Performance in the Fundamentals of Laparoscopic Surgery: Does it reflect global rating scales in the Objective Structured Assessment of Technical Skills in porcine laparoscopic surgery?

Objective:To correlate the utility of the Fundamentals of Laparoscopic Surgery(FLS)manual skills program with the Objective Structured Assessment of Technical Skills(OSATS)global rating scale in evaluating operative performance.Methods:The Asian Urological Surgery Training and Educational Group(AUSTEG)Laparoscopic Upper Tract Surgery Course implemented and validated the FLS program for its usage in laparoscopic surgical training.Delegates’basic laparoscopic skills were assessed using three different training models(peg transfer,precision cutting,and intra-corporeal suturing).They also performed live porcine laparoscopic surgery at the same workshop.Live surgery skills were assessed by blinded faculty using the OSATS rating scale.Results:From March 2016 to March 2019,a total of 81 certified urologists participated in the course,with a median of 5 years of post-residency experience.Although differences in task time did not reach statistical significance,those with more surgical experience were visibly faster at completing the peg transfer and intra-corporeal suturing FLS tasks.However,they took longer to complete the precision cutting task than participants with less experience.Overall OSATS scores correlated weakly with all three FLS tasks(peg transfer time:r=0.331,r^(2)=0.110;precision cutting time:r=0.240,r^(2)=0.058;suturing with intracorporeal knot time:r=0.451,r^(2)=0.203).Conclusion:FLS task parameters did not correlate strongly with OSATS globing rating scale performance.Although FLS task models demonstrated strong validity,it is important to assimilate the inconsistencies when benchmarking technical proficiency against real-life operative competence,as evaluated by FLS and OSATS,respectively.

Theory and practice for assessing structural integrity and dynamical integrity of high-speed trains

Purpose–The safety and reliability of high-speed trains rely on the structural integrity of their components and the dynamic performance of the entire vehicle system.This paper aims to define and substantiate the assessment of the structural integrity and dynamical integrity of high-speed trains in both theory and practice.The key principles and approacheswill be proposed,and their applications to high-speed trains in Chinawill be presented.Design/methodology/approach–First,the structural integrity and dynamical integrity of high-speed trains are defined,and their relationship is introduced.Then,the principles for assessing the structural integrity of structural and dynamical components are presented and practical examples of gearboxes and dampers are provided.Finally,the principles and approaches for assessing the dynamical integrity of highspeed trains are presented and a novel operational assessment method is further presented.Findings–Vehicle system dynamics is the core of the proposed framework that provides the loads and vibrations on train components and the dynamic performance of the entire vehicle system.For assessing the structural integrity of structural components,an open-loop analysis considering both normal and abnormal vehicle conditions is needed.For assessing the structural integrity of dynamical components,a closed-loop analysis involving the influence of wear and degradation on vehicle system dynamics is needed.The analysis of vehicle system dynamics should follow the principles of complete objects,conditions and indices.Numerical,experimental and operational approaches should be combined to achieve effective assessments.Originality/value–The practical applications demonstrate that assessing the structural integrity and dynamical integrity of high-speed trains can support better control of critical defects,better lifespan management of train components and better maintenance decision-making for high-speed trains.

A longitudinal analysis of the U.S. Air Force Reserve Officers’ Training Corps physical fitness assessment

Background:The U.S.Air Force physical fitness assessment(PFA)is used to determine the overall fitness of their personnel.It is currently unknown to what extent the PFA scores of Reserve Officers’Training Corps(ROTC)cadets are affected by mandatory physical training.The purpose of this investigation was to longitudinally examine the PFAs of ROTC cadets over a four-year period,evaluate the results across class ranks,and evaluate the sensitivity of the classification of the tests.Methods:Air Force ROTC cadets performed the PFAs(abdominal circumference,1-min pushups,1-min sit-ups,and a 1.5-mile run)in both the spring(n=26)and fall(n=22)semesters.PFAs were compiled over a four-year period(Spring 2014–Fall 2017)and were performed in accordance with Air Force Instruction 36–2905.A oneway repeated measures ANOVA was performed separately for the fall and spring groups for each dependent variable across the 4 years.Additionally,a one-way between groups ANOVA was performed for each dependent variable during the time point(fall 2015;n=46)with the most recorded cadets for each class rank.Results:Longitudinal assessments revealed a main effect of time(P=0.010)on abdominal circumference;cadets had a smaller abdominal circumference in their freshman year than in their senior year.A main effect of time(P=0.006)was also observed on sit-up quantity;cadets performed more sit-ups in their junior year than in their freshman year.Examining between class ranks during the same year(between-subjects ANOVA)revealed a main effect of class rank on sit-up quantity(P=0.003);the freshmen completed fewer repetitions than the sophomores(P=0.018)and the juniors did(P=0.001).Conclusions:The results indicated that only the sit-up component showed differences between class ranks.These findings suggest that the Air Force PFA may not be sensitive enough to detect changes in physical fitness or distinguish between class ranks regarding physical performance,even after years of training.This limitation may be in part due to the limited duration of training incorporated by the ROTC program(2 h per week),which provided a maintenance effect rather than improvement in physical performance.We recommend that more attention be directed to the efficacy of physical training,the sensitivity of measures included in the PFA,or both.

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Prostate cancer （PCa） is the most common visceral malignancy in men with androgen deprivation therapy （ADT） the preferred therapy to suppress testosterone production and hence tumor growth. Despite its effectiveness in lowering testosterone, ADT is associated with side effects including loss of muscle mass, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life. This review reports a survey of the literature with a focus on changes in muscle strength, physical function and body composition, due to short-term and long-term ADT. Studies in these areas are sparse, especially well-controlled, prospective randomized trials. Cross-sectional and longitudinal data （up to 2 years） for men with PCa treated with ADT as well as patients with PCa not receiving ADT and age-matched healthy men are presented when available. Based on limited longitudinal data, the adverse effects of ADT on muscle function, physical performance and body composition occur shortly after the onset of ADT and tend to persist and worsen over time. Exercise training is a safe and effective intervention for mitigating these changes and initial guidelines for exercise program design for men with PCa have been published by the American College of Sports Medicine. Disparities in study duration, types of studies and other patient-specific variables such as time since diagnosis, cancer stage and comorbidities may all affect an understanding of the influence of ADT on health, physical performance and mortality.

Analysis and Study on the Effect of PNF Stretching and Resistance Training on the Rehabilitation of Superior Chiasma Syndrome

In this paper,18 subjects with superior chiasma syndrome were analyzed and studied according to the inducement and correction method of superior chiasma syndrome by questionnaire survey,literature review and experimental research.To explore the effect of bad posture on the posture of patients,and to explore the effect of PNF stretching,anti-resistance training and manual loosening on the rehabilitation of patients with superior chiasma.Methods:the subjects were divided into three experimental groups,A,B and C,for 6 weeks,4 times a week for resistance training and PNF stretching training.It has been proved that the population with chest ambushes for a long time will cause the imbalance of muscle strength of shoulder,neck and chest,abnormal physiological curvature of cervical vertebrae and thoracic vertebrae,and induce chronic injury of shoulder and neck muscles and soft tissue,which will lead to symptoms of superior chiasma syndrome.According to the designed rehabilitation training experiment,PNF stretching training and anti-resistance training were carried out for the shoulder and neck muscles which caused superior chiasma syndrome,and the rehabilitation effect was very significant,which was obviously better than that of PNF stretching or resistance training alone.Therefore,PNF stretching and resistance training should be fully combined in rehabilitation training to improve the posture problem in order to achieve twice the result with half the effort.

Education Training Improvement of Built Environment and Energy Application Engineering in Line with the ABET Criteria

Built Environment and Energy Application Engineering(BEEAE),namely Heating,Ventilating,Air Conditioning and Refrigerating(HVAC&R),is one of the international accreditation programs.Its knowledge system of professional theory and professional education in accredited engineering academic programs must meet the requirements of the relevant international engineering certification.In view of professional engineers and technicians training of BEEAE,the professional training programs and the knowledge system are compared and explored in line with the international certification criteria.This study compares the items and requirements of different international certification criteria,and summarizes the experienced methods of education training.The undergraduate education and training programs are then improved in accordance with the requirements from international certification criteria.The BEEAE education training schemes should combine the knowledge system of the national professional guidance standards with the items from international certification criteria.

An Informative System Based on the Skill Gap Analysis to Planning Training Courses

By using the skill gap analysis we propose a new quantitative method to plan training courses. By comparing the differences between the competences needed to cover a position and the ones possessed, it is possible to find the cases that need to be trained. According to different situations we propose some algorithms to plan courses and to find the subjects that require to be trained.

Examining teachers' perceptions and practice of formative assessment in Chinese ESL classrooms

自2001年课程改革以来,中小学英语课堂形成性评价受到了教育管理者、研究者和实践者的广泛支持,但对于教师是如何理解和实施形成性评价的这一问题,还需要研究。本研究通过问卷调查方式探究中学英语教师对形成性评价的认识及其实施现状:(1)从六个维度(评价主体、评价构念、评价工具、评价时间、反馈、终结性评价与形成性评价之间的关系)了解教师对形成性评价的认识;(2)从五个方面(学习目标、反馈、终结性评价的形成性使用、不同学习阶段的形成性评价、自我和同伴评价)揭示教师形成性评价的实践特征。基于这些特征,本文为形成性评价教师培训提出了建议。

The usefulness and significance of assessing rapidly progressive spermatozoa

It is possible and clinically relevant to distinguish between slow and rapid progressive spermatozoa in basic semen analysis. This is discussed in light of the different purposes of semen analysis for the subfertile couple and the male patient. The two groups of progressive spermatozoa should be distinguished to help ensure that pertinent information available in the semen sample is not neglected.

Effect of Combined Low-frequency Repetitive Transcranial Magnetic Stimulation and Virtual Reality Training on Upper Limb Function in Subacute Stroke:a Double-blind Randomized Controlled Trail

The effect of combined low-frequency repetitive transcranial magnetic stimulation（LF r TMS） and virtual reality（VR） training in patients after stroke was assessed. In a double-blind randomized controlled trial, 112 patients with hemiplegia after stroke were randomly divided into two groups： experimental and control. In experimental group, the patients received LF r TMS and VR training treatment, and those in control group received sham r TMS and VR training treatment. Participants in both groups received therapy of 6 days per week for 4 weeks. The primary endpoint including the upper limb motor function test of Fugl-meyer assessment（U-FMA） and wolf motor function test（WMFT）, and the secondary endpoint including modified Barthel index（MBI） and 36-item Short Form Health Survey Questionnaire（SF-36） were assessed before and 4 weeks after treatment. Totally, 108 subjects completed the study（55 in experimental group and 53 in control group respectively）. After 4-week treatment, the U-FMA scores [mean difference of 13.2, 95% confidence interval（CI） 3.6 to 22.7, P〈0.01], WMFT scores（mean difference of 2.9, 95% CI 2.7 to 12.3, P〈0.01）, and MBI scores（mean difference 16.1, 95% CI 3.8 to 9.4, P〈0.05） were significantly increased in the experimental group as compared with the control group. The results suggested the combined use of LF r TMS with VR training could effectively improve the upper limb function, the living activity, and the quality of life in patients with hemiplegia following subacute stroke, which may provide a better rehabilitation treatment for subacute stroke.

Feasibility of hydrogen fuel cell technology for railway intercity services:a case study for the Piedmont in North Carolina

Diesel fuel combustion results in exhaust containing air pollutants and greenhouse gas emissions.Many railway vehicles use diesel fuel as their energy source.Exhaust emissions,as well as concerns about economical,alternative power supply,have driven efforts to move to hydrogen motive power.Hydrogen fuel cell technology applied to railways offers the opportunity to eliminate harmful exhaust emissions and the potential for a low-or zero-emission energy supply chain.Currently,only multiple-unit trains with hydrail technology operate commercially.Development of an Integrated Hybrid Train Simulator for intercity railway is presented.The proposed tool incorporates the effect of powertrain components during the wheel-to-tank process.Compared to its predecessors,the proposed reconfigurable tool provides high fidelity with medium requirements and minimum computation time.Single train simulation and the federal government’s Greenhouse gases,Regulated Emissions,and Energy use in Transportation(GREET)model are used in combination to evaluate the feasibility of various train and powertrain configurations.The Piedmont intercity service operating in North Carolina is used as a case study.The study includes six train configurations and powertrain options as well as nine hydrogen supply options in addition to the diesel supply.The results show that a hydrail option is not only feasible,but a low-or zero-carbon hydrogen supply chain could be possible.

Changes in motor function in the unaffected hand of stroke patients should not be ignored

Motor function changes in the unaffected hand of stroke patients with hemiplegia. These changes are often ignored by clinicians owing to the extent of motor disability of the affected hand. Finger tapping frequency and Lind-mark hand function score showed that the motor function of unaffected hands in stroke patients was poorer than that of a healthy control hand. After 2 weeks of rehabilitation treatment, motor function of the unaffected hand of stroke patients was obviously improved. Therefore, attention should also be paid to motor function in the unaffected hand of stroke patients with hemiplegia during rehabilitation.

Communication Skills Training for Residents: Which Variables Predict Learning of Skills?

Objective: This study aimed to determine variables associated (predictors and correlates) with the learning of assessment and supportive skills in the context of a communication skills training for medical residents. Methods: Learning was measured by comparing residents’ communication skills in a simulated consultation before and after a communication skills training. Communication skills were transcribed and tagged with a computer-assisted program. Potential variables associated with learning (residents’ characteristics, contextual characteristics and pre-training communication skills) were measured before the training and entered in regression analysis. Results: Fifty-six residents followed the training between 2002 and 2006. Poor pre-training assessment and supportive skills predicted the respective learning of these skills. Better assessment skills’ learning was predicted by copings (i.e. lower level of emotional coping), lower levels of self-efficacy and depersonalization. Better supportive skills’ learning was predicted by a lower work experience and associated with a higher training attendance rate. Conclusions: Predictors and correlates of assessment and supportive skills learning were different. Trainers needed to detect certain residents’ characteristics (i.e. depersonalization) in order to optimize assessment skills learning. Trainers needed to be aware that supportive skills are difficult to learn and to teach and may need more training hours.

Are High School Students Ready to Stop the Bleed from Injuries? Needs Assessment in a Low Resource Country

Background: Life-threatening bleeding is a major cause of trauma-related deaths. Stop the Bleed—Active bleeding control (ABC) program in Hyderabad recently showed that lay first responders can be effectively trained. However, the willingness of high school students to train in bleeding control is unknown. We report Stop the Bleed training needs assessment from high schools in India and estimate the potential multiplier effect. Methods: A cross-sectional survey was conducted from 12 randomly selected schools in Hyderabad. The study was to understand current knowledge, skills and willingness to get trained and respond to life-threatening bleeding from injuries. 107 Participants (35 Teachers and 72 students) were purposively selected for telephonic interviews with a structured questionnaire. Results: Response rate was 93% overall. 80% of participants have never been trained in bleeding control. 84% reported willingness to be trained, train others and help bleeding victims. All the teachers reported that stop the bleed training would be useful in high schools. 70.6% of teachers recommended that training could start from middle school (10 to 15 years), 47% preferred the online training mode. Only 20% of participants had prior training in lifesaving first aid and 32% did not know the number of emergency medical services (EMS). Each trained participant has the potential to train 3 to 4 people at the household level and perhaps more at the community level. Conclusion: The surveyed schools in Hyderabad do not have the knowledge, skills, or training curriculum in Stop the Bleed. Students and teachers are willing to be trained and train others, with great potential for a “multiplier-effect” in the community.

Assessment and Analysis of Carrying Capacity of 350 km/h EMUs Operating on Beijing-Shanghai Highspeed Railway

This paper makes an analysis of the impact on the structure of the corridortype train working diagram by increasing the 350 km/h train pairs of Beijing-Shanghai High-speed Railway(HSR).According to the requirements of operation speed diversity,the multi-station receiving characteristics of cross-line trains and different train stopping schemes,this paper proposes a scheme of adding 350 km/h train pairs via computer analysis of carrying capability mode.The scheme is divided into three stages:(1)Initial stage:It is planned to increase trains running at 350 km/h,with 15~26 pairs of trains put into operation;(2)Rapid increase stage:27~142 pairs of 350 km/h trains are put into operation;(3)Full replacement stage:143~195 pairs of 350 km/h trains are put into operation,during which the number of cross-line trains under operation is controlled,the number of cross-line trains in each section is determined,the operation and connection scheme of cross-line trains is adjusted and the train stopping scheme is optimized.The results of this study were used for the adjustment of the train working diagram in the third quarter of June 25,2021 to increase the number of 350 km/h train pairs from 19 to 30 on Beijing-Shanghai HSR.350 km/h trains are evenly arranged during 7:00—19:00 on the train working diagram and 300 km/h trains are arranged by making full use of every time and space,to improve the travelling speed on Beijing-Shanghai HSR as a whole.

Education Programs for Invasive Procedures Involving Nurses: A Scoping Review

Background: Implementing invasive procedures is an important part of patient management by clinical nurses;however, there are gaps between nurses’ actual knowledge and skills and expected professional care capacity. Purpose: This scoping review aimed to map the existing literature related to recent institution-provided educational programs for invasive procedures involving clinical nurses. This study seeks to understand the contents of educational programs and the methods for assessing educational effects. Methods: This scoping review was completed using the following four databases: PubMed (MEDLINE), Embase, Cochrane Library, and Emcare for the period 2000-2022. We included studies that used all forms of educational approaches (e.g., didactic lectures, hands-on training, or on-the-job training). This scoping review considered peer-reviewed publications published in English using quantitative, qualitative, or mixed approaches. A total of 83 studies underwent in the final analysis. Results and Conclusion: A combination of didactic lectures and hands-on training was provided as an educational program in most studies. Contrary to our prediction, educational interventions with advanced technologies such as VR are extremely rare, suggesting that the effectiveness of advanced technologies in learning invasive procedures should be examined to facilitate and retain educational effects more efficiently in future studies. Regarding the assessment of educational effects, nurses’ cognitive (i.e., theoretical knowledge about procedures), psychomotor (i.e., implementing procedures), and psychological aspects (e.g., confidence and self-efficacy in procedures) were evaluated using questionnaires and observational methods. While most studies used a one-group pretest-posttest design, the ratio of randomized controlled trials (RCT) was relatively low. Thus, an RCT design should be introduced in future studies to test the validity of the developed educational program more accurately.

Need for education of psychiatric evaluation of offenders with mental disorders:A questionnaire survey for Japanese designated psychiatrists

BACKGROUND The management of offenders with mental disorders has been a significant concern in forensic psychiatry.In Japan,the introduction of the Medical Treatment and Supervision Act in 2005 addressed the issue.However,numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization(AIH)scheme,which lacks clarity and updated standards.AIM To explore current as well as optimized learning strategies for risk assessment in AIH decision making.METHODS We conducted a questionnaire survey among designated psychiatrists to explore their experiences and expectations regarding training methods for psychiatric assessments of offenders with mental disorders.RESULTS The findings of this study’s survey suggest a prevalent reliance on traditional learning approaches such as oral education and on-the-job training.CONCLUSION This underscores the pressing need for structured training protocols in AIH consultations.Moreover,feedback derived from inpatient treatment experiences is identified as a crucial element for enhancing risk assessment skills.

基于预训练模型和Transformer架构的大数据与计算机类科普书籍难度分类研究

针对当前研究在书籍级长文本可读性评估方面的不足,本文提出了一种新颖的PTDE-CAC模型。该模型将书籍分割为固定片段,利用无监督聚类获取难度感知片段,对预训练模型进行再训练,使其学习难度知识,将长文本表示为多个不同难度级别的向量。本文构建了大数据、计算机科普教材分级数据集,实验证明PTDE-CAC模型在可读性评估中表现优异,优于传统方法和现有预训练模型。本工作为书籍级可读性评估提供了新思路,也为相关教材编写选择提供了参考。

Integrated assessment of sea water quality based on BP artificial neural network

In order to carry out an integrated assessment of sea water quality objectively, this paper based on the concept and principle of artificial neural network, generated appropriate training samples for BP artificial neural network model through the method of producing samples to the concentration of various pollution index of sea water quality from the viewpoint of threshold, established the BP artificial neural network model of sea water quality assessment using multi-layer neural network with error back-propagation algorithm. This model was used to assess water environment and obtain sea water quality categories of offshore area in Bohai Bay through calculating. The calculations shown that pollution index in river＇s wet season was higher than that in dry season from 2004 to 2007, and the pollution was particularly serious in 2005 and 2006, but a little better in 2007. The assessed results of cases shown that the model was reasonable in design and higher in generalization, meanwhile, it was common, objective and practical to sea water quality assessment.

基于Tri-training-SSAE半监督学习算法的电力系统暂态稳定评估

基于机器学习的暂态稳定评估方法主要采用监督学习方法,为了解决监督学习方法所需的有标签样本难以获取的问题,提出基于三体训练-稀疏堆叠自动编码器(Tri-training-SSAE)半监督学习算法的电力系统暂态稳定评估方法。构建基于堆叠稀疏自动编码器的暂态稳定评估模型;在传统的三体训练过程中加入伪标签样本置信度判断,以减小噪声数据对模型训练的影响;以堆叠稀疏自动编码器为基分类器构建三体训练-稀疏堆叠自动编码器模型,利用大量的无标签样本提高模型的泛化能力。通过IEEE 39节点系统与华东某省级电网进行分析验证,结果表明,所提方法在有标签样本数较少时具有更高的评估准确度。