Abernathywhitehead4775

The contour of the pancreas could be traced relatively well using the trained MLM. Further investigations and training of the system are needed to develop a practical navigation system.

The contour of the pancreas could be traced relatively well using the trained MLM. Further investigations and training of the system are needed to develop a practical navigation system.

Oral frailty is characterized by a decrease in the oral and swallowing function and is a risk factor for pneumonia. In the current study, we analyzed the association between the masseter muscle thickness (MMT) and postoperative pneumonia and mortality after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm.

Overall, 247 patients were retrospectively evaluated. The primary end point was postoperative pneumonia. The MMT was measured as the maximum thickness of the masseter muscle 2cm caudal to the zygomatic arch using computed tomography images obtained within 3months before EVAR. Pneumonia was defined as the presence of progressive infiltrates, consolidation, or cavitation on imaging and a fever or leukocytosis.

Twenty (8.1%) cases of postoperative pneumonia occurred within 1year after EVAR. We found that patients with a low MMT (≤ 30th percentile males, 10.4mm; females 8.8mm) had a significantly higher risk of developing postoperative pneumonia within 1year after elective EVAR than those with a high value. A comparison of the utility of the MMT and psoas muscle index (PMI) for predicting the 1-, 3-, and 5-year all-cause mortality revealed that the MMT had superior predictive performance.

The MMT before elective EVAR predicted postoperative pneumonia and life expectancy, and its predictive performance was superior to that of the PMI.

The MMT before elective EVAR predicted postoperative pneumonia and life expectancy, and its predictive performance was superior to that of the PMI.Understanding the response process used by test takers when responding to multiple-choice questions (MCQs) is particularly important in evaluating the validity of score interpretations. Previous authors have recommended eye-tracking technology as a useful approach for collecting data on the processes test taker's use to respond to test questions. This study proposes a new method for evaluating alternative score interpretations by using eye-tracking data and machine learning. We collect eye-tracking data from 26 students responding to clinical MCQs. Analysis is performed by providing 119 eye-tracking features as input for a machine-learning model aiming to classify correct and incorrect responses. The predictive power of various combinations of features within the model is evaluated to understand how different feature interactions contribute to the predictions. The emerging eye-movement patterns indicate that incorrect responses are associated with working from the options to the stem. By contrast, correct responses are associated with working from the stem to the options, spending more time on reading the problem carefully, and a more decisive selection of a response option. The results suggest that the behaviours associated with correct responses are aligned with the real-world model used for score interpretation, while those associated with incorrect responses are not. To the best of our knowledge, this is the first study to perform data-driven, machine-learning experiments with eye-tracking data for the purpose of evaluating score interpretation validity.The Ottawa Surgical Competency Operating Room Evaluation (OSCORE) is an assessment tool that has gained prominence in postgraduate competency-based training programs. We undertook a systematic review and narrative synthesis to articulate the underlying validity argument in support of this tool. Although originally developed to assess readiness for independent performance of a procedure, contemporary implementation includes using the OSCORE for entrustment supervision decisions. We used systematic review methodology to search, identify, appraise and abstract relevant articles from 2005 to September 2020, across MEDLINE, EMBASE and Google Scholar databases. Nineteen original, English-language, quantitative or qualitative articles addressing the use of the OSCORE for health professionals' assessment were included. We organized and synthesized the validity evidence according to Kane's framework, articulating the validity argument and identifying evidence gaps. We demonstrate a reasonable validity argument for the OSCORE in surgical specialties, based on assessing surgical competence as readiness for independent performance for a given procedure, which relates to ad hoc, retrospective, entrustment supervision decisions. The scoring, generalization and extrapolation inferences are well-supported. However, there is a notable lack of implications evidence focused on the impact of the OSCORE on summative decision-making within surgical training programs. selleck kinase inhibitor In non-surgical specialties, the interpretation/use argument for the OSCORE has not been clearly articulated. The OSCORE has been reduced to a single-item global rating scale, and there is limited validity evidence to support its use in workplace-based assessment. Widespread adoption of the OSCORE must be informed by concurrent data collection in more diverse settings and specialties.

Chronic pain of various origin is known to be associated with selective cognitive impairment. Osteoarthritis (OA) of the hip is one of the leading causes of chronic pain in the adult population, but its association with cognitive performance has not been evaluated. Here, we investigate the effect of chronic pain due to unilateral OA of one hip and no further source of chronic pain on cognitive performance.

A neuropsychological test battery, consisting of the Mini-Mental State Examination, Rey-Osterrieth complex figure test, Rivermead behavioural memory test, d2 test of attention, and F-A-S test was applied in 148 patients and 82 healthy pain-free control individuals. The influence of potentially confounding factors such as depression and anxiety was examined.

Patients with OA of the hip showed decreased performance in specific neuropsychological tests. Performance in verbal and visual short-term and long-term memory and selective attention tests was significantly poorer compared to healthy controls. Whereas the executive functions "updating", "set shifting", "response inhibition" and "reflection" appear intact, "problem solving" and "planning" were impaired. None of the confounders showed any influence on cognitive performance in both study groups.

We conclude that chronic pain secondary to end-stage hip OA is associated with selective cognitive impairment. Future studies are required to investigate the effect of total hip arthroplasty on cognitive performance.

We conclude that chronic pain secondary to end-stage hip OA is associated with selective cognitive impairment. Future studies are required to investigate the effect of total hip arthroplasty on cognitive performance.

Given the lack of guidelines regarding the operative management of elderly patients needing lumbar spine fusion for degenerative disease, it is often difficult to balance between invasiveness respecting the fragile spine and geriatric comorbidities.

To compare reoperation rates and clinical outcome in patients above 70years of age undergoing Transforaminal Lumbar Interbody Fusion (TLIF) with titanium rods or posterior stabilization with Polyetheretherketone (PEEK) rods for the treatment of one-level lumbar spine degenerative disease.

Retrospective review of baseline characteristics, reoperation rates as well as the clinical and radiological outcomes of patients, older than 70years, undergoing posterolateral fusion with PEEK rods (n = 76, PEEK group) or TLIF with titanium rods (n = 67, TLIF group) for a single-level lumbar degenerative disease from 2014 to 2020. Additional subanalysis on the patients above 80years of age was performed.

Our results showed similar reoperation rates and outcomes in the TLsis still have to be investigated.

Pelvic palpation is a core component of every Gynecologic examination. It requires vigorous training, which is difficult due to its intimate nature, leading to a need of simulation. Up until now, there are mainly models available for mere palpation which do not offer adequate visualization of the concerning anatomical structures. In this study we present a 3D printed model of the female pelvis. It can improve both the practical teaching of gynecological pelvic examination for health care professionals and the spatial understanding of the relevant anatomy.

We developed a virtual, simplified model showing selected parts of the female pelvis. 3D printing was used to create a physical model.

The life-size 3D printed model has the ability of being physically assembled step by step by its users. Consequently, it improves teaching especially when combining it with commercial phantoms, which are built solely for palpation training. This is achieved by correlating haptic and visual sensations with the resulting feedback received.

The presented 3D printed model of the female pelvis can be of aid for visualizing and teaching pelvic anatomy and examination to medical staff. 3D printing provides the possibility of creating, multiplying, adapting and sharing such data worldwide with little investment of resources. Thus, an important contribution to the international medical community can be made for training this challenging examination.

The presented 3D printed model of the female pelvis can be of aid for visualizing and teaching pelvic anatomy and examination to medical staff. 3D printing provides the possibility of creating, multiplying, adapting and sharing such data worldwide with little investment of resources. Thus, an important contribution to the international medical community can be made for training this challenging examination.

Environmental epidemiology has long considered socioeconomic position (SEP) to be an important confounder of pollution effects on health, given that, in the USA, lower-income and minority communities are often disproportionately exposed to pollution. In recent decades, a growing literature has revealed that lower-SEP communities may also be more susceptible to pollution. Given the vast number of material and psychosocial stressors that vary by SEP, however, it is unclear which specific aspects of SEP may underlie this susceptibility. As environmental epidemiology engages more rigorously with issues of differential susceptibility, it is pertinent to define SEP more clearly, to disentangle its many aspects, and to move towards identifying causal components. Myriad stressors and exposures vary with SEP, with effects accumulating and interacting over the lifecourse. Here, we ask In the context of environmental epidemiology, how do we meaningfully characterize"SEP"?

In answering this question, it is critical ts from qualitative data on neighborhood perceptions and stress (including violence and police-community relations), we offer a lens towards unpacking the complex interplay among SEP, community stressors, race, and pollution in US cities.

This study aims to determine if there is a correlation between differences in optic nerve sheath diameter (ONSD) and changes in PaCO

and pH values that were measured in the arterial blood gas (ABG) before and after treatment in COPD patients with acute hypercarbic respiratory failure (AHRF).

This study serves as a prospective self-controlled non-randomized trial study conducted in the emergency clinic of a tertiary hospital. Forty-four patients with COPD, who were found to have acidosis and hypercarbia in ABG and had an indication for non-invasive mechanic ventilation (NIMV), were analyzed prospectively. Demographic information, vital findings, initial ABG values, the ONSD measurement (before the NIMV treatment), consciousness state, and the ABG results obtained in the second hour of the monitoring and the ONSD measurement (after the NIMV treatment) were recorded.

In this study, 13 (29.5%) of the patients were female and 31 (70.5%) were male. The age distribution was evaluated as 68.3 ± 9.2years; the minimum age was 54 and the maximum was 91.