Teaching Ultrasound Imaging for Central Line Placement—A Resident’s Perspective

The availability of ultrasound (US) devices has refined techniques for vascular access. The resident trainee’s ability to learn US techniques depends upon device availability, skills, and motivation of instructors. We hypothesized that hands-on teaching program of US techniques for vascular access would have a positive impact on the trainee’s perceptions. After IRB approval, PGY3 anesthesiology residents with limited prior experience in US-guided vascular access underwent close supervision by attending staff as they performed US-guided Internal Jugular Vein (IJV) central line placements. A total of 66 land mark (LM) and 75 US-guided IJV cannulation performed by 19 residents were supervised. Residents completing the study were more proactive with 68.4% agreeing to use US based techniques for an anticipated difficulty in accessing central lines. The graduating residents involved in the study all strongly agreed that US imaging for vascular access was within the scope of practice of all anesthesiologists, and that training guidelines be established and incorporated in their practice. Fifty eight percent of residents stated that their confidence and skill levels had significantly improved. Teaching US-guided techniques resulted in an increase employment of such techniques by graduating residents with no impediment attributed to knowledge deficits or inexperience. Residents were more proactive with using US for anticipated difficulty in IJV placement. A short neck, poor landmark, anticoagulation, morbid obesity favored US use by residents. Systematic teaching of US techniques is justified as it significantly improves the resident’s perceptions and confidence.

CAS-TWAS President’s Fellowship Programme for PhD Candidates from Developing Countries

Call for ApplicationsIntroduction According to a new agreement between the Chinese Academy of Sciences （CAS） and the academy of sciences for the developing world （TWAS）, up to 140 students/scholars per year from the developing world will be sponsored to travel to China for up to four years of PhD study and research.

Ophthalmic exam and ophthalmology residents’ subspecialty preference

AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.

Post competency training in standardized training of resident physicians and integrated postgraduates

We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice.Post competency training represents a commitment to excellence in medical education,striving to produce competent,skilled practitioners to meet the challenges of modern healthcare.

Analysis of Influencing Factors on Fruit Consumption of Urban and Rural Residents in Beijing

In light of the rapid expansion of China s economy,there has been a notable shift in the consumption patterns of urban and rural residents.This is evident in the increased consumption of agricultural products,with fruit consumption representing a particularly pronounced trend.The 2023 Beijing Consumption Statistics indicate that demand for fruit is increasing,accompanied by heightened competition for quality and brands.The paper is based on research that examines the current situation of fruit consumption among urban and rural residents in Beijing.The results indicate that when urban and rural residents in Beijing purchase fruits,price is the most significant factor influencing fruit consumption.Taste,appearance,and variety are also considered to be important influencing factors,while the influence of factors such as fruit type,consumption pattern,and fruit brand is relatively minor.

Coupling Coordination Relationship between Ecological Human Settlements and the Happiness Levels of Residents in the Yangtze River Delta Urban Agglomeration

Promoting the coordinated development of ecological human settlements and the happiness levels of residents will help to promote people-centered high-quality development.This study was based on the 2011-2021 data of the Yangtze River Delta urban agglomeration,and constructed an evaluation index system of ecological human settlements and the happiness levels of residents.The entropy value method,coupling coordination degree model,Dagum Gini coefficient and Geodetector model were used to explore the coupling coordination relationship and influencing factors of these two systems.The findings indicate that ecological human settlements and the happiness levels of residents in the Yangtze River Delta urban agglomeration have shown an upward trend over time.By 2021,the overall level of the region had significantly improved.The coupling coordination level between these two systems has gradually increased,showing a spatial distribution pattern of high in the east and low in the west.The Dagum Gini coefficient shows a fluctuating downward trend in the overall and intra-regional differences,with the largest inter-regional difference between Shanghai and Anhui,and the inter-regional difference is the main source of the spatial differences.Economic development level(Eco)was the main factor influencing the coupling coordination of the two systems from 2011 to 2021.The results of this study provide references for constructing ecological human settlements and enhancing the happiness levels of residents.

The Impact of the Digital Economy on Rural Residents’Working Hours:Mechanisms and Empirical Evidence

The rapid development of the digital economy has provided a new impetus for rural residents to extend their working hours.Based on the data collected by the China Labor-force Dynamics Survey(CLDS)in 2014,2016,and 2018,this paper measured the development level of the digital economy in China from the perspectives of internet development and digital financial inclusion,and tested the mechanisms of how the digital economy affected rural residents’working hours.The results showed that the digital economy extended rural residents’working hours by expanding information channels and enhancing human capital,and this mechanism was affected by heterogeneity in rural residents’educational background,age,and social capital.Building on these findings,this paper holds that to increase rural residents’income by extending their working hours and achieving common prosperity for all,it is necessary to expand the opportunities for rural residents to participate in skills training and promote their accumulation of human capital.

Assessment of Online Transgender Healthcare Teaching Modules for Internal Medicine Residents and Fellows

Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.

The Prediction for the Consumer Price Index of Residents in Perspective of Time Series Method in Case of Chongqing

The consumer price index (CPI) measures the relative number of changes in the price level of consumer goods and services over time, reflecting the trend and degree of changes in the price level of goods and services purchased by residents. This article uses the ARMA model to analyze the fluctuation trend of the CPI (taking Chongqing as an example) and make short-term predictions. To test the predictive performance of the model, the observation values from January to December 2023 were retained as the reference object for evaluating the predictive accuracy of the model. Finally, through trial predictions of the data from May to August 2023, it was found that the constructed model had good fitting performance.

Spatial Morphology Evolution Characteristics Analysis of the Resident Population Distribution in Henan, China

The population spatial distribution pattern and its evolving pattern play an important role in regional allocation of social resources and production factors, formulation of regional development plans, construction of a better life society, and promotion of regional economic development. Based on the resident population statistics data of Henan province from 2006 to 2021, with county as the basic study unit, the paper studies the spatial morphology characteristics and its evolution patterns of resident population distribution, by using spatial analysis methods such as population distribution center, standard deviation ellipse, and spatial auto correlation analysis. The results show that: the resident population spatial distribution shows unbalanced state, the population agglomeration areas mainly distribute in the northeast part and north part, where the resident population growth rate is significantly higher than other regions, over time, this trend is gradually becoming significant. The resident population distribution has a trend of centripetal concentration, with the degree and trend of centripetal gradually strengthening. The resident population distribution has obvious directional characteristics, but the significance is not high, the weighted resident population average center is approximately located at (4.13740˚N, 113.8935˚E), and the azimuth of the distribution axis is approximately 11.19˚. The population distribution has obvious agglomeration characteristics, with the built-up areas of Zhengzhou and Luoyang as their centers, where have a significant siphon effect on the surrounding population. The southern and southwestern regions in the province form a relatively stable belt area of Low-Low agglomeration areas.

Application of BOPPPS + Mind Maps to Improve Clinical Competence of General Practitioner Residents: Taking Cough as an Example

Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group participants receiving traditional teaching and 6 observation group participants receiving the combined teaching method(BOPPPS+mind maps).The study analyzed various indicators between the two groups(including mind map scores and assessment results).Results:Compared with the control group,the assessment scores of the observation group were significantly higher(P<0.05).Conclusion:The application of the combined teaching method(BOPPPS+mind maps)by general practitioner residents can significantly improve their comprehensive abilities.

Study on the Impacts of Tourism Development in Letong Ancient Town:A Resident Perception-Based Approach

Residents constitute the principal elements of regional tourism deveopment,and their behavioral cognition will play a certain role in promoting local tourism development.In recent years,although tourism along the Sichuan-Tibet Line(318 and 317 routes)has made some progress,there are some problems,such as homogenization of products,a single local culture,and inconspicuous brand characteristics.At the same time,due to the remote geographical location,living conditions,health conditions,and other imperfections,resulting in greater constraints on tourism development.This article employs Letong Ancient Town as a representative case study,and discusses the impact of tourism development on the local economy,environment,society,and culture from the perspective of residents’perception through field research and data analysis,thereby providing a reference for regional tourism development.

Exploration of the Integration of Curriculum Ideology and Politics into the Educational Pathway of Standardized Training for General Practice Residents

In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice residents(commonly referred to as general resident training)is an unavoidable trend in the teaching field.Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University,this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum,despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training.In our hospital,we must assess the ideological and political education in the curriculum of general resident training,proposing a scientific,reasonable ideological and political education concept system for general practice courses,integrating ideological and political education with general practice resident training,and strengthening the team of ideological and political education physicians to teach them to carry out such education,this would foster enthusiasm and initiative.Strengthening admission education and training for general practice resident training,as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.

Cross-Cultural Adjustment and Coping:U.S.Students in Taiwan Residents Higher Education

The aim of this study was to investigate the adjustment problems of students from the United States enrolled in universities in the East,specifically in Taiwan,their problems related to cultural adaptation,and the process of adjustment to student life in Taiwan.Under investigation were cultural adjustment and coping skills as these students transitioned from West to East.Qualitative data were collected from interviews with participants and faculty members as well as participant observations.Results indicated that U.S.students found their own ways to acclimate to their new academic setting as well as to social relations,cross-cultural issues,and the linguistic environment in Taiwan to achieve effective adaptation.They made changes in themselves to cope with all situations they encountered.This study provides suggestions for international students abroad in Taiwan,for the Taiwan Residents government,and for universities or colleges in terms of what they should offer to current and future international students.

Geochemical and Isotopic Techniques Constraints on the Origin,Evolution,and Residence Time of Low-enthalpy Geothermal Water in Western Wugongshan,SE China

Geothermal resources are increasingly gaining attention as a competitive,clean energy source to address the energy crisis and mitigate climate change.The Wugongshan area,situated in the southeast coast geothermal belt of China,is a typical geothermal anomaly and contains abundant medium-and low-temperature geothermal resources.This study employed hydrogeochemical and isotopic techniques to explore the cyclic evolution of geothermal water in the western Wugongshan region,encompassing the recharge origin,water-rock interaction mechanisms,and residence time.The results show that the geothermal water in the western region of Wugongshan is weakly alkaline,with low enthalpy and mineralization levels.The hydrochemistry of geothermal waters is dominated by Na-HCO_(3)and Na-SO_(4),while the hydrochemistry types of cold springs are all Na-HCO_(3).The hydrochemistry types of surface waters and rain waters are NaHCO_(3)or Ca-HCO_(3).The δD and δ^(18)O values reveal that the geothermal waters are recharged by atmospheric precipitation at an altitude between 550.0 and 1218.6 m.Molar ratios of maj or solutes and isotopic compositions of^(87)Sr/^(86)Sr underscore the significant role of silicate weathering,dissolution,and cation exchange in controlling geothermal water chemistry.Additionally,geothermal waters experienced varying degrees of mixing with cold water during their ascent.Theδ^(13)C values suggest that the primary sources of carbon in the geothermal waters were biogenic and organic.Theδ^(34)S value suggests that the sulfates in geothermal water originate from sulfide minerals in the surrounding rock.Age dating using 3H and^(14)C isotopes suggests that geothermal waters have a residence time exceeding 1 kaBP and undergo a long-distance cycling process.

Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics & Gynecology Residency Websites between Two Consecutive Years

Background: Few studies have focused on the geographic and chronologic assessment of inclusivity and wellness in Obstetrics and Gynecology residency websites across the US. Objective: To identify variations in wellness and inclusivity website depictions across CREOG districts over the past two years. Methods: This is a cross-sectional analysis of the websites of ACGME-accredited OB/GYN residency programs across the United States between April 2022 and April 2023. The assessment was based on a compilation of 22 attributes devised and piloted by 49 medical students. A racially, geographically, and gender-diverse cohort of 11 students performed data collection. Results: A total of 560 websites were analyzed over two years. Wellness efforts remained unchanged in both years (website content, dedicated support personnel, and group activities). In 2023, a reduction in referencing of wellness (22%) and inclusivity (30%) occurred in leadership messaging. However, a 7% increase in the use of inclusive pronouns was noted. A reduction in gender diversity was identified (9% in faculty, 5% in residents), with programs favoring female-only teams. Similarly, a 7% reduction in the number of underrepresented in medicine faculty and residents was noted. A 15% reduction was noted in curricula referencing inclusivity in their mission statement and inclusivity focused research. Conclusions: This study suggests the variations across websites relative to inclusivity and wellness over the past two years. Updated websites may provide an accurate reflection of the offerings of programs and their investment in wellness and inclusivity across the nation.

Analysis model of internal residence time distribution for fluid flow in a multi-strand continuous casting tundish

The external residence time distribution(RTD)curve is extensively used to characterise fluid flow within the single-strand continuous casting tundish.Dead volume fraction determination typically relies on the external RTD curve to reveal macroscopic fluid flow behaviour.Based on the external RTD to effectively assess dead volume fractions and other fluid characteristics under conditions of internal non-uniform flow,an internal RTD was introduced.In a smooth pipe under laminar flow conditions,the dead region occupies 25%of the total volume,which is defined as the space between the pipe wall and a radius of 0.866 R0(where R0 is the radius of pipe).Under turbulent flow conditions,the dead region only occupies 0.38%of the reactor’s internal volume,spanning from the pipe wall to a radius of 0.00189 R0.The results obtained using the external RTD method are consistent with the theoretical analysis.Experimental trials involving water were conducted to examine the flow of molten steel within a five-strand tundish.Subsequently,an analysis approach employing internal RTD was employed to evaluate fluid mixing within a multi-flow continuous casting tundish.Using the internal RTD method,the analysis revealed that the whole dead zone volume fraction of the intermediate package decreased from 26.9%to 18.9%after the addition of the flow control device.The dead volume fraction can be accurately depicted by utilising the internal mean RTD function.The association between the internal RTD function and the external average RTD can be effectively employed to scrutinise the response curve of the tracer within a system exhibiting uneven flow distribution.

Particle residence time distribution and axial dispersion coefficient in a pressurized circulating fluidized bed by using multiphase particle-in-cell simulation

The particle residence time distribution(RTD)and axial dispersion coefficient are key parameters for the design and operation of a pressurized circulating fluidized bed(PCFB).In this study,the effects of pressure(0.1-0.6 MPa),fluidizing gas velocity(2-7 m·s^(-1)),and solid circulation rate(10-90 kg·m^(-2)·s^(-1))on particle RTD and axial dispersion coefficient in a PCFB are numerically investigated based on the multiphase particle-in-cell(MP-PIC)method.The details of the gas-solid flow behaviors of PCFB are revealed.Based on the gas-solid flow pattern,the particles tend to move more orderly under elevated pressures.With an increase in either fluidizing gas velocity or solid circulation rate,the mean residence time of particles decreases while the axial dispersion coefficient increases.With an increase in pressure,the core-annulus flow is strengthened,which leads to a wider shape of the particle RTD curve and a larger mean particle residence time.The back-mixing of particles increases with increasing pressure,resulting in an increase in the axial dispersion coefficient.

Flipped classroom approach to global outreach:cross-cultural teaching of horizontal strabismus to Chinese ophthalmology residents

AIM:To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.METHODS:Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in 2018.Residents were instructed to watch a pre-class video lecture prior to the in-class-casebased activity.Content tests(5 Ophthalmic Knowledge Assessment Program style questions)and surveys were administered before and after the classroom sessions(100%response rate).These results were compared to that of an American cohort who were taught the same content.RESULTS:The Chinese cohort of 12 residents preferred the flipped classroom to the traditional classroom at higher rates than the American cohort of 40 residents(92%vs 55%,P=0.04)and felt that all ophthalmology topics would be appropriate for the flipped classroom teaching style(P-values between 0.008 and<0.001).In both Chinese and American cohorts,we found that the exotropia curriculum saw a small but significant improvement in performance following the flipped classroom session(P=0.025 for Chinese residents;P=0.001 for US residents),whereas scores in both groups for the esotropia course did not significantly improve.CONCLUSION:This is the first study to evaluate the flipped classroom model implemented by a visiting ophthalmology professor in a global outreach setting.The flipped classroom sessions are viewed favorably by the Chinese residents relative to the US cohort with a modest impact on knowledge.Decreased in-person interpreter requirement and increased student engagement make this model valuable in cross-cultural visiting professorship settings.Finally,the flipped classroom may lend itself well to a virtual format to prevent the transmission of COVID-19,although such a format requires further study.

Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.