How to Improve Student Education in Cardiology? 13 Essential Answers Through Medical Simulation

DergiPark: 379021tmsjAims: Is there a difference, from a clinical point of view, between a first year resident and a 4th year one, in the branch of Cardiology? If so, do we need to diminish it? And more importantly, do we have the tools? In this study it is aimed to evaluate medical simulation and its applicability in cardiology as an education method contributing to make students and residents more experienced and sufficient. Methods: The descriptive, cross-sectional study based on a survey which was applied to the groups of students in Carol Davila’ University of Medicine and Pharmacy (146) and residents (33 out of which 18 in the first two years and 15 in the last 3 years) was conducted between November 2014 and January 2015. Responses regarding evaluation of medical simulation as an education method were analyzed by using descriptive statistics including frequencies and percentages.Results: The results showed that with the usage of medical simulation as an education method 128 (87.6 %) students would have felt more confident and learnt faster, while 113 (77.5%) students would have found studying more appealing. Furthermore 10 (68%) of residents in the 3rd, 4th, 5th year would have felt more experienced, if they actually encountered rare simulated pathologies; thus 16 (91%) of the residents in the 1st, 2nd year thought the risks would have decreased for patients.Conclusion: Medical Simulation remains a necessity as an education method to improve practical skills of both students and residents in branch of cardiolog

Archaeometrical Characterization of Romanian Late Bronze Age Ceramic Fragments

Knowledge of the past can provide information to protect the future and the potential of the technological development in the analytical sciences can be successfully applied for the study and conservation of cultural objects. In this context, in the present paper we propose an analytical methodology to characterize seven samples of ancient ceramic objects (dating to the Late Bronze Age). The samples were analyzed using optical microscopy, and all the samples presented a strong inhomogeneity on the surface, as suggested by the different colors of the ceramics. X-ray fluorescence (XRF) results reveal a relatively heterogenous composition of the samples, as well as strong differences between the different surfaces of each sample. By comparative analysis of the diffractograms recorded for both sides of the same samples were observed some differences, especially in terms of relative concentration of the component minerals, and, in lesser content, in terms of new phases present in the samples. Corroborated results obtained by XRF and X-ray diffraction (XRD) offered information regarding mineralogical composition of the samples: for some of them illite/muscovite and plagioclase phases are present in higher quantities or a lower quartz content. The presence of these components was confirmed by Fourier-transform infrared spectroscopy (FTIR) analysis. The thermal analysis completes the analytical investigation of the ceramic samples. The thermal behavior of the sample conducted to some explanation regarding the observed differences, due to the raw materials (that the major clay mineral in the samples is represented by illite) or to environmental factors during their burial in the soil

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

PEGylated Gold Nanoparticles with Interesting Plasmonic Properties Synthesized Using an Original, Rapid, and Easy-to-Implement Procedure

In this letter, we report a new, one-step, rapid, and easy-to-implement method for the synthesis of PEGylated gold nanoparticles (PEG-AuNPs) having a narrow size distribution and very interesting plasmonic properties. Unmodified polyethylene glycol molecules with a molecular weight of 1000 g/mole (PEG1000) have been employed as reducing and capping agents for the synthesis of spherical gold nanoparticles having an average diameter of 35 nm, within a few minutes. The novelty of the herein proposed synthesis method consists in the fact that the synthesis takes place inside of a sealed bottle flask containing aqueous solutions of PEG1000, tetrachloroauric(III) acid (HAuCl4), and NaOH, placed in the center of a microwave oven, capable to provide a very uniform temperature environment. It turned out that, during the very short synthesis procedure (2 minutes), PEG 1000 suffers an oxidative transformation in such a manner that its terminal alcohol groups (-CH2-OH) are transformed in carboxylate ones (-COO−). The as-synthesized PEG-AuNPs possess very interesting plasmonic properties allowing the detection of different molecules by means of SER spectroscopy performed either in liquid droplets or on solid spots. As a consequence of their unique plasmonic properties, the SER spectra acquired using this new class of nanoparticles on different molecules of interest (methylene blue, rhodamine 6G, doxorubicin, and 5-fluorouracil) are highly reproducible, making them ideal candidates for further use as SERS substrates

Clam Shell-Derived Hydroxyapatite: A Green Approach for the Photocatalytic Degradation of a Model Pollutant from the Textile Industry

This work aims to evaluate the potential use of natural wastes (in particular, clam shells) to synthesize one of the most well-known and versatile materials from the phosphate mineral group, hydroxyapatite (HAP). The obtained material was characterized in terms of morphology and composition using several analytical methods (scanning electron microscopy—SEM, X-ray diffraction—XRD, X-ray fluorescence—XRF, Fourier transform infrared spectroscopy—FTIR, thermal analysis—TGA, and evaluation of the porosity and specific surface characteristics by the Brunauer–Emmett–Teller—BET method) in order to confirm the successful synthesis of the material and to evaluate the presence of potential secondary phases. The developed material was further doped with iron oxide (HAP-Fe) using a microwave-assisted method, and both materials were evaluated in terms of photocatalytic activity determined by the photodecomposition of methylene blue (MB) which served as a contaminant model. The best results (approx. 33% MB degradation efficiency, after 120 min. of exposure) were obtained for the hydroxyapatite material, superior to the HAP-Fe composite (approx. 27%). The utilization of hydroxyapatite obtained from clam shells underscores the importance of sustainable and eco-friendly practices in materials syntheses. By repurposing waste materials from the seafood industry, we not only reduce environmental impact, but also create a valuable resource with diverse applications, contributing to advancements in both healthcare and environmental protection

Hybrid Lipid Nanoformulations for Hepatoma Therapy: Sorafenib Loaded Nanoliposomes—A Preliminary Study

Sorafenib is a multikinase inhibitor that has received increasing attention due to its high efficacy in hepatocellular carcinoma treatment. However, its poor pharmacokinetic properties (limited water solubility, rapid elimination, and metabolism) still represent major bottlenecks that need to be overcome in order to improve Sorafenib’s clinical application. In this paper, we propose a nanotechnology-based hybrid formulation that has the potential to overcome these challenges: sorafenib-loaded nanoliposomes. Sorafenib molecules have been incorporated into the hydrophobic lipidic bilayer during the synthesis process of nanoliposomes using an original procedure developed in our laboratory and, to the best of our knowledge, this is the first paper reporting this type of analysis. The liposomal hybrid formulations have been characterized by transmission electron microscopy (TEM), dynamic light scattering (DLS), and nanoparticle tracking analysis (NTA) that provided useful information concerning their shape, size, zeta-potential, and concentration. The therapeutic efficacy of the nanohybrids has been evaluated on a normal cell line (LX2) and two hepatocarcinoma cell lines, SK-HEP-1 and HepG2, respectively

New Insights into the Multivariate Analysis of SER Spectra Collected on Blood Samples for Prostate Cancer Detection: Towards a Better Understanding of the Role Played by Different Biomolecules on Cancer Screening: A Preliminary Study

It is possible to obtain diagnostically relevant data on the changes in biochemical elements brought on by cancer via the use of multivariate analysis of vibrational spectra recorded on biological fluids. Prostate cancer and control groups included in this research generated almost similar SERS spectra, which means that the values of peak intensities present in SERS spectra can only give unspecific and limited information for distinguishing between the two groups. Our diagnostic algorithm for prostate cancer (PCa) differentiation was built using principal component analysis and linear discriminant analysis (PCA-LDA) analysis of spectral data, which has been widely used in spectral data management in many studies and has shown promising results so far. In order to fully utilize the entire SERS spectrum and automatically determine the most meaningful spectral features that can be used to differentiate PCa from healthy patients, we perform a multivariate analysis on both the entire and specific spectral intervals. Using the PCA-LDA model, the prostate cancer and control groups are clearly distinguished in our investigation. The separability of the following two data sets is also evaluated using two alternative discrimination techniques: principal least squares discriminant analysis (PLS-DA) and principal component analysis—support vector machine (PCA-SVM)