Quality of dictated feedback associated with SIMPL operative assessments of pediatric surgical trainees

BackgroundSIMPL is a workplace-based operative performance assessment tool which allows for dictated feedback (DF). To better understand the value of DF, we sought to characterize the type and quality of DF generated during SIMPL evaluations.MethodsThematic analysis of DF from SIMPL assessments between June 2017 and December 2018 at a single pediatric surgery fellowship program was performed. Comments were categorized as specific, encouraging or corrective. Categories were combined to determine DF quality as effective, mediocre or ineffective.ResultsOf 781 SIMPL assessments (21 faculty, 5 trainees), 451 (57%) had DF. Most comments were encouraging (93%) and specific (65%). Only 21% were corrective, 17% had entrustment features, and 8% had an explicit learning plan. Feedback quality was deemed mediocre (45%), ineffective (33%) and effective (21%).ConclusionSIMPL dictated feedback was mostly encouraging and specific. To improve quality, feedback should incorporate learning plans as well as corrective and entrustment features.     

Evaluation of Job Strain of Family Physicians in COVID-19 Pandemic Period- An Example from Turkey

Journal of Community Health - The purpose of this study was to evaluate family physicians’ job strain during the Covid-19 pandemic and determine the effective factors. The study was carried...     

Digital eye strain and its associated factors in children during the COVID-19 pandemic

Purpose:This study was undertaken to identify the prevalence of symptoms related to the use of display devices and contributing factors in children engaged in distance learning during the COVID-19 pandemic.Methods:An online electronic survey form was prepared using Google Forms (Alphabet Co., Mountain View, CA) and sent to parents of children under the age of 18 years engaged in distance learning during the COVID-19 pandemic. The types of display devices children use, how often such devices are used, the symptoms of digital eye strain, and the severity and frequency of the symptoms were recorded, and the associations between the factors were analyzed.Results:A total of 692 participants were included. The mean age of the children was 9.72 ± 3.02 years. The most common display devices used were personal computers (n = 435, 61.7%) for online classes and smartphones (n = 400, 57.8%) for nonacademic purposes. The mean duration of display device use was 71.1 ± 36.02 min without a break and 7.02 ± 4.55 h per day. The most common reported symptom was headache (n = 361, 52.2%). Of the participants, 48.2% (n = 332) reported experiencing 3 or more symptoms. The multivariate analysis detected that being male (P = 0.005) and older age (P = 0.001) were independent risk factors for experiencing 3 or more symptoms.Conclusion:The increasing use of digital devices by children is exacerbating the problem of digital eye strain in children as a side effect of online learning. Public awareness should be improved.     

The effect of age on peripheral stem cell mobilization in healthy donors,single center experience

Purpose : Peripheral stem cell transplantation is used as a life‐saving therapeutic option in hematological malignancies. As previously established, most hematological malignancies are seen in the elderly population. Therefore, possible HLA‐identical sibling donors of elderly patients are generally of an advanced age. In this study, we aimed to evaluate the effect of old age on stem cell mobilization and quality in older adult healthy sibling donors. Materials and Methods : Between 2006 and 2014, we evaluated 38 healthy donors aged ≥55 years. The granulocyte‐colony stimulating factor (G‐CSF) analogs were used at a dose of 5 µg/kg/day and administered subcutaneously twice a day for five days. CD34+ cells were estimated in the peripheral blood before collection of the apheresis product. The National Marrow Donor Program selects healthy unrelated donors if they are younger than 60 years. Therefore, we compared the product quality in donors over the age of 60 to that in donors aged 60 years or less. Results : We collected sufficient products from all the donors with one to three apheresis procedures. No serious complication was detected in all donors. Reaching the target CD34+ cell count in one day were detected in 83% of younger and 79% of older donors (P = NS). Collected CD34+ cells x10e6/recipient body weight (kg) was same and 5.1 in the groups (P = NS). There were no correlation between the donor age and these parameters. Conclusion : Healthy donor apheresis in older adults can be performed effectively and possible donors should be evaluated regardless of their age. J. Clin. Apheresis 32:16–20, 2017. © 2016 Wiley Periodicals, Inc.     

Delineation of an Octopus‐Like Thrombus Attached to the Eustachian Valve

Eustachian valve (EV) is a vestige of the valve of the inferior vena cava which directs the umbilical vein blood through open foramen ovale in fetal life. Following birth it gradually regresses, but it may persist in variable size, shape, and thickness as a functionless and benign structure. However, there are reports suggesting that persistent EV may not be completely innocent. It has been accused of being a predisposing cause of patent foramen ovale and paradoxical embolism and also interfering with transseptal interventional procedures. It may serve as a site of infective vegetations and be mistaken as a tumor or thrombus. In the present case, an octopus‐like thrombus attached to the EV was delineated with the utility of two‐dimensional and real time three‐dimensional transesophageal echocardiography. EV was considered to play an essential role in preventing potential pulmonary embolism.     

Reaction control of metal-assisted chemical etching for silicon-based zone plate nanostructures

Metal-assisted chemical etching (MACE) reaction parameters were investigated for the fabrication of specially designed silicon-based X-ray zone plate nanostructures using a gold catalyst pattern and etching solutions composed of HF and H₂O₂. Etching depth, zone verticality and zone roughness were studied as a function of etching solution composition, temperature and processing time. Homogeneous, vertical etching with increasing depth is observed at increasing H₂O₂ concentrations and elevated processing temperatures, implying a balance in the hole injection and silica dissolution kinetics at the gold–silicon interface. The etching depth decreases and zone roughness increases at the highest investigated H₂O₂ concentration and temperature. Possible reasons for these observations are discussed based on reaction chemistry and zone plate design. Optimum MACE conditions are found at HF : H₂O₂ concentrations of 4.7 M : 0.68 M and room temperature with an etching rate of ≈0.7 μm min⁻¹, which is about an order of magnitude higher than previous reports. Moreover, our results show that a grid catalyst design is important for successful fabrication of vertical high aspect ratio silicon nanostructures.

Specially designed X-ray zone plates with high aspect-ratios have been fabricated via metal-assisted chemical etching, by controlling the reaction kinetics.