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https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#1
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28438178/automatic-construction-of-statistical-shape-models-using-deformable-simplex-meshes-with-vector-field-convolution-energy
#2
Jinke Wang, Changfa Shi
BACKGROUND: In the active shape model framework, principal component analysis (PCA) based statistical shape models (SSMs) are widely employed to incorporate high-level a priori shape knowledge of the structure to be segmented to achieve robustness. A crucial component of building SSMs is to establish shape correspondence between all training shapes, which is a very challenging task, especially in three dimensions. METHODS: We propose a novel mesh-to-volume registration based shape correspondence establishment method to improve the accuracy and reduce the computational cost...
April 24, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28435687/an-evaluation-of-low-volume-high-intensity-intermittent-training-hiit-for-health-risk-reduction-in-overweight-and-obese-men
#3
Benjamin M Kelly, Soteris Xenophontos, James A King, Myra A Nimmo
ᅟ: Both sprint interval training (SIT) and high-intensity intermittent training (HIIT) have been described as time-efficient strategies for inducing favourable metabolic and cardiorespiratory adaptations in healthy and diseased participants. BACKGROUND: To date, little attention has been given to profiling the potential health benefits of HIIT or modified HIIT training within overweight and obese cohorts with particular focus on inflammation. Within this pilot trial, we tested the hypothesis that 6 sessions of HIIT performed over 2 weeks with 1-2 days' rest would improve aerobic capacity, glucose metabolism and inflammatory profile in an overweight and obese male cohort...
2017: BMC Obesity
https://www.readbyqxmd.com/read/28435239/pulmonary-rehabilitation-for-copd-improves-exercise-time-rather-than-exercise-tolerance-effects-and-mechanisms
#4
Keisuke Miki, Ryoji Maekura, Seigo Kitada, Mari Miki, Kenji Yoshimura, Hiroshi Yamamoto, Toshiko Kawabe, Hiroyuki Kagawa, Yohei Oshitani, Akitoshi Satomi, Kohei Nishida, Nobuhiko Sawa, Kimiko Inoue
BACKGROUND: COPD patients undergoing pulmonary rehabilitation (PR) show various responses. The purpose of this study was to investigate the possible mechanisms and predictors of the response to PR in COPD patients. METHODS: Thirty-six stable COPD patients underwent PR including a 4-week high-intensity exercise training program, and they were evaluated by cardiopulmonary exercise testing. All patients (mean age 69 years, severe and very severe COPD 94%) were classified into four groups by whether the exercise time (Tex) or the peak oxygen uptake [Formula: see text] increased after PR: two factors increased (both the Tex and the peak [Formula: see text] increased); two factors decreased; time only increased (the Tex increased, but the peak [Formula: see text] economized); and [Formula: see text] only increased (the Tex decreased, but the peak [Formula: see text] increased)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28435096/improving-automated-multiple-sclerosis-lesion-segmentation-with-a-cascaded-3d-convolutional-neural-network-approach
#5
Sergi Valverde, Mariano Cabezas, Eloy Roura, Sandra González-Villà, Deborah Pareto, Joan C Vilanova, Lluís Ramió-Torrentà, Àlex Rovira, Arnau Oliver, Xavier Lladó
In this paper, we present a novel automated method for White Matter (WM) lesion segmentation of Multiple Sclerosis (MS) patient images. Our approach is based on a cascade of two 3D patch-wise convolutional neural networks (CNN). The first network is trained to be more sensitive revealing possible candidate lesion voxels while the second network is trained to reduce the number of misclassified voxels coming from the first network. This cascaded CNN architecture tends to learn well from a small (n≤35) set of labeled data of the same MRI contrast, which can be very interesting in practice, given the difficulty to obtain manual label annotations and the large amount of available unlabeled Magnetic Resonance Imaging (MRI) data...
April 18, 2017: NeuroImage
https://www.readbyqxmd.com/read/28434455/creating-a-pediatric-joint-council-to-promote-patient-safety-and-quality-governance-and-accountability-across-johns-hopkins-medicine
#6
Michael Rosen, Brigitta U Mueller, Aaron M Milstone, Denise R Remus, Renee Demski, Peter J Pronovost, Marlene R Miller
BACKGROUND: Large multihospital health systems with multiple children's hospitals are relatively few in number. With a paucity of national pediatric measures for quality and patient safety, there are unique challenges to ensuring consistent levels of care across diverse health care delivery settings. At Johns Hopkins Medicine, a Pediatric Joint Council was created to help ensure high-quality and safe care across a health system encompassing two full-service children's hospitals and two community hospitals with significant pediatric volumes across two states...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28433473/sex-difference-in-the-heat-shock-response-to-high-external-load-resistance-training-in-older-humans
#7
Rose Njemini, Louis Nuvagah Forti, Tony Mets, Evelien Van Roie, Walter Coudyzer, Ingo Beyer, Christophe Delecluse, Ivan Bautmans
BACKGROUND: Literature reports on the effects of resistance training on heat shock protein70 (Hsp70) adaptation in older subjects are scarce. Moreover, the optimum training load required to obtain a beneficial adaptation profile is lacking. Therefore, the aim of this study was to determine the effects of resistance training at various external loads on extracellular Hsp70 (eHsp70) resting levels in older humans. METHODS: Fifty-six community-dwelling older (68±5years) volunteers were randomized to 12weeks of resistance training (3×/week) at either high-resistance (HIGH, 8 males, 10 females, 2×10-15 repetitions at 80%1RM), low resistance (LOW, 9 Males, 10 Females, 1×80-100 repetitions at 20%1RM), or mixed low resistance (LOW+, 9 Males, 10 Females, 1×60 repetitions at 20%1RM followed by 1×10-20 repetitions at 40%1RM)...
April 19, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28433237/inspiratory-muscle-training-improves-respiratory-muscle-strength-functional-capacity-and-quality-of-life-in-patients-with-chronic-kidney-disease-a-systematic-review
#8
Ana Irene Carlos de Medeiros, Helen Kerlen Bastos Fuzari, Catarina Rattesa, Daniella Cunha Brandão, Patrícia Érika de Melo Marinho
QUESTION: Does inspiratory muscle training improve respiratory muscle strength, functional capacity, lung function and quality of life of patients with chronic kidney disease? Does inspiratory muscle training improve these outcomes more than breathing exercises? DESIGN: Systematic review and meta-analysis of randomised trials. PARTICIPANTS: People with chronic kidney disease undergoing dialysis treatment. OUTCOME MEASURES: The primary outcomes were: maximal inspiratory pressure, maximal expiratory pressure, and distance covered on the 6-minute walk test...
April 2017: Journal of Physiotherapy
https://www.readbyqxmd.com/read/28431408/the-effects-of-exercise-modality-during-additional-high-intensity-interval-training-upon-aerobic-fitness-and-strength-in-powerlifting-and-strongman-athletes
#9
Patroklos Androulakis-Korakakis, Louis Langdown, Adam Lewis, James Fisher, Paulo Gentil, Antonio Paoli, James Steele
Powerlifters and strongman athletes have a necessity for optimal levels of muscular strength whilst maintaining sufficient aerobic capacity to perform and recover between events. HIIT has been popularized for its efficacy in improving both aerobic fitness and strength but never assessed within the aforementioned population group. The present study looked to compare the effect of exercise modality, e.g. a traditional aerobic mode (AM), and strength mode, (SM), during HIIT upon aerobic fitness and strength. Sixteen well resistance trained male participants, currently competing in powerlifting and strongman events, completed 8 weeks of approximately effort- and volume-matched HIIT in 2 groups: AM (cycling, n=8) and SM (resistance training, n=8)...
April 21, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28431275/learning-non-rigid-deformations-for-robust-constrained-point-based-registration-in-image-guided-mr-trus-prostate-intervention
#10
John A Onofrey, Lawrence H Staib, Saradwata Sarkar, Rajesh Venkataraman, Cayce B Nawaf, Preston C Sprenkle, Xenophon Papademetris
Accurate and robust non-rigid registration of pre-procedure magnetic resonance (MR) imaging to intra-procedure trans-rectal ultrasound (TRUS) is critical for image-guided biopsies of prostate cancer. Prostate cancer is one of the most prevalent forms of cancer and the second leading cause of cancer-related death in men in the United States. TRUS-guided biopsy is the current clinical standard for prostate cancer diagnosis and assessment. State-of-the-art, clinical MR-TRUS image fusion relies upon semi-automated segmentations of the prostate in both the MR and the TRUS images to perform non-rigid surface-based registration of the gland...
April 12, 2017: Medical Image Analysis
https://www.readbyqxmd.com/read/28427550/home-made-spacer-as-an-auxiliary-device-in-administration-of-beclomethasone-via-pressurized-metered-dose-inhaler-for-asthma-control-a-randomized-controlled-pragmatic-trial
#11
Deborah Schor, José Ângelo Rizzo, Decio Medeiros, Ana Carolina Dela Bianca, Almerinda Rego Silva, Carlos Nunes, Mário Morais-Almeida, Emanuel Sarinho
BACKGROUND: Holding chambers or spacers can enhance the efficacy of pressurized metered dose inhalers (pMDI) in delivering inhaled medications, as they reduce the need for hand-breath coordination and improve lower airways deposition. Nevertheless, their cost can be high for patients in low-income countries. OBJECTIVE: To compare asthma control achieved with beclomethasone-dipropionate administered through a hydrofluoroalkane-driven pMDI (BDp-pMDI) coupled to a home-made spacer (HmS) or to a valved commercial spacer (VCS) as auxiliary devices...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28426514/comparison-of-the-hang-high-pull-and-loaded-jump-squat-for-the-development-of-vertical-jump-and-isometric-force-time-characteristics
#12
Dustin J Oranchuk, Tracey L Robinson, Zachary J Switaj, Eric J Drinkwater
Weightlifting movements have high skill demands and require expert coaching. Loaded jumps have a comparably lower skill demand, but may be similarly effective for improving explosive performance. The purpose of this study was to compare vertical jump performance, isometric force, and rate of force development (RFD) following a ten-week intervention employing the hang high-pull (hang-pull) or trap-bar jump squat (jump-squat). Eighteen NCAA Division II swimmers (8 males, 10 females) with at least one year of resistance training experience volunteered to participate...
April 15, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28422779/the-utility-of-high-fidelity-simulation-for-training-critical-care-fellows-in-the-management-of-extracorporeal-membrane-oxygenation-emergencies-a-randomized-controlled-trial
#13
Bishoy M Zakhary, Lily M Kam, Brian S Kaufman, Kevin J Felner
OBJECTIVE: Although extracorporeal membrane oxygenation volume has increased, proficiency in the technology requires extensive training. We compared traditional water-drill-based extracorporeal membrane oxygenation training with simulation-based extracorporeal membrane oxygenation training with the hypothesis that simulation-based training is superior. DESIGN: Randomized controlled trial. SETTING: Academic medical center. SUBJECTS: Pulmonary/critical care fellows...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28420999/functional-high-intensity-circuit-training-improves-body-composition-peak-oxygen-uptake-strength-and-alters-certain-dimensions-of-quality-of-life-in-overweight-women
#14
Billy Sperlich, Birgit Wallmann-Sperlich, Christoph Zinner, Valerie Von Stauffenberg, Helena Losert, Hans-Christer Holmberg
The effects of circuit-like functional high-intensity training (CircuitHIIT) alone or in combination with high-volume low-intensity exercise (Circuitcombined) on selected cardio-respiratory and metabolic parameters, body composition, functional strength and the quality of life of overweight women were compared. In this single-center, two-armed randomized, controlled study, overweight women performed 9-weeks (3 sessions·wk(-1)) of either CircuitHIIT (n = 11), or Circuitcombined (n = 8). Peak oxygen uptake and perception of physical pain were increased to a greater extent (p < 0...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28420250/the-european-association-of-preventive-cardiology-exercise-prescription-in-everyday-practice-and-rehabilitative-training-expert-tool-a-digital-training-and-decision-support-system-for-optimized-exercise-prescription-in-cardiovascular-disease-concept-definitions
#15
Dominique Hansen, Paul Dendale, Karin Coninx, Luc Vanhees, Massimo F Piepoli, Josef Niebauer, Veronique Cornelissen, Roberto Pedretti, Eva Geurts, Gustavo R Ruiz, Ugo Corrà, Jean-Paul Schmid, Eugenio Greco, Constantinos H Davos, Frank Edelmann, Ana Abreu, Bernhard Rauch, Marco Ambrosetti, Simona S Braga, Olga Barna, Paul Beckers, Maurizio Bussotti, Robert Fagard, Pompilio Faggiano, Esteban Garcia-Porrero, Evangelia Kouidi, Michel Lamotte, Daniel Neunhäuserer, Rona Reibis, Martijn A Spruit, Christoph Stettler, Tim Takken, Cajsa Tonoli, Carlo Vigorito, Heinz Völler, Patrick Doherty
Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28419206/short-term-preoperative-exercise-therapy-does-not-improve-long-term-outcome-after-lung-cancer-surgery-a-randomized-controlled-study%C3%A2
#16
Wolfram Karenovics, Marc Licker, Christoph Ellenberger, Michel Christodoulou, John Diaper, Chetna Bhatia, John Robert, Pierre-Olivier Bridevaux, Frédéric Triponez
OBJECTIVES: Poor aerobic fitness is a potential modifiable risk factor for long-term survival and quality of life in patients with lung cancer. This randomized trial evaluates the impact of adding rehabilitation (Rehab) with high-intensity interval training (HIIT) before lung cancer surgery to enhance cardiorespiratory fitness and improve long-term postoperative outcome. METHODS: Patients with operable lung cancer were randomly assigned to usual care (UC, n  = 77) or to intervention group (Rehab, n  = 74) that entailed HIIT that was implemented only preoperatively...
April 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28410880/the-effect-of-user-experience-and-inflation-technique-on-endotracheal-tube-cuff-pressure-using-a-feline-airway-simulator
#17
Donna M White, José I Redondo, Alastair R Mair, Fernando Martinez-Taboada
OBJECTIVE: The effect of user experience and inflation technique on endotracheal tube cuff pressure using a feline airway simulator. STUDY DESIGN: Prospective, experimental clinical study. METHODS: Participants included veterinary students at the beginning (group S1) and end (group S2) of their 2-week anaesthesia rotation and veterinary anaesthetists (group A). The feline airway simulator was designed to simulate an average size feline trachea, intubated with a 4...
February 24, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28409690/salivary-cortisol-concentration-after-high-intensity-interval-exercise-time-of-day-and-chronotype-effect
#18
Matteo Bonato, Antonio La Torre, Marina Saresella, Ivana Marventano, Giampiero Merati, Jacopo Antonino Vitale
Due to personal and working necessities, the time for exercise is often short, and scheduled early in the morning or late in the afternoon. Cortisol plays a central role in the physiological and behavioral response to a physical challenge and can be considered as an index of exercise stress. Therefore, the aim of this study was to evaluate the influence of the circadian phenotype classification on salivary cortisol concentration in relation to an acute session of high-intensity interval exercise (HIIE) performed at different times of the day...
April 14, 2017: Chronobiology International
https://www.readbyqxmd.com/read/28399624/effect-of-respiratory-muscle-training-on-pulmonary-function-and-aerobic-endurance-in-soccer-players
#19
Tarik Ozmen, Gokce Y Gunes, Ilyas Ucar, Hanife Dogan, Tuba U Gafuroglu
BACKGROUND: Few studies investigated the effects of the respiratory muscle training (RMT) in soccer although exhaustive high intensity exercise is known to lead to muscle fatigue in respiratory muscles. The purpose of this study was to investigate the effect of RMT on pulmonary function and aerobic endurance in soccer players. METHODS: Eighteen male soccer players (mean age 22.2±1.4 years) participated in this study. Participants were assigned randomly to either an RMT or a control (CON) group...
May 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28399607/surgeon-reported-needs-for-improved-training-in-identifying-and-managing-free-flap-compromise
#20
Catherine McMillan, Veerle D'Hondt, Alexandra H Marshall, Paul Binhammer, Joan Lipa, Laura Snell
Background This study examined the need for improved training in the identification and management of free flap (FF) compromise and assessed a potential role for simulated scenario training. Methods Online needs assessment surveys were completed by plastic surgeons and a subsample with expertise in microsurgery education participated in focus groups. Data were analyzed using descriptive statistics and mixed qualitative methods. Results In this study, 77 surgeons completed surveys and 11 experts participated in one of two focus groups...
April 11, 2017: Journal of Reconstructive Microsurgery
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