Boylewolfe0930

Regarding learning curve, or the rate of skill acquisition, an angle error of 43 ± 24° (pre) changed to 22 ± 14° (interim test, P  less then  .0001 vs. pretest) and remained at that level for the post-test evaluation on both the repeated case (23 ± 16°) and the new case (26 ± 18°). CONCLUSIONS This study describes the learning curve and technical skill acquisition in FoCUS. A simulator-based curriculum improved medical student's skills in an objective and quantifiable manner. The individually paced curriculum allowed for independent knowledge and skill attainment, without facilitator oversight. © 2020 Wiley Periodicals, Inc.BACKGROUND Information regarding outcome of dogs undergoing surgical management for insulinoma is based on studies of a small number of dogs. SW-100 inhibitor OBJECTIVES To report the outcomes of dogs undergoing surgery as treatment for insulinoma, the prevalence of postoperative diabetes mellitus (DM) in this group and to determine if development of DM can be predicted. ANIMALS Forty-eight client-owned dogs, with a histopathological diagnosis of insulinoma, from three European referral hospitals. METHODS Retrospective observational study. Dogs were identified from a search of electronic hospital records. Cox's regression was used to determine factors associated with postoperative survival and relapse, and logistic regression was used to determine factors associated with the development of DM. RESULTS Median survival time (MST) was 372 days (range 1-1680 days), with dogs with stage I disease having the longest survival time. Stage I dogs had MST of 652 days (range 2-1680 days), whereas dogs with either stage II or III disease had MST of 320 days (range 1-1260 days; P = 0.045). Postoperative hyperglycemia was identified in 33% (16/48) of the dogs, of which 9 (19% of the total population) developed persistent DM. No factors that could be used as predictors for development of DM were identified. CONCLUSIONS AND CLINICAL IMPORTANCE Stage of disease and postoperative hypoglycemia were associated with greater odds of relapse and decreased survival time; these could be used when discussing prognosis. In this study, postoperative DM developed more commonly than previously reported, but no factors were identified that might be useful predictors. © 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.INTRODUCTION Limited data are available regarding the evaluation of right ventricular (RV) performance in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). OBJECTIVE To evaluate the prevalence of RV dysfunction in patients with severe AS undergoing TAVI and long-term changes. METHODS Consecutive patients with severe AS undergoing TAVI from January 2016 to July 2017 were included. RV anatomical and functional parameters were analyzed RV diameters, fractional area change, tricuspid annular plane systolic excursion (TAPSE), S-wave tissue Doppler of the tricuspid annulus (RV-S'TDI), global longitudinal strain (RV-GLS), and free wall strain (RV-FWS). Preprocedure and 1-year echo were analyzed. RESULTS Final population included 114 patients, mean age 83.63 ± 6.31 years, and 38.2% women. The prevalence of abnormal RV function was high, variable depending on the parameter that we analyzed, and it showed a significant reduction 1 year after TAVI implantation 13.9% vs 6.8% (TAPSE  [20]), P = .03. Significant differences were noted between patients with low-flow (LF) vs normal-flow (NF) AS in RV dysfunction prevalence as well as in RV function recovery which is less evident in LF compared with NF patients. CONCLUSIONS RV dysfunction is high among symptomatic AS patients undergoing TAVI, with variable prevalence depending on the echocardiographic parameter used. © 2020 Wiley Periodicals, Inc.BACKGROUND Age is known to be associated with the prevalence and pathophysiology of hypertension. However, there is little information on whether age stands as a good proxy for the specific hemodynamic profile of an individual with elevated blood pressure (BP), which could be important in the selection of therapy. DESIGN This is a cross-sectional study. SETTING People who underwent a noninvasive, hemodynamic assessment using impedance cardiography at 51 sites of iKang Health Checkup Centers throughout China between January 2012 and October 2018. PARTICIPANTS We included 116,851 individuals, aged 20 to 80 years. MAIN OUTCOMES AND MEASURES Relationship between age and hemodynamic parameters (cardiac index, systemic vascular resistance index [SVRI]), among individuals with elevated BP (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg). RESULTS Final study population included 45,082 individuals with elevated BP 29,194 men and 15,888 women with a mean (±SD) age of 48 (±13) and 54 (±12) years, respectively. Cardiac index was negatively associated with age with an adjusted, per decade decrease of 0.17 (95% confidence interval [CI] = 0.17-0.18) L/min/m2 in men and 0.24 (95% CI = 0.23-0.25) L/min/m2 in women. SVRI was positively associated with age with an adjusted, per-decade increase of 174.2 (95% CI = 168.8-179.7) dynes·s·cm-5 ·m2 in men and 214.1 (95% CI = 204.3-223.8) dynes·s·cm-5 ·m2 in women. However, there was substantial overlap in the distribution of these parameters across different age groups in both sexes. CONCLUSIONS In this large study, we observed that cardiac index decreased and SVRI increased with age among individuals with elevated BP. Even though there was a general trend with age, we observed heterogeneity within age strata, suggesting that age alone is inadequate to indicate the hemodynamic profile for an individual. © 2020 The American Geriatrics Society.The genus Nanovirus consists of plant viruses that predominantly infect legumes leading to devastating crop losses. Nanoviruses are transmitted by various aphid species. The transmission occurs in a circulative nonpropagative manner. It was long suspected that a virus-encoded helper factor would be needed for successful transmission by aphids. Recently, a helper factor was identified as the nanovirus-encoded nuclear shuttle protein (NSP). The mode of action of NSP is currently unknown in contrast to helper factors from other plant viruses that, for example, facilitate binding of virus particles to receptors within the aphids' stylets. In this review, we are summarizing the current knowledge about nanovirus-aphid vector interactions. © 2020 The Authors. Archives of Insect Biochemistry and Physiology published by Wiley Periodicals, Inc.