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At least 451 records · Page 25Linked to original sources
PubMed2005

Validity of the MISTELS simulator for laparoscopy training in urology.

BACKGROUND AND PURPOSE: The McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) consists of a series of five laparoscopic exercises performed in an endotrainer box. MISTELS has been validated for use in both training and evaluation of general surgery residents in fundamental laparoscopic skills. The purpose of this study was to demonstrate the construct validity of MISTELS for urology residents. SUBJECTS AND METHODS: Seventeen participants were evaluated during performance of the five MISTELS tasks (peg transfer, pattern cutting, ligating loop, and suturing with extracorporeal and intracorporeal knots) using the standardized scoring system, which rewards both speed and precision. Participants included 13 urology residents (PGY 1-5), 1 fellow, and 3 urologists experienced in laparoscopy. Results are expressed as median (range). The Mann-Whitney U-test was used to compare MISTELS scores for 9 novice (PGY 1-4) and 8 experienced urologists (PGY 5-attending). P < 0.05 was considered statistically significant. RESULTS: The median MISTELS total normalized score for novices was 52.3 (range 15-68.9) compared with 71.7 (range 56.3-82.9) for experienced urologists (P = 0.007). Although the experienced group achieved higher scores in all five individual tasks, statistically significant differences were demonstrated for the peg transfer and intracorporeal suture tasks only. CONCLUSION: These data provide evidence for construct validity of the MISTELS system for urology residents.

Education, Medical, Graduate↗
PubMed1996

Performance of a computer simulated neural network trained to categorise normal, premalignant and malignant oral smears.

The accurate detection of malignant neoplasms whilst they are still small is recognised as one of the main factors increasing chances of survival. Neural networks have many biomedical applications and they have been applied to neoplasia but their use in oral pathology has only recently been documented. The objectives of this study were to train networks to discriminate between normal and dysplastic mucosa. Each network was trained by back propagation, internal cross validation and tested on additional data. The data were derived by analysing 348 intra-oral smears and included mean nuclear and mean cytoplasmic areas of the smears measured by image analysis. A neural network differentiated between normal/non-dysplastic mucosa and dysplastic/malignant mucosa (specificity 0.82, sensitivity 0.76). These early results suggest that integrating neural networks and image analysis, as well as investigating additional criteria, could enhance automation and accuracy of smear techniques in diagnosing oral malignancy.

Automation↗
PubMed2003

Isolated heart responsiveness to beta-simulation after exercise training in obesity.

PURPOSE: Exercise training results in many health benefits, but few studies have focused on whether exercise training might attenuate the adverse effects of obesity on heart function. Therefore, the purpose of this study was to determine whether exercise training attenuated obesity-related decreases in systolic contractile function in response to beta-adrenergic stimulation, using the rabbit model of obesity. METHODS: Female New Zealand white rabbits were divided into four groups: lean sedentary, lean exercise-trained, obese sedentary, and obese exercise-trained. Obese rabbits were fed an ad libitum high-fat diet. Exercise-trained rabbits underwent a 12-wk progressive treadmill exercise training protocol. After 12 wk, the Langendorff isolated heart method was used to study developed pressure, +dP/dt, and -dP/dt responses to increasing concentrations of isoproterenol (10(-9)--3 x 10(-7) M). Log concentration-response data were fit to a sigmoidal function, using a four-parameter (minimum, maximum, EC(50), slope) logistic equation. Groups were compared using a 2 x 2 analysis of variance. RESULTS: Although obesity shifted the concentration-response curves for developed pressure, +dP/dt, and -dP/dt to the right as indicated by an increase in the EC(50) (P < or = 0.05), there was no effect of exercise training on any of the logistic regression parameters. EC(50) (log M) values for combined lean versus combined obese were -8.50 +/- 0.7 vs -8.20 +/- 0.09 (developed pressure), -8.04 +/- 0.06 vs -7.68 +/- 0.07 (+dP/dt), and -8.17 +/- 0.07 vs -7.91 +/- 0.09 (-dP/dt). CONCLUSION: These results confirm the negative effect of obesity on responsiveness of the isolated heart to beta-adrenergic stimulation but indicate that exercise training does not significantly attenuate obesity-related changes.

Adrenergic beta-Agonists↗
PubMed2005

Gastric ulcer development in horses in a simulated show or training environment.

OBJECTIVE: To determine whether conditions representing activities that are typical in the recreational use of horses, including transport to and from show grounds, stall confinement in unfamiliar surroundings, and light exercise, are associated with increased incidence of gastric ulcers in horses. DESIGN: Randomized controlled study. ANIMALS: 20 client-owned horses. PROCEDURE: Horses had no gastric ulcers as determined by endoscopic examination on study day -1. Ten control horses were maintained on-site with no changes in management variables. Ten horses were transported via trailer for 4 hours on day 0 to another site, placed in individual stalls, fed twice daily, and exercised twice daily for 3 days. On day 4, they were transported back to the original site via trailer for 4 hours. On day 5, endoscopic examinations were performed on all horses to assess gastric mucosa status. RESULTS: Horses that were transported and housed off-site had a significantly higher incidence of hyperkeratosis and reddening of the gastric mucosa than control horses. Two control horses and 7 transported horses developed gastric ulcers by day 5. Ulcer scores of transported horses increased significantly from day -1, whereas ulcer scores in control horses did not change significantly from day -1. CONCLUSIONS AND CLINICAL RELEVANCE: Activities that are typical in recreational use of horses were ulcerogenic, and ulcers in the gastric squamous mucosa can develop under these conditions within 6 days.

Animals↗
PubMed2002

Evaluation of a virtual reality simulator in sustainment training.

Is there a better way to train and prepare our health care personnel to function in a chemical biological environment while continuing to provide for patient care in a variety of healthcare settings? The purpose of this pilot work was to compare the effectiveness and user satisfaction of the Cath-Sim Intravenous Training System to the traditional IV arm model for teaching and achieving competence at IV insertion while in Mission-Oriented Protective Posture level 4 for Army medical personnel. Grounded in adult psychomotor learning principles and in an established evaluation model, participants were tested on both the traditional IV arm and Cath-Sim models and then allowed to practice on each model while at Mission-Oriented Protective Posture level 4. One week later, participants were again tested on both models. Outcome measures included (1) a computer-generated score sheet measuring time to success and criterion success/nonsuccess on the Cath-Sim; (2) time and success rating for IV insertion on the IV arm model; and (3) satisfaction evaluations completed by the participants. There were conflicting evaluation scores for recommending one model over the other. Participants felt that there was some benefit to each model depending on user, setting, and purpose.

Biological Warfare↗