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1.
Sensors (Basel) ; 21(17)2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34502602

RESUMO

This work presents a novel dc-dc bidirectional buck-boost converter between a battery pack and the inverter to regulate the dc-bus in an electric vehicle (EV) powertrain. The converter is based on the versatile buck-boost converter, which has shown an excellent performance in different fuel cell systems operating in low-voltage and hard-switching applications. Therefore, extending this converter to higher voltage applications such as the EV is a challenging task reported in this work. A high-efficiency step-up/step-down versatile converter can improve the EV powertrain efficiency for an extended range of electric motor (EM) speeds, comprising urban and highway driving cycles while allowing the operation under motoring and regeneration (regenerative brake) conditions. DC-bus voltage regulation is implemented using a digital two-loop control strategy. The inner feedback loop is based on the discrete-time sliding-mode current control (DSMCC) strategy, and for the outer feedback loop, a proportional-integral (PI) control is employed. Both digital control loops and the necessary transition mode strategy are implemented using a digital signal controller TMS320F28377S. The theoretical analysis has been validated on a 400 V 1.6 kW prototype and tested through simulation and an EV powertrain system testing.


Assuntos
Fontes de Energia Elétrica , Eletricidade , Simulação por Computador , Retroalimentação
2.
Sensors (Basel) ; 21(17)2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34502639

RESUMO

In this work, we extend the previously proposed approach of improving mutual perception during human-robot collaboration by communicating the robot's motion intentions and status to a human worker using hand-worn haptic feedback devices. The improvement is presented by introducing spatial tactile feedback, which provides the human worker with more intuitive information about the currently planned robot's trajectory, given its spatial configuration. The enhanced feedback devices communicate directional information through activation of six tactors spatially organised to represent an orthogonal coordinate frame: the vibration activates on the side of the feedback device that is closest to the future path of the robot. To test the effectiveness of the improved human-machine interface, two user studies were prepared and conducted. The first study aimed to quantitatively evaluate the ease of differentiating activation of individual tactors of the notification devices. The second user study aimed to assess the overall usability of the enhanced notification mode for improving human awareness about the planned trajectory of a robot. The results of the first experiment allowed to identify the tactors for which vibration intensity was most often confused by users. The results of the second experiment showed that the enhanced notification system allowed the participants to complete the task faster and, in general, improved user awareness of the robot's movement plan, according to both objective and subjective data. Moreover, the majority of participants (82%) favoured the improved notification system over its previous non-directional version and vision-based inspection.


Assuntos
Robótica , Retroalimentação , Mãos , Humanos , Tato , Interface Usuário-Computador
3.
BMC Med Educ ; 21(1): 486, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34503487

RESUMO

BACKGROUND: Feedback, if effectively provided by the teacher and utilised by the learner, enables improvement in academic performance. It is clear from current literature that the provision of feedback by teachers is not sufficient on its own to guarantee improvements as early university entrants may not be sufficiently equipped to effectively engage with feedback. Nonetheless, it is critical for health professional students to develop feedback literacy early, in order to prepare them for a professional career of lifelong learning and critical thinking. The overarching aim of this study was to identify a feasible, sustainable approach to improve feedback literacy among students on pre-qualifying health professional programmes. METHODS: The study was divided into two phases. A mixed-methods approach grounded in constructivism was employed. Participants included teachers and learners from the School of Allied Health at X University, and two internationally acclaimed educationalists. In phase 1, first year students were encouraged to use an established online platform to upload modular feedback and develop personal learning action plans aimed at improving academic performance. A follow-up survey highlighted poor engagement with this method. Thus, the second phase focused on the co-construction of a suite of modules to develop these skills, supported by academic staff. Interviews were conducted with participants to review and refine this initiative. RESULTS: Learners' engagement with the first phase of the study was poor. Thus, the second phase provided all stakeholders with the opportunity to feed into the development of a suite of modules, designed to encourage teachers and learners to work in partnership to nurture these skills. All stakeholder groups reported short- and long-term benefits with this approach, but also highlighted challenges towards its implementation. CONCLUSION: The development of feedback literacy among health professional learners is essential. The transferability of such skills has been highlighted in the literature and by all stakeholder groups involved in this study. Finding a balance between introducing these skills at a time early enough to highlight their importance among university entrants is challenging. Further balance must be achieved between the workload required to achieve these skills and current programme demands for both teachers and learners.


Assuntos
Aprendizagem , Alfabetização , Retroalimentação , Pessoal de Saúde , Humanos , Estudantes
4.
Chaos ; 31(8): 083128, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34470231

RESUMO

Oscillatory activities in the brain, detected by electroencephalograms, have identified synchronization patterns. These synchronized activities in neurons are related to cognitive processes. Additionally, experimental research studies on neuronal rhythms have shown synchronous oscillations in brain disorders. Mathematical modeling of networks has been used to mimic these neuronal synchronizations. Actually, networks with scale-free properties were identified in some regions of the cortex. In this work, to investigate these brain synchronizations, we focus on neuronal synchronization in a network with coupled scale-free networks. The networks are connected according to a topological organization in the structural cortical regions of the human brain. The neuronal dynamic is given by the Rulkov model, which is a two-dimensional iterated map. The Rulkov neuron can generate quiescence, tonic spiking, and bursting. Depending on the parameters, we identify synchronous behavior among the neurons in the clustered networks. In this work, we aim to suppress the neuronal burst synchronization by the application of an external perturbation as a function of the mean-field of membrane potential. We found that the method we used to suppress synchronization presents better results when compared to the time-delayed feedback method when applied to the same model of the neuronal network.


Assuntos
Modelos Neurológicos , Rede Nervosa , Potenciais de Ação , Retroalimentação , Humanos , Neurônios
5.
Health Res Policy Syst ; 19(Suppl 2): 69, 2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34380516

RESUMO

BACKGROUND: Losing children to follow-up is one of the major barriers identified in Ethiopia's immunization programme. In many urban slum areas like Lideta sub-city, Addis Ababa, several demand- and supply-side factors affect the follow-up visits for routine immunization services, so this study aimed to explore the influence of linkages, a feedback mechanism, and caregiver mobility on immunization follow-up visits. METHODS: The study team employed a qualitative method and conducted 30 in-depth interviews with caregivers, 26 interviews with key informants, and five focus group discussions with health officials and decision-makers. A deductive content and thematic analysis was carried out by importing the transcripts into OpenCodes, applying the a priori codes, and identifying new codes and themes. RESULTS: The linkages among health facilities included those from hospitals to health centres, from hospitals to hospitals, and from health centres to health centres within and outside the sub-city. Using these linkages, most vaccinators transfer caregivers without providing multi-dose vial (MDV) vaccines, mainly bacille Calmette-Guérin (BCG) and measles-containing vaccines (MCV), "to minimize wastage" and thus successfully reduce vaccine wastage rates; yet most caregivers wasted their time, energy, and money travelling from one health facility to another. Despite some efforts to transfer caregivers using "transferal slips" and informal phone calls to vaccinators' friends, unfortunately, there was no formally established system for obtaining feedback about the arrival of caregivers and continuation of the follow-up visits. Overall, the transfer process lacked uniformity, used various approaches, and was not systematic. CONCLUSIONS: Transferal of caregivers for the sake of minimizing wastage of MDV vaccines without checking the vaccination schedules of the receiving health facilities, using various informal types of tools and approaches, along with a poor follow-up and feedback system, were major identified challenges which cost caregivers extra money, energy, and time in getting timely immunization services. Therefore, the Federal Ministry of Health should strengthen the linkages among facilities, ensure the establishment of formal communications by developing guidelines and standardized tools - transferal slips and approaches - and initiate a fast feedback provision system using SMS text messages.


Assuntos
Cuidadores , Vacinação , Criança , Etiópia , Retroalimentação , Seguimentos , Humanos
6.
J Chem Phys ; 155(6): 064102, 2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34391352

RESUMO

The self-assembly of peptides and proteins into amyloid fibrils plays a causative role in a wide range of increasingly common and currently incurable diseases. The molecular mechanisms underlying this process have recently been discovered, prompting the development of drugs that inhibit specific reaction steps as possible treatments for some of these disorders. A crucial part of treatment design is to determine how much drug to give and when to give it, informed by its efficacy and intrinsic toxicity. Since amyloid formation does not proceed at the same pace in different individuals, it is also important that treatment design is informed by local measurements of the extent of protein aggregation. Here, we use stochastic optimal control theory to determine treatment regimens for inhibitory drugs targeting several key reaction steps in protein aggregation, explicitly taking into account variability in the reaction kinetics. We demonstrate how these regimens may be updated "on the fly" as new measurements of the protein aggregate concentration become available, in principle, enabling treatments to be tailored to the individual. We find that treatment timing, duration, and drug dosage all depend strongly on the particular reaction step being targeted. Moreover, for some kinds of inhibitory drugs, the optimal regimen exhibits high sensitivity to stochastic fluctuations. Feedback controls tailored to the individual may therefore substantially increase the effectiveness of future treatments.


Assuntos
Amiloide/antagonistas & inibidores , Amiloide/metabolismo , Retroalimentação , Humanos , Cinética , Agregados Proteicos/efeitos dos fármacos , Processos Estocásticos
8.
MedEdPORTAL ; 17: 11178, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34423125

RESUMO

Introduction: Preoperative assessment is a core competency for internal medicine residents, but one with limited educational resources available presently. Ideally, residencies would provide an introduction to this topic prior to their residents performing preoperative assessments in clinic or during internal medicine consultation rotations. Methods: We developed a 120-minute case-based teaching session on preoperative assessment for PGY 2 residents where they reviewed a series of cases, applied preoperative risk calculators, and made recommendations on medication management using the same online tools they employ while working clinically. Interspersed lecture sections reviewed guiding principles, detailed key trials, and explored nuances of the topic. We performed pre- and posttests of knowledge and also obtained learner feedback. Results: Thirty-three out of 40 participants completed the pre- and posttests. The session was rated highly (M = 4.0 out of 5) and was viewed as preferable to a lecture-based approach (M = 4.4 out of 5); mean participant knowledge improved from 11.7 to 17.5 (p < .001) out of 22 points possible. The most consistently offered feedback was to give more time for the session than the 120 minutes allotted. Discussion: A teaching session mixing lecture with review of composite cases and application of preoperative assessment tools with immediate feedback improved knowledge and was viewed as enjoyable and preferable to lecture alone by participants. We recommend providing more time for the teaching by increasing the session length from 120 minutes to 140 minutes.


Assuntos
Medicina Interna , Internato e Residência , Retroalimentação , Humanos , Medicina Interna/educação
9.
Work ; 69(4): 1217-1227, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34334441

RESUMO

BACKGROUND: The demanding working conditions of teachers make them susceptible to stress. Monitoring temporal changes in recovery and stress may provide a valuable approach for maintaining well-being. OBJECTIVE: This exploratory study followed a two-stage approach aimed at: a) collecting data about the potential effects of holidays on stress in teachers, and b) utilizing these findings to provide tangible feedback to teachers. METHODS: Thirty-seven German teachers completed online questionnaires over six months (eight measurements) which included two holiday periods (Easter break, Summer break). Sociodemographic data regarding recovery and stress were gathered using the Recovery-Stress Questionnaire Work. Interested teachers received individual feedback sessions. RESULTS: The results, inter alia, indicated significant time effects for the dimensions Overall Stress (F(7,119) = 5.31, p < 0.001) and Overall Recovery (F(3.7,67.7) = 4.33, p = 0.004). Significant positive changes were identified over the Summer, but not the Easter break. In the feedback sessions, group-based findings were connected with the individual recovery-stress values. Notable scores were highlighted in a matrix. CONCLUSIONS: This study demonstrates an approach to monitoring and providing group and personalised feedback to raise teachers' awareness and sensitivity of psychological health status in relation to their working environment.


Assuntos
Estresse Ocupacional , Retroalimentação , Humanos , Saúde Mental , Professores Escolares , Inquéritos e Questionários
10.
Artigo em Inglês | MEDLINE | ID: mdl-34444526

RESUMO

Patient-controlled epidural analgesia is widely used to control postoperative pain following major intra-abdominal surgeries. However, determining the optimal infusion dose that can produce effective analgesia while reducing side effects remains a task to be solved. Postoperative pain and adverse effects between variable-rate feedback infusion (VFIM group, n = 36) and conventional fixed-rate basal infusion (CFIM group, n = 36) of fentanyl/ropivacaine-based patient-controlled epidural analgesia were evaluated. In the CFIM group, the basal infusion rate was fixed (5 mL/h), whereas, in the VFIM group, the basal infusion rate was increased by 0.5 mL/h each time a bolus dose was administered and decreased by 0.3 mL/h when a bolus dose was not administered for 2 h. Patients in the VFIM group experienced significantly less pain at one to six hours after surgery than those in the CFIM group. Further, the number of patients who suffered from postoperative nausea was significantly lower in the VFIM group than in the CFIM group until six hours after surgery. The variable-rate feedback infusion mode of patient-controlled epidural analgesia may provide better analgesia accompanied with significantly less nausea in the early postoperative period than the conventional fixed-rate basal infusion mode following open gastrectomy.


Assuntos
Analgesia Epidural , Amidas , Analgésicos Opioides/uso terapêutico , Anestésicos Locais , Retroalimentação , Fentanila , Gastrectomia/efeitos adversos , Humanos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Ropivacaina
11.
Sensors (Basel) ; 21(16)2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34450965

RESUMO

Nowadays, touchscreens have been used worldwide. However, most of them lack realistic haptic feedback. Several haptic feedback devices employ one-dimensional vibration only. We aim at a novel rendering method for direction-controlled 2-dimensional vibration display to present texture information. This paper proposed a rendering method of texture information that enables lateral-force-based 2-dimensional vibration in the X and Y-axis. Moreover, we proposed combining AKAZE image feature information of the textures to improve the fidelity for larger periodic textures. We held experiments to evaluate the fidelity of the proposed method. The result shows that the proposed method has higher fidelity in presenting randomized textures and large periodic textures than the conventional method.


Assuntos
Interface Usuário-Computador , Vibração , Retroalimentação
12.
Sensors (Basel) ; 21(16)2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34451052

RESUMO

The paper develops the adaptive dynamic programming toolbox (ADPT), which is a MATLAB-based software package and computationally solves optimal control problems for continuous-time control-affine systems. The ADPT produces approximate optimal feedback controls by employing the adaptive dynamic programming technique and solving the Hamilton-Jacobi-Bellman equation approximately. A novel implementation method is derived to optimize the memory consumption by the ADPT throughout its execution. The ADPT supports two working modes: model-based mode and model-free mode. In the former mode, the ADPT computes optimal feedback controls provided the system dynamics. In the latter mode, optimal feedback controls are generated from the measurements of system trajectories, without the requirement of knowledge of the system model. Multiple setting options are provided in the ADPT, such that various customized circumstances can be accommodated. Compared to other popular software toolboxes for optimal control, the ADPT features computational precision and time efficiency, which is illustrated with its applications to a highly non-linear satellite attitude control problem.


Assuntos
Redes Neurais de Computação , Dinâmica não Linear , Retroalimentação , Software
13.
BMC Health Serv Res ; 21(1): 891, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34461903

RESUMO

BACKGROUND: Using patient audio recordings of medical visits to provide clinicians with feedback on their attention to patient life context in care planning can improve health care delivery and outcomes, and reduce costs. However, such an initiative can raise concerns across stakeholders about surveillance, intrusiveness and merit. This study examined the perspectives of patients, physicians and other clinical staff, and facility leaders over 3 years at six sites during the implementation of a patient-collected audio quality improvement program designed to improve patient-centered care in a non-threatening manner and with minimal effort required of patients and clinicians. METHODS: Patients were invited during the first and third year to complete exit surveys when they returned their audio recorders following visits, and clinicians to complete surveys annually. Clinicians were invited to participate in focus groups in the first and third years. Facility leaders were interviewed individually during the last 6 months of the study. RESULTS: There were a total of 12 focus groups with 89 participants, and 30 leadership interviews. Two hundred fourteen clinicians and 800 patients completed surveys. In a qualitative analysis of focus group data employing NVivo, clinicians initially expressed concerns that the program could be disruptive and/or burdensome, but these diminished with program exposure and were substantially replaced by an appreciation for the value of low stakes constructive feedback. They were also significantly more confident in the value of the intervention in the final year (p = .008), more likely to agree that leadership supports continuous improvement of patient care and gives feedback on outcomes (p = .02), and at a time that is convenient (p = .04). Patients who volunteered sometimes expressed concerns they were "spying" on their doctors, but most saw it as an opportunity to improve care. Leaders were supportive of the program but not yet prepared to commit to funding it exclusively with facility resources. CONCLUSIONS: A patient-collected audio program can be implemented when it is perceived as safe, not disruptive or burdensome, and as contributing to better health care.


Assuntos
Assistência Centrada no Paciente , Melhoria de Qualidade , Atenção à Saúde , Retroalimentação , Humanos , Liderança
14.
Percept Mot Skills ; 128(5): 2381-2397, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34338053

RESUMO

The purpose of this study was to compare the relative effects of self-controlled knowledge of results (SCKR) to other KR schedules of varying relative frequency (25%, 50%, and 100% of acquisition trials) on motor skill learning. Participants received basic instructions on the soccer overhead throw and then performed 50 acquisition trials, during which KR was provided according to the assigned schedule, followed by a retention test, during which no KR was provided. Retention scores were highest for the SCKR and 50% KR frequency groups who shared comparable absolute KR frequency and distribution relative to successful versus unsuccessful trials. These results indicated that both self-control and moderate frequency feedback enhanced learning, supporting an inverted U-shaped effect of feedback frequency on skill acquisition.


Assuntos
Conhecimento Psicológico de Resultados , Autocontrole , Retroalimentação , Retroalimentação Psicológica , Humanos , Destreza Motora
15.
Percept Mot Skills ; 128(5): 2398-2414, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34340632

RESUMO

This study investigated the impact of mental fatigue and self-controlled versus yoked feedback on learning a force production task. We randomly assigned 44 non-athlete male students (Mage = 21.4, SD = 1.4 years) to four groups; (a) MF&SCF = mental fatigue & self-controlled feedback, (b) MF&Y = mental fatigue & yoked, (c) NMF&SCF = no mental fatigue & self-controlled feedback, and (d) NMF&Y = no mental fatigue & yoked). SCF group participants were provided feedback whenever they requested it, while YK group participants received feedback according to a schedule created by their SCF counterparts. To induce mental fatigue, participants performed a Stroop color-word task for one hour. During the acquisition (practice) phase, participants were asked to produce a given percentage of their maximum force (20%) in 12 blocks of six trials. We recorded the participants' absolute error at the end of the acquisition phase, the immediate retention test, the first transfer test, and the second transfer test (after 24 hours and without any further mental fatigue). The acquisition phase data were analyzed in a 2 (feedback) × 2 (mental fatigue) × 12 (block) ANOVA with repeated measures on the last factor, while the retention and transfer data were analyzed in 2 (feedback) × 2 (mental fatigue) ANOVAs. We found that all four groups made significant progress during practice (p < .001), but there were no significant group differences during this phase (p>.05). There was a significant interaction effect of self-controlled feedback and mental fatigue at retention (p = .018) and transfer testing (p < .001). In the mental fatigue condition, participants in the self-controlled group had poorer learning compared to participants in the yoked group; but when not mentally fatigued, participants in the self-controlled group had better learning than those in the yoked group. These findings suggest that mental fatigue reduces typical advantages of self-controlled feedback in motor learning.


Assuntos
Aprendizagem , Destreza Motora , Retroalimentação , Retroalimentação Psicológica , Humanos , Masculino , Fadiga Mental
16.
Artigo em Inglês | MEDLINE | ID: mdl-34360267

RESUMO

BACKGROUND: General practitioners (GPs) in developed countries widely prescribe benzodiazepines (BZDs) for their anxiolytic, hypnotic, and muscle-relaxant effects. Treatment duration, however, is rarely limited, and this results in a significant number of chronic users. Long-term BZD use is associated with cognitive impairment, falls with hip fractures, traffic accidents, and increased mortality. The BENZORED IV trial was a hybrid type-1 trial conducted to evaluate the effectiveness and implementation of an intervention to reduce BZD prescription in primary care. The purpose of this qualitative study was to analyze the facilitators and barriers regarding the implementation of the intervention in primary care settings. METHODS: A qualitative interview study with 40 GPs from three Spanish health districts. Focus group meetings with GPs from the intervention arm of the BENZORED IV trial were held at primary healthcare centers in the three districts. For sampling purposes, the GPs were classified as high or low implementers according to the success of the intervention measured at 12 months. The Consolidated Framework for Implementation Research (CFIR) was used to conduct the meetings and to code, rate, and analyze the data. RESULTS: Three of the 41 CFIR constructs strongly distinguished between high and low implementers: the complexity of the intervention, the individual Stage of Change, and the key stakeholder's engagement. Seven constructs weakly discriminated between the two groups: adaptability in the intervention, external policy and incentives, implementation climate, relative priority, self-efficacy, compatibility, and engaging a formally appointed implementation leader. Fourteen constructs did not discriminate between the two groups, six had insufficient data for evaluation, and eleven had no data for evaluation. CONCLUSIONS: We identified constructs that could explain differences in the efficacy in implementation of the intervention. This information is relevant for the design of successful strategies for implementation of the intervention.


Assuntos
Clínicos Gerais , Benzodiazepinas , Retroalimentação , Humanos , Prescrições , Atenção Primária à Saúde
17.
Artigo em Inglês | MEDLINE | ID: mdl-34360379

RESUMO

Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.


Assuntos
Reanimação Cardiopulmonar , Criança , Retroalimentação , Retroalimentação Sensorial , Humanos , Manequins , Pressão
18.
Sensors (Basel) ; 21(15)2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34372409

RESUMO

Considerable research and surveys indicate that skin lesions are an early symptom of skin cancer. Segmentation of skin lesions is still a hot research topic. Dermatological datasets in skin lesion segmentation tasks generated a large number of parameters when data augmented, limiting the application of smart assisted medicine in real life. Hence, this paper proposes an effective feedback attention network (FAC-Net). The network is equipped with the feedback fusion block (FFB) and the attention mechanism block (AMB), through the combination of these two modules, we can obtain richer and more specific feature mapping without data enhancement. Numerous experimental tests were given by us on public datasets (ISIC2018, ISBI2017, ISBI2016), and a good deal of metrics like the Jaccard index (JA) and Dice coefficient (DC) were used to evaluate the results of segmentation. On the ISIC2018 dataset, we obtained results for DC equal to 91.19% and JA equal to 83.99%, compared with the based network. The results of these two main metrics were improved by more than 1%. In addition, the metrics were also improved in the other two datasets. It can be demonstrated through experiments that without any enhancements of the datasets, our lightweight model can achieve better segmentation performance than most deep learning architectures.


Assuntos
Dermatopatias , Neoplasias Cutâneas , Retroalimentação , Humanos , Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Manejo de Espécimes
19.
BMC Health Serv Res ; 21(1): 800, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384410

RESUMO

BACKGROUND: In many healthcare systems, physicians are accustomed to periodically participate in individual performance appraisals to guide their professional development. For the purpose of revalidation, or maintenance of certification, they need to demonstrate that they have engaged with the outcomes of these appraisals. The combination of taking ownership in professional development and meeting accountability requirements may cause undesirable interference of purposes. To support physicians in their professional development, new Dutch legislation requires that they discuss their performance data with a non-hierarchical (peer)coach and draft a personal development plan. In this study, we report on the design of this system for performance appraisal in a Dutch academic medical center. METHODS: Using a design-based research approach, a hospital-based research group had the lead in drafting and implementing a performance appraisal protocol, selecting a multisource feedback tool, co-developing and piloting a coaching approach, implementing a planning tool, recruiting peer coaches and facilitating their training and peer group debriefings. RESULTS: The system consisted of a two-hour peer-to-peer conversation based on the principles of appreciative inquiry and solution-focused coaching. Sessions were rated as highly motivating, development-oriented, concrete and valuable. Peer coaches were considered suitable, although occasionally physicians preferred a professional coach because of their expertise. The system honored both accountability and professional development purposes. By integrating the performance appraisal system with an already existing internal performance system, physicians were enabled to openly and safely discuss their professional development with a peer, while also being supported by their superior in their self-defined developmental goals. Although the peer-to-peer conversation was mandatory and participation in the process was documented, it was up to the physician whether or not to share its results with others, including their superior. CONCLUSIONS: In the context of mandatory revalidation, professional development can be supported when the appraisal process involves three characteristics: the appraisal process is appreciative and explores developmental opportunities; coaches are trustworthy and skilled; and the physician has control over the disclosure of the appraisal output. Although the peer-to-peer conversations were positively evaluated, the effects on physicians' professional development have yet to be investigated in longitudinal research designs.


Assuntos
Tutoria , Médicos , Certificação , Competência Clínica , Avaliação de Desempenho Profissional , Retroalimentação , Humanos , Responsabilidade Social
20.
BMC Med Educ ; 21(1): 426, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384418

RESUMO

BACKGROUND: Peer review in Team-based learning (TBL) exists for three key reasons: to promote reflection on individual behaviours; provide opportunities to develop professional skills; and prevent 'free riders' who fail to contribute effectively to team discussions. A well-developed process that engages students is needed. However, evidence suggests it remains a difficult task to effectively incorporate into TBL. The purpose of this study was to assess medical students' ability to provide written feedback to their peers in TBL, and to explore students' perception of the process, using the conceptual framework of Biggs '3P model'. METHODS: Year 2 students (n = 255) participated in peer review twice during 2019. We evaluated the quality of feedback using a theoretically derived rubric, and undertook a qualitative analysis of focus group data to seek explanations for feedback behaviors. RESULTS: Students demonstrated reasonable ability to provide positive feedback, but were less prepared to identify areas for improvement. Their ability did not improve over time, and was influenced by the perceived task difficulty; social discomfort; and sense of responsibility in providing written feedback. CONCLUSIONS: To increase student engagement, we require a transparent process that incorporates verbal feedback and team discussion, with monitoring of outcomes by faculty and adequate training.


Assuntos
Alfabetização , Estudantes de Medicina , Retroalimentação , Humanos , Grupo Associado , Revisão por Pares , Aprendizagem Baseada em Problemas
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