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.
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
Using the ImmunoChip custom genotyping array, we analyzed 14,498 subjects with multiple sclerosis and 24,091 healthy controls for 161,311 autosomal variants and identified 135 potentially associated ...regions (P < 1.0 × 10(-4)). In a replication phase, we combined these data with previous genome-wide association study (GWAS) data from an independent 14,802 subjects with multiple sclerosis and 26,703 healthy controls. In these 80,094 individuals of European ancestry, we identified 48 new susceptibility variants (P < 5.0 × 10(-8)), 3 of which we found after conditioning on previously identified variants. Thus, there are now 110 established multiple sclerosis risk variants at 103 discrete loci outside of the major histocompatibility complex. With high-resolution Bayesian fine mapping, we identified five regions where one variant accounted for more than 50% of the posterior probability of association. This study enhances the catalog of multiple sclerosis risk variants and illustrates the value of fine mapping in the resolution of GWAS signals.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The purpose here is to study the variation in the natural frequency of a material due to damage. Also, compare the shift in Natural Frequency that of a SYP-SP (Sweet Potato) bio-composite to a ...commercial SYP composite. Additionally, the motivation behind the study is to eventually provide biodegradable materials, as petroleum-based products being a finite resource and having more potential to harm the environment. The researcher obtained the Natural Frequencies by Experimental modal analysis using a cantilever beam vibration technique. The shift for the first three natural frequencies for damage induced SYP-SP composite was 10%, 8.6%, and 9.5% and for SYP-Commercial composite was 7.95%, 0.7%, and 0.9% respectively. The undamaged specimens of SYP-SP bio-composite and that of a commercial SYP composite showed behaviour almost on similar lines. Thus, stating the potential use of SYP-SP bio-composite for commercial applications like wood flooring, fencing, and other related applications.
Introduction:
Sickle cell disease (SCD) is one of the commonest autosomal inherited diseases globally. India has high Sickle cell disease burden, presented with very wide clinical phenotypes. Gujarat ...state particularly central and south region of state has a high prevalence of the sickle cell anemia. Though being commonly encountered in this region, there are hardly few large scale studies done on sickle cell anemia and its clinical impact on health. With this background in mind, we did this retrospective analysis of laboratory parameters to understand the correlation of HbA2 values in sickle cell population.
Materials and Methods:
This retrospective analysis of Capillary electrophoresis (CE) or High performance liquid chromatography (HPLC) results of total 30845 sample size was done. Study period June 2013 to June 2017. Investigation carried out at 4 different laboratories was reviewed for analysis of Hemoglobin A2 (HbA2) values in Sickle cell population in the central Gujarat region of India. Hematological indices, Solubility tests, were also taken into considerations. Initially, all the data were reviewed and analyzed separately and then they were compiled together and analyzed. Out of 30845, 28495 results were reviewed. Rests were omitted either due to incomplete data. On capillary electrophoresis 19383 tests were conducted, whereas, 9112 tests were conducted on HPLC.
Result
Out of total 28495 samples, 2327 were sickle positive, 846 had HBS >50% (SCD), 1471 had HBS<50% Sickle cell trait (SCT), 26168 no sickle window. With respect to HbA2 value, we divided them further into 3 groups. Group 1 : HbA2 between 2 - 3.5%, Group 2 : HbA2 more than 3.5% and Group 3:HbA2 less than 2%. Further sub analysis of all the 3 groups was done on the basis of MCV. As we assume that high HbF with HbA2<2% may be associated with δ-β thalassemias and low HbF with HBA2<2% may be associated with α-thalassemia, in group 3, Hb F was also considered in sub analysis. The results of the analysis are as depicted in table.
Conclusion
In this retrospective analytic study we found that SCD can be categorized into 3 groups based on HB A2 value, further sub analysis with respect to MCV and HB F value shows, 644 (75.2%) have probability of having co inheritance of Thalassemia (MCV< 80 FL), remaining 212(24.8%)may be representing homozygous SCD with no co inheritance of α or β or δ-β Thalassemia (MCV>80 FL).As we could not find single sample having HBA2 <2% with HBF(<10%) with low MCV in SCD category, raises possibility are we dealing with δ-β Thalassemia in this study population? These patients require further family studies and molecular study to confirm co-association of Thalassemia.There is high possibility that heterogeneity in clinical presentation of SCD patients found in Gujarat may have correlation with low MCV and variability in A2 value (indirect evidence of underlying co-inheritance of Thalassemia). Prospective large cohort study is required to document clinico-pathological correlation.
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No relevant conflicts of interest to declare.
There are many question-answer forum but still when a user wants an answer to his/her question, posting it on the forum or manually searching the answer on the forum is a tedious task. Also, when it ...comes to searching for the answer that a user wants, make it even more difficult. On top of that, every other person can form the similar meaning question differently and if that question isn't present in the forum it will add it and may create redundancy in the database and also on the forum. So, our proposed system which not only will remove the redundancy of the similar meaning question but also will rank the answer based on like and comments. We also added various features like bookmark the answer a user likes and also send those question and answer to the user via e-mail. Above all, we are also helping the user to get a recommendation based on the user activity. The system is a domain specific. So, we will be using three domain of 1. Programming Languages 2. Higher Studies 3. In-Car Assistance for the question-answer forum and the date i.e. questions and answers to them will be created dynamically.
The requirement engineering phase of Software Engineering (SE) deals with various activities starting from customer interaction to specifications of the requirements for the designing initiative. ...Now-a-days security, privacy and trustworthiness have become additional set of crucial requirements in view of the fact that software is vulnerable to various attacks. Many existing paradigms of SE deal with requirements, but less attention has been paid to address the issues of security, privacy and trust implementations. In practice, major attention is given to incorporate security aspects during coding and testing phases. Some paradigms address these issues, but they consider either security or privacy or trust requirements but not all of them together. We believe that security, privacy and trust requirements must be well collected, analyzed and specified through various stages of Requirement Engineering (RE) itself. This paper attempts to model RE activities incorporating security, privacy and trust requirements in effective way during all sub stages of RE phase. The activities of requirements modeling are well detailed and supported with case study of an online examination system of higher education (like University).
Heterocyclic arynes, or hetarynes, have been studied for over 100 years. However, challenges associated with observing these reactive species, as well as developing synthetically useful methods for ...their generation and trapping, have limited their use. This review provides a brief historical perspective on the field of hetarynes, in addition to a discussion of pyridyne and indolyne methodologies. Moreover, this review highlights the use of pyridynes, indolynes, and related strained intermediates in natural product synthesis.
This feature article showcases the use of pyridynes and indolynes to construct functionalized heterocycles and complex natural products.
Objectives: The objectives of the study were to compare the performance of students in written tests on a topics taught by didactic lecture (DL) and case-based learning (CBL) supplemented with ...patients' laboratory reports (LR), and to assess students' perception on the usefulness of CBL supplemented with LR. Methodology: After prior ethical approval, total 60 1st MBBS students were enrolled voluntarily and written informed consent were obtained. They were divided into two groups: Group A (30) and B (30) by lottery method. Two topics were selected for learning sessions. The study process for topic-1 included pre-test for all students, DL session for Gr-A and CBL supplemented with LR session for Gr-B on selected topic followed by the post-test after one week. Crossover was done for Topic-2. Paired and unpaired (independent) t-tests were used to compare pretest and post-test results within the groups and across the groups respectively. Perception of students' was taken on five-point Likert scale. Data were analysed by using SPSS software. The p<0.05 was considered as statistically significant. Results: Statistically significant difference was observed in pre and post-tests performance of students for topics taught by CBL with LR method than DL (p<0.0001). 100% students felt that CBL supplemented with LR method was very helpful, interesting and improved their interpretation skills. Conclusions: CBL supplemented with LR proved to be a very good student-centric teaching-learning method in Biochemistry as students who exposed to CBL supplemented with LR had better understanding of Biochemistry and performed better in written tests. Keywords : Case-based learning, Laboratory Reports, Didactic lecture
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