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

Polymorphism of the Prolactin (PRL) Gene and Its Effect on Milk Production Traits in Romanian Cattle Breeds

In the present study, we investigated one polymorphism of the PRL gene (rs211032652 SNP) and assessed its influence on milk production and chemical composition in two Romanian cattle breeds. A total of 119 cattle from two breeds reared in Western Romania (64 Romanian Spotted and 55 Romanian Brown) were included in the research herd. A PCR-RFLP genotyping assay was used for the identification of the rs211032652 SNP variants. Shapiro’s test and Levene’s test were used to verify ANOVA assumptions and ANOVA and Tukey’s test were employed to test the associations between PRL genotypes and five milk traits. Among the studied breeds, our results showed that PRL genotypes were significantly associated (p < 0.05) with fat and protein percentage in the milk of Romanian Brown cattle. The AA genotype was associated with a higher fat percentage in milk (4.76 ± 0.28) compared to the GG genotype (4.04 ± 0.22, p = 0.048), as well as a higher protein percentage (3.96 ± 0.32% vs. 3.43 ± 0.15%, p = 0.027) in Romanian Brown cattle. Moreover, the PRL locus favored a significantly higher fat (p = 0.021) and protein (p = 0.028) percentage in the milk of Romanian Brown cattle compared to the Romanian Spotted breed, with a difference of 0.263% and 0.170%, respectively

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

The insulin polymorphism -23Hph increases the risk for type 1 diabetes mellitus in the Romanian population

The insulin -23Hph and IGF2 Apa polymorphisms were genotyped in Romanian patients with T1DM (n = 204), T2DM (n = 215) or obesity (n = 200) and normoponderal healthy subjects (n = 750). The genotypes of both polymorphisms were distributed in concordance with Hardy-Weinberg equilibrium in all groups. The -23Hph AA genotype increased the risk for T1DM (OR: 3.22, 95%CI: 2.09-4.98, p < 0,0001), especially in patients without macroalbuminuria (OR: 4.32, 95%CI: 2.54-7.45, p < 0,0001). No other significant association between the alleles or genotypes of insulin -23Hph and IGF2 Apa and diabetes or obesity was identified

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

<i>In Vitro</i> Assessment of Yeasts Strains with Probiotic Attributes for Aquaculture Use

This study aimed to investigate in vitro the probiotic potential of three yeasts strains (BB06, OBT05, and MT07) isolated from agro-food natural sources. Screening was performed, including several functional, technological, and safety aspects of the yeast strains, in comparison to a reference Saccharomyces boulardii, to identify the ones with suitable probiotic attributes in aquaculture. The yeast strains were identified by 5.8S rDNA-ITS region sequencing as Metschnikowia pulcherrima OBT05, Saccharomyces cerevisiae BB06, and Torulaspora delbrueckii MT07. All yeast strains were tolerant to different temperatures, sodium chloride concentrations, and wide pH ranges. S. cerevisiae BB06 showed a strong and broad antagonistic activity. Moreover, the S. cerevisiae strain exhibited a high auto-aggregation ability (92.08 ± 1.49%) and good surface hydrophobicity to hexane as a solvent (53.43%). All of the yeast strains have excellent antioxidant properties (>55%). The high survival rate in the gastrointestinal tract (GIT) can promote yeast isolates as probiotics. All yeast strains presented a resistance pattern to the antibacterial antibiotics. Non-hemolytic activity was detected. Furthermore, freeze-drying with cryoprotective agents maintained a high survival rate of yeast strains, in the range of 74.95–97.85%. According to the results obtained, the S. cerevisiae BB06 strain was found to have valuable probiotic traits

Liver Transplant in Patients with Hepatocarcinoma: Imaging Guidelines and Future Perspectives Using Artificial Intelligence

Hepatocellular carcinoma is the most common primary malignant hepatic tumor and occurs most often in the setting of chronic liver disease. Liver transplantation is a curative treatment option and is an ideal solution because it solves the chronic underlying liver disorder while removing the malignant lesion. However, due to organ shortages, this treatment can only be applied to carefully selected patients according to clinical guidelines. Artificial intelligence is an emerging technology with multiple applications in medicine with a predilection for domains that work with medical imaging, like radiology. With the help of these technologies, laborious tasks can be automated, and new lesion imaging criteria can be developed based on pixel-level analysis. Our objectives are to review the developing AI applications that could be implemented to better stratify liver transplant candidates. The papers analysed applied AI for liver segmentation, evaluation of steatosis, sarcopenia assessment, lesion detection, segmentation, and characterization. A liver transplant is an optimal treatment for patients with hepatocellular carcinoma in the setting of chronic liver disease. Furthermore, AI could provide solutions for improving the management of liver transplant candidates to improve survival

Synthesis and Characterization of PLA-Micro-structured Hydroxyapatite Composite Films

This article presents a facile synthesis method used to obtain new composite films based on polylactic acid and micro-structured hydroxyapatite particles. The composite films were synthesized starting from a polymeric solution in chloroform (12 wt.%) in which various concentrations of hydroxyapatite (1, 2, and 4 wt.% related to polymer) were homogenously dispersed using ultrasonication followed by solvent evaporation. The synthesized composite films were morphologically (through SEM and atomic force microscopy (AFM)) and structurally (through FT-IR and Raman spectroscopy) characterized. The thermal behavior of the composite films was also determined. The SEM and AFM analyses showed the presence of micro-structured hydroxyapatite particles in the film&rsquo;s structure, as well as changes in the surface morphology. There was a significant decrease in the crystallinity of the composite films compared to the pure polymer, this being explained by a decrease in the arrangement of the polymer chains and a concurrent increase in the degree of their clutter. The presence of hydroxyapatite crystals did not have a significant influence on the degradation temperature of the composite film

Comparative study on production, reproduction and functional traits between Fleckvieh and Braunvieh cattle

Objective Aim of the current comparative study was to evaluate production outputs, reproduction efficiency and functional traits in dual-purpose Fleckvieh and Braunvieh cows, reared under temperate European conditions. Methods A data-set from 414 Fleckvieh and 42 Braunvieh cows and 799 lactations was analysed. ID tag number, milk yield per milking session, number of steps/interval and milk conductivity were recorded and collected daily using AfiMilk 3.076 A-DU software (Afimilk Ltd., Kibbutz, Israel). Production and milk quality data were taken from the results of the official performance recordings and the reproductive outputs of cows were recorded by the research stations veterinarians. Comparisons between the two genotypes were carried out using the one way analysis of variance protocol, with categorical factor being considered the breed of cows. All the statistical inferences were carried out using Statistica software (StatSoft Inc., Tulsa, OK, USA). Results Fleckvieh cows significantly outperformed (p≤0.05) the Braunvieh herd, with average milk yields of 5,252.1±35.79 kg and 4,897.6±128.94 kg, respectively. Age at first calving was significantly (p≤0.01) influenced by the breed, with Fleckvieh heifers being more precocious (32.8±0.29 mo) compared to those of Braunvieh breed (35.7±0.84 mo). Reproduction efficiency as defined by the number of inseminations per gestation, calving interval, dystocia, days dry and days open, was not influenced by genotype (p>0.05). Incidences of sub-clinical mastitis, clinical mastitis, lameness and abortions were not influenced by the breed factor (p>0.05). Stayability of cows was significantly (p≤0.001) influenced by genotype, with Braunvieh cows having an average age at culling of 117.88±11.78 months compared to 90.88±2.89 months in Fleckvieh. Conclusion Overall, results have shown that genotype significantly influenced milk yield, age at first calving and longevity