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Ultrasound in Medicine & Biology Dec 2021Early diagnosis and treatment of rhabdomyolysis are very important, but difficult to achieve for some atypical cases. Our study was aimed at determining the diagnostic...
Early diagnosis and treatment of rhabdomyolysis are very important, but difficult to achieve for some atypical cases. Our study was aimed at determining the diagnostic value of ultrasonography in rhabdomyolysis caused by different factors. The study enrolled 50 patients with rhabdomyolysis diagnosed in our hospital. Among the 50 cases (mean age = 38.4 y, 22 women) of rhabdomyolysis, 26 cases (mean age = 35.5 y, 8 women) were induced by exercise. During the patients' first visit, 5 cases (mean age = 30.6 y, 1 woman) were suspected of having rhabdomyolysis and were diagnosed by clinicians; 12 cases (mean age = 34.8 y, 5 women) were correctly diagnosed under ultrasound; and 9 cases (mean age = 39.2 y, 2 women) were misdiagnosed. Ultrasound did not play a critical role in 24 patients (mean age = 41.5 y, 14 women) with rhabdomyolysis caused by trauma, infection, crayfish consumption, drugs, alcohol and heat stroke. We then concluded that exercise-induced rhabdomyolysis is a common type of rhabdomyolysis. Ultrasonography plays an important role in the early diagnosis of exercise-induced rhabdomyolysis but has limited value in the diagnosis of rhabdomyolysis caused by other etiologies.
Topics: Adult; Exercise; Female; Humans; Male; Rhabdomyolysis; Ultrasonography
PubMed: 34535325
DOI: 10.1016/j.ultrasmedbio.2021.08.012 -
BMC Medical Education Jul 2022During the Covid-19 pandemic, formative OSCE were transformed into online OSCE, and senior students (near peers) substituted experienced clinical teachers. The aims of...
PURPOSE OF THE ARTICLE
During the Covid-19 pandemic, formative OSCE were transformed into online OSCE, and senior students (near peers) substituted experienced clinical teachers. The aims of the study were to evaluate quality of the feedbacks given by near peers during online OSCEs and explore the experience of near-peer feedback from both learner's and near peer's perspectives.
MATERIALS AND METHODS
All 2nd year medical students (n = 158) attended an online OSCE under the supervision of twelve senior medical students. Outcome measures were 1) students' perception of the quality of the feedback through an online survey (Likert 1-5); 2) objective assessment of the quality of the feedback focusing on both the process and the content using a feedback scale (Likert 1-5); 3) experience of near peer feedback in two different focus groups.
RESULTS
One hundred six medical students answered the questionnaire and had their feedback session videotaped. The mean perceived overall quality of senior students' overall feedback was 4.75 SD 0.52. They especially valued self-evaluation (mean 4.80 SD 0.67), balanced feedback (mean 4.93 SD 0.29) and provision of simulated patient's feedback (mean 4.97 SD 0.17). The overall objective assessment of the feedback quality was 3.73 SD 0.38: highly scored skills were subjectivity (mean 3.95 SD 1.12) and taking into account student's self-evaluation (mean 3.71 (SD 0.87). Senior students mainly addressed history taking issues (mean items 3.53 SD 2.37) and communication skills (mean items 4.89 SD 2.43) during feedback. Participants reported that near peer feedback was less stressful and more tailored to learning needs- challenges for senior students included to remain objective and to provide negative feedback.
CONCLUSION
Increased involvement of near peers in teaching activities is strongly supported for formative OSCE and should be implemented in parallel even if experience teachers are again involved in such teaching activities. However, it requires training not only on feedback skills but also on the specific content of the formative OSCE.
Topics: COVID-19; Clinical Competence; Educational Measurement; Feedback; Humans; Pandemics; Peer Group; Students, Medical
PubMed: 35879752
DOI: 10.1186/s12909-022-03629-8 -
Journal of Clinical Medicine Feb 2023The aim of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip (DDH) with periacetabular osteotomy (PAO) and determine the...
The aim of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip (DDH) with periacetabular osteotomy (PAO) and determine the values of radiological parameters that would allow us to obtain an optimal clinical result. Radiological evaluation included determining the center-edge angle (CEA), medialization, distalization, femoral head coverage (FHC), and ilioischial angle as measured on a standardized AP radiograph of the hip joints. Clinical evaluation was based on the HHS, WOMAC, Merle d'Aubigne-Postel scales and Hip Lag Sign. The results of PAO presented decreased medialization (mean 3.4 mm), distalization (mean 3.5 mm), and ilioischial angle (mean 2.7°); improvement in femoral head bone cover; an increased CEA (mean 16.3°) and FHC (mean 15.2%); clinically increased HHS (mean 22 points) and M. Postel-d'Aubigne (mean 3.5 points) scores; and a decrease in WOMAC (mean 24%). HLS improved in 67% of patients after surgery. Qualification of patients with DDH for PAO should be based on the following values of three parameters: CEA < 26°, FHC < 75%, and ilioischial angle >85.9°. To achieve better clinical results, it is necessary to increase the average CEA value by 11° and the average FHC by 11% and reduce the average ilioischial angle by 3°.
PubMed: 36902624
DOI: 10.3390/jcm12051837 -
JAMA Ophthalmology Mar 2021The coronavirus disease 2019 pandemic illustrates the increasingly important role of telemedicine as a method of clinician-patient interaction. However, electronic... (Comparative Study)
Comparative Study
IMPORTANCE
The coronavirus disease 2019 pandemic illustrates the increasingly important role of telemedicine as a method of clinician-patient interaction. However, electronic applications (apps) for the testing of ophthalmology vital signs, such as visual acuity, can be published and used without any verification of accuracy, validity, or reliability.
OBJECTIVE
To reassess the accuracy of visual acuity-testing apps and assess their viability for telehealth.
DESIGN, SETTING, AND PARTICIPANTS
The US Apple App Store was queried for apps for visual acuity testing. Anticipated optotype size for various visual acuity lines were calculated and compared against the actual measured optotype size on 4 different Apple hardware devices. No human participants were part of this study.
MAIN OUTCOMES AND MEASURES
Mean (SD) errors were calculated per device and across multiple devices.
RESULTS
On iPhones, 10 apps met inclusion criteria, with mean errors ranging from 0.2% to 109.9%. On the iPads, 9 apps met inclusion criteria, with mean errors ranging from 0.2% to 398.1%. Six apps met criteria and worked on both iPhone and iPad, with mean errors from 0.2% to 249.5%. Of the 6 apps that worked across devices, the top 3 most accurate apps were Visual Acuity Charts (mean [SD] error, 0.2% [0.0%]), Kay iSight Test Professional (mean [SD] error, 3.5% [0.7%]), and Smart Optometry (mean [SD] error, 15.9% [4.3%]). None of the apps tested were ideal for telemedicine, because some apps displayed accurate optotype size, while others displayed the same letters on separate devices; no apps exhibited both characteristics.
CONCLUSIONS AND RELEVANCE
Both Visual Acuity Charts and Kay iSight Test Professional had low mean (SD) errors and functionality across all tested devices, but no apps were suitable for telemedicine. This suggests that new and/or improved visual acuity-testing apps are necessary for optimal telemedicine use.
Topics: COVID-19; Humans; Mobile Applications; Optometry; Predictive Value of Tests; Reproducibility of Results; Smartphone; Telemedicine; Visual Acuity
PubMed: 33443550
DOI: 10.1001/jamaophthalmol.2020.6177 -
PloS One 2023Few studies including contradictory results have addressed the acute effects of the 11+ on motor performance, indicating a potentially reduced applicability of the... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Few studies including contradictory results have addressed the acute effects of the 11+ on motor performance, indicating a potentially reduced applicability of the program for warming up before competitions. This study aims to compare the acute effects of a soccer-specific warm-up (Football+) and the 11+ on motor performance.
MATERIALS AND METHODS
Thirty-eight volunteer collegiate players (22 males; age = 21.1±1.9 years, height = 1.81± 0.06 m, weight = 73.4± 9.5 kg; 16 females; age = 21.3±1.5 years; height = 1.71± 0.07 m, weight = 67.8± 8.5 kg) underwent the 11+ and the Football+ in a randomized crossover design with a one-week washout. The Football+ starts with a self-estimated 40-50 percent running, followed by dynamic stretching of the hip muscles, shoulder contact, controlled lunge, Copenhagen exercise, and modified Nordic hamstring exercise. The second part involves roughly intensive small-sided games, followed by plyometric and anaerobic exercises in the third part. The warm ups' effects on performance were determined by a linear sprinting test (20 m), countermovement jump performance (CMJ), Illinois agility (IA), and dribbling speed (DS) tests. Within-subject differences were reported as the means and SD. Pairwise t tests at the significance level of p<0.05 were used to calculate the significant differences.
RESULTS
Overall, except for the CMJ (mean = -0.43±3.20 cm, p = 0.21, d = -0.13), significant differences for the 20 m sprint (mean = 0.04±0.10 s, p = 0.005, d = 0.42), IA (mean = 0.65±0.45 s, p = 0.01, d = 1.43), and DS (mean = 0.60±1.58 s, p = 0.012, d = 0.38) were observed. In females, significant differences observed only for IA (mean difference = 0.52±0.42 s, p<0.001, d = 1.24) and DS (mean difference = 1.29±1,77 s, p = 0.005, d = 0.73), with the Football+ showing superiority. In males, significant differences were found only for 20 m sprinting (mean difference = 0.06±0.09, p = 0.005, d = 0.60) and IA (mean difference = 0.74±0.46, p<0.001, d = 1.62), with the Football+ having superiority.
DISCUSSION
Although practicable for injury prevention, the 11+ may not optimize acute performance and prepare players for high-intensity physical tasks as well as a well-structured, roughly intensive warm-up. Further gender-specific studies should evaluate the long-term effects of the Football+ on performance and injury prevention.
Topics: Adult; Humans; Male; Young Adult; Athletic Performance; Exercise; Muscle Strength; Soccer
PubMed: 37079585
DOI: 10.1371/journal.pone.0284702 -
The Indian Journal of Radiology &... Apr 2023The aim of this study was to determine the changes in the mean arterial blood pressure (MAP) and mean uterine artery (UtA) pulsatility index (PI) from 11-14 to...
A Comparison of Changes in the Mean Arterial Blood Pressure and Mean Uterine Artery Pulsatility Index from 11-14 to 19-24 + 6 Gestation Weeks in Low-Risk and High-Risk Asian Indian Pregnant Women.
The aim of this study was to determine the changes in the mean arterial blood pressure (MAP) and mean uterine artery (UtA) pulsatility index (PI) from 11-14 to 19-24 + 6 gestation weeks in Asian Indian pregnant women. Clinical and demographic details, MAP, and mean UtA PI measures were ascertained for pregnant women at 11 to 14 gestation weeks and 19-24 + 6 gestation weeks. Women were categorized as a high-or-low risk for preterm preeclampsia using the Fetal Medicine Foundation algorithm and 1 in 150 cutoff. High-risk pregnant women were recommended low-dose aspirin 150 mg daily at bedtime. Changes in MAP and mean UtA PI were compared for gestational age intervals and high-and-low risk women using nonparametric tests. The study analyzed the results of 1,163 pregnant women. Both MAP (mean difference: 5.14, < 0.001) and mean UtA PI (mean difference: 0.14, < 0.001) remained significantly higher at the second-trimester assessment in high-risk pregnant women compared to low-risk pregnant women. Seventy-seven (35.16%) of the 219 pregnant women with abnormal mean UtA PI in the first trimester had an abnormal mean UtA PI in the second-trimester assessment. One hundred (10.59%) of the 944 pregnant women with normal mean UtA PI in the first trimester had an abnormal mean UtA PI in the 19-24 + 6 weeks assessment. Seventy-seven pregnant women (6.62% of 1,163 women, 95% confidence interval: 5.33, 8.20) had an abnormal mean UtA PI at both gestation age intervals. High-risk pregnant women taking low-dose aspirin daily showed a larger reduction in mean UtA PI compared to high-risk pregnant women that did not report the use of low-dose aspirin (0.89 vs. 0.62, <0.001) MAP and mean UtA PI decreased significantly from the first to the second trimester of pregnancy. Sequential assessment of the MAP and mean UtA PI in the first and second trimesters of pregnancy will be useful for fetal radiologists in India to identify a subgroup of women with abnormal mean UtA PI at both trimesters that may need more intense surveillance and follow-up till childbirth.
PubMed: 37123569
DOI: 10.1055/s-0043-1761250 -
Entropy (Basel, Switzerland) May 2021In this paper, we present order invariance theoretical results for weighted quasi-arithmetic means of a monotonic series of numbers. The quasi-arithmetic mean, or...
In this paper, we present order invariance theoretical results for weighted quasi-arithmetic means of a monotonic series of numbers. The quasi-arithmetic mean, or Kolmogorov-Nagumo mean, generalizes the classical mean and appears in many disciplines, from information theory to physics, from economics to traffic flow. Stochastic orders are defined on weights (or equivalently, discrete probability distributions). They were introduced to study risk in economics and decision theory, and recently have found utility in Monte Carlo techniques and in image processing. We show in this paper that, if two distributions of weights are ordered under first stochastic order, then for any monotonic series of numbers their weighted quasi-arithmetic means share the same order. This means for instance that arithmetic and harmonic mean for two different distributions of weights always have to be aligned if the weights are stochastically ordered, this is, either both means increase or both decrease. We explore the invariance properties when convex (concave) functions define both the quasi-arithmetic mean and the series of numbers, we show its relationship with increasing concave order and increasing convex order, and we observe the important role played by a new defined mirror property of stochastic orders. We also give some applications to entropy and cross-entropy and present an example of multiple importance sampling Monte Carlo technique that illustrates the usefulness and transversality of our approach. Invariance theorems are useful when a system is represented by a set of quasi-arithmetic means and we want to change the distribution of weights so that all means evolve in the same direction.
PubMed: 34070385
DOI: 10.3390/e23060662 -
Japanese Journal of Clinical Oncology May 2022The relationship between preoperative mean corpuscular volume and postoperative prognosis has been reported in some cancers recently, but no certain consensus has been...
OBJECTIVE
The relationship between preoperative mean corpuscular volume and postoperative prognosis has been reported in some cancers recently, but no certain consensus has been reached, especially for colorectal cancer. We evaluated the usefulness of mean corpuscular volume as a prognostic factor in colorectal cancer patients.
METHODS
This study included 1003 patients with colorectal cancer who underwent curative surgery in a single institution. The relationship between mean corpuscular volume values and postoperative recurrence was evaluated by fractional polynomial model. Based on the result, patients were divided into groups according to mean corpuscular volume values. Clinicopathological factors and long-term outcomes were compared between the groups.
RESULTS
The risk of postoperative recurrence according to mean corpuscular volume value showed a J-shaped curve, suggesting that both low and high mean corpuscular volume have high risk. Low mean corpuscular volume (≤84 fl) group was oncologically advanced in terms of pathological tumor stage, histological grade and lymphatic invasion with higher inflammation markers. High mean corpuscular volume (>95 fl) group had higher frequency of drinking habit with higher values of aspartate aminotransferase, alanine aminotransferase and γ-glutamyl transpeptidase. Abnormal mean corpuscular volume group including these two groups showed significantly worse disease-free survival than the other (P < 0.001). Multivariate analysis suggested that abnormal mean corpuscular volume was an independent risk factor for postoperative recurrence (hazard ratio, 1.344; 95% confidence interval, 1.005-1.796; P = 0.046). Furthermore, its prognostic impact was more significant in pStage III than in other stages.
CONCLUSION
Preoperative low and high mean corpuscular volume is a poor prognostic factor in colorectal cancer patients. It could be a predictive marker to estimate worse survival outcome after surgery.
Topics: Biomarkers; Colorectal Neoplasms; Disease-Free Survival; Erythrocyte Indices; Humans; Neoplasm Staging; Prognosis; Proportional Hazards Models; Retrospective Studies
PubMed: 35253057
DOI: 10.1093/jjco/hyac023 -
Frontiers in Psychology 2022Third language (L3) learners have great potential in developing creativity; however, the factors affecting L3 learners' creativity have received little attention. This...
Third language (L3) learners have great potential in developing creativity; however, the factors affecting L3 learners' creativity have received little attention. This study investigated the relationships between proactive personality, three different thinking patterns (i.e., growth mindset, fixed mindset, and golden mean thinking), and creativity among L3 learners. The participants were 220 Chinese students who attended an obligatory L3 course in college. The results showed that proactive personality, growth mindset, golden mean thinking, and creativity had significant intercorrelations. Moreover, the role of growth mindset and golden mean thinking as mediators of the proactive personality and creativity relation was supported, and the mediating effect of growth mindset was larger than that of golden mean thinking. However, the fixed mindset did not show a significant indirect effect on the path from proactive personality to creativity. This is the first research to treat growth mindset, fixed mindset, and golden mean thinking as mediating variables on the path from proactive personality to creativity, particularly demonstrating that golden mean thinking, which is specific to Asian students and located midway between a growth mindset and a fixed mindset, can cultivate creativity. Some suggestions for fostering creativity in L3 students were also included in this study.
PubMed: 36405117
DOI: 10.3389/fpsyg.2022.969209 -
Journal of Patient Safety Dec 2021The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents' profession was...
OBJECTIVES
The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents' profession was examined.
METHODS
A cross-sectional study was conducted by administering the SCOPE-Primary Care questionnaire in two home care service organizations.
RESULTS
In total, 1875 valid questionnaires were returned from 2930 employees, representing a response rate of 64%. The highest mean patient safety culture score was found for "organizational learning" (mean [SD] = 3.81 [0.53]), followed by "support and fellowship" (mean [SD] = 3.76 [0.61]), "open communication and learning from error" (mean [SD] = 3.73 [0.64]), and "patient safety management" (mean [SD] = 3.71 [0.60]). The lowest mean scores were found for "handover and teamwork" (mean [SD] = 3.28 [0.58]) and "adequate procedures and working conditions" (mean [SD] = 3.30 [0.56]). Moreover, managers/supervisors scored significantly higher on the dimensions "open communication and learning from error," "adequate procedures and working conditions," "patient safety management," "support and fellowship," and "organizational learning" than clinical and nonclinical staff.
CONCLUSIONS
In conclusion, organizational learning is perceived as most positive. However, large gaps remain in the continuity of care as "handover and teamwork" is perceived as the most negative safety culture dimension. With knowledge of the current patient safety culture, organizations can redesign processes or implement improvement strategies to avoid patient safety incidents and patient harm in the future.
Topics: Attitude of Health Personnel; Cross-Sectional Studies; Humans; Organizational Culture; Patient Safety; Primary Health Care; Safety Management; Surveys and Questionnaires
PubMed: 29394195
DOI: 10.1097/PTS.0000000000000458