Teaching ultrasound in a curricular course according to certified EFSUMB standards during undergraduate medical education: a prospective study

Background: As a non-invasive and readily available diagnostic tool, ultrasound is one of the most important imaging techniques in medicine. Ultrasound is usually trained during residency preferable according to German Society of Ultrasound in Medicine (DEGUM) standards. Our curriculum calls for undergraduate training in ultrasound of medical students in their 4th year of undergraduate education. An explorative pilot study evaluated the acceptance of this teaching method, and compared it to other practical activities in medical education at Muenster University. Methods: 240 medical students in their 4th year of undergraduate medical education participated in the training and completed a pre- and post-questionnaire for self-assessment of technical knowledge, self-assurance of the procedure, and motivation in performing ultrasound using a Likert scale. Moreover, students were asked about their interest in pursuing a career in internal medicine. To compare this training to other educational activities a standardized online evaluation tool was used. A direct observation of procedural skills assessment (DOPS) for the first time applied on ultrasound aimed to independently assess the success of our teaching method. Results: There was a significant increase in technical knowledge and self-assurance (p < 0.001) of the students’ self-assessments. The clinical relevance and self-motivation of the teaching were evaluated positively. The students’ DOPS results demonstrated proficiency in the understanding of anatomic structures shown in ultrasonographic images, including terminology, machine settings, and transducer frequencies. Conclusions: Training ultrasound according to certified DEGUM standards was successful and should be offered in undergraduate medical education. The evaluation of the course affirmed the necessity, quality and clinical relevance of the course with a top ranking score of hands-on training courses within the educational activities of the Medical Faculty of Muenster.<br

Qui meurt après une néphrectomie pour cancer ? Étude des facteurs de risque de décès, des causes de décès et des réunions de morbi-mortalité (étude UroCCR-33)

BACKGROUND AND METHODS: Nephrectomy is the treatment for renal cell cancer from T1-4 tumors but remains at risk. To determine the thirty-day mortality rate after nephrectomy for cancer and to identify causes and risk factors of death in order to find clinical applications. From 2014 to 2017, we performed a retrospective multicentric analysis of prospectively collected data study involving the French network for research on kidney cancer (UroCCR). All patients who died after nephrectomy for cancer during the first thirty days were identified. Patients\u27 characteristics, causes of death and morbidity and mortality reviews reports were analyzed for each death. RESULTS AND LIMITATIONS: In total, 2578 patients underwent nephrectomy and 35 deaths occurred. The thirty-day mortality rate was 1.4%. In univariate analysis, symptoms at diagnosis (P=0.006, OR=2.56 IC (1.3-5.03)), c stage superior to cT1 (P&lt;0.0001, OR=6.13 IC (2.8-13.2)), cT stage superior to cT2 (P&lt;0.0001, OR=8.8 IC (4.39-17.8)), nodal invasion (P&lt;0.0001, OR=4.6 IC (1.9-10.7)), distant metastasis (P=0.001, OR=4.01 IC (1.7-8.9)), open surgery (P&lt;0.0001, OR=0.272 IC (0.13-0.54)) and radical nephrectomy (P=0.007, OR=2.737 IC (1.3-5.7)) were risk factors of thirty-day mortality. In a multivariable model, only cT stage superior to T2 (P=0.015, OR=3.55 IC (1.27-10.01)) was a risk factor of thirty-day mortality. The main cause of postoperative death was pulmonary (n=15; 43%). The second cause was postoperative digestive sepsis for 7 patients (20%). Only 2 morbidity and mortality reviews had been done for the 35 deaths. Limitations are related to the thirty-day mortality criteria and descriptive study design. CONCLUSIONS: Symptomatic patients, stage cTNM and type and techniques of surgery are determinants of thirty-day mortality after nephrectomy for cancer. The first cause of postoperative death is pulmonary. Morbidity and mortality reviews should be considered to better understand causes of death and to reduce early mortality after nephrectomy for cancer. LEVEL OF EVIDENCE: 4

Localization by disorder in the infrared conductivity of (Y,Pr)Ba2Cu3O7 films

The ab-plane reflectivity of (Y{1-x}Prx)Ba2Cu3O7 thin films was measured in the 30-30000 cm-1 range for samples with x = 0 (Tc = 90 K), x = 0.4 (Tc = 35 K) and x = 0.5 (Tc = 19 K) as a function of temperature in the normal state. The effective charge density obtained from the integrated spectral weight decreases with increasing x. The variation is consistent with the higher dc resistivity for x = 0.4, but is one order of magnitude smaller than what would be expected for x = 0.5. In the latter sample, the conductivity is dominated at all temperatures by a large localization peak. Its magnitude increases as the temperature decreases. We relate this peak to the dc resistivity enhancement. A simple localization-by-disorder model accounts for the optical conductivity of the x = 0.5 sample.Comment: 7 pages with (4) figures include

Ginzburg-Landau functional for nearly antiferromagnetic perfect and disordered Kondo lattices

Interplay between Kondo effect and trends to antiferromagnetic and spin glass ordering in perfect and disordered bipartite Kondo lattices is considered. Ginzburg-Landau equation is derived from the microscopic effective action written in three mode representation (Kondo screening, antiferromagnetic correlations and spin liquid correlations). The problem of local constraint is resolved by means of Popov-Fedotov representation for localized spin operators. It is shown that the Kondo screening enhances the trend to a spin liquid crossover and suppresses antiferromagnetic ordering in perfect Kondo lattices and spin glass ordering in doped Kondo lattices. The modified Doniach's diagram is constructed, and possibilities of going beyond the mean field approximation are discussed.Comment: 18 pages, RevTeX, 7 EPS figures include

Enseignement et perception de l’urologie à la fin du deuxième cycle des études médicales : état des lieux

Objectifs Déterminer la perception de l’urologie par les étudiants en fin de deuxième cycle des études médicales (DCEM) et connaître leurs supports d’enseignement. Matériel et méthodes Un auto-questionnaire a été diffusé par internet à 1600 étudiants de 16 facultés au cours de leur dernier semestre de DCEM. Résultats Au total, 590 réponses ont été reçues (36,8 %). Dans notre population, 70,2 % des étudiants étaient des femmes. Parmi eux, 24,1 % avaient fait un stage en urologie. L’urologie était considérée comme une discipline médicale, chirurgicale et médicochirurgicale, respectivement par 3,7 %, 37,8 % et 58 % d’entre eux. L’urologie était considérée comme une discipline très importante, importante, peu importante et pas importante par 5,1 %, 54,4 %, 37,5 % et 2,4 % d’entre eux. Les supports d’enseignement les plus utilisés pour préparer l’examen national classant (ENC) étaient les polycopiés d’internat (45,3 %), les conférences d’internat (43,7 %), le polycopié national du collège d’Urologie (38,6 %) et les cours dispensés à la faculté (32 %). Les items d’urologie les mieux assimilés étaient les pathologies lithiasiques (86,3 %), les troubles urinaires du bas appareil (76,3 %) et les cancers urologiques (56,7 %). À l’inverse, seulement 34,7 % et 28 % considéraient leurs connaissances suffisantes sur la dysfonction érectile et la transplantation rénale. Enfin, 7,5 % exprimaient le souhait de devenir urologue. La réalisation d’un stage en urologie était associée au sentiment d’avoir acquis les connaissances pour débuter l’internat (p &lt; 0,001) et au souhait d’être urologue (p &lt; 0,001). Conclusion Contre toute attente, l’urologie était considérée comme une discipline médicochirurgicale importante par la moitié des étudiants en fin de DCEM malgré le faible nombre d’items dédiés à l’urologie dans le programme de l’ENC. Un tiers d’entre eux utilisaient le polycopié national du collège d’Urologie pour préparer l’ENC et un quart avait réalisé un stage en urologie

Azimuthal asymmetries of charged hadrons produced by high-energy muons scattered off longitudinally polarised deuterons

Azimuthal asymmetries in semi-inclusive production of positive (h^+) and negative hadrons (h^-) have been measured by scattering 160 GeV muons off longitudinally polarised deuterons at CERN. The asymmetries were decomposed in several terms according to their expected modulation in the azimuthal angle phi of the outgoing hadron. Each term receives contributions from one or several spin and transverse-momentum-dependent parton distribution and fragmentation functions. The amplitudes of all phi-modulation terms of the hadron asymmetries integrated over the kinematic variables are found to be consistent with zero within statistical errors, while the constant terms are nonzero and equal for h^+ and h^- within the statistical errors. The dependencies of the phi-modulated terms versus the Bjorken momentum fraction x, the hadron fractional momentum z, and the hadron transverse momentum p_h^T were studied. The x dependence of the constant terms for both positive and negative hadrons is in agreement with the longitudinal double-spin hadron asymmetries, measured in semi-inclusive deep-inelastic scattering. The x dependence of the sin phi-modulation term is less pronounced than that in the corresponding HERMES data. All other dependencies of the phi-modulation amplitudes are consistent with zero within the statistical errors.Comment: 12 pages, 11 Figures; revision 1 signs in Eq 5 corrected, polishe

Search for displaced vertices arising from decays of new heavy particles in 7 TeV pp collisions at ATLAS

We present the results of a search for new, heavy particles that decay at a significant distance from their production point into a final state containing charged hadrons in association with a high-momentum muon. The search is conducted in a pp-collision data sample with a center-of-mass energy of 7 TeV and an integrated luminosity of 33 pb^-1 collected in 2010 by the ATLAS detector operating at the Large Hadron Collider. Production of such particles is expected in various scenarios of physics beyond the standard model. We observe no signal and place limits on the production cross-section of supersymmetric particles in an R-parity-violating scenario as a function of the neutralino lifetime. Limits are presented for different squark and neutralino masses, enabling extension of the limits to a variety of other models.Comment: 8 pages plus author list (20 pages total), 8 figures, 1 table, final version to appear in Physics Letters

Measurement of the polarisation of W bosons produced with large transverse momentum in pp collisions at sqrt(s) = 7 TeV with the ATLAS experiment

This paper describes an analysis of the angular distribution of W->enu and W->munu decays, using data from pp collisions at sqrt(s) = 7 TeV recorded with the ATLAS detector at the LHC in 2010, corresponding to an integrated luminosity of about 35 pb^-1. Using the decay lepton transverse momentum and the missing transverse energy, the W decay angular distribution projected onto the transverse plane is obtained and analysed in terms of helicity fractions f0, fL and fR over two ranges of W transverse momentum (ptw): 35 < ptw < 50 GeV and ptw > 50 GeV. Good agreement is found with theoretical predictions. For ptw > 50 GeV, the values of f0 and fL-fR, averaged over charge and lepton flavour, are measured to be : f0 = 0.127 +/- 0.030 +/- 0.108 and fL-fR = 0.252 +/- 0.017 +/- 0.030, where the first uncertainties are statistical, and the second include all systematic effects.Comment: 19 pages plus author list (34 pages total), 9 figures, 11 tables, revised author list, matches European Journal of Physics C versio

Observation of a new chi_b state in radiative transitions to Upsilon(1S) and Upsilon(2S) at ATLAS

The chi_b(nP) quarkonium states are produced in proton-proton collisions at the Large Hadron Collider (LHC) at sqrt(s) = 7 TeV and recorded by the ATLAS detector. Using a data sample corresponding to an integrated luminosity of 4.4 fb^-1, these states are reconstructed through their radiative decays to Upsilon(1S,2S) with Upsilon->mu+mu-. In addition to the mass peaks corresponding to the decay modes chi_b(1P,2P)->Upsilon(1S)gamma, a new structure centered at a mass of 10.530+/-0.005 (stat.)+/-0.009 (syst.) GeV is also observed, in both the Upsilon(1S)gamma and Upsilon(2S)gamma decay modes. This is interpreted as the chi_b(3P) system.Comment: 5 pages plus author list (18 pages total), 2 figures, 1 table, corrected author list, matches final version in Physical Review Letter