Surgical Research Papers - Academia.edu (original) (raw)

Although gamification is one of the latest education trends, it has not been investigated adequately in the Egyptian EFL context. Hence, this mixed-method study aimed to explore the effect of using gamification on Egyptian EFL... more

Although gamification is one of the latest education trends, it has not been investigated adequately in the Egyptian EFL context. Hence, this mixed-method study aimed to explore the effect of using gamification on Egyptian EFL learners' vocabulary knowledge and their attitudes toward gamification use. The study followed a pre-posttest quasi-experimental research design. A total of 68 English Majors in the Faculty of Education at New Valley University participated in this study. The instruments included a vocabulary test (APTIS), an attitude questionnaire (designed by the researcher), learning logs and follow-up interviews. The experimental group used Quizizz, whereas the control group used paper-based sheets. After a seven-week treatment period, the participants were post-tested. The results showed significantly increased vocabulary knowledge of the experimental group in the APTIS test compared to the control group. The effect size of the treatment was remarkable (Cohen’s d = 1....

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The needle biopsy technique described by Bergström is the most commonly used technique to obtain samples to assess muscle metabolism. Sampling of muscle, particularly the vastus lateralis, has become an essential tool in biomedical and... more

The needle biopsy technique described by Bergström is the most commonly used technique to obtain samples to assess muscle metabolism. Sampling of muscle, particularly the vastus lateralis, has become an essential tool in biomedical and clinical research. Optimal sample size is critical for availability of tissue for processing. To evaluate the effectiveness of a novel technique to obtain adequate sample size using wall suction applied to needle muscle biopsy, we collected samples from subjects in on-going clinical studies for gene expression.Muscle biopsy samples of the vastus lateralis using 6 mm Bergström needles under local anesthesia were obtained from 55 subjects who had volunteered to participate in this research project. The vastus lateralis was biopsied according to the methods described by Bergström with a 6 mm biopsy needle. Wall suction was applied to the inner bore of the biopsy needle after the needle was inserted into the muscle.The mean sample of biopsy taken using the 6 mm was 233 mg (n = 55). The wall suction (200 mm Hg) applied to the needle pulled the surrounding tissue into the central bore of the needle. The quality of the samples was adequate for all biochemical assays. The biopsy technique did not result in any complications due to infection or bleeding.Using a novel technique of connecting a 6 mm Bergström biopsy needle to wall suction, we have obtained 200 to 300 mg muscle biopsy specimens uniformly, with ease, and minimal discomfort. An increase in sample size allows for a wider variety of biochemical and histopathological analysis.

Aims: To describe the process of designing a new surgical safety checklist for the prevention of wrong patient and wrong site/side surgery using ‘failure mode and effects analysis’ (FMEA), and to carry out a compliance audit on the use... more

Aims: To describe the process of designing a new surgical safety checklist for the prevention of wrong patient and wrong site/side surgery using ‘failure mode and effects analysis’ (FMEA), and to carry out a compliance audit on the use of the new checklist in a surgical department.Methods: Using FMEA as a tool, a multidisciplinary team of medical professionals in the New Territories East Cluster of the Hospital Authority sought to identify key steps at-risk associated with a patient's journey through elective surgery. The whole process was redesigned and incorporated into a new safety checklist with a view to preventing wrong patient and wrong site/side surgery. A compliance audit was carried out after implementation of the checklist.Results: The newly designed safety checklist, known as ‘123-Surgical Safety-123’, involved a longitudinal series of checkpoints from upstream to downstream with repeated/redundant cross-checking at key steps. The checkpoints included consenting process, sending of patient to the theatre, theatre reception, sign-in, time-out, and sign-out. At each step, one designated person (either a doctor or a nurse) was responsible for checking the correctness of those items listed on the checklist. The new checklist was implemented in February 2009. A compliance audit on the use of the checklist was carried out between 13 February and 17 April 2009. A total of 322 patients were operated on during the study period. The overall compliance rate was 95%.Conclusion: By using FMEA as a platform, a new surgical safety checklist for prevention of wrong patient and wrong site/side surgery was designed and successfully implemented in a surgical department. A high compliance rate was achieved. However, whether or not the implementation of this new checklist will improve the outcome of surgical patients still awaits further evaluation.

The injury caused by reperfusion of ischemic skeletal muscle is mediated by the membrane attack complex of complement (C) . This C activation results from local classical pathway activation after deposition of IgM in injured muscle, an... more

The injury caused by reperfusion of ischemic skeletal muscle is mediated by the membrane attack complex of complement (C) . This C activation results from local classical pathway activation after deposition of IgM in injured muscle, an event analogous to C deposition in the mucosa of the gut during reperfusion . Our past analysis has indicated that the injury is not uniform even within a single microscopic section. This study was performed to elucidate the exact site of IgM and C deposition on muscle injured by ischemia and reperfusion. C57Bl/6 mice were subjected to 2 h of tourniquet-induced hindlimb ischemia followed by reperfusion for 0-6 h. Three muscle groups (vastus, gastrocnemius, and soleus) of varying fast-myosin content were compared for muscle fiber damage and C deposition. Adjacent paraffin-embedded cross-sections were immunostained to correlate C3 deposition with muscle fiber type as defined by monoclonal antibodies. Muscle injury after ischemia and reperfusion is not u...

We previously (1997) demonstrated superior clinical but similar cognitive performance after the new interactive compared to the old ATLS course. The present study is aimed at determining whether this difference was short term or... more

We previously (1997) demonstrated superior clinical but similar cognitive performance after the new interactive compared to the old ATLS course. The present study is aimed at determining whether this difference was short term or maintained over time (2 years). Two groups of 13 physicians out of the original 32 physicians were available for the study which compared performance in a 40-item MCQ examination on trauma topics and clinical performance in 4 trauma OSCE stations consisting of simulated trauma patients. Paired and unpaired t tests were used for within- and between-group comparisons, respectively, with P < 0.05 being considered statistically significant. Overall OSCE scores (maximum standard 20), adherence to priority scores (Priority, scale 1 to 7), and overall approach (Approach, scale 1 to 5) scores were analyzed. Values are means +/- SD; (+)-P < 0.05 compared to 1999; *P < 0.05 compared to old group [table in text]. Although knowledge base decreases similarly with time after both courses, the new interactive course participants maintained a consistently higher clinical skill performance level at 2 years.

Background: Endoscopic surgeons rely on visual feedback to control their movements but lack stereopsis, an important depth cue. Previous three-dimensional (3D) systems alternated images on a two-dimensional (2D) screen, which was... more

Background: Endoscopic surgeons rely on visual feedback to control their movements but lack stereopsis, an important depth cue. Previous three-dimensional (3D) systems alternated images on a two-dimensional (2D) screen, which was uncomfortable for surgeons. A second-generation 3D system provides continuous stereoscopic images on a monitor suspended at arm's length. We studied its effect on the laparoscopic precision of novices and experienced surgeons. Methods: Experienced laparoscopic surgeons (n= 12) and novices (n= 16) performed a total of 672 tasks in 2D, 3D, and under direct vision. Precision was assessed using the Imperial College Surgical Assessment Device (ICSAD), which generates objective scores of performance by analyzing the movements of surgical instruments. Results: We found that 2D endoscopic vision impaired performance by 35–100% when compared with direct vision, whereas 3D reduced this endoscopic handicap by 41–53% in novices and experienced surgeons (p p Conclusions: Second-generation 3D significantly improved the laparoscopic precision of novices and experienced surgeons, without the side effects reported from previous systems. This technology is expected to improve the ease and safety of laparoscopic surgery.

Pneumothorax (Ptx) is a life-threatening complication that can result from trauma, mechanical ventilation, and invasive procedures. Infrared thermography (IRT), a compact and portable technology, has become highly sensitive. We... more

Pneumothorax (Ptx) is a life-threatening complication that can result from trauma, mechanical ventilation, and invasive procedures. Infrared thermography (IRT), a compact and portable technology, has become highly sensitive. We hypothesized that IRT could detect Ptx by identifying associated changes in skin temperature.Bilateral nonpenetrating chest incisions or needle punctures were performed in 21 anesthetized rats. Rats were then randomized to no, bilateral, left, or right Ptx by either open (n = 16) or closed percutaneous (n = 5) puncture through selected pleurae. Real-time thermographic images and surface temperature data were acquired with a noncooled infrared camera.In all cases, blinded observers correctly identified each Ptx with real-time grayscale image analysis. When compared to either the ipsilateral baseline or an abdominal reference, experimental Ptx produced a significantly greater decrease in surface temperature when compared to non-Ptx control.These results demonstrate that portable infrared imaging can rapidly and accurately detect changes in thoracic surface temperature associated with experimental pneumothorax.

Background: Blood-borne infection is an ever-present fear for medical professionals, espe-cially surgeons and operating room personnel. Safety is paramount, and the reliability and efficacy of surgical gloves are crucial, as gloves are... more

Background: Blood-borne infection is an ever-present fear for medical professionals, espe-cially surgeons and operating room personnel. Safety is paramount, and the reliability and efficacy of surgical gloves are crucial, as gloves are the most important barriers protecting hospital ...

Whole-body positron emission tomography (PET) has been shown to be a highly sensitive method for detecting malignancy not imaged by conventional modalities. We have adapted a hand-held gamma-ray-sensitive probe to detect the radiation... more

Whole-body positron emission tomography (PET) has been shown to be a highly sensitive method for detecting malignancy not imaged by conventional modalities. We have adapted a hand-held gamma-ray-sensitive probe to detect the radiation emission from the [(18)F]fluorodeoxyglucose (FDG) used in PET imaging. This pilot study was devised to examine the feasibility of using a hand-held probe to intraoperatively differentiate normal from tumor-bearing tissue. A commercially available gamma probe was adapted to detect the radioactivity released from FDG and examined to determine the in vitro sensitivity for localization of a FDG point source. Eight consecutive patients underwent resection of metastatic colon cancer or melanoma; each received a preoperative injection of 7--10 mCi of FDG. The gamma probe was used to determine radioactive counts per second from tumor and normal tissue, and ratios of tumor to adjacent normal background were calculated. In vitro studies with a FDG point source demonstrated the probe could identify the source with a 50% reduction in maximum counts 1.7 +/- 0.1 cm from the source (full-width half-maximum measurement). Based on the results of their preoperative PET scans 17 tumors were identified from the 8 patients. Of the 17 tumors assessed the in vivo tumor-to-background ratios varied from 1.16:1 to 4.67:1 for the melanoma patients (13 tumors) and from 1.19:1 to 7.92:1 for colon cancer patients (4 tumors). Thirteen tumors were resected; four (2 patients) were unresectable. This study demonstrates the use of a hand-held gamma-ray-sensitive probe to intraoperatively differentiate the radioactivity released from FDG from tumor-bearing and adjacent normal tissue. While further studies are necessary for us to optimize the use of this probe, the intraoperative detection of FDG-avid malignancies may ultimately improve our ability to completely resect patients with metastatic disease.

Glucagon-like peptide 2 (GLP-2) is an endogenous hormone with potent and specific intestinotrophic activity in vivo and in vitro. The aim of this study was to define the initial signal transduction mechanisms mediating the proliferative... more

Glucagon-like peptide 2 (GLP-2) is an endogenous hormone with potent and specific intestinotrophic activity in vivo and in vitro. The aim of this study was to define the initial signal transduction mechanisms mediating the proliferative actions of GLP-2 on intestinal epithelial cells.The proliferative actions of GLP-2 on the human Caco-2 cell line were assessed. Specific G-protein inhibitors, pertussis and cholera toxin, were used to characterize the roles of early signal transduction mechanisms in mediating the proliferative actions of GLP-2 in these cells.GLP-2 directly stimulated proliferation in the Caco-2 cells. GLP-2 stimulated proliferation was (1) inhibited in a dose-dependent fashion by both pertussis and cholera toxin and (2) augmented by 2′,5′-dideoxyadenosine. Proliferation rates were inversely proportional to changes in intracellular cAMP concentration.Our findings suggest that a G-protein-linked signaling pathway is involved with GLP-2 bioactivity in the intestinal epithelial cell line Caco-2.

Parathyroid hormone (PTH) levels are often measured after thyroid surgery and are used to detect patients at risk for postoperative hypoparathyroidism. However, there is a lack of consensus in the literature about how to define the... more

Parathyroid hormone (PTH) levels are often measured after thyroid surgery and are used to detect patients at risk for postoperative hypoparathyroidism. However, there is a lack of consensus in the literature about how to define the recovery of parathyroid gland function and when to classify hypoparathyroidism as permanent. The goals of this study were to determine the incidence of low postoperative PTH in total thyroidectomy patients and to monitor their time course to recovery of parathyroid gland function. We identified 1054 consecutive patients who underwent a total or completion thyroidectomy from January, 2006-December, 2013. Low PTH was defined as a PTH measurement <10 pg/mL immediately after surgery. Patients were considered to be permanently hypoparathyroid if they had not recovered within 1 y. Recovery of parathyroid gland function was defined as PTH ≥10 pg/mL and no need for therapeutic calcium or activated vitamin D (calcitriol) supplementation to prevent hypocalcemic ...