Grimbizis G.F.,Aristotle University of Thessaloniki |
Campo R.,Surgery Academy
Fertility and Sterility | Year: 2010
Current proposals for classifying female genital anomalies seem to be associated with limitations in effective categorization, creating the need for a new classification system that is as simple as possible, clear and accurate in its definitions, comprehensive, and correlated with patients' clinical presentation, prognosis, and treatment on an evidence-based foundation. Although creating a new classification system is not an easy task, it is feasible when taking into account the experience gained from applying the existing classification systems, mainly that of the American Fertility Society. © 2010 American Society for Reproductive Medicine.
Rosenfeld R.M.,New York University |
Shiffman R.N.,Yale University |
Robertson P.,Surgery Academy
Otolaryngology - Head and Neck Surgery (United States) | Year: 2013
Background. Guidelines translate best evidence into best practice. A well-crafted guideline promotes quality by reducing health care variations, improving diagnostic accuracy, promoting effective therapy, and discouraging ineffective- or potentially harmful-interventions. Despite a plethora of published guidelines, methodology is often poorly defined and varies greatly within and among organizations. Purpose. The third edition of this manual describes the principles and practices used successfully by the American Academy of Otolaryngology-Head and Neck Surgery Foundation to produce quality-driven, evidence-based guidelines using efficient and transparent methodology for actionable recommendations with multidisciplinary applicability. The development process emphasizes a logical sequence of key action statements supported by amplifying text, action statement profiles, and recommendation grades linking action to evidence. New material in this edition includes standards for trustworthy guidelines, updated classification of evidence levels, increased patient and public involvement, assessing confidence in the evidence, documenting differences of opinion, expanded discussion of conflict of interest, and use of computerized decision support for crafting actionable recommendations. Conclusion. As clinical practice guidelines become more prominent as a key metric of quality health care, organizations must develop efficient production strategies that balance rigor and pragmatism. Equally important, clinicians must become savvy in understanding what guidelines are-and are not-and how they are best used to improve care. The information in this manual should help clinicians and organizations achieve these goals. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2013.
Hou B.,Surgery Academy
Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2012
To explore the clinical significance of miRNA-216a expression in pancreatic cancer. Fourteen patients with pancreatic cancer undergoing pancreaticoduodenectomy and 6 patients with benign pancreas lesions were examined for miR-216a expressions in the tumor or lesion tissues using Agilent Human miRNA Microarray (V12.0). The relationship between miR-216a expressions and the clinicopathological features of the patients was analyzed. The expression of miRNA-216a was significantly lower in pancreatic cancer than in benign pancreas lesions (P=0.000). The expression of miRNA-216a was significantly correlated with the T stage of the tumor (P=0.002), but not with the patients' age, gender, smoking status, tumor stage, lymph node metastases, distant metastasis, tumor differentiation, nerve invasion, vessel invasion or serum CA19-9 level (P>0.05). The down-regulated expression of miR-216a in pancreatic cancer suggests the involvement of miR-216a in the tumorigenesis and development of pancreatic cancer. miR-216a may potentially serve as a novel tumor marker and also a prognostic factor for pancreatic cancer.
Rigal S.,Percy Military Hospital |
Rigal S.,Surgery Academy
International Orthopaedics | Year: 2012
Purpose: Indications for amputation in natural disasters are not the same compared to our daily practice. They must be determined by those with great surgical experience and good knowledge of military or disaster surgical doctrine. Unfortunately, nowadays few surgeons have this experience. In fact, some volunteer surgeons may be interested in providing care for civilian victims of war or disaster in developing countries. However, there are significant differences between the type and the management of cases seen in this context versus those seen at home. The problems of amputations cannot be solved schematically. Amputation will depend on several factors: the form of warfare or disaster, the conditions for surgery, the skill of the surgical team and the experience of the surgeon, and the length or duration of the mission. Methods: Here is a schematic showing the three main situations: civilian practice, war practice and disaster context. These three different situations require different strategies for treating the wounded and for making amputation decisions. Results: In the case of a natural disaster, there are many wounded civilians, they arrive at the medical facility late and there is usually only one surgeon and a single, limited medical facility to provide all treatment. He must make quick, wise choices, economising limited blood supplies and the use of surgical procedures. The decision to proceed with limb salvage or amputation for patients with severely injured limbs will be a source of continued debate. Amputation, radical and irreversible intervention, is a frequent and essential procedure in the disaster context and one of the standard means to successful treatment of limb wounds. Conclusions: We propose to reflect on the following questions: why to amputate, how to perform amputation under these conditions and how to pass on a doctrine to the voluntary surgeons who lack experience in a disaster context. © 2012 Springer-Verlag.
Frodel J.,Surgery Academy
Facial Plastic Surgery | Year: 2012
Facial trauma commonly includes injury to the nose and perinasal area. In this review, we will focus on the sequelae of severe nasal trauma and provide examples of correction of the severely deviated nose, the severely collapsed nose, and revision of a traumatic deformity after prior rhinoplasty. We will then discuss coexistent deformities of perinasal regions in addition to functional and posttraumatic nasal correction, including posttraumatic periorbital deformities. Copyright © 2012 by Thieme Medical Publishers, Inc.
Zor F.,Surgery Academy
Gulhane Medical Journal | Year: 2013
Reconstruction of severe composite defects of the face is challenging for reconstructive surgeons. Despite several reconstructive techniques, the functional and aesthetic results of these patients are not acceptable. As a major organ, face, has an utmost importance in daily life. The specific characteristics of face require not a reconstruction, but a replace with same tissue. With the evolution of vascularized composite tissue allotransplantation, successful reconstruction of these defects became into reality. However, this new reconstructive option brings its new problems with it. Today, we are witnesses of evolution of reconstructive surgery to restorative surgery. In this article, this evolution is summarized. © Gülhane Askeri Tip Akademisi 2013.
Rangaswamy M.,Surgery Academy
Indian Journal of Plastic Surgery | Year: 2013
Significant complications still occur after abdominoplasty, the rate varies widely in different series. This variation suggests that there is a lot of scope for improvement. This paper reviews the various complications and also the technical improvements reported in the last 20 years. The root cause of each complication is analysed and preventive steps are suggested based on the literature and the authorfs own personal series with very low complication rates. Proper case selection, risk stratified prophylaxis of thromboembolism, initial synchronous liposuction, flap elevation at the Scarpa fascia level, discontinuous incremental flap dissection, vascular preservation and obliteration of the sub.flap space by multiple sutures emerge as the strongest preventive factors. It is proposed that most of the complications of abdominoplasty are preventable and that it is possible to greatly enhance the aesthetic and safety profile of this surgery.
Doganci S.,Surgery Academy |
Demirkilic U.,Surgery Academy
European Journal of Vascular and Endovascular Surgery | Year: 2010
Objectives: The aim of this study is to compare efficacy, early postoperative morbidity and patient comfort of two laser wavelengths and fibre types in treatment of great saphenous vein (GSV) incompetence resulting in varicosities of the lower limb. Design: Prospective randomised clinical trial. Materials and Methods: Sixty patients (106 limbs) were randomised into two groups. They were treated with bare-tip fibres and a 980 nm laser in group 1 and radial fibres and 1470 nm laser in group 2 in order to ablate the GSV. Local pain, ecchymosis, induration and paraesthesia in treated regions, distance from skin, vein diameter, treated vein length, tumescent anaesthesia volume, delivered energy and patient satisfaction were recorded. Follow-up visits were planned on the 2nd postoperative day, 7th day, 1st, 2nd, 3rd and 6th months. Results: Mean GSV diameters at saphenofemoral junction and knee levels were 12.1 S.D. 4.3 mm and 8.2 S.D. 2.4 mm, and 11.8 S.D. 4.1 mm and 7.9 S.D. 2.6 mm respectively in groups 1 and 2. There were 14 patients with induration, 13 with ecchymosis and nine minimal paraesthesia in group 1 and no or minimal local pain, minimum ecchymosis or induration in group 2. Duration of pain and need for analgesia was also lower in group 2 (p < 0.05). There was significant difference on postoperative day 2, day 7 and 1st month control in favour of group 2 in venous clinical severity scores (VCSS). Conclusion: Treatment of the GSV by endovenous laser ablation using a 1470 nm laser and a radial fibre resulted in less postoperative pain and better VCSS scores in the first month than treatment with a 980 nm laser and a bare-tip fibre. © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Sokolis D.P.,Surgery Academy
Biomechanics and Modeling in Mechanobiology | Year: 2013
Numerous studies have provided material models of arterial walls, but limited information is available on the pseudo-elastic response of vein walls and their underlying microstructure, and only few constitutive formulations have been proposed heretofore. Accordingly, we identified the histomechanics of healthy porcine jugular veins by applying an integrated approach of inflation/extension tests and histomorphometric evaluation. Several alternate phenomenological and microstructure-based strain-energy functions (SEF) were attempted to mimic the material response. Evaluation of their descriptive/predictive capacities showed that the exponential Fung-type SEF alone or in tandem with the neo-Hookean term did not capture the deformational response at high pressures. This problem was solved to a degree with the neo-Hookean and two-fiber (diagonally arranged) family SEF, but altogether the least reliable fit was generated. Fitting precision was much improved with the four-fiber (diagonally, circumferentially, longitudinally arranged) family model, as the inability of neo-Hookean function with force data was alleviated by use of the longitudinal-fiber family. Implementation of a quadratic term as a descriptor of low-pressure anisotropy facilitated the simulation of low-pressure and force data, and the four-fiber families simulated more faithfully than the two-fiber families the physiologic and high-pressure response. Importantly, this SEF was consistent with vein angioarchitecture, namely the occurrence of extensive elastin fibers along the longitudinal axis and few orthogonal fibers attached to them and of three collagen sets with circumferential, longitudinal, and diagonal arrangement, respectively. Our findings help to establish the relationship between vein microstructure and its biomechanical response, yet additional observations are obligatory prior to endeavoring generalizations to other veins. © 2012 Springer-Verlag.
News Article | September 3, 2014
Happy 3rd anniversary to DS106 Radio, a live-streaming station that grew out of the University of Mary Washington DS 106 course. Maryland schools will need $100 million in technology upgrades in order to be prepared for the new online testing required by the Common Core State Standards. The White House has launched an initiative to end rape and sexual assault on college campuses. 138 educators in Philadelphia have been implicated in test score cheating, according to Education Week. 5 Newark principals have been suspended indefinitely (allegedly) for speaking out against proposed changes to the school district (which is run by the state). After penning a letter to the campus protesting proposed budget cuts, CSU sociology professor Tim McGettigan had his email suspended by the university. McGettigan’s email compared the budget cuts to the Ludlow massacres (the massacre in 1914 of striking coal miners in the region). The university said the email was a threat and compared McGettigan to the shooters at Columbine and Virginia Tech. By the end of the week – after a huge outcry about academic freedom and the administration’s inability to grasp analogy, McGettigan’s email was restored. More via Inside Higher Ed. LEGO has added a new curriculum pack to its Mindstorms robotics kit that focuses on space exploration. The Space Challenge kit was developed with the help of NASA engineers. Johnson & Johnson has released a new version of its “No More Tears” baby shampoo. This one, without formaldehyde. Uhhhhh. Last week, two Yale students got in trouble for creating a website to help other students plan their course schedule. In response to the university shutting down that site, another student Sean Haufler made an “unblockable replacement.” The URL for his blog post is great: “i-hope-i-dont-get-kicked-out-of-yale-for-this/” – and I don’t think he will. Yale later admitted that it had made a mistake in banning the website. Edsurge has the names of the 6 startups participating in the Emerge Education ed-tech accelerator program. Edsurge also reports that the startups that participated in the Kaplan accelerator program have raised over $10 million in funding. The program is accepting applications for its next cohort. “TechStars will invest $20K in each company in return for 6% equity (a fairly standard term). They will also each receive from Kaplan a $150K convertible debt note–up from $100K last year.” Apple has expanded access to iTextbooks and iTunes U Course Manager to more countries. At BETT (the British Education Technology Tradeshow), Microsoft announced “XBox 360 for Education.” The Digital Reader reports that Intel will release a new educational tablet and laptop. Unglue.it has released its first “buy-to-unglue” book: Lagos_2060, a collection of science fiction stories. Unglue.it recently changed its model. Now you can buy and download the e-book, and if enough folks do so, the e-book becomes free and openly licensed for everyone. EdX has published research from the first full year of its courses. The research includes 16 working papers. You can read more on HarvardX researcher Justin Reich’s blog, in The Atlantic, The Chronicle of Higher Education, as well as a review of the research from Tony Bates. Surgery Academy has launched a crowdfunding campaign for a surgery MOOC. Because learning surgery on your iPhone sounds like a brilliant idea (right up until you actually need surgery, I reckon). Coursera unveiled “Specializations,” a sequence of courses in certain topics. These specializations will offer a certificate via Coursera’s Signature Track and will require students take a series of classes as well as complete a capstone project. Regent University has launched a “Christian MOOC platform” called Luxvera, reports The Chronicle of Higher Education. “The initial offerings are limited to three courses asking ‘Who Is Jesus?’ and a series of ‘great talks’ by conservative figures connected to the university, including Pat Robertson, the university’s chancellor and the founder of the Christian Broadcasting Network.” Inside Higher Ed reports that the Coursera course “Constitutional Struggles in the Muslim World” faced a major challenge when the discussion forums for the class “‘very quickly disintegrated into a snakepit of personal venom, religious bigotry and thinly disguised calls for violence.’ But some students have accused him of abusive and tyrannical behavior in his attempts to restore civility.” (How will MOOCs handle controversial classes and controversial subject matter?) Harvard plans to offer 3 versions of its Introduction to Computer Science course this spring: Version 1: a HarvardX version (free, self-paced, for no credit). Version 2: Harvard Extension School (cost of $2050). Version 3: a hybrid version: HarvardX plus biweekly online office hours (cost of $350 and you get a certificate for successful completion). The Centre for Educational Technology, Interoperability, and Standards (CETIS) has published a research paper “Beyond MOOCs: Sustainable Online Learning in Institutions.” (PDF) According to The Globe and Mail, Ontario will launch a $42 million online learning platform, “featuring a course hub where schools can post and promote their online course offerings in a central list.” The for-profit Rasmussen College announced that it will become a Public Benefit Corporation. (This designation means it will focus on social and not just financial performance.) California Governor Jerry Brown spoke to the UC Board of Regents this week, urging them to find the “outer limits” of online education, including developing classes that require “no human intervention.” (Maybe I can get him to write the intro to my book on this history of automating education!) “Yale College Seeks Smart Students From Poor Families. They’re out there – but hard to find.” Ugh. The University of Cambria will accept the cryptocurrency Bitcoin as payment for the fees for two programs that deal with currencies. Education Week examines the “growing pains” for the Rocketship chain of charter schools. The Association of American Colleges and Universities is launching an effort to rethink how general education works, including developing a “competency-based framework.” More in Inside Higher Ed. State higher education spending is up, according to Inside Higher Ed, although not back to pre-recession levels. “There Has Been An Average Of One School Shooting Every Other School Day So Far This Year,” according to ThinkProgress, including one this week on campus of Widener University in Pennsylvania and one at Purdue University. There were also reports of a shooting at the University of Oklahoma. A federal judge in Virginia has blocked the Accrediting Commission of Career Schools and Colleges’ decision to strip a Missouri massage school of its accreditation and has also fined the accreditor for a sum equal to the school’s lost revenue (an unprecedented move). More via Inside Higher Ed. According to The Texas Tribune, the UT system will not see any financial returns on its MyEdu investment, despite pouring $10 million into the product in 2011. (MyEdu was recently acquired by Blackboard.) “Pearson fell the most since 2002 after reporting higher costs to push into digital services,” reports Bloomberg. Edsurge reports that Edsby has raised an undisclosed amount of investment. “Edsby helps districts deploy an array of online social learning tools–from gradebooks, attendance trackers, and parent-teacher communication tools to content management and single sign-on integration–within the existing student information system.” Phil Hill continues his analysis of IPEDS and Babson Survey data, noting the discrepancies between the two (no big surprise there: one is a mandatory federal report and the other a voluntary survey). Hill notes that “Twice as many institutions as previously reported have no online courses.” The Children’s Defense Fund has released its report “State of America’s Children 2014.” 1 in 5 children in the US is poor. 40% of poor children live in extreme poverty – that is, at below half the poverty level. Microsoft Research has adopted an open access policy for its researchers’ publications. A liberal arts major isn’t such a bad deal after all. (Go figure.) More details on the report “How Liberal Arts and Sciences Majors Fare in Employment” in Inside Higher Ed. The University of North Carolina, Chapel Hill has halted the research of learning specialist Mary Willingham. Her work into the literacy levels of college athletes has been making headlines (and prompting death threats against her too.) More in The Chronicle of Higher Education. Every year, I say “ignore the US News & World Report’s college rankings!” “It’s a rigged game!” But according to a study from the AERA, both it and the Princeton Review do effect where students do decide to apply to school. More on the study in The Atlantic. The blog Gas Station Without Pumps pushes back on some of the hype and hand-wringing about the diversity of those taking the AP exam in Computer Science. For example, “No females took the exam in Wyoming.” Well, turns out no one took the exam in Wyoming. So a closer look – with statistics! – at the under-representation that was reported. “Facebook will lose 80% of its users by 2017, say Princeton researchers.” And then suddenly, the tech press, which consistently reports statistics pushed out by the industry without blinking an eye, is upset that this study wasn’t peer reviewed.