scholarly journals Learning process of ultrasound-guided Ilio-fascial compartment block on a simulator: a feasibility study

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Julien Celi ◽  
Christophe A. Fehlmann ◽  
Olivier T. Rutschmann ◽  
Iris Pelieu-Lamps ◽  
Roxane Fournier ◽  
...  
Keyword(s):  
Medical Students ◽  
Feasibility Study ◽  
Median Number ◽  
Emergency Physicians ◽  
Ultrasound Guided ◽  
Learning Path ◽  
Significant Difference ◽  
The Us ◽  
The Difference ◽  
The Stability

Abstract Background Ultrasound-guided fascia iliaca compartment block (US-FICB) is not part of the learning curriculum of the emergency physicians (EP) and is usually performed by anesthesiologists. However, several studies promote EP to use this procedure. The goal of this study was to assess the feasibility of a training concept for non-anesthesiologists for the US-FICB on a simulator based on a validating learning path. Method This was a feasibility study. Emergency physicians and medical students received a 1-day training with a learning phase (theoretical and practical skills), followed by an assessment phase. The primary outcome at the assessment phase was the number of attempts before successfully completing the procedure. The secondary outcomes were the success rate at first attempt, the length of procedure (LOP), and the stability of the probe, corresponding to the visualization of the needle tip (and its tracking) throughout the procedure, evaluated on a Likert scale. Results A total of 25 participants were included. The median number of attempts was 2.0 for emergency physicians and 2.5 for medical students, and this difference was not significant (p = 0.140). Seven participants (28%) succeeded at the first attempt of the procedure; the difference between emergency physicians and medical students was not significant (37% versus 21%; p = 0.409). The average LOP was 19.7 min with a significant difference between emergency physicians and medical students (p = 0.001). There was no significant difference regarding the stability of the probe between the two groups. Conclusion Our 1-day training for non-anesthesiologists with or without previous skills in ultrasound seems to be feasible for learning the US-FICB procedure on a simulator.

Stability and mutual impact of perception of parental pressure and infants' social support – A study based on the difference between employment status and household income

2021 ◽  
pp. 002072092199705
Author(s):  
Yong Wang
Keyword(s):  
Household Income ◽  
Employment Status ◽  
Working Mothers ◽  
Social Research ◽  
Research Report ◽  
Parental Pressure ◽  
Income Levels ◽  
Significant Difference ◽  
The Difference ◽  
The Stability

The purpose of this study is to explore the stability and interaction between parental pressure and social research report, as well as the role of employment status and family income levels in this process. This study used a special study on Korean children (PSKC) 2–4 waves. Use t-test, correlation and autoregressive cross-delay modeling to analyze the data. The main findings of this study are: First, over time, parental pressure and mother’s social research report are consistent. Secondly, the pressure of motherhood and childcare has an obvious lagging effect on upbringing, and vice versa. Third, there is no significant difference between working mothers and non-working mothers in terms of the stability of working parents' pressure, social research report and social research report for children's pressure channels. However, parental pressure can only predict the social research report of working mothers. Fourth, there is no significant difference between the stability and interaction of these two structures in household income levels. In short, the results show that, over time, parental pressure is consistent with mother’s social research report. The results also show that there is a significant cross-lag effect between the mothers’ perceptions of mutual pressure analysis. In the process from parental pressure to social research report, I found the difference between working and non-working mothers. The advantage of this study is that the expected longitudinal design was adopted during infancy and the priority between the two structures can be considered. The results of this study can be used as a source of intervention plans to help parents withstand severe parenting pressure and lack of social research report.

scholarly journals Dynamics Analysis of a Mathematical Model for New Product Innovation Diffusion

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Chunru Li ◽  
Zujun Ma
Keyword(s):  
Mathematical Model ◽  
Time Delay ◽  
Media Coverage ◽  
New Product ◽  
Normal Form Theory ◽  
Center Manifold Theorem ◽  
Significant Difference ◽  
Form Theory ◽  
The Difference ◽  
The Stability

In this paper, a mathematical model with time-delay-related parameters and media coverage to describe the diffusion process of new products is proposed, in which the time-delay-related parameters denote the stage in which potential customers decide whether to adopt a new product. Then, the stability and the Hopf bifurcation of the proposed model are analyzed in detail. The center manifold theorem and the normal form theory are used to investigate the stability of the bifurcating periodic solution. Moreover, a numerical simulation is conducted to investigate the difference between the model with delay-dependent parameters and that with delay-independent parameters. The results show that there is significant difference between the two models.

scholarly journals Accuracy of Ultrasound-Guided Pudendal Nerve Block in the Ischial Spine and Alcock’s Canal Levels: A Cadaveric Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2692-2698
Author(s):  
Béatrice Soucy ◽  
Dien Hung Luong ◽  
Johan Michaud ◽  
Mathieu Boudier-Revéret ◽  
Stéphane Sobczak
Keyword(s):  
Pudendal Nerve ◽  
Ischial Spine ◽  
Ultrasound Guided ◽  
Us Guidance ◽  
Significant Difference ◽  
Alcock’S Canal ◽  
The Difference ◽  
One Year ◽  
Musculoskeletal Us ◽  
Different Levels

Abstract Background Blockade of the pudendal nerve (PN) using ultrasound (US) guidance has been described at the levels of the ischial spine and Alcock’s canal. However, no study has been conducted to compare anatomical accuracy between different approaches in targeting the PN. Objective To investigate the accuracy of US-guided injection of the PN at the ischial spine and Alcock’s canal levels. This study also compared the accuracy of the infiltrations by three sonographers with different levels of experience. Subjects Eight Thiel-embalmed cadavers (16 hemipelvises). Methods Three physiatrists trained in musculoskeletal US imaging with 12 years, five years, and one year of experience performed the injections. Each injected a 0.1-mL bolus of colored dye in both hemipelvises of each cadaver at the ischial spine and Alcock’s canal levels under US guidance. Each cadaver received three injections per hemipelvis. The accuracy of the injection was determined following hemipelvis dissection by an anatomist. Results The injections were accurate 33 times out of the total 42 attempts, resulting in 78% accuracy. Sixteen out of 21 injections at the ischial spine level were on target (76% accuracy), while the approach at Alcock’s canal level yielded 17 successful injections (81% accuracy). The difference between the approaches was not statistically significant. There was also no significant difference in accuracy between the operators. Conclusions US-guided injection of the PN can be performed accurately at both the ischial spine and Alcock’s canal levels. The difference between the approaches was not statistically significant.

cT3N0 rectal cancer: Potential overtreatment with preoperative chemoradiation (CRT) is warranted

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3568-3568
Author(s):  
J. G. Guillem ◽  
J. Diaz-Gonzalez ◽  
B. Minsky ◽  
M. Rodriguez-Bigas ◽  
S. Jeong ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anal Verge ◽  
Pathologic Complete Response ◽  
Radical Resection ◽  
Complete Response ◽  
Median Number ◽  
Mri Staging ◽  
Significant Difference ◽  
The Us ◽  
To Receive

3568 Background: Although CRT has emerged as the preferred treatment for T3 and/or lymph node (LN) positive rectal cancer, Sauer et al (NEJM 2004) demonstrated that 18% of patients deemed suitable for preop CRT via endorectal ultrasound (ERUS) were overstaged and therefore received unnecessary preoperative CRT. Since data also suggest that LN negative rectal cancer s/p TME may not need adjuvant therapy, it is reasonable to consider the omission of radiotherapy for the cT3N0 subset. We therefore determined the accuracy of pre-CRT ERUS/MRI staging in order to explore the validity of a non-radiation approach for cT3N0 disease. Methods: 188 ERUS/MRI staged T3N0 rectal cancer patients from 6 insitutions in the US, Europe and Asia received preoperative CRT (5-FU based and 45–52.5 Gy) followed by radical resection. Rates of pathologic complete response (pCR) and mesorectal LN involvement were determined. Results: Tumors were located a median of 5 centimeters from the anal verge. Sphincter-preserving surgery was performed in 135 (81%) patients. Overall pCR was 19%. Median number of LN sampled was 9 (range 0–38). Rate of positive LN was significantly associated with T-stage: pT0: 3%, pT1: 7%, pT2: 20%, pT3–4: 36%(p=0.001). 41 patients (22%) had pathologically positive mesorectal LN. There was no significant difference in rate of positive LN between those staged by ERUS and MRI(25% vs 16%, p=0.19). Conclusions: Accuracy of preoperative ERUS/MRI for identifying mid to distal T3N0 rectal cancer is limited, as 22% will have undetected mesorectal LN involvement despite CRT. Therefore, ERUS/MRI staged T3N0 patients should continue to receive preoperative CRT. Although 19% are overstaged and therefore overtreated, our data suggest that an even larger number would be understaged and require postoperative CRT, which is associated with inferior local control, higher toxicity, and poor functional outcome. No significant financial relationships to disclose.

scholarly journals Attitudes and Knowledge of Medical Students about Distance Learning / Stavovi i znanje studenata medicine o učenju na daljinu

2015 ◽  
Vol 32 (3) ◽  
pp. 199-207 ◽  
Author(s):  
Aleksandra Stanković ◽  
Branislav Petrović ◽  
Zoran Milosević
Keyword(s):  
Distance Learning ◽  
Medical Students ◽  
First Year ◽  
Sources Of Information ◽  
Positive Attitudes ◽  
Significant Difference ◽  
E Learning ◽  
Attitudes And Knowledge ◽  
The Difference ◽  
Methods Of Learning

Abstract Distance learning can be defined as education or training offered to participants at a different place, physically distant from the lecturer or sources of information. The difference in attitudes and knowledge of students about distance learning in relation to gender and year of studying was examined. The study sample included 371 students of the Faculty of Medicine in Niš (165 students were at the first year of studies and 206 students were at the sixth year of studies). Originally structured epidemiological questionnaire was distributed to students. Gender and age had no significant influence on students’ knowledge of distance learning. There was no statistically significant difference in taking positive attitudes about distance learning among medical students of the first and sixth year. Gender has statistically significantly affected the attitudes. E-learning does not eliminate the existing methods of learning, but it supplements them and greatly helps in teaching plans and programs.

Dynamic High-Field MR Imaging in Experimental Porcine Acute Pancreatitis

1995 ◽  
Vol 36 (2) ◽  
pp. 182-187 ◽  
Author(s):  
A. Piironen ◽  
R. Kivisaari ◽  
P. Pitkäranta ◽  
V.-P. Poutanen ◽  
P. Laippala ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Mr Imaging ◽  
High Field ◽  
Spin Echo ◽  
Flip Angle ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
The Stability ◽  
Signal Intensities

The effects of acute pancreatitis on MR imaging signal intensities (SIs) were determined in an experimental study at 1.0 T. Oedematous pancreatitis was induced in 9 piglets and haemorrhagic pancreatitis in 11 piglets. Each animal served as its own control for MR imaging before and after induction of pancreatitis. T1-weighted spin echo (450/15 ms) and dynamic turbo FLASH (flip angle 8°) sequences were used without contrast medium in testing the stability of the SI measurements. There was no significant difference in the SI-versus-time curves of the pancreas in piglets with oedematous and haemorrhagic pancreatitis. However, the difference in mean SIs between healthy and diseased piglets was significant. Thus, although non-contrast MR may be useful in the diagnosis of acute pancreatitis, it does not distinguish between oedematous and haemorrhagic pancreatitis.

Endometrial biopsy in women with abnormal uterine bleeding: inadequate and unassessable categorisation is not clinically relevant

2014 ◽  
Vol 67 (8) ◽  
pp. 673-677 ◽  
Author(s):  
Ayman A A Ewies ◽  
Kadry A A Shaaban ◽  
Reena Merard ◽  
Ulises Zanetto
Keyword(s):  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Final Diagnosis ◽  
Median Number ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Initial Finding ◽  
Significant Difference ◽  
The Difference ◽  
Clinical Records

AimsInadequate endometrial biopsy comprises a dilemma for gynaecologists and histopathologists alike. This study was conducted to assess the clinical merit of classifying scant endometrial biopsy into inadequate and unassessable using McCluggage criteria.MethodsWe retrospectively classified 268 endometrial biopsies, initially reported as inadequate, into inadequate (n=74) and unassessable (n=174) using McCluggage criteria after excluding 20 cases; all taken from patients aged ≥50 years with abnormal uterine bleeding attending Sandwell and West Birmingham Hospitals, UK from 1 January 2007 until 30 September 2012. The electronic clinical records were reviewed to find out the consequent clinical decisions and final outcomes. The follow-up period was 15 months after including the last patient.ResultsThe median age was 57 years (range: 50–97), and the median number of visits to hospital till the diagnosis was achieved was 2 (range: 1–4). The final diagnosis of endometrial hyperplasia or cancer was reported in 9 cases; 5 (7.1%) with an initial finding of inadequate and 4 with unassessable (2.4%); the difference was statistically insignificant (p=0.13). More patients in the inadequate category (82.4%) underwent further investigations when compared with the unassessable category (68.4%); the difference was statistically significant (p=0.029). There was no statistically significant difference in the inadequate to unassessable ratio when the endometrial thickness was ≥5 mm or <5 mm within the Pipelle group (p=0.46) or the curettage group (p=0.34).ConclusionsOur findings suggest that categorising scant endometrial specimens into inadequate or unassessable has no clinical implications. The gynaecologist should interpret the histopathology report in the light of clinical scenario.

Feasibility study: a new way to check the stability of industrial ginning throughout the season

2017 ◽  
Vol 88 (20) ◽  
pp. 2362-2378
Author(s):  
Mamadou Togola ◽  
Jean-Paul Gourlot ◽  
Eric Gozé ◽  
Bruno Bachelier ◽  
Massa Coulibaly ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Management Practices ◽  
Seed Cotton ◽  
Harvesting Technique ◽  
The Difference ◽  
The Stability ◽  
The Impact ◽  
Production Conditions ◽  
Comparison Data

The quality of cotton fiber observed at classing depends on the production conditions (soil, variety, climate, and crop management practices, including harvesting technique) and on the ginning conditions (seed-cotton cleaning, ginning, and lint cleaning). Thus, when lint quality is monitored, variations in seed-cotton quality may be confused with the impact of variations in ginning conditions. So, rather than measuring the quality of the cotton leaving the ginning mill, we propose measuring the impact of ginning conditions on the difference in quality between a batch of cotton ginned in the mill and a sample of the same batch ginned using micro-ginning equipment. By comparing 11 industrial ginning mills with the micro-ginning equipment used as a control, this feasibility study evaluated the impact of ginning conditions in an experiment on 119 seed-cotton modules in Mali throughout the 2014–2015 season. Based on this comparison, data analysis showed that the ginning process did have an impact on cotton quality, that the impact varied with the date, and that it was only linked to ginning conditions. Conversely, no alert concerning the impact of industrial ginning conditions was issued based on the results of the evaluation of the quality of fiber samples from industrial ginning mills alone.

scholarly journals Feedback to Receivers: Knowledge and Perception of Medical Students in a Public Sector Institute of a Developing Country

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Hamza Waqar Bhatti ◽  
Syed Muhammad Jawad Zaidi ◽  
Mehwish Kaneez ◽  
Javeria Awan ◽  
Rashid Naeem Khan ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Developing Country ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Level Of Knowledge ◽  
The Difference ◽  
Medical University ◽  
Feedback Delivery

Background: The practice of effective feedback delivery in medical institutes of developing countries lags behind the modern principles of medical education. This demands the need to understand the students’ knowledge and perception regarding received feedback in the setting of a developing country. Aims: To assess the level of knowledge and perception of feedback among students. To find the correlation between knowledge and perception. To identify problematic areas in feedback delivery and provide recommendations for rectification. Methods: A cross-sectional study conducted in Rawalpindi Medical University Pakistan, in which 480 medical students from 2nd till 5th-year MBBS were evaluated regarding their knowledge and perception about feedback using structured questionnaires. Results: The students had a good level of knowledge regarding The concept of feedback. However, they had a negative perception of the feedback given to them by their teachers. There was no correlation between mean knowledge and perception scores (r=-0.05, p = 0.272). There was a significant difference between knowledge (p=0.0004) and perception (p=0.02) scores across gender. The difference in mean knowledge scores across academic years was not significant (p=0.267) but this difference was significant for mean perception scores (p=0.001). Conclusion: Strategies should be adopted to incorporate feedback into the curriculum for improving the quality of medical education in a developing country.

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