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At least 613 records · Page 34Linked to original sources
PubMedDate not supplied

Direct trocar insertion without pneumoperitoneum and the Veress needle in laparoscopic cholecystectomy : a comparative study.

PURPOSE: The purpose of this study is to compare the safety and complications of direct trocar insertion without pneumoperitoneum (DTI) with Veress needle (VN) in laparoscopic cholecystectomy (LC). METHODS: We studied 84 patients admitted to our hospital for LC, in a random simple blind design, 42 patients were assigned to DTI and 42 to VN. The variables analysed were : procedure complications, laparoscope insertion time and duration of surgery. RESULTS: Complication percentages between the groups were significantly different (DTI 2.3% versus VN 23.8%, p = 0.009). The duration of surgery between the two groups was also significantly different (DTI 56+/-31 versus VN 71+/-28 minutes, p < 0.02). Finally, laparoscope insertion time between the two techniques was significantly different (DTI 1.5+/-0.5 versus VN 3.0+/-0.4 minutes p < 0.001). CONCLUSIONS: Our results show DTI to be a safe, efficient, rapid and easily-learned alternative technique, reducing the number of procedure-related complications.

Adult↗
PubMed2003

Professional socialization revised: medical students' own conceptions related to adoption of the future physician's role--a qualitative study.

This qualitative study investigated medical students' experiences of and conceptions concerning their professional development during their first clinical year. Twenty-two medical students participated in a portfolio course. Their personal writings were analysed by qualitative content analysis. Self-image as a future doctor rapidly evolved during patient contacts in the first clinical year. At the beginning, students felt lacking in credibility in front of their patients but towards the end they enjoyed their role as student-physicians. The medical students felt intense stress but the majority of this may stem from strong emotional experiences rather than the medical knowledge to be absorbed. Students were afraid of being humiliated by hospital staff and they felt themselves to be outsiders. No cynicism or suppression of feelings was observed in writings. The first clinical year is a period of intense emotional experiences and rapid development. Portfolios as learning tools may help in recognizing key experiences and in supporting professional development.

Adult↗
PubMed2002

Particle toxicology: from coal mining to nanotechnology.

Particle research has been historically closely connected to industrial activities or materials, such as coal, asbestos, man-made mineral fibers, and more recently ambient particulate matter (PM). It is the purpose of this review to combine insights and developments in particle toxicology with the historical context of exposure and organizations sponsoring such research in Europe. In supporting research on particle-induced respiratory effects and mechanisms, research programs of the European Community on Steel and Coal (ECSC) have played a tremendous role. Current particle research in Europe is dominated by PM, and funded by the World Health Organization (WHO), European Union Framework programs, and the Health Effects Institute (HEI). Differences between historical and current research in particle toxicology include the exposure concentrations, particle size, target populations, endpoints, and length of exposure. Inhaled particle effects are no longer confined to the lung, since particles are suggested to translocate to the blood while lung inflammation invokes systemic responses. Finally, the particle size and concentrations have both been reduced about 100-fold from 2-5 mg/m3 to 20-50 mg/m3 and from 1-2 microm to 20-100 nm (ultrafine) as domestic fuel burning has decreased and vehicle sources have increased and attention has moved from coal mining industry to general environment. There is, however, a further occupational link to nanotechnology, which continuously produces new materials in the ultrafine range. Although inhalation exposure is considered to be minimal in this technology, some particles are produced to be used for carrier purpose in medical applications. Based on our current knowledge of particle toxicology, it is highly desirable that toxicology and technology are linked in this extremely rapid developing area, to learn more about potential risks and also to develop knowledge on the role of surface and size in particle toxicity.

Coal↗
PubMed2025

Smarter stomata: emergent technologies unlocking yield potential in a changing climate.

Stomata, the gatekeepers of leaf gas exchange, regulate carbon dioxide uptake and water loss, functions increasingly critical as crops face more frequent, intense heat and drought. Under dry conditions, stomatal conductance (g s) typically decreases, limiting carbon assimilation and yield. Heat stress, in contrast, elicits variable g S responses: sometimes increasing to facilitate transpirational cooling, while at other times decreasing, especially when combined with drought. Heat and drought also induce complex, context-dependent shifts in stomatal anatomy. Smaller, denser stomata improve drought resilience in some cases, while reduced density confers greater tolerance in others. The optimal stomatal ideotype remains unknown, and different or even opposing traits may confer resilience dependent on the environmental scenario. Substantial genotypic variation in g s and stomatal anatomy, high heritability and co-localized quantitative trait loci for stomatal traits and yield highlight their untapped potential as breeding targets for climate-resilient crops. However, stomatal traits remain largely absent from breeding pipelines due to challenges of phenotyping at scale. This is changing rapidly. Advances in deep learning, porometry, digital microscopy, and remote sensing now enable high-throughput measurement of stomatal physiology and anatomy. Next-generation breeding technologies including clustered regularly interspaced short palindromic repeats (CRISPR), multi-omics approaches, and artificial intelligence-driven ideotype selection models could revolutionize breeding, allowing precise engineering of stomatal traits for resilience to environmental stress. The time has come to move beyond characterizing stomatal traits and start actively incorporating them into breeding strategies. By leveraging these technologies, stomatal traits can become high value targets, unlocking their potential to enhance crop performance in a hotter, drier future.

abiotic stress↗
PubMed1994

The oesophageal detector device. An assessment of accuracy and ease of use by paramedics.

Accuracy, ease and speed of recognition of tracheal tube position were assessed using the oesophageal detector device in a series of 40 tests on 29 patients. A single blind method was used, with each paramedic performing a single test on each patient. The tests were randomly split between two groups consisting of those tests performed on the tracheal or oesophageal tube respectively. Of the 40 tests performed, 21 were on tracheal tubes and 19 on oesophageal tubes. Correct placement was diagnosed with 100% accuracy by the paramedics, none of whom had previously used the oesophageal detector device. Each paramedic also graded speed of recognition of position and ease of use of the device. Recognition of position was graded as instant in 37 out of 40 tests. Use of the oesophageal detector device by previously inexperienced paramedics has thus been shown to be accurate, rapid and easy to learn.

Adolescent↗
PubMed1986

Stress inoculation training: a case study in gymnastics.

A young female gymnast of regional squad potential had ceased to make progress when she resumed training after a series of injuries and was given stress inoculation training to help her to regain her form. Preliminary interviews revealed that she had developed a number of negative self-statements and images which, it was hypothesised, may have been contributing towards her lack of progress. In order to replace these with positive self-statements and images a treatment programme of eight training sessions was implemented. Recorded interviews and subsequent comparison of comments made by the subject before and after the intervention programme, indicated that the training had been successful. This was endorsed by the coaches who reported an improved attitude to training and rapid progress in skill learning.

Child↗
PubMed1997

Teaching physiology and the World Wide Web: electrochemistry and electrophysiology on the Internet.

Students seek active learning experiences that can rapidly impart relevant information in the most convenient way possible. Computer-assisted education can now use the resources of the World Wide Web to convey the important characteristics of events as elemental as the physical properties of osmotically active particles in the cell and as complex as the nerve action potential or the integrative behavior of the intact organism. We have designed laboratory exercises that introduce first-year medical students to membrane and action potentials, as well as the more complex example of integrative physiology, using the dynamic properties of computer simulations. Two specific examples are presented. The first presents the physical laws that apply to osmotic, chemical, and electrical gradients, leading to the development of the concept of membrane potentials; this module concludes with the simulation of the ability of the sodium-potassium pump to establish chemical gradients and maintain cell volume. The second module simulates the action potential according to the Hodgkin-Huxley model, illustrating the concepts of threshold, inactivation, refractory period, and accommodation. Students can access these resources during the scheduled laboratories or on their own time via our Web site on the Internet (http./(/)phys-main.umsmed.edu) by using the World Wide Web protocol. Accurate version control is possible because one valid, but easily edited, copy of the labs exists at the Web site. A common graphical interface is possible through the use of the Hypertext mark-up language. Platform independence is possible through the logical and arithmetic calculations inherent to graphical browsers and the Javascript computer language. The initial success of this program indicates that medical education can be very effective both by the use of accurate simulations and by the existence of a universally accessible Internet resource.

Computer Communication Networks↗
PubMedDate not supplied

Imprint cytology of parathyroid tissue in relation to other tissues of the neck and mediastinum.

OBJECTIVE: To retest the hypothesis that imprint cytology may be used to reliably diagnose parathyroid tissue and, if so, to ascertain whether accuracy in this technique may be easily attained. STUDY DESIGN: Imprint preparations from 15 parathyroid, 10 thyroid, 8 lymphoreticular and 2 adipose tissue specimens were assessed blindly by two pathologists, one of whom (pathologist B) had only limited experience with endocrine tissue imprint cytology. RESULTS: Both assessors consistently distinguished parathyroid and thyroid preparations from lymphoreticular and adipose tissue preparations. While there was occasional difficulty in distinguishing between parathyroid and thyroid preparations, this was usually attributable to the scanty nature of the preparations. No single cytologic feature allowed a distinction between parathyroid and thyroid tissue. However, by considering several relatively diagnostic features collectively, pathologist B showed an increase in specificity and sensitivity rates for distinguishing parathyroid from thyroid imprints from 82% to 100% and 57% to 83%, respectively. CONCLUSION: The high accuracy rates and rapid [table: see text] learning curve shown by imprint cytology in distinguishing between different neck or mediastinal tissue types, together with its time- and cost-cutting potential, support a role for the technique in the intraoperative diagnosis of parathyroid tissue.

Cytodiagnosis↗
PubMed1992

Memory function in normal aging.

We evaluated memory function in a group of 161 community-dwelling, cognitively normal individuals aged 62 to 100 years recruited as part of the Mayo Clinic Alzheimer's Disease Patient Registry. We used the Free and Cued Selective Reminding Test and the Rey Auditory Verbal Learning Test to evaluate two aspects of memory function thought to be sensitive to the effects of aging: learning (acquisition) and delayed recall (forgetting). The results were quite consistent and demonstrated that learning or acquisition performance declines uniformly with increasing age but is not related to education. Delayed recall or forgetting, however, remained relatively stable across age when adjusted for the amount of material initially learned. These findings are relevant for assessing normal memory function relative to the early impairments found in dementia and form a baseline against which memory performance can be assessed by the clinician. In particular, suspicion regarding a disorder of brain function affecting memory processes should be raised if learning performance declines more rapidly than expected or if delayed recall is impaired to any significant extent.

Aged↗
PubMed1986

Measuring social behavior: social dominance.

Social dominance develops more slowly when young animals are kept in intact peer groups where they need not compete for resources. Learned generalizations may cause smaller and weaker animals to accept subordinate status readily when confronted with strangers that would be formidable opponents. Sexual hormones and sensitivity to them can influence the onset of aggression and status attained. After dominance orders are established, they tend to be stable in female groups but are less so in male groups. Psychological influences can affect dominance relationships when strangers meet and social alliances within groups may affect relative status of individuals. Whether status associated with agonistic behavior is correlated with control of space and scarce resources needs to be determined for each species and each kind of resource. When such correlations exists, competitive tests and agonistic behavior associated with gaining access to scarce resources can be useful to the observer in learning about dominance relationships rapidly. Examples are given to illustrate how estimates of social dominance can be readily attained and some strengths and weaknesses of the various methods.

Aggression↗
PubMed2004

Self-evaluation as a moderating factor of strategy change in directed forgetting benefits.

In list method directed forgetting, instructing people to forget a studied word list usually results in better recall for a newly studied list. Sahakyan and Delaney (2003) have suggested that these benefits are due to a change in encoding strategy that occurs between the study of the first list and the study of the second list. To investigate what might mediate such strategy change decisions, in two experiments we induced both forget and remember participants to evaluate their memory performance on the two lists. In Experiment 1, they were asked to explicitly recall the items from the first list before studying the second list. In Experiment 2, after the study of the first list, the participants provided a rapid aggregate judgment of learning. Evaluation eliminated the differences between the forget and remember groups for the second list in both experiments, because the remember group achieved recall levels comparable to those for the forget group. The role of performance evaluation in mediating directed forgetting benefits is discussed.

Humans↗
PubMed2001

Keeping sharp: Internet CE update and experience.

The Internet as a distance-learning tool is evolving rapidly. Most Internet-based Continuing Education (CE) experiences follow a standard didactic approach as demonstrated by lectures, slide presentations, written journals, videotape, and audiotape; however, some Internet-based educators are exploring the full interactive, problem-solving potential of Internet technology. With support from NIMH we are reviewing the state of the art in Internet-based CE and developing CE courses targeted toward primary care providers that aim to alter clinical skills related to depression treatment.

Clinical Competence↗
PubMed2001

[Stem cells in medicine].

We witness an unprecedented explosion of knowledge and interest in the field of stem cells and stem cell-dependent organ systems. The notion of stem cell has expanded to encompass cells with different properties but all amenable to ex vivo manipulation. We have learned that not only rapidly self-renewing tissues, but also unsuspected systems such as the central nervous system are associated with post-natal progenitor cells. The bone marrow seems to represent an important cross-road of many different progenitors, and perhaps the easiest source of diverse progenitors to be used for therapeutic purposes in a large spectrum of diseases. While some applicative uses of post-natal progenitor cells are either already in use, or soon to be routinely implemented, much larger perspectives are linked to the design of appropriate strategies for cell delivery and stable cell transduction. Meanwhile, major gains in understanding of the biology of different diseases are implied by the very recognition that many diseases are indeed stem cell diseases.

Bone Marrow↗
PubMed1982

The role of an endogenous amnesic mechanism mediated by brain beta-endorphin in memory modulation.

1. Post-training administration of the opiate receptor antagonist naloxone facilitates the memory consolidation of a wide variety of tasks by rats. 2. Post-training administration of subanalgesic doses of beta-endorphin causes retrograde amnesia. This effect is shared by other opiates and opioids and is competitively antagonized by naloxone. These other opiates and opioids probably act by the release of endogenous beta-endorphin. 3. During various forms of aversive and non-aversive training beta-endorphin (but not Met-enkephalin) is released in the rat brain in amounts compatible with amnestic doses of this substance. 4. A number of treatments that cause naloxone-reversible retrograde amnesia, i.e. high doses of ACTH or adrenaline, low doses of morphine or of opioids, electroconvulsive shock, release massive amounts of beta-endorphin and Met-enkephalin in the rat brain. 5. These findings point to the existence of a physiological amnesic mechanism mediated by beta-endorphin, and perhaps other opioids as well, that normally prevents memory from being as good as it could be, and when operating at an exaggerated level may cause complete amnesia. 6. This mechanism interacts with other systems that influence memory consolidation (central dopaminergic and noradrenergic pathways, ACTH, peripheral adrenaline) and is a powerful modulator of their activity. 7. One possible role of the amnesic mechanism during training is to cause the rapid forgetting of adventitious learning that may interfere with acquisition of the main tasks for which animals are being trained. 8. Either through this action, or by some direct effect, beta-endorphin facilitates retrieval of a variety of behaviors in the rat when given before a test session.

Amnesia, Retrograde↗
PubMed1977

Development of tolerance to the disruptive effects of cocaine on repeated acquisition and performance of response sequences.

Pigeons obtained food by making four responses on three keys in a specified sequence. Errors produced 5-second timeout periods, during which the keylights were off and responses had no effect. To establish a base line of repeated acquisition, the sequence of correct responses was changed from session to session. Cocaine (3 mg/kg) disrupted the behavior: total errors increased, the relative frequency of perseverative errors increased, the rate of within-session error reduction (learning) decreased and the total trial time (pausing) increased. During repeated drug administration (30-50 sessions), these effects disappeared, i.e., tolerance developed. Tolerance did not develop, however, to cocaine-induced increases or decreases in timeout responding; such effects were nondisruptive in the sense thay they did not reduce the rate of food reinforcement. For comparison, cocaine (3-10 mg/kg) was also studied under a "performance" condition, in which the sequence of correct responses was the same from session to session. Cocaine increased performance errors and produced pausing, but tolerance developed more quickly under the learning condition . The more rapid development of tolerance was presumably due to the stronger stimulus control of behavior under the performance condition.

Animals↗
PubMed2003

Interactive instruction of cellular physiology for remote learning.

The biomedical sciences are a rapidly changing discipline that have adapted to innovative technological advances. Despite these many advances, we face two major challenges: a) the number of experts in the field is vastly outnumbered by the number of students, many of whom are separated geographically or temporally and b) the teaching methods used to instruct students and learners have not changed. Today's students have adapted to technology--they use the web as a source of information and communicate via email and chat rooms. Teaching in the biomedical sciences should adopt these new information technologies (IT), but has thus far failed to capitalize on technological opportunity. Creating a "digital textbook" of the traditional learning material is not sufficient for dynamic processes such as cellular physiology. This paper describes innovative teaching techniques that incorporate familiar IT and high-quality interactive learning content with user-centric instruction design models. The Virtual Labs Project from Stanford University has created effective interactive online teaching modules in physiology (simPHYSIO) and delivered them over broadband networks to their undergraduate and medical students. Evaluation results of the modules are given as a measure of success of such innovative teaching method. This learning media strategically merges IT innovations with pedagogy to produce user-driven animations of processes and engaging interactive simulations.

Biology↗
PubMed2001

Prisoners with HIV/AIDS: a participatory learning and action initiative in Malaysia.

Rapid participatory research and project development is possible within a tightly controlled social context such as a prison. Having gained access, based on trust and mutual respect, external agents may then facilitate significant change. Given adequate support, incarcerated people with HIV/AIDS and limited medical access may be able to develop mutual care, social support and income-generating activities. In the Malaysian context, we estimated in 1998 that up to one-quarter of prisoners with HIV had indicators of significant disease. We estimated that significant indicators remained unrevealed among between one-half and two-thirds of these. Given prevailing conditions, these would probably only be amenable to peer-based care.

Female↗