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It is difficult to implement interprofessional education (IPE) in the classroom due to COVID-19. To share our knowledge of online IPE, we report on how we provided IPE for first-year students at two universities. At Mie University, a class was implemented to use Zoom. Quizzes and chats promoted interactions between instructors and students. At Hokkaido University of Science, an online team medical experience game was conducted via Zoom and a Learning Management System (LMS). The activity promoted interaction between students through gameplay and clear instructions. In both cases, students could successfully develop online IPE based on existing learning methods. Through their experience, it was clear that students are able to understand other professionals’ roles. They were also to commit to membership and/or teamship. On the other hand, students faced challenges with faculty familiarity and time allocation.
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Introducción: La circunferencia del brazo (CB) se reconoce como buen indicador del estado nutricional. Objetivo: Estimar los percentilos de referencia para la CB y las áreas muscular (AM) y grasa (AG) del brazo en la población infantojuvenil argentina mediante el empleo del método LMS (lambda, mu, sigma, en inglés). Materiales y métodos: La muestra estuvo constituida por escolares de 4,0 a 13,9 años residentes en Jujuy, Catamarca, Misiones, Buenos Aires, Mendoza y Chubut. Las mediciones antropométricas de la CB y del pliegue tricipital se realizaron entre 2003 y 2008 siguiendo protocolos estandarizados. Se estimaron las AM, AG, se calcularon los percentilos por edad y sexo, y se compararon mediante el análisis de la varianza. Resultados: Se incluyeron 22 736 escolares (11 397 varones y 11 339 mujeres). Los valores correspondientes al percentilo 50 fueron superiores, en las mujeres, para CB y AG, y, en los varones, para AM. Las curvas de CB presentaron incrementos más marcados a partir de los 7 años en todos los percentilos, para ambos sexos. Un patrón similar se observó para AM, con valores superiores en los varones. Por último, el AG mostró aumento constante en las mujeres y estabilización en los varones a partir de los 11 años. Se observaron diferencias para la edad. Conclusiones: Los valores de percentilos, tabulados y graficados, de la CB y de las AM y AG del brazo pueden constituir una referencia local para estudios epidemiológicos y antropológicos.
Introduction: Mid-upper arm circumference (MUAC) is widely recognized as an adequate indicator of nutritional status. Objective: To estimate the reference percentiles for MUAC, upper arm muscle area (UAMA), and upper arm fat area (UAFA) in the Argentine child and adolescent population using the LMS method (lambda, mu, sigma) Materials and methods: The sample was made up of schoolchildren aged 4.0-13.9 years living in Jujuy, Catamarca, Misiones, Buenos Aires, Mendoza, and Chubut. MUAC and tricipital skinfold anthropometric measurements were obtained between 2003 and 2008 as per standardized protocols. UAMA and UAFA were calculated, and percentiles by age and sex were estimated and compared using an analysis of variance. Results: A total of 22 736 schoolchildren (11 397 boys and 11 339 girls) were included. The 50th percentile was higher for the MUAC and UAFA among girls and for the UAMA among boys. The MUAC curves showed sharper increases as of 7 years old in all percentiles among both boys and girls. A similar pattern was observed for the UAMA, with higher values among boys. Lastly, the UAFA showed a constant increase among girls and a stabilization among boys as of 11 years old. Differences for age were observed. Conclusions: The tabulated and plotted percentiles and the MUAC, UAMA, and UAFA may be used as local references for epidemiological and anthropological studies.
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Humans , Male , Female , Child, Preschool , Child , Adolescent , Argentina , Reference Values , Mid-Upper Arm Circumference , Body Composition , AnthropometryABSTRACT
Objective To fit children and adolescents' normal values and curves of BMI with coefficient of skewness-median-coefficient of variation (LMS) method, so as to provide a reference for the monitoring of obesity in children and adolescents. Methods 15259 children and adolescents aged 7 to 18 years old were selected in Shanghai, and the height and weight of the subjects were measured . The LMS Chartmaker software was used to fit the percentile curves of BMI of boys and girls with age. With P3, P5, P10, P15, P25, P50, P75, P85, P90, P95, P97 as the reference curve. Results The percentile of students showed an increasing trend with the age increases, and the boys are higher than girls. The P50 of all age groups of boys and girls in Shanghai was higher than that of the national level. The P85 and P95 of BMI were basically equal to the national level in the early stage, and was higher than the national level in the later period. The curve of boys has entered the peak of BMI growth since 9 years old, after 12 years old, the growth rate is slow, the curve is still rising at 18 years old. The curve of girls has entered the peak since 10 years old, after 14 years old, the growth rate is slow, after 16 years old, the curve tends to be stable. Conclusion The BMI percentile curve constructed by LMS method can correctly reflect the growing development of children and adolescents, and the BMI of children and adolescents in Shanghai is higher than the national level.
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BACKGROUND: The present study aimed to update the prediction equations for spirometry and their lower limits of normal (LLN) by using the lambda, mu, sigma (LMS) method and to compare the outcomes with the values of previous spirometric reference equations. METHODS: Spirometric data of 10,249 healthy non-smokers (8,776 females) were extracted from the fourth and fifth versions of the Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007–2009; V, 2010–2012). Reference equations were derived using the LMS method which allows modeling skewness (lambda [L]), mean (mu [M]), and coefficient of variation (sigma [S]). The outcome equations were compared with previous reference values. RESULTS: Prediction equations were presented in the following form: predicted value = e {a + b × ln(height) + c × ln(age) + M − spline}. The new predicted values for spirometry and their LLN derived using the LMS method were shown to more accurately reflect transitions in pulmonary function in young adults than previous prediction equations derived using conventional regression analysis in 2013. There were partial discrepancies between the new reference values and the reference values from the Global Lung Function Initiative in 2012. CONCLUSION: The results should be interpreted with caution for young adults and elderly males, particularly in terms of the LLN for forced expiratory volume in one second/forced vital capacity in elderly males. Serial spirometry follow-up, together with correlations with other clinical findings, should be emphasized in evaluating the pulmonary function of individuals. Future studies are needed to improve the accuracy of reference data and to develop continuous reference values for spirometry across all ages.
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Adult , Aged , Humans , Male , Young Adult , Follow-Up Studies , Forced Expiratory Volume , Korea , Lung , Methods , Nutrition Surveys , Reference Values , Spirometry , Vital CapacityABSTRACT
Many congenital diseases are associated with growth failure, and patients with these diseases have specific growth patterns. As the growth patterns of affected individuals differ from those of normal populations, it is challenging to detect additional conditions that can influence growth using standard growth charts. Disease-specific growth charts are thus very useful tools and can be helpful for understanding the growth pattern and pathogenesis of congenital diseases. In addition, disease-specific growth charts allow doctors to detect deviations from the usual growth patterns for early diagnosis of an additional condition and can be used to evaluate the effects of growth-promoting treatment for patients. When developing these charts, factors that can affect the reliability of the charts should be considered. These factors include the definition of the disease with growth failure, selection bias in the measurements used to develop the charts, secular trends of the subjects, the numbers of subjects of varying ages and ethnicities, and the statistical method used to develop the charts. In this review, we summarize the development of disease-specific growth charts for Japanese individuals with Turner syndrome and Noonan syndrome and evaluate the efforts to collect unbiased measurements of subjects with these diseases. These charts were the only available disease-specific growth charts of Turner syndrome and Noonan syndrome for Asian populations and were developed using a Japanese population. Therefore, when these charts are adopted for Asian populations other than Japanese, different growth patterns should be considered.
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Humans , Asian People , Early Diagnosis , Growth Charts , Methods , Noonan Syndrome , Selection Bias , Turner SyndromeABSTRACT
PURPOSE: The purpose of this study was to establish an e-learning system to support learning in medical education and identify solutions for improving the system. METHODS: A learning management system (LMS) and computer-based test (CBT) system were established to support e-learning for medical students. A survey of 219 first- and second-grade medical students was administered. The questionnaire included 9 forced choice questions about the usability of system and 2 open-ended questions about necessary improvements to the system. RESULTS: The LMS consisted of a class management, class evaluation, and class attendance system. CBT consisted of a test management, item bank, and authoring tool system. The results of the survey showed a high level of satisfaction in all system usability items except for stability. Further, the advantages of the e-learning system were ensuring information accessibility, providing constant feedback, and designing an intuitive interface. Necessary improvements to the system were stability, user control, readability, and diverse device usage. CONCLUSION: Based on the findings, suggestions for developing an e-learning system to improve usability by medical students and support learning effectively are recommended.
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Humans , Comprehension , Education, Medical , Learning , Students, Medical , Surveys and QuestionnairesABSTRACT
The study aims to evaluate students’ perceptions towards e-Learning Management System (e-LMS) in pharmacy education. A cross-sectional survey was conducted among all undergraduates enrolled at School of Pharmaceutical Sciences, Universiti Sains Malaysia. A pre-validated questionnaire consisting of two domains (demographic characteristics and students’ perception regarding the use of e-LMS) was used for data collection. Descriptive statistics were used to describe the demographic characteristics of the study respondents. Chi Square test was used to measure association between the study variables. All analysis was performed by using Predictive Analytical Software (PASW) v. 18. A total of 315 students completed the survey questionnaire with a response rate of 57.6%. Majority of the students (61.0%) accessed e-LMS to acquire lecture notes for their studies, followed by 53.3% have used e-LMS for the preparation of the assignments. Seventy eight percent of the respondents agreed that e-LMS is very useful and felt that e-LMS is making their studies easier. However, 50% of students claimed that poor network connection at the campus is a major barrier in accessing e-LMS. Moreover, 48% of the respondents disagreed that e-LMS should be taken into account as an assessment criterion for students’ grading. Students are found to be frequently engaged in using e-LMS and believed that online based learning is enhancing their academic performances. Nevertheless, students still prefer hybrid teaching methodologies than choosing traditional system or e-learning as an alone entity.
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2007 Korean National Growth Charts were published by The Korean Pediatric Society and Korea Centers for Disease Control and Prevention in October, 2007. These Growth Charts are composed of Growth Curves and Tables, which are based on the principles such as pooling data of the different generations and application of LMS method. In this review, several tips of application using these new charts are summarized with points of view both in clinical and research fields.
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Family Characteristics , Growth Charts , KoreaABSTRACT
PURPOSE: This study was to provide the methods of developing the growth charts and the blood pressure nomogram among Korean children and adolescents. METHODS: The growth charts were developed based on the data from the national growth surveys for children and adolescents in 1998 and 2005. The percentile charts were developed through two stages. At the first stage, the selected empirical charts were smoothed through several fitting procedures including parametric and non-parametric methods. At the second stage, a modified LMS (lambda, mu, sigma) statistical procedure was applied to the smoothed percentile charts. The LMS procedure allowed to estimate any percentile and to calculate standard deviation units and z-scores. The charts for weight-for-age, height-for-age, BMI-for-age, weight-for-height and head circumference-for-age were developed by sex. Age and normalized height controlled sex-specific nomograms of systolic and diastolic blood pressure were developed by a fixed effect model of general regression using the data from 2005 national growth survey. RESULTS: The significant systemic differences between the percentiles of growth charts and the empirical data were not found. The final output of the study is available from Korean Center for Disease Control and Prevention homepage, http://www.cdc.go.kr/webcdc/. Blood Pressure nomogram was tabulated by height percentiles and age using the regression coefficients analyzed with regression model. CONCLUSION: 2007 growth charts and blood pressure nomogram were the first products based on the statistical modeling using the national survey data. The further study on the methodology including data collection, data cleaning and statistical modeling for representative growth charts would be needed.
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Adolescent , Child , Humans , Blood Pressure , Data Collection , Growth Charts , Head , Models, Statistical , NomogramsABSTRACT
OBJECTIVE: Uterine sarcoma is relatively rare tumor of mesodermal origin, and constitutes 2% to 6% of uterine malignancies. It is the most malignant group of gynecologic tumors and presents difficult problems in regard to diagnosis and management. The purpose of this study is to investigate the clinicopathologic findings and outcome of patients with uterine sarcoma. METHODS: From March 1990 to March 2004, 8 patients were evaluated with histologically proven uterine sarcoma at department of obstetrics and gynecology of Gyeongsang University Hospital for their clinical profiles and survival retrospectively. RESULTS: The age of patients with uterine sarcoma ranged 39 to 71, and the mean age was 58.4 years. The common presenting symptoms were abnormal uterine bleeding, abdominal pain and lower abdominal palpable mass. Using the FIGO classification: two patients had stage I, one patients had stage II, two patients had stage III, three patients had stage IV disease. Four patients were treated with surgery followed by postoperative adjuvant chemotherapy and/or radiotherapy, three patients were treated surgery alone, and one patient was treated with radiotherapy alone. Recurrences were revealed at two patients, and the sites were pelvis and brain. The mean duration of follow up was 25.1 months and the overall 2 years survival rate was 25%. The most common pathologic type of uterine sarcomas was leiomyosarcoma. MMMT (malignant mixed mullerian tumor) showed worse prognosis than LMS (leiomyosarcoma) or ESS (endometrial stromal sarcoma). CONCLUSION: Uterine sarcoma are aggressive tumors with a poor prognosis. Age and stage were significant prognostic factor. The primary treatment modality has been surgical resection. The role of adjuvant chemotherapy and radiotherapy have not get been clearly defined and further large scaled multicentric studies are needed.
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Humans , Abdominal Pain , Brain , Chemotherapy, Adjuvant , Classification , Diagnosis , Follow-Up Studies , Gynecology , Leiomyosarcoma , Mesoderm , Obstetrics , Pelvis , Prognosis , Radiotherapy , Recurrence , Retrospective Studies , Sarcoma , Survival Rate , Uterine HemorrhageABSTRACT
Lives are maintained by enough oxygen.Blood oxygen saturation is one of the important parameters which reflects oxygen concentration in blood.The accurate monitoring of blood oxygen saturation is very important to both physiological research and medical application.At present,dual-wavelength method is widely adopted in noninvasive detection of blood oxygen saturation.Therefore,accurate recognition of peak-to-peak value of pulse waveform is a key process in monitoring blood oxygen saturation.In the paper,LMS self-adaptive arithmetic is applied to processing pulse waveform signal.The ratio of corrective detection is improved by the method.
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Self-adaptive interference canceller based on LMS algorithm is an excellent filter which can adjust system parameter automatically. With good robustness, it can be applied to every signal abstraction and data treatment, especially bioelectric signals. By this algorithm, both the power frequency interference and baseline shift, for example, the ones of ECG signals, can be successfully eliminated.
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This paper introduces the structure and main features of TMS320VC5416, the 16-bit fixed-point DSP of TI company. It discusses the principle and scheme of the adaptive filter using LMS and FX-LMS algorithm to distill voice form noises and to cancel noises with this kind of DSP. It also describes the problems during the process of designing the hardware and software.