Aim: The aim of this study was to understand the impact of an active meditation protocol on heart rate variability (HRV) and mood in women as compared to breath-focused silence meditation. Materials ...and Methods: Women experienced two different practices of 20 min each: (a) control group: silence meditation focusing on breath and (b) experiment group: active meditation that included four activities, each lasting for 5 minutes - (1) simple humming, (2) coherent heart-focused breathing with 5s of inhalation and 5s of exhalation, (3) coherent heart-focused breathing while invoking positive emotions, and (4) guided imagery about a preidentified goal. The silence meditation encouraged women to only focus on the breath. The Positive and Negative Affect Scale measured mood before/after the practice (n = 24), and emWavePro device measured HRV parameters for 5 min before/after the practices (n = 18). Statistical data analysis was done using a paired t-test. Results: HRV (specifically, parasympathetic nervous system PNS) parameters showed a statistically significant improvement in the experiment group as compared to the control group. There was a statistically significant reduction in negative affect after both the practices, and the increase in positive affect was observed only for the experiment group. Conclusions: The active meditation provides a significant enhancement in mood and HRV parameters related to PNS as compared to silence meditation where the changes in HRV were not consistent and the positive mood did not increase significantly. Future research in this area could explore the impact of such practice for a longer duration and understand the impact of each component of the meditative practices.
Notion: A New Way to Learn Residency Sathe, Tejas S; Shah, Meghal
Journal of the American College of Surgeons,
11/2022, Letnik:
235, Številka:
5
Journal Article
Surgeons are predisposed to neck pain due to the need to look down while operating for prolonged periods of time, and this problem is further magnified in the population of surgeons who utilize ...loupes.1,2 Loupes are additional lenses mounted onto prescription or nonprescription glasses (Fig. 1). The trainee holds their thumbs at the estimated working height, and the representative takes a series of measurements. Since trainees are fitted for loupes before they have significant experience performing loupe-requiring operations, they often do not know the correct working height or optimal posture. Use an unused or simulated OR for the time period of the fitting and ensure that there are step stools and a height adjustable table available to make the event accessible to trainees of varying heights.3 Simulate the activity The working distance, or focal length, of loupes falls in a narrow range, so they will force the wearer into whatever position achieves that focus. Additional postural recommendations, such as optimal table height, are available in resources such as the Surgical Ergonomic Recommendations Guidebook by the American College of Surgeons (ACS), the Society of Surgical Ergonomics, and the Surgical Ergonomics module on the Surgical Council on Resident Education (SCORE) platform.9,105 Recommendations on loupes When choosing loupes, opt for the lightest weight frames.
Profunda femoris artery aneurysms (PFAA) account for less than 0.5% of peripheral aneurysms. Most PFAA are secondary to trauma, iatrogenic injury, or infection, whereas the incidence of true ...atherosclerotic aneurysms is especially rare. These aneurysms are typically asymptomatic but can cause nerve compression, deep vein thrombosis, pain, swelling, and even rupture. We present a case of bilateral PFAA in conjunction with bilateral popliteal artery aneurysms in which the patient had rare unilateral symptoms involving calf ulcerations suggestive of geniculate emboli. We explore this unusual presentation and etiology as well as discuss the options for repair of complex PFAA.
Epilepsy is one of the most common neurological disorders, yet its global surgical burden has yet to be characterized. The authors sought to compile the most current epidemiological data to quantify ...global prevalence and incidence, and estimate global surgically treatable epilepsy. Understanding regional and global epilepsy trends and potential surgical volume is crucial for future policy efforts and resource allocation.
The authors performed a systematic literature review and meta-analysis to determine the global incidence, lifetime prevalence, and active prevalence of epilepsy; to estimate surgically treatable epilepsy volume; and to evaluate regional trends by WHO regions and World Bank income levels. Data were extracted from all population-based studies with prespecified methodological quality across all countries and demographics, performed between 1990 and 2016 and indexed on PubMed, EMBASE, and Cochrane. The current and annual new case volumes for surgically treatable epilepsy were derived from global epilepsy prevalence and incidence.
This systematic review yielded 167 articles, across all WHO regions and income levels. Meta-analysis showed a raw global prevalence of lifetime epilepsy of 1099 per 100,000 people, whereas active epilepsy prevalence is slightly lower at 690 per 100,000 people. Global incidence was found to be 62 cases per 100,000 person-years. The meta-analysis predicted 4.6 million new cases of epilepsy annually worldwide, a prevalence of 51.7 million active epilepsy cases, and 82.3 million people with any lifetime epilepsy diagnosis. Differences across WHO regions and country incomes were significant. The authors estimate that currently 10.1 million patients with epilepsy may be surgical treatment candidates, and 1.4 million new surgically treatable epilepsy cases arise annually. The highest prevalences are found in Africa and Latin America, although the highest incidences are reported in the Middle East and Latin America. These regions are primarily low- and middle-income countries; as expected, the highest disease burden falls disproportionately on regions with the fewest healthcare resources.
Understanding of the global epilepsy burden has evolved as more regions have been studied. This up-to-date worldwide analysis provides the first estimate of surgical epilepsy volume and an updated comprehensive overview of current epidemiological trends. The disproportionate burden of epilepsy on low- and middle-income countries will require targeted diagnostic and treatment efforts to reduce the global disparities in care and cost. Quantifying global epilepsy provides the first step toward restructuring the allocation of healthcare resources as part of global healthcare system strengthening.
Here, the authors examined the factors involved in the volumetric progression of traumatic brain contusions. The variables significant in this progression are identified, and the expansion rate of a ...brain bleed can now effectively be predicted given the presenting characteristics of the patient.
The American Board of Surgery is transitioning from a volume-based to a competency-based assessment of residents using Entrustable Professional Activities. This form of feedback and evaluation should ...also apply to operative procedures to help residents track their own progress. We describe an operative readiness tool that measures perceived competency in trainees across several operative, procedural, and clinical activities.
We distributed a survey to General Surgery trainees at our institution. Participants were asked to rate their level of comfort in 28 operative, procedural, or clinical activities using the standard Entrustable Professional Activity scale: (1) Observation Only, (2) Direct Supervision, (3) Indirect Supervision, (4) Unsupervised Practice, or (5) Supervising Others.
43 of 46 residents (93%) responded to the survey. Median perceived comfort level generally increased with post graduate year level across all competencies. Residents reached a median perceived level of “Unsupervised Practice” by post graduate year 5 in 17 of 28 competencies of various complexity levels.
While residents are not expected to achieve an “Unsupervised Practice” comfort level in all competencies, creating a transparent platform for reporting this information provides programs a tool to guide educational quality improvement efforts. In addition, it allows for program directors to have greater resolution into the operative advancement of residents outside of their own specialty. In the future, this tool may be instrumental in the development of national competency standards.
Two-thirds of surgeons report work-related musculoskeletal disorders (WRMD). There is limited data on WRMD symptoms experienced by pregnant surgeons.
We distributed an electronic survey via personal ...contacts to attending and trainee surgeons across six academic institutions to assess the impact of procedural activities and surgical ergonomics (SE) on WRMD symptoms during pregnancy.
Fifty-three respondents were currently or had been pregnant while clinically active, representing 93 total pregnancies. 94.7% reported that symptoms were exacerbated by workplace activities during pregnancy and 13.2% took unplanned time off work as a result. Beyond 24 weeks of pregnancy, 89.2% of respondents continued to operate/perform procedures, 81.7% worked >24-h shifts and 69.9% performed repetitive lifting >50 pounds. No respondents were aware of any institutional pregnancy-specific SE policies.
Procedural activities can exacerbate pain symptoms for the pregnant surgeon. SE best practices during pregnancy warrant further attention.
Coloured dissolved and detrital matter (CDM) forms a significant fraction of the total dissolved organic matter (DOM) in water bodies. It absorbs light strongly in the ultraviolet and blue domains of ...the electromagnetic spectrum. The present study maps CDM absorption of the entire Chilika lagoon, Odisha, India (an optically complex water body) using hyperspectral data of AVIRIS-NG. This study takes advantage of hyperspectral data which use SWIR bands for the estimation of remote sensing reflectance in highly turbid waters of Chilika lagoon (northern sector, which otherwise is masked using standard atmospheric correction schemes). During 24–27 December 2015, we have collected in situ bio-optical data over waters of Chilika lagoon, for studying the distribution of CDM. AVIRIS-NG data have also been acquired synchronous to in situ measurements over the study area. CDM absorption coefficient is retrieved using quasi analytical algorithm and the distribution of CDM is discussed in detail in three different sectors of Chilika lagoon (southern, central, northern) and at the outer channel. The variability of CDM absorption at 412 nm shows that in the north sector of Chilika lagoon, CDM absorption is quite high compared to other sectors (5.5 m−1 with a standard deviation of 0.06 m−1). In the southern sector and at the outer channel it is 1.8 m−1 with a standard deviation of 0.02 m−1 and in the central sector it is 3.76 m−1 with a standard deviation of 0.22 m−1. High CDM in the northern sector is attributed to the inflow of terrestrial organic matter. The advantage of hyperspectral data is that it gives CDM absorption contiguous in the range of 375–425 nm, where the absorption by CDM is strong and away from chlorophyll-a absorption.
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BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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