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learning curve

Robert N Goldstone, Shirin R Hasan, Steven Drury, Teresa M Darragh, Annemieke van Zante, Stephen E Goldstone
PURPOSE: Radiofrequency ablation (RFA) effectively treats esophageal high-grade dysplasia, but its efficacy in treating anal canal high-grade squamous intraepithelial lesions (HSILs) is unsubstantiated. This prospective study assessed the safety and efficacy of applying hemi-circumferential RFA to anal canal HSIL. METHODS: Twenty-one HIV-negative participants with HSIL occupying ≤ half the anal canal circumference were treated with hemi-circumferential anal canal RFA...
October 21, 2016: International Journal of Colorectal Disease
Eddie Y Liu, Bo Li, Cindy M L Hutnik
Wet lab and surgical simulation can reduce the learning curve of difficult surgical techniques, accelerate the rate for trainees to achieve surgical competency, and improve patient safety. To provide the most up-to-date information and hands-on experiences with novel ophthalmic surgical techniques and instruments, the Department of Ophthalmology at Western University has created a wet lab-based, multilevel microsurgery skills transfer course through collaboration with various industry partners. Several elements in the course goal and design differentiate this type of surgical course from typical wet labs: the format is multileveled surgical training, with a beginner level targeting undergraduate medical students, an intermediate level for ophthalmology residents, and an advanced level for trained ophthalmologist...
October 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Nathan T Zwagerman, Georgios Zenonos, Stefan Lieber, Wei-Hsin Wang, Eric W Wang, Juan C Fernandez-Miranda, Carl H Snyderman, Paul A Gardner
The endoscopic endonasal approach (EEA) has significantly evolved since its initial uses in pituitary and sinonasal surgery. The literature is filled with reports and case series demonstrating efficacy and advantages for the entire ventral skull base. With competence in 'minimally invasive' parasellar approaches, larger and more complex approaches were developed to utilize the endonasal corridor to create maximally invasive endoscopic skull base procedures. The challenges of these more complex endoscopic procedures include a long learning curve and navigating in a narrow corridor; reconstruction of defects presented new challenges and early experience revealed a significantly higher risk of cerebrospinal fluid leak...
October 20, 2016: Journal of Neuro-oncology
Benoit Peyronnet, Grégoire Robert, Vincent Comat, Morgan Rouprêt, Fernando Gomez-Sancha, Jean-Nicolas Cornu, Vincent Misrai
PURPOSE: To compare the learning curves, perioperative and early functional outcomes after HoLEP and GreenLEP. METHODS: Data from the first 100 consecutive cases treated by GreenLEP and HoLEP by two surgeons were prospectively collected from dedicated databases and analysed retrospectively. En-bloc GreenLEP and two-lobar HoLEP enucleations were conducted using the GreenLight HPS™ 2090 laser and Lumenis™ holmium laser. Patients' characteristics, perioperative outcomes and functional outcomes after 1, 3 and 6 months were compared between groups...
October 20, 2016: World Journal of Urology
Matthew C Henn, Thomas Percival, Alan Zajarias, Spencer J Melby, Brian R Lindman, Nishath Quader, Ralph J Damiano, Marc R Moon, John M Lasala, Ravinder S Rao, Jennifer Bell, Marci S Damiano, Hersh S Maniar
BACKGROUND: Smaller transcatheter aortic valve replacement (TAVR) delivery systems have increased the number of patients eligible for transfemoral procedures while decreasing the need for transaortic (TAo) or transapical (TA) access. As a result, newer TAVR centers are likely to have less exposure to these alternative access techniques, making it harder to achieve proficiency. The purpose of this study was to evaluate the learning curve for TAVR approaches and compare perioperative outcomes...
October 17, 2016: Annals of Thoracic Surgery
Hasseeb Azzawi, Jingyu Hou, Yong Xiang, Russul Alanni
Lung cancer is a leading cause of cancer-related death worldwide. The early diagnosis of cancer has demonstrated to be greatly helpful for curing the disease effectively. Microarray technology provides a promising approach of exploiting gene profiles for cancer diagnosis. In this study, the authors propose a gene expression programming (GEP)-based model to predict lung cancer from microarray data. The authors use two gene selection methods to extract the significant lung cancer related genes, and accordingly propose different GEP-based prediction models...
October 2016: IET Systems Biology
Shekhar Dethe, M Deepak, Amit Agarwal
BACKGROUND: Bacopa monnieri (L.) Wettst., commonly known as Brahmi, is renowned in Indian traditional system for its potent memory enhancing activity, which has been validated by various scientific studies. OBJECTIVE: The objective of this study was to understand the molecular mechanism of memory enhancing activity of BacoMind(®) (BM), a standardized extract of B. monnieri. MATERIALS AND METHODS: BM was screened in vitro in a panel of cell-free and receptor-transfected cell assays...
July 2016: Pharmacognosy Magazine
Vladimir Dedovic, Goran Stankovic
Despite permanent improvement in success rate and technical developments, chronic total occlusion (CTO) remains undertreated by percutaneous coronary intervention (PCI). Dedicated CTO operators from Japan, Europe and USA perform these procedures with success rate beyond 90%, but there is still huge gap between this group of specialists and broader population of PCI operators. Recently proposed CTO scores can be used for patients' selection according to the CTO operators' experience. Patients with low CTO score values may be suitable for less experienced operators at the beginning of the CTO PCI learning curve, while more complex CTOs (higher CTO score values) should be differed to CTO experts...
October 19, 2016: Panminerva Medica
R John Sawyer, S Marc Testa, Moira Dux
OBJECTIVE: Various research studies and neuropsychology practice organizations have reiterated the importance of developing embedded performance validity tests (PVTs) to detect potentially invalid neurocognitive test data. This study investigated whether measures within the Hopkins Verbal Learning Test - Revised (HVLT-R) and the Brief Visuospatial Memory Test - Revised (BVMT-R) could accurately classify individuals who fail two or more PVTs during routine clinical assessment. METHOD: The present sample of 109 United States military veterans (Mean age = 52...
October 19, 2016: Clinical Neuropsychologist
Timothy B Lannin, Fredrik I Thege, Brian J Kirby
Advances in rare cell capture technology have made possible the interrogation of circulating tumor cells (CTCs) captured from whole patient blood. However, locating captured cells in the device by manual counting bottlenecks data processing by being tedious (hours per sample) and compromises the results by being inconsistent and prone to user bias. Some recent work has been done to automate the cell location and classification process to address these problems, employing image processing and machine learning (ML) algorithms to locate and classify cells in fluorescent microscope images...
October 2016: Cytometry. Part A: the Journal of the International Society for Analytical Cytology
A van Uitert, F C H d'Ancona, J Deinum, H J L M Timmers, J F Langenhuijsen
BACKGROUND: Laparoscopic adrenalectomy is an effective method for benign adrenal tumor removal. In the literature, both lateral transperitoneal (TLA) and posterior retroperitoneoscopic (RPA) approaches are described. Since 2007, the number of patients increased significantly in our center. Therefore, RPA was introduced in 2011 because of its potential advantages in operating and recovery times. The learning curve of RPA is now evaluated. METHODS: All data of patients undergoing laparoscopic adrenalectomy from 2007 until 2014 were prospectively collected...
October 17, 2016: Surgical Endoscopy
Pedro Roldán, Sergio García, Josep González, Luis Alberto Reyes, Jorge Torales, Ricard Valero, Laura Oleaga, Joaquim Enseñat
OBJECTIVES: Intra-operative magnetic resonance imaging (iMRI) is a recently introduced tool in the most advanced neurosurgical operating rooms worldwide. We present our preliminary experience in brain tumour surgery with low field PoleStar N30® intraoperative MRI since its introduction in 2013 in the Barcelona Clinic Hospital. MATERIAL AND METHODS: A prospective non-randomised study was conducted on cases operated on using iMRI and intention of complete removal up to October 2015...
October 14, 2016: Neurocirugía
Sheng-Han Tsai, Chien-An Liu, Kuo-Hung Huang, Yuan-Tzu Lan, Ming-Huang Chen, Yee Chao, Su-Shun Lo, Anna Fen-Yau Li, Chew-Wun Wu, Shih-Hwa Chiou, Muh-Hwa Yang, Yi-Ming Shyr, Wen-Liang Fang
Robot-assisted gastrectomy has been reported to be a safe alternative to both conventional laparoscopy and the open approach for treating early gastric carcinoma. Currently, there are a limited number of published reports on this technique in the literature. We assessed the current status of robotic and laparoscopic surgery in the treatment of gastric cancer and compared the operative outcomes, learning curves, and oncological outcome of the two approaches. Robotic gastrectomy offers benefits that include increased ease of performing D2 lymph node dissection and reduced blood loss compared with laparoscopic gastrectomy...
October 17, 2016: Pathology Oncology Research: POR
Antonio Mazzella, Anne Olland, Pierre Emmanuel Falcoz, Stephane Renaud, Nicola Santelmo, Gilbert Massard
BACKGROUND: This study evaluates the number of video-assisted thoracic surgery-lobectomies (VATS-lobectomies) required for an experienced consultant thoracic surgeon to obtain competence and to perform standard quality surgery. METHODS: We have analysed the initial VATS-experience (January 2012 to September 2014) of a confirmed senior consultant who has performed 145 consecutive anatomic resections by thoracoscopy. After excluding bilobectomies, segmentectomies, and lobectomies for infectious disease, we have focused into 119 consecutive lobectomies, classified into 4 chronologic groups of 30 each...
September 2016: Journal of Thoracic Disease
Arvind G Kulkarni, Hussain Bohra, Abhilash Dhruv, Abhishek Sarraf, Anupreet Bassi, Vishwanath M Patil
BACKGROUND: The aim of the present prospective study is to evaluate whether the touted advantages of minimal invasive-transforaminal lumbar interbody fusion (MI-TLIF) translate into superior, equal, or inferior outcomes as compared to open-transforaminal lumbar interbody fusion (O-TLIF). This is the first study from the Indian subcontinent prospectively comparing the outcomes of MI-TLIF and O-TLIF. MATERIALS AND METHODS: All consecutive cases of open and MI-TLIF were prospectively followed up...
September 2016: Indian Journal of Orthopaedics
Harneet Gujral, Annmarie Vilkins, Nisse Clark, Alison B Vogell, Kelly N Wright
STUDY OBJECTIVE: To compare the operative time of contained hand tissue extraction to power morcellation and to quantify the learning curve required to develop this skill. DESIGN: Retrospective cohort study DESIGN: Classification: II-3 SETTING: Lahey Hospital and Medical Center, a suburban academic tertiary care center serving a broad base of patients. PATIENTS: Eighty-eight women undergoing laparoscopic hysterectomy requiring morcellation or tissue extraction from 2012 through 2015...
October 13, 2016: Journal of Minimally Invasive Gynecology
Li-Jen Kuo, James Chi-Yong Ngu, Yiu-Shun Tong, Chia-Che Chen
OBJECTIVE: Robot-assisted rectal surgery is gaining popularity, and robotic single-site surgery is also being explored clinically. We report our initial experience with robotic transanal total mesorectal excision (R-taTME) and radical proctectomy using the robotic single-site plus one-port (R-SSPO) technique for low rectal surgery. METHODS: Between July 2015 and March 2016, 15 consecutive patients with ultra-low rectal lesions underwent R-taTME followed by radical proctectomy using the R-SSPO technique by a single surgeon...
October 15, 2016: International Journal of Colorectal Disease
Chikezie I Eseonu, Karim ReFaey, Jordina Rincon-Torroella, Oscar Garcia, Gary S Wand, Roberto Salvatori, Alfredo Quinones-Hinojosa
OBJECTIVE: The transition from microscopic to a fully endoscopic transsphenoidal surgery requires a surgeon to assess how the change in technique will affect the extent of tumor resection (EOR), outcomes, and complications. We compared a single surgeon's experience transitioning from one technique to the other, and examined the operative outcomes and EOR between microscopic versus endoscopic transsphenoidal surgery. METHODS: Retrospective data analysis of adult patients who were treated surgically for a pituitary adenoma between August 2005 and May 2015 by a single neurosurgeon, who was originally trained and practiced in the microscopic transsphenoidal approach...
October 11, 2016: World Neurosurgery
Simon Kocbek, Lawrence Cavedon, David Martinez, Christopher Bain, Chris Mac Manus, Gholamreza Haffari, Ingrid Zukerman, Karin Verspoor
OBJECTIVE: Text and data mining play an important role in obtaining insights from Health and Hospital Information Systems. This paper presents a text mining system for detecting admissions marked as positive for several diseases: Lung Cancer, Breast Cancer, Colon Cancer, Secondary Malignant Neoplasm of Respiratory and Digestive Organs, Multiple Myeloma and Malignant Plasma Cell Neoplasms, Pneumonia, and Pulmonary Embolism. We specifically examine the effect of linking multiple data sources on text classification performance...
October 11, 2016: Journal of Biomedical Informatics
Anthony J Rosellini, John Monahan, Amy E Street, Eric D Hill, Maria Petukhova, Ben Y Reis, Nancy A Sampson, David M Benedek, Paul Bliese, Murray B Stein, Robert J Ursano, Ronald C Kessler
Growing concerns exist about violent crimes perpetrated by U.S. military personnel. Although interventions exist to reduce violent crimes in high-risk populations, optimal implementation requires evidence-based targeting. The goal of the current study was to use machine learning methods (stepwise and penalized regression; random forests) to develop models to predict minor violent crime perpetration among U.S. Army soldiers. Predictors were abstracted from administrative data available for all 975,057 soldiers in the U...
September 30, 2016: Journal of Psychiatric Research
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