Impact of general practice / family medicine clerkships on Japanese medical students: Using text mining to analyze reflective writing

Background: In order for general practice / family medicine clerkships to be improved in undergraduate medical education, it is necessary to clarify the impacts of general practice / family medicine clerkships. Using text mining to analyze the reflective writing of medical students may be useful for further understanding the impacts of clinical clerkships on medical students. Methods: The study involved 125 fifth-year Fukushima Medical University School of Medicine students in the academic year 2018-2019. The settings were three clinics and the study period was 5 days. The clerkships included outpatient and home visits. Students' reflective writing on their clerkship experience was collected on the final day. Text mining was used to extract the most frequent words (nouns) from the reflective writing. A co-occurrence network map was created to illustrate the relationships between the most frequent words. Results: 124 students participated in the study. The total number of sentences extracted was 321 and the total number of words was 10,627. The top five frequently-occurring words were patient, home-visit, medical practice, medical care, and family. From the co-occurrence network map, a co-occurrence relationship was recognized between home-visit and family. Conclusion: Data suggest that medical students may learn the necessity of care for the family as well as the patient in a home-care setting

Preliminary in vivo evaluation of a needle insertion manipulator for central venous catheterization

Central venous catheterization is associated with potential complications secondary to accidental puncture, including venous bleeding and pneumothorax. We developed a system that avoids these complications and simplifies the procedure using a robot to provide puncture assistance. We herein report a puncture experiment conducted in vivo in a porcine to evaluate the manipulator. The right and left jugular veins of a pig were punctured five times each through both opened and unopened skin at a puncture angle and speed. A venous placement rate of 80% was obtained with opened skin. A much lower rate of 40% was obtained with unopened skin. One of five attempts in opened skin was unsuccessful, likely because of the stick-slip phenomenon. This system was effective for jugular venous puncture of opened skin. Future studies should focus on puncture conditions that facilitate needle placement, inhibit the stick-slip phenomenon, and minimize needle bending due to the presence of skin. © 2014 Kobayashi et al.; licensee Springer.1

Absolute Electron Emission Calibration: Round Robin Tests of Au and Polyimide

Accurate determination of the absolute electron yields of conducting and insulating materials are essential for models of spacecraft charging and related processes involving charge accumulation and emission due to electron beams and plasmas. Apparatus using low-fluence pulsed electron beam sources and various methods to minimize charge accumulation have been developed at facilities around the world. This study presents a round robin comparison of such tests performed in CSIC at Instituto de Ciencia de Materiales de Madrid, LaSeine at Kyushu Institute of Technology, DESSE at ONEREA, and the Space Environment Effects Materials (SEEM) test facility at Utah State University. The primary objectives of the study were to determine the consistency and uncertainties of these absolute yields measurements, and to investigate the effects of the similarities and differences of the diverse facilities. Measurements were made of the absolute total, secondary and backscattered electron yields at normal incidence over the full range of incident energies accessible with each group’s instrumentation (a full range of ~5 eV to ~30 keV). Electron emission spectra at specific incident electron energies were also measured. Measurements were made for identical samples with reproducible sample preparation of two standard materials: (1) the elemental conductor Au (25 μm thick 6N high purity Au foils) and (2) the polymeric insulator polyimide (25 μm thick Kapton HNTM). Studies of the effects on electron yield of Au surface contamination—as measured with Auger Electron Spectroscopy and other techniques—were made for samples: (1) as received, (2) subject to a simple standard cleaning procedure, (3) subsequently baked out under ultrahigh vacuum, and (4) after Ar ion sputter cleaning and thermal annealing. Similarly, studies of the effects of absorbed water and volatile compounds on electron yield were made for polyimide samples: (1) unbaked and (2) subjected to a vacuum bake out. An outline of measurement and analysis techniques used by each laboratory is presented, along with methods used to calibrate the incident energies and absolute yields measured with their different electron detectors. The effects of different charge minimization and neutralization methods are compared. Various empirical and physics-based models to characterize the electron yield curves are used to parameterize the yield data. The values determined at each laboratory for the maximum yield and energy at this yield, the first and second crossover energies, and the asymptotic yield at high energy are also compiled and compared

Use of puncture force measurement to investigate the conditions of blood vessel needle insertion

Central venous catheterization involves venous puncture and catheter insertion for transfusions. Quantitative conditions that facilitate insertion of the needle, such as the angle and velocity of insertion, have not been clarified. We previously developed a robotic system for guiding the needle along a specified puncture path with high precision and are currently implementing a hardware design for a robotic system to assist in blood vessel puncture. In this study, we proposed the insertion angle and velocity for stopping the needle in a blood vessel, assuming that a robotic system such as ours is used during the procedure. We inserted a needle into a segment of porcine jugular vein and obtained the puncture reaction force. Evaluation indices were the magnitude of the sudden decrease in reaction force at the point at which the needle advances and the length of time that the needle is present within the vein. Results indicated that the conditions under which it was easiest to stop the needle inside the vein were an insertion angle range of 10-20 and an insertion velocity of 3 mm/s. © 2012 IPEM.FALS

Telesurgery of Microscopic Micromanipulator System “NeuRobot” in Neurosurgery: Interhospital Preliminary Study

Object Robotic surgery can be applied as a novel technology. Our master-slave microscopic-micromanipulator system (NeuRobot), which has a rigid endoscope and three robot-arms, has been developed to perform neurosurgical procedures, and employed successfully in some clinical cases. Although the master and slave parts of NeuRobot are directly connected by wire, it is possible to separate each part and to apply it to telesurgery with some modifications. To evaluate feasibility of NeuRobot in telesurgery, some basic experiments were performed. Methods The quality of telemedicine network system between Shinshu University and one of the affiliated hospitals, which was completely separated from other public network systems, was investigated. The communication delay was calculated from the transmitting and the receiving records in the computers set in each hospital. The relationship between the change in communication delay from the master part to the slave part of NeuRobot (0, 100, 300, 500 and 700 ms) respectively and feasibility of NeuRobot was investigated. The task performance time in each time changing group was compared. Feasibility of NeuRobot in telesurgical usage was evaluated. The master part and the slave part of NeuRobot placed in each hospital were connected through private network system. Interhospitally connected NeuRobot was compared with directly connected one in terms of task performance time. Results Less than 1 ms was required for corresponding the data in a steady transmitting state. Within 2 seconds after connection, relative time delay (maximum 40 ms) and packet loss were sometimes observed. The mean task performance time was significantly longer in over 500 ms delayed group compared with directly connected NeuRobot. There was no significant difference in the task performance time between directly connected NeuRobot and interhospitally connected NeuRobot. Conclusion Our results proved that telesurgical usage of NeuRobot was feasible. Telesurgical usage of telecontrolled manipulator system is recommended for application in a private network system in order to reduce technical and ethical problems. Some technical innovations will bring breakthrough to the telemedicine field