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An open label, multicenter 16‐week trial of cryopreserved human umbilical cord (TTAX01) was previously undertaken in 32 subjects presenting with a Wagner grade 3 or 4 diabetic foot ulcer, with 16 (50%) of these having confirmed closure following a median of one product application (previous study). All but two subjects (30/32; 94%) consented to participate in this follow‐up study to 1‐year postexposure. No restrictions were placed on treatments for open wounds. At 8‐week intervals, subjects were evaluated for adverse events (AEs) and wound status (open or closed). Average time from initial exposure to end of follow‐up was 378 days (range 343‐433), with 29 of 30 (97%) subjects completing a full year. AEs were all typical for the population under study, and none were attributed to prior exposure to TTAX01. One previously healed wound re‐opened, one previously unconfirmed closed wound remained healed, and nine new wound closures occurred, giving 25 of 29 (86.2%) healed in the ITT population. Three of the new closures followed the use of various tissue‐based products. Three subjects whose wounds were healed required subsequent minor amputations due to osteomyelitis, one of which progressed to a major amputation (1/29; 3.4%). One additional subject underwent two minor amputations prior to healing. Overall, the study found TTAX01 to be safe in long‐term follow‐up and associated with both a low rate of major amputation and a higher than expected rates of healing.

Fragestellung/Zielsetzung: Aktive Teilhabe in der Praxis der Patientenversorgung ist für Medizinstudierende essentiell, um ärztliche Kompetenzen und ein Sinn für die professioneller Identität zu erwerben. Die klinische Lernumgebung wird jedoch zunehmend durch Spezialisierung, [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Clinical trials of potential new therapies for diabetic foot ulcers rarely enroll patients whose wounds extend to muscle, fascia, or bone with clinical and radiographic evidence of underlying osteomyelitis. An open‐label, multicenter trial of cryopreserved human umbilical cord (TTAX01) was undertaken in 32 subjects presenting with such complex wounds with a mean duration of 6.1 ± 9.0 (range: 0.2–47.1) months and wound area at screening of 3.8 ± 2.9 (range: 1.0–9.6) cm2. Aggressive surgical debridement at baseline resulted in 17 minor amputations and an increase in mean wound area to 7.4 ± 5.8 (range: 1.1–28.6) cm2. All subjects were placed on systemic antibiotics for at least 6 weeks in conjunction with baseline application of TTAX01. Repeat applications were made at no less than 4‐week intervals over the 16‐week trial. Initial closure occurred in 18 of 32 (56%) wounds, with 16 (50%) of these having confirmed closure in 16 weeks with a median of one‐product application. Cases with biopsy confirmed osteomyelitis (n = 20) showed initial closure in 12 (60%) wounds and confirmed closure in 10 (50%) wounds. Four of the five ulcers presenting as recurrences experienced confirmed closure. Mean overall time to healing was 12.8 ± 4.3 weeks. Mean wound area reduction from baseline was 91% for all wounds. Of the 16 wounds without confirmed closure during the 16‐week treatment period, five (31.3%) achieved 99–100% wound area reduction by their final visit. The product was well tolerated. Two minor amputations occurred during the study period due to recurrent or persistent osteomyelitis; however, there were no major amputations.

The Lavrion area corresponds to the western part of the Attic-Cycladic metamorphic belt, in the back-arc region of the active Hellenic subduction zone. Between the Eocene and the Miocene, metamorphic rocks (mainly marbles and schists) underwent several stages of metamorphism and deformation due to collision and collapse of the Cycladic belt. Exhumation during the Miocene was accommodated by the movement of a large-scale detachment fault system, which also enhanced emplacement of magmatic rocks, leading to the formation of the famous Lavrion silver deposits. The area around the mines shows the stacking of nappes, with ore deposition mainly localized within the marbles, at marble-schist contacts, below, within, or above the detachment. The Lavrion deposit comprises five genetically-related but different styles of mineralization, a feature never observed in another ore deposit elsewhere, containing the highest number of different elements of any known mining district. The local geology, tectonic, and magmatic activity were fundamental factors in determining how and when the mineralization formed. Other key factors, such as the rise and the fall of sea level, which resulted from climate change over the last million years, were also of major importance for the subsequent surface oxidation at Lavrion that created an unmatched diversity of secondary minerals. As a result, the Lavrion deposit contains 638 minerals of which Lavrion is type-locality for 23 of them, which is nearly 12% of all known species. Apart from being famous for its silver exploitation, this mining district contains more minerals than any other district on Earth. The unique geological, mineralogical, and educational (mining, archaeological, and environmental) features suggest that it is highly suitable to be developed as a future UNESCO Global Geopark. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

The outbreak of pandemic COVID-19 has disrupted daily activities. Human and social interaction have been suppressed in order to prevent contagion. Indonesian government has implemented PSBB or social distancing. Social distancing means the practice of limiting social and physical interaction between individuals. WFH or Work From Home has become a terminology that rocketed. Within qualitative approach, this study used phenomenology method of individuals who belongs to 3B cluster group: studying, working and Worshipping. Each occupation of 3B has 2 key informants. From these key informants, we found out the types and the brands of social media and how social media is used during social distancing. The validity check is using space and people for triangulation technique by interviewing 5 individuals living abroad.

Purpose To evaluate the clinical outcomes of self-retained cryopreserved amniotic membrane (cAM) for the treatment of corneal ulcers. Methods This was a single-center, retrospective review of consecutive patients with non-healing corneal ulcers that underwent treatment with self-retained cAM (PROKERA® Slim). The primary outcome measure was time to complete corneal epithelialization. Ocular discomfort, corneal staining, corneal signs, and visual acuity were assessed at 1 week, 1 month, 3 months, and 6 months. Complications, adverse events, and ulcer recurrence were also recorded. Results A total of 13 eyes (13 patients) with recalcitrant corneal ulcers were included for analysis, 9 (69%) of which progressed from neurotrophic keratitis (NK). Prior to cAM application, patients used conventional treatments such as artificial tears (n = 11), antibiotics (n = 11), ointment (n = 11), steroids (n = 6), and antivirals (n = 3). Self-retained cAMs (n = 1.5 ± 0.8) were placed for 6.8 ± 3.4 days, during which time antibiotics were continued. Four cases (31%) were subsequently treated with bandage contact lens (n = 3) and tarsorrhaphy (n = 1). All corneal ulcers healed in a median of 14 days (range: 4–43). This was accompanied by a significant improvement in ocular discomfort, corneal staining, and corneal signs at 1 week, 1 month, 3 months, and 6 months (P

Daniel Brocks,1 Olivia G Mead,2 Sean Tighe,3,4 Scheffer CG Tseng2 1BostonSight, Needham, MA, USA; 2Ocular Surface Center and TissueTech Inc, Miami, FL, USA; 3Department of Ophthalmology, Florida International University, Miami, FL, USA; 4Department of Biochemistry and Molecular Biology, University of Miami, Miami, FL, USACorrespondence: Daniel BrocksBostonSight, 464 Hillside Ave Suite 205, Needham, MA 02494, USATel +1 781 726 7337Email danielbrocks@yahoo.comPurpose: To evaluate the clinical outcomes of self-retained cryopreserved amniotic membrane (cAM) for the treatment of corneal ulcers.Methods: This was a single-center, retrospective review of consecutive patients with non-healing corneal ulcers that underwent treatment with self-retained cAM (PROKERA® Slim). The primary outcome measure was time to complete corneal epithelialization. Ocular discomfort, corneal staining, corneal signs, and visual acuity were assessed at 1 week, 1 month, 3 months, and 6 months. Complications, adverse events, and ulcer recurrence were also recorded.Results: A total of 13 eyes (13 patients) with recalcitrant corneal ulcers were included for analysis, 9 (69%) of which progressed from neurotrophic keratitis (NK). Prior to cAM application, patients used conventional treatments such as artificial tears (n = 11), antibiotics (n = 11), ointment (n = 11), steroids (n = 6), and antivirals (n = 3). Self-retained cAMs (n = 1.5 ± 0.8) were placed for 6.8 ± 3.4 days, during which time antibiotics were continued. Four cases (31%) were subsequently treated with bandage contact lens (n = 3) and tarsorrhaphy (n = 1). All corneal ulcers healed in a median of 14 days (range: 4– 43). This was accompanied by a significant improvement in ocular discomfort, corneal staining, and corneal signs at 1 week, 1 month, 3 months, and 6 months (P

The formation of ore deposits in the Lavrion Pb-Zn-Ag district was associated with Miocene detachment that accommodated orogenic collapse and exhumation of high-grade nappes across the ductile-brittle transition. This district consists of (1) low-grade porphyry Mo style, (2) Cu-Fe skarn, (3) high-temperature carbonate replacement Pb-Zn-Ag, and (4) vein and breccia Pb-Zn-Ag mineralization. The vein and breccia mineralization locally contains high-grade silver in base metal sulfides that are cemented by fluorite and carbonate gangue. The rare earth element contents of these gangue minerals, chondrite-normalized patterns, and fluid inclusion studies suggest that they precipitated from a low-temperature hydrothermal fluid. Primary and pseudosecondary fluid inclusions in fluorite and calcite are characterized by a wide range of homogenization temperatures (92°–207°C) and salinities of up to 17.1 wt % NaCl equiv. Secondary fluid inclusions only represent

Greece hosts a variety of magmatic-hydrothermal ore deposits/prospects with porphyry- and epithermal styles playing a major role in its total gold endowment. These deposit types are mainly clustered in two areas, the Rhodope- and Attico-Cycladic massifs, and formed from about 33 Ma to the Pleistocene, as a result of back-arc extension in the Aegean Sea, metamorphic core complex formation, and contemporaneous post-subduction and arc magmatism. In the Serbo-Macedonian massif, porphyry Cu-Au deposits include Skouries, Fisoka, Tsikara, Vathi and Gerakario. Causative intrusives are Oligocene to Miocene granodiorites to monzonites. Gold and PGE mineralization is associated with potassic alteration of the intrusives. In the eastern Rhodope massif and the NE Aegean islands, porphyry prospects occur at Pagoni Rachi, Konos Hill, Myli, Melitena (west Thrace), Fakos, Sardes, and Kaspakas (Limnos island) and Stypsi (Lesvos island). Mineralization is associated with Oligocene to Miocene subvolcanics of calc-alkaline to shoshonitic affinity. Feature of these prospects, which they share in common with several porphyry Au-only systems, is their shallow depth of emplacement, the presence of potassic/sodic-calcic and/or phyllic alteration, a strong epithermal overprint, their low Cu content, an extreme Re-enrichment, the multistage introduction of Au, the presence of banded quartz veinlets, and the local presence of tourmaline. New discoveries of porphyry-style mineralization at King Arthur, St. Philippos and Aisymi, increases the gold potential in west Thrace. High-intermediate sulfidation epithermal Au-Ag polymetallic deposits/prospects overprint and/or occur laterally from porphyry-style mineralization, where they are spatially associated with lithocaps of advanced argillic alteration. High-intermediate sulfidation Au-Ag epithermal mineralization at Perama Hill, Mavrokoryfi and Pefka in west Thrace, and at Pterounda, Mesotopos and Megala Therma on Lesvos island is controlled by steeply-dipping extensional faults within volcanic rocks, without any obvious genetic relationship to spatially-related porphyry-style mineralization. Polymetallic epithermal deposits and prospects contain critical and energy critical metals (e.g., Te, Se, Bi, Sb, In, Ge and Ga), which may be considered as by-products. In the Attico-Cycladic area, porphyry Mo-W mineralization occurs as sheeted quartz veins and stockworks cutting a potassic- to sericitic-altered Miocene granodiorite stock in the Lavrion district. Bonanza grade Au- and/or Ag-rich veins with epithermal affinities crosscut metamorphic rocks at Lavrion, and on Syros, Tinos, Antiparos and Anafi islands. Milos island is characterized by shallow submarine volcanic-hosted IS-HS epithermal Au-Ag-Te and base metal deposits. Antimony-As-Ag-Au deposits/prospects on Chios, Samos and Kos islands in the eastern Aegean Sea, indicate the potential for Carlin-style mineralization in Greece. Several factors played a role to the metal endowment of the Aegean porphyry-epithermal systems: magma fertility in the source regions, depth of emplacement of causative intrusives, relative contribution of mantle versus crustal material, redox state of subduction-related magmas, and physico-chemical fluid conditions at the site of ore deposition. © 2019 Elsevier B.V.

The Trikorfo area (Thassos Island, Rhodope massif, Northern Greece) represents a unique mineralogical locality with Mn-rich minerals including kyanite, andalusite, garnet and epidote. Their vivid colors and large crystal size make them good indicators of gem-quality materials, although crystals found up to now are too fractured to be considered as marketable gems. The dominant lithology is represented by a garnet–kyanite–biotite–hematite–plagioclase ± staurolite ± sillimanite paragneiss. Thermodynamic Perple_X modeling indicates conditions of ca. 630–710◦C and 7.8–10.4 kbars. Post-metamorphic metasomatic silicate and calc-silicate (Mn-rich)-minerals are found within (i) green-red horizons with a mineralogical zonation from diopside, hornblende, epidote and grossular, (ii) mica schists containing spessartine, kyanite, andalusite and piemontite, and (iii) weakly deformed quartz-feldspar coarse-grained veins with kyanite at the interface with the metamorphic gneiss. The transition towards brittle conditions is shown by Alpine-type tension gashes, including spessartine–epidote–clinochlore–hornblende-quartz veins, cross-cutting the metamorphic foliation. Kyanite is of particular interest because it is present in the metamorphic paragenesis and locally in metasomatic assemblages with a large variety of colors (zoned blue to green/yellow-transparent and orange). Element analyses and UV-near infrared spectroscopy analyses indicate that the variation in color is due to a combination of Ti4+–Fe2+, Fe3+ and Mn3+ substitutions with Al3+. Structural and mineralogical observations point to a two-stage evolution of the Trikorfo area, where post-metamorphic hydrothermal fluid circulation lead locally to metasomatic reactions from ductile to brittle conditions during Miocene exhumation of the high-grade host-rocks. The large variety of mineral compositions and assemblages points to a local control of the mineralogy and fO2 conditions during metasomatic reactions and interactions between hydrothermal active fluids and surrounding rocks. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Problemstellung/Ziele: Das Studium soll nicht nur Fachwissen vermitteln, sondern die Studierenden insbesondere im Bereich der Persönlichkeitsentwicklung hin zu einer verantwortlichen und zugewandten Arztpersönlichkeit unterstützen. Ob und in wie weit dies in einem mit großem[zum vollständigen Text gelangen Sie über die oben angegebene URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

In-field tracking of crank angles is important for analyzing outdoor cycling biomechanics, but current encoder-based methods are expensive and time-consuming. Inertial and magnetic measurement systems (IMMSs) have the potential for minimally invasive crank angle tracking, although errors due to magnetic interference and static calibration hinder performance. This paper presents a nonlinear complimentary filter, called the constrained rotational acceleration and kinematics (CRANK) filter, which estimates crank angles without magnetometer measurements or a static calibration for the crank arm IMMS. The CRANK filter removes drift errors by exploiting constraints on the kinematics of the crank arm relative to the bicycle frame. Three 5 min cycling tests were conducted using stereophotogrammetry and two IMMSs; a slow ( $\sim 80$ r/min) and medium (90 r/min) cadence test on a level surface and a fast cadence test (100 r/min) with the bicycle inclined at 20° to the ground. A novel two-segment methodology for collecting ground truth data with an optical motion capture system is presented. We also provide analysis of CRANK filter performance for simulated outdoor dynamics (lateral tilt and roll). The CRANK filter achieved absolute errors (AEs) of 0.9 ± 0.6°, 1.7 ± 1.4°, and 1.8 ± 1.2° for the slow, medium, and fast tests, outperforming a commercial Kalman filter that produced AEs of $\sim 10^{\circ }$ . Under simulated outdoor conditions the CRANK filter was only slightly less accurate ( ${\rm AEs}\approx 3 {^{\circ }}$ ). The CRANK filter is shown to be accurate, drift-free, easy to implement and robust against magnetic disturbances, sensor positioning, bicycle inclination, and bicycle frame dynamics.

Vein-type Pb-Ni-Bi-Au-Ag mineralization at the Clemence deposit in the Kamariza and “km3” in the Lavrion area, was synchronous with the intrusion of a Miocene granodiorite body and related felsic and mafic dikes and sills within marbles and schists in the footwall of (and within) the Western Cycladic detachment system. In the Serpieri deposit (Kamariza area), a porphyry-style pyrrhotite-arsenopyrite mineralized microgranitic dike is genetically related to a garnet-wollastonite bearing skarn characterized by a similar base metal and Ni (up to 219 ppm) enrichment. The Ni–Bi–Au association in the Clemence deposit consists of initial deposition of pyrite and arsenopyrite followed by an intergrowth of native gold-bismuthinite and oscillatory zoned gersdorffite. The zoning is related to variable As, Ni, and Fe contents, indicating fluctuations of arsenic and sulfur fugacity in the hydrothermal fluid. A late evolution towards higher sulfur fugacity in the mineralization is evident by the deposition of chalcopyrite, tennantite, enargite, and galena rimming gersdorffite. At the “km3” locality, Ni sulfides and sulfarsenides, vaesite, millerite, ullmannite, and polydymite, are enclosed in gersdorffite and/or galena. The gersdorffite is homogenous and contains less Fe (up to 2 wt.%) than that from the Clemence deposit (up to 9 wt.%). Bulk ore analyses of the Clemence ore reveal Au and Ag grades both exceeding 100 g/t, Pb and Zn > 1 wt.%, Ni up to 9700 ppm, Co up to 118 ppm, Sn > 100 ppm, and Bi > 2000 ppm. The “km3” mineralization is enriched in Mo (up to 36 ppm), Ni (>1 wt.%), and Co (up to 1290 ppm). Our data further support a magmatic contribution to the ore-forming fluids, although remobilization and leaching of metals from previous mineralization and/or host rocks, through the late involvement of non-magmatic fluid in the ore system, cannot be excluded. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Purpose To evaluate the therapeutic benefit of self-retained cryopreserved amniotic membrane in conjunction with oral antiviral therapy in herpetic epithelial keratitis. Methods Retrospective review of 4 patients with primary (1 eye) and recurrent (3 eyes) unilateral herpetic epithelial keratitis treated with cryopreserved amniotic membrane through the placement of the PROKERA Slim (PKS) (Bio-Tissue, Inc) in conjunction with oral acyclovir. Their symptoms, conjunctival inflammation, corneal staining, and visual acuity were compared before and after treatment. Results Herpetic epithelial keratitis presented as dendritic (3 eyes) and geographic (1 eye) epithelial lesions. After epithelial debridement and placement of the PKS for 5 ± 3.7 days, all patients reported significant relief of symptoms, rapid corneal epithelialization, and reduction of ocular surface inflammation. The visual acuity was also improved in all eyes from 0.7 ± 0.7 to 0.4 ± 0.7 logarithm of the minimum angle of resolution (P = 0.2). They remained symptom-free during a follow-up period of 2.7 to 50.8 (20.3 ± 21.7) months. Conclusions The PKS in conjunction with oral acyclovir facilitates the ease of early intervention to accelerate restoration of a normal corneal epithelium in herpetic epithelial keratitis.

To report the clinical characteristics and correlation between meibomian gland dysfunction (MGD) and keratitis in young patients with ocular demodicosis.Observational case series of 60 patients younger than 35 years with ocular demodicosis, of which the diagnosis was based on microscopic counting ofMGD was detected in 54/60 (90%) patients with the loss of meibomian gland in the upper lid more than the lower lid (p0.001). Blepharoconjunctivitis and a variety of corneal pathologies were noted in 47/60 (78.3%) and 39/60 (65%) patients, respectively. For a total of 120 eyes, normal cornea was noted in 53 (44.2%) eyes, superficial punctate keratitis or limbitis was noted in 17 (14.2%), while corneal stromal infiltration was found in 50 (41.7%) eyes. Both univariate and multivariate analyses showed that the severity of meibomian gland loss was significantly correlated with higherThere is a significant correlation between MGD and keratitis in young patients with ocular demodicosis especially inflicted by

As wireless motion sensors become more compact and robust, new opportunities emerge to develop wearable measurement technologies for in-field sports analysis. This paper presents a nonlinear complimentary filter for tracking 3-D hip joint angles during cycling using inertial and magnetic measurement systems (IMMSs). The filter utilizes a novel method of dynamic acceleration compensation in the sensor frame based on the assumption of pendulum motion of the thigh around the hip joint center. A dynamic calibration is proposed in which the center of rotation of the thigh IMMS can be estimated during a functional hip movement in standing. Validation results from a gold-standard optical system showed that the filter IMMS tracking is drift-free with mean absolute errors of less than 3° for all IMMS axes combined at low, medium, and high pedaling speeds. Hip angles were also validated using the Vicon biomechanical model for standing and sitting calibration poses as well as true and normalized soft-tissue-artefact (STA). The best mean absolute errors for the sagittal, frontal, and coronal planes were 0.8°, 6.7°, and 2.2°, respectively. Variability due to calibrations and STA ranged from 1.4° to 8.1°. This demonstrates the high accuracies possible for IMMS tracking using algorithms designed for specific sports despite larger errors due to modeling.

The impact of lithological heterogeneities on deformation, fluid flow and ore deposition is discussed based on the example of the Lavrion low-angle detachment partly accommodating gravitational collapse of the Hellenides orogenic belt in Greece. The Lavrion peninsula is characterised by a multiphase Pb-Zn-Fe-Cu-Ag ore system with a probable pre-concentration before subduction followed by progressive remobilisation and deposition coeval with the development of a low-angle ductile to brittle shear zone. The mylonitic marble below the detachment shear zone is composed of white layers of pure marble alternating with blue layers containing impurities (SiO2, Al2O3, carbonaceous material). Ductile mylonitic deformation is more pervasive in the less competent impure blue marble. We propose that localised deformation in the impure marble is associated with fluid circulation and dolomitisation, which in turn causes an increase in competence of these layers. Mineralised cataclastic zones, crosscutting the mylonitic fabric, are preferentially localised in the more competent dolomitic layers. Oxygen and carbon isotopic signatures of marble invaded by carbonate replacement deposits during ductile to ductile-brittle deformation are consistent with decarbonation coeval with the invasion of magmatic fluids. Mineralised cataclastic zones reflecting brittle deformation evolve from low 13C to low 18O signatures, interpreted as local interaction with carbonaceous material that trends toward the contribution of a surface-derived fluid. These features indicate that the Lavrion area records a complex deposition history influenced by the evolution of fluid reservoirs induced by the thermal and mechanical evolution of the marble nappe stack. Ore remobilisation and deposition associated with the activity of the low-angle detachment is (i) firstly related to the intrusion of the Plaka granodiorite leading to porphyry-type and carbonate replacement mineralisation during ductile-brittle deformation and (ii) then marked by progressive penetration of surface-derived fluids guided by strain localisation in the more competent levels leading to epithermal mineralisation associated with brittle deformation. © 2017 Elsevier B.V.

Prenatal spina bifida (SB) repair with a regenerative patch may improve neurological outcomes by decreasing inflammatory scarring.This study aims to compare cryopreserved human umbilical cord (HUC) and biocellulose film (BCF) patches sutured over SB lesions for regeneration of native cells and inflammatory response.Sprague-Dawley rats were gavaged with retinoic acid (RA) on embryonic day 10 to induce SB. Hysterotomy was performed on embryonic day 20 and on HUC or BCF patches sutured over the defect. Pups were harvested 30 to 34 h later, and hematoxylin and eosin staining and Trichrome staining assessed basic cellular migration. Immunohistochemistry demonstrated the exact nature of the cellular migration. Patches and surrounding exudates were evaluated with microscopy and cells quantified.Histology showed cellular migration with all HUC patches compared with none with BCF patches. Epithelial cells were noted migrating over the dorsal HUC surface, astrocytes were noted along the HUC surface adjacent to the lesion, and endothelial cells were noted within the HUC. HUC patches showed minimal inflammatory cells. Exudates surrounding the HUC patches had fewer inflammatory cells than exudates around BCF patches.HUC promotes cellular migration of native cells with minimal inflammatory response compared with BCF. HUC may be the superior patch material for prenatal SB repair. © 2017 John WileySons, Ltd.

Sitzung des Ausschuss Integrative Medizin und Perspektivenpluralismus, GMA 2016 Bern Ziel der Ausschusssitzung Berichte und Austausch zu aktuellen Entwicklung in der Integrativen Medizin Best-practice Modelle für die Lehre: Falltag Integrative Medizin Bestandsaufnahme zum Nationalen Kompetenzbasierten[zum vollständigen Text gelangen Sie über die oben angegebene URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

Fragestellung/Einleitung: Lernen ist eine zentrale, lebenslang entwickelbare Kern-Kompetenz. Der Eintritt in das Studium ruft Studierende zur Transformation ihres bisherigen Lernverhaltens auf und stellt Institutionen vor besondere Herausforderungen zur Gestaltung der Studieneingangsphase. Zu ihr[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) und des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ)

Anzahl der Teilnehmer: 5-30 Lernziele: Während ihres Praktischen Jahres (PJ) sind Medizinstudierenden wegen Mangels an Zeit oder Lehrerfahrung seitens der ausbildenden Ärzte oft über- oder unterfordert. Um dem entgegen zu treten und den Studierenden eine aktive Mitbetreuung unter ärztlicher[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) und des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ)

Direct metal laser sintering (DMLS) is a selective laser melting (SLM) manufacturing process that can produce near net shape parts from metallic powders. A range of materials are suitable for SLM; they include various metals such as titanium, steel, aluminium, and cobalt-chrome alloys. This paper forms part of a research drive that aims to evaluate the material performance of the SLM-manufactured metals. It presents DMLS-produced Ti-6Al-4V, a titanium alloy often used in biomedical and aerospace applications. This paper also studies the effect of several heat treatments on the microstructure and mechanical properties of Ti-6Al-4V processed by SLM. It reports the achievable mechanical properties of the alloy, including quasi-static, crack growth behaviour, density and porosity distribution, and post-processing using various heat-treatment conditions. Direkte metaal-laser-sintering is 'n selektiewe lasersmeltvervaardigingsproses wat naby aan netto-vorm onderdele van metaalpoeiers kan produseer. Verskeie materiale is geskik vir lasersmeltvervaardiging, onder andere titaan, staal, aluminium en kobaltchroom legerings. Die doel van dié navorsing is om die materiaaleienskappe van lasersmeltvervaardigde onderdele te ondersoek. 'n Titaan legering (Ti-6Al-4V) wat dikwels biomediese en ruimte toepassings het, word voorgehou. Verder word die effek van verskeie hittebehandelings op die mikrostruktuur en meganiese eienskappe van die titaan legering, na dit lasersmeltvervaardiging ondergaan het, ondersoek. Die quasi-statiese kraakvoortplanting, digtheid- en poreusheidsverspreiding en die verwerking met verskeie hittebehandelingtoestande word bespreek.

PURPOSE: To evaluate the ocular surface changes in patients with laser in situ keratomileusis (LASIK) -induced neurotrophic epitheliopathy. METHODS: Seven consecutive patients with LASIK-induced neurotrophic epitheliopathy were studied prospectively and compared to a control group (seven consecutive patients who had LASIK-but without neurotrophic epitheliopathy). Bilateral sequential LASIK was performed at a 1-week interval; the first operated eye of each patient was considered for statistical analysis. Blinking, corneal sensitivity, tear break-up time, tear secretion and clearance were measured preoperatively (T 0 ) and postoperatively at 1 week after surgery on the first eye (T 1 ), and 1 week (T 2 ), 1 month (T 3 ), and 3 months (T 4 ) after surgery was performed on the second eye. RESULTS: Laser in situ keratomileusis-induced neurotrophic epitheliopathy occurred bilaterally in all patients. During follow-up, patients with LASIK-induced neurotrophic epitheliopathy showed a significant decrease in blinking (P=.0002), which was not observed in cases without LASIK. Compared to eyes without LASIK-induced neurotrophic epitheliopathy, those with LASIK-induced neurotrophic epitheliopathy revealed lower values of sensitivity in the central cornea preoperatively and early post-operatively (T 0 , P=.004; T 1 , P=.003; T 2 , P=.003). A trend towards reduced sensitivity was also detected in the central cornea in late follow-up and in the superior, temporal, and nasal sectors of the flap at all examinations. No significant differences were observed in break-up time, tear secretion, or clearance within or between the two groups. CONCLUSION: Decreased blinking seems to be involved in the pathogenesis of LASIK-induced neurotrophic epitheliopathy. The reduction probably depends on the lower levels of corneal sensitivity and induces the epitheliopathy by increasing the ocular surface exposure. [J Refract Surg 2004;20:803-809]

Fragestellung/Einleitung: Im Gemeinschaftskrankenhaus Herdecke gibt es seit 2007 eine internistische, integrativ-medizinische Ausbildungsstation(ASIM). Studierende übernehmen unter enger ärztlicher Supervision die Patientenversorgung von 2–4 Patienten. Diese Studie untersucht, [for full text, please go to the a.m. URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

Fragestellung/Einleitung: Medizinisches Wissen ist heute – mit sinkender Halbwertzeit – an jedem Ort und zu jeder Zeit verfügbar. Universitäten stehen deshalb vor der Aufgabe, der Vermittlung von Fähigkeiten und Haltungen, die lebenslanges Lernen befördern, größeres[for full text, please go to the a.m. URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

Fragestellung/Einleitung: Verschiedene Studien weisen darauf hin, dass Studierende ihr Medizinstudium als hohe Belastung erfahren und dass sich dies beispielweise negativ auf Empathie und Patientenorientierung auswirkt [ref:3], [ref:2], [ref:1]. Ziel der Pilotstudie[for full text, please go to the a.m. URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

Objective: The present study gives a brief introduction into the definition of physician empathy (PE) and its influence on patients’ health outcomes. Furthermore we present assessment instruments to measure PE from the perspective of the patient and medical student. The latter topic will be explored in detail as we conducted a pilot study on the German versions of two self-assessment instruments of empathy, which are mostly used in medical education research, namely the “Jefferson Scale of Physician Empathy, Student Version” (JSPE-S) and the “Interpersonal Reactivity Index” (IRI). Methods: We first present an overview of the current empirical and theoretical literature on the definition and outcome-relevance of PE. Additionally, we conducted basic psychometric analyses of the German versions of the JSPE-S and the IRI. Data for this analyses is based on a cross-sectional pilot-survey in N=44 medical students and N=63 students of other disciplines from the University of Cologne. Results: PE includes the understanding of the patient as well as verbal and non-verbal communication, which should result in a helpful therapeutic action of the physician. Patients’ health outcomes in different healthcare settings can be improved considerably from a high quality empathic encounter with their clinician. Basic psychometric results of the German JSPE-S and IRI measures show first promising results. Conclusion: PE as an essential and outcome-relevant element in the patient-physician relationship requires more consideration in the education of medical students and, thus, in medical education research. The German versions of the JSPE-S and IRI measures seem to be promising means to evaluate these education aims and to conduct medical education research on empathy., GMS Zeitschrift für Medizinische Ausbildung; 29(1):Doc11; ISSN 1860-3572

Fragestellung: Nachdem die erste PJ-Ausbildungsstation Innere Medizin sowohl von Studierenden als auch von Patienten und Mitarbeitern positiv evaluiert wurde [ref:2], [ref:3] hat das Integrierte Begleitstudium Anthroposophische Medizin (IBAM) das Modell der klinischen Ausbildungsstation[for full text, please go to the a.m. URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

Hintergrund: Im Praktischen Jahr (PJ) sollen die Studierenden ihre medizinischen Kenntnisse und Fertigkeiten erweitern und vertiefen sowie ihre ärztliche Professionalität fortentwickeln. Bisherige Umfragen zeigen, dass das PJ von den Studierenden häufig kritisch gesehen wird; viele erleben[for full text, please go to the a.m. URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung - GMA

Hintergrund und Ziele: Für das Tertial Innere Medizin schreibt die in Deutschland geltende Ärztliche Approbationsordnung eine stationsgebundene Ausbildung von 16 Wochen vor. Die Ausbildung im Praktischen Jahr (PJ) sollte im Kontext des späteren beruflichen Umfeldes und kompetenzbasiert erfolgen. Die wesentlichen Ziele des hier beschriebenen Projektes liegen darin, erstens eine Ausbildungsstation für eine praxisnahe und selbstgesteuerte Ausbildung von PJ-Studierenden aufzubauen sowie zweitens unter Beteiligung der relevanten Personengruppen (Patienten, Mitarbeiter, Studierende) die Auswirkungen dieses Modells auf Patientenversorgung, Stationsorganisation und Lernprozess der Studierenden zu untersuchen. Dabei sollen die Voraussetzungen für eine „lernende Organisation“ geschaffen werden. Methoden: Im Herbst 2007 wurde im Rahmen eines Pilotprojektes eine Ausbildungsstation in einer internistischen Abteilung aufgebaut. Dabei übernehmen Studierende im PJ als „Ärzte unter Supervision“ die Betreuung der Patienten. Sie werden dabei fachärztlich angeleitet und supervidiert. Alle behandelten Patienten wurden nach Entlassung mittels eines Fragebogens zu einer Beurteilung der studentischen Integration in die Patientenversorgung aufgefordert. Ebenso wurden alle beteiligten Mitarbeiter (Ärzte, Pflegende, Therapeuten) bezüglich der Veränderungen in der Stationsorganisation und der interprofessionellen Zusammenarbeit befragt. Mit den Studierenden wurden vor dem Tertial Ausbildungsziele in definierten Kompetenzfeldern vereinbart. Die Studierenden schätzten sich am Beginn und am Ende des Tertials selbst zu diesen Kompetenzen ein. Das Projekt ist Teil des Begleitstudiums Anthroposophische Medizin an der Universität Witten/Herdecke, in dem u. a. selbstgesteuertes Lernen gefördert werden soll. Ergebnisse: Von 56 befragten Patienten beantworteten 34 den Fragebogen (Rücklaufquote 60,7%). Die Mehrzahl (71%) der Patienten beurteilten die Auswirkung der studentischen Einbindung auf die Patientenversorgung als positiv. Die Mitarbeiter (n=28, Rücklauf: 23 (82%)) befürworteten alle die Weiterentwicklung der Ausbildungsstation zu einer kontinuierlichen Einrichtung. Die PJ-Studierenden der ersten beiden Tertiale (n=9) haben nach Selbsteinschätzung in allen Kompetenzfeldern Fortschritte erzielt, am meisten in Organisations- und Entscheidungskompetenz. Schlussfolgerung: Die betroffenen Personengruppen (Patienten, Mitarbeiter, Studierende) beurteilen die der auf der Ausbildungsstation realisierte Verbindung von Patientenversorgung und Lehre weit überwiegend positiv. Weitere Studien werden durchgeführt um zu klären, ob die Ausbildungsstation sich langfristig bewährt und ob sie als Modell auch für andere klinische Abteilungen geeignet ist., GMS Zeitschrift für Medizinische Ausbildung; 26(3):Doc31; ISSN 1860-3572

This paper compares two neural network input selection schemes, the Principal Component Analysis (PCA) and the Automatic Relevance Determination (ARD) based on Mac-Kay's evidence framework. The PCA takes all the input data and projects it onto a lower dimension space, thereby reduc-ing the dimension of the input space. This input reduction method often results with parameters that have significant influence on the dynamics of the data being diluted by those that do not influence the dynamics of the data. The ARD selects the most relevant input parameters and discards those that do not contribute significantly to the dynamics of the data being modelled. The ARD sometimes results with important input parameters being discarded thereby compromising the dynamics of the data. The PCA and ARD methods are implemented together with a Multi-Layer-Perceptron (MLP) network for fault identification in structures and the performance of the two methods is as-sessed. It is observed that ARD and PCA give similar accu-racy levels when used as input-selection schemes. There-fore, the choice of input-selection scheme is dependent on the nature of the data being processed., 6 pages

Complementary and Alternative Medicine (CAM) is highly requested by patients. Therefore, medical students have to be prepared and educated for this situation. We report about the first Case Conference on Integrative Medicine under the auspices of the president of the German Medical Association. In contrast to often-occurring polemic and polarizing discussions the dialog was characterized by serious and open-minded contributions in order to find the best therapeutic concept for patients. The authors suggest to establish a committee of the Gesellschaft für Medizinische Ausbildung (GMA) to work on key questions in this field. Possible topics and questions are listed. Vor dem Hintergrund der weiten Verbreitung von Komplementär- und Alternativmedizin (CAM) und dem Bedarf einer Vorbereitung und Ausbildung der Medizinstudierenden auf dem Umgang mit CAM wird im folgenden von der ersten Fallkonferenz Integrative Medizin unter Schirmherrschaft des Bundesärztekammerpräsidenten berichtet. Statt der sonst bei dieser Thematik häufig anzutreffenden Polarisierung und Polemisierung war die Atmosphäre bei diesem Symposium geprägt von Dialogbereitschaft und dem gemeinsamen Bemühen um eine patientengerechte Integrative Medizin. Die Autoren schlagen vor, für die in diesem Zusammenhang noch völlig unbearbeiteten Ausbildungsfragen einen Ausschuss der Gesellschaft für Medizinische Ausbildung (GMA) zu gründen. Mögliche Themen und Arbeitsfelder werden dargestellt.