Dermoscopy Proficiency Expectations for US Dermatology Resident Physicians: Results of a Modified Delphi Survey of Pigmented Lesion Experts

Importance: Dermoscopy education in US dermatology residency programs varies widely, and there is currently no existing expert consensus identifying what is most important for resident physicians to know. Objectives: To identify consensus-based learning constructs representing an appropriate foundational proficiency in dermoscopic image interpretation for dermatology resident physicians, including dermoscopic diagnoses, associated features, and representative teaching images. Defining these foundational proficiency learning constructs will facilitate further skill development in dermoscopic image interpretation to help residents achieve clinical proficiency. Design, Setting, and Participants: A 2-phase modified Delphi surveying technique was used to identify resident learning constructs in 3 sequential sets of surveys - diagnoses, features, and images. Expert panelists were recruited through an email distributed to the 32 members of the Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group. Twenty-six (81%) opted to participate. Surveys were distributed using RedCAP software. Main Outcomes and Measures: Consensus on diagnoses, associated dermoscopic features, and representative teaching images reflective of a foundational proficiency in dermoscopic image interpretation for US dermatology resident physicians. Results: Twenty-six pigmented lesion and dermoscopy specialists completed 8 rounds of surveys, with 100% (26/26) response rate in all rounds. A final list of 32 diagnoses and 116 associated dermoscopic features was generated. Three hundred seventy-eight representative teaching images reached consensus with panelists. Conclusions and Relevance: Consensus achieved in this modified Delphi process identified common dermoscopic diagnoses, associated features, and representative teaching images reflective of a foundational proficiency in dermoscopic image interpretation for dermatology residency training. This list of validated objectives provides a consensus-based foundation of key learning points in dermoscopy to help resident physicians achieve clinical proficiency in dermoscopic image interpretation. © 2021 American Medical Association. All rights reserved.12 month embargo; published: 06 January 2021This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Assessing locomotion deficiency in broiler chicken Medida de deficiência locomotora em frango de corte

Locomotion deficiencies in broiler production cause poor welfare and lead to change in drinking and feeding behavior with consequent loss in weight gain. This research aimed to assess locomotion deficiencies in broiler chicken by analyzing the vertical peak force on both feet during walk. A chamber was built with an inlet ramp, a horizontal walkway in the middle and an outlet ramp. In the walkway a thin mat with piezoelectric crystal sensors was placed to record the step vertical peak force of the feet while walking on the force platform. The measurement system consisted of a mat with electronic sensors and software that allowed real time recording of the forces and the processing and analysis of data. Footage was taken from two digital video cameras and used for gait scoring. Forty male broilers were chosen at random, grown under similar rearing conditions and farms, with age varying from 49 to 28 days (ten birds of same age) to be used in the trial. Measurement consisted of inducing the bird to walk on the force platform which automatically registered the peak vertical force of the steps. Results showed that the gait score increased with the weight and age of the birds. Peak force asymmetry was found for each foot, independent of age or gait score. Although not identified visually in the broilers, the peak vertical force values differed in both right and left feet leading to slow and uneven walking. Walking deficiency was more severe in older birds.<br>Deficiência em locomoção é hoje um dos problemas mais importantes na produção de frangos de corte. É causa de baixo bem-estar e leva a alteração no comportamento de bebida e alimentação, com conseqüente perda de ganho de peso. Mediram-se deficiências locomotoras em frango de corte por meio da análise do pico de força plantar vertical em ambas as patas, durante a caminhada. Foi construída uma câmara com uma rampa de entrada, uma área horizontal de passagem e uma rampa de saída. Na parte horizontal da área de passagem foi colocado um tapete fino, com elementos sensores de cristal piezoelétrico, para registrar o pico de força vertical das patas do frango quando este caminhava sobre a plataforma. O sistema de mensuração consistiu de um tapete com sensores eletrônicos e um programa computacional que permitiu o registro de forças em tempo real e o processamento e a análise de dados. Imagens de vídeo foram tomadas a partir de duas câmeras digitais para atribuir o gait score. Quarenta frangos machos foram aleatoriamente selecionados em condições similares de alojamento e da mesma granja, com idade variando de 49 a 28 dias (dez de cada idade) e usados no experimento. A medida consistiu em induzir a ave a caminhar sobre a plataforma de força que automaticamente registrava o pico de força da passada. O gait score aumentou com o peso e a idade das aves. Foi encontrada assimetria nos picos de força da cada pata, independente da idade ou gait score. Embora não tenha sido identificado visualmente nos frangos, o pico de força vertical é diferente tanto na pata direita quanto na esquerda, levando a um caminhar lento e desigual. A deficiência locomotora foi mais intensa em aves mais velhas