Exploring the Map of Medicine's potential in undergraduate medical education.

BACKGROUND: Map of Medicine is a web-based knowledge resource depicting evidence-based pathways of patient care. Recent publications suggest a possible role for the Map of Medicine as a training tool in postgraduate education. AIM: The aim of this study was to explore the potential of the Map of Medicine to enhance undergraduate medical education. METHODS: A mixed-method study including a survey of UK medical schools, and the embedding of the resource at one medical school and the evaluation of its impact. RESULTS: The survey found that only 1 of 23 medical schools was using the Map of Medicine in its undergraduate curriculum. The Peninsula Medical School students' reaction to the resource was extremely positive. Students liked the Map of Medicine's navigability and help in accessing reliable information. Use of the resource by students grew steadily throughout the period of the study and peaked at 595 sessions a month. There was evidence that usage was directly linked to curricular events, particularly problem-based learning tutorials and medical knowledge assessments. CONCLUSION: There is clear potential for the Map of Medicine in undergraduate medical education and a short-active period of resource promotion led to its embedding within routine learning practice

The Map of Medicine: a review of evidence for its impact on healthcare.

OBJECTIVES: Map of Medicine is an evidence-based online clinical knowledge resource. Procured at significant cost by healthcare providers in the UK, Sweden and Denmark, it is important to establish the beneficial impact that investment has had on healthcare practise and, ultimately, on patient outcomes. The objective of this study is to review the evidence for the impact of the Map of Medicine on clinical practice. METHODS: A systematic review of peer-reviewed and grey literature was conducted. Nine healthcare databases, Google Scholar and Google were searched for articles containing the terms 'map of medicine'. RESULTS: The search identified 133 articles. Eleven of the articles identified met the inclusion criteria. The main finding of the study is the paucity of evidence available on the impact of the Map of Medicine and the variable quality of that which does exist. There are some encouraging early indications for the Map of Medicine as a tool within service redesign, leading to an increase in appropriate referrals to secondary care, decreased patient waiting times and considerable cost savings. CONCLUSION: Further research with study designs that can generate high quality evidence for the impact of Map of Medicine is essential in order to support policy decisions

Mean value coordinates–based caricature and expression synthesis

We present a novel method for caricature synthesis based on mean value coordinates (MVC). Our method can be applied to any single frontal face image to learn a specified caricature face pair for frontal and 3D caricature synthesis. This technique only requires one or a small number of exemplar pairs and a natural frontal face image training set, while the system can transfer the style of the exemplar pair across individuals. Further exaggeration can be fulfilled in a controllable way. Our method is further applied to facial expression transfer, interpolation, and exaggeration, which are applications of expression editing. Additionally, we have extended our approach to 3D caricature synthesis based on the 3D version of MVC. With experiments we demonstrate that the transferred expressions are credible and the resulting caricatures can be characterized and recognized

Numerical Analysis of the Changes in Dense Medium Feed Solids on Dense Medium Cyclone Performance

Numerical simulations of changes in feed medium solids on dense medium cyclone performance were performed using a multi-phase mixture CFD (Computational Fluid Dynamics) model for medium and air-core coupled with Lagrangian model for coal particles for a 350mm DSM cyclone. The turbulence was resolved using Large Eddy Simulation (LES). The mixture model considered the interactions between water and solid phases in terms of hindered settling, lift and Bagnold forces at high feed medium solid loadings. The medium properties were modified by changing the particle size distribution and concentration. Three different medium sizes (ultrafine, superfine and fine) were used in the simulations. The effect of medium stability and rheology on DMC performance is related to feed medium size in terms of density differential and medium segregation. The simulations predicted low Ep (Ecort probability) values with finer medium which gives high separation efficiency on density. A reduction in cyclone efficiency observed for a given feed medium solids distribution at higher feed medium concentrations due to an increase in slurry viscosit

Serous cystadenocarcinoma of the pancreas: report of a case and management reflections

<p>Abstract</p> <p>Background</p> <p>Serous adenomas represent 1-2% of pancreatic neoplasms and typically are asymptomatic not requiring any treatment and simple observation is the option of choice. Although, they carry a realistic risk of malignancy despite the general view that they never become malignant. We report a case, which, according to our best knowledge is the 27th case reported in the literature.</p> <p>Methods</p> <p>We reviewed the literature by performing a search in Pub Med and Medline.</p> <p>Results</p> <p>A 86-year old patient known to have a serous cystadenoma of the pancreas treated conservatively through a close clinical and radiological follow up which was unattended for 4 years ending up to our emergency department suffering an acute abdomen. Exploratory laparotomy revealed a perforated prepyloric ulcer which was treated accordingly. Patient died some weeks later due to severe medical co morbidities.</p> <p>Conclusion</p> <p>Serous cystic neoplasms of the pancreas carry a realistic risk of malignancy despite the general view that they never become malignant. In our opinion the treatment strategy of serous cystic neoplasms of the pancreas should be aggressive even in cases of remote metastases since prognosis of the disease is satisfactory</p

Has the phasing out of stavudine in accordance with changes in WHO guidelines led to a decrease in single-drug substitutions in first-line antiretroviral therapy for HIV in sub-Saharan Africa?

This version is the Accepted Manuscript and is published in final edited form as: AIDS. 2017 January 02; 31(1): 147–157. doi:10.1097/QAD.0000000000001307OBJECTIVE: We assessed the relationship between phasing out stavudine in first-line antiretroviral therapy (ART) in accordance with WHO 2010 policy and single-drug substitutions (SDS) (substituting the nucleoside reverse transcriptase inhibitor in first-line ART) in sub-Saharan Africa. DESIGN: Prospective cohort analysis (International epidemiological Databases to Evaluate AIDS-Multiregional) including ART-naive, HIV-infected patients aged at least 16 years, initiating ART between January 2005 and December 2012. Before April 2010 (July 2007 in Zambia) national guidelines called for patients to initiate stavudine-based or zidovudine-based regimen, whereas thereafter tenofovir or zidovudine replaced stavudine in first-line ART. METHODS: We evaluated the frequency of stavudine use and SDS by calendar year 2004-2014. Competing risk regression was used to assess the association between nucleoside reverse transcriptase inhibitor use and SDS in the first 24 months on ART. RESULTS: In all, 33 441 (8.9%; 95% confience interval 8.7-8.9%) SDS occurred among 377 656 patients in the first 24 months on ART, close to 40% of which were amongst patients on stavudine. The decrease in SDS corresponded with the phasing out of stavudine. Competing risks regression models showed that patients on tenofovir were 20-95% less likely to require a SDS than patients on stavudine, whereas patients on zidovudine had a 75-85% decrease in the hazards of SDS when compared to stavudine. CONCLUSION: The decline in SDS in the first 24 months on treatment appears to be associated with phasing out stavudine for zidovudine or tenofovir in first-line ART in our study. Further efforts to decrease the cost of tenofovir and zidovudine for use in this setting is warranted to substitute all patients still receiving stavudine

Impact Ionization in ZnS

The impact ionization rate and its orientation dependence in k space is calculated for ZnS. The numerical results indicate a strong correlation to the band structure. The use of a q-dependent screening function for the Coulomb interaction between conduction and valence electrons is found to be essential. A simple fit formula is presented for easy calculation of the energy dependent transition rate.Comment: 9 pages LaTeX file, 3 EPS-figures (use psfig.sty), accepted for publication in PRB as brief Report (LaTeX source replaces raw-postscript file