633 research outputs found

    Obstetrics Emergency Labor and Delivery Case Simulations with Normal Vaginal Delivery Demonstration: A Hands-on Simulation for Clerkship Students

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    Introduction: Simulation is rarely used for medical student education in the field of obstetrics. This method is an effective model of learning for topics that are encountered in clinical situations and for topics that pose significant risk to patients when an untrained individual is involved. Methods: A 2-hour obstetric delivery simulation session was developed and incorporated into the third-year obstetrics and gynecology clerkship rotation at Wright State University Boonshoft School of Medicine. Medical students completed self-guided content reviews with resources provided prior to the session. During the session, each medical student conducted a normal vaginal delivery and one of the emergent cases (umbilical cord prolapse, pre-eclampsia/eclampsia, shoulder dystocia, and postpartum hemorrhage). During each case the Resident facilitator followed a script which included asking questions using gamification strategies to promote a low-stress learning environment. Critical action checklists were used to ensure students gained a strong understanding of topics. Simulation sessions were conducted both remotely and in-person. The simulation experience was evaluated using surveys and quizzes completed prior to and after participating in the simulation session. Results: Students reported that the simulation experience increased their comfort with emergent obstetric situations, increased their medical knowledge, and was beneficial to their education. Discussion: Simulation is an untapped learning method in obstetrics. We developed simulations for obstetric events to provide medical students with hands-on exposure to important obstetric experiences. This simulation session provides the framework for other medical schools to incorporate these obstetric simulations into their clerkship curriculum

    Patient Self-Testing of Kidney Function at Home, a Prospective Clinical Feasibility Study in Kidney Transplant Recipients

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    IntroductionPeople with long-term health conditions often attend clinics for kidney function tests. The Self-Testing Own Kidneys (STOK) study assessed feasibility of kidney transplant recipients using hand-held devices to self-test kidney function at home and investigated agreement between home self-test and standard clinic test results.MethodsA prospective, observational, single-center, clinical feasibility study (TRN: ISRCTN68116915), with N = 15 stable kidney transplant recipients, investigated blood potassium and creatinine results agreement between index self-tests at home (patient self-testing of capillary blood, using Abbott i-STAT Alinity analyzers [i-STAT]) and reference tests in clinic (staff sampled venous blood, analyzed with laboratory Siemens Advia Chemistry XPT analyzer) using Bland-Altman and error grid analysis.ResultsThe mean within-patient difference between index and reference test in creatinine was 2.25 ╬╝mol/l (95% confidence interval [CI]: Ôłĺ12.13, 16.81 ╬╝mol/l) and in potassium was 0.66 mmol/l (95% CI: Ôłĺ1.47, 2.79 mmol/l). All creatinine pairs and 27 of 40 (67.5%) potassium pairs were judged clinically equivalent. Planned follow-up analysis suggests that biochemical variables associated with potassium measurement in capillary blood were predominant sources of paired test result differences. Paired patient and nurse i-STAT capillary blood test potassium results were not statistically significantly different.ConclusionsThis small feasibility study observed that training selected patients to competently use hand-held devices to self-test kidney function at home is possible. Self-test creatinine results showed good analytical and clinical agreement with standard clinic test results. Self-test potassium results showed poorer agreement with standard clinic test results; however, patient use of hand-held devices to self-test at home was not a statistically significant source of paired potassium test result differences

    Prospectus, November 9, 1973

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    FORD - OUR NEXT PRESIDENT?; Faculty, Staff Evaluations Adopted As College Policy; Fellowships For Women Announced; Student Senate Vice-President Resigns Post; Debaters Take Third At IVC Meet; Vandalism Suspected In Fire; Parkland To Participate In Conference; Declaration Of Impeachment; Prospectus In Perspective; Letters From Our Readers; Student Opinion Survey; President\u27s Comment; The Short Circuit; Behind The Books; Counselors And Question Marks; Zindars Shares Her Experiences; $6 Bid Tops In Vets Dance, Slave-Auction; UFO\u27s: Citizens Vs. Air Force; The Pinkertons Are At Parkland; Allied Health Program; November Student Activities Parkland College; American Assoc. Of Univ. Women Host General Meeting Nov. 11; Peterson Addresses Phi Beta Lambda; PLATO Popular With Students, Teachers; Cycle Mishap Injures One; Road Rally; Mutt and Mortie; Evening Program Diversified Next Quarter At P/C; Geology Flight Delayed; Final Exam Schedule - Fall Quarter; Costs At School Dominate P.C.A. Senate Meeting; \u27Passion Play\u27 Not Dull; P/C Gen. Biology-Pollution, Genetics Other Relevant Topics; No Grease-Monkey Graduatess At Parkland; Campus Leaders Exchange Ideas at Allerton Meeting; Parkland Co-Hosts Veterans Conference; TB Examinations; Classified Ads; A Column By And For Women: Originality, The Cell; Monday\u27s Coach; Jim Redman, Jane Hawthorne Grab Parkland\u27s First Road Rally; Football Finals To Be Held Tuesday; Fast Freddy\u27s Football Forecast; WVLJ Plans Broadcasts Of PC Basketball; Thompson Wins Fast Freddy As Upsets Abound; Local Volunteer Suggests Grants; Lost And Found; Earle, Seger Go To N.J.C.A.A. Nationals; Parkland Cagers Start Practice For Nov. 29 Debut With Millikin; Wrestlers Open Workouts, Seven Spots Open On 10-Man Roster; Parkland College Basketball Schedule 1973-74; Parkland College Wrestling Schedule 1973-74; Bowing Bulletin Board; Callboard; Changes In Calendar, Staff Status, Registration Proposed; Cade Re-elected Board Chairmanhttps://spark.parkland.edu/prospectus_1973/1002/thumbnail.jp

    Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care

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    Abstract Background Ventilator-associated pneumonia (VAP) is an important diagnosis in critical care. VAP research is complicated by the lack of agreed diagnostic criteria and reference standard test criteria. Our aim was to review which reference standard tests are used to evaluate novel index tests for suspected VAP. Methods We conducted a comprehensive search using electronic databases and hand reference checks. The Cochrane Library, MEDLINE, CINHAL, EMBASE, and web of science were searched from 2008 until November 2018. All terms related to VAP diagnostics in the intensive treatment unit were used to conduct the search. We adopted a checklist from the critical appraisal skills programme checklist for diagnostic studies to assess the quality of the included studies. Results We identified 2441 records, of which 178 were selected for full-text review. Following methodological examination and quality assessment, 44 studies were included in narrative data synthesis. Thirty-two (72.7%) studies utilised a sole microbiological reference standard; the remaining 12 studies utilised a composite reference standard, nine of which included a mandatory microbiological criterion. Histopathological criteria were optional in four studies but mandatory in none. Conclusions Nearly all reference standards for VAP used in diagnostic test research required some microbiological confirmation of infection, with BAL culture being the most common reference standard used

    Non-culprit MACE-rate in LRP:The influence of optimal medical therapy using DAPT and statins

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    Background/Purpose: The Lipid Rich Plaque (LRP) study demonstrated the association between coronary plaque lipid content and outcomes. In this LRP substudy, we assessed the impact of optimal medical therapy (OMT) on the occurrence of non-culprit major adverse cardiac events (NC-MACE). Advanced intracoronary imaging modalities are able to identify patients with vulnerable coronary lesion morphology associated with future events. Methods/Materials: A total of 1270 patients who underwent cardiac catheterization for suspected coronary artery disease (CAD) with evaluable maxLCBI4mm in non-culprit vessels and known medical therapy after discharge were followed for 2 years. OMT was defined as the use of a statin and dual antiplatelet therapy (DAPT). Results: Among the 1270 patients included in this substudy, 1110 (87.7%) had PCI for an index event, and 1014 (80%) patients received OMT. Estimated cumulative incidence functions of NC-MACE did not differ significantly between patients treated with or without OMT (log-rank p-value = 0.876). In patients labeled high risk (maxLCBI4mm > 400), cumulative incidence function also did not differ between patients treated with vs without OMT (log-rank p-value = 0.19). Conclusions: In the current LRP analysis, we could not identify a beneficial effect of OMT in the reduction of NC-MACE rate, even in patients with high-risk plaques during 24-month follow-up

    Chandra observations and classification of AGN-candidates correlated with Auger UHECRs

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    We report on Chandra X-ray observations of possible-AGNs which have been correlated with Ultra-high Energy Cosmic Rays (UHECRs) observed by the Pierre Auger Collaboration. Combining our X-ray observations with optical observations, we conclude that one-third of the 21 Veron-Cetty Veron (VCV) galaxies correlating with UHECRs in the first Auger data-release are actually not AGNs. We review existing optical observations of the 20 VCV galaxies correlating with UHECRs in the second Auger data-release and determine that three of them are not AGNs and two are uncertain. Overall, of the 57 published UHECRs with |b|>10 degrees, 22 or 23 correlate with true AGNs using the Auger correlation parameters. We also measured the X-ray luminosity of ESO139-G12 to complete the determination of the bolometric luminosities of AGNs correlating with UHECRs in the first data-set. Apart from two candidate sources which require further observation, we determined bolometric luminosities for the candidate galaxies of the second dataset. We find that only two of the total of 69 published UHECRs correlate with AGNs (IC5135 and IC4329a) which are powerful enough in their steady-state to accelerate protons to the observed energies of their correlated UHECRs. The GZK expectation is that about 45% of the sources of UHECRs above 60 EeV should be contained within the z<0.018 volume defined by the Auger scan analysis, so an observed level of 30-50% correlation with weak AGNs is compatible with the suggestion that AGNs experience transient high-luminosity states during which they accelerate UHECRs.Comment: ApJ in press; extends and supersedes arXiv:1109.0267. arXiv admin note: substantial text overlap with arXiv:1109.026

    Inferring cost of transport from whole-body kinematics in three sympatric turtle species with different locomotor habits

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    Chelonians are mechanically unusual vertebrates as an exoskeleton limits their body wall mobility. They generallymove slowly on land and have aquatic or semi-aquatic lifestyles. Somewhat surprisingly, the limitedexperimental work that has been done suggests that their energetic cost of transport (CoT) are relatively low.This study examines the mechanical evidence for CoT in three turtle species that have differing degrees ofterrestrial activity. Our results show that Apolone travels faster than the other two species, and that Chelydra hashigher levels of yaw. All the species show poor mean levels of energy recovery, and, whilst there is considerablevariation, never show the high levels of energy recovery seen in cursorial quadrupeds. The mean mechanical CoTis 2 to 4 times higher than is generally seen in terrestrial animals. We therefore find no mechanical support for alow CoT in these species. This study illustrates the need for research on a wider range of chelonians to discoverwhether there are indeed general trends in mechanical and metabolic energy costs
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