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1.
J Sports Sci Med ; 23(1): 209-218, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38455427

RESUMO

Recent research has shown more favorable training adaptations for inactive adults when cardiorespiratory fitness (CRF) exercise is prescribed with the use of ventilatory thresholds compared to percentages of heart rate reserve (HRR). However, there is limited research on changes in health-related outcomes with the use of these CRF methods in combination with muscular fitness exercises. The objective of this study was to compare the effectiveness of two training programs for improving CRF, muscular fitness, and cardiometabolic risk factors. Inactive men and women (n=109, aged 49.3±15.5 years) were randomized to a non-exercise control group or one of two exercise training groups. The exercise training groups consisted of 13 weeks of structured exercise with progression using either CRF exercise prescribed with the use of ventilatory thresholds and functional training for muscular fitness (THRESH group) or HRR and traditional muscular fitness training (STND group). After the 13-week protocol, there were significant differences in body weight, body composition, systolic blood pressure, high-density lipoprotein cholesterol (HDL-c), VO2max, 5-repetition maximum (RM) bench press, and 5-RM leg press for both treatment groups compared to the control group after controlling for baseline values. However, the THRESH group had significantly more desirable outcomes for VO2max, 5-RM bench press, 5-RM leg press, body composition, and HDL-c when compared to both the STND and control group. Additionally, the proportion of individuals estimated as likely to respond above 3.5 mL·kg-1·min-1 in VO2max (i.e., the minimal clinically important difference) was 76.4%, 20.8%, and 0.13% for the THRESH, STND, and control groups, respectively. While both exercise programs elicited favorable health-related adaptations after 13 weeks, these results suggest that a personalized program with exercise prescribed based on ventilatory threshold and with the use of functional muscular fitness training may yield greater training adaptations.


Assuntos
Aptidão Cardiorrespiratória , Exercício Físico , Adulto , Feminino , Humanos , Masculino , Aptidão Cardiorrespiratória/fisiologia , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Pessoa de Meia-Idade
2.
BMC Health Serv Res ; 23(1): 601, 2023 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-37291539

RESUMO

BACKGROUND: Risk-appropriate care improves outcomes by ensuring birthing people and infants receive care at a facility prepared to meet their needs. Perinatal regionalization has particular importance in rural areas where pregnant people might not live in a community with a birthing facility or specialty care. Limited research focuses on operationalizing risk-appropriate care in rural and remote settings. Through the implementation of the Centers for Disease Control and Prevention (CDC) Levels of Care Assessment Tool (LOCATe), this study assessed the system of risk-appropriate perinatal care in Montana. METHODS: Primary data was collected from Montana birthing facilities that participated in the CDC LOCATe version 9.2 (collected July 2021 - October 2021). Secondary data included 2021 Montana birth records. All birthing facilities in Montana received an invitation to complete LOCATe. LOCATe collects information on facility staffing, service delivery, drills, and facility-level statistics. We added additional questions on transport. RESULTS: Nearly all (96%) birthing facilities in Montana completed LOCATe (N = 25). The CDC applied its LOCATe algorithm to assign each facility with a level of care that aligns directly with guidelines published by the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG), and Society for Maternal-Fetal Medicine (SMFM). LOCATe-assessed levels for neonatal care ranged from Level I to Level III. Most (68%) facilities LOCATe-assessed at Level I or lower for maternal care. Close to half (40%) self-reported a higher-level of maternal care than their LOCATe-assessed level, indicating that many facilities believe they have greater capacity than outlined in their LOCATe-assessed level. The most common ACOG/SMFM requirements contributing to the maternal care discrepancies were the lack of obstetric ultrasound services and a physician anesthesiologist. CONCLUSIONS: The Montana LOCATe results can drive broader conversations on the staffing and service requirements necessary to provide high-quality obstetric care in low-volume rural hospitals. Montana hospitals often rely on Certified Registered Nurse Anesthetists (CRNA) for anesthesia services and telemedicine to access specialty providers. Integrating a rural health perspective into the national guidelines could enhance the utility of LOCATe to support state strategies to improve the provision of risk-appropriate care.


Assuntos
Serviços de Saúde Materna , Assistência Perinatal , Gravidez , Feminino , Recém-Nascido , Humanos , Criança , Parto , Instalações de Saúde , Políticas
3.
J Neurooncol ; 160(2): 331-339, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36289149

RESUMO

BACKGROUND: Intraoperative magnetic resonance imaging (iMRI) is a useful adjunct for resection of primary malignant brain tumors (MBTs). The aim of our study is to investigate the impact of iMRI on health care utilization in patients who underwent craniotomy for resection of MBTs. MATERIALS AND METHODS: MarketScan database were queried using the ICD-9/10 and CPT 4th edition, from 2008 to 2020. We included patients ≥ 18 years of age who underwent a craniotomy with at-least one year follow-up. Outcomes were length of stay (LOS), discharge disposition, hospital/emergency room (ER) re-admissions, outpatient services, medication refills and corresponding payments. RESULTS: Of 6,640 patients who underwent craniotomy for MBTs, 465 patients (7%) had iMRI used during the procedure with 0.7% per year increase in iMRI use during the study period. Patients without iMRI use had higher complications at index hospitalization compared to those with iMRI use (19% vs. 14%, p = 0.04). There was no difference in the ER admission rates among the patients who underwent surgery with and without iMRI use at 6-months and 1-year after the index procedure. In terms of post-discharge payments, no significant differences were noted among the patients without and with iMRI use at 6-months ($81,107 vs. $ 81,458, p = 0.26) and 1-year ($132,657 vs. $ 118,113, p = 0.12). CONCLUSION: iMRI use during craniotomy for MBT gradually increased during the study period. iMRI did not result in higher payments at index hospitalization, 6-months, and 1-year after the index procedure.


Assuntos
Neoplasias Encefálicas , Monitorização Intraoperatória , Humanos , Monitorização Intraoperatória/métodos , Sobrecarga do Cuidador , Assistência ao Convalescente , Estudos Retrospectivos , Alta do Paciente , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Neoplasias Encefálicas/patologia , Imageamento por Ressonância Magnética/métodos
4.
Cancer Treat Res ; 182: 255-271, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34542887

RESUMO

Cancer patients have unique symptoms from tumor burden and cancer treatments, which affect functional status and quality of life. Reports have shown approximately 65% of cancer patients have at least one functional/rehabilitation need, yet fewer than 10% of these needs get addressed during their cancer journey.


Assuntos
Neoplasias , Medicina Física e Reabilitação , Humanos , Neoplasias/terapia , Modalidades de Fisioterapia , Qualidade de Vida
5.
J Behav Med ; 43(6): 1014-1025, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32451650

RESUMO

We examined whether screen time was associated with cardiometabolic disease (CMD) risk factors in young adults. Ninety-five adults (19.9 ± 11.4 years) self-reported medical and health behavior history, screen time (television viewing, video games and computer games), and dietary intake. Waist circumference, blood pressure, fasting glucose and lipid levels, cardiorespiratory fitness (VO2peak), and body composition were measured. Total sedentary behavior and moderate-to-vigorous physical activity (MVPA) were measured by accelerometer. On average, leisure screen time (2.0 ± 1.6 h day-1) accounted for 24% of total sedentary time (8.4 ± 1.5 h day-1). After adjustment for demographics, smoking, sleep duration, total energy intake, total sedentary time and MVPA, a 1-standard deviation increase in leisure screen time was associated with a 26% higher BMI, 29% higher waist circumference, 25% higher fat mass, 23% higher triglyceride, and 24% lower VO2peak (p < 0.05). Our findings suggest that screen time may contribute to the risk of obesity and CMD in young adults.


Assuntos
Doenças Cardiovasculares , Tempo de Tela , Biomarcadores , Doenças Cardiovasculares/etiologia , Estudos Transversais , Humanos , Atividades de Lazer , Fatores de Risco , Circunferência da Cintura , Adulto Jovem
6.
J Strength Cond Res ; 34(8): 2205-2213, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29461422

RESUMO

Oranchuk, DJ, Mannerberg, JM, Robinson, TL, and Nelson, MC. Eight weeks of strength and power training improves club head speed in collegiate golfers. J Strength Cond Res 34(8): 2205-2213, 2020-Club head speed (CHS) is a major determinant of drive distance, a key component of golf performance. The purpose of this study was to determine the indirect effects of an 8-week strength and power program on CHS. Twelve (6 men, 6 women) NCAA Division II golfers (20.3 ± 1.5 years) randomly assigned to an intervention or control group underwent either a periodized strength and power program consisting of high-load barbell movements or a bodyweight and rotational movement focused resistance training program. Outcomes were CHS, countermovement jump (CMJ) height, and 1RM back squat (BS), power clean (PC), and deadlift (DL). Dependent t-tests were used to assess differences in outcome variables pre-to-post for each group, independent t-tests were used to assess differences between groups, and Pearson correlations were used to assess associations between CHS and outcome variables. On average, the intervention group experienced improvements in all outcome variables except peak CHS (p = 0.60); the control group displayed no changes in any outcome variable except a decrease in average CHS (p = 0.028). Compared with the control group, the intervention group experienced greater improvements in average CHS, BS, PC, and average and peak CMJ height (p ≤ 0.05). Additionally, CHS had large associations with PC (r = 0.70, p = 0.012), BS (r = 0.64, p = 0.025), DL (r = 0.54, p = 0.068) and CMJ (r = 0.73, p = 0.007). These results suggest that improving muscular strength and power by increasing PC, BS, and CMJ is associated with increased CHS in collegiate golfers. Integrating a high-load, barbell-focused strength and power program may be beneficial for improving CHS and indirectly, golf performance.


Assuntos
Desempenho Atlético/fisiologia , Golfe/fisiologia , Força Muscular/fisiologia , Músculo Esquelético/fisiologia , Treinamento Resistido/métodos , Feminino , Cabeça , Humanos , Masculino , Postura , Universidades , Adulto Jovem
7.
BMC Infect Dis ; 19(1): 144, 2019 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-30755177

RESUMO

BACKGROUND: Emerging antimicrobial resistance is a significant threat to human health. However, methods for rapidly diagnosing antimicrobial resistance generally require multi-day culture-based assays. Macrolide efflux gene A, mef(A), provides resistance against erythromycin and azithromycin and is known to be laterally transferred among a wide range of bacterial species. METHODS: We use Recombinase Polymerase Assay (RPA) to detect the antimicrobial resistance gene mef(A) from raw lysates without nucleic acid purification. To validate these results we performed broth dilution assays to assess antimicrobial resistance to erythromycin and ampicillin (a negative control). RESULTS: We validate the detection of mef(A) in raw lysates of Streptococcus pyogenes, S. pneumoniae, S. salivarius, and Enterococcus faecium bacterial lysates within 7-10 min of assay time. We show that detection of mef(A) accurately predicts real antimicrobial resistance assessed by traditional culture methods, and that the assay is robust to high levels of spiked-in non-specific nucleic acid contaminant. The assay was unaffected by single-nucleotide polymorphisms within divergent mef(A) gene sequences, strengthening its utility as a robust diagnostic tool. CONCLUSIONS: This finding opens the door to implementation of rapid genomic diagnostics in a clinical setting, while providing researchers a rapid, cost-effective tool to track antibiotic resistance in both pathogens and commensal strains.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Genes Bacterianos , Macrolídeos/farmacologia , Azitromicina/farmacologia , Eritromicina/farmacologia , Humanos , Testes de Sensibilidade Microbiana/métodos , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pyogenes/efeitos dos fármacos
8.
Oncology ; 95(1): 39-42, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29694955

RESUMO

OBJECTIVE: In this phase II study, we investigate clinical outcomes and tolerability of hypofractionated radiotherapy (HRT) combined with temozolomide (TMZ) to treat elderly patients with glioblastoma (GBM). METHODS: Patients 70 years of age or older with newly diagnosed GBM received HRT to a dose of 34 Gy given in ten fractions over 2 weeks, delivered with concurrent and adjuvant TMZ. RESULTS: In this interim analysis, ten patients were enrolled on trial from 12/1/2015 to 4/5/2017. With a median follow-up of 9 months (range 3-12 months), median progression-free survival (PFS) was 6 months. The median overall survival (OS) has not been reached. Estimated 1-year OS and PFS rates were 53.3 and 44.4%, respectively. All patients completed the full course of RT, with no patients developing grade 3 or higher adverse events from treatment. CONCLUSIONS: The preliminary results of our phase II trial suggest HRT delivered over 2 weeks with concurrent and adjuvant TMZ is well tolerated in elderly patients with GBM without compromising clinical outcomes.


Assuntos
Antineoplásicos Alquilantes/efeitos adversos , Antineoplásicos Alquilantes/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Dacarbazina/análogos & derivados , Glioblastoma/tratamento farmacológico , Glioblastoma/radioterapia , Hipofracionamento da Dose de Radiação , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/mortalidade , Dacarbazina/efeitos adversos , Dacarbazina/uso terapêutico , Progressão da Doença , Intervalo Livre de Doença , Feminino , Glioblastoma/mortalidade , Humanos , Masculino , Qualidade de Vida , Inquéritos e Questionários , Temozolomida
9.
J Neurooncol ; 136(3): 545-553, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29143275

RESUMO

We sought to determine the impact of time to initiation (TTI) of post-operative radiosurgery on clinical outcomes for patients with resected brain metastases and to identify predictors associated with TTI. All patients with resected brain metastases treated with postoperative SRS or fractionated stereotactic radiation therapy (fSRT) from 2012 to 2016 at a single institution were reviewed. TTI was defined as the interval from resection to first day of radiosurgery. Receiver operating characteristic (ROC) curves were used to identify an optimal threshold for TTI with respect to local failure (LF). Survival outcomes were estimated using the Kaplan-Meier method and analyzed using the log-rank test and Cox proportional hazards models. Logistic regression models were used to identify factors associated with ROC-determined TTI covariates. A total of 79 resected lesions from 73 patients were evaluated. An ROC curve of LF and TTI identified an optimal threshold for TTI of 30.5 days, with an area under the curve of 0.637. TTI > 30 days was associated with an increased hazard of LF (HR 4.525, CI 1.239-16.527) but was not significantly associated with survival (HR 1.002, CI 0.547-1.823) or distant brain failure (DBF, HR 1.943, CI 0.989-3.816). Fifteen patients (20.5%) required post-operative inpatient rehabilitation. Post-operative rehabilitation was associated with TTI > 30 days (OR 1.48, CI 1.142-1.922). In our study of resected brain metastases, longer time to initiation of post-operative radiosurgery was associated with increased local failure. Ideally, post-op SRS should be initiated within 30 days of resection if feasible.


Assuntos
Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/terapia , Procedimentos Neurocirúrgicos , Radiocirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/mortalidade , Terapia Combinada/métodos , Fracionamento da Dose de Radiação , Humanos , Pessoa de Meia-Idade , Período Pós-Operatório , Prognóstico , Radiocirurgia/métodos , Tempo para o Tratamento
10.
Nord J Psychiatry ; 69(7): 509-14, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25698304

RESUMO

BACKGROUND: The Body Shape Questionnaire (BSQ) is a widely used self-report measure of body shape dissatisfaction. AIMS: We aimed to establish psychometric properties and report normative data for the Norwegian 14-item BSQ in a clinical and non-clinical sample. METHODS: A total of 423 female students, 267 male students and 49 female inpatients [anorexia nervosa (AN) and subthreshold AN] were administered the BSQ, the Body Checking Questionnaire (BCQ), and the Eating Disorder Examination Questionnaire (EDE-Q). RESULTS: On average, the male and female controls were aged (mean± standard deviation) 20.98 ± 5.68 years and 24.35 ± 9.89 years with mean body mass indexes (BMIs) of 23.34 ± 3.13 and 22.30 ± 3.62 kg/m(2), respectively. Patients were 19.04 ± 3.06 years with a mean BMI of 16.48 ± 1.81. Divergent validity was indicated by significantly (P < 0.001) different means between the patient group versus female controls, 56.80 ± 18.89 and 35.89 ± 15.19, respectively. Cronbach's alpha was satisfactory for all three groups (0.91-0.96), indicating excellent internal consistency. The BSQ correlated significantly (P < 0.001) with the BCQ and EDE-Q, indicating concurrent validity. BMI and BSQ scores did not correlate significantly within the population as a whole. However, when subdividing the sample, higher BMI was associated with higher BSQ scores among females and males within the non-clinical sample. CONCLUSIONS: Our study provides psychometric support for the Norwegian version of the BSQ-14 among a clinical and non-clinical sample of both young men and women.


Assuntos
Anorexia Nervosa/epidemiologia , Anorexia Nervosa/psicologia , Imagem Corporal/psicologia , Índice de Massa Corporal , Tamanho Corporal , Inquéritos e Questionários/normas , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Etnicidade , Feminino , Humanos , Masculino , Noruega/epidemiologia , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Autorrelato , Adulto Jovem
11.
Surgery ; 176(2): 319-323, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38763791

RESUMO

BACKGROUND: Answering calls in the literature, we developed and introduced an evidence-based tool for surgeons facing errors in the operating room: the STOPS framework (stop, talk to you team, obtain help, plan, succeed). The purpose of this research was to assess the impact of presenting this psychological tool on resident coping in the operating room and the related outcome of burnout while examining sex differences. METHODS: In a natural experiment, general surgery residents were invited to attend 2 separate educational conferences regarding coping with errors in the operating room. Three months later, all residents were asked to fill out a survey assessing their coping in the operating room, level of burnout, and demographics. We assessed the impact of the educational intervention by comparing those who attended the coping conferences with those who did not attend. RESULTS: Thirty-five residents responded to the survey (65% response rate, 54% female respondents, 49% junior residents). Our hypothesized moderated mediation model was supported. Sex was found to moderate the impact of the STOPS framework-female residents who attended the coping educational conference reported higher coping self-efficacy, whereas attendance had no statistically significant impact on male levels of coping self-efficacy. In turn, higher coping self-efficacy was associated with lower levels of burnout. CONCLUSION: Our results suggest that there is evidence of efficacy in this instruction-female residents presented this material report higher levels of coping in the operating room compared to those who did not receive the framework. Further, increase in coping ability was associated with reduced levels of burnout for both genders.


Assuntos
Adaptação Psicológica , Esgotamento Profissional , Internato e Residência , Humanos , Feminino , Masculino , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Adulto , Erros Médicos/prevenção & controle , Erros Médicos/psicologia , Cirurgia Geral/educação , Cirurgiões/psicologia , Cirurgiões/educação , Inquéritos e Questionários , Salas Cirúrgicas , Autoeficácia , Fatores Sexuais
12.
Infect Dis Ther ; 13(7): 1683-1701, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38869840

RESUMO

INTRODUCTION: The United States Centers for Disease Control and Prevention (CDC) advises testing individuals for COVID-19 after exposure or if they display symptoms. However, a deeper understanding of demographic factors associated with testing hesitancy is necessary. METHODS: A US nationwide cross-sectional survey of adults with risk factors for developing severe COVID-19 ("high-risk" individuals) was conducted from August 18-September 5, 2023. Objectives included characterizing demographics and attitudes associated with COVID-19 testing. Inverse propensity weighting was used to weight the data to accurately reflect the high-risk adult US population as reflected in IQVIA medical claims data. We describe here the weighted results modeled to characterize demographic factors driving hesitancy. RESULTS: In the weighted sample of 5019 respondents at high risk for severe COVID-19, 58.2% were female, 37.8% were ≥ 65 years old, 77.1% were White, and 13.9% had a postgraduate degree. Overall, 67% were Non-testers (who indicated that they were unlikely or unsure of their likelihood of being tested within the next 6 months); these respondents were significantly more likely than Testers (who indicated a higher probability of testing within 6 months) to be female (60.2 vs. 54.1%; odds ratio [OR] [95% confidence interval (CI)], 1.3 [1.1‒1.4]), aged ≥ 65 years old (41.5 vs. 30.3%; OR [95% CI] compared with ages 18‒34 years, 0.6 [0.5‒0.7]), White (82.1 vs. 66.8%; OR [95% CI], 1.4 [1.1‒1.8]), and to identify as politically conservative (40.9 vs. 18.1%; OR [95% CI], 2.6 [2.3‒2.9]). In contrast, Testers were significantly more likely than Non-testers to have previous experience with COVID-19 testing, infection, or vaccination; greater knowledge regarding COVID-19 and testing; greater healthcare engagement; and concerns about COVID-19. CONCLUSIONS: Older, female, White, rural-dwelling, and politically conservative high-risk adults are the most likely individuals to experience COVID-19 testing hesitancy. Understanding these demographic factors will help guide strategies to improve US testing rates.

13.
Microbiol Resour Announc ; 13(6): e0018224, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38651927

RESUMO

Amabiko is a lytic subcluster BE2 bacteriophage that infects Streptomyces scabiei-a bacterium causing common scab in potatoes. Its 131,414 bp genome has a GC content of 49.5% and contains 245 putative protein-coding genes, 45 tRNAs, and one tmRNA. Amabiko is closely related to Streptomyces bacteriophage MindFlayer (gene content similarity: 86.5%).

14.
J Am Coll Health ; : 1-9, 2023 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-37053593

RESUMO

Objective: To characterize the context, patterns, and correlates of sedentary behavior (SB) in university students. Participants: A total of 95 adults (41% men) enrolled in 34 different undergraduate majors. Methods: SB was assessed by questionnaire and accelerometer. Results: Objective SB and moderate-to-vigorous physical activity (MVPA) accounted for 8.4 ± 1.5 and 1.2 ± 0.5 h·day-1, respectively. Most SB was spent in occupational, leisure, and screen time behaviors, and was accumulated in short bouts of 10 min or longer. Women were more sedentary than men (522.0 ± 80.3 vs. 486.1 ± 91.3 min·day-1, p = 0.03) and engaged in more prolonged bouts of SB. Correlates of SB included female sex, smoking, light activity, MVPA, and markers of obesity, with higher levels of light activity and current smoking the strongest and most consistent correlates of reduced SB. Conclusions: University students engage in high amounts of SB and accumulate most of their SB in short bouts, with differences in patterns of SB between men and women.

15.
J Surg Educ ; 80(12): 1737-1740, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37679289

RESUMO

BACKGROUND AND RATIONALE: Recent research has called for further resident training in coping with errors and adverse events in the operating room. To the best of our knowledge, there currently exists no evidence-based curriculum or training on this topic. MATERIALS AND METHODS: Synthesizing three prior studies on how experienced surgeons react to errors and adverse events, we developed the STOPS framework for handling surgical errors and adverse events (Stop, Talk to your team, Obtain help, Plan, Succeed). This material was presented to residents in two teaching sessions. RESULTS AND CONCLUSION: In this paper, we describe the presentation of, and the uniformly positive resident reaction to, the STOPS framework: an empirically based psychological tool for surgeons who experience operative errors or adverse events.


Assuntos
Internato e Residência , Humanos , Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina/métodos , Adaptação Psicológica
16.
J Surg Educ ; 80(11): 1717-1722, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37596106

RESUMO

OBJECTIVE: Robotically assisted surgery has become more common in general surgery, but there is limited guidance from the Accreditation Council for Graduate Medical Education (ACGME) regarding this type of training. We sought to determine common elements and differences in the robotic educational curricula developed by general surgery residency programs. DESIGN: Robotic educational curricula were obtained from the 7 individuals who presented at the workshop, "Robotic Education in General Surgery" at the 2023 Association of Program Directors in Surgery annual meeting. RESULTS: All 7 general surgery programs had training beginning intern year, required online robotic modules, had at least 1 dedicated simulation training console not used for clinical purposes, and ran dry and wet (tissue) robotic labs at least annually. All programs had bedside and console surgeon case minimums and had administrative support to run the educational programs. Differences existed regarding how training intern year was executed, the simulations required, clinical practice minimum requirements, how progress was monitored over time, and how case numbers were tracked. Some programs had salary support for a director of robotic education. CONCLUSIONS: There are several common elements to robotic educational curricula in general surgery, however significant variation does exist between programs. Given the frequency of robotic use in general surgery and current lack of standardization, formal guidance from the ACGME specifically regarding robotic education in general surgery residency is warranted.


Assuntos
Cirurgia Geral , Internato e Residência , Procedimentos Cirúrgicos Robóticos , Humanos , Procedimentos Cirúrgicos Robóticos/educação , Educação de Pós-Graduação em Medicina , Currículo , Acreditação , Cirurgia Geral/educação
17.
Magn Reson Imaging ; 101: 57-66, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37028608

RESUMO

Alzheimer's disease (AD) has been associated with amyloid and tau pathology, as well as neurodegeneration. Beyond these hallmark features, white matter microstructural abnormalities have been observed using MRI. The objective of this study was to assess grey matter atrophy and white matter microstructural changes in a preclinical mouse model of AD (3xTg-AD) using voxel-based morphometry (VBM) and free-water (FW) diffusion tensor imaging (FW-DTI). Compared to controls, lower grey matter density was observed in the 3xTg-AD model, corresponding to the small clusters in the caudate-putamen, hypothalamus, and cortex. DTI-based fractional anisotropy (FA) was decreased in the 3xTg model, while the FW index was increased. Notably, the largest clusters for both FW-FA and FW index were in the fimbria, with other regions including the anterior commissure, corpus callosum, forebrain septum, and internal capsule. Additionally, the presence of amyloid and tau in the 3xTg model was confirmed with histopathology, with significantly higher levels observed across many regions of the brain. Taken together, these results are consistent with subtle neurodegenerative and white matter microstructural changes in the 3xTg-AD model that manifest as increased FW, decreased FW-FA, and decreased grey matter density.


Assuntos
Doença de Alzheimer , Substância Branca , Camundongos , Animais , Doença de Alzheimer/patologia , Substância Cinzenta/patologia , Imagem de Tensor de Difusão/métodos , Substância Branca/patologia , Encéfalo/patologia , Atrofia/patologia
18.
Transl Anim Sci ; 7(1): txad064, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37601954

RESUMO

Sire selection for beef on dairy crosses plays an important role in livestock systems as it may affect future performance and carcass traits of growing and finishing crossbred cattle. The phenotypic variation found in beef on dairy crosses has raised concerns from meat packers due to animals with dairy-type carcass characteristics. The use of morphometric measurements may help to understand the phenotypic structures of sire progeny for selecting animals with greater performance. In addition, due to the relationship with growth, these measurements could be used to early predict the performance until the transition from dairy farms to sales. The objectives of this study were 1) to evaluate the effect of different beef sires and breeds on the morphometric measurements of crossbred calves including cannon bone (CB), forearm (FA), hip height (HH), face length (FL), face width (FW) and growth performance; and (2) to predict the weight gain from birth to transition from dairy farms to sale (WG) and the body weight at sale (BW) using such morphometric measurements obtained at first days of animals' life. CB, FA, HH, FL, FW, and weight at 7 ±â€…5 d (BW7) (Table 1) were measured on 206 calves, from four different sire breeds [Angus (AN), SimAngus (SA), Simmental (SI), and Limousin (LI)], from five farms. To evaluate the morphometric measurements at the transition from dairy farms to sale and animal performance 91 out of 206 calves sourced from four farms, and offspring of two different sires (AN and SA) were used. To predict the WG and BW, 97 calves, and offspring of three different sires (AN, SA, and LI) were used. The data were analyzed using a mixed model, considering farm and sire as random effects. To predict WG and BW, two linear models (including or not the morphometric measurements) were used, and a leave-one-out cross-validation strategy was used to evaluate their predictive quality. The HH and BW7 were 7.67% and 10.7% higher (P < 0.05) in SA crossbred calves compared to AN, respectively. However, the ADG and adjusted body weight to 120 d were 14.3% and 9.46% greater (P < 0.05) in AN compared to SA. The morphometric measurements improved the model's predictive performance for WG and BW. In conclusion, morphometric measurements at the first days of calves' life can be used to predict animals' performance in beef on dairy. Such a strategy could lead to optimized management decisions and greater profitability in dairy farms.

19.
Microsc Microanal ; 18(1): 134-42, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22214568

RESUMO

Biologically and chemically modified nanoparticles are gaining much attention as a new tool in cancer detection and treatment. Herein, we demonstrate that an alizarin red S (ARS) dye coating on TiO2 nanoparticles enables visible light activation of the nanoparticles leading to degradation of neighboring biological structures through localized production of reactive oxygen species. Successful coating of nanoparticles with dye is demonstrated through sedimentation, spectrophotometry, and gel electrophoresis techniques. Using gel electrophoresis, we demonstrate that visible light activation of dye-TiO2 nanoparticles leads to degradation of plasmid DNA in vitro. Alterations in integrity and distribution of nuclear membrane associated proteins were detected via fluorescence confocal microscopy in HeLa cells exposed to perinuclear localized ARS-TiO2 nanoparticles that were photoactivated with visible light. This study expands upon previous studies that indicated dye coatings on TiO2 nanoparticles can serve to enhance imaging, by clearly showing that dye coatings on TiO2 nanoparticles can also enhance the photoreactivity of TiO2 nanoparticles by allowing visible light activation. The findings of our study suggest a therapeutic application of dye-coated TiO2 nanoparticles in cancer research; however, at the same time they may reveal limitations on the use of dye assisted visualization of TiO2 nanoparticles in live-cell imaging.


Assuntos
Antineoplásicos/química , Antineoplásicos/farmacologia , Materiais Revestidos Biocompatíveis , Corantes/metabolismo , Nanopartículas , Titânio/química , Titânio/farmacologia , Células HeLa , Humanos , Luz , Fotoquímica , Plasmídeos , Espécies Reativas de Oxigênio/metabolismo , Espécies Reativas de Oxigênio/toxicidade
20.
J Adolesc ; 35(1): 11-20, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21782233

RESUMO

This study investigated whether major depression in adolescence is characterized by neurocognitive deficits in attention, affective decision making, and cognitive control of emotion processing. Neuropsychological tests including the Wechsler Abbreviated Scale of Intelligence, the Continuous Performance Test-Identical Pairs, the Attention Network Test, the Iowa Gambling Task, the Emotional Go-NoGo Task, and the Face Go-NoGo Task were administered to adolescents with Major Depressive Disorder (MDD) (n = 31) and psychiatric diagnosis free controls (n = 30). Findings indicated that compared with controls, depressed adolescents exhibited impaired sustained attention; a gender by group interaction on affective decision making such that depressed males tended to make less advantageous choices on the IGT; and an inverse pattern of correlations between depressive symptom counts and reaction time to affective stimuli, characterizing greater affective reactivity in depressed adolescents. Findings demonstrate that adolescents with MDD display selective neurocognitive impairments on tasks capturing 'cool' and 'hot' executive functioning.


Assuntos
Transtornos Cognitivos/complicações , Transtorno Depressivo Maior/complicações , Adolescente , Atenção , Tomada de Decisões , Transtorno Depressivo Maior/psicologia , Função Executiva , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Adulto Jovem
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