scholarly journals Una experiencia de integración de la Formación Sanitaria Especializada con la Universitaria de Posgrado: Entrenamiento por etapas en cirugía laparoscópica.

2020 ◽  
Vol 1 (2) ◽  
pp. 82-89
Author(s):  
Diego Flores-Funes ◽  
Enrique Pellicer-Franco ◽  
Benito Flores-Pastor ◽  
Matilde Moreno-Cascales ◽  
Miguel Ángel Fernández-Villacañas-Marín ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Basic Skills ◽  
First Year ◽  
Clinical Anatomy ◽  
Box Trainer ◽  
Synthetic Materials ◽  
Proposed Model ◽  
Intracorporeal Suture ◽  
Model Training ◽  
Stage 1

Antecedentes: Diseño de un modelo de simulación para formación en cirugía laparoscópica. Métodos: Dentro del Máster Anatomía Aplicada a la Clínica se implementaron tres etapas de formación progresiva en médicos residentes. La etapa 1 se realizó en simulador con material no biológico: manejo de objetos, disección con pinza y tijera, y sutura laparoscópica. La etapa 2 utilizó material biológico (tubo digestivo en fresco) en simulador, para la práctica de sección intestinal y anastomosis intracorpórea. En la etapa 3 se realizaron técnicas laparoscópicas en cadáver en fresco (apendicectomía, colecistectomía, apertura de la transcavidad epiploica, hemicolectomías derecha e izquierda). Se añadió una encuesta de satisfacción a los participantes de la actividad. Resultados: El programa se impartió a 6 residentes de Cirugía General. Todos completaron los ejercicios de las etapas 1 y 2. En la etapa 3 se pudo realizar el neumoperitoneo sin dificultad y los tejidos presentaron una textura adecuada. Los residentes de primer año completaron la apendicectomía y la colecistectomía, pero procedimientos más complejos requirieron residentes con más experiencia. Los participantes encuestados reflejaron que el programa es adecuado y útil para el entrenamiento en laparoscopia. Conclusiones: El modelo propuesto es reproducible y adecuado en adquisición de competencias básicas en cirugía laparoscópica. Background: Design of a simulation model training in laparoscopic surgery for surgical residents. Methods: Three stages of progressive training were programmed within a Postgraduate Degree in Clinical Anatomy. Stage 1 was performed in a box-trainer with synthetic materials: managing small objects, dissection with clamp and scissors, and laparoscopic intracorporeal suture. Stage 2 used biological material (fresh digestive tract from a human corpse) in box-trainer, practicing section and intracorporeal anastomosis. In stage 3, laparoscopy was performed on a fresh corpse (appendectomy, cholecystectomy, lesser sac opening, right and left colectomy). A satisfaction survey was carried out to the participants. Results: Some six General and Digestive Surgery residents took the program. All of them completed the stage 1 and 2 exercises. In stage 3, the pneumoperitoneum could be performed without any complications, and tissues presented an adequate texture. First-year residents completed appendectomy and cholecystectomy, but more complex procedures required more experienced residents. The participants reflected that the program is adequate and useful to gain basic skills in laparoscopy. Conclusions: The proposed model is reproducible and adequate in acquisition of basic skills in laparoscopic surgery.

scholarly journals Assessment of laparoscopic skills of Gynecology and Obstetrics residents after a training program

2016 ◽  
Vol 14 (4) ◽  
pp. 468-472 ◽  
Author(s):  
Carla Ferreira Kikuchi Fernandes ◽  
◽  
José Maria Cordeiro Ruano ◽  
Lea Mina Kati ◽  
Alberto Sinhiti Noguti ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Training Program ◽  
Demographic Data ◽  
Medical Residency ◽  
Box Trainer ◽  
Laparoscopic Skills ◽  
Surgical Competence ◽  
Gynecology And Obstetrics ◽  
Level 1 ◽  
And Training

ABSTRACT Objective To evaluate laparoscopic skills of third-year Gynecology and Obstetrics residents after training at a training and surgical experimentation center. Methods Use of a prospective questionnaire analyzing demographic data, medical residency, skills, competences, and training in a box trainer and in pigs. Results After the training, there was significant improvement in laparoscopic skills according to the residents (before 1.3/after 2.7; p=0.000) and preceptors (before 2.1/after 4.8; p=0.000). There was also significant improvement in the feeling of competence in surgeries with level 1 and 2 of difficulty. All residents approved the training. Conclusion The training was distributed into 12 hours in the box trainer and 20 hours in animals, and led to better laparoscopic skills and a feeling of more surgical competence in laparoscopic surgery levels 1 and 2.

scholarly journals IntroVNMT: An Introspective Model for Variational Neural Machine Translation

2020 ◽  
Vol 34 (05) ◽  
pp. 8830-8837
Author(s):  
Xin Sheng ◽  
Linli Xu ◽  
Junliang Guo ◽  
Jingchang Liu ◽  
Ruoyu Zhao ◽  
...  
Keyword(s):  
Machine Translation ◽  
Latent Variables ◽  
Image Synthesis ◽  
Target Language ◽  
Generative Adversarial Network ◽  
Neural Machine Translation ◽  
Adversarial Network ◽  
Proposed Model ◽  
Model Training ◽  
High Level

We propose a novel introspective model for variational neural machine translation (IntroVNMT) in this paper, inspired by the recent successful application of introspective variational autoencoder (IntroVAE) in high quality image synthesis. Different from the vanilla variational NMT model, IntroVNMT is capable of improving itself introspectively by evaluating the quality of the generated target sentences according to the high-level latent variables of the real and generated target sentences. As a consequence of introspective training, the proposed model is able to discriminate between the generated and real sentences of the target language via the latent variables generated by the encoder of the model. In this way, IntroVNMT is able to generate more realistic target sentences in practice. In the meantime, IntroVNMT inherits the advantages of the variational autoencoders (VAEs), and the model training process is more stable than the generative adversarial network (GAN) based models. Experimental results on different translation tasks demonstrate that the proposed model can achieve significant improvements over the vanilla variational NMT model.

Is Laparoscopic Simulator Performance Affected by Training Environment?

2011 ◽  
Vol 93 (5) ◽  
pp. 169-172 ◽  
Author(s):  
P Tsim ◽  
E Ferguson ◽  
H-M Carty ◽  
B Baxendale ◽  
R Dhinsa ◽  
...  
Keyword(s):  
Patient Safety ◽  
Laparoscopic Surgery ◽  
Basic Skills ◽  
Working Hours ◽  
Surgical Skills ◽  
Operating Theatre ◽  
Training Environment ◽  
Laparoscopic Simulator ◽  
Laparoscopic Techniques

The use of simulators in laparoscopic surgery complements current training with reduced working hours. Trainees can acquire basic skills quickly and efficiently without compromising patient safety. Competence in skills learnt on a simulator has been shown to translate to operating theatre performance. In addition to this, laparoscopic surgeons require new skills since no transfer has been reported between open surgical skills and new laparoscopic techniques. As a result of their numerous advantages, simulators are routinely used as part of training in laparoscopic surgery.

Effects of career‐related continuous learning: a case study

2008 ◽  
Vol 15 (1) ◽  
pp. 45-57 ◽  
Author(s):  
Jens Rowold ◽  
Sabine Hochholdinger ◽  
Jan Schilling
Keyword(s):  
Job Performance ◽  
Call Center ◽  
Positive Impact ◽  
Learning Climate ◽  
First Year ◽  
Continuous Learning ◽  
Content Type ◽  
Organizational Contexts ◽  
Proposed Model ◽  
The Impact

PurposeAlthough proposed from theory, the assumption that career‐related continuous learning (CRCL) has a positive impact on subsequent job performance has not been tested empirically. The present study aims to close this gap in the literature. A model is derived from theory that predicts a positive impact of CRCL, learning climate, and initial job performance on consequent job performance. In addition, CRCL is hypothesized to mediate the impact of learning climate on final job performance.Design/methodology/approachImplementing a longitudinal approach, this model was tested empirically in a call center context. Within the first year of their respective career, multiple source data were gathered from employees about their formal CRCL activities, their initial performance, as well as their perception about learning climate.FindingsResults indicated that CRCL predicted final job performance and mediated the impact of learning climate on final job performance. A total of 28 percent of final job performance was explained by the proposed model, highlighting the importance of CRCL for organizational contexts.Practical implicationsThe results of this study support the notion that CRCL programs are highly useful for both employees and organizations.Originality/valueFor the first time, the impact of CRCL on job performance is demonstrated empirically.

scholarly journals Structure of unoperated congenital heart diseases in children of Zabaikalsky Territory

2020 ◽  
pp. 83-89
Author(s):  
A.V. Ignatieva ◽  
◽  
O.F. Sibira ◽  
I.N. Gaimolenko ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Exclusion Criterion ◽  
First Year ◽  
Congenital Heart Diseases ◽  
Significance Level ◽  
Septal Defects ◽  
Stage 1 ◽  
First Time

The aim of the research is to study the morbidity by appealability and some characteristics of congenital heart diseases in children of Zabaikalsky Territory. Material and methods. A retrospective clinical and anamnestic analysis of children with congenital heart diseases without surgical treatment, who were hospitalized, was carried out. The analysis included 3 year-observation. CHD diagnosed is an inclusion criterion; while surgical treatment of heart diseases is exclusion criterion. Statistical data processing was carried out using Microsoft Excel 2007, Statistica v.10.0 software package. χ2 test (Pearson) was used to compare two independent groups by qualitative characteristics. The results were considered statistically significant (reliable) at the achieved significance level of p <0.05. Results. In Zabaikalsky Territory, approximately 200 children with congenital heart disease without surgical treatment are hospitalized annually; the average age is 3 years. Fifty-three per cent of children applied for inpatient care for the first time, 44% of them were children at their first year. Gender distribution indicates the highest incidence of the pathology in girls. In CHD structure, atrial septal defects are on the first place, while interventricular septal defects are on the second. Combination of ASD and IVSD was observed with approximately equal frequency. Chronic heart failure associated with CHD was registered in 77% of children. In most cases CHF, stage 1, was diagnosed (63%). In 2/3 of cases, pulmonary hypertension of various severity was detected. Analysis of place of residence of children with CHD in the Zabaikalsky Territory shows that children from areas with the highest population density are hospitalized more often. Conclusion. The problem of congenital heart diseases in children of Zabaikalsky Territory is of current importance due to the widespread prevalence and high specific gravity among all internal organ defects in children of this region.

scholarly journals FACTORS ASSOCIATED WITH TUMOR RECURRENCE IN STAGE 1 BLADDER TRANSITIONAL CELL CARCINOMA IN SARDJITO HOSPITAL YOGYAKARTA

2016 ◽  
Vol 23 (2) ◽  
Author(s):  
Donny eka Putra ◽  
Trisula Utomo
Keyword(s):  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Recurrence ◽  
Transitional Cell ◽  
Tumour Recurrence ◽  
Intravesical Chemotherapy ◽  
First Year ◽  
Tumor Diameter ◽  
Factors Associated ◽  
Stage 1

Objective: This study is assigned to evaluate factors associated with tumor recurrence in patients with superficial transitional cell carcinoma (TCC) of bladder in Sardjito General Hospital Yogyakarta. Material & methods:A prospective observational study design is conducted to evaluate patients with T1 TCC of bladder between 2011 and 2012. Inclusion criteria was patients with T1 TCC of bladder from pathological report. The independent variables are ages, hemoglobin, albumin, creatinine level, urine cytology, tumor grade, tumor diameter, number of tumor, and intravesical chemotherapy. The outcome measure is tumor recurrence during cystoscopy at 3, 6, 9, and 12 month after first resection. This study used chi-square and logistic regression analysis as statistical methods with p < 0.05 and a = 5% are considered significant. All analyses were performed with SPSS statistical software, version 20.0. Result: Sixty-two patients were participated in this study with mean age 60.62 ± 12.15 years. There were 32 patients (51.6%) who had tumour recurrence during first year that need to be resected. Of these patients, 9 patients (14.5%) had tumour recurrence more than one time during first year. In multivariate analysis, factors associated with tumour recurrence were tumour grade (p = 0.041, CI = 0.008-0.908), number of tumor (p = 0.003, CI = 0.003-0.293), and intravesical chemotherapy (p = 0.022, CI = 0.015-0.719). Conclusion: Degree of tumor differentiation, number of tumor and intravesical chemotherapy are factors affecting recurrence of stage 1 transitional cell carcinoma of the bladder.

scholarly journals Perspectives on Laparoscopic Surgery Among Chinese General Surgery Residents: Single-Site Survey Study with Instructive Lessons for Program Directors and Teaching Hospitals

2019 ◽  
Author(s):  
Bao Jin ◽  
Zhibo Zheng ◽  
Yongchang Zheng ◽  
Haifeng Xu ◽  
Tianyi Chi ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Procedure ◽  
Final Analysis ◽  
Survey Study ◽  
Teaching Hospitals ◽  
First Year ◽  
Laparoscopic Procedures ◽  
Surgical Residents ◽  
Site Survey ◽  
Hands On

Abstract Background To assess resident perspectives on laparoscopic surgery and how it might differ compared to open surgery. Materials and Methods Anonymous surveys were sent to residents who came to hepatic surgery service rotation during Sep 2013 to Aug 2017. Statistical comparisons were conducted using student T-test, comparing mean satisfaction and preferences. Results A total of 80 residents responded to the survey, distributed across the spectrum of training levels. Of the 80 respondents, 9 were in their first year of training, while 18, 41, and 12 were in their second, third, or fourth years of training, respectively. Among them, there were 11 residents were not included in the final analysis. Residents indicated that they preferred open procedures for conferring greater exposure to operating (7.172 ± 1.4646 for open vs 4.414 ± 2.1442 for laparoscopy, p < 0.001). Residents indicated that laparoscopic procedures were preferred in aiding in understanding of the surgical procedure (6.814 ± 1.3323 for open vs 7.407 ± 1.3014 for laparoscopy, p = 0.016). Conclusions These results suggest that residents prefer open procedures for hands-on experience, while laparoscopic procedures confer the advantage of facilitating the learning of a surgical procedure. This provides an opportunity for intervention, as minimally invasive surgeries(MIS) are a major component of modern surgical practice and, therefore, must be an area of strength in the training of surgical residents.

scholarly journals ECG Heartbeat Classification Based on an Improved ResNet-18 Model

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Enbiao Jing ◽  
Haiyang Zhang ◽  
ZhiGang Li ◽  
Yazhi Liu ◽  
Zhanlin Ji ◽  
...  
Keyword(s):  
State Of The Art ◽  
Classification Performance ◽  
Classification Models ◽  
Heartbeat Classification ◽  
Ecg Signals ◽  
Residual Structure ◽  
Proposed Model ◽  
Model Training ◽  
Electrocardiogram Ecg

Based on a convolutional neural network (CNN) approach, this article proposes an improved ResNet-18 model for heartbeat classification of electrocardiogram (ECG) signals through appropriate model training and parameter adjustment. Due to the unique residual structure of the model, the utilized CNN layered structure can be deepened in order to achieve better classification performance. The results of applying the proposed model to the MIT-BIH arrhythmia database demonstrate that the model achieves higher accuracy (96.50%) compared to other state-of-the-art classification models, while specifically for the ventricular ectopic heartbeat class, its sensitivity is 93.83% and the precision is 97.44%.

scholarly journals Predicting Self-harm Incidents Following Inpatient Visits using Disease Comorbidity Network

2020 ◽  
Author(s):  
Zhongzhi Xu ◽  
Qingpeng Zhang ◽  
Paul Siu Fai Yip
Keyword(s):  
Deep Learning ◽  
Screening Strategy ◽  
Public Hospitals ◽  
Baseline Model ◽  
C Statistic ◽  
Proposed Model ◽  
Self Harm ◽  
Model Training ◽  
Screening And Prevention ◽  
Individual Self

AbstractSelf-harm is serious but preventable, particularly if the risk can be identified early. But the early detection of self-harm individuals is so far not satisfied. This study aims to develop and test a comorbidity network-enhanced deep learning framework to improve the prediction of individual self-harm within 12 months after hospital discharge. Between January 1, 2007, and December 31, 2010, we obtained 2,323 patients with self-harm clinical record from 1,764,094 inpatients across 44 public hospitals in Hong Kong and 46,460 randomly sampled population controls from those same hospitals. Eighty percent (80%) of the study sample was randomly selected for model training, and the remaining 20% was set aside for model testing. The proposed comorbidity network-enhanced model was compared with a baseline deep learning model for self-harm prediction. The C-statistic, precision and sensitivity were used to evaluate the prediction accuracy of the proposed model and the baseline model. Experiments demonstrated that the proposed comorbidity network-enhanced model outperformed baseline model in identifying patients who would self-harm within 12 months (C-statistic of proposed model 0.89). The precision was 0.54 for positive cases and 0.98 for negative cases, whilst the sensitivity was 0.72 for positive cases and 0.96 for negative cases. Results indicated that it is critical to consider the general disease comorbidity patterns in self-harm screening and prevention programs. The model also extracted the most predictive diagnoses, and pairs of comorbid diagnoses which provide medical professionals with an effective screening strategy.

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