Quality of dictated feedback associated with SIMPL operative assessments of pediatric surgical trainees

BackgroundSIMPL is a workplace-based operative performance assessment tool which allows for dictated feedback (DF). To better understand the value of DF, we sought to characterize the type and quality of DF generated during SIMPL evaluations.MethodsThematic analysis of DF from SIMPL assessments between June 2017 and December 2018 at a single pediatric surgery fellowship program was performed. Comments were categorized as specific, encouraging or corrective. Categories were combined to determine DF quality as effective, mediocre or ineffective.ResultsOf 781 SIMPL assessments (21 faculty, 5 trainees), 451 (57%) had DF. Most comments were encouraging (93%) and specific (65%). Only 21% were corrective, 17% had entrustment features, and 8% had an explicit learning plan. Feedback quality was deemed mediocre (45%), ineffective (33%) and effective (21%).ConclusionSIMPL dictated feedback was mostly encouraging and specific. To improve quality, feedback should incorporate learning plans as well as corrective and entrustment features.     

Evaluation of Job Strain of Family Physicians in COVID-19 Pandemic Period- An Example from Turkey

Journal of Community Health - The purpose of this study was to evaluate family physicians’ job strain during the Covid-19 pandemic and determine the effective factors. The study was carried...     

Intima-media thickness and arterial distensibility in Behçet's disease

The etiology of Beh?et's disease, a systemic vasculitis, is unknown. Vascular involvement may be seen in 25% of patients with Beh?et's disease. Vasculitis make the prognosis of Beh?et's disease severe. The aim of this study is to examine the structural and functional changes and relations of these changes with progression and prognosis of Beh?et's disease. For this purpose, 40 patients with Beh?et's disease and 40 healthy volunteer control subjects were analyzed, additionally patients with Beh?et's disease were divided into 2 subgroups as those with vascular complications and those without vascular complications. Intima-media thickness and arterial distensibility were measured in all subjects with carotid artery ultrasonography. Carotid artery distensibility was significantly lower in the patient group compared to the control group (0.67 +/- 0.2, 0.93 +/- 0.4, p < 0.05), and carotid artery IMT was significantly higher (0.59 +/- 12, 0.80 +/- 0.11, p < 0.05). A statistically significant increase in IMT has been detected (0.77 +/- 11, 0.86 +/- 11, p < 0.05) in patients with Beh?et's disease with vascular involvement compared to patients with Beh?et's disease without vascular involvement, arterial distensibility in patients with vascular disease was similar with those who has no vascular disease (0.69 +/- 0.25, 0.63 +/- 0.25, p > 0.05). There was a significant negative linear regression between arterial distensibility and systolic blood pressure (SBP) (B = -1 x 10(-2), p < 0.05), and a significant positive linear regression has also been found between IMT and SBP and diastolic blood pressure (DBP) and pulse pressure (PP) (B = 6.8 x 10(-3) for SBP, p < 0.05, B = 6.9 x 10(-3) for DBP, p < 0.05, B = 6 x 10(-3) for PP, p < 0.05). As a result, IMT increases and AD decreases in patients with Beh?et's disease compared to results in the control group. Although more studies are required for this subject, use of noninvasive parameters such as IMT and AD, which reflect the structural and functional characteristics of vasculature, may be useful to define disease progression and subjects at high risk.     

Delineation of an Octopus‐Like Thrombus Attached to the Eustachian Valve

Eustachian valve (EV) is a vestige of the valve of the inferior vena cava which directs the umbilical vein blood through open foramen ovale in fetal life. Following birth it gradually regresses, but it may persist in variable size, shape, and thickness as a functionless and benign structure. However, there are reports suggesting that persistent EV may not be completely innocent. It has been accused of being a predisposing cause of patent foramen ovale and paradoxical embolism and also interfering with transseptal interventional procedures. It may serve as a site of infective vegetations and be mistaken as a tumor or thrombus. In the present case, an octopus‐like thrombus attached to the EV was delineated with the utility of two‐dimensional and real time three‐dimensional transesophageal echocardiography. EV was considered to play an essential role in preventing potential pulmonary embolism.     

Reaction control of metal-assisted chemical etching for silicon-based zone plate nanostructures

Metal-assisted chemical etching (MACE) reaction parameters were investigated for the fabrication of specially designed silicon-based X-ray zone plate nanostructures using a gold catalyst pattern and etching solutions composed of HF and H₂O₂. Etching depth, zone verticality and zone roughness were studied as a function of etching solution composition, temperature and processing time. Homogeneous, vertical etching with increasing depth is observed at increasing H₂O₂ concentrations and elevated processing temperatures, implying a balance in the hole injection and silica dissolution kinetics at the gold–silicon interface. The etching depth decreases and zone roughness increases at the highest investigated H₂O₂ concentration and temperature. Possible reasons for these observations are discussed based on reaction chemistry and zone plate design. Optimum MACE conditions are found at HF : H₂O₂ concentrations of 4.7 M : 0.68 M and room temperature with an etching rate of ≈0.7 μm min⁻¹, which is about an order of magnitude higher than previous reports. Moreover, our results show that a grid catalyst design is important for successful fabrication of vertical high aspect ratio silicon nanostructures.

Specially designed X-ray zone plates with high aspect-ratios have been fabricated via metal-assisted chemical etching, by controlling the reaction kinetics.