International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) - the propagation of knowledge in ultrasound for the improvement of OB/GYN care worldwide: experience of basic ultrasound training in Oman.

BACKGROUND: The aim of this study is to evaluate effectiveness of a new ISUOG (International Society of Ultrasound in Obstetrics and Gynecology) Outreach Teaching and Training Program delivered in Muscat, Oman. METHODS: Quantitative assessments to evaluate knowledge and practical skills were administered before and after an ultrasound course for sonologists attending the ISUOG Outreach Course, which took place in November, 2017, in Oman. Trainees were selected from each region of the country following a national vetting process conducted by the Oman Ministry of Health. Twenty-eight of the participants were included in the analysis. Pre- and post-training practical and theoretical scores were evaluated and compared. RESULTS: Participants achieved statistically significant improvements, on average by 47% (p < 0.001), in both theoretical knowledge and practical skills. Specifically, the mean score in the theoretical knowledge test significantly increased from 55.6% (± 14.0%) to 81.6% (± 8.2%), while in the practical test, the mean score increased from 44.6% (± 19.5%) to 65.7% (± 23.0%) (p < 0.001). Performance was improved post-course among 27/28 participants (96.4%) in the theoretical test (range: 14 to 200%) and among 24/28 (85.7%) trainees in the practical skills test (range: 5 to 217%). CONCLUSION: Application of the ISUOG Basic Training Curriculum and Outreach Teaching and Training Course improved the theoretical knowledge and practical skills of local health personnel. Long-term re-evaluation is, however, considered imperative to ascertain and ensure knowledge retention

Fetal Myocardial Performance Index in the Third Trimester of Pregnancy: Feasibility and Reproducibility of Conventional Spectral Doppler versus Spectral Tissue Doppler Technique

Objective: This study aims to compare completion rates and reproducibility of myocardial performance index (MPI) using conventional spectral Doppler versus tissue Doppler in an unselected high-risk third trimester population. Study Design: This was a prospective cross-sectional study of high-risk pregnancies at ≥28 + 0 weeks’ gestation. Conventional spectral and tissue Doppler MPI of the left ventricle (LV) and right ventricle (RV) was attempted on all patients. Results: Seventy-nine pregnancies were evaluated. LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (63/79, 79.7% vs. 45/79, 55.7%), p-value Conclusion: Tissue Doppler had statistically higher completion rates than conventional spectral Doppler, including the obese subgroup, with evidence of strong reproducibility in the third trimester

The effect of transurethral resection of the prostate on erectile and ejaculatory functions in patients with benign prostatic hyperplasia

Introduction: The aim of this study was to investigate the effect of TURP on erectile function (EF) and ejaculatory function (EJF). Methods: A total of 91 patients who underwent TURP were retrospectively assessed. Patients were divided into two groups based on International Index of Erectile Function (IIEF-5): group A included 41 patients with normal EF, and group B included 50 patients with erectile dysfunction (ED). All patients were evaluated for EF and EJF at baseline, 1, 3, and 6 months after TURP by using IIEF-5, Ejaculatory Domain-Male Sexual-Health Inventory (Ej-MSHQ). Results: In group A, there were no significant statistical differences in mean IIEF-5 at baseline and after TURP 22.88 ± 0.81 versus 22.63 ± 2.63 (p = 0.065). However, in group B, there was significant improvement in IIEF-5 after TURP all over the follow-up time points in comparison to the baseline (p = &lt;0.001). The loss of EJF was significant among patients in group A. There was significant improvement of IPSS and Qmax in group A after surgery compared to group B. Conclusion: The results confirmed that TURP has no significant negative influence on EF, and patients with preexisting ED were improved after TURP. On the contrary, the loss of EJF was significant

Cancer Cell-Derived PDGFB Stimulates mTORC1 Activation in Renal Carcinoma

Clear cell renal cell carcinoma (ccRCC) is a hypervascular tumor that is characterized by bi-allelic inactivation of the VHL tumor suppressor gene and mTOR signalling pathway hyperactivation. The pro-angiogenic factor PDGFB, a transcriptional target of super enhancer-driven KLF6, can activate the mTORC1 signalling pathway in ccRCC. However, the detailed mechanisms of PDGFB-mediated mTORC1 activation in ccRCC have remained elusive. Here, we investigated whether ccRCC cells are able to secrete PDGFB into the extracellular milieu and stimulate mTORC1 signalling activity. We found that ccRCC cells secreted PDGFB extracellularly, and by utilizing KLF6- and PDGFB-engineered ccRCC cells, we showed that the level of PDGFB secretion was positively correlated with the expression of intracellular KLF6 and PDGFB. Moreover, the reintroduction of either KLF6 or PDGFB was able to sustain mTORC1 signalling activity in KLF6-targeted ccRCC cells. We further demonstrated that conditioned media of PDGFB-overexpressing ccRCC cells was able to re-activate mTORC1 activity in KLF6-targeted cells. In conclusion, cancer cell-derived PDGFB can mediate mTORC1 signalling pathway activation in ccRCC, further consolidating the link between the KLF6-PDGFB axis and the mTORC1 signalling pathway activity in ccRCC

A QUALITATIVE ANALYSIS OF PRODUCT INNOVATION IN JORDAN’S PHARMACEUTICAL SECTOR

Product Innovation, especially New Product Development (NPD) is critical for the continued success, development, and long-term growth of a company. Despite extensive research on how to achieve NPD success, NPD process remains a difficult and a highly risky venture. The research was conducted to investigate factors that affect NPD in the Jordanian pharmaceutical sector. Five factors were conceptually identified from past literature as initial factors. They include senior management support (SMS), cross-functional teams (CFT), customer involvement (CI), supplier integration (SI), and time to market (TTM). These five factors were used to build the basic research model as independent variables; whereas NPD was the dependent variable for the research model. A qualitative research methodology was designed and used to achieve the research objectives. The needed data for this study was captured through personal interviews, and a survey that targeted all Jordanian pharmaceutical companies. The population from which respondents was chosen included research and development managers, marketing managers, and other personnel involved in NPD process in Jordanian pharmaceutical producing companies. Through conducting a number of personal interviews and using Content Analytical Technique (CAT) for data analysis, the results of the research show the existence of a number of factors that affect NPD process in Jordanian pharmaceutical sector such as: SMS, TTM, CFT, R&amp;R, Knowledge, and Technology. In addition, a number of factors were identified as NPD challenges and constraints. These factors include the toughness and lack of clarity in R&amp;R related to NPD process, the lack of financial and human resources, as well as addition to increasing DC. This paper suggests several recommendations. Firstly, senior managements need to provide enough support to NPD process whether as financial, moral or any other kind of support. Secondly, companies have to take the necessary actions to speed up NPD process in order to get the benefits of introducing products earlier into the market. Thirdly, companies have to work hard to ensure higher levels of knowledge among their staff, especially those who are involved in NPD process by providing continued periodic training to them

A QUALITATIVE ANALYSIS OF PRODUCT INNOVATION IN JORDAN’S PHARMACEUTICAL SECTOR

Product Innovation, especially New Product Development (NPD) is critical for the continued success, development, and long-term growth of a company. Despite extensive research on how to achieve NPD success, NPD process remains a difficult and a highly risky venture. The research was conducted to investigate factors that affect NPD in the Jordanian pharmaceutical sector. Five factors were conceptually identified from past literature as initial factors. They include senior management support (SMS), cross-functional teams (CFT), customer involvement (CI), supplier integration (SI), and time to market (TTM). These five factors were used to build the basic research model as independent variables; whereas NPD was the dependent variable for the research model. A qualitative research methodology was designed and used to achieve the research objectives. The needed data for this study was captured through personal interviews, and a survey that targeted all Jordanian pharmaceutical companies. The population from which respondents was chosen included research and development managers, marketing managers, and other personnel involved in NPD process in Jordanian pharmaceutical producing companies. Through conducting a number of personal interviews and using Content Analytical Technique (CAT) for data analysis, the results of the research show the existence of a number of factors that affect NPD process in Jordanian pharmaceutical sector such as: SMS, TTM, CFT, R&amp;R, Knowledge, and Technology. In addition, a number of factors were identified as NPD challenges and constraints. These factors include the toughness and lack of clarity in R&amp;R related to NPD process, the lack of financial and human resources, as well as addition to increasing DC. This paper suggests several recommendations. Firstly, senior managements need to provide enough support to NPD process whether as financial, moral or any other kind of support. Secondly, companies have to take the necessary actions to speed up NPD process in order to get the benefits of introducing products earlier into the market. Thirdly, companies have to work hard to ensure higher levels of knowledge among their staff, especially those who are involved in NPD process by providing continued periodic training to them

Advancing ethics review practices in AI research

The implementation of ethics review processes is an important first step for anticipating and mitigating the potential harms of AI research. Its long-term success, however, requires a coordinated community effort, to support experimentation with different ethics review processes, to study their effect, and to provide opportunities for diverse voices from the community to share insights and foster norms

NIH Workshop 2018: Towards Minimally Invasive or Noninvasive Approaches to Assess Tissue Oxygenation Pre- and Post-transfusion

Because blood transfusion is one of the most common therapeutic interventions in hospitalized patients, much recent research has focused on improving the storage quality in vitro of donor red blood cells (RBCs) that are then used for transfusion. However, there is a significant need for enhancing our understanding of the efficacy of the transfused RBCs in vivo. To this end, the NIH sponsored a one-and-a-half-day workshop that brought together experts in multiple disciplines relevant to tissue oxygenation (eg, transfusion medicine, critical care medicine, cardiology, neurology, neonatology and pediatrics, bioengineering, biochemistry, and imaging). These individuals presented their latest findings, discussed key challenges, and aimed to identify opportunities for facilitating development of new technologies and/or biomarker panels to assess tissue oxygenation in a minimally-invasive to non-invasive fashion, before and after RBC transfusion

NIH Workshop 2018: Towards Minimally-invasive or Non-invasive Approaches to Assess Tissue Oxygenation Pre- and Post-Transfusion

Because blood transfusion is one of the most common therapeutic interventions in hospitalized patients, much recent research has focused on improving the storage quality in vitro of donor red blood cells (RBCs) that are then used for transfusion. However, there is a significant need for enhancing our understanding of the efficacy of the transfused RBCs in vivo. To this end, the NIH sponsored a one-and-a-half-day workshop that brought together experts in multiple disciplines relevant to tissue oxygenation (e.g., transfusion medicine, critical care medicine, cardiology, neurology, neonatology and pediatrics, bioengineering, biochemistry, and imaging). These individuals presented their latest findings, discussed key challenges, and aimed to construct recommendations for facilitating development of new technologies and/or biomarker panels to assess tissue oxygenation in a minimally-invasive to non-invasive fashion, before and after RBC transfusion. The workshop was structured into four sessions: (1) Global Perspective; (2) Organ Systems; (3) Neonatology; and (4) Emerging Technologies. The first day provided an overview of current approaches in the clinical setting, both from a global perspective, including the use of metabolomics for studying RBCs and tissue perfusion, and from a more focused perspective, including tissue oxygenation assessments in neonates and in specific adult organ systems. The second day focused on emerging technologies, which could be applied pre- and post-RBC transfusion, to assess tissue oxygenation in minimally-invasive or non-invasive ways. Each day concluded with an open-microphone discussion among the speakers and workshop participants. The workshop presentations and ensuing interdisciplinary discussions highlighted the potential of technologies to combine global “omics” signatures with additional measures (e.g., thenar eminence measurements or various imaging methods) to predict which patients could potentially benefit from a RBC transfusion and whether the ensuing RBC transfusion was effective. The discussions highlighted the need for collaborations across the various disciplines represented at the meeting to leverage existing technologies and to develop novel approaches for assessing RBC transfusion efficacy in various clinical settings. Although the Workshop took place in April, 2018, the concepts described and the ensuing discussions were, perhaps, even more relevant in April, 2020, at the time of writing this manuscript, during the explosive growth of the COVID-19 pandemic in the United States. Thus, issues relating to maintaining and improving tissue oxygenation and perfusion are especially pertinent because of the extensive pulmonary damage resulting from SARS-CoV-2 infection [1], compromises in perfusion caused by thrombotic-embolic phenomena [2], and damage to circulating RBCs, potentially compromising their oxygen-carrying capacity [3]. The severe end organ effects of SARS-CoV-2 infection mandate even more urgency for improving our understanding of tissue perfusion and oxygenation, improve methods for measuring and monitoring them, and develop novel ways of enhancing them

An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience

A review of the development and implementation of a 4-year medical student integrated ultrasound curriculum is presented. Multiple teaching and assessment modalities are discussed as well as results from testing and student surveys. Lessons learned while establishing the curriculum are summarized. It is concluded that ultrasound is a well received, valuable teaching tool across all 4 years of medical school, and students learn ultrasound well, and they feel their ultrasound experience enhances their medical education