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information technology [keywords]
- Electronic Medical Records in Clinical Teaching. [JOURNAL ARTICLE]
- Nurse Educ 2014 Jul 25.
The purpose of the project was to provide students with experiences to develop their technology competency and examine student perceptions about an academic electronic medical record (EMR) as a learning tool. Nurse educators need to integrate EMRs into their curricula to give students practice in the use of electronic documentation and retrieval of clinical information. The findings of this study indicated that students' use of EMRs at least 5 times resulted in the development of positive perceptions about their EMR experience.
- Long-Term Sacral Magnetic Stimulation for Refractory Stress Urinary Incontinence. [JOURNAL ARTICLE]
- Arch Phys Med Rehabil 2014 Jul 26.
To evaluate the effects of sacral magnetic stimulation (SMS) on functional and urodynamic improvement in refractory stress urinary incontinence (SUI) patients.A sham-controlled, double-blind parallel study design with a 4.5-month follow-up.A tertiary hospital PARTICIPANTS: Thirty-four female SUI patients (aged 45-75 y) refractory to first-line management were allocated to an experimental group (n = 20) or a sham (n = 14) group.The SMS protocol consisted of 5-Hz, 20-minute treatments administered over the bilateral third sacral roots, with the intensity set at approximately 70% of the maximal output, for 12 consecutive weekdays.Urodynamic assessments and 2 life stress questionnaires, namely the Urge-Urinary Distress Inventory (Urge-UDI) and Overactive Bladder Questionnaire (OAB-q), were administered pre- and post-SMS intervention. We administered the Urge-UDI (primary outcome measure) and OAB-q at 3-week intervals during the follow-up period until 18 weeks after the final intervention.Following the SMS intervention, the experimental group exhibited significant improvements in both Urge-UDI and OAB-q scores postintervention (P = .011-.014), and at the follow-up visits (P < .001-.007) compared with the sham group. In addition, significant increases in bladder capacity, urethral functional length (UFL), and the pressure transmission ratio (P = .009-.033) were noted postintervention. Multivariate regression analysis revealed that patients with more severe symptoms benefited more from SMS. A poorer baseline Urge-UDI score and a shorter UFL were associated with a greater response to SMS.Our observations of a greater response to SMS in patients with more severe SUI than in those with mild symptoms, as well as the long-term benefits of the treatment, confirm the efficacy of SMS in treating SUI.
- Experimental demonstration of delayed-choice decoherence suppression. [JOURNAL ARTICLE]
- Nat Commun 2014.:4522.
Wheeler's delayed-choice experiment illustrates vividly that the observer plays a central role in quantum physics by demonstrating that complementarity or wave-particle duality can be enforced even after the photon has already entered the interferometer. The delayed-choice quantum eraser experiment further demonstrates that complementarity can be enforced even after detection of a quantum system, elucidating the foundational nature of complementarity in quantum physics. However, the applicability of the delayed-choice method for practical quantum information protocols continues to be an open question. Here, we introduce and experimentally demonstrate the delayed-choice decoherence suppression protocol, in which the decision to suppress decoherence on an entangled two-qubit state is delayed until after the decoherence and even after the detection of a qubit. Our result suggests a new way to tackle Markovian decoherence in a delayed manner, applicable for practical entanglement distribution over a dissipative channel.
- Prevalence and mapping of a plasmid encoding a type IV secretion system in Acinetobacter baumannii. [JOURNAL ARTICLE]
- Genomics 2014 Jul 26.
We investigated the prevalence of a type IV secretion system (T4SS)-bearing plasmid among clinical isolates of carbapenem-resistant Acinetobacter baumannii (CRAB) using plasmid replicon typing. The complete sequence of a T4SS-bearing plasmid, pAB_CC, isolated from A. baumannii TYTH-1 was determined, and a comparative analysis of the T4SS gene modules was performed. Of the 129 isolates studied, GR6 (repAci6) was the most common (45 of 96 isolates) and was strongly linked with the T4SS. A comparative analysis of the T4SS locus in seven plasmid genomes, including pAB_CC, pACICU2, pABKp1, pABTJ1, p1BJAB0714, p2BJAB0868, and p2ABTCDC0715, indicated that fourteen genes on these plasmids were highly conserved compared to those of the F plasmid. Additionally, the chromosomes in the seven representative isolates may be evolutionary distinct from their intrinsic T4SS-bearing plasmids, suggesting that the two T4SS lineages emerged long before the appearance of ECII. These two lineages are now widespread in A. baumannii strains.
- Risk-Based Learning Games Improve Long-Term Retention of Information among School Pupils. [JOURNAL ARTICLE]
- PLoS One 2014; 9(7):e103640.
Risk heightens motivation and, if used appropriately, may have the potential to improve engagement in the classroom. We have developed a risk-based learning game for school pupils in order to test whether such learning games can improve later recall of information. The study was performed during a series of public engagement workshops delivered by undergraduate students. Undergraduate neuroscience students delivered 90-minute science workshops to 9-10 year old school pupils (n = 448) that were divided into 'Risk', 'No risk' and 'Control' classes. 'Risk' classes received periodic multiple-choice questions (MCQs) during the workshops which required small teams of pupils to assign tokens to the answer(s) they believed to be correct. Tokens assigned to the correct answer were returned to the group and an equal number given back as a prize; tokens assigned to incorrect answers were lost. Participation was incentivised by the promise of a brain-related prize to the team with the most tokens at the end of the workshop. 'No risk' classes received MCQs without the risk component whilst the 'Control' classes received no MCQs. When presented with a neuroscience quiz based on workshop content at the end of the workshop, pupils in the 'Risk' classes exhibited significantly greater recall of information one week later. Quiz scores were higher than scores from the day of the workshop which suggested pupils may have discussed the workshop content outside of the classroom, thereby increasing knowledge over and above what was learned during the workshop. This is supported by feedback from pupils in 'Risk' classes which indicated that 'Risk' workshops were more interesting than 'No risk' and 'Control' workshops. These data suggest that there is a role for risk in the classroom but further investigations are required to elucidate the causal mechanisms of improved retention of information.
- Strengthening Research Governance for Sustainable Research: Experiences From Three Zimbabwean Universities. [JOURNAL ARTICLE]
- Acad Med 2014 Aug; 89(8 Suppl):S69-S72.
A robust research system requires a robust governance framework. As part of the Medical Education Partnership Initiative, three Zimbabwean universities partnered with two U.S. universities in a project to strengthen research governance in the Zimbabwean universities. The project aimed at (1) developing research policies, (2) strengthening central research management offices, (3) developing a research administration curriculum, and (4) enhancing awareness about the role and relevance of research administration in other universities and research institutions in Zimbabwe. Through the efforts of the partners, a generic research policy was developed and successfully adapted by the institutions. A curriculum was drafted, and module development experts are helping to finalize the curriculum to meet university requirements for accreditation of training research administrators. The Association of Research Managers of Zimbabwe was established to promote information sharing and professionalize research administration. The consortium approach enabled rapid and smooth development and adoption of research policies in the institutions. It also helped researchers and managers accept research administration as an essential structure and function. The experiences and lessons learned are reported here to benefit other institutions and consortia.
- Modernizing and Transforming Medical Education at the Kilimanjaro Christian Medical University College. [JOURNAL ARTICLE]
- Acad Med 2014 Aug; 89(8 Suppl):S60-S64.
The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college's medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college's administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued.
- Implementation of the Medical Education Partnership Initiative: Medical Students' Perspective. [JOURNAL ARTICLE]
- Acad Med 2014 Aug; 89(8 Suppl):S32-S34.
The Medical Education Partnership Initiative (MEPI) is contributing to the transformation of medical training in Africa. In this paper, medical students present their perspective on how MEPI initiatives have influenced five key areas related to African medical trainees: educational infrastructure, information technology, community-based training, scientific research, and professional outlook and goals. They propose three new areas of focus that could further assist MEPI in bettering medical training in Africa.
- [(C2H5)4N][U2O4(HCOO)5], an Ammonium Uranyl Formate Framework Showing Para- to Ferro-Electric Transition: Synthesis, Structures, and Properties. [JOURNAL ARTICLE]
- Inorg Chem 2014 Jul 29.
We report an ammonium uranyl formate framework of formula [(C2H5)4N][U2O4(HCOO)5], prepared by using components of tetraethylammonium, uranyl, and formate. The compound possesses a layered structure of anionic uranyl-formate wavy sheets and intercalated (C2H5)4N(+) cations. The sheet consists of pentagonal bipyramidal uranyl cations connected by equatorial anti-anti and anti-syn HCOO(-) bridges, and it has a topology of 3(3)·4(3)·5(4) made of edge-sharing square and triangle grids. The high-temperature (HT) phase belongs to the chiral but nonpolar tetragonal space group P4̅21m. In the structure, one HCOO(-) is 2-fold disordered, showing a flip motion between the two anti-syn orientations. On cooling, this flip motion slowed and finally froze, leading to a phase transition at ∼200 K. The low-temperature (LT) structure is monoclinic and polar in space group P21; the cations shift, and the layers slide. Especially, the concerted and net shifts of the ammonium cations toward the -b direction, with respect to the anionic sheets, result in an estimated spontaneous polarization of 0.86 μC cm(-2) in LT. The phase transition is thus para- to ferro-electric, in Aizu notation 4̅2mF2, accompanied by significant, anisotropic dielectric anomalies, with a quite significant thermal hysteresis. Variable-temperature luminescent spectroscopy and differential scanning calorimetry confirmed the transition and provided further information. The structure-property relationship is established.
- Laparoscopic Sleeve Gastrectomy as Revisional Surgery for Adjustable Gastric Band Erosion. [JOURNAL ARTICLE]
- J Laparoendosc Adv Surg Tech A 2014 Jul 29.
Abstract Background: Laparoscopic sleeve gastrectomy (LSG) has been increasingly adopted as a revisional surgery for failed gastric banding. However, little information is available regarding the outcome of revisional LSG for band erosion. Materials and Methods: A retrospective database analysis was performed to study LSG as revisional surgery for band erosion. For staged revision, we waited a minimum of 3 months after band removal, and for single-stage revision, the band was removed by gastrotomy, and sleeve gastrectomy was performed at the same time. Main outcome measures were success rates of therapeutic strategies, morbidity, and mortality rates, length of stay, and body mass index (BMI) (percentage excess weight loss [%EWL]) before and after revision. Results: From March 2011 to February 2013, 9 female patients underwent revisional LSG. Average age was 34.7 years. Six patients underwent a staged procedure, and the other 3 underwent a single-stage revision. Among the 6 staged patients, eroded bands had been removed by laparoscopy in 4 and by endoscopy in 2 without complications. Their LSGs were performed at a median of 4.4 months after band removal. Another 2 patients underwent single-stage revision. In the last patient, band erosion was incidentally found during a revisional LSG for insufficient weight loss. No mortality occurred. There were one stenosis and two proximal leaks. Two patients with leak underwent total gastrectomy and fistulojejunostomy. After a mean follow-up of 19.1 months, all 9 patients exhibited weight loss. The mean (±standard deviation [SD]) pre- and post-LSG BMIs were 34.0±4.4 and 25.6±2.1 kg/m(2), respectively, and their mean (±SD) %EWL from prebanding was 86.8±10.1%. Revisional LSG resulted in a further median %EWL of 28.0% (range, 7.9%-68.9%) versus weight at time of band removal. Conclusions: Revisional LSG after band erosion was found to be feasible and effective. However, it is prone to severe complication. In selected cases of band erosion, LSG can be performed at the time of band removal in a single stage.