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1.
BMC Med Educ ; 21(1): 174, 2021 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-33743676

RESUMEN

BACKGROUND: In response to the COVID-19 pandemic, medical schools suspended clinical rotations. This displacement of medical students from wards has limited experiential learning. Concurrently, outpatient practices are experiencing reduced volumes of in-person visits and are shifting towards virtual healthcare, a transition that comes with its own logistical challenges. This article describes a workflow that enabled medical students to engage in meaningful clinical education while helping an institution's outpatient practices implement remote telemedicine visits. METHODS: A 4-week virtual elective was designed to allow clinical learners to participate in virtual telemedicine patient encounters. Students were prepared with EMR training and introduced to a novel workflow that supported healthcare providers in the outpatient setting. Patients were consented to telehealth services before encounters with medical students. All collected clinical information was documented in the EMR, after which students transitioned patients to a virtual Doxy.me video appointment. Surveys were used to evaluate clinical and educational outcomes of students' participation. Elective evaluations and student reflections were also collected. RESULTS: Survey results showed students felt well-prepared to initiate patient encounters. They expressed comfort while engaging with patients virtually during telemedicine appointments. Students identified clinical educational value, citing opportunities to develop patient management plans consistent with in-person experiences. A significant healthcare burden was also alleviated by student involvement. Over 1000 total scheduled appointments were serviced by students who transitioned more than 80 % of patients into virtual attending provider waiting rooms. CONCLUSIONS: After piloting this elective with fourth-year students, pre-clerkship students were also recruited to act in a role normally associated with clinical learners (e.g., elicit patient histories, conduct a review of systems, etc.). Furthermore, additional telemedicine electives are being designed so medical students can contribute to patient care without risk of exposure to COVID-19. These efforts will allow students to continue with their clinical education during the pandemic. Medical educators can adopt a similar workflow to suit evolving remote learning needs.


Asunto(s)
Atención Ambulatoria/métodos , Competencia Clínica , Curriculum , Educación de Pregrado en Medicina/métodos , Pandemias , Telemedicina , Educación a Distancia/métodos , Humanos , Proyectos Piloto , Flujo de Trabajo
2.
Methods Mol Biol ; 2292: 115-120, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33651356

RESUMEN

The analysis of liquid biopsy as a source of diagnostic, prognostic, and predictive biomarkers is still object of the main research in the prostate cancer field. Many advantages, such as less invasiveness compared to plasma or serum analysis and the rich content, confer to urine a role as an interesting fluid to be analysed especially in urological diseases. Here we report a workflow focused on profile, concentration, and protein surface characterization of EVs from urinary supernatant.


Asunto(s)
Exosomas/patología , Neoplasias de la Próstata/diagnóstico , Biomarcadores de Tumor/análisis , Biomarcadores de Tumor/orina , Humanos , Biopsia Líquida/métodos , Masculino , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/orina , Proteínas/análisis , Proteinuria/diagnóstico , Proteinuria/patología , Proteinuria/orina , Toma de Muestras de Orina/métodos , Flujo de Trabajo
3.
Mol Syst Biol ; 17(3): e9923, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33749993

RESUMEN

Molecular knowledge of biological processes is a cornerstone in omics data analysis. Applied to single-cell data, such analyses provide mechanistic insights into individual cells and their interactions. However, knowledge of intercellular communication is scarce, scattered across resources, and not linked to intracellular processes. To address this gap, we combined over 100 resources covering interactions and roles of proteins in inter- and intracellular signaling, as well as transcriptional and post-transcriptional regulation. We added protein complex information and annotations on function, localization, and role in diseases for each protein. The resource is available for human, and via homology translation for mouse and rat. The data are accessible via OmniPath's web service (https://omnipathdb.org/), a Cytoscape plug-in, and packages in R/Bioconductor and Python, providing access options for computational and experimental scientists. We created workflows with tutorials to facilitate the analysis of cell-cell interactions and affected downstream intracellular signaling processes. OmniPath provides a single access point to knowledge spanning intra- and intercellular processes for data analysis, as we demonstrate in applications studying SARS-CoV-2 infection and ulcerative colitis.


Asunto(s)
/metabolismo , Colitis Ulcerosa/metabolismo , Biología Computacional/métodos , Proteínas/metabolismo , Transducción de Señal , Animales , Comunicación Celular , Colitis Ulcerosa/patología , Bases de Datos Factuales , Enzimas/metabolismo , Humanos , Ratones , Procesamiento Proteico-Postraduccional , Proteínas/genética , Ratas , Análisis de la Célula Individual , Programas Informáticos , Flujo de Trabajo
5.
Compend Contin Educ Dent ; 42(2): 86-92, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33735581

RESUMEN

A customized healing abutment may be used to create a soft-tissue emergence profile that is more realistic looking compared to when a commercially available stock healing abutment is used. This article describes a workflow for the design and fabrication of a customized healing abutment based on the anticipated final restoration. Utilizing dental CAD/CAM software, a dynamic navigation virtual treatment plan, and 3D printing, this workflow can be accomplished in an all-digital, presurgical fashion.


Asunto(s)
Pilares Dentales , Implantes Dentales , Diseño Asistido por Computadora , Atención Odontológica , Humanos , Flujo de Trabajo
6.
Sensors (Basel) ; 21(4)2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33672053

RESUMEN

During the last decade, orthopedic oncology has experienced the benefits of computerized medical imaging to reduce human dependency, improving accuracy and clinical outcomes. However, traditional surgical navigation systems do not always adapt properly to this kind of interventions. Augmented reality (AR) and three-dimensional (3D) printing are technologies lately introduced in the surgical environment with promising results. Here we present an innovative solution combining 3D printing and AR in orthopedic oncological surgery. A new surgical workflow is proposed, including 3D printed models and a novel AR-based smartphone application (app). This app can display the patient's anatomy and the tumor's location. A 3D-printed reference marker, designed to fit in a unique position of the affected bone tissue, enables automatic registration. The system has been evaluated in terms of visualization accuracy and usability during the whole surgical workflow. Experiments on six realistic phantoms provided a visualization error below 3 mm. The AR system was tested in two clinical cases during surgical planning, patient communication, and surgical intervention. These results and the positive feedback obtained from surgeons and patients suggest that the combination of AR and 3D printing can improve efficacy, accuracy, and patients' experience.


Asunto(s)
Realidad Aumentada , Imagenología Tridimensional , Teléfono Inteligente , Cirugía Asistida por Computador , Humanos , Impresión Tridimensional , Flujo de Trabajo
7.
BMC Gastroenterol ; 21(1): 98, 2021 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-33657994

RESUMEN

BACKGROUND: Health care professionals in endoscopic labs have an elevated risk for COVID-19 infection, therefore, we aimed to determine the effect of current pandemic on the workflow and infection prevention and control strategies of endoscopy units in real-life setting. METHODS: All members of Hungarian Society of Gastroenterology were invited between 7 and 17 April 2020 to participate in this cross-section survey study and to complete an online, anonymous questionnaire. RESULTS: Total of 120 endoscopists from 83 institutes were enrolled of which 35.83% worked in regions with high cumulative incidence of COVID-19. Only 33.33% of them had undergone training about infection prevention in their workplace. 95.83% of endoscopists regularly used risk stratification of patients for infection prior endoscopy. While indications of examinations in low risk patients varied widely, in high-risk or positive patients endoscopy was limited to gastrointestinal bleeding (95.00%), removal of foreign body from esophagus (87.50%), management of obstructive jaundice (72.50%) and biliary pancreatitis (67.50%). Appropriate amount of personal protective equipment was available in 60.85% of endoscopy units. In high-risk or positive patients, surgical mask, filtering facepiece mask, protective eyewear and two pairs of gloves were applied in 30.83%, 76.67%, 90.00% and 87.50% of cases, respectively. Personal protective equipment fully complied with European guideline only in 67.50% of cases. CONCLUSIONS: Survey found large variability in indications of endoscopy and relative weak compliance to national and international practical recommendations in terms of protective equipment. This could be improved by adequate training about infection prevention.


Asunto(s)
/prevención & control , Endoscopía Gastrointestinal , Gastroenterología/organización & administración , Unidades Hospitalarias/organización & administración , Control de Infecciones/organización & administración , Flujo de Trabajo , /epidemiología , Estudios Transversales , Humanos , Hungría , Selección de Paciente , Equipo de Protección Personal
8.
Int J Pharm Pract ; 29(2): 186-188, 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-33729532

RESUMEN

OBJECTIVES: The nation was recovering from the aftermath of the catastrophic 2019-2020 bushfires when the first cases of the COVID-19 pandemic emerged in Australia. During the peak of the pandemic, Australia closed both its state and international borders to all travelers and interstate travel was very tightly regulated. Community pharmacists and pharmacy staff were one of the very few primary healthcare workers still serving their communities during these periods of strict lockdown. In this personal view article, the challenges and their toll on the mental health and wellbeing of these "essential workers" are described. KEY FINDINGS: Community pharmacists and pharmacy staff were under immense pressure to remain open and serve their communities amidst rapidly changing legislation and, at times, conflicting advice from the range of Australian health agencies. Rapid changes to workload and workflow were combined with the dilemma of balancing professional obligations with the personal duty of keeping themselves and their sometimes geographically distant families safe. Fluctuating demands and traumatic situations found community pharmacy staff often feeling distressed and underprepared. SUMMARY: Despite a global pandemic following a season of extraordinary bushfires, it has barely been acknowledged that community pharmacy staff are one of the highest risk groups for long-term psychological impacts. To our knowledge, very little research has addressed the toll of these cataclysmic events on this group of essential healthcare workers.


Asunto(s)
/psicología , Fuego , Salud Mental/tendencias , Pandemias , Farmacias , Farmacéuticos , Australia , Servicios Comunitarios de Farmacia , Personal de Salud , Humanos , Estudios Longitudinales , Distrés Psicológico , Flujo de Trabajo , Carga de Trabajo
9.
Methods Mol Biol ; 2278: 157-182, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33649956

RESUMEN

Bifidobacteria represent an important group of (mostly) commensal microorganisms, which have enjoyed increasing scientific and industrial attention due to their purported health-promoting attributes. For the latter reason, several species have been granted "generally recognized as safe" (GRAS) and "qualified presumption of safety" (QPS) status by the Food and Drugs Administration (FDA) and European Food Safety Authority (EFSA) organizations. Increasing scientific evidence supports their potential as oral delivery vectors to produce bioactive and therapeutic molecules at intestinal level. In order to achieve an efficient utilization of bifidobacterial strains as health-promoting (food) ingredients, it is necessary to provide evidence on the molecular mechanisms behind their purported beneficial and probiotic traits, and precise mechanisms of interaction with their human (or other mammalian) host. In this context, developing appropriate molecular tools to generate and investigate recombinant strains is necessary. While bifidobacteria have long remained recalcitrant to genetic manipulation, a wide array of Bifidobacterium-specific replicating vectors and genetic modification procedures have been described in literature. The current chapter intends to provide an updated overview on the vectors used to genetically modify and manipulate bifidobacteria, including their general characteristics, reviewing examples of their use to successfully generate recombinant bifidobacterial strains for specific purposes, and providing a general workflow and cautions to design and conduct heterologous expression in bifidobacteria. Knowledge gaps and fields of research that may help to widen the molecular toolbox to improve the functional and technological potential of bifidobacteria are also discussed.


Asunto(s)
Bifidobacterium/genética , Clonación Molecular/métodos , Vectores Genéticos/genética , Expresión Génica , Microbiología Industrial/métodos , Plásmidos/genética , Flujo de Trabajo
10.
World Neurosurg ; 148: 256-262, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33770848

RESUMEN

Coronavirus disease 2019 (COVID-19) has disrupted lives and indelibly impacted the practice of medicine since emerging as a pandemic in March 2020. For neurosurgery departments throughout the United States, the pandemic has created unique challenges across subspecialties in devising methods of triage, workflow, and operating room safety. Located in New York City, at the early epicenter of the COVID-19 crisis, the Weill Cornell Medicine Department of Neurological Surgery was disrupted and challenged in many ways, requiring adaptations in clinical operations, workforce management, research, and education. Through our department's collective experience, we offer a glimpse at how our faculty and administrators overcame obstacles, and transformed in the process, at the height of the COVID-19 pandemic.


Asunto(s)
Prestación de Atención de Salud , Educación a Distancia , Neurocirugia/organización & administración , Procedimientos Neuroquirúrgicos , Centros Médicos Académicos , Investigación Biomédica , Docentes Médicos , Personal de Salud , Departamentos de Hospitales , Humanos , Neurocirugia/educación , Neurocirugia/métodos , Ciudad de Nueva York , Quirófanos , Administración de Personal , Triaje , Difusión por la Web como Asunto , Flujo de Trabajo
11.
Nurs Res ; 70(2): 132-141, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33630536

RESUMEN

OBJECTIVE: The aim of this study was to describe computational ethnography as a contemporary and supplemental methodology in EHR workflow analysis and the relevance of this method to nursing research. METHODS: We explore the use of audit logs as a computational ethnographic data source and the utility of data mining techniques, including sequential pattern mining (SPM) and Markov chain analysis (MCA), to analyze nurses' workflow within the EHRs. SPM extracts frequent patterns in a given transactional database (e.g., audit logs from the record). MCA is a stochastic process that models a sequence of states and allows for calculating the probability of moving from one state to the next. These methods can help uncover nurses' global navigational patterns (i.e., how nurses navigate within the record) and enable robust workflow analyses. RESULTS: We demonstrate hypothetical examples from SPM and MCA, such as (a) the most frequent sequential pattern of nurses' workflow when navigating the EHR using SPM and (b) transition probability from one record screen to the next using MCA. These examples demonstrate new methods to address the inflexibility of current approaches used to examine nursing EHR workflow. DISCUSSION: Within a clinical context, the use of computational ethnographic data and data mining techniques can inform the optimization of the EHR. Results from these analyses can be used to supplement the data needed in redesigning the EHR, such as organizing and combining features within a screen or predicting future navigation to improve the record that nurses use.


Asunto(s)
Actitud del Personal de Salud , Registros Electrónicos de Salud/organización & administración , Almacenamiento y Recuperación de la Información/métodos , Atención de Enfermería/organización & administración , Carga de Trabajo/estadística & datos numéricos , Humanos , Investigación en Enfermería , Interfaz Usuario-Computador , Flujo de Trabajo
12.
Anal Chem ; 93(7): 3325-3330, 2021 02 23.
Artículo en Inglés | MEDLINE | ID: mdl-33570399

RESUMEN

Rapid tests for pathogen identification and spread assessment are critical for infectious disease control and prevention. The control of viral outbreaks requires a nucleic acid diagnostic test that is sensitive and simple and delivers fast and reliable results. Here, we report a one-pot direct reverse transcript loop-mediated isothermal amplification (RT-LAMP) assay of SARS-CoV-2 based on a lateral flow assay in clinical samples. The entire contiguous sample-to-answer workflow takes less than 40 min from a clinical swab sample to a diagnostic result without professional instruments and technicians. The assay achieved an accuracy of 100% in 12 synthetic and 12 clinical samples compared to the data from PCR-based assays. We anticipate that our method will provide a universal platform for rapid and point-of-care detection of emerging infectious diseases.


Asunto(s)
/diagnóstico , Humanos , Técnicas de Diagnóstico Molecular , Técnicas de Amplificación de Ácido Nucleico , Pruebas en el Punto de Atención , Factores de Tiempo , Flujo de Trabajo
13.
PLoS Comput Biol ; 17(2): e1008685, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33534793

RESUMEN

The SARS-CoV-2 pandemic of 2020 has mobilised scientists around the globe to research all aspects of the coronavirus virus and its infection. For fruitful and rapid investigation of viral pathomechanisms, a collaborative and interdisciplinary approach is required. Therefore, we have developed ViralLink: a systems biology workflow which reconstructs and analyses networks representing the effect of viruses on intracellular signalling. These networks trace the flow of signal from intracellular viral proteins through their human binding proteins and downstream signalling pathways, ending with transcription factors regulating genes differentially expressed upon viral exposure. In this way, the workflow provides a mechanistic insight from previously identified knowledge of virally infected cells. By default, the workflow is set up to analyse the intracellular effects of SARS-CoV-2, requiring only transcriptomics counts data as input from the user: thus, encouraging and enabling rapid multidisciplinary research. However, the wide-ranging applicability and modularity of the workflow facilitates customisation of viral context, a priori interactions and analysis methods. Through a case study of SARS-CoV-2 infected bronchial/tracheal epithelial cells, we evidence the functionality of the workflow and its ability to identify key pathways and proteins in the cellular response to infection. The application of ViralLink to different viral infections in a context specific manner using different available transcriptomics datasets will uncover key mechanisms in viral pathogenesis.


Asunto(s)
/metabolismo , Biología Computacional/métodos , Regulación Viral de la Expresión Génica , Transducción de Señal , Algoritmos , Bronquios/virología , Análisis por Conglomerados , Perfilación de la Expresión Génica , Interacciones Huésped-Patógeno , Humanos , Investigación Interdisciplinaria , Pulmón/virología , Modelos Estadísticos , Biología de Sistemas , Transcriptoma , Flujo de Trabajo
14.
BMC Bioinformatics ; 22(1): 41, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33526006

RESUMEN

BACKGROUND: The drive to understand how microbial communities interact with their environments has inspired innovations across many fields. The data generated from sequence-based analyses of microbial communities typically are of high dimensionality and can involve multiple data tables consisting of taxonomic or functional gene/pathway counts. Merging multiple high dimensional tables with study-related metadata can be challenging. Existing microbiome pipelines available in R have created their own data structures to manage this problem. However, these data structures may be unfamiliar to analysts new to microbiome data or R and do not allow for deviations from internal workflows. Existing analysis tools also focus primarily on community-level analyses and exploratory visualizations, as opposed to analyses of individual taxa. RESULTS: We developed the R package "tidyMicro" to serve as a more complete microbiome analysis pipeline. This open source software provides all of the essential tools available in other popular packages (e.g., management of sequence count tables, standard exploratory visualizations, and diversity inference tools) supplemented with multiple options for regression modelling (e.g., negative binomial, beta binomial, and/or rank based testing) and novel visualizations to improve interpretability (e.g., Rocky Mountain plots, longitudinal ordination plots). This comprehensive pipeline for microbiome analysis also maintains data structures familiar to R users to improve analysts' control over workflow. A complete vignette is provided to aid new users in analysis workflow. CONCLUSIONS: tidyMicro provides a reliable alternative to popular microbiome analysis packages in R. We provide standard tools as well as novel extensions on standard analyses to improve interpretability results while maintaining object malleability to encourage open source collaboration. The simple examples and full workflow from the package are reproducible and applicable to external data sets.


Asunto(s)
Análisis de Datos , Microbiota , Programas Informáticos , Flujo de Trabajo
15.
Int J Prosthodont ; 34(1): 27-36, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33570517

RESUMEN

PURPOSE: To investigate the effect of training on scanning accuracy of complete arch scans (CAS) performed by first-time users, with a distinction made between specific training (repeated performance of CAS) and nonspecific training (simple use of an intraoral optical scanner for a sextant scan in the context of a CAD/CAM teaching module). MATERIALS AND METHODS: A total of 36 students with no experience in intraoral scanning were randomized into three groups (n = 12 per group) according to the number of CAS sessions: three sessions (3S), two sessions (2S), and one session (1S). Each student had to perform 10 CAS per scanning session. Sessions were scheduled at T0, T1, and T2 for group 3S; at T0 and T2 for group 2S; and at T2 for group 1S. Before the final scanning session in each group (ie, the first scanning session in group 1S), the students completed a CAD/CAM teaching module, which included fabrication of a monolithic crown in a fully digital chairside workflow. RESULTS: In all groups, repeated CAS resulted in improved scanning accuracy. Participation in the CAD/CAM module had a positive effect on initial accuracy for CAS. Mean absolute deviations in cross-arch distance were 84 µm (T0), 68 µm (T1), and 63 µm (T2) for group 3S; 79 µm (T0) and 61 µm (T2) for group 2S; and 67 µm (T2) for group 1S. CONCLUSION: To perform CAS with the best possible accuracy, specific training is highly recommended. In addition, nonspecific training leads to an improvement in initial scanning accuracy.


Asunto(s)
Diseño Asistido por Computadora , Coronas , Técnica de Impresión Dental , Modelos Dentales , Humanos , Imagenología Tridimensional , Flujo de Trabajo
16.
Ann R Coll Surg Engl ; 103(2): 88-95, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33559552

RESUMEN

INTRODUCTION: COVID-19 remains a threat for a fear of a second pandemic. Emergency orthopaedic operations are still among the most commonly performed procedures with increased risk of transmission of SARS CoV-2 to the patients and the healthcare workers. The aim of this study was to present the evidence available into best practices limiting the spread of COVID-19 in healthcare setting during current and future pandemics. METHODS: A review of the literature was performed in multiple databases (PubMed, the Cochrane Library, Google Scholar, World Health Organization and Centers for Disease Control), using 'COVID-19' with other relevant keywords in different combinations. Owing to the limited and heterogenous evidence available, data were presented in a narrative manner. FINDINGS: From the evidence gathered it was noted that a multimodal approach to minimising pathogen transmission is required. This primarily comprises the wider engineering and administrative controls to reduce the concentration of the pathogen and to separate staff and patients from it. Theatre isolation and traffic control bundling, theatre flow and logistics, ventilation and waste management form a pivotal role in the environmental/engineering controls. Administrative measures include policies for both patients and staff. For patients, isolation and preoperative screening are of utmost value. For staff, testing for COVID-19, risk assessment, redeployment and provision of persona; protective equipment, together with the necessary training are important administrative controls. CONCLUSION: We believe these measures are likely to improve the sustainability of resources and can be carried to elective settings in order to return to some form of normality and help to mitigate the effects of future pandemics.


Asunto(s)
/prevención & control , Servicio de Limpieza en Hospital , Control de Infecciones/métodos , Quirófanos , Equipo de Protección Personal , Ventilación , Administración de Residuos , Flujo de Trabajo , Filtros de Aire , Humanos , Capacitación en Servicio , Admisión y Programación de Personal , Medición de Riesgo , Medicina Estatal , Reino Unido
17.
BMC Bioinformatics ; 22(1): 60, 2021 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-33563206

RESUMEN

BACKGROUND: Current high-throughput technologies-i.e. whole genome sequencing, RNA-Seq, ChIP-Seq, etc.-generate huge amounts of data and their usage gets more widespread with each passing year. Complex analysis pipelines involving several computationally-intensive steps have to be applied on an increasing number of samples. Workflow management systems allow parallelization and a more efficient usage of computational power. Nevertheless, this mostly happens by assigning the available cores to a single or few samples' pipeline at a time. We refer to this approach as naive parallel strategy (NPS). Here, we discuss an alternative approach, which we refer to as concurrent execution strategy (CES), which equally distributes the available processors across every sample's pipeline. RESULTS: Theoretically, we show that the CES results, under loose conditions, in a substantial speedup, with an ideal gain range spanning from 1 to the number of samples. Also, we observe that the CES yields even faster executions since parallelly computable tasks scale sub-linearly. Practically, we tested both strategies on a whole exome sequencing pipeline applied to three publicly available matched tumour-normal sample pairs of gastrointestinal stromal tumour. The CES achieved speedups in latency up to 2-2.4 compared to the NPS. CONCLUSIONS: Our results hint that if resources distribution is further tailored to fit specific situations, an even greater gain in performance of multiple samples pipelines execution could be achieved. For this to be feasible, a benchmarking of the tools included in the pipeline would be necessary. It is our opinion these benchmarks should be consistently performed by the tools' developers. Finally, these results suggest that concurrent strategies might also lead to energy and cost savings by making feasible the usage of low power machine clusters.


Asunto(s)
Biología Computacional , Secuenciación de Nucleótidos de Alto Rendimiento , Programas Informáticos , Secuenciación del Exoma Completo , Secuenciación de Inmunoprecipitación de Cromatina , Biología Computacional/métodos , Secuenciación del Exoma Completo/normas , Flujo de Trabajo
18.
Int J Oral Maxillofac Implants ; 36(1): Ie1-e6, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600540

RESUMEN

This case report demonstrates the use of dynamic navigation guidance for bone reduction. Information about smile line position incorporated in a virtual plan and accurate transfer to the surgical field enhances the predictability of the treatment. A virtual wax-up was made, and implant positions along with bone reduction were planned accordingly. Residual teeth in the maxilla were extracted, and bone reduction and zygomatic implant placement were assisted by surgical navigation, while conventional implants were placed using the surgical template, followed by immediate loading. When surgical navigation is used for implant placement, navigated bone reduction can easily be incorporated in the workflow. The accuracy of bone reduction was evaluated together with the accuracy of two zygomatic implants assisted by a navigation system and four conventional implants assisted by a static template. The mean deviation between planned and performed bone reduction was 1.3 ± 0.39 mm (range: 0.8 to 1.7 mm). The accuracy of this procedure corresponds to the accuracy of guided implant placement and can be considered reliable after confirmation through clinical trials.


Asunto(s)
Implantes Dentales , Procedimientos Quirúrgicos Reconstructivos , Cirugía Asistida por Computador , Implantación Dental Endoósea , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Flujo de Trabajo
19.
BMC Med Educ ; 21(1): 120, 2021 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-33618711

RESUMEN

BACKGROUND: Undergraduate medical education was severely impacted by the COVID-19 pandemic. As traditional clinical rotations were suspended, medical students quickly began alternative, novel educational experiences. Third-year medical students at an academic medical center were given the opportunity to join inpatient eConsult teams within the department of medicine. This study describes the development and implementation of this program as well as the experiences of student and faculty participants. METHODS: Student eConsult participation was rapidly developed and implemented within medical subspecialty teams in either infectious diseases (ID) or nephrology. Twelve third-year medical students and 15 subspecialty attendings participated in this program during an eight-week period from April 6 through May 29, 2020. Breadth of student clinical experience was assessed via review of clinical documentation and surveys. Participating students and attending physicians completed surveys to reflect upon their impressions of the program. Surveys were returned by nine students and eight faculty members. Survey responses were summarized with descriptive statistics. RESULTS: Over an eight-week period, student consultants wrote 126 notes on 100 patients; 74 of these patients (74%) were hospitalized with COVID-19. Student experiences were largely positive with most strongly agreeing that attendings promoted interactive and engaged learning (N = 8 of 8, 100%), that the experience helped to expand their knowledge about consultant roles (N = 6, 75%), and that they would participate in a remote eConsult program again if given the opportunity (N = 6, 75%). Faculty also were largely positive about the experience with most agreeing or strongly agreeing with the importance of teaching medical students about telehealth (N = 7 of 8, 88%) and eConsults (N = 6, 75%). In narrative responses, students and faculty agreed that teaching was a strength of the program whereas lack of in-person contact was a challenge. CONCLUSIONS: Rapid development of an inpatient eConsult-based educational experience for third-year medical students was feasible and successful. Student-consultants saw a range of pathology including COVID-19 and related complications. Students were satisfied with the program. They were able to develop a strong relationship with attendings while learning about the role of a consultant. Faculty agreed with the importance of teaching students about telehealth and eConsults specifically.


Asunto(s)
/diagnóstico , Derivación y Consulta , Estudiantes de Medicina , Centros Médicos Académicos , Adulto , Curriculum , Educación de Pregrado en Medicina , Femenino , Humanos , Pacientes Internos , Masculino , Ciudad de Nueva York , Flujo de Trabajo , Adulto Joven
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