Educational Effectiveness of Telementoring as a Continuing Professional Development Intervention for Surgeons in Practice: A Systematic Review.

Objective: We performed a systematic review to determine the educational effectiveness of telementoring as a continuing professional development (CPD) intervention for surgeons in practice. Background: Surgeons can mentor their peers in remote locations using videoconferencing communication, referred to as telementoring. Methods: We searched MEDLINE and EMBASE and included studies assessing the educational effectiveness of telementoring interventions used by surgeons in practice. We excluded studies involving only trainees and those not evaluating educational effectiveness. Two reviewers independently screened, extracted data, and assessed study quality using the Medical Education Research Study Quality Instrument (MERSQI; maximum score 18). Educational outcomes were categorized using Moore's Outcomes Framework. Results: We retrieved a total of 1351 records, and 252 studies were selected for full-text review. Twenty-eight studies were included with 1 randomized controlled trial, 19 cohort studies, 5 qualitative studies, and 3 case studies, totaling 178 surgeons and 499 cases. The average MERSQI score was 10.21 ± 2.2 out of 18. Educational outcomes included surgeons' satisfaction with telementoring interventions (Moore's Level 2) in 12 studies, improvement in surgeons' procedural knowledge (Level 3b) in 3 studies, improvements in surgeons' procedural competence in an educational setting (Level 4) in 4 studies, performance in a workplace-based setting (Level 5) in 23 studies, and patient outcomes (Level 6) in 3 studies. No studies reported community health outcomes (Level 7). Conclusions: Moderate-level evidence demonstrates the use of telementoring as effective in changing surgeons' knowledge and competence in both educational and workplace-based settings. Its use is also associated with changes in patient outcomes.

Neuroanatomical predictors of problematic alcohol consumption in adolescents: a systematic review of longitudinal studies.

AIMS: This study aimed to systematically review the literature on neuroanatomical predictors of future problematic drinking in adolescents. METHODS: Using PRISMA guidelines, a systematic review was conducted to evaluate neuroanatomical predictors of problematic alcohol consumption in adolescents. EMBASE, MEDLINE, and PsycINFO databases were searched from inception to 6 January 2023. Studies were included if they were original, had a prospective design, had a sample size of at least 12, had a follow-up period of at least 1 year, had at least one structural neuroimaging scan before 18 with no prior alcohol use, and had alcohol use as the primary outcome. Studies were excluded if they had animals only and were not in English. Risk of bias was conducted using the CASP tool. RESULTS: Out of 1412 studies identified, 19 studies met the criteria, consisting of 11 gray matter (n = 4040), 5 white matter (n = 319), and 3 assessing both (n = 3608). Neuroanatomical predictors of future problematic drinking in adolescents were reported to be distributed across various brain regions such as the orbitofrontal cortex and paralimbic regions. However, the findings were largely heterogeneous. CONCLUSIONS: This is the first systematic review to map out the existing literature on neuroanatomical predictors of problematic drinking in adolescents. Future research should focus on the aforementioned regions to determine their role in predicting future problematic drinking with more certainty.

Cholinergic upregulation by optogenetic stimulation of nucleus basalis after photothrombotic stroke in forelimb somatosensory cortex improves endpoint and motor but not sensory control of skilled reaching in mice.

A network of cholinergic neurons in the basal forebrain innerve the forebrain and are proposed to contribute to a variety of functions including cortical plasticity, attention, and sensorimotor behavior. This study examined the contribution of the nucleus basalis cholinergic projection to the sensorimotor cortex on recovery on a skilled reach-to-eat task following photothrombotic stroke in the forelimb region of the somatosensory cortex. Mice were trained to perform a single pellet skilled reaching task and their pre and poststroke performance, from Day 4 to Day 28 poststroke, was assessed frame-by-frame by video analysis with endpoint, movement and sensorimotor integration measures. Somatosensory forelimb lesions produced impairments in endpoint and movement component measures of reaching and increased the incidence of fictive eating, a sensory impairment in mistaking a missed reach for a successful reach. Upregulated acetylcholine (ACh) release, as measured by local field potential recording, elicited via optogenetic stimulation of the nucleus basalis improved recovery of reaching and improved movement scores but did not affect sensorimotor integration impairment poststroke. The results show that the mouse cortical forelimb somatosensory region contributes to forelimb motor behavior and suggest that ACh upregulation could serve as an adjunct to behavioral therapy for acute treatment of stroke.

A Matlab-based toolbox for characterizing behavior of rodents engaged in string-pulling.

String-pulling by rodents is a behavior in which animals make rhythmical body, head, and bilateral forearm as well as skilled hand movements to spontaneously reel in a string. Typical analysis includes kinematic assessment of hand movements done by manually annotating frames. Here, we describe a Matlab-based software that allows whole-body motion characterization using optical flow estimation, descriptive statistics, principal component, and independent component analyses as well as temporal measures of Fano factor, entropy, and Higuchi fractal dimension. Based on image-segmentation and heuristic algorithms for object tracking, the software also allows tracking of body, ears, nose, and forehands for estimation of kinematic parameters such as body length, body angle, head roll, head yaw, head pitch, and path and speed of hand movements. The utility of the task and software is demonstrated by characterizing postural and hand kinematic differences in string-pulling behavior of two strains of mice, C57BL/6 and Swiss Webster.

The temporal choreography of the yo-yo movement of getting spaghetti into the mouth by the head-fixed mouse.

There is debate over whether single-handed eating movements, reaching for food and withdrawing the hand to place the food in the mouth, originated in the primate lineage or whether they originated in phylogenetically-earlier Euarchontoglires. Most spontaneous hand use in eating by the laboratory mouse (Mus domestica) involves both hands, and a central question is the extent to which the movements are symmetric. Here we describe an asymmetry of spontaneous single hand use by the head-fixed mouse in making the yo-yo hand movement of removing and replacing a piece of pasta (spaghetti) in the mouth for eating. We also describe the problem/solution of placing into the mouth the end of a held item that protrudes at some distance from the hand. Pasta-eating proceeds in bouts, and a bout starts with raising the hands, which are holding a piece of pasta, to place one end of the pasta in the mouth for biting. A bout ends with lowering the hands, still holding the pasta stem, while the pasta morsel that has been bitten off is chewed. Hand-lowering after the pasta is removed from the mouth is slow, concurrent and symmetric, both when the pasta is held by both hands and when it is held in one hand. Hand-raising to place the pasta in the mouth is fast, consecutive and asymmetric, both when the pasta is held in both hands and when it is held in one hand. Frame-by-frame analyses of the video record combined with kinematic analyses show that a preferred single hand not only directs one end of the pasta to the mouth but also readjusts the trajectory of the pasta if it misses the mouth. The specialized use of a single hand by the mouse, even when the hands are bilaterally engaged, and the corrective asymmetric movements with which one hand adjusts the pasta's trajectory with the other hand playing a supporting role, is discussed in relation to the idea that hand preference, specialization, and dexterity have somatosensory and preprimate origins.