The Benefits of Expert Instruction in Microsurgery Courses

2020 ◽  
Author(s):  
Joseph Paladino ◽  
Konstantinos Gasteratos ◽  
Yelena Akelina ◽  
Brittany Marshall ◽  
Lysimachos G. Papazoglou ◽  
...  
Keyword(s):  
United States ◽  
The Other ◽  
Columbia University ◽  
Venous Anastomosis ◽  
P Values ◽  
Repeated Practice ◽  
Proficiency Level ◽  
Chi Squared ◽  
And Training

Abstract Background Microsurgery requires repeated practice and training to achieve proficiency, and there are a variety of curriculums available. This study aims to determine the importance of an expert instructor to guide students through procedures. We compared student proficiency across two microsurgery courses: one with (Columbia University, United States [CU] cohort) and one without a dedicated microsurgery instructor (University of Thessaloniki, Greece [UT] cohort). Methods Students were divided into two cohorts of 22 students (UT cohort) and 25 students (CU cohort). Student progress was evaluated by examining patency (lift-up and milking tests), anastomotic timing, and quality (Anastomosis Lapse Index [ALI]) of end-to-end arterial and venous anastomoses on day 1 and again on day 5. Chi-squared tests evaluated patency immediately and 30 minutes postoperation. t-Tests evaluated anastomotic timing and ALI scores. p-Values < 0.05 were considered significant. Results We evaluated progress within and between each cohort. Within the CU cohort, the quality of the arterial and venous anastomosis improved, respectively (by 54%, p = 0.0059 and by 43%, p = 0.0027), the patency of both the arterial and venous anastomosis improved, respectively (by 44%, p = 0.0002 and by 40%, p = 0.0019), and timing of arterial and venous anastomosis reduced respectively (by 36%, p = 0.0002 and by 33%, p = 0.0010). The UT cohort improved the quality of their arterial anastomoses (by 29%, p = 0.0312). The UT cohort did not demonstrate significant improvement in the other above-mentioned parameters. The CU cohort improved materially over the UT cohort across categories of quality, patency, and timing. Conclusion There are clear benefits of an expert instructor when examining the rate of progress and proficiency level attained at the conclusion of the course. We suggest students who are seeking to maximize proficiency in microsurgical procedures enroll in courses with an expert instructor.

Quality of Glucosamine Products: Is it a Potential Reason for Inconsistent Clinical Outcomes in Osteoarthritis?

2020 ◽  
Author(s):  
Chhavi Asthana ◽  
Gregory M Peterson ◽  
Madhur D Shastri ◽  
Rahul P Patel
Keyword(s):  
United States ◽  
Clinical Studies ◽  
The United States ◽  
The Other ◽  
Quality Analysis ◽  
Therapeutic Effects ◽  
Clinical Effects ◽  
United States Pharmacopoeia ◽  
Potential Reason

Abstract Background Clinical studies have reported inconsistent outcomes of glucosamine therapy in osteoarthritis patients. One possible reason could be the use of glucosamine products of varying quality. Objective Hence, this study aimed to assess the quality of glucosamine products marketed in Australia and India. This is the first study to investigate both the content and dissolution profiles of glucosamine products. Method The content and dissolution analysis of Australian (n = 25 brands) and Indian (n = 21 brands) glucosamine products was performed according to the criteria specified in the United States Pharmacopoeia (USP). Results The quality analysis revealed that 16% and 18% of Australian brands, as well as 24% and 19% of Indian brands, did not fulfil the USP content and dissolution criteria, respectively. In approximately half of these cases, the glucosamine content was only slightly below (&lt;3%) that specified by the USP and dissolution was achieved within 15 min after the duration specified by the USP. Conclusions The majority of the brands did meet both the content and dissolution analysis criteria of the USP. The extent of deviation from the specified criteria for the other brands was probably insufficient to account for the significant variability in clinical effects. Hence, the study proposed that inter-patient pharmacokinetic variations in glucosamine could be another potential reason for inconsistent therapeutic effects. Highlights

scholarly journals The Middle East and the United States: A Problem of “Brain Drain”

1977 ◽  
Vol 8 (1) ◽  
pp. 65-90 ◽  
Author(s):  
Hossein G. Askari ◽  
John Thomas Cummings
Keyword(s):  
United States ◽  
Human Capital ◽  
National Income ◽  
Physical Capital ◽  
The United States ◽  
Industrialized Nations ◽  
Managerial Knowledge ◽  
Determinants Of Economic Growth ◽  
And Training

In explaining the determinants of economic growth, economists have attempted to distinguish the relative contributions made by various inputs. Theodore Schultz concluded that improvements in human capital have made larger contributions to growth than increases in physical capital. E. F. Denison was even more specific in his pioneering studies of changes in real national income in the United States from 1927 to 1967, estimating that 23 percent of the growth could be explained by improvements in the educational level of the labor force and 20 percent by advances in technological and managerial knowledge. On the basis of such results, we may conclude that expenditures on education and training, public health, and general research contribute significantly to productivity in the industrialized nations by raising the quality of human capital; thus these outlays command a continuing return in the future.

Ten-Print Fingerprint Capture: Effect of Instructional Modes on User Performance

2007 ◽  
Vol 51 (10) ◽  
pp. 597-601
Author(s):  
Mary Theofanos ◽  
Brian Stanton ◽  
Shahram Orandi ◽  
Ross Micheals ◽  
Nien-Fan Zhang
Keyword(s):  
United States ◽  
User Behavior ◽  
United States Government ◽  
Capture Effect ◽  
User Performance ◽  
Verbal Instructions ◽  
States Government ◽  
Customs And Border Protection ◽  
And Training

Despite the increased deployment of biometric technologies in United States government applications, not enough attention is being paid to the human factors that such technologies involve. The use of biometric applications will be unfamiliar to many users, who may neither understand nor be comfortable with the technology. Currently, U.S. Customs and Border Protection (CBP) Officers are critical in communicating and training users in the acquisition of fingerprints. Since user behavior can affect both the throughput of the system as well as the quality of the captured images, guidelines for developing interactions with biometric applications that increase throughput and image quality would be valuable. This study examines the effect of instructional modes on user performance. Posters were not as effective in providing instructions to users as video or verbal instructions.

The African Derivation of Black Fraternal Orders in the United States

1983 ◽  
Vol 25 (4) ◽  
pp. 559-592 ◽  
Author(s):  
Betty M. Kuyk
Keyword(s):  
United States ◽  
Detailed Analysis ◽  
Jim Crow ◽  
The United States ◽  
Turn Of The Century ◽  
The Other ◽  
Black And White ◽  
Fraternal Organizations ◽  
Key Phrases

At the turn of the century, when lynching, Jim Crow laws, and disfranchisement were at their worst, black fraternal organizations offered Afro-Americans a place to preserve their self-respect. Scholars have studied these organizations little and understood them less. One early study dismissed them as merely parodying white organizations, but hardly resembling them, while the blacks, it claimed, exaggerated both regalia and ritual. When Noel Gist published his Study of Fraternalism in the United States, Carter Woodson charged that Gist failed to understand the importance of fraternal orders to blacks and that, indeed, Gist barely mentioned the black orders. After a detailed analysis, W. E. B. DuBois found that even black and white orders that shared a name might not resemble one another. He found similarities only in Pythians, Odd Fellows, and Masons. He thought the other black societies were “Negro inventions” and “curious and instructive” organizations. “Invention,” “curious,” “exaggeration,” “parody,” “importance to blacks”—these are the key phrases. All attempt to describe an amorphous quality of black fraternal orders that makes them unique. Yet while failing to define that quality, its would-be describers avoid the issue.

Answers to Fallacies on the Decimal Question: Balance of Trade, Exchanges, and Common Coins

1855 ◽  
Vol 5 (4) ◽  
pp. 304-309
Author(s):  
William Brown
Keyword(s):  
United States ◽  
The United States ◽  
The Other ◽  
The Face ◽  
Balance Of Trade ◽  
Fine Gold

Let us suppose France and the United States to enter into a convention with us to issue pieces of gold of the same weight and fineness as our sovereign—that is, containing 113 grains of fine gold; the three countries would then have a common standard of gold money. Let us examine whether, in the face of the operations of commerce, the international quality of value of these coins could at all times be maintained. The temporary balance of trade is always fluctuating in favour of one or the other country; a permanent balance against any country is impossible.

scholarly journals The effect of cane vigour on the kiwifruit (Actinidia chinensis) and kiwiberry (Actinidia arguta) quality

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aljaz Medic ◽  
Metka Hudina ◽  
Robert Veberic
Keyword(s):  
Fruit Quality ◽  
Fruit Size ◽  
The Other ◽  
Actinidia Chinensis ◽  
Plant Vigour ◽  
Actinidia Arguta ◽  
Training Systems ◽  
And Training ◽  
Pruning Technique

AbstractKiwifruit has not been studied as much as other well-known fruits especially when it comes to studies about plant vigour and training systems. The aim of the study was to determine the importance of cane vigour of Actinidia chinensis var. deliciosa ‘Hayward’ and Actinidia arguta ‘Issai’ in order to develop the proper pruning technique that results in the best fruit quality. In addition, the effect of storage parameters such as weight, firmness and quality of the fruit was also studied. The study showed that the fruit size and weight are lower in low vigour canes in A. arguta, in contrast to A. chinensis, where the fruit size and weight are smaller on high-vigorous canes. For A. arguta, it is recommended to choose high-vigour canes as the optimal fruit wood during pruning. In this way, the fruits will ripen more evenly. The other possibility is to perform the harvest two to three times per season to achieve a more uniform fruit quality. In the case of A. chinensis the fruit are less variable between different cane vigour, so harvesting can be done in a single picking. In A. chinensis the less vigorous canes tend to show a slightly better fruit quality.

scholarly journals Improving Fluidization Hydrodynamics of Group C Particles by Mixing with Group B Particles

2018 ◽  
Vol 8 (9) ◽  
pp. 1469 ◽  
Author(s):  
Ebrahim Al-Ghurabi ◽  
Abdelhamid Ajbar ◽  
Mohammad Asif
Keyword(s):  
Activated Carbon ◽  
Pressure Drop ◽  
Calcium Hydroxide ◽  
The Other ◽  
Particle Mixing ◽  
External Group ◽  
Chi Squared ◽  
Group B ◽  
Porous Activated Carbon

We have developed a new particle-mixing strategy for improving the fluidization hydrodynamics of Geldart group C powders by mixing with small proportions of group B particles. Two different group C particles with widely different physical properties, i.e., 1 μm calcium hydroxide powder and 27 μm porous activated carbon, were selected for investigation in the present work. A carefully sieved sample of inert sand was used as external group B particles for mixing. Fluidization experiments were carried out, and the quality of the fluidization was assessed using the fluidization index. For the monocomponent fluidization of fine calcium hydroxide powder, pressure drop was sometimes as much as 250% higher than the effective weight of the bed. The proposed strategy of particle mixing substantially improved its fluidization hydrodynamics. On the other hand, the development of channels and cracks during the monocomponent fluidization of the activated carbon led to gas bypassing, resulting in low pressure drop and poor contact of phases. Particle mixing was found to improve fluidization behavior, and the chi-squared test showed that the best results were obtained with 13 wt% particle mixing.

scholarly journals Mortality of Centenarians in the United States

2020 ◽  
pp. 57-66
Author(s):  
Bert Kestenbaum
Keyword(s):  
United States ◽  
Mathematical Model ◽  
Main Part ◽  
The United States ◽  
The Other ◽  
Quality Data ◽  
Critical Examination ◽  
Death Rates ◽  
Historical Series

AbstractIn the United States, we have not yet reached the point where unedited numerators and denominators for death rates or probabilities are of satisfactory quality for measuring the mortality of centenarians. Ignoring this reality can lead to an estimation of extreme-age mortality which is unacceptable, as is the case for the NCHS’ Data Brief no. 233. Even the better-quality data from the Medicare health insurance program are beset by problems of (1) unreported or unrecorded deaths and (2) date of birth misstatement. On the other hand, there are steps that can be taken to improve the quality of the underlying data, so that the threshold age at which a mathematical model replaces actual data and closes out the life table is pushed further out.The paper begins with a description of the unacceptable results published in Data Brief no. 233 and a critical examination of their sources. The main part of the paper presents some steps to improve the quality of the Medicare enrollment counts. By rearranging the historical series on Medicare enrollment by cohort, it is possible to eliminate unreported and unrecorded deaths. A simple model is then introduced to deal with date of birth misstatement.

Quality of Association Rules by Chi-Squared Test

2011 ◽  
pp. 1639-1645 ◽  
Author(s):  
Wen-Chi Hou
Keyword(s):  
Association Rules ◽  
Relationship Management ◽  
Research Problem ◽  
The Other ◽  
Customer Relationship ◽  
Market Basket ◽  
Fundamental Class ◽  
Management Association ◽  
Chi Squared

Mining market basket data (Agrawal et al. 1993, Agrawal et al. 1994) has received a great deal of attention in the recent past, partly due to its utility and partly due to the research challenges it presents. Market basket data typically consists of store items purchased on a per-transaction basis, but it may also consist of items bought by a customer over a period of time. The goal is to discover buying patterns, such as two or more items that are often bought together. Such finding could aid in marketing promotions and customer relationship management. Association rules reflect a fundamental class of patterns that exist in the data. Consequently, mining association rules in market basket data has become one of the most important problems in data mining. Agrawal et al. (Agrawal, et al. 1993, Agrawal et al. 1994) have provided the initial foundation for this research problem. Since then, there has been considerable amount of work (Bayardo et al. 1999, Bayardo et al. 1999, Brin et al. 1997, Han et al. 2000, Park et al. 1995, Srikant et al. 1995, Srikant et al. 1997, Zaki et al. 1997, etc.) in developing faster algorithms to find association rules. While these algorithms may be different in their efficiency, they all use minsup (minimum support) and minconf (minimum confidence) as the criteria to determine the validity of the rules due to their simplicity and natural appeals. Few researchers (Brin et al. 1997, Aumann et al. 1999, Elder, 1999, Tan et al. 2002) have suspected the sufficiency of these criteria. On the other hand, Chi-squared test has been used widely in statistics related fields for independence test. In this research, we shall examine the rules derived based on the support-confidence framework (Agrawal et al. 1993, Agrawal et al. 1994) statistically by conducting Chi-squared tests. Our experimental results show that a surprising 30% of the rules fulfilling the minsup and minconf criteria are indeed insignificant statistically.

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