1
|
Schaffler BC, Longwell M, Byers B, Kreft R, Ramot R, Ramot Y, Schwarzkopf R. Nanoparticle ultrasonication outperforms conventional irrigation solutions in eradicating Staphylococcus aureus biofilm from titanium surfaces: an in vitro study. Eur J Orthop Surg Traumatol 2024:10.1007/s00590-024-03982-y. [PMID: 38761198 DOI: 10.1007/s00590-024-03982-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/29/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE Bacterial biofilms create a challenge in the treatment of prosthetic joint infection (PJI), and failure to eradicate biofilms is often implicated in the high rates of recurrence. In this study, we aimed to compare the effectiveness of a novel nanoparticle ultrasonication technology on Staphylococcus aureus biofilm eradication compared to commonly used orthopedic irrigation solutions. METHODS Twenty-four sterile, titanium alloy discs were inoculated with a standardized concentration of methicillin-resistant S. aureus and cultured for seven days to allow for biofilm formation. Discs were then treated with either ultrasonicated nanoparticle therapy or irrigation with chlorhexidine gluconate, povidone-iodine or normal saline. The remaining bacteria on each surface was subsequently plated for colony-forming units of S. aureus. Bacterial eradication was reported as a decrease in CFUs relative to the control group. Mann-Whitney U tests were used to compare between groups. RESULTS Treatment with ultrasonicated nanoparticles resulted in a significant mean decrease in CFUs of 99.3% compared to controls (p < 0.0001). Irrigation with povidone-iodine also resulted in a significant 77.5% reduction in CFUs compared to controls (p < 0.0001). Comparisons between ultrasonicated nanoparticles and povidone-iodine demonstrated a significantly higher reduction in bacterial CFUs in the nanoparticle group (p < 0.0001). CONCLUSION Ultrasonicated nanoparticle were superior to commonly used bactericidal irrigation solutions in the eradication of S. aureus from a titanium surface. Future clinical studies are warranted to evaluate this ultrsonication technology in the treatment of PJI.
Collapse
Affiliation(s)
- Benjamin C Schaffler
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, 301 East 17Th Street, New York, NY, 10003, USA
| | - Mark Longwell
- Center for Excellence in Biofilm Research, Allegheny Health Network Research Institute, Pittsburgh, PA, USA
| | - Barbara Byers
- Center for Excellence in Biofilm Research, Allegheny Health Network Research Institute, Pittsburgh, PA, USA
| | - Rachel Kreft
- Center for Excellence in Biofilm Research, Allegheny Health Network Research Institute, Pittsburgh, PA, USA
| | - Roi Ramot
- Center for Excellence in Biofilm Research, Allegheny Health Network Research Institute, Pittsburgh, PA, USA
| | - Yair Ramot
- Center for Excellence in Biofilm Research, Allegheny Health Network Research Institute, Pittsburgh, PA, USA
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, 301 East 17Th Street, New York, NY, 10003, USA.
| |
Collapse
|
2
|
Acharya S, Godhi BS, Saxena V, Assiry AA, Alessa NA, Dawasaz AA, Alqarni A, Karobari MI. Role of artificial intelligence in behavior management of pediatric dental patients-a mini review. J Clin Pediatr Dent 2024; 48:24-30. [PMID: 38755978 DOI: 10.22514/jocpd.2024.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/18/2023] [Indexed: 05/18/2024] Open
Abstract
The influence of behavioral science on various organizations has been experiencing remarkable growth worldwide. With the integration of recent technological advancements, behavioral science's impact has expanded into diverse fields such as finance and policy. The term "artificial intelligence" (AI) has become increasingly prevalent, but it is essential to provide clarity before proceeding. AI pertains to the theory and creation of systems capable of executing tasks that typically necessitate human intelligence. Integrating artificial intelligence (AI) in pediatric dentistry has emerged as a promising avenue to enhance patient care, improve diagnostic accuracy, streamline treatment planning, and augment patient engagement. AI-driven tools such as image analysis, natural language processing, and machine learning algorithms assist in early caries detection, orthodontic treatment planning, behavior management, and personalized oral hygiene education for pediatric patients. This paper presents an overview of AI's applications in pediatric dentistry, particularly behavior management, highlighting its potential to revolutionize traditional pediatric dental practices.
Collapse
Affiliation(s)
- Sonu Acharya
- Pediatric and Preventive Dentistry, Institute of Dental Sciences, Siksha 'O'Anusandhan (Deemed to be) University, 751016 Bhubaneswar, India
| | - Brinda S Godhi
- Department of Pediatric and Preventive Dentistry, JSS Dental College, JSS Academy of Higher Education and research, 570015 Mysuru, India
| | - Vrinda Saxena
- Department of Public Health Dentistry, Government Dental College, 452001 Indore, India
| | - Ali A Assiry
- Preventive Dental Science Department, Faculty of Dentistry, Najran University, 1988 Najran, Kingdom of Saudi Arabia
| | - Noura Abdulaziz Alessa
- Department of pediatric dentistry and orthodontics, dental college, King Saud University, 11454 Riyadh, Kingdom of Saudi Arabia
| | - Ali Azhar Dawasaz
- Department of diagnostic dental sciences, College of dentistry, King Khalid University, 61421 Abha, Kingdom of Saudi Arabia
| | - Abdullah Alqarni
- Department of Diagnostics Dental Sciences and Oral Biology, College of Dentistry, King Khalid University, 61421 Abha, Kingdom of Saudi Arabia
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 600077 Chennai, India
| |
Collapse
|
3
|
Christensen JO, Johannessen H. Is new tech a pain in the neck? The impact of introducing new technologies in home-care on neck pain: a prospective study. BMC Public Health 2024; 24:734. [PMID: 38454440 PMCID: PMC10921650 DOI: 10.1186/s12889-024-18252-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/01/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Home healthcare services are increasingly utilizing novel technologies to enhance quality and efficiency of caregiving, to reduce workloads and compensate for expected labor shortages in the future due to ageing populations. However, rapid, ongoing implementation of new technologies may demand considerable adaptation for employees. The objective of this study was to prospectively examine associations of newly introduced work technologies with neck pain complaints. METHODS With a nationally representative prospective sample of home-care workers in Norway (N = 887), we estimated effects of 1) introducing new technologies and 2) the appraised quality of training during implementation on neck pain eight months after. RESULTS A majority of employees reported new technologies having been introduced the previous 12 months (73.8%). This was not by itself associated with neck pain. However, perceived high quality of training was associated with less subsequent neck pain, also after adjustment for job demands and job control. The strongest effect was seen for "very good" versus "very poor" quality training (OR 0.35, 95% CI 0.17,0.71, in the fully adjusted model). Cross-lagged path analyses ruled out potential reverse causation stemming from the influence of pain on needs for or appraisals of training. CONCLUSION The present findings suggest the introduction of new work technologies has a significant impact on home-care workers' health, depending on the quality of training during implementation. This highlights the need to include training programs in risk assessments when implementing new technologies.
Collapse
|
4
|
Heo S, Lee G, Na HE, Park JH, Kim T, Oh SE, Jeong DW. Current status of the novel food ingredient safety evaluation system. Food Sci Biotechnol 2024; 33:1-11. [PMID: 38186627 PMCID: PMC10767037 DOI: 10.1007/s10068-023-01396-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/25/2023] [Accepted: 07/16/2023] [Indexed: 01/09/2024] Open
Abstract
Increasing demand for new foods, technological development, and vegan market growth have led to an increase in new food ingredients, so the need for safety assessment of these ingredients is important. Representative safety assessment systems are the Generally Recognized as Safe (GRAS) notification of the Food and Drug Administration in the USA and the novel food system of the European Food Safety Authority in the European Union. GRAS is a notification system for information on food ingredients, food additives and functional foods under the responsibility of the applicant, while the novel food system assesses the safety of food ingredients excluding food additives. In Korea, a safety evaluation system is established for temporary food ingredients, which includes food ingredients without a domestic intake history. However, safety assessment systems for novel foods from other countries and food ingredients produced by the application of new technology need to be improved.
Collapse
Affiliation(s)
- Sojeong Heo
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, 02748 Republic of Korea
| | - Gawon Lee
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, 02748 Republic of Korea
| | - Hong-Eun Na
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, 02748 Republic of Korea
| | - Jung-Hyun Park
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, 02748 Republic of Korea
| | - Tao Kim
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, 02748 Republic of Korea
| | - Seung-Eun Oh
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, 02748 Republic of Korea
| | - Do-Won Jeong
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, 02748 Republic of Korea
| |
Collapse
|
5
|
Rutala WA, Donskey CJ, Weber DJ. Disinfection and sterilization: New technologies. Am J Infect Control 2023; 51:A13-A21. [PMID: 37890943 DOI: 10.1016/j.ajic.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Adherence to professional guidelines and/or manufacturer's instructions for use regarding proper disinfection and sterilization of medical devices is crucial to preventing cross transmission of pathogens between patients. Emerging pathogens (e.g., Candida auris) and complex medical devices provide new challenges. METHODS A search for published English articles on new disinfection and sterilization technologies was conducted by Google, Google scholar and PubMed. RESULTS Several new disinfection methods or products (e.g., electrostatic spraying, new sporicides, colorized disinfectants, "no touch" room decontamination, continuous room decontamination) and sterilization technologies (e.g., new sterilization technology for endoscopes) were identified. CONCLUSIONS These technologies should reduce patient risk.
Collapse
Affiliation(s)
- William A Rutala
- Statewide Program for Infection Control and Epidemiology, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
| | - Curtis J Donskey
- Geriatric Research, Education and Clinical Care, Louis Stokes Cleveland VA Medical Center, Cleveland, OH
| | - David J Weber
- Statewide Program for Infection Control and Epidemiology, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC; Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
| |
Collapse
|
6
|
Maganty A, Hollenbeck BK. New technology in prostate cancer and financial toxicity. Urol Oncol 2023; 41:376-379. [PMID: 37173237 PMCID: PMC10524964 DOI: 10.1016/j.urolonc.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
The management of prostate cancer has significantly evolved over the last few decades with the emergence of new diagnostic and treatment technologies, which are typically more expensive than the previous alternatives. However, decision-making regarding which diagnostics and treatment to pursue is often influenced by perceived benefits, adverse effects, and physician recommendations, without considering the financial liability borne by patients. New technologies may exacerbate financial toxicity by replacing less costly alternatives, promoting unrealistic expectations, and expanding treatment to those who would have previously gone untreated. More judicious use of technologies with an understanding of the contexts in which they are most beneficial may help prevent avoidable financial toxicity to patients.
Collapse
Affiliation(s)
- Avinash Maganty
- Department of Urology, Division of Health Services Research, University of Michigan, Ann Arbor, MI.
| | - Brent K Hollenbeck
- Department of Urology, Division of Health Services Research, University of Michigan, Ann Arbor, MI
| |
Collapse
|
7
|
Hardman D, Bennett R, Mikhail E. Laparoscopic Shaving of Rectosigmoid Deep Infiltrating Endometriosis Under Laparoscopic Ultrasound Guidance. Fertil Steril 2023:S0015-0282(23)00311-4. [PMID: 37116640 DOI: 10.1016/j.fertnstert.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To present laparoscopic shaving of rectosigmoid endometriosis using the novel approach of laparoscopic ultrasound guidance to enhance complete excision. DESIGN The intervention performed includes excision of rectosigmoid deep infiltrating endometriosis under guidance of laparoscopic ultrasound. MAIN OUTCOME MEASURES NA RESULTS & CONCLUSION: It is important to perform a complete pre-operative evaluation to determine the extent of disease and the necessity of a multidisciplinary approach. Intraoperative laparoscopic ultrasound can provide additional information including size and depth of lesions, which could play a role in surgical decision making. Laparoscopic ultrasound may enhance complete excision of DIE lesions and decrease the incidence of recurrence.
Collapse
Affiliation(s)
- Danielle Hardman
- University of South Florida Department of Obstetrics and Gynecology, Tampa, FL
| | - Robert Bennett
- University of South Florida Department of General Surgery, Division of Colorectal Surgery, Tampa, FL
| | - Emad Mikhail
- University of South Florida Department of Obstetrics and Gynecology, Division of Gynecologic Subspecialties, Tampa, FL
| |
Collapse
|
8
|
Kim SY, Blanco MN, Bi J, Larson TV, Sheppard L. Exposure assessment for air pollution epidemiology: A scoping review of emerging monitoring platforms and designs. Environ Res 2023; 223:115451. [PMID: 36764437 PMCID: PMC9992293 DOI: 10.1016/j.envres.2023.115451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/10/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Both exposure monitoring and exposure prediction have played key roles in assessing individual-level long-term exposure to air pollutants and their associations with human health. While there have been notable advances in exposure prediction methods, improvements in monitoring designs are also necessary, particularly given new monitoring paradigms leveraging low-cost sensors and mobile platforms. OBJECTIVES We aim to provide a conceptual summary of novel monitoring designs for air pollution cohort studies that leverage new paradigms and technologies, to investigate their characteristics in real-world examples, and to offer practical guidance to future studies. METHODS We propose a conceptual summary that focuses on two overarching types of monitoring designs, mobile and non-mobile, as well as their subtypes. We define mobile designs as monitoring from a moving platform, and non-mobile designs as stationary monitoring from permanent or temporary locations. We only consider non-mobile studies with cost-effective sampling devices. Then we discuss similarities and differences across previous studies with respect to spatial and temporal representation, data comparability between design classes, and the data leveraged for model development. Finally, we provide specific suggestions for future monitoring designs. RESULTS Most mobile and non-mobile monitoring studies selected monitoring sites based on land use instead of residential locations, and deployed monitors over limited time periods. Some studies applied multiple design and/or sub-design classes to the same area, time period, or instrumentation, to allow comparison. Even fewer studies leveraged monitoring data from different designs to improve exposure assessment by capitalizing on different strengths. In order to maximize the benefit of new monitoring technologies, future studies should adopt monitoring designs that prioritize residence-based site selection with comprehensive temporal coverage and leverage data from different designs for model development in the presence of good data compatibility. DISCUSSION Our conceptual overview provides practical guidance on novel exposure assessment monitoring for epidemiological applications.
Collapse
Affiliation(s)
- Sun-Young Kim
- Department of Cancer AI and Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Magali N Blanco
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jianzhao Bi
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Timothy V Larson
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA
| |
Collapse
|
9
|
Mestriner AB, Antonelli B, Schwab PE, Chen AF, Jones T, Ackermann J, Merkely GB, Lange JK. Short-to Mid-Term Survivorship of a Patient-specific Unicompartmental Knee Arthroplasty Implant Cast from a Three-Dimensional Printed Mold. Orthop Clin North Am 2023; 54:193-199. [PMID: 36894291 DOI: 10.1016/j.ocl.2022.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
The purpose of this study was to determine early survivorship and complication rates associated with the implantation of a new patient-specific unicompartmental knee implant cast from a three-dimensional (3D) printed mold, introduced in 2012. We retrospectively reviewed 92 consecutive patients who underwent unicompartmental knee arthroplasty (UKA) with a patient-specific implant cast from a 3D printed mold between September 2012 and October 2015. The early results of a patient-specific UKA implant were favorable in our cohort, with survivorship free from reoperation of 97% at an average 4.5 years follow-up. Future studies are necessary to investigate the long-term performance of this implant. Survivorship of a patient-specific unicompartmental knee arthroplasty implant cast from a 3D printed mold.
Collapse
Affiliation(s)
- Alexandre Barbieri Mestriner
- Department of Orthopedics and Traumatology, Federal University of Sao Paulo - Paulista, School of Medicine, Sao Paulo, Brazil
| | - Brielle Antonelli
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | | | - Antonia F Chen
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - Todd Jones
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - Jakob Ackermann
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Gergo Bela Merkely
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - Jeffrey K Lange
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA.
| |
Collapse
|
10
|
Yang L, Li H, Ren Y, Shan J, Liu S, Wei H, Chen H. Development and evaluation of an ultra-wide bandwidth based electronic hand hygiene monitoring system. Am J Infect Control 2023; 51:313-318. [PMID: 35868459 DOI: 10.1016/j.ajic.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND A large variety of electronic hand hygiene monitoring systems (EHHMS) are being developed and applied in health care settings. Monitoring hand hygiene (HH) opportunity at bed-level has been the key technical challenge. Accuracy evaluation needs more attention as the prerequisite upon widespread acceptance and adoption. METHODS For the first time, we explored, debugged and upgraded an EHHMS based on ultra-wide bandwidth (UWB) which can obtain HH opportunities at bed-level. The real-time positioning and electronic fence of UWB technology was applied for EHHMS. The accuracy of EHHMS was compared with the simultaneous manual direct observations in real-world clinical setting. Sensitivity and specificity were calculated for EHHMS capturing HH action and opportunity. RESULTS Two generations of EHHMS were constructed. For the first generation, the system properly recorded 84% and 78% of the pre-identified HH actions and opportunities performed by experimenters. For the second generation, sensitivity and specificity of the system capturing HH action were 89% (84.83-92.36) and 100% (98.26-100.00), respectively. For capturing HH opportunity, the system showed the sensitivity and specificity of 86.52% (82.52-89.89) and 88.10% (84.14-91.36)), respectively. CONCLUSION The EHHMS based on UWB could accurately identify HH action and opportunity with equivalent accuracy compared with simultaneous direct observation.
Collapse
Affiliation(s)
- Lin Yang
- Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China
| | - Hong Li
- Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China
| | - Yan Ren
- Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China
| | - Jiao Shan
- Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China
| | - Shuang Liu
- Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China
| | - Hongxin Wei
- Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China
| | - Hui Chen
- Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China; Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China.
| |
Collapse
|
11
|
Jadesola Ololade A, Odunayo Paul S, Tolulope Morenike A, Augustina Esitse D. Bolstering the role of human resource information system on employees' behavioural outcomes of selected manufacturing firms in Nigeria. Heliyon 2023; 9:e12785. [PMID: 36699272 PMCID: PMC9868372 DOI: 10.1016/j.heliyon.2022.e12785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023] Open
Abstract
The efficient use of an organisation's valuable human resources is crucial to its success. Organizations are embracing HRIS more and more to ensure the efficient utilization of their human resources (a relatively new technology in HRM). However, enterprises, especially manufacturing firms, are lagging in reaping the benefits of modern technology due to a slew of challenges. To close the stated gaps, the current study investigated the role of human resource information system on employees' behavioural outcomes in selected manufacturing firms in Nigeria. The diffusion of innovation theory was used to explain the inevitability of new technology in HRM. The target population comprised managers and supervisors of Nigeria's selected Fast Moving Consumer Goods firms (FMCGs). Specifically, the purposive sampling technique was adopted to select the participants for this study. Copies of the questionnaire was used to collect data from a diverse cross-section of the managers and supervisors. The information collected was analyzed using structural equation modeling. The findings revealed that manpower planning information, performance appraisal information and succession planning information are predictors of employees' behavioural outcomes. It was concluded that management apprehension, employee privacy concerns, internal organisational opposition, and conversion costs are the most significant barriers to effective HRIS implementation. Finally, several quantifiable approaches to improve new technology in HRM were proffered.
Collapse
|
12
|
Affiliation(s)
- Ugo Boggi
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
| |
Collapse
|
13
|
Coccia M. Effects of strict containment policies on COVID-19 pandemic crisis: lessons to cope with next pandemic impacts. Environ Sci Pollut Res Int 2023; 30:2020-2028. [PMID: 35925462 PMCID: PMC9362501 DOI: 10.1007/s11356-022-22024-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/11/2022] [Indexed: 04/16/2023]
Abstract
The goal of the study here is to analyze and assess whether strict containment policies to cope with Coronavirus Disease 2019 (COVID-19) pandemic crisis are effective interventions to reduce high numbers of infections and deaths. A homogenous sample of 31 countries is categorized in two sets: countries with high or low strictness of public policy to cope with COVID-19 pandemic crisis. The findings here suggest that countries with a low intensity of strictness have average confirmed cases and fatality rates related to COVID-19 lower than countries with high strictness in containment policies (confirmed cases are 24.69% vs. 26.06% and fatality rates are 74.33% vs. 76.38%, respectively, in countries with low and high strictness of COVID-19 public policies of containment). What this study adds is that high levels of strict restriction policies may not be useful measures of control in containing the spread and negative impact of pandemics similar to COVID-19 and additionally a high strictness in containment policies generates substantial social and economic costs. These findings can be explained with manifold socioeconomic and environmental factors that support transmission dynamics and circulation of COVID-19 pandemic. Hence, high levels of strictness in public policy (and also a high share of administering new vaccines) seem to have low effectiveness to stop pandemics similar to COVID-19 driven by mutant viral agents. These results here suggest that the design of effective health policies for prevention and preparedness of future pandemics should be underpinned in a good governance of countries and adoption of new technology, rather than strict and generalized health polices having ambiguous effects of containment in society.
Collapse
Affiliation(s)
- Mario Coccia
- CNR-National Research Council of Italy, Collegio Carlo Alberto, Via Real Collegio, 30, Moncalieri, 10024, Turin, Italy.
| |
Collapse
|
14
|
Wijnen F, Walma van der Molen J, Voogt J. Primary teachers' attitudes towards using new technology and stimulating higher-order thinking in students: A profile analysis. Educ Inf Technol (Dordr) 2022; 28:6347-6372. [PMID: 36406790 PMCID: PMC9651889 DOI: 10.1007/s10639-022-11413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 10/18/2022] [Indexed: 05/25/2023]
Abstract
Critical thinking, creative thinking, problem solving and other so-called higher-order thinking skills are regarded as crucial for students to develop. Research shows that technology can be used as a tool to stimulate students' higher-order thinking skills. However, most teachers rarely use new technology to stimulate students to engage in higher-order thinking. To help teachers in this, we need to gain an understanding of teachers' attitudes towards using new technology and towards stimulating higher-order thinking. In this study, we explore these teacher attitudes by identifying teacher profiles based on primary school teachers' attitudes (N = 659) towards (a) using new technology and (b) stimulating higher-order thinking. Results of the cluster-analysis revealed three teacher profiles. In follow-up focus group interviews with 21 participants, we found that teachers recognized the identified profiles and that the results of the cluster-analysis matched teachers' self-chosen profiles in almost all cases. These results indicate that we can suitably characterize teachers based on their attitudes towards using new technology and stimulating higher-order thinking. Identification of these profiles may help us understand why certain groups of teachers may use new technology to stimulate students' higher-order thinking, while other teachers might not. This might provide starting points for tailored teacher professionalization for different groups of teachers.
Collapse
Affiliation(s)
- Frances Wijnen
- Department of Teacher Development, ELAN, University of Twente, 7522 NB Enschede, The Netherlands
| | | | - Joke Voogt
- Faculty of Social and Behavioural Sciences, University of Amsterdam, 1012 WX Amsterdam, The Netherlands
| |
Collapse
|
15
|
Chu KK, Zhao Y, Jelly ET, Steelman ZA, Crose M, Cox B, Ofori-Marfoh Y, Moussa L, Cirri H, Watts A, Shaheen N, Wax A. Esophageal OCT Imaging Using a Paddle Probe Externally Attached to Endoscope. Dig Dis Sci 2022; 67:4805-12. [PMID: 35084606 DOI: 10.1007/s10620-021-07372-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/18/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Endoscopic surveillance of Barrett's esophagus (BE) by white light examination is insufficient to diagnose dysplastic change. In this work, we describe an optical imaging method to obtain high-resolution cross-sectional imaging using a paddle-shaped probe affixed to the endoscope tip. METHODS We integrated Optical Coherence Tomography (OCT), an optical imaging method that produces cross-sectional images, into a paddle probe attached to video endoscope. We acquired images of esophageal epithelium from patients undergoing routine upper GI endoscopy. Images were classified by a reviewer blinded to patient identity and condition, and these results were compared with clinical diagnosis. RESULTS We successfully captured epithelial OCT images from 30 patients and identified features consistent with both squamous epithelium and Barrett's esophagus. Our blinded image reviewer classified BE versus non-BE with 91.5% accuracy (65/71 image regions), including sensitivity of 84.6% for BE (11/13) and a specificity of 93.1% (54/58). However, in 16 patients, intubation of the probe into the esophagus could not be achieved. CONCLUSIONS A paddle probe is a feasible imaging format for acquiring cross-sectional OCT images from the esophagus and can provide a structural assessment of BE and non-BE tissue. Probe form factor is the current limiting obstacle, but could be addressed by further miniaturization.
Collapse
|
16
|
Co M, John Yuen TH, Cheung HH. Using clinical history taking chatbot mobile app for clinical bedside teachings - A prospective case control study. Heliyon 2022; 8:e09751. [PMID: 35770149 PMCID: PMC9234591 DOI: 10.1016/j.heliyon.2022.e09751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/12/2022] [Accepted: 06/15/2022] [Indexed: 10/28/2022] Open
Abstract
Introduction A novel chatbot mobile app for training of undergraduate medical students' clinical history taking skills was developed in 2021. Students were able to take clinical history from the virtual patient for bedside teaching. A case-control study was conducted to evaluate the effectiveness of learning with chatbot mobile app, versus conventional bedside teachings with real patients. Methods 132 final year medical students were randomized into two groups - Conventional bedside teaching with clinical history taken from a real patient, and Bedside teaching with clinical history taken from the Chatbot. Independent blinded assessment of students' history taking skills was conducted. Students' performance were assessed by standardized marking scheme. Results Median age was 23 years old (Range 21-30 years old). There were 62 female and 70 male students.64 students were randomized into conventional group while 68 students were randomized into the chatbot group. Baseline demographic data were comparable between the two groups.Blinded assessment of students' performance in clinical history taking were comparable between the conventional group and chatbot group (p > 0.05). Conclusion With the promising results we have demonstrated in this study, we believe training of history taking skills by chatbot will be a feasible alternative to conventional bedside teaching.
Collapse
Affiliation(s)
- Michael Co
- Centre for Education and Training, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | | | - Ho Hung Cheung
- Centre for Education and Training, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong
| |
Collapse
|
17
|
Sassani JC, Clark SG, McGough CE, Shepherd JP, Bonidie M. Sacrocolpopexy experience with a novel robotic surgical platform. Int Urogynecol J 2022; 33:3255-3260. [PMID: 35312804 DOI: 10.1007/s00192-022-05155-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/20/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to describe early experience performing sacrocolpopexy using a novel robotic surgical platform. METHODS This is a case series of all women who underwent robotic-assisted sacrocolpopexy using a new robotics platform (TransEnterix Senhance) between January 2019 and July 2021. All sacrocolpopexies were performed by a single Female Pelvic Medicine and Reconstructive surgeon at a large academic institution. Perioperative information including complications was abstracted from the medical record. Anatomical recurrence was defined as any anatomical point at or past the hymen (≥0). Data are descriptive, with Mann-Whitney U test used for comparison of operative time between the first and second half of the patients. RESULTS A total of 25 sacrocolpopexies were performed using the new robotics platform. Mean age was 62.3 years (±9.2) and mean BMI was 26.5 (±3.8). Ten (40.0%) patients had a prior hysterectomy. Most (n = 21, 84.0%) had stage III or IV prolapse preoperatively. Mean operative time was 210.2 min (±48.6) and median estimated blood loss was 35 ml (IQR 25-50). Mean operative time decreased between the first and second half of the patients (231.7 min vs 190.3 min, p = 0.047). There were no major intraoperative complications. Median follow-up time was 16 weeks (IQR 4-34) and there were no subjective recurrences or retreatments during this period. Two patients (8.0%) had anatomical recurrence without subjective bother. There were two postoperative readmissions (8.0%) within 30 days for small bowel obstruction, one treated surgically and the other with nonsurgical management. CONCLUSIONS Our case series demonstrates feasibility and successful early adoption of a new robotics platform for robotic sacrocolpopexy.
Collapse
Affiliation(s)
- Jessica C Sassani
- Division of Urogynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Stephanie Glass Clark
- Division of Urogynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Christine E McGough
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jonathan P Shepherd
- Department of Obstetrics & Gynecology, University of Connecticut Health Center, Farmington, CT, USA
| | - Michael Bonidie
- Division of Urogynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| |
Collapse
|
18
|
Gray M, Downer T, Hartz D, Andersen P, Hanson J, Gao Y. The impact of three-dimensional visualisation on midwifery student learning, compared with traditional education for teaching the third stage of labour: A pilot randomised controlled trial. Nurse Educ Today 2022; 108:105184. [PMID: 34717099 DOI: 10.1016/j.nedt.2021.105184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/07/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Complex physiological processes are often difficult for midwifery students to comprehend when using traditional teaching and learning approaches. Face to face instructional workshops using simulation have had some impact on improving understanding. However, in the 21st century new technologies offer the opportunity to provide alternative learning approaches. AIM To investigate the impact of using three-dimensional (3D) visualisation in midwifery education on student's experience of learning, and retention of knowledge at three points in time. DESIGN A pilot study involving a two-armed parallel Randomised Controlled Trial (RCT) comparing the retention of knowledge scores between the control and intervention groups. SETTING An Australian University in the Northern Territory. PARTICIPANTS The sample included second year Bachelor of Midwifery students (n = 38). All received traditional midwifery education before being randomly allocated to either the intervention (n = 20) or control (n = 18) group. METHODS A new immersive virtual environment was introduced to complement existing traditional midwifery education on the third stage of labour. This intervention was evaluated using a demographic survey and multiple-choice questionnaire to collect baseline information via Qualtrics. To measure change in knowledge and comprehension, participants completed the same multiple-choice knowledge questionnaire at three time points; pre, immediately post and at 1 month post intervention. In addition, the intervention group completed a 3D student satisfaction survey. RESULTS Baseline knowledge scores were similar between the groups. A statistically significant increase in knowledge score was evident immediately post intervention for the intervention group, however there was no significant difference in knowledge score at one month. CONCLUSIONS The results support the creation of further three-dimensional visualisation teaching resources for midwifery education. However, a larger randomised controlled study is needed to seek generalisation of these findings to confirm enhanced student learning and retention of knowledge post 3DMVR, beyond the immediate exposure time.
Collapse
Affiliation(s)
- Michelle Gray
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia; School of Nursing and Midwifery, Edith Cowan University, Western Australia, Australia.
| | - Terri Downer
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Queensland, Australia
| | - Donna Hartz
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Patrea Andersen
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Queensland, Australia; Centre for Health and Social Practice, Waikato Institute of Technology, Hamilton, New Zealand
| | - Julie Hanson
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Queensland, Australia
| | - Yu Gao
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| |
Collapse
|
19
|
Watsjold B, Ilgen J, Monteiro S, Sibbald M, Goldberger ZD, Thompson WR, Norman G. Do you hear what you see? Utilizing phonocardiography to enhance proficiency in cardiac auscultation. Perspect Med Educ 2021; 10:148-154. [PMID: 33438146 PMCID: PMC8187497 DOI: 10.1007/s40037-020-00646-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Cardiac auscultation skills have proven difficult to train and maintain. The authors investigated whether using phonocardiograms as visual adjuncts to audio cases improved first-year medical students' cardiac auscultation performance. METHODS The authors randomized 135 first-year medical students using an email referral link in 2018 and 2019 to train using audio-only cases (audio group) or audio with phonocardiogram tracings (combined group). Training included 7 cases with normal and abnormal auscultation findings. The assessment included feature identification and diagnostic accuracy using 14 audio-only cases, 7 presented during training, and 7 alternate versions of the same diagnoses. The assessment-administered immediately after training and repeated 7 days later-prompted participants to identify the key features and diagnoses for 14 audio-only cases. Key feature scores and diagnostic accuracy were compared between groups using repeated measures ANOVA. RESULTS Mean key feature scores were statistically significantly higher in the combined group (70%, 95% CI 67-75%) compared to the audio group (61%, 95% CI 56-66%) (F(1,116) = 6.144, p = 0.015, ds = 0.45). Similarly, mean diagnostic accuracy in the combined group (68%, 95% CI 62-73%) was significantly higher than the audio group, although with small effect size (59%, 95% CI 54-65%) (F(1,116) = 4.548, p = 0.035, ds = 0.40). Time on task for the assessment and prior auscultation experience did not significantly impact performance on either measure. DISCUSSION The addition of phonocardiograms to supplement cardiac auscultation training improves diagnostic accuracy and heart sound feature identification amongst novice students compared to training with audio alone.
Collapse
Affiliation(s)
- Bjorn Watsjold
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, WA, USA.
| | - Jonathan Ilgen
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Center for Leadership & Innovation in Medical Education, University of Washington School of Medicine, Seattle, WA, USA
| | - Sandra Monteiro
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Matthew Sibbald
- Division of Cardiology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Zachary D Goldberger
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - W Reid Thompson
- Division of Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Geoff Norman
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
20
|
van Gaalen AEJ, Brouwer J, Schönrock-Adema J, Bouwkamp-Timmer T, Jaarsma ADC, Georgiadis JR. Gamification of health professions education: a systematic review. Adv Health Sci Educ Theory Pract 2021; 26:683-711. [PMID: 33128662 PMCID: PMC8041684 DOI: 10.1007/s10459-020-10000-3] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/12/2020] [Indexed: 05/06/2023]
Abstract
Gamification refers to using game attributes in a non-gaming context. Health professions educators increasingly turn to gamification to optimize students' learning outcomes. However, little is known about the concept of gamification and its possible working mechanisms. This review focused on empirical evidence for the effectiveness of gamification approaches and theoretical rationales for applying the chosen game attributes. We systematically searched multiple databases, and included all empirical studies evaluating the use of game attributes in health professions education. Of 5044 articles initially identified, 44 met the inclusion criteria. Negative outcomes for using gamification were not reported. Almost all studies included assessment attributes (n = 40), mostly in combination with conflict/challenge attributes (n = 27). Eight studies revealed that this specific combination had increased the use of the learning material, sometimes leading to improved learning outcomes. A relatively small number of studies was performed to explain mechanisms underlying the use of game attributes (n = 7). Our findings suggest that it is possible to improve learning outcomes in health professions education by using gamification, especially when employing game attributes that improve learning behaviours and attitudes towards learning. However, most studies lacked well-defined control groups and did not apply and/or report theory to understand underlying processes. Future research should clarify mechanisms underlying gamified educational interventions and explore theories that could explain the effects of these interventions on learning outcomes, using well-defined control groups, in a longitudinal way. In doing so, we can build on existing theories and gain a practical and comprehensive understanding of how to select the right game elements for the right educational context and the right type of student.
Collapse
Affiliation(s)
- A E J van Gaalen
- Department of Biomedical Sciences of Cells and Systems, Section Anatomy & Medical Physiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - J Brouwer
- Faculty Behavioural and Social Sciences, Department of Educational Sciences, University of Groningen, Groningen, The Netherlands
| | - J Schönrock-Adema
- Center for Education Development and Research in Health Professions (CEDAR), LEARN, University Medical Center Groningen, University of Groningen, 713AV, Groningen, The Netherlands
| | - T Bouwkamp-Timmer
- Center for Education Development and Research in Health Professions (CEDAR), LEARN, University Medical Center Groningen, University of Groningen, 713AV, Groningen, The Netherlands
| | - A D C Jaarsma
- Center for Education Development and Research in Health Professions (CEDAR), LEARN, University Medical Center Groningen, University of Groningen, 713AV, Groningen, The Netherlands
| | - J R Georgiadis
- Department of Biomedical Sciences of Cells and Systems, Section Anatomy & Medical Physiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
21
|
Hong J, Kang H, An J, Choi J, Hong T, Park HS, Lee DE. Towards environmental sustainability in the local community: Future insights for managing the hazardous pollutants at construction sites. J Hazard Mater 2021; 403:123804. [PMID: 33264906 DOI: 10.1016/j.jhazmat.2020.123804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/06/2020] [Accepted: 08/24/2020] [Indexed: 06/12/2023]
Abstract
Although various technologies are being developed in the construction industry, management technologies for achieving environmental sustainability in the local community are still lacking. As such, this study suggests future insights for the development of an automated intelligent environment management system for the promotion of environmental sustainability in the local community, through a systematic review of 1,707 relevant literature. The systematic review was conducted in two steps: (i) quantitative review: keyword co-occurrence and trend analysis; and (ii) qualitative review: a review on monitoring, evaluation, and improvement technologies. As a result, the research level related to the local-level pollutants (noise, vibration, and dust) was found to be quantitatively insufficient, and the limitations of the existing technologies for these pollutants were presented. Eventually, to overcome these limitations, new technologies and application strategies that can be applied to construction sites as future research roadmap to effectively manage the hazardous pollutants were proposed. Furthermore, an intelligent management system should be developed, and the management of environmental complaints is also necessary for environmental sustainability at the local level in the construction industry. As a fundamental study, this study could become a benchmark for future researches dealing with environmental sustainability and hazardous pollutants in the construction industry.
Collapse
Affiliation(s)
- Juwon Hong
- Department of Architecture and Architectural Engineering, Yonsei University, Seoul, Republic of Korea.
| | - Hyuna Kang
- Department of Architecture and Architectural Engineering, Yonsei University, Seoul, Republic of Korea.
| | - Jongbaek An
- Department of Architecture and Architectural Engineering, Yonsei University, Seoul, Republic of Korea.
| | - Jinwoo Choi
- Department of Architecture and Architectural Engineering, Yonsei University, Seoul, Republic of Korea.
| | - Taehoon Hong
- Department of Architecture and Architectural Engineering, Yonsei University, Seoul, Republic of Korea.
| | - Hyo Seon Park
- Department of Architecture and Architectural Engineering, Yonsei University, Seoul, Republic of Korea.
| | - Dong-Eun Lee
- School of Arch, Civil, Environment, and Energy, Kyungpook National University, Daegu, Republic of Korea.
| |
Collapse
|
22
|
Nikshad A, Aghlmandi A, Safaralizadeh R, Aghebati-Maleki L, Warkiani ME, Khiavi FM, Yousefi M. Advances of microfluidic technology in reproductive biology. Life Sci 2020; 265:118767. [PMID: 33212151 DOI: 10.1016/j.lfs.2020.118767] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 12/22/2022]
Abstract
According to World Health Organization (WHO) reports about 70 million couples suffer from infertility all over the world. A lot of research groups are working on this issue and have made therapeutic approaches by integrating biology, medicine, genetics, chemistry, psychology, mechanic, and many other branches of science. However, these methods have their own pros and cons. Assisted Reproductive Technologies (ART) has appeared to solve infertility problems. In Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), Intrauterine Insemination (IUI) are the most common and conventional technologies in this regard. There are at least two characteristics of microfluidics, mechanical and biochemical, which can be influential in the field of mammalian gamete and preimplantation embryo biology. These microfluidic characteristics can assist in basic biological studies on sperm, oocyte and preimplantation embryo structure, function and environment. Using microfluidics in sorting sperm, conducting different steps of oocyte selection and preparation, and transferring embryo by passing sub-microliter fluid through microchannels results in low cost and short time. The size and shape of microchannels and the volume of used fluid differs from non-human cells to human cells. The most progressions have been seen in animal models. Results suggest that microfluidic systems will lead to improved efficiencies in assisted reproduction.
Collapse
Affiliation(s)
- Aylin Nikshad
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| | - Afsoon Aghlmandi
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| | - Reza Safaralizadeh
- Department of Animal Biology, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| | | | - Majid Ebrahimi Warkiani
- The School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Mehdi Yousefi
- Stem Cell Research Center, Tabriz University of Medical Science, Tabriz, Iran.
| |
Collapse
|
23
|
Shoji M, Inaba K, Itami J, Hamada M, Okamoto H, Iwasa T, Ushigusa T, Yoshida M, Matsuyama TA, Otsuka T, Kumagai K, Hirao K, Maguire P, Qian P, Gardner E, Zei PC. Advantages and challenges for noninvasive atrial fibrillation ablation. J Interv Card Electrophysiol 2020; 62:319-327. [PMID: 33106957 DOI: 10.1007/s10840-020-00904-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Although catheter ablation is an effective therapy for atrial fibrillation (AF), risks remain and improved efficacy is desired. Stereotactic radiotherapy is a well-established therapy used to noninvasively treat malignancies with precision. We sought to evaluate stereotactic arrhythmia radioablation (STAR) as a therapeutic option for treating AF. METHODS AND RESULTS Three cancer patients with drug refractory AF were enrolled. Planning software using 3-D CT of the left atrium was used to design a desired ablation volume encompassing antral circumferential pulmonary vein isolation, roof and floor lines to create a "box" lesion set. After planning, patients were treated in the radioablation suite. STAR was able to deliver the intended radiation dose to the target in all 3 patients. No complications were observed over a follow-up period of 24 months. One patient with paroxysmal AF died from deterioration of cancer. The autopsy revealed evidence of fibroblasts and fibrogenesis in the region of atrial tissues targeted with radioablation. In one of these patients, left atrial posterior wall electrograms recorded from the esophagus before and 3 months after STAR indicated successful electrical isolation. CONCLUSIONS This is the first report of non-invasive radioablation of the left atrium with demonstration of successful electrical isolation. Although STAR may be safe and effective in delivering ablative energy to the left atrium, further evaluation is warranted regarding effectiveness.
Collapse
Affiliation(s)
- Masaaki Shoji
- Department of Cardiovascular Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan.
| | - Koji Inaba
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Jun Itami
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Minoru Hamada
- Department of Radiological Technology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Okamoto
- Department of Medical Physics, National Cancer Center Hospital, Tokyo, Japan
| | - Takeshi Iwasa
- Department of Cardiovascular Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan
| | - Takeshi Ushigusa
- Department of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Masayuki Yoshida
- Department of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Taka-Aki Matsuyama
- Department of Legal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takayuki Otsuka
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | | | - Kenzo Hirao
- Division of Cardiovascular Medicine, AOI Universal Hospital, Kanagawa, Japan
| | | | - Pierre Qian
- Cardiac Arrhythmia Service, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Paul C Zei
- Cardiac Arrhythmia Service, Brigham and Women's Hospital, Boston, MA, USA
| |
Collapse
|
24
|
Perrone E, Rossitto C, Fanfani F, Cianci S, Fagotti A, Uccella S, Vizzielli G, Vascone C, Restaino S, Fedele C, Saleh FL, Scambia G, Gueli Alletti S. Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison. Gynecol Obstet Invest 2020; 85:318-326. [PMID: 32920558 DOI: 10.1159/000509877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/22/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the feasibility of percutaneous approach, we prospectively compared our experience in percutaneous-assisted hysterectomy (PSS-H) with that in a series of laparoscopic hysterectomies (LPS-Hs). METHODS In this multicentric cohort study, from May 2015 to October 2017, 160 patients affected by benign and malignant gynecological conditions were considered eligible for minimally invasive surgery (MIS): 80 patients received PSS-H and 80 LPS-H. In each group, 30 cases of low-/intermediate-risk endometrial cancer were enrolled. For both groups, we documented preoperative outcomes, postoperative pain, and cosmetic outcomes. RESULTS No statistically significant differences were noted in baseline characteristics or operative time. We observed significant differences in estimated blood loss: median of 50 cc (PSS-H) and 100 cc (LPS-H) (p = 0.0001). In LPS-H, we reported 4 (5.0%) intraoperative complications and 1 (1.3%) in PSS-H. Thirty-day complications were 4 (5%) in PSS-H and 11 (13.8%) in LPS-H (p = 0.058). No significative differences were found in visual analog scale score, despite a relevant disparity in cosmetic outcome (p = 0.0001). For oncological cases, the 2 techniques had comparable intra- and postoperative outcomes and oncological accuracy. CONCLUSIONS In this study, we reported that PSS-H is comparable to LPS-H for intra- and perioperative outcomes and postoperative pain, while PSS-H seems to be superior in cosmetic outcomes and patient satisfaction. PSS-H may represent a valid alternative in ultra-MIS for benign gynecological conditions and low-/intermediate-risk endometrial cancer.
Collapse
Affiliation(s)
- Emanuele Perrone
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy,
| | - Cristiano Rossitto
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Fanfani
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Cianci
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Anna Fagotti
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Uccella
- Division of Obstetrics and Gynecology, Ospedale degli Infermi, Biella, Italy
| | - Giuseppe Vizzielli
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carmine Vascone
- Department of Obstetrics and Gynecology, Pineta Grande Hospital, Castel Volturno, Italy
| | - Stefano Restaino
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Camilla Fedele
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Farrah Layla Saleh
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Giovanni Scambia
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Salvatore Gueli Alletti
- Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
25
|
Ralston A, Graham P, Poder J, Yuen J. The RABBIT risk-based approach to clinical implementation of new technology: SRS as a case study. Tech Innov Patient Support Radiat Oncol 2020; 14:51-60. [PMID: 32566770 PMCID: PMC7296429 DOI: 10.1016/j.tipsro.2020.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 04/03/2020] [Accepted: 04/28/2020] [Indexed: 12/03/2022] Open
Abstract
Radiation oncology technology continues to evolve rapidly, resulting in advanced versions frequently being brought to market. Before a new product is used standard tests are carried out to reduce the risks associated with failure of the equipment to comply with well-established technical specifications. It is much harder to identify and reduce the risks associated with how the new technology is used clinically, such as those related to poor communication and high workload. To ensure that new technology and techniques are used safely and appropriately the implementation project should be managed by a multidisciplinary team (MDT) made up of representatives from all the relevant professions. The MDT’s role is to agree on the project scope, identify and rank all risks and benefits, and direct resources towards mitigating the highest risks. Before clinical release there should be consensus from the MDT that the benefits of the new technology outweigh the residual risks. The introduction of initiatives to optimise current practice may involve major changes which can be met with barriers such as limited support from management, insufficient time for MDT meetings, and staff fearful of being shown to have poor practices. To help overcome these challenges our team at St George Hospital Cancer Care Centre has developed a Risk and Benefit Balance Impact Template (RABBIT), which guides an MDT through the rapid implementation and safe use of new technology and techniques with an easy to follow Microsoft Word document. The implementation of stereotactic radiosurgery is used as a case study to illustrate the RABBIT methodology. The RABBIT is a user-friendly method for a busy radiotherapy clinic to transition to a risk-based MDT approach for the implementation of new technologies and techniques. When staff from all disciplines feel empowered to raise concerns about risks the workplace become inherently safer for patients and staff alike.
Collapse
Affiliation(s)
- Anna Ralston
- Cancer Care Centre, St George Hospital, Kogarah, NSW, Australia.,Centre for Medical Radiation Physics, University of Wollongong, Australia
| | - Peter Graham
- Cancer Care Centre, St George Hospital, Kogarah, NSW, Australia.,St George and Sutherland Clinical School, Faculty of Medicine, University of New South Wales, Australia
| | - Joel Poder
- Cancer Care Centre, St George Hospital, Kogarah, NSW, Australia.,Centre for Medical Radiation Physics, University of Wollongong, Australia
| | - Johnson Yuen
- Cancer Care Centre, St George Hospital, Kogarah, NSW, Australia.,South Western Clinical School, University of New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, Australia
| |
Collapse
|
26
|
Caycedo-Marulanda A, Patel S, Merchant S, Brown C. Introduction of new techniques and technologies in surgery: Where is transanal total mesorectal excision today? World J Gastrointest Surg 2020; 12:203-207. [PMID: 32551026 PMCID: PMC7289648 DOI: 10.4240/wjgs.v12.i5.203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/14/2020] [Accepted: 05/13/2020] [Indexed: 02/06/2023] Open
Abstract
The introduction of new surgical techniques and technologies has traditionally been unregulated. In many settings surgeons frequently adopt novel procedures without following a structured program of implementation or supervision. The appearance of innovative technology played a pivotal role in the advancement of new surgical techniques during the industrial revolution. Innovation has been an essential component of surgical development, which led to contemporary surgical techniques such as minimally invasive surgery. Different initiatives have been developed to guide the safe introduction of new surgical techniques and other procedures. Those include comprehensive concepts such as the Idea, Development, Exploration, Assessment, Long-term study framework, which could be particularly relevant when reflecting on the novel transanal total mesorectal excision (taTME), introduced a decade ago. This relatively novel and complex procedure promised to overcome some of the major limitations of traditional surgical approaches for rectal cancer. According to the Idea, Development, Exploration, Assessment, Long-term study framework, taTME is in the phase of exploration, where there is an existing and increasing number of reports being published as the experience grows. The current management of rectal cancer is in a state of radical evolution, with multiple options that were not previously available. TaTME is only one technique amongst many which could be part of a rectal cancer surgeon’s armamentarium; however, it requires further rigorous study and evaluation.
Collapse
Affiliation(s)
- Antonio Caycedo-Marulanda
- Department of surgery, Queen’s University and Kingston General Hospital, Kingston K7L 2V7, Ontario, Canada
| | - Sunil Patel
- Department of surgery, Queen’s University and Kingston General Hospital, Kingston K7L 2V7, Ontario, Canada
| | - Shaila Merchant
- Department of surgery, Queen’s University and Kingston General Hospital, Kingston K7L 2V7, Ontario, Canada
| | - Carl Brown
- Department of Surgery, University of British Columbia and St. Paul Hospital, Vancouver V6Z 1Y6, British Columbia, Canada
| |
Collapse
|
27
|
Ahmadi M, Chen Z. Challenges and future of chemical assisted heavy oil recovery processes. Adv Colloid Interface Sci 2020; 275:102081. [PMID: 31830684 DOI: 10.1016/j.cis.2019.102081] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/20/2019] [Accepted: 11/20/2019] [Indexed: 11/17/2022]
Abstract
The primary method for heavy oil and bitumen production across the world is still in-situ steam-based technology. There are some drawbacks associated with steam-driven heavy oil recovery methods such as cyclic steam stimulation (CSS), steam flooding, and steam-assisted gravity drainage (SAGD). These cons include the high greenhouse gas footprint, low heavy oil/bitumen recovery, and difficulty in stop operation in emergency conditions. There exists a need for an improved method for recovering residual oils after applying steam injection. One of the potential technologies for doing this is chemical assisted heavy oil recovery, especially alkaline and surfactant additives. But the challenging question is how to develop a chemical-based oil recovery method considering long-term steam-rock interactions. Several associated issues of chemical additives, including adsorption behavior of surfactant at reservoir conditions and thermal stability of surfactant at steam chamber temperature, make this question more complex. This paper addresses all these concerns and provides solid knowledge regarding this technology. We delve into newly formulated chemicals for coupling with thermal oil recovery techniques that are still limited to lab-scale research, with the need for further studies. This critical review also provides the opportunities and challenges associated with chemical assisted heavy oil/bitumen production in a post-steam injection scenario. Finally, different aspects of such a method are covered in this review, along with practical information on field trials and best practices across the world.
Collapse
Affiliation(s)
- Mohammadali Ahmadi
- Department of Chemical and Petroleum Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N1T4, Canada.
| | - Zhangxin Chen
- Department of Chemical and Petroleum Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N1T4, Canada
| |
Collapse
|
28
|
Abstract
BACKGROUND Laparoscopic staplers are integral to bariatric surgery. Their pricing significantly impacts the overall cost of procedures. An independent device company has designed a stapler handle and single-use reloads for cross-compatibility and equivalency with existing manufacturers, at a lower cost. OBJECTIVES We aim to demonstrate non-inferior function and cross-compatibility of a newly introduced stapler handle and reloads compared to our institution's current stapling system in a large animal survival study. SETTING University-affiliated animal research facility, USA. METHODS Matched small bowel anastomoses were created in four pigs, one with each stapler (a total of two per animal). After 14 days, investigators blinded to stapler type evaluated the anastomoses grossly and microscopically. Each anastomosis was scored on multiple measures of healing. Individual parameters were added for a global "healing score." RESULTS Clinical stapler function and gross quality of anastomoses were similar between stapler groups. Individual scores for anastomotic ulceration, reepithelialization, granulation tissue, mural healing, eosinophilic infiltration, serosal inflammation, and microscopic adherences were also statistically similar. The mean "healing scores" were equal. While this study was underpowered for subtle differences, safe and reliable performance in large animals still supports the feasibility of introducing new devices into human use. CONCLUSIONS The new stapler system delivers a similar technical performance and is cross-compatible with currently marketed stapling devices. An equivalent quality device at a lower price point should enable case cost reduction, helping to maintain hospital case margin and procedure value in the face of potentially declining reimbursement. This device may provide a safe and functional alternative to currently used laparoscopic surgical staplers.
Collapse
Affiliation(s)
- Kurt E Roberts
- Department of Surgery, Gastrointestinal Section, Yale University, 40 Temple Street, Suite 7B, New Haven, CT, 06510, USA
| | - L Renee Hilton
- Department of Surgery, Gastrointestinal Section, Yale University, 40 Temple Street, Suite 7B, New Haven, CT, 06510, USA.,Department of Surgery, Minimally Invasive and Digestive Diseases, Augusta University, Augusta, GA, USA
| | - Danielle T Friedman
- Department of Surgery, Gastrointestinal Section, Yale University, 40 Temple Street, Suite 7B, New Haven, CT, 06510, USA.
| | | | - Xuchen Zhang
- Department of Surgical Pathology, Yale University, New Haven, CT, 06520, USA
| | - Andrew J Duffy
- Department of Surgery, Gastrointestinal Section, Yale University, 40 Temple Street, Suite 7B, New Haven, CT, 06510, USA
| |
Collapse
|
29
|
Ward A, Bethea J, Hsu R. Exploring life with a long-term condition using asynchronous online communication. Patient Educ Couns 2019; 102:2325-2329. [PMID: 31447196 DOI: 10.1016/j.pec.2019.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/11/2019] [Accepted: 08/16/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE We describe the development and evaluation of a novel programme that uses an online patient portal system to provide medical students with early and authentic experience of patient interaction. METHODS Focus group discussions were held with students, tutors and patients who had taken part in the first year of the programme. RESULTS The programme provided an opportunity for early patient interaction in a safe environment. Students were able to practice communication skills learnt elsewhere in the course as well as identifying some of the different skills required for asynchronous online interactions. The approach gave opportunities to develop understanding of aspects of life with a long-term condition. CONCLUSION Using an online patient portal system to interact with a patient enabled students to develop and apply their communication skills in a safe environment and gain a holistic view of a patient's experience. PRACTICE IMPLICATIONS Medical students need to be equipped with the skills needed to communicate electronically with patients. Current medical curricula currently focus on more traditional models of the consultation. Further research is needed to establish best practice in this rapidly growing area.
Collapse
Affiliation(s)
- Andy Ward
- Leicester Medical School, University of Leicester, Leicester, UK.
| | - Jane Bethea
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Ron Hsu
- Leicester Medical School, University of Leicester, Leicester, UK
| |
Collapse
|
30
|
Liao F, Murphy D. Evaluation of therapeutic relationship skills training for mental health professionals: the Therapeutic Relationship Enabling Programme (TREP). MedEdPublish (2016) 2019; 8:112. [PMID: 38089364 PMCID: PMC10712454 DOI: 10.15694/mep.2019.000112.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: A 3-day workshop in Taiwan, developed in accordance with Carl Rogers' person-centred theory, used an experiential-learning pedagogy and a helping learning technology mPath. This study aimed to evaluate the effectiveness of a short-term course for mental health professional students assessing to the acquisition of therapeutic relationship competencies. Objective:To evaluate the training effects and investigate any changes in the level of therapeutic relationship competence of the participants before, at the end and two weeks after the intervention. Methods:A sample of 59 mental health professional students from 7 medical schools studying in nursing, occupational therapy, medicine, clinical psychology and other specialities with the completion of psychiatry-relevant courses. 26 of 59 mental health professional students volunteered to form the experimental group, and the controls were recruited using the snowball sampling technique. All of them completed the Barrett-Lennard Relationship Inventory OS-40 three times. Mean values and statistical significance tests were computed to compare the results. Results:Within 3 days, the mental health professional students in the experimental group (N=26) completed the Therapeutic Relationship Enabling Programme (TREP) and showed a statistically significant level of change (Mean Difference= +9.5, p= 0.002), which was in contrast to the outcome of the control group (N=33, Mean Difference= +0.18, p= 0.683), in the therapeutic relationship competences. The effecting growth curve of therapeutic relationship competence in the experimental group continually inclined two weeks after the intervention (Mean Difference= +19.423, p= 0.000) while the control group reflected a decline in therapeutic relationship competence (Mean Difference= -0.515, p= 0.812). Conclusions: A person-centred-theory-based training workshop with the use of a specially designed technology enhanced Taiwanese mental health professional students' learning on therapeutic relationship competences. A further investigation into learning person-centred therapeutic relationship qualities in the workshop as an innovative pedagogy and learning approach for medical education would be recommended.
Collapse
|
31
|
Angelico R, Lisignoli V, Monti L, Pariante R, Grimaldi C, Saffioti MC, Gagliardi MG, Spada M. Laparoscopic liver resection for hepatocellular carcinoma in Fontan-associated chronic liver disease. The first case report. Int J Surg Case Rep 2019; 59:144-147. [PMID: 31146196 PMCID: PMC6541760 DOI: 10.1016/j.ijscr.2019.05.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 01/22/2023] Open
Abstract
Hepatocellular carcinoma after Fontan procedure is associated with high mortality. Liver resection after Fontan procedure has high-risk liver/cardiac decompensation. Laparoscopic liver resection is feasible with low intra-abdominal pressures. Adequate anaesthetic management is essential in Fontan procedure patients. Laparoscopic liver resection is a new therapeutic option after Fontan procedure.
Introduction A well-recognized long-term complication after Fontan procedure (FP), a complex cardiac surgery performed in patients with univentricular hearts, is the development of chronic liver disease and hepatocellular carcinoma (HCC). Due to the risk of cardiac and liver decompensation, liver resection of HCC is challenging and the laparoscopic approach has never been reported. Presentation of the case We present the first case of laparoscopic liver resection (LLR) of HCC in a 33-years-old girl with cardiac-related cirrhosis after FP. Intraoperatively, the pneumoperitoneum was established at 8–10 mmHg and adequate fluid infusion was given to maintain the cardiac preload. After an ultrasound-guided thermoablation along the free-tumor margin of the hepatic lesion, a full laparoscopic non-anatomical resection of the tumor in segment V was performed, without Pringle manouver and blood transfusion requirement. The cardiac function remained stable during the surgery and thereafter, and the post-operative course was uneventful. Discussion HCC in chronic liver disease after FP is associated with high-risk mortality. Due to the complex hemodynamic changes after FP, open surgical resections often aren’t feasible and loco-regional percutaneous treatment or combined liver-heart transplantation are the only therapeutic options. This case suggests that LLR in FP patients has low-risk of liver and cardiac decompensation, minimizing the pneumoperitoneum insufflation to ensure low intra-abdominal/intra-thoracic pressures and providing accurate anaesthetic management to maintain proper cardiac preload and output. Conclusion LLR for HCC after FP is safe and feasible, and might be considered an alternative treatment of HCC for which the best treatment has not been defined yet.
Collapse
Affiliation(s)
- Roberta Angelico
- Division of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Veronica Lisignoli
- Department of Cardiology, Division of Grow Up Congenital Heart, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Lidia Monti
- Department of Radiology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Rosanna Pariante
- Department of Anesthesiology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Chiara Grimaldi
- Division of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Maria Cristina Saffioti
- Division of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Maria Giulia Gagliardi
- Department of Cardiology, Division of Grow Up Congenital Heart, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Marco Spada
- Division of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
| |
Collapse
|
32
|
Abstract
The development of medicine technology is supported by the progress of materials, electronics, machinery, physics and other related fields.The article mainly reviews the research achievements of traumatic orthopedics from four aspects: big data, new theory, new technology and new implants. The prospects of intelligent minimally invasive, new materials, three-dimensional printing technology, surgical assistant robot of fracture reduction, digital orthopedics and other aspects are presented.Aiming at improving the treatments of traumatic orthopedics in China, this paper tracks the frontier of the orthopedics and absorbed advanced concepts and technologies of treatments on traumatic orthopedics in the world.
Collapse
Affiliation(s)
- Y Z Zhang
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Key Laboratory of Orthopaedic Biomechanics of Hebei Province, Shijiazhuang 050051, China
| |
Collapse
|
33
|
Lindberg K, Mørk BE, Walter L. Emergent coordination and situated learning in a Hybrid OR: The mixed blessing of using radiation. Soc Sci Med 2019; 228:232-239. [PMID: 30928881 DOI: 10.1016/j.socscimed.2019.03.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 02/23/2019] [Accepted: 03/21/2019] [Indexed: 11/17/2022]
Abstract
Mobilising knowledge and coordinating actions in order to make use of new innovations and technologies is a major challenge in the health care sector. Drawing upon a longitudinal, qualitative study of a Hybrid Operating Room in Sweden, we illustrate how the staff from a variety of medical specialties need to coordinate their tasks and competencies, and learn how to use the technology in a safe way. This study shows that learning across highly-professionalized communities is a recursive process of emergent coordination and situated learning, which includes the acknowledgement of others' expertise, task interdependence, and the pragmatic accommodation of latitude and control. Moreover, there was continuous negotiations between the different communities about what should constitute approved practice based on the task being performed. This obstructed the development of a dominant community with the authority to independently exclude other communities. We thus conclude that emergent coordination of tasks and expertise is an important aspect of learning how to use technologies that break with conventions of established and previously separated practices.
Collapse
Affiliation(s)
- Kajsa Lindberg
- Department of Business Administration, School of Business, Economics and Law, University of Gothenburg, P.O. Box 610, SE-405 30, Gothenburg, Sweden.
| | - Bjørn Erik Mørk
- Department of Strategy and Entrepreneurship, BI Norwegian Business School, Norway; IKON, Warwick Business School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Lars Walter
- Department of Business Administration, School of Business, Economics and Law, University of Gothenburg, P.O. Box 610, SE-405 30, Gothenburg, Sweden
| |
Collapse
|
34
|
Dammerer D, Putzer D, Wurm A, Liebensteiner M, Nogler M, Krismer M. Progress in Knee Arthroscopy Skills of Residents and Medical Students: A Prospective Assessment of Simulator Exercises and Analysis of Learning Curves. J Surg Educ 2018; 75:1643-1649. [PMID: 29929818 DOI: 10.1016/j.jsurg.2018.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/26/2018] [Accepted: 05/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Knee arthroscopies are very common orthopedic procedures. For a number of reasons, including increased public awareness for medical errors, patient safety, strict regulations governing duty-hours for residents, surgeons' liability, and an increasing emphasis on the efficient use of operating room time, interest in simulator training is on the rise. It was the purpose of this study to analyze learning curves of medical students and orthopedic resident surgeons using a virtual knee arthroscopy simulator. DESIGN Learning curves of medical students and orthopedic residents were measured perspective using an arthroscopic training simulator for 2 different exercises. Time, camera and probe movement as well as camera and probe roughness were the parameters to be compared. Mean and standard deviation of the initial and the final score for the consecutively performed exercises as well as their slope were reported. SETTING The study was performed at the Medical University of Innsbruck, Department of Orthopaedic Surgery. Level of clinical care: institutional. PARTICIPANTS A Students Group (n = 10) consisting of medical students at the Medical University of Innsbruck with no prior knowledge of arthroscopy but interest in orthopedic surgery was selected. The group was compared to a Residents Group (n = 9) which was comprised of orthopedic resident surgeons who had learned arthroscopy in operation courses. All participants involved in the study did several repetitions of the described exercises. RESULTS Both groups improved their skills after several repetitions. Residents were on average faster, moved the camera less, and touched the cortical tissue less than the students. For certain parameters students showed a steeper improvement curve than did residents, because the students started from a different experience level. CONCLUSIONS In conclusion, our results demonstrate the usefulness of virtual knee arthroscopy simulators as an important tool for improving surgical and arthroscopic skills in orthopedic resident surgeons, and medical students.
Collapse
Affiliation(s)
- Dietmar Dammerer
- Medical University of Innsbruck, Department of Orthopaedics, Innsbruck, Austria
| | - David Putzer
- Medical University of Innsbruck, Department of Orthopaedics - Experimental Orthopaedics, Innsbruck, Austria.
| | - Alexander Wurm
- Medical University of Innsbruck, Department of Orthopaedics, Innsbruck, Austria
| | | | - Michael Nogler
- Medical University of Innsbruck, Department of Orthopaedics - Experimental Orthopaedics, Innsbruck, Austria
| | - Martin Krismer
- Medical University of Innsbruck, Department of Orthopaedics, Innsbruck, Austria
| |
Collapse
|
35
|
Abstract
Adoption of new practices is challenging to the surgeon innovator given lack of standardized processes for implementation. Credentialed surgeons who want to apply new practices need to ensure adequate training depending on the procedure and underlying skills. A competent and motivated team needs to be identified and appropriate privileging sought for the procedure from the local institution. Planning for meticulous monitoring of outcomes ensures continuous safety and quality surveillance. Patients need complete transparency when being informed about a novel practice with information on comparison to standard of care treatments.
Collapse
Affiliation(s)
- Monisha Sudarshan
- Division of Thoracic Surgery, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55902, USA
| | - Shanda H Blackmon
- Division of Thoracic Surgery, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55902, USA.
| |
Collapse
|
36
|
Ahmed K, Ozturk I. What new technology means for the energy demand in China? A sustainable development perspective. Environ Sci Pollut Res Int 2018; 25:29766-29771. [PMID: 30141168 DOI: 10.1007/s11356-018-2957-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/14/2018] [Indexed: 05/06/2023]
Abstract
This paper explores the direct impact of new technology on the energy intensity in China. The autoregressive distributed lag (ARDL) bounds test approach to cointegration is utilised over the extended period of 1985-2013. The variables found cointegrated and confirm the long-run association among all the underlying vectors. Furthermore, the results of long- and short-run analysis reveal that new technology spurs energy intensity in China. A 1% increase in technological innovation boosts energy intensity by 0.4% and 0.03% in the long and short run, respectively. The findings suggest that the establishment of smart grids and solar energy parks followed by the reforms in energy sector is yet to achieve plausible efficiency in China. The existing investment and innovation policy reforms are insufficient to assist the energy sector to cope up with the country's exceptional economic growth trend. Unlike other studies, this paper accommodates structural break in the series. During sensitivity analysis, the model is found stable. Hence, the findings possess important policy implications for China and open up new discussion in the field.
Collapse
Affiliation(s)
- Khalid Ahmed
- Sukkur IBA University, Airport Road, Sukkur, 65200, Pakistan
- University of Göttingen, Wilhelmsplatz 1, 37073, Göttingen, Germany
| | - Ilhan Ozturk
- Cag University, Adana - Mersin Otoyolu, 33800, Mersin, Turkey.
| |
Collapse
|
37
|
Cianci S, Abatini C, Fagotti A, Chiofalo B, Tropea A, Biondi A, Scambia G, Pacelli F. Hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies using new hybrid CO 2 system: preliminary experience in referral center. Updates Surg 2018; 71:555-560. [PMID: 30094567 DOI: 10.1007/s13304-018-0578-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/03/2018] [Indexed: 12/13/2022]
Abstract
The most frequent peritoneal surface malignancies originate principally by gastric cancer, colorectal cancer and ovarian cancer. Apart from the origin, peritoneal carcinosis (PC) is considered a negative prognostic factor. The hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal malignancies is considered an attractive method to deliver chemotherapy with enhanced effect directly at the tumor site. The use of such loco-regional approach has proved to improve prognosis of peritoneal carcinomatosis from different origins. Recently, new devices are suitable for loco-regional intraperitoneal chemotherapy as Peritoneal Recirculation System (PRS-1.0 Combat) with CO2 technology. This is a retrospective study with the aim to assess the perioperative outcomes using PRS. Seventeen patients were enrolled affected by colorectal or ovarian cancer. Complete cytoreduction (RT = 0) was achieved for all cases. Median operative time was 420 min (range: 335-665) and median drugs dose used for HIPEC was 137 mg/m2 (115-756). Median EBL was 200 ml (range 50-1000). Median post-operative hospital stay was 9 days (range: 4-24). Treatment-related early complications were recorded in 8 (47.0%) cases and were G1-G2 Major complications occurred in two (11.7%) cases. Considering our aim to test the PRS in different cases and in different pathologies, the results confirmed that the technique is feasible with good perioperative outcomes.
Collapse
Affiliation(s)
- Stefano Cianci
- Unità Operativa Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - Carlo Abatini
- Dipartimento di Chirurgia Generale, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Anna Fagotti
- Unità Operativa Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Benito Chiofalo
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - Alessandro Tropea
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Giovanni Scambia
- Unità Operativa Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabio Pacelli
- Dipartimento di Chirurgia Generale, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
38
|
Abstract
There are multiple complex issues to consider when evaluating any new technology. First evaluate the efficacy of the device. Then considering your patient population decide whether this technology brings an added benefit to your patients. If it meets these 2 criteria, then proceed to the financial analysis of acquiring this technology. The complete financial analysis has several important components that include but are not limited to cost, value, alternatives, return on investment, and associated marketing expense.
Collapse
|
39
|
Schroeck FR, Jacobs BL, Bhayani SB, Nguyen PL, Penson D, Hu J. Cost of New Technologies in Prostate Cancer Treatment: Systematic Review of Costs and Cost Effectiveness of Robotic-assisted Laparoscopic Prostatectomy, Intensity-modulated Radiotherapy, and Proton Beam Therapy. Eur Urol 2017; 72:712-735. [PMID: 28366513 PMCID: PMC5623181 DOI: 10.1016/j.eururo.2017.03.028] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/17/2017] [Indexed: 02/02/2023]
Abstract
CONTEXT Some of the high costs of robot-assisted radical prostatectomy (RARP), intensity-modulated radiotherapy (IMRT), and proton beam therapy may be offset by better outcomes or less resource use during the treatment episode. OBJECTIVE To systematically review the literature to identify the key economic trade-offs implicit in a particular treatment choice for prostate cancer. EVIDENCE ACQUISITION We systematically reviewed the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and protocol. We searched Medline, Embase, and Web of Science for articles published between January 2001 and July 2016, which compared the treatment costs of RARP, IMRT, or proton beam therapy to the standard treatment. We identified 37, nine, and three studies, respectively. EVIDENCE SYNTHESIS RARP is costlier than radical retropubic prostatectomy for hospitals and payers. However, RARP has the potential for a moderate cost advantage for payers and society over a longer time horizon when optimal cancer and quality-of-life outcomes are achieved. IMRT is more expensive from a payer's perspective compared with three-dimensional conformal radiotherapy, but also more cost effective when defined by an incremental cost effectiveness ratio <$50 000 per quality-adjusted life year. Proton beam therapy is costlier than IMRT and its cost effectiveness remains unclear given the limited comparative data on outcomes. Using the Grades of Recommendation, Assessment, Development and Evaluation approach, the quality of evidence was low for RARP and IMRT, and very low for proton beam therapy. CONCLUSIONS Treatment with new versus traditional technologies is costlier. However, given the low quality of evidence and the inconsistencies across studies, the precise difference in costs remains unclear. Attempts to estimate whether this increased cost is worth the expense are hampered by the uncertainty surrounding improvements in outcomes, such as cancer control and side effects of treatment. If the new technologies can consistently achieve better outcomes, then they may be cost effective. PATIENT SUMMARY We review the cost and cost effectiveness of robot-assisted radical prostatectomy, intensity-modulated radiotherapy, and proton beam therapy in prostate cancer treatment. These technologies are costlier than their traditional counterparts. It remains unclear whether their use is associated with improved cure and reduced morbidity, and whether the increased cost is worth the expense.
Collapse
Affiliation(s)
- Florian Rudolf Schroeck
- White River Junction VA Medical Center, White River Junction, VT, USA; Section of Urology and Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA.
| | - Bruce L Jacobs
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA; Center for Research on Health Care, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sam B Bhayani
- Division of Urology, Washington University School of Medicine, St Louis, MO, USA
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA
| | - David Penson
- Department of Urologic Surgery, Vanderbilt University, Nashville, TN, USA; VA Tennessee Valley Geriatric Research, Education, and Clinical Center (GRECC), Nashville, TN, USA
| | - Jim Hu
- Department of Urology, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, NY, USA
| |
Collapse
|
40
|
Bonnechère B, Sholukha V, Omelina L, Van Vooren M, Jansen B, Van Sint Jan S. Suitability of functional evaluation embedded in serious game rehabilitation exercises to assess motor development across lifespan. Gait Posture 2017; 57:35-9. [PMID: 28564622 DOI: 10.1016/j.gaitpost.2017.05.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/11/2017] [Accepted: 05/23/2017] [Indexed: 02/02/2023]
Abstract
The aim of this study was to determine if the results of activities performed using specially developed serious games for physical rehabilitation could be used as an indicator of the natural maturation and decline of motor control in healthy participants. Eighty-one participants (19 children (5-15 years old), 40 adults (18-65 years old) and 22 aged subjects (60-88 years old) participated in this study. Motions performed were recorded using the Kinect sensor. Three different exercises embedded in the games were used to assess upper limb, trunk and lower limb control. The trial duration and accuracy, measures of gross motor function and fine motor control, respectively, were computed for each participant. ANOVA tests shows statistically significant differences between the three groups for duration (53±15, 27±10 and 119±30s for children, adults and elderly subjects respectively) and accuracy (87±5, 89±10 and 70±8% for children, adults and elderly subjects respectively). The slopes of the curves that approximated the evolution of the performance over various ages are coherent with previous studies about motor control development and physiological decline. The proposed solution, i.e. serious games rehabilitation exercises coupled to motion analysis, seems to be an interesting tool to assess global motor function. Further studies are needed to study the influence of pathologies on the studied parameters.
Collapse
|
41
|
Abstract
Cytometry aims to analyze cells, of any type, using dedicated instruments. The quantitative aspect makes flow cytometry (FCM) a good complementary tool for morphology. Most of the identification tools are based on immunostaining of cell structure details and more and more tools are available in terms of specificities and labels. FCM is under exponential development thanks to technical, immunological and data analysis progresses. Actual generations are now routinely using 6 to 10 simultaneous immuno-labeling on 20 to 100,000 cells, at high speed and short sample preparation and can easily detect rare events at frequency below 10-4 cells. Data interpretation is complex and requires expertise. Mathematical tools are available to support analysis and classification of cells based. Cells from tissues can also be analyzed by FCM after mechanical and or enzymatic separation, but in situ cells can also be analyzed with the help of cytometry. Very new instruments bring spectral analysis, image in flow and mass spectrometry. Medical applications are very broad, notably in hemopathies, immunology, solid tumors, but also microbiology, toxicology, drug discovery, food and environmental industry. But, the limit of FCM is its dependence on operator from sample preparation, instrument settings up to data analysis and a strong effort is now under progress for standardization and constitution of international data bank for references and education.
Collapse
Affiliation(s)
- A-E Depince-Berger
- Immunology Laboratory, CNRS, UMR5307, Laboratoire Georges-Friedel (LGF), Biology-Pathology Department, University Hospital, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - C Aanei
- Haematology Laboratory; Biology-Pathology Department, University Hospital, 42055 Saint-Étienne cedex 2, France
| | - C Iobagiu
- Haematology Laboratory, General hospital, CS 80511, 42328 Roanne cedex, France
| | - M Jeraiby
- Immunology Laboratory, CNRS, UMR5307, Laboratoire Georges-Friedel (LGF), Biology-Pathology Department, University Hospital, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
| | - C Lambert
- Immunology Laboratory, CNRS, UMR5307, Laboratoire Georges-Friedel (LGF), Biology-Pathology Department, University Hospital, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
| |
Collapse
|
42
|
van den Haak L, Rhemrev JP, Blikkendaal MD, Luteijn AC, van den Dobbelsteen JJ, Driessen SR, Jansen FW. A new approach to simplify surgical colpotomy in laparoscopic hysterectomy. Gynecol Surg 2016; 13:63-9. [PMID: 26918004 DOI: 10.1007/s10397-015-0929-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 12/23/2015] [Indexed: 11/01/2022]
Abstract
New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and duration. Furthermore, it proposes an alternative route that may simplify this step in laparoscopic hysterectomy. A structured interview, a prospective cohort study, and a problem analysis were performed regarding experienced difficulty and duration of surgical colpotomy in laparoscopic hysterectomy. Sixteen experts in minimally invasive gynecologic surgery from 12 hospitals participated in the structured interview using a 5-point Likert scale. The colpotomy in LH received the highest scores for complexity (2.8 ± 1.2), compared to AH and VH. Colpotomy in LH was estimated as more difficult than in AH (2.8 vs 1.4, p < .001). In the cohort study, 107 patients undergoing LH were included. Sixteen percent of the total procedure time was spent on colpotomy (SD 7.8 %). BMI was positively correlated with colpotomy time, even after correcting for longer operation time. No relation was found between colpotomy time and blood loss or uterine weight. The surgical colpotomy step in laparoscopic hysterectomy should be simplified as this study demonstrates that it is time consuming and is considered to be more difficult than in other hysterectomy procedures. A vaginal approach to the colpotomy is proposed to achieve this simplification.
Collapse
|
43
|
Nakazaki T, Ikeda K, Iwasaki K, Umezu M. Regulatory science of new technology: tendency of medical professionals' interests on silicone breast implants. J Artif Organs 2016; 19:283-8. [PMID: 26920582 DOI: 10.1007/s10047-016-0888-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
Abstract
New technology related to artificial organs is most attractive for worldwide researchers. We believe they must contribute for the future patients against untreatable diseases. Regulatory science is a new science to establish 'social acceptance' of new technology into the clinical market as soon as possible. In the history of silicone breast implants, we could recognize risks many times; however, we missed such chances to prevent a subsequent crisis. We analyzed the trend of published literature related to silicone breast implants to review the medical professionals' interests on such risks. This trend showed, despite issues of a social acceptance of silicone breast implants in a few countries, other countries' medical professionals had no interest. Our hypothesis is 'medical professionals face the government and do not have contributed to re-establish the social acceptance of new technologies for patients'. Any technology does not have the complete evidence of safety, efficacy and quality, despite regulatory authorities' review and approval with clinical evidences. medical professionals need to conduct subsequently the epidemiological study, to take a meta-analysis periodically and to create/update the guidance for their patients under their professional ethics after the marketing of new technologies. We need to take seriously the 'lesson learned' from the history of silicone breast implants for all kind of new technologies existed in the present.
Collapse
Affiliation(s)
- Tomomichi Nakazaki
- Cooperative Major in Advanced Biomedical Science, Joint Graduate School of Tokyo, Women's Medical University and Waseda University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan.
| | - Koji Ikeda
- Department of Development Promotion, Clinical Research, Innovation and Education Center, Tohoku University Hospital (CRIETO), Miyagi, Japan
| | - Kiyotaka Iwasaki
- Department of Advanced Science and Engineering, Faculty of Science and Engineering, Waseda University, Tokyo, Japan
| | - Mitsuo Umezu
- Department of Modern Mechanical Engineering, Faculty of Science and Engineering, Waseda University, Tokyo, Japan
| |
Collapse
|
44
|
Giaj-Levra N, Ricchetti F, Alongi F. What is changing in radiotherapy for the treatment of locally advanced nonsmall cell lung cancer patients? A review. Cancer Invest 2016; 34:80-93. [PMID: 26810755 DOI: 10.3109/07357907.2015.1114121] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Radiotherapy treatment continues to have a relevant impact in the treatment of nonsmall cell cancer (NSCLC). Use of concurrent chemotherapy and radiotherapy is considered the gold standard in the treatment of locally advanced NSCLC but clinical outcomes are not satisfactory. Introduction of new radiotherapy technology and chemotherapy regimens are under investigation in this setting with the goal to improve unsatisfactory results. We report how radiotherapy is changing in the treatment of locally advanced NSCLC.
Collapse
Affiliation(s)
- Niccoló Giaj-Levra
- a Radiation Oncology Department , Sacro Cuore-Don Calabria Hospital , Negrar-Verona , Italy
| | - Francesco Ricchetti
- a Radiation Oncology Department , Sacro Cuore-Don Calabria Hospital , Negrar-Verona , Italy
| | - Filippo Alongi
- a Radiation Oncology Department , Sacro Cuore-Don Calabria Hospital , Negrar-Verona , Italy
| |
Collapse
|
45
|
Alberti LR, Garcia DPC, Coelho DL, Lima DCAD, Petroianu A. How to improve colon cancer screening rates. World J Gastrointest Oncol 2015; 7:484-491. [PMID: 26688708 PMCID: PMC4678395 DOI: 10.4251/wjgo.v7.i12.484] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 10/08/2015] [Accepted: 11/17/2015] [Indexed: 02/05/2023] Open
Abstract
Colorectal carcinoma is a common cause of death throughout the world and may be prevented by routine control, which can detect precancerous neoplasms and early cancers before they undergo malignant transformation or metastasis. Three strategies may improve colon cancer screening rates: convince the population about the importance of undergoing a screening test; achieve higher efficacy in standard screening tests and make them more available to the community and develop new more sensitive and efficacious screening methods and make them available as routine tests. In this light, the present study seeks to review these three means through which to increase colon cancer screening rates.
Collapse
|
46
|
Gagner M. Safety and efficacy of a side-to-side duodeno-ileal anastomosis for weight loss and type-2 diabetes: duodenal bipartition, a novel metabolic surgery procedure. Ann Surg Innov Res 2015; 9:6. [PMID: 26473004 PMCID: PMC4607140 DOI: 10.1186/s13022-015-0015-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/06/2015] [Indexed: 11/17/2022]
Abstract
Background Partial bypass of the GI tract may promote weight loss by decreased absorption of nutrients and changes in incretins. The aim of the study was to evaluate the safety and efficacy of performing a side-to-side duodeno-ileal anastomosis. Methods Seven 40–50 kg female Yorkshire pigs were allocated to a duodeno-ileal anastomosis (DIA), and were compared to a control group (SHAM). Swine’s weights were followed for 56 days. Gastroscopies were also performed at 28 days. Blood samples were also taken at regular intervals (CBC and Basic biochemistry profiles). At autopsy, gross changes and histological changes of the liver, duodenum and ileum samples were performed. Results While the SHAM group gained 33.2 % more weight at 56 days, the DIA group had shown a weight loss of −6.8 %, for a difference of 40.0 % between the 2 groups (p < 0.05). One pig developed an incisional hernia. Gastroscopies demonstrated normal healing without ulceration or inflammation at 28 days. Histological examination of the anastomosis at 56 days showed normal and smooth healing, with absence of liver toxicity. Conclusion In this porcine model with short follow-up, a side-to-side duodeno-ileal anastomosis provided excellent weight loss without apparent nutritional or grossly aberrant histological changes.
Collapse
Affiliation(s)
- Michel Gagner
- Department of Surgery, Herbert Wertheim School of Medicine, Hopital du Sacre Coeur, Florida International University, 315 Place D'Youville, Suite 191, Montreal, QC H2Y 0A4 Canada
| |
Collapse
|
47
|
Bond A, Sarkar S. New technologies and techniques to improve adenoma detection in colonoscopy. World J Gastrointest Endosc 2015; 7:969-980. [PMID: 26265990 PMCID: PMC4530330 DOI: 10.4253/wjge.v7.i10.969] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/17/2015] [Accepted: 07/08/2015] [Indexed: 02/05/2023] Open
Abstract
Adenoma detection rate (ADR) is a key component of colonoscopy quality assessment, with a direct link between itself and future mortality from colorectal cancer. There are a number of potential factors, both modifiable and non-modifiable that can impact upon ADR. As methods, understanding and technologies advance, so should our ability to improve ADRs, and thus, reduce colorectal cancer mortality. This article will review new technologies and techniques that improve ADR, both in terms of the endoscopes themselves and adjuncts to current systems. In particular it focuses on effective techniques and behaviours, developments in image enhancement, advancement in endoscope design and developments in accessories that may improve ADR. It also highlights the key role that continued medical education plays in improving the quality of colonoscopy and thus ADR. The review aims to present a balanced summary of the evidence currently available and does not propose to serve as a guideline.
Collapse
|
48
|
Alherbish A, Priestap F, Arntfield R. The introduction of basic critical care echocardiography reduces the use of diagnostic echocardiography in the intensive care unit. J Crit Care 2015; 30:1419.e7-1419.e11. [PMID: 26337559 DOI: 10.1016/j.jcrc.2015.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 07/26/2015] [Accepted: 08/05/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Basic critical care echocardiography (CCE) is routinely used by intensive care unit (ICU) providers to rapidly address key hemodynamic questions for the critically ill. By comparison, diagnostic echocardiography (DE) uses a comprehensive examination with more traditional workflow and sophisticated techniques. Despite these differences, both are frequently used to answer similar questions in ICU. This overlap raises questions of duplicate testing and redundancy of hospital resources. We therefore evaluated the effect of the introduction of basic CCE over the use of DE in Victoria Hospital, a tertiary care ICU in London Ontario, Canada. METHODS The monthly mean ratios of basic CCE and DE studies to patient care days (PCD) were plotted and general linear models were used to test for trends over time. Student t test was used to compare the mean DE/PCD before and after the introduction of basic CCE. The ratio of management actions for basic CCE studies was described. Outcome measures were compared using Pearson χ(2) test of association or the Wilcoxon rank sum test. RESULTS Over the 2-year study period, 1264 basic CCE studies were performed. Over this time, the ratio of CCE/PCD increased significantly (P<.001), whereas the ratio of DE/PCD decreased significantly (P=.004). When comparing the pre- and post-CCE periods, the mean DE/PCD decreased significantly from 5.27% to 4.51% (P=.01). There was no adverse change in ICU outcomes before and after the introduction of basic CCE. Mortality rates (pre- and post-CCE) were 23.69% and 24.61% (P=.48); median length of stay was 4.18 and 3.53 days (P<.001); and ventilated patient day rate was 64.96% and 64.93% (P>.9). There was a significant increase in vasoactive/inotropic drugs from a 20.47% vasoactive/inotropic drug/patient day rate to 21.99% (P<.001). Of all basic CCE studies, 61% led to a specific management action, including ordering a DE in 10.7% of cases. CONCLUSION In a hospital with a significant increase in basic CCE use, an associated significant decrease in DE use was observed with no increase in adverse outcomes. The significant increase in basic CCE use resulted in a change of management in most cases including the request for DE in a minority of cases.
Collapse
Affiliation(s)
- Aws Alherbish
- Department of Medicine, Division of Critical Care, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.
| | - Fran Priestap
- Department of Medicine, Division of Critical Care, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.
| | - Robert Arntfield
- Department of Medicine, Division of Critical Care, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada.
| |
Collapse
|
49
|
Berducci M, Fuchs HF, Omelanczuk P, Broderick RC, Harnsberger CR, Langert J, Nefa J, Jaureguiberry P, Gomez P, Miranda L, Jacobsen GR, Sandler BJ, Horgan S. Phase II clinical experience and long-term follow-up using the next-generation single-incision platform FMX314. Surg Endosc 2016; 30:953-60. [PMID: 26123331 DOI: 10.1007/s00464-015-4319-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 06/08/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Single-incision minimally invasive surgery has previously been associated with incisions 2.0-3.0 cm in length. We present a novel single-incision surgical platform compatible for insertion through a standard 15-mm trocar we previously described in six patients with short-term follow-up data. The objective of this phase II study was to evaluate the safety and feasibility of the platform in a larger collective and to evaluate 1-year follow-up data of the phase I trial. METHODS The technology features a multiple-use introducer, accommodating the articulating instruments, and is inserted through a 15-mm laparoscopic trocar. Cholecystectomy is performed through an umbilical incision. A prospective feasibility study was performed at a single center. Inclusion criteria were age of 18-75 years and biliary colic, exclusion criteria were acute cholecystitis, dilation of the biliary tree, severe coagulopathy, BMI > 40 kg/m(2), or choledocholithiasis. Endpoints included complications, length of stay, pain medication, cosmetic results, and the presence of hernia. RESULTS Twenty-seven patients (23 females; phase I: 6 patients, phase II: 21 patients) with an average age of 41.7 years and BMI 26.6 kg/m(2) were recruited for the study. Umbilical incision length did not exceed 15 mm. There were no intraoperative complications. Average OR time decreased from 91 min for the first six cases to 56 min for the last six cases. Average length of stay was 7.8 h. Pain control was achieved with diclofenac for no more than 7 days. All patients had no adverse events at 5-month follow-up, and all phase I patients had no adverse events nor evidence of umbilical hernia at 1 year. CONCLUSION This study demonstrates that single-incision cholecystectomy with the platform is feasible, safe, and reproducible in a larger patient population. Long-term follow-up showed no hernias or other adverse events. Further studies will be needed to evaluate longer-term hernia rates.
Collapse
|
50
|
Lanza M, Iaccarino S, Cennamo M, Irregolare C, Romano V, Carnevale UAG. Comparison between Corvis and other tonometers in healthy eyes. Cont Lens Anterior Eye 2014; 38:94-8. [PMID: 25467287 DOI: 10.1016/j.clae.2014.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 10/31/2014] [Accepted: 11/04/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To determine the agreement of intraocular pressure (IOP) values in healthy eyes among Goldmann applanation tonometer, dynamic contour tonometer, ocular response analyzer and Corvis. Additionally, to study the relationship between their differences with central corneal thickness (CCT) and corneal curvature (CK). METHODS Seventy-six eyes of 76 healthy subjects were examined. Every subject underwent a complete ophthalmic evaluation, a Pentacam scan and three consecutive IOP measurements with each instrument (DCT, GAT, ORA and CST). IOP measurements provided by each device were compared with each other and the differences between them were correlated with morphological parameters obtained by Pentacam (CCT and CK). Statistical analysis was performed using SPSS software, version 18.0. RESULTS The mean age of enrolled subjects was 36.8 ± 10.6 years old. The mean IOP measurements that were obtained with GAT, DCT, ORA and CST was 15.62 ± 2.33 mmHg, 17.44 ± 2.51 mmHg, 15.99 ± 3.58 mmHg and 17.24 ± 3.44 mmHg respectively. The mean CCT was 543.63 ± 36.15 μm, the mean CK was 43.35 ± 1.23 D. GAT and ORA provided IOP values not showing a statistical difference; CST and DCT IOP measurements did not show a statistical difference whereas CST provided statistically higher IOP values both than GAT and both ORA. CONCLUSIONS According to our data, CST produces IOP values that are notably higher than GAT measures; therefore they cannot be used interchangeably. If CST should be used as the next gold standard, higher IOP values will come to be considered normal.
Collapse
Affiliation(s)
- Michele Lanza
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Seconda Università di Napoli, Napoli, Italy; Centro Grandi Apparecchiature, Seconda Università di Napoli, Napoli, Italy.
| | - Stefania Iaccarino
- Centro Grandi Apparecchiature, Seconda Università di Napoli, Napoli, Italy
| | - Michela Cennamo
- Centro Grandi Apparecchiature, Seconda Università di Napoli, Napoli, Italy
| | - Carlo Irregolare
- Centro Grandi Apparecchiature, Seconda Università di Napoli, Napoli, Italy
| | - Vito Romano
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Seconda Università di Napoli, Napoli, Italy
| | | |
Collapse
|