scholarly journals Half-life of surgical truth in general surgery

2021 ◽  
Vol 103 (5) ◽  
pp. 254-257
Author(s):  
OP James ◽  
L Smith ◽  
D Locker ◽  
L Hopkins ◽  
DBT Robinson ◽  
...  
Keyword(s):  
General Surgery ◽  
Half Life ◽  
Positive Response ◽  
Regression Line ◽  
True Statement ◽  
John Hunter ◽  
General Surgeons ◽  
Positive Response Rate ◽  
Seven Generations ◽  
The Relationship

Introduction Karl Popper’s hypothetico-deductive model contends that an assertion is true if it agrees with the facts, and that science progresses via paradigms held to be true until replaced by better approximations of reality. Our study aimed to estimate the half-life of surgical dogma. Methods The first 15 general surgery articles at 5-year intervals were extracted from the British Journal of Surgery since its inception in 1913. A statement summarising each article’s conclusion was formatted, and non-conducive articles were excluded (n=22). A total of 293 article statements were reviewed and marked as true or false by a cohort of 15 senior general surgeons, with a majority positive response denoting a true statement. Regression analysis of the relationship between perceived truth and time was performed. Results Median reviewer positive response rate was 49.5% (range 35.8–64.2%), with over 80% of responders in total agreement regarding 151 statements (51.5%) and deeming 137 (46.8%) currently true. Publication year correlated with percentage of true responses (rho 0.647, p=0.002). Linear modelling of true responses related to 5-year intervals (R2=0.398, p=0.002) estimated the annual rate of loss of truth to be 0.25%, equating to a half-life of 200.0 years. Conclusions Contrary to popular belief, it appears THAT surgical dogma does not lose its lustre for some seven generations. Regression line extrapolation is contentious but would suggest that the current era of surgical knowledge extends from 1769 – the days of John Hunter, the ‘father of modern surgery’ – to 2176, although relative rates of innovation may accelerate and move the nexus point.

scholarly journals Association of shared decision making with inpatient satisfaction: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huiwen Luo ◽  
Guohua Liu ◽  
Jing Lu ◽  
Di Xue
Keyword(s):  
Patient Satisfaction ◽  
Inpatient Care ◽  
Response Rate ◽  
Positive Response ◽  
Physician Services ◽  
Cross Sectional ◽  
Medical Expenses ◽  
Tertiary Hospitals ◽  
Positive Response Rate ◽  
High Level

Abstract Background We assessed inpatient perceived shared decision making (SDM) and tested the association of SDM with inpatient satisfaction in public tertiary hospitals in Shanghai, China. Methods A cross-sectional survey of 2585 inpatients in 47 public tertiary hospitals in Shanghai in July and August 2018 was conducted. We assessed overall SDM and 4 aspects of SDM and tested the factors influencing SDM and the association of SDM with patient satisfaction (patient satisfaction with physician services, medical expenses, outcomes and overall inpatient care), by adopting linear or two-level regression models. Results The positive response rate (PRR) and high positive response rate (HPRR) to overall SDM among the inpatients of public tertiary hospitals in Shanghai were relatively high (95.30% and 87.86%, respectively), while the HPRR to “My physician informed me of different treatment alternatives” was relatively low (80.09%). In addition, the inpatients who underwent surgery during admission had higher HPRRs and adjusted HPRRs to overall SDM than those who did not undergo surgery. The study showed that the adjusted high satisfaction rates (HSRs) with physician services, medical expenses, outcomes and overall inpatient care among the inpatients with high level of overall SDM were higher (96.50%, 68.44%, 89.50% and 92.60%) than those among the inpatients without a high level of overall SDM (71.77%, 35.19%, 57.30% and 67.49%). The greatest differences in the adjusted HSRs between the inpatients with and without a high level of SDM were found in inpatient satisfaction with medical expenses and informed consent in SDM. Moreover, 46.22% of the variances in the HSRs with overall inpatient care across the hospitals were attributed to the hospital type (general hospitals vs. specialty hospitals). Conclusions Inpatient PRRs and HPRRs to SDM in public tertiary hospitals in Shanghai are relatively high overall but lower to information regarding alternatives. SDM can be affected by the SDM preference of both the patients and physicians and medical condition. Patient satisfaction can be improved through better SDM and should be committed at the hospital level.

Volumetric properties of intracellular compartments in canine cardiac Purkinje cells

1980 ◽  
Vol 238 (4) ◽  
pp. H561-H568
Author(s):  
S. R. Houser ◽  
A. R. Freeman
Keyword(s):  
Purkinje Cells ◽  
Regression Line ◽  
Resting Potential ◽  
Volumetric Properties ◽  
Bathing Medium ◽  
Cellular Volume ◽  
Cardiac Purkinje Fibers ◽  
Cardiac Purkinje Cells ◽  
Intracellular Compartments ◽  
The Relationship

Volumetric properties of canine cardiac Purkinje fibers were examined. Purkinje cells were superfused with anisosmolar solutions, and changes in extracellular space and relative cell volume were determined. The relationship between cellular volume and the osmolarity of the bathing medium was shown to be linear except in solutions of very low osmolarity. A linear regression line crossed the volume axis at 38%, suggesting an osmometric dead space of 38% and correspondingly an osmometric compartment comprising about 62% of the cell interior. To determine the volumetric properties of the "electrophysiological compartment," Purkinje cells were impaled with voltage-sensitive microelectrodes, and cellular resting potentials were recorded. When log K was plotted against resting potential (Em) in preparations bathed in normal and hyperosmotic solutions, it was shown that Em was increased in hyperosmotic solutions (13.5 and 21 mV in 600 and 850 mosM solutions, respectively). Calculations using the Nernst equation showed that the compartment containing the intracellular K involved in membrane electrical events behaves as a near-perfect osmometer in hyperosmotic solutions. Changes in the osmometric compartment were well correlated with K changes in the electrophysiological compartment, thus suggesting that the K is homogeneously distributed intracellularly.

The relationship between steady-state transpiration rates and leaf water potential in cassava (Manihot esculenta cv. Llanera)

1978 ◽  
Vol 56 (13) ◽  
pp. 1537-1539 ◽  
Author(s):  
I. F. Ike ◽  
G. W. Thurtell ◽  
K. R. Stevenson
Keyword(s):  
Steady State ◽  
Water Potential ◽  
Leaf Water Potential ◽  
Manihot Esculenta ◽  
Regression Line ◽  
Leaf Water ◽  
Dew Point ◽  
Manihot Esculenta Crantz ◽  
The Relationship

The relationship between leaf water potential (ψL) and transpiration rate (T) was investigated using indoor-grown cassava plants (Manihot esculenta Crantz cv. Llanera). Leaf water potentials were measured with in situ dew-point hygrometer and transpiration rates by gas exchange analysis technique.Regression analyses of the data showed that T was consistently linearly related to ψL (r2 = 0.94). This implies that the plant resistance to flow was constant and hence that an Ohm's Law analog is valid for the transpiration range studied. Extrapolated values of leaf water potential at zero transpiration were close to the osmotic potential of the nutrient solution. Calculated resistance values (slope of regression line for individual plants) varied between 2.90 and 3.05 bars dm2 h g−1 (1 bar = 100 kPa).

General Surgery Resident Vascular Operative Experience in the Era of Endovascular Surgery and Vascular Fellowships

2015 ◽  
Vol 81 (10) ◽  
pp. 1093-1096 ◽  
Author(s):  
Huan Yan ◽  
Steven Maximus ◽  
Jerry J. Kim ◽  
Brian Smith ◽  
Dennis Kim ◽  
...  
Keyword(s):  
General Surgery ◽  
Endovascular Surgery ◽  
Dialysis Access ◽  
Arterial Reconstruction ◽  
Period 2 ◽  
Significant Difference ◽  
General Surgery Resident ◽  
General Surgeons ◽  
Surgery Resident ◽  
Aneurysm Repair

Advances in endovascular surgery have resulted in a decline in major open arterial reconstructions nationwide. Our objective is to investigate the effect of endovascular surgery on general surgery resident experience with open vascular surgery. Between 2004 and 2014, 112 residents graduated from two academic institutions in Southern California. Residents were separated into those who graduated in 2004 to 2008 (period 1) and in 2009 to 2014 (period 2). Case volumes of vascular procedures were compared using two-sample t test. A total of 43 residents were in period 1 and 59 residents were in period 2. In aggregate, there was no significant difference in open cases recorded between the two periods (84 vs 87, P = 0.194). Subgroup analysis showed period 2 recorded significantly fewer cases of open aneurysm repair (5 vs 3, P < 0.001), cerebrovascular (14 vs 10, P = 0.007), and peripheral obstructive procedures (16 vs 13, P = 0.017). Dialysis access procedures constituted the largest group of procedures and remained similar between the two periods (35 vs 42, P = 0.582). General surgery residents experienced a significant decline in several index open major arterial reconstruction cases. This decline was offset by maintenance of dialysis access procedures. If the trend continues, future general surgeons will not be proficient in open vascular procedures.

A longitudinal study of sleep deprivation responses in depression; The variability is highly related to diurnal mood variability

1995 ◽  
Vol 7 (2) ◽  
pp. 58-60 ◽  
Author(s):  
M.C.M. Gordijn ◽  
D.G.M. Beersma ◽  
A.L. Bouhuys ◽  
H.J. Korte ◽  
R.H. van den Hoofdakker
Keyword(s):  
Sleep Deprivation ◽  
Diurnal Variation ◽  
Positive Response ◽  
Diurnal Variations ◽  
Cross Sectional ◽  
Antidepressive Effect ◽  
Mood Variability ◽  
Mood Changes ◽  
Diurnal Variation Of Mood ◽  
The Relationship

Unequivocal results demonstrating a causal relationship between a disturbance in circadian rhythms and depression have not yet been reported (reviews). However, acute mood changes, such as the antidepressive effect of sleep deprivation, diurnal variations of mood and their interrelationship, are commonly put forward as evidence of the importance of circadian dysregulations in affective disorders. The purpose of the present study is to obtain more insight in the mechanisms underlying these mood changes. The results will be discussed in the context of a recently postulated non-chronobiological explanation.Earlier studies have suggested that the relationship between diurnal variation of mood and the response to total sleep deprivation (TSD) is clear and unambiguous: improvement of mood during the day prior to TSD (a positive diurnal variation) is followed by a positive response (mood improvement) to TSD, while no improvement or deterioration of mood during the day prior to TSD (a negative diurnal variation) may result in no, or even a negative, TSD response (for references see Van den Hoofdakker). However, these conclusions were based on the results from cross-sectional studies, comparing single TSD effects across individuals. Comparison of sleep deprivation effects within individuals, however, revealed that the course of mood during the day prior to TSD is irrelevant for the TSD response. Accordingly, a favourable response to TSD appeared to be related to the patient's propensity to show diurnal mood variations per se, irrespective of their direction.

scholarly journals The Perceptual Categorization of Enshi Mandarin Regional Varieties

2015 ◽  
Vol 3 (1) ◽  
pp. 1-19 ◽  
Author(s):  
Qingyang Yan
Keyword(s):  
Response Bias ◽  
Positive Response ◽  
Social Background ◽  
Classification Performance ◽  
Classification Task ◽  
Perceptual Categorization ◽  
Rating Task ◽  
Dialect Classification ◽  
The Relationship

The current study used a hand-drawn map task, a dialect difference rating task, and a dialect classification task to explore the relationship between participants’ ideologies about dialect differences and their classification of authentic talkers from six regional varieties in Enshi Prefecture, China. The talkers frequently mistaken for each other in the dialect classification task were those who came from counties that were perceived to have similar dialects in the hand-drawn map task and the dialect difference rating task. Participants showed a positive response bias for the Enshi dialect in classifying talkers, corresponding to the dialect difference ratings that Enshi was rated as least different. Thus participants’ classification of real talkers was largely consistent with their ideologies about differences among “imagined” dialects. Participants’ ideologies about dialect differences were shaped by their home county, and their classification performance was affected by their home county and the talker’s social background.

The measurement of actual acidity in acid sulfate soils and the determination of sulfidic acidity in suspension after peroxide oxidation

Soil Research ◽  
2002 ◽  
Vol 40 (7) ◽  
pp. 1133 ◽  
Author(s):  
Angus E. McElnea ◽  
Col R. Ahern ◽  
Neal W. Menzies
Keyword(s):  
Regression Line ◽  
Correction Factors ◽  
Acid Sulfate Soils ◽  
Peroxide Oxidation ◽  
Acid Sulfate ◽  
Inorganic Sulfur ◽  
Actual Acidity ◽  
Sulfate Soils ◽  
The Relationship

Improvements to the routine methods for the determination of actual acidity in suspension for acid sulfate soils (ASS) are introduced. The titratable sulfidic acidity (TSA) results using an improved peroxide-based method were compared with the theoretical acidity predicted by the chromium reducible sulfur method for 9 acid sulfate soils. The regression between these 2 measures of sulfidic acidity was highly significant, the slope of the regression line not significantly different from unity (P = 0.05) and the intercept not significantly different from zero. This contrasts with results of other workers using earlier peroxide oxidation methods, where TSA substantially underestimated the theoretical acidity predicted by reduced inorganic sulfur analysis. Comparison was made between the 2 principal measurements from the improved peroxide method (TSA and SPOS), with SPOS converted to theoretical sulfidic acidity to allow comparison. The relationship between these 2 measurements was highly significant. The effects of titration in suspension, as well as raising titration end points to pH 6.5, were investigated, principally with respect to the titratable actual acidity (TAA) result. TAA results obtained by KCl extraction were compared with those obtained using BaCl2, MgCl2, and water extraction. TAA in 1 M KCl suspensions titrated to pH 6.5 agreed well with titratable actual acidity measured using the 25-h extraction approach of the Lin et al. (2000a) BaCl2 method. Both BaCl2 and KCl solutions were ineffective at fully recovering acidity from synthetic jarosite without repeated extraction and titration. The application of correction factors for the estimation of total actual acidity in ASS is not supported by the results of this investigation. Acid sulfate soils that contain substantial quantities of jarosite or other acid-producing but relatively insoluble sulfate minerals continue to prove problematic to chemically analyse; however, an approach for estimating this component is discussed.

THE RELATIONSHIP BETWEEN CHLOROPHYLL CONTENT AND RATE OF PHOTOSYNTHESIS IN SOYBEANS

1977 ◽  
Vol 57 (1) ◽  
pp. 1-5 ◽  
Author(s):  
B. R. BUTTERY ◽  
R. I. BUZZELL
Keyword(s):  
Linear Regression ◽  
Chlorophyll Content ◽  
Photosynthetic Rate ◽  
Regression Line ◽  
Quadratic Equation ◽  
Chlorophyll Contents ◽  
Rate Of Photosynthesis ◽  
Highly Correlated ◽  
The Relationship ◽  
Selection Of

Photosynthetic rate of soybeans (on a leaf area basis, PA) estimated from the incorporation of 14CO2 under field conditions was highly correlated with chlorophyll content of the side leaflets of the same leaves. Among a collection of 48 cultivars, the linear regression of PA on chlorophyll content accounted for 44% of the variation, whereas with a selection of genotypes with various mutant chlorophyll genes, the regression accounted for 81%. When the data for the two tests were re-calculated relative to the check cv. Altona, a quadratic equation between PA and chlorophyll accounted for nearly 90% of the variation. When photosynthetic rate was expressed on a unit chlorophyll basis (Pc), no significant differences among lines were established in the cultivar test. In the mutants test, significant differences in Pc were established with higher values of Pc associated with lower chlorophyll contents; a linear regression accounted for 45% of the variation. Transformation of the data from both experiments relative to Altona allowed the fitting of a common regression line (quadratic) which accounted for 63% of the variation. We suggest that initial screening of progenies in a breeding program for high photosynthetic rate could be done by measuring chlorophyll content.

Clinical assessment and management of general surgery patients via synchronous telehealth

2016 ◽  
Vol 23 (2) ◽  
pp. 371-375 ◽  
Author(s):  
Steven M Cain ◽  
Robert Moore ◽  
Lauren Sturm ◽  
Travis Mason ◽  
Caitlin Fuhrman ◽  
...  
Keyword(s):  
General Surgery ◽  
Medical Center ◽  
Physician Assistants ◽  
Geographic Area ◽  
High Definition ◽  
Medical Specialties ◽  
Regional Medical ◽  
Regional Medical Center ◽  
General Surgeons ◽  
Surgical Conditions

Objective This paper describes how a clinical team at Landstuhl Regional Medical Center (LRMC) successfully integrated synchronous telehealth (TH) into their routine clinical practice. Methods and materials Synchronous TH encounters were performed using Polycom® software on surgeons’ computers with high-definition (HD) cameras on monitors at distant sites and PolyCom HDX9000® Telehealth Practitioner Carts at originating sites. Patients provided consented and were presented to general surgeons by nurses and medical technicians at Army health clinics throughout the European Theater. Results In calendar year (CY) 2014, five general surgeons and two surgical physician assistants (PAs) at Landstuhl Regional Medical Center along with registered nurses (RNs) at six originating clinic sites throughout Europe completed 130 synchronous TH encounters for 101 general surgery patients resulting in 73 completed and 16 recommended surgeries. Eighty-eight percent of patients had a completed or recommended surgery. No surgeries or procedures planned after initial TH evaluation were cancelled. Originating site clinics ranged in distance from 68 miles to 517 miles. Acceptance by providers, patients and clinic staff was high. Conclusion Synchronous TH was effective and safe in evaluating common general surgical conditions. We excluded sensitive and complex conditions requiring a nuanced physical examination. The TH efforts of the general surgery staff have resulted in high-quality, seamless and predictable TH activities that continue to expand into other surgical and medical specialties beyond general surgery. Seven surgeons and two PAs use synchronous TH regularly serving patients over a broad geographic area.

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