Modern Teaching Methods in the Training of Basic Surgical Skills

Az NPT módszerrel kapcsolatos kutatásunk célja a közeli kortársoktatás hatékonyságának vizsgálata alapvető sebészeti készségek oktatásakor. Fő hipotézisünk volt, hogy a kortársoktató a kurzus oktatásába szignifikánsan javítja a hallgatók vizsgaeredményeit. Alhipotézisünk volt, hogy az NPT alkalmazása javítja a hallgatók összesített elégedettségét a kurzussal kapcsolatban. A távoktatás hatékonyságának vizsgálata során az alapvető sebészeti ismeretek oktatását elemeztük. Célom volt, hogy objektív módszertan segítségével vizsgáljam a sebészeti alapkészségekhez kapcsolódó távoktatás hatékonyságát. Feltételeztük, hogy egy online tanfolyam megfelelő képzési eszközökkel ugyanolyan hatékony lehet, mint egy „normál” személyes kurzus az alapvető sebészeti ismeretek területén. 5 A kutatómunka eredményei potenciálisan hozzájárulhatnak mind az online, mind a távoktatás feltörekvő területéhez, amely elsősorban a gyakorlati képzések és gyakorlati ismeretek terén jelentenek komoly kihívást az egészségügyi szakemberek képzésében. A bemutatott módszer és a következtetések további kutatásokat kívánnak inspirálni az orvosképzés területén, ezért remélhetőleg további készségalapú kurzusokat is megvizsgálnak digitális környezetben

Disrupted Neural Regeneration in Dry Eye Secondary to Ankylosing Spondylitis - With a Theoretical Link between Piezo2 Channelopathy and Gateway Reflex, WDR Neurons, and Flare-Ups

This study aimed at analyzing the corneal neural regeneration in ankylosing spondylitis patients using in vivo corneal confocal microscopy in correlation with Langerhans cell density, morphology, and dry eye parameters. Approximately 24 ankylosing spondylitis subjects and 35 age- and gender-matched control subjects were enrolled. Data analysis showed that all corneal nerve-fiber descriptives were lower in the ankylosing spondylitis group, implicating disrupted neural regeneration. Peripheral Langerhans cell density showed a negative correlation with nerve fiber descriptions. A negative correlation between tear film break-up time and corneal nerve fiber total branch density was detected. The potential role of somatosensory terminal Piezo2 channelopathy in the pathogenesis of dry eye disease and ankylosing spondylitis is highlighted in our study, exposing the neuroimmunological link between these diseases. We hypothesized earlier that spinal neuroimmune-induced sensitization due to this somatosensory terminal primary damage could lead to Langerhans cell activation in the cornea, in association with downregulated Piezo1 channels on these cells. This activation could lead to a Th17/Treg imbalance in dry eye secondary to ankylosing spondylitis. Hence, the corneal Piezo2 channelopathy-induced impaired Piezo2-Piezo1 crosstalk could explain the disrupted neural regeneration. Moreover, the translation of our findings highlights the link between Piezo2 channelopathy-induced gateway to pathophysiology and the gateway reflex, not to mention the potential role of spinal wide dynamic range neurons in the evolution of neuropathic pain and the flare-ups in ankylosing spondylitis and dry eye disease

Comparison of an automated ELFA and two different real-time PCR techniques for Salmonella detection in poultry samples

The aim of this study was to compare an enzyme-linked fluorescent assay (ELFA)-based and two real-time polymerase chain reaction (PCR) methods with the results of the standard culture-based method EN ISO 6579:2002 (bacteriological standard method used in the European Union) for the detection of Salmonella spp. in raw chicken meat. Our investigations were performed on 141 poultry samples sorted from supermarkets.Relative accuracy, relative specificity and relative sensitivity were determined. According to the ISO 16140:2003 criteria for validation of alternative microbiological methods, the ELFA-based method (VIDAS ICS2 + SLM), and real-time PCR methods (TaqMan, Bax) were comparable to the reference standard method for the detection of Salmonella spp. in chicken meat. The use of these methods provide results within 48 hours with high sensitivity (100%). The TaqMan real-time PCR showed a relative specificity of 98% and both of the real-time PCR methods presented 100%.The VIDAS ICS2 + SLM and the Bax real-time PCR methods showed the highest relative accuracy (100%) and 99% in case of the TaqMan method. In conclusion, both the real-time PCR and the ELFA-based assay can be used as a rapid and user-friendly diagnostic method for detection of Salmonella spp. in chicken meat samples

Arcüregbe diszlokált fogimplantátum eltávolítása endoszkópos ellenőrzéssel. Esetismertetés a szakirodalom tükrében

Az utóbbi időben egyre gyakoribbá vált fogászati implantáció egyik nem kívánt szövődménye az arcüregbe került implantátum, amely a maxilla molaris, esetenként praemolaris régiójának implantációjakor fordulhat elő. Ennek oka lehet a kúpsugaras komputertomográfia nélküli, azaz nem megfelelő tervezés, fennálló arcüreggyulladás és -ventilációs probléma, kevés, puha csont, a fúrási vagy implantátumbehelyezési sebészi gyakorlat hiánya, észre nem vett membránperforáció arcüreg-csontfeltöltés esetén. Esetünkben implantáció előtt a beteg szájsebész orvosa kúpsugaras komputertomográfia alapján sinusventilációs zavart és arcüreggyulladást véleményezett. Az arcüreggyulladás funkcionális endoszkópos sinussebészeti műtéttel történő kezelését és gyógyulását követően két lépésben, először arcüreg-csontfeltöltést, majd 6 hónappal később implantációt végeztek. 4 hónap panasz- és tünetmentes gyógyulást követően az implantátumfeltárás előtt derült fény az arcüregbe került implantátumra, amelyet funkcionális endoszkópos sinussebészeti eljárással, transnasalis (Lothrop) és intraoralis behatolás kombinációjával távolítottunk el. Az implantátumok arcüregbe kerülésének gyakorisága továbbra is ismeretlen, a szakirodalomban kb. 70 közölt esetről tudunk; a leggyakrabban egy-egy implantátummal kapcsolatban születnek cikkek, ami az összes beültetett implantátum számához képest elenyésző. Az arcüregben lévő szabad implantátum arcüreggyulladást okoz, eltávolítása szükséges, kötelező. A sinus hátsó részében elhelyezkedő implantátum esetén elsősorban funkcionális endoszkópos sinussebészeti eljárás javasolt. Az első recessusban lévő implantátum eltávolítására a legjobbnak a praelacrimalis recessusból végzett korszerű behatolás tűnik. Tradicionális transoralis/Luc-Caldwell-féle behatolást a friss sinuslift utáni gyulladt csontexcochleatio esetén javasolunk, illetve ha fennálló oroantralis fistulát is zárnunk kell

Effectivity of Distance Learning in the Training of Basic Surgical Skills—A Randomized Controlled Trial

Background: Distance learning is an interactive way of education when teachers and students are physically separated. Our purpose was to examine its effectivity in training of basic surgical techniques and to provide an alternative sustainable methodology for the training of medical professionals. Methods: Sixty students were involved in our single blinded randomized controlled study. Six homogenized groups were created then randomized into three groups of distance learning and three groups of in-person teaching. The groups completed the same curriculum using our own “SkillBox”. All students took the same pre- and post-course test evaluated blindly. The students filled out an online feedback form after the course. A financial analysis was also made. Results: There was no significant difference in the post-course exam results (distance 28.200 vs. in-person 25.200). We managed to achieve significantly better improvements in the distance learning of suturing (distance 19.967 vs. in-person 15.900, p = 0.043). According to 93% of the study group students, the quality of teaching did not decrease compared to the traditional classes. Conclusion: The results of the students improved similarly in distance learning and in-person education. The online form of teaching was received positively among the students; they found it an effective and good alternative

Determining unintelligible words from their textual contexts

We propose a method to determine unintelligible words based on the textual context of the word determined. As there can be many different possibilities for the word, a robust, large-scale method is needed. The large scale makes the problem sensitive to spurious similarities of contexts: when the contexts of two, different words are similar. To reduce this effect, we induce structured sparsity on the words by formulating the task as a group Lasso problem. We compare this formulation to a k-nearest neighbor and a support vector machine based approach, and find that group Lasso outperforms both by a large margin. We achieve up to 75 % of accuracy when determining the word from among 1000 words both on the Brown corpus and on the British National Corpus. Unintelligible words are often the result of errors in Optical Character Recognition (OCR) algorithms. As the proposed method utilizes information independent from information used in OCR, we expect that a combined approach could be very successful, as OCR and the proposed method complement each other

Classifying GRB 170817A/GW170817 in a Fermi duration–hardness plane

GRB 170817A, associated with the LIGO-Virgo GW170817 neutron-star merger event, lacks the short duration and hard spectrum of a Short gamma-ray burst (GRB) expected from long-standing classification models. Correctly identifying the class to which this burst belongs requires comparison with other GRBs detected by the Fermi GBM. The aim of our analysis is to classify Fermi GRBs and to test whether or not GRB 170817A belongs—as suggested—to the Short GRB class. The Fermi GBM catalog provides a large database with many measured variables that can be used to explore gamma-ray burst classification. We use statistical techniques to look for clustering in a sample of 1298 gamma-ray bursts described by duration and spectral hardness. Classification of the detected bursts shows that GRB 170817A most likely belongs to the Intermediate, rather than the Short GRB class. We discuss this result in light of theoretical neutron-star merger models and existing GRB classification schemes. It appears that GRB classification schemes may not yet be linked to appropriate theoretical models, and that theoretical models may not yet adequately account for known GRB class properties. We conclude that GRB 170817A may not fit into a simple phenomenological classification scheme. © 2018, Springer Science+Business Media B.V., part of Springer Nature

Selective CRF2 receptor agonists ameliorate the anxiety- and depression-like state developed during chronic nicotine treatment and consequent acute withdrawal in mice

The aim of the present study was to investigate the effects of the selective agonists of the corticotropin-releasing factor (CRF) 2 receptor, urocortin 2 (UCN 2) and urocortin 3 (UCN 3), on the anxiety- and depression-like signs induced by acute nicotine withdrawal in mice. In order to do so, male CFLP mice were exposed for 7 days to repeated intraperitoneal (IP) injection with nicotine or saline solution and 1day of acute withdrawal and then a single intracerebroventricular (ICV) injection with UCN 2, UCN 3 or saline solution. After 30min the mice were observed in an elevated plus-maze test or a forced swim test, for anxiety- and depression-like behavior. After 5min of testing, the plasma corticosterone concentration reflecting the activity of the hypothalamic-pituitary-adrenal (HPA) axis was also determined by a chemo-fluorescent method. Half of the animals were treated ICV and evaluated on the 8th day, the other half on the 9th day. On the 8th day, nicotine-treated mice presented signs of anxiolysis and depression, but no significant elevation of the plasma corticosterone concentration. On the 9th day, nicotine-treated mice exhibited signs of anxiety and depression and a significant increase of the plasma corticosterone levels. Central administration of UCN 2 or UCN 3 ameliorated the anxiety- and depression-like state including the hyperactivity of the HPA axis, developed during acute withdrawal following chronic nicotine treatment. The present study suggests that selective CRF2 receptor agonists could be used as a therapy in nicotine addiction