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https://www.readbyqxmd.com/read/28646483/from-novice-to-expert-analyzing-the-learning-curve-for-mri-transrectal-ultrasonography-fusion-guided-transrectal-prostate-biopsy
#1
R Mager, M P Brandt, H Borgmann, K M Gust, A Haferkamp, M Kurosch
PURPOSE: To investigate the learning curve of a novice in MRI/TRUS software fusion biopsy and to compare his results with the expert standard at our institution. METHODS: Overall 126 MRI/TRUS fusion-guided transrectal biopsies were performed using an electromagnetic tracking ultrasonography platform. The learning progress of the novice was evaluated comparing his initial 42 procedures (group A) with his following 42 (group B). The institution's expert standard (group C), which was compared to the novice's groups, was defined by the expert's experience of 42 MRI/TRUS fusion biopsies...
June 23, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28646321/early-outcomes-of-robotic-assisted-inguinal-hernia-repair-in-obese-patients-a-multi-institutional-retrospective-study
#2
Ramachandra Kolachalam, Eugene Dickens, Lawrence D'Amico, Christopher Richardson, Jorge Rabaza, Reza Gamagami, Anthony Gonzalez
BACKGROUND: Minimally invasive inguinal hernia repair (IHR) in general and particularly in obese patients has not been widely adopted, potentially due to the perceived technical challenges and the well-documented learning curve associated with laparoscopic repair. Outcomes in robotic-assisted IHR in obese (BMI ≥ 30 kg/m(2)) patients have not been described and warrant study. METHODS: Seven surgeons conducted a multicenter retrospective chart review of their early robotic-assisted IHR (RHR) cases and compared them with their open IHR (OHR) cases...
June 23, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28644545/robotic-versus-laparoscopic-rectal-surgery-in-high-risk-patients
#3
Jamil Ahmed, Han Cao, Sofoklis Panteleimonitis, Jim Khan, Amjad Parvaiz
AIM: Laparoscopic rectal surgery is associated with a steep learning curve and high conversion rate despite progress in equipment design and consistent practice. The robotic system has shown the advantage over laparoscopic approach due to stable three-dimensional views, improved dexterity and better ergonomics. These factors make the robotic approach more favourable for rectal surgery. The aim of this study was to compare the perioperative outcomes of laparoscopic and robotic rectal cancer surgery in high-risk patients...
June 23, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28644239/effect-of-the-learning-curve-on-visual-and-refractive-outcomes-of-small-incision-lenticule-extraction
#4
Tommy C Y Chan, Alex L K Ng, George P M Cheng, Victor C P Woo, Jiamei Zhang, Yan Wang, Vishal Jhanji
PURPOSE: To investigate the effect of the learning curve for small-incision lenticule extraction during the first 2 years of experience. METHODS: Small-incision lenticule extraction was performed using the 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec) by the same surgeon. The initial 100 patients since the surgeon started operating independently were considered as group 1; the recent 100 patients were considered as group 2. The same laser settings and technique were used...
June 21, 2017: Cornea
https://www.readbyqxmd.com/read/28643605/novel-simulation-device-for-targeting-tumors-in-laparoscopic-ablation-a-learning-curve-study
#5
Zeljka Jutric, Jan Grendar, William L Brown, Maria A Cassera, Ronald F Wolf, Paul D Hansen, Chet W Hammill
INTRODUCTION: A novel 3-dimensional (3D) guidance system was developed to aid accurate needle placement during ablation. METHODS: Five novices and 5 experienced hepatobiliary surgeons were recruited. Using an agar block with analog tumor, participants targeted under 4 conditions: in-line with the ultrasound plane using ultrasound, in-line using 3D guidance, 45° off-axis using ultrasound, and off-axis using 3D guidance. Time to target the tumor, number of withdrawals, and the National Aeronautics and Space Administration Task Load Index were collected...
June 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28643302/-comparison-of-robotic-and-laparoscopic-total-mesorectal-excision
#6
Pan Chi, Zhifen Chen
Laparoscopic total mesorectal excision (TME) has been commonly applied in the operation of mid-low rectal cancer, but the conventional laparoscopic TME has the disadvantages of major operative difficulty and long learning-curve, due to its limitations of 2-dimension vision and common laparoscopic instruments. Robotic surgical system with high-qualified 3-dimenstion vision and flexible Endo Wrist instruments can overcome those limitations of conventional laparoscopy, and is useful for the TME that demands deep pelvic operation and flexible dissection in the space of distal rectum...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28643300/-advantages-and-disadvantages-of-minimally-invasive-surgery-in-colorectal-cancer-surgery
#7
Minhua Zheng, Junjun Ma
Since the emergence of minimally invasive technology twenty years ago, as a surgical concept and surgical technique for colorectal cancer surgery, its obvious advantages have been recognized. Laparoscopic technology, as one of the most important technology platform, has got a lot of evidence-based support for the oncological safety and effectiveness in colorectal cancer surgery Laparoscopic technique has advantages in terms of identification of anatomic plane and autonomic nerve, protection of pelvic structure, and fine dissection of vessels...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28643059/the-learning-effect-of-using-stereoscopic-vision-in-the-early-phase-of-laparoscopic-surgical-training-for-novices
#8
Hitoshi Harada, Shingo Kanaji, Masayasu Nishi, Yoshito Otake, Hiroshi Hasegawa, Masashi Yamamoto, Yoshiko Matsuda, Kimihiro Yamashita, Takeru Matsuda, Taro Oshikiri, Yasuo Sumi, Tetsu Nakamura, Satoshi Suzuki, Yoshinobu Sato, Yoshihiro Kakeji
BACKGROUND: Recently to improve depth perception, the performance of three-dimensional (3D) laparoscopic surgeries has increased. However, the effects of laparoscopic training using 3D are still unclear. This study aimed to clarify the effects of using a 3D monitor among novices in the early phase of training. METHODS: Participants were 40 novices who had never performed laparoscopic surgery (20 medical students and 20 junior residents). Three laparoscopic phantom tasks (task 1: touching markers on a flat disk with a rod; task 2: straight rod transfer through a single loop; and task 3: curved rod transfer through two loops) in the training box were performed ten times, respectively...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28640984/is-it-right-to-ignore-learning-curve-patients-laparoscopic-colorectal-trials
#9
Alan P Meagher, Shi Yang, Shuyuan Li
BACKGROUND: Increasingly complex, technically demanding surgical procedures utilizing emerging technologies have developed over recent decades and are recognized as having long 'learning curves'. This raises significant new issues. Ethically and scientifically, the outcome of a patient in the learning curve is as important as the outcome of a patient outside the learning curve. The aim of this study is to highlight just one aspect of our approach to learning-curve patients that should change...
June 22, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28640655/usual-interstitial-pneumonia-can-be-detected-in-transbronchial-biopsies-using-machine-learning
#10
Daniel G Pankratz, Yoonha Choi, Urooj Imtiaz, Grażyna M Fedorowicz, Jessica D Anderson, Thomas V Colby, Jeffrey L Myers, David A Lynch, Kevin K Brown, Kevin R Flaherty, Mark P Steele, Steve D Groshong, Ganesh Raghu, Neil M Barth, P Sean Walsh, Jing Huang, Giulia C Kennedy, Fernando J Martinez
RATIONALE: Usual interstitial pneumonia (UIP) is the histopathologic hallmark of idiopathic pulmonary fibrosis. While UIP can be detected by high-resolution computed tomography (HRCT) of the chest, HRCT results are frequently inconclusive, and pathology from transbronchial biopsy (TBB) has poor sensitivity. Surgical lung biopsy (SLB) may be necessary for a definitive diagnosis. OBJECTIVES: To develop a genomic classifier in tissue obtained by TBB that distinguishes UIP from non-UIP, trained against central pathology as the reference standard...
June 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28640478/usefulness-of-office-examination-with-narrow-band-imaging-for-the-diagnosis-of-head-and-neck-squamous-cell-carcinoma-and-follow-up-of-premalignant-lesions
#11
Isabel Vilaseca, Meritxell Valls-Mateus, Anna Nogués, Eduardo Lehrer, Mauricio López-Chacón, Francesc Xavier Avilés-Jurado, José Luis Blanch, Manuel Bernal-Sprekelsen
BACKGROUND: The purpose of this study was to evaluate the value of narrow band imaging (NBI) examination in the office for the diagnosis and follow-up of upper airway premalignant and malignant lesions. METHODS: Four hundred eighty lesions were evaluated with white light endoscopy (WLE) and NBI before a biopsy/excision. Additionally, 151 premalignant lesions were followed up without proven biopsy. Carcinoma-free survival was calculated. The learning curve was analyzed...
June 22, 2017: Head & Neck
https://www.readbyqxmd.com/read/28640248/voluntary-distance-running-prevents-tnf-mediated-liver-injury-in-mice-through-alterations-of-the-intrahepatic-immune-milieu
#12
Yvonne Huber, Nadine Gehrke, Jana Biedenbach, Susanne Helmig, Perikles Simon, Beate K Straub, Ina Bergheim, Tobias Huber, Detlef Schuppan, Peter R Galle, Marcus A Wörns, Marcus Schuchmann, Jörn M Schattenberg
Physical activity confers a broad spectrum of health benefits. Beyond the obvious role in metabolically driven diseases, the role of physical activity in acute liver injury is poorly explored. To study the role of physical activity in acute liver injury, a novel model of voluntary distance running in mice was developed and mice were subjected to acute liver injury induced by N-galactosamine (GalN) and lipopolysaccharide (LPS). Analyses included histological stains, immunoblotting, qRT-PCR and FACS analysis...
June 22, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28640031/identifying-gaps-in-the-performance-of-pediatric-trainees-who-receive-marginal-unsatisfactory-ratings
#13
Su-Ting T Li, Daniel J Tancredi, Alan Schwartz, Ann Guillot, Ann Burke, R Franklin Trimm, Susan Guralnick, John D Mahan, Kimberly A Gifford
PURPOSE: To perform a derivation study to determine in which subcompetencies marginal/unsatisfactory pediatric residents had the greatest deficits compared with their satisfactorily performing peers and which subcompetencies best discriminated between marginal/unsatisfactory and satisfactorily performing residents. METHOD: Multi-institutional cohort study of all 21 milestones (rated on four or five levels) reported to the Accreditation Council for Graduate Medical Education, and global marginal/unsatisfactory versus satisfactory performance reported to the American Board of Pediatrics...
June 20, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28638915/-optogenetic-activation-of-dorsal-hippocampal-astrocytic-rac1-blocks-the-learning-of-associative-memory
#14
Xiao-Mu Guo, Zhao-Hui Liao, Ye-Zheng Tao, Fei-Fei Wang, Lan Ma
Rac1 belongs to the family of Rho GTPases, and plays important roles in the brain function. It affects the cell migration and axon guidance via regulating the cytoskeleton and cellular morphology. However, the effect of its dynamic activation in regulating physiological function remains unclear. Recently, a photoactivatable analogue of Rac1 (PA-Rac1) has been developed, allowing the activation of Rac1 by the specific wavelength of light in living cells. Thus, we constructed recombinant adeno-associated virus (AAV) of PA-Rac1 and its light-insensitive mutant PA-Rac1-C450A under the control of the mouse glial fibrillary acidic protein (mGFAP) promoter to manipulate Rac1 activity in astrocytes by optical stimulation...
June 25, 2017: Sheng Li Xue Bao: [Acta Physiologica Sinica]
https://www.readbyqxmd.com/read/28637364/comparison-of-perioperative-outcomes-between-holmium-laser-enucleation-of-the-prostate-and-robotic-assisted-simple-prostatectomy
#15
Mimi Zhang, Marawan El Tayeb, Michael Borofsky, Casey Dauw, Kristofer R Wagner, Patrick S Lowry, Erin T BIrd, Tillman C Hudson, James E Lingeman
OBJECTIVES: To compare perioperative outcomes for patients undergoing holmium laser enucleation of the prostate (HoLEP) and robotic assisted simple prostatectomy (RSP) for benign prostatic hypertrophy (BPH). METHODS: Patient demographics and perioperative outcomes were compared between 600 patients undergoing HoLEP and 32 patients undergoing RSP at two separate academic institutions between 2008 and 2015. RESULTS: Patients undergoing HoLEP and RSP had comparable ages (71 vs...
June 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28634646/the-role-of-robotics-in-the-invasive-management-of-bladder-cancer
#16
REVIEW
Pramit Khetrapal, Wei Shen Tan, Benjamin Lamb, Melanie Tan, Hilary Baker, James Thompson, Ashwin Sridhar, John D Kelly, Tim Briggs
Robot-assisted radical cystectomy (RARC) has been adopted widely in many centres, owed largely to the success of robot-assisted laparoscopic prostatectomy (RALP). It aims to replicate the oncological outcomes of open radical cystectomy (ORC), while providing a shorter recovery period. Despite this, previous RCTs have failed to show a benefit for RARC over ORC. These trials have compared extracorporeal RARC (eRARC) with ORC, which requires a further incision to mobilise the bowel for urinary reconstruction with an open technique...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28634041/a-machine-learning-algorithm-toward-color-analysis-for-chronic-liver-disease-classification-employing-ultrasound-shear-wave-elastography
#17
Ilias Gatos, Stavros Tsantis, Stavros Spiliopoulos, Dimitris Karnabatidis, Ioannis Theotokas, Pavlos Zoumpoulis, Thanasis Loupas, John D Hazle, George C Kagadis
The purpose of the present study was to employ a computer-aided diagnosis system that classifies chronic liver disease (CLD) using ultrasound shear wave elastography (SWE) imaging, with a stiffness value-clustering and machine-learning algorithm. A clinical data set of 126 patients (56 healthy controls, 70 with CLD) was analyzed. First, an RGB-to-stiffness inverse mapping technique was employed. A five-cluster segmentation was then performed associating corresponding different-color regions with certain stiffness value ranges acquired from the SWE manufacturer-provided color bar...
June 17, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28633996/effects-of-monoaminergic-drugs-on-training-induced-motor-cortex-plasticity-in-older-adults
#18
Trisha M Kesar, Samir R Belagaje, Paola Pergami, Marc W Haut, Gerald Hobbs, Cathrin M Buetefisch
Primary motor cortex (M1) plasticity is involved in motor learning and stroke motor recovery, and enhanced by increasing monoaminergic transmission. Age impacts these processes but there is a paucity of systematic studies on the effects of monoaminergic drugs in older adults. Here, in ten older adults (age 61+ 4 years, 4 males), we determine the effects of a single oral dose of carbidopa/levodopa (DOPA), d-amphetamine (AMPH), methylphenidate (MEPH) and placebo (PLAC) on M1 excitability and motor training-induced M1 plasticity...
June 17, 2017: Brain Research
https://www.readbyqxmd.com/read/28632761/experience-improves-the-performance-of-endobronchial-ultrasound-guided-transbronchial-biopsy-for-peripheral-pulmonary-lesions-a-learning-curve-at-a-medical-centre
#19
Chun-Ta Huang, Sheng-Yuan Ruan, Yi-Ju Tsai, Chao-Chi Ho, Chong-Jen Yu
BACKGROUND: Endobronchial ultrasound(EBUS)-guided transbronchial biopsy(TBB) is the preferred diagnostic tool for peripheral pulmonary lesions(PPLs) and mastering this procedure is an important task in the training of chest physicians. Little has been published about the learning experience of physicians with this technique, particularly at an institutional level. We aimed to establish a learning curve for EBUS-guided TBB for PPLs at a medical center. METHODS: Between 2008 and 2015, consecutive patients with PPLs referred for EBUS-guided TBB at National Taiwan University Hospital were enrolled...
2017: PloS One
https://www.readbyqxmd.com/read/28632737/supervised-filters-for-eeg-signal-in-naturally-occurring-epilepsy-forecasting
#20
Francisco Javier Muñoz-Almaraz, Francisco Zamora-Martínez, Paloma Botella-Rocamora, Juan Pardo
Nearly 1% of the global population has Epilepsy. Forecasting epileptic seizures with an acceptable confidence level, could improve the disease treatment and thus the lifestyle of the people who suffer it. To do that the electroencephalogram (EEG) signal is usually studied through spectral power band filtering, but this paper proposes an alternative novel method of preprocessing the EEG signal based on supervised filters. Such filters have been employed in a machine learning algorithm, such as the K-Nearest Neighbor (KNN), to improve the prediction of seizures...
2017: PloS One
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