Preventing sexism and sexual harassment in medical schools by using Theater of the Oppressed as an interactive and reflexive tool.

OBJECTIVES: Among the measures taken to combat sexism and sexual harassment, prevention courses for medical students are one possibility. We aimed to describe the process of implementing a training course on the prevention of sexism and sexual harassment for medical students in two Swiss medical schools by using the Theater of the Oppressed as an interactive and reflexive tool within the course. The purpose of this theater was to give the students the opportunity to express themselves and to collectively look for and discuss ways to combat and escape from oppressive situations. RESULTS: This collaborative, innovative, and interactive implementation showed that different forms of a training course can be implemented with similar objectives in an adaptable and transferable manner. The interactive and reflexive Theater of the Oppressed was an appropriate option to reach the objectives. Courses were based on identifying and acting on concrete problematic situations by focusing on individual, collective, and institutional resources. Students reported a high level of satisfaction.

A Deep Learning Approach to Segment and Classify C-Shaped Canal Morphologies in Mandibular Second Molars Using Cone-beam Computed Tomography.

INTRODUCTION: The identification of C-shaped root canal anatomy on radiographic images affects clinical decision making and treatment. The aims of this study were to develop a deep learning (DL) model to classify C-shaped canal anatomy in mandibular second molars from cone-beam computed tomographic (CBCT) volumes and to compare the performance of 3 different architectures. METHODS: U-Net, residual U-Net, and Xception U-Net architectures were used for image segmentation and classification of C-shaped anatomies. Model training and validation were performed on 100 of a total of 135 available limited field of view CBCT images containing mandibular molars with C-shaped anatomy. Thirty-five CBCT images were used for testing. Voxel-matching accuracy of the automated labeling of the C-shaped anatomy was assessed with the Dice index. The mean sensitivity of predicting the correct C-shape subcategory was calculated based on detection accuracy. One-way analysis of variance and post hoc Tukey honestly significant difference tests were used for statistical evaluation. RESULTS: The mean Dice coefficients were 0.768 ± 0.0349 for Xception U-Net, 0.736 ± 0.0297 for residual U-Net, and 0.660 ± 0.0354 for U-Net on the test data set. The performance of the 3 models was significantly different overall (analysis of variance, P = .000779). Both Xception U-Net (Q = 7.23, P = .00070) and residual U-Net (Q = 5.09, P = .00951) performed significantly better than U-Net (post hoc Tukey honestly significant difference test). The mean sensitivity values were 0.786 ± 0.0378 for Xception U-Net, 0.746 ± 0.0391 for residual U-Net, and 0.720 ± 0.0495 for U-Net. The mean positive predictive values were 77.6% ± 0.1998% for U-Net, 78.2% ± 0.0.1971% for residual U-Net, and 80.0% ± 0.1098% for Xception U-Net. The addition of contrast-limited adaptive histogram equalization had improved overall architecture efficacy by a mean of 4.6% (P < .0001). CONCLUSIONS: DL may aid in the detection and classification of C-shaped canal anatomy.

[The burned patient: intervention by the liaison psychiatrist]. / Le patient brûlé: accompagnement par le psychiatre de liaison.

Patients suffering from burns, especially when they are extensive, benefit from specialized multidisciplinary care at the Lausanne University Hospital. In recent decades, major advances in medical research have made possible a significant reduction in morbidity and mortality. At the same time, the psychological needs of those patients have continued to increase, with the need for professional and individualized care. Intervention by the liaison psychiatrist face the challenge of integration within the complex somatic care.

Au CHUV, le patient victime de brûlures, notamment lorsque celles-ci sont étendues, bénéficie d'une prise en charge pluridisciplinaire spécialisée. Ces dernières décennies, des avancées majeures au niveau de la recherche médicale ont rendu possible une réduction conséquente de la morbidité et de la mortalité. En parallèle, les besoins psychologiques de cette patientèle n'ont eu de cesse d'augmenter, avec par conséquent la nécessité d'un accompagnement professionnel et individualisé, dont l'articulation reste parfois complexe avec l'ensemble de la prise en charge somatique.

In-field stereotactic body radiotherapy (SBRT) reirradiation for pulmonary malignancies as a multicentre analysis of the German Society of Radiation Oncology (DEGRO).

Data of thoracic in-field reirradiation with two courses of stereotactic body radiotherapy (SBRT) is scarce. Aim of this study is to investigate feasibility and safety of this approach. Patients with a second course of thoracic SBRT and planning target volume (PTV) overlap were analyzed in this retrospective, multicenter study. All plans and clinical data were centrally collected. 27 patients from 8 centers have been amenable for evaluation: 12 with non-small-cell lung cancer, 16 with metastases, treated from 2009 (oldest first course) to 2020 (latest second course). A median dose of 38.5 Gy to the 65%-isodose over a median of 5 fractions was prescribed in the first course and 40 Gy in 5 fractions for the second SBRT-course. Median PTV of the second SBRT was 29.5 cm3, median PTV overlap 22 cm3. With a median interval of 20.2 months between the two SBRT-courses, 1-year OS, and -LCR were 78.3% and 70.3% respectively. 3 patients developed grade 1 and one grade 2 pneumonitis. No grade > 2 toxicity was observed. Peripheral location and dose were the only factors correlating with tumor control. A second SBRT-course with PTV overlap appears safe and achieves reasonable local control.