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1.
Nicholas E. Anton Tomoko Mizota Lava R. Timsina Jake A. Whiteside Erinn M. Myers Dimitrios Stefanidis 《American journal of surgery》2019,217(2):266-271
Introduction
Several studies demonstrated that simulator-acquired skill transfer to the operating room is incomplete. Our objective was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room.Methods
Trainees completed baseline assessments including intracorporeal suturing (IS) performance, attentional selectivity, self-reported use of mental skills, and self-reported prior clinical and simulated laparoscopic experience and confidence. Residents then followed proficiency-based laparoscopic skills training, and their skill transfer was assessed on a live-anesthetized porcine model. Predictive characteristics for transfer test performance were assessed using multiple linear regression.Results
Thirty-eight residents completed the study. Automaticity, attentional selectivity, resident perceived ability with laparoscopy and simulators, and post-training IS performance were predictive of IS performance during the transfer test.Conclusions
Promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. Mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal. 相似文献2.
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4.
Jerzy Slowinski Jake Dominik Ryan J. Uitti Zeshan Ahmed Dennis D. Dickson Zbigniew K. Wszolek 《Neuropathology》2007,27(1):73-80
We present a case of frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP‐17) harboring the N279K mutation in the MAPT gene from the family known as pallido‐ponto‐nigral degeneration (PPND). This 49‐year‐old man was followed for 17 years. He presented at age 41 years with left leg stiffness and en‐bloc turning. During the course of his illness he developed a constellation of symptoms including parkinsonism, pyramidal signs, vertical gaze palsy, dysphagia, dystonia, personality and cognitive dysfunction, weight loss and mutism. Gross neuropathological examination showed mild atrophy of the cerebral cortex, hippocampal formation, amygdala, thalamus, subthalamic nucleus and depigmentation of the substantia nigra. Microscopy revealed neuronal loss and gliosis in the same regions. Tau immunohistochemistry showed pretangles, numerous threads, grain‐like structures and oligodendroglial tau‐positive inclusions (“coiled bodies”). In the spinal cord the tau pathology was more abundant in gray than white matter. Pretangles and threads were present in the anterior and, to a lesser extent, in the posterior horns. FTDP‐17 should be suspected in patients with a history of familial parkinsonism combined with behavioral and cognitive changes, onset before age 65 years and an aggressive clinical course. 相似文献
5.
Steffen Rickes Peter Rauh Daniel Ensberg Christine Uhle und Frank Aedtner 《Medizinische Klinik》2007,102(9):778-780
Ohne Zusammenfassung 相似文献
6.
J. R. Buscombe I. Khalkhali G. R. Mason D. Rauh J. Meatherall W. J. G. Oyen F. H. M. Corstens 《European journal of nuclear medicine and molecular imaging》1994,21(10):1148-1150
Functional imaging is ideally suited to monitoring the effect of specific therapy on disease processes. In this pilot study five patients with AIDS and Pneumocystis carinii pneumonia (PCP) were imaged with Indium-111 labelled pooled human immunoglobulin (111In-HIG) during infection and after therapy for PCP. The lung activity of t t tln-HIG, measured as a lung/heart ratio, was calculated in a study performed during infection with PCP and after therapy. In all five patients the lung/heart ratio of t t 1ln-HIG was reduced after treatment. The mean reduction in heart/lung ratio was 27% (range 12%-53%). If these results are confirmed by a larger study, 11In-HIG will be useful in monitoring the response of PCP to therapy in patients with AIDS. 相似文献
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8.
Jake M. Najman 《Australian and New Zealand journal of public health》1988,12(1):31-41
Recent findings have pointed to an association between socioeconomic status and health in Australia but have, in the process, raised important questions about the validity of various methods of determining a respondent's location within the hierarchy. While some of the problems associated with the use of the Australian Bureau of Statistics classification were known, the full extent of these deficiencies was not. This paper reviews past and present methods of measuring socioeconomic inequality in Australia. After pointing to the criteria which should be applied to determine the adequacy of any method of socioeconomic classification, the paper reviews the main strengths and weaknesses of the methods of classification used in health-related research in Australia. 相似文献
9.
The convolution method can be used to model the effect of random geometric uncertainties into planned dose distributions used in radiation treatment planning. This is effectively done by linearly adding infinitesimally small doses, each with a particular geometric offset, over an assumed infinite number of fractions. However, this process inherently ignores the radiobiological dose-per-fraction effect since only the summed physical dose distribution is generated. The resultant potential error on predicted radiobiological outcome [quantified in this work with tumor control probability (TCP), equivalent uniform dose (EUD), normal tissue complication probability (NTCP), and generalized equivalent uniform dose (gEUD)] has yet to be thoroughly quantified. In this work, the results of a Monte Carlo simulation of geometric displacements are compared to those of the convolution method for random geometric uncertainties of 0, 1, 2, 3, 4, and 5 mm (standard deviation). The alpha/betaCTV ratios of 0.8, 1.5, 3, 5, and 10 Gy are used to represent the range of radiation responses for different tumors, whereas a single alpha/betaOAR ratio of 3 Gy is used to represent all the organs at risk (OAR). The analysis is performed on a four-field prostate treatment plan of 18 MV x rays. The fraction numbers are varied from 1-50, with isoeffective adjustments of the corresponding dose-per-fractions to maintain a constant tumor control, using the linear-quadratic cell survival model. The average differences in TCP and EUD of the target, and in NTCP and gEUD of the OAR calculated from the convolution and Monte Carlo methods reduced asymptotically as the total fraction number increased, with the differences reaching negligible levels beyond the treatment fraction number of > or =20. The convolution method generally overestimates the radiobiological indices, as compared to the Monte Carlo method, for the target volume, and underestimates those for the OAR. These effects are interconnected and attributed to assuming an infinite number of fractions inherent in the implementation of the convolution technique, irrespective of the uniqueness of each treatment schedule. Based on the fraction numbers analyzed (1-50), and the range of fraction numbers normally used clinically (> or =20), the convolution method can be used safely to estimate the effects of random geometric uncertainties on prostate treatment radiobiological outcomes, for both the target and the OAR. Although the results of this study is likely to apply to other clinical sites and treatment techniques other than the four-field, further validation similar to those done in this study may be necessary prior to clinical implementation. 相似文献
10.
At least three distinct B cell epitopes reside in the C-terminal half of La protein, as determined by a recombinant DNA approach 总被引:7,自引:0,他引:7
The La antigen is a nuclear protein that is one of the major target antigens of autoantibodies found in the sera of patients with primary Sj?gren's syndrome. The formation of such autoantibodies is therefore likely to reflect the basic immunopathogenesis of this disorder. A recombinant DNA strategy has been used to examine the La protein for sequences that encode autoimmunizing B cell epitopes. We have isolated and characterized a 1.2-kb-long cDNA from a human liver cDNA library encoding a region of the La protein; this region contains 296 amino acids, including the C terminus. A sub-library of recombinant DNA in the expression vector pEX was made from portions of the La cDNA. Individual fusion proteins were tested by immunoblotting and enzyme-linked immunosorbent assay for their ability to react with anti-La autoantibodies contained in sera from patients with Sj?gren's syndrome. In this way, we have identified at least three distinct epitopes in the C-terminal half of the La protein. Every anti-La serum tested contained antibodies against all three of the antigenic regions identified. Furthermore, most of the sera display similar ratios between the titers of antibodies with the three kinds of specificity. Our data suggest that the production of anti-La autoantibodies may be antigen driven. 相似文献