11 research outputs found

    The Brazilian Ceremony in Honor of Body Donors: An opportunity to express gratitude and reflect on medical education

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    Introduction: Memorial ceremonies are a way for institutions to show their gratitude for the gesture made by body donors and are an opportunity for students to reflect on the ethical paradigm shift. Therefore, this study aims to describe the memorial ceremony at the Federal University of Health Sciences of Porto Alegre and assess the perception of both students and the donors’ relatives regarding the event. Material and methods: In 2016, a questionnaire was applied to donors’ relatives with questions regarding structure of the ceremony, ethical training of the students and importance of body donation. Another questionnaire was applied to the first-year students of the medical school, with questions about understanding the use of bodies, and their thoughts on death and relevant ethical issues. Results: Fifty questionnaires were answered by family members and 98% agreed that the ceremony was an opportunity to feel closer to the donors and 100% said that the ceremony is important in the ethical training of students. Among students, 68 questionnaires were answered, and all affirmed that the event had a positive impact on the perception of physician-patient relationship and personal growth, and 86.7% reported enhanced empathy. Conclusion: The memorial ceremony seems to encourage students to reflect on ethical issues, because at the same time that the donors’ relatives perceive an attitude of care and respect on the part of the students, the students state a heightened sense of commitment and responsibility regarding their learning and professional formation, which depends on the gesture made by the donors

    Observation of a new boson at a mass of 125 GeV with the CMS experiment at the LHC

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    Search for the associated production of a Higgs boson with a single top quark in proton-proton collisions at root s=8 TeV

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    A New Boson with a Mass of 125 GeV Observed with the CMS Experiment at the Large Hadron Collider

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    The Higgs boson was postulated nearly five decades ago within the framework of the standard model of particle physics and has been the subject of numerous searches at accelerators around the world. Its discovery would verify the existence of a complex scalar field thought to give mass to three of the carriers of the electroweak force-the W+, W-, and Z(0) bosons-as well as to the fundamental quarks and leptons. The CMS Collaboration has observed, with a statistical significance of five standard deviations, a new particle produced in proton-proton collisions at the Large Hadron Collider at CERN. The evidence is strongest in the diphoton and four-lepton (electrons and/or muons) final states, which provide the best mass resolution in the CMS detector. The probability of the observed signal being due to a random fluctuation of the background is about 1 in 3 x 10(6). The new particle is a boson with spin not equal to 1 and has a mass of about 1.25 giga-electron volts. Although its measured properties are, within the uncertainties of the present data, consistent with those expected of the Higgs boson, more data are needed to elucidate the precise nature of the new particle

    Observation of a new boson at a mass of 125 GeV with the CMS experiment at the LHC

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    The article is the pre-print version of the final publishing paper that is available from the link below.Results are presented from searches for the standard model Higgs boson in proton–proton collisions At √s = 7 and 8 TeV in the Compact Muon Solenoid experiment at the LHC, using data samples corresponding to integrated luminosities of up to 5.1 fb−1 at 7TeV and 5.3 fb−1 at 8 TeV. The search is performed in five decay modes: γγ, ZZ, W+W−, τ+τ−, and bb. An excess of events is observed above the expected background, with a local significance of 5.0 standard deviations, at a mass near 125 GeV, signalling the production of a new particle. The expected significance for a standard model Higgs boson of that mass is 5.8 standard deviations. The excess is most significant in the two decay modes with the best mass resolution, γγ and ZZ; a fit to these signals gives a mass of 125.3±0.4(stat.)±0.5(syst.) GeV. The decay to two photons indicates that the new particle is a boson with spin different from one

    The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

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    © 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

    Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

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    Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally
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