RESUMO
BACKGROUND: Artificial intelligence (AI) techniques play a major role in anesthesiology, even though their importance is often overlooked. In the extant literature, AI approaches, such as artificial neural networks (ANNs), have been underutilized, being used mainly to model patient's consciousness state, to predict the precise number of anesthetic gases, the level of analgesia, or the need of anesthesiological blocks, among others. In the field of neurosurgery, ANNs have been effectively applied to the diagnosis and prognosis of cerebral tumors, seizures, low back pain, and also to the monitoring of intracranial pressure (ICP). METHODS: A multilayer perceptron (MLP), which is a feedforward ANN, with hyperbolic tangent as activation function in the input/hidden layers, softmax as activation function in the output layer, and cross-entropy as error function, was used to model the impact of prone versus supine position and the use of positive end expiratory pressure (PEEP) on ICP in a sample of 30 patients undergoing spinal surgery. Different noninvasive surrogate estimations of ICP have been used and compared: namely, mean optic nerve sheath diameter (ONSD), noninvasive estimated cerebral perfusion pressure (NCPP), Pulsatility Index (PI), ICP derived from PI (ICP-PI), and flow velocity diastolic formula (FVDICP). RESULTS: ONSD proved to be a more robust surrogate estimation of ICP, with a predictive power of 75%, whilst the power of NCPP, ICP-PI, PI, and FVDICP were 60.5%, 54.8%, 53.1%, and 47.7%, respectively. CONCLUSIONS: Our MLP analysis confirmed our findings previously obtained with regression, correlation, multivariate receiving operator curve (multi-ROC) analyses. ANNs can be successfully used to predict the effects of prone versus supine position and PEEP on ICP in patients undergoing spinal surgery using different noninvasive surrogate estimators of ICP.
Assuntos
Hipertensão Intracraniana , Humanos , Ultrassonografia/métodos , Hipertensão Intracraniana/cirurgia , Pressão Intracraniana/fisiologia , Inteligência Artificial , Nervo Óptico/diagnóstico por imagem , Redes Neurais de ComputaçãoRESUMO
BACKGROUND: The increasing attention to the potential application of technology in medicine represents a dangerous warning in the direction of a reductionist approach. The academic system should therefore be strongly engaged to ensure even in medical practice the greatest enhancement of the human dimension. Targets: How much space is offered to the teaching of History of Medicine (HM) in Italian Universities? This work aims to answer this question through an in-depth analysis of the teaching plans of the degree courses in Medicine and Surgery (CLMC) activated in Italy. MATERIALS AND METHODS: The survey was carried out through the consultation of information, relating to the year 2019-2020, contained in the UniversItaly portal of the Italian Ministry of Education, University and Research, created to accompany students in their studies, as well as through the information published in the web portals of the various universities. RESULTS AND DISCUSSION: In Italy in 43 out of 97 Universities there is the Degree Course in Medicine and Surgery for a total of 66 degree courses; some Universities have activated more degree courses depending on the number of learners or on issues of territorial distribution. The teaching of HM is present in the curricula of 54 CLMC (82%) and in these is mandatory. In 93% of the cases, it is included in integrated courses (CI) and for only 4 CLMC it results as autonomous teaching. For the most part (86%) it is included in the first year's educational plan. The typology of the different CIs is extremely varied, both in terms of denomination, year and content, as well as in the overall CFUs assigned. The current teaching staff is divided as follows: 6 full professors; 12 associate professors; 13 Researchers (RU/RD); 20 contract professors. 19 are the researchers/professors engaged in the scientific field of the HM (MED/02). CONCLUSION: Those findings indicate that the HM subject in the Italian medical education programs is not yet universally recognized as able to stimulate medical students to a holistic view of the person and illness and therefore not sufficiently valued.
Assuntos
Educação Médica , Estudantes de Medicina , Currículo , História da Medicina , Humanos , Itália , UniversidadesRESUMO
Creativity is an ability that plays a major role in the modern economy and society. It should represent an important component of the medical syllabus. However, it is often overlooked by the formal courses at universities. The current study aimed at evaluating whether the interactive educational models, recently adopted by the Faculty of Medicine and Surgery, at the University of Genoa, Italy, would favor the adoption of critical thinking, attitudes to changes, cultural diversity acceptance, and the adoption of relational soft skills versus traditional and frontal didactic teaching. Thirty students, who attended the last year of health care professional course at the Faculty of Medicine, volunteered to take part in the study and were randomly allocated to two groups: one group receiving an innovative, interactive excellence course and the other group receiving a more traditional approach. Ethnopsychiatry was chosen as the topic since it was hypothesized that it would have contributed to generation of a new approach toward diseases and patients. The first group of students, exposed to interactive lectures with the aim of promoting the adoption of critical thinking, were more satisfied than the second group. Participants who were involved in an active manner and had to work in small groups, actively finding their own solutions to solve the problems, perceived the utilized teaching method and experience more stimulating, involving, and effective. Implications for education policy makers are also envisaged.