have always been arbitrarily determined in many institutions. Some institutions ..... Research. December 2017, Vol. 9, No. 4 AJHPE 175 correct answers to the judges before the scoring exercise, an observation that arguably creates bias.
2 AJHPE. Research. The Ugandan Ministry of Health (MOH) identified lack of leadership and management skills, rather than lack of resources, as the main reason for poor healthcare delivery in the country. Healthcare professionals, as an integral component of Uganda's healthcare system, receive a high level of training ...
Jan 11, 2012 ... 1MPH Programme, Department of Community Medicine, University of Zimbabwe, Zimbabwe, 2Department of Epidemiology and Disease Control,. Ministry ... Pan African Medical Journal. 2012; 11: ..... Mufuta Tshimanga: Had oversight of all the stages of the research and critically reviewed the final draft for.
Research. Clinical teaching is a technique used in the education of nurses. It involves the exposure of students to authentic clinical environments and guiding them to attain specific requirements applicable in that particular environment. The clinical environment is a platform for the application of knowledge and skills that ...
This model involves the allocation of nursing students to a qualified professional nurse who, in the course of ... who qualified in general nursing and midwifery at a rural hospital in. Lesotho. Eight professional .... research that explored the experiences and perceptions of healthcare workers in clinical environments about the ...
Apr 20, 2016 ... were reviewed using an agreed data collection pro forma considering 3 main outcomes; i) quantity of complete entries, ii) percentage completeness of individual sections, iii) documentation ... impossible to evaluate the reliability of this data and the utility of these books as a tool for research. A clinical audit ...
May 1, 2017 ... p=0.019) respectively. Conclusion: Patient's perceived attitude and stigma towards treatment observers contribute to non-adherence on TB treatment. For improved local TB control, ... Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net). Research. Open Access ...
tions as their reality.. Research context. At Stellenbosch University (SU), Cape Town,. SA, final-year physiotherapy students each spend. 6 weeks at a community site learning to integrate and apply the principles of PHC and community- based rehabilitation. Approximately 5 - 10 clients are seen in their homes per week.
acquire public health, clinical, and/or research skills, usually through applied learning in a community setting, with goals that include: creating knowledge, skills and attitudes among students to ensure they are capable of providing high- quality health services to local, underserved communities, often in rural areas.
Communities provide the reality of social and health challenges and therefore provide the platform for learning and exploring their authentic challenges. Community-university partnerships are thus intended to bring together academic researchers and communities, share power, establish trust, foster co-learning, enhance ...
good) and the weaknesses (things that need to be improved) of students' performance, and possible things that can be improved after the mini-CEX assessment. The existence of this reflection on experience indicates that there has been a deep learning process.[12,14] We suggest that future research should elaborate on ...
Jul 13, 2016 ... definitions of invasive fungal disease of the European Organization for Research and Treatment of Cancer/Mycosis Study Group. (EORTC/MSG) . In total, 91 patients were identified that among them, 16 were excluded because of discharge against medical advice. The cases that were diagnosed on an ...
May 13, 2016 ... based study that enrolled breast cancer patients from catchment area of an oncology service hospital in Nigeria between 2007 and 2013. ... ISSN: 1937- 8688 (www.panafrican-med-journal.com). Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net). Research.
Feb 17, 2012 ... Psychology and Health. 2001; 16(4): 423-441. 15. Creswell J: Research Design. Qualitative & Quantitative Approaches. 1994; Sage Publications. 16. Biomedical communication. Avalable at http://www.bmc.med.utoronto.ca/bmc/index.php. Accessed 1 February 2012. 17. Glaser BG. Emergence vs. Forcing.
Mar 2, 2017 ... In summary, this study explored the perceptions and experiences of nurse educators' use of HFS in teaching, as its acceptability by educators as a teaching strategy is important for effective use. Methods. Research design. A descriptive, qualitative case study design was utilised to explore nursing.
May 2, 2014 ... the quality of graduates and providing them with the necessary skills and competencies to ... However, most of the aforementioned evaluation studies focus on the training process .... except two areas, i.e. X-ray image interpretation and research skills. All 72 respondents ... Ultrasound. Mammography.
May 26, 2016 ...  At the nucleus of systems thinking is the ability 'to balance the interests of several conflicting interests with an ultimate focus on the benefit of the institution as a whole'. ... The longitudinal series of interviews formed part of the first author's action research design, aimed at her professional development.
Mar 13, 2014 ... Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net). Research ..... Artisan. 361(15.1). Civil servant. 348(14.6). Professional/Business Executive. 138(5.8). Mode of acquisition of HIV. Heterosexual Contact. 1876(78.5). Blood and Blood product. 129(5.4). MTCT.