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101.
Konstantinos Toutouzas Georgios Benetos Vasilis Voudris Maria Drakopoulou Konstantinos Stathogiannis George Latsios Andreas Synetos Alexios Antonopoulos Elias Kosmas Ioannis Iakovou Georgios Katsimagklis Antonios Mastrokostopoulos Sotiris Moraitis Vicki Zeniou Haim Danenberg Manolis Vavuranakis Dimitris Tousoulis 《JACC: Cardiovascular Interventions》2019,12(8):767-777
Objectives
The aim of this study was to compare the implantation of a self-expanding valve with or without balloon aortic valvuloplasty (BAV) in an open-label, noninferiority, randomized trial.Background
There are no randomized studies comparing the implantation of a self-expanding valve with (pre-BAV) or without BAV.Methods
Consecutive patients with severe aortic stenosis were randomly assigned to undergo transcatheter aortic valve replacement with the use of self-expanding prostheses with (pre-BAV) or without (no-BAV) pre-dilatation. The primary endpoint was device success according to the Valve Academic Research Consortium 2 criteria. Secondary endpoints included periprocedural mortality and stroke, new permanent pacemaker implantation, vascular complications, and 1-year mortality. The trial was scheduled to show noninferiority (Δ = 15%) of the direct versus the pre-BAV approach.Results
A total of 171 patients were randomized at 4 centers. Of these, 86 underwent transcatheter aortic valve replacement with pre-dilatation and 85 without. Device success was noninferior in the no-BAV group compared with the pre-BAV group (65 of 85 [76.5%] for no-BAV vs. 64 of 86 [74.4%] for pre-BAV; mean difference 2.1%; 90% confidence interval: ?8.9% to 13%). In the no-BAV group, 25 patients (29.4%) underwent post-balloon dilatation, and in the pre-BAV group, 13 patients (15.1%) underwent post-balloon dilatation (p = 0.03). Regarding major vascular complications and permanent pacemaker implantation, there was no difference between the 2 groups (log-rank p = 0.49, log-rank p = 0.54). In 1-month completed follow-up for all patients, there was 1 periprocedural stroke (0.5%), without any deaths.Conclusions
Direct, without balloon pre-dilatation, transcatheter aortic valve replacement with a self-expanding prosthesis system is noninferior to the pre-dilatation procedure. Lower post-dilatation rates were encountered in the group with pre-dilatation. (The Predilatation in Transcatheter Aortic Valve Implantation Trial [DIRECT]; NCT02448927) 相似文献102.
Background
Obesity is a global public health issue and worldwide rates of childhood obesity are ten times higher than 40 years ago. A limited number of studies have been conducted to determine the prevalence of preschool obesity and overweight and associated factors in Palestinian children. The aim of this study was to examine sociodemographic and economic factors associated with preschool overweight and obesity in Palestinian children younger than 5 years of age.Methods
We used data from the fifth Palestinian Multiple Indicator Cluster Survey (MICS5), a cross-sectional survey of a representative sample of Palestinian households in 2014. The analysis was based on 6853 children (after excluding children whose z-score was out of range or not measured) below 5 years of age (46% [3152 out of 6853] in the Gaza Strip and 54% [3701 out of 6853] in the West Bank), drawn from 7816 completed surveys of a multi-stage cluster sample (99% response rate). The z-scores for BMI-for-age of children were used to evaluate weight status. Underweight, overweight, and obesity were defined as the proportion of preschool children with z-score values of 2 SDs or less, greater than 2 SDs, and greater than 3 SDs, respectively, from the WHO Child Growth Standards. Covariates included gender, age, area and region, number of children per household, mother's level of education, marital status of the mother, mother's age at birth, and wealth quantile (which we used as a composite indicator of wealth, with the first quintile representing the poorest households, and the fifth quintile representing the wealthiest households). We used multiple logistic regression analysis to estimate adjusted odds ratios (AORs) with 95% confidence intervals (CIs).Findings
The overall prevalence of overweight and obesity in Palestinian children (birth to 5 years) was 8·8% (95% CI 8·1–9·4); 7·3% were overweight and 1·5% were obese. The prevalence of underweight was 1·4%. The odds of overweight and obesity were lower among children in the Gaza Strip than in the West Bank (AOR=0·74; 95% CI 0·61–0·90). Girls were less likely to be obese and overweight than boys (AOR=0·75; 95% CI 0·63–0·89). Children under 4 years of age had a higher risk of being obese and overweight than children aged 4–5 years. Children who lived in the wealthiest households (fifth quintile) were more likely to be overweight and obese than children in the poorest (first) quintile (AOR=1·36; 95% CI 1·09–1·71).Interpretation
The prevalence of obesity and overweight among preschool children in Palestine (8·8%) is higher than the global prevalence (6·7%; derived using the same standardised method as in this study, and using the WHO Child Growth Standards to assess the nutritional status of children). Obesity and overweight were more likely to affect children from wealthier households, children from the West Bank, boys, and younger children. Excessive weight gain in early childhood is a strong predictor of adulthood obesity. Routine assessment of all children needs to become standard clinical practice from very early childhood. Effective management and preventive interventions are needed to tackle the increasing obesity problem in preschool children.Funding
None. 相似文献103.
Shaun C. Daly Rebecca A. Deal Daniel E. Rinewalt Amanda B. Francescatti Minh B. Luu Keith W. Millikan Mary C. Anderson Jonathan A. Myers 《American journal of surgery》2014
Background
The purpose of our study was to determine the predictive impact of individual academic measures for the matriculation of senior medical students into a general surgery residency.Methods
Academic records were evaluated for third-year medical students (n = 781) at a single institution between 2004 and 2011. Cohorts were defined by student matriculation into either a general surgery residency program (n = 58) or a non–general surgery residency program (n = 723). Multivariate logistic regression was performed to evaluate independently significant academic measures.Results
Clinical evaluation raw scores were predictive of general surgery matriculation (P = .014). In addition, multivariate modeling showed lower United States Medical Licensing Examination Step 1 scores to be independently associated with matriculation into general surgery (P = .007).Conclusions
Superior clinical aptitude is independently associated with general surgical matriculation. This is in contrast to the negative correlation United States Medical Licensing Examination Step 1 scores have on general surgery matriculation. Recognizing this, surgical clerkship directors can offer opportunities for continued surgical education to students showing high clinical aptitude, increasing their likelihood of surgical matriculation. 相似文献104.
Robert M.A. van der Boon Bertrand Marcheix Didier Tchetche Alaide Chieffo Nicolas M. Van Mieghem Nicolas Dumonteil Olivier Vahdat Francesco Maisano Patrick W. Serruys A. Pieter Kappetein Jean Fajadet Antonio Colombo Didier Carrié Ron T. van Domburg Peter P.T. de Jaegere 《The Annals of thoracic surgery》2014
105.
目的 探讨翻转课堂教学模式在低年资护士安全文化培训中的应用效果。方法 选择2017年8月在安徽医科大学附属六安医院工作年限≤ 5年的150名护士为研究对象,采用随机数字表法分为对照组与观察组,每组75名。对照组采用传统课堂培训形式,观察组进行相同课程内容的翻转课堂教学模式。培训后分析两组护士综合考核成绩、学业情绪、安全文化感知水平、护理不良事件发生率,比较2种不同培训形式的培训效果。结果 观察组护士理论知识考核成绩为（85.72±10.08）分、案例分析考核成绩为（78.51±7.13）分、学业情绪积极活动得分为（71.73±5.32）分、积极结果得分为（30.11±2.10）分、患者安全文化感知水平得分为（4.65±0.41）分,均高于对照组,学业情绪消极活动得分（18.42±2.86）分、消极结果得分（29.12±6.01）分,均低于对照组,差异均有统计学意义（P<0.05）。培训后6个月内,观察组共发生护理不良事件5例,对照组15例,差异有统计学意义（χ2=5.769,P=0.016）。结论 翻转课堂教学模式可以有效提升低年资护士安全文化培训综合考核成绩和患者安全文化感知水平,改善学业情绪,降低护理不良事件发生率。 相似文献
106.
Mohammed N. Al-Arifi 《Saudi Pharmaceutical Journal》2019,27(4):517-520
BackgroundAcademic research is an essential part of undergraduate and post graduate education to become qualified health care professionals. The objective of this study was to evaluate the attitudes of pharmacy students towards scientific research and/or academic careers in Saudi Arabia.MethodsA cross-sectional survey based study was conducted among pharmacy students at King Saud University. A self-administered questionnaire was implemented over a period of 3 months (January to March 2018).ResultsA total of 223 students returned the survey. More than one third students (66.3%) agreed that participation in research increased their interest in pursuing a career in research/academic pharmacy. Most students (75.3%) were interested in participating research during the course of study and 73.6% believed that research training should be a compulsory part of teaching curriculum. In addition, more than half of students (54.5%) were interested in higher studies such as PhD after graduation. Most of students (70.3%) ranked lifestyle (73.6%) and earning potential (70.3%) as an important factor for them when choosing a specialty.ConclusionsPharmacy students had positive attitudes towards research activities and they desired to be involved more in research publications. However, addressing the barriers and improving student participation will increase their interest in academic research. 相似文献
107.
本文通过分析当前中西医结合传染病专业研究生教学的现状,从举办研究生论坛的筹备、实施、注意事项、体会等方面论述了实践经验和体会。实践证明,以研究生论坛为平台可显著激发学生学习积极性,培养科研兴趣,进而提升教学质量。 相似文献
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