Indicadores del éxito académico en la educación universitaria: análisis naturaleza de los cursos / Indicadores do sucesso acadêmico na educação superior: análise segundo natureza dos cursos / Indicators of academic success in higher education: analysis in function of courses nature

O sucesso acadêmico na Educação Superior é um construto multidimensional, influenciado por diferentes variáveis da trajetória estudantil. Assim, analisamos o rendimento acadêmico (CRE) de estudantes ingressantes da ES, tomando variáveis pessoais/sociais, adaptativas e relacionadas à aprendizagem, diferenciando as análises de acordo com a natureza dos cursos. Participaram 715 estudantes (M = 22.10 anos, DP = 6.92), oriundos de 26 cursos superiores do Instituto Federal da Paraíba (Brasil), cujos dados foram coletados de forma documental e usando um questionário aplicado online. Os resultados apontam que o conjunto das variáveis do estudo explicam 89% do CRE de estudantes do bacharelado, 85% da licenciatura e 84% do rendimento de cursos tecnológicos, com destaque para as variáveis renda familiar, opção na escolha do curso, contato extraclasse com professor e atividades extracurriculares, faltas e disciplinas aprovadas versus disciplinas cursadas. Apontam-se implicações desses resultados para futuras intervenções com foco no sucesso acadêmico e conclusão dos cursos.

El éxito académico en la Educación Universitaria es un constructo multidimensional, influenciado por distintas variables de la trayectoria estudiantil. Así, analizamos el rendimiento académico (CRE) de estudiantes ingresantes de la ES, tomando variables personales/sociales, adaptativas y relacionadas al aprendizaje, diferenciando los análisis de acuerdo con la naturaleza de los cursos. Participaron 715 estudiantes (M = 22.10 años, DP = 6.92), provenientes de 26 cursos universitarios del Instituto Federal de Paraíba (Brasil), cuyos datos se recolectaron de forma documental y utilizando un cuestionario aplicado online. Los resultados apuntan que el conjunto de las variables del estudio explica el 89% del CRE de estudiantes de bachillerato, el 85% da licenciatura y el 84% del rendimiento de cursos tecnológicos, con destaque para las variables renta familiar, opción en la escoja del curso, contacto extra-aula con profesor y actividades extracurriculares, faltas y asignaturas aprobadas versus asignaturas cursadas. Se apuntan implicaciones de estos resultados para futuras intervenciones con enfoque en el éxito académico y conclusión de los cursos.

Academic success in Higher Education is a multidimensional construct, influenced by different variables in the student trajectory. Thus, we assessed the academic performance (CRE) of incoming Higher Education students, taking personal/social, adaptive, and learning-related variables, differentiating the analysis according to the nature of the courses. In this way, 715 students participated (age: M = 22.10 years, SD = 6.92), from 26 Higher Education courses at a Federal Institute of Paraíba (Brazil), whose data were collected in a documentary form and using an online questionnaire. The results indicate that the set of variables in the study explain 89% of the CRE of bachelor students, 85% of undergraduate students, and 84% of the performance of technological courses, with the following variables: emphasis on family income, option in choosing the course, extra-class contact with teacher and extracurricular activities, absences and discipline approvals versus completed disciplines. Implications of these results are highlighted for future interventions focusing on academic success and course completion.

Factores determinantes del éxito en la carrera de enfermeras actuantes en tecnología de reproducción asistida / Factors that affect career success of nurses who practice in assisted reproductive technology / Fatores que afetam o sucesso profissional de enfermeiros que atuam na área de tecnologia de reprodução assistida

Objetivo: examinar la relación entre éxito en la carrera y ambiente de trabajo con enfermeras actuantes en tecnología de reproducción asistida (TRA), e identificar factores que afectan su éxito en la carrera. Método: estudio transversal realizado en 53 centros de fertilidad de 26 provincias en la China Continental. Datos recolectados utilizando cuestionario de datos demográficos, un Cuestionario de Competencias de TRA para Enfermeras Especializadas, la Career-Success Scale (Escala de éxito profesional) y la Nursing Work Environment Scale (Escala del entorno de trabajo de enfermería). Se aplicó estadística inferencial y descriptiva. Resultados: 597 enfermeras actuantes en TRA participaron en nuestra encuesta, entregando 555 cuestionarios válidos. Los puntajes generales promedio de éxito en la carrera y ambiente de trabajo fueron 3,75 (desviación estándar, [DE]=1,01) y 3,42 (DE=0,77) respectivamente. Se observó fuerte correlación positiva entre éxito en la carrera y ambiente de trabajo (r=0,742; p<0,01). La regresión múltiple mostró que la concurrencia a conferencias académicas, atención psicológica, desarrollo profesional, apoyo y cuidado, salario y bienestar constituyeron factores significantes con influencia en el éxito en la carrera. Conclusión: la concurrencia a conferencias académicas, atención psicológica y ambiente de trabajo guardan relación positiva con el éxito en la carrera. Los gestores deberían considerar formas de abordar tales factores.

Objective: to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. Method: a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. Results: 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. Conclusion: attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.

Objetivo: examinar a relação entre o sucesso profissional e o ambiente de trabalho de enfermeiros da área de tecnologia de reprodução assistida e identificar os fatores que afetaram tal sucesso. Método: estudo transversal conduzido em 53 centros de fertilidade em 26 províncias da China Continental. Os dados foram coletados por meio de um questionário demográfico, um questionário sobre competências de enfermagem especializada em tecnologias de reprodução assistida, da Career-Success Scale (Escala de Sucesso Profissional) e da Nursing Work Environment Scale (Escala do Ambiente de Trabalho na Enfermagem). Aplicaram-se análises de estatística descritiva e inferencial. Resultados: participaram do estudo 597 enfermeiros da área de tecnologia de reprodução assistida, e 555 questionários válidos foram coletados. As pontuações globais médias para o sucesso profissional e o ambiente de trabalho foram 3,75 [desvio padrão (DP) = 1,01] e 3,42 (DP = 0,77), respectivamente. Verificou-se forte correlação positiva entre o sucesso profissional e o ambiente de trabalho (r = 0,742; p < 0,01). A análise de regressão múltipla mostrou que a participação em eventos acadêmicos, a assistência psicológica, o desenvolvimento profissional, o apoio e os cuidados, e o salário e o bem-estar foram fatores que influenciaram significativamente o sucesso profissional. Conclusão: a participação em eventos acadêmicos, a assistência psicológica e o ambiente de trabalho mostraram correlação positiva com o sucesso profissional. Os gestores deveriam considerar formas de abordar esses fatores.

Retinopexia neumática para el tratamiento de desprendimientos regmatógenos de retina seleccionados

Objetivo: Determinar los resultados anatómicos y funcionales en pacientes operados de desprendimiento de retina regmatógeno con técnica de retinopexia neumática. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo con pacientes operados con técnica de retinopexia neumática en el Centro Oftalmológico de Villa Clara entre junio del 2019 y abril del 2023. Resultados: La edad media de los pacientes estudiados fue de 62,1años. Los hombres fueron más afectados que las mujeres (60,6 %). El 57,6 % de los ojos tuvo agudeza visual mejor corregida de movimiento de manos al diagnóstico y el 93,9 % mácula desprendida. En el 66,7 % de las operaciones se utilizó el hexafloruro de azufre como tamponador. Se logró el éxito anatómico con una intervención en el 81,8 % (IC 95 %: 80-83,6 %) de los casos. En estos, se alcanzó el éxito funcional en el 85,2 % (IC 95 %: 83,4 -87 %). Los ojos con éxito anatómico alcanzaron como media una agudeza visual mejor corregida de 0,5 décimas (IC 95 %: 0,2-0,7) y se logró una ganancia media de 0,4 décimas (IC 95 %: 0,3-0,5). La complicación más frecuente fue la persistencia de líquido subretinal residual, el cual se presentó con más frecuencia en pacientes mayores de 60 años y desapareció como promedio a los 55,9 días sin necesidad de tratamiento. Conclusiones: La retinopexia neumática es una muy buena opción para tratar desprendimientos de retina seleccionados. En pacientes con ninguna o mínima vitreorretinopatía proliferativa, se logran buenos resultados anatómicos y funcionales.

Objective: To determine the anatomical and functional results in patients operated on for rhegmatogenous retinal detachment using the pneumatic retinopexy technique. Methods: A descriptive, longitudinal and prospective study was conducted with patients operated on using the pneumatic retinopexy technique at Centro Oftalmológico, of Villa Clara Province, Cuba, between June 2019 and April 2023. Results: The mean age of the studied patients was 62.1 years. Men were more affected than women (60.6 %). 57.6 % of the eyes had best-corrected visual acuity of hand movement at diagnosis and 93.9 % had detached macula. Sulfur hexafluoride was used as a buffer solution in 66.7 % of the operations. Anatomical success was achieved with one operation in 81.8 % (95 % CI: 80-83.6 %) of cases. In these, functional success was achieved in 85.2 % (95 % CI: 83.4-87 %). The anatomically successful eyes achieved a mean best-corrected visual acuity of 0.5 tenths (95 % CI: 0.2-0.7), apart from a mean gain of 0.4 tenths (95 % CI: 0.3-0.5). The most frequent complication was the persistence of residual subretinal fluid, which occurred more frequently in patients older than 60 years and disappeared, on average, at 55.9 days without the need for treatment. Conclusions: Pneumatic retinopexy is a very good option to treat selected retinal detachments. In patients with no or minimal proliferative vitreoretinopathy, good anatomical and functional results are achieved.

Long-term outcomes of therapeutic corneal transplants performed in a tertiary eye care hospital in South India

Purpose: This study aimed to review the demographics, clinical characteristics, and long?term outcomes of therapeutic penetrating keratoplasty (TPK) performed in a tertiary eye care hospital. Methods: Case records of 149 therapeutic transplants (135 patients) that were performed during the calendar year 2016 were retrospectively analyzed, and outcomes were measured until 3 years of follow?up. Information on demographics, presentation characteristics, keratoplasty indications, offending microbe, and secondary surgical interventions was studied. The final outcome was classified in terms of therapeutic, anatomical, and functional outcomes. Results: The median age of the recipients was 55 years with 61% men. The most common indications for TPK were perforated infectious ulcer (45.9%), nonhealing ulcers (29.9%), and graft infections (17.4%). Fungal etiology was noted in 61.2% and bacterial etiology in 17.4% of the eyes. Therapeutic success was achieved in 130 eyes (89%) at the end of 1 month. Anatomical success was achieved in 130 (98.5%) and 88 patients (86.3%) at the end of 1 and 6 months, respectively. At the 6?month time point, 78 patients (76.5%) attained functional success with vision better than light perception. Three?year follow?up data were available for 23.7% of recipients, of which only 12 patients (37.5%) retained a clear graft either after a primary therapeutic or secondary optical keratoplasty. Conclusion: Therapeutic keratoplasty is highly effective in eradicating infection and providing anatomical integrity. However, timely intervention can aid in achieving the best functional outcome.

Morphological Characteristics of Elite Female Volleyball Players Under 19 / Características Morfológicas de Jugadoras de Voleibol de Élite Menores de 19 Años

SUMMARY: The aim of the article is to determine the differences in morphological characteristics and jumping abilities between female volleyball players who play for different national teams. The sample consists of 48 elite female volleyball players from four different national teams which participated in European championship qualifications. The variables studied were: body height, mass, body mass index, standing reach and spike reach. The results show differences in body mass index, standing reach and spike reach. These differences are related to the needs of the different positions with regard to the actions they execute. In conclusion morphological parameters are important components of performance in many sports (volleyball). Different sports disciplines require different body parameters and body structure for maximum performance.

El objetivo del artículo fue determinar las diferencias en las características morfológicas y habilidades de salto entre las jugadoras de voleibol que juegan en diferentes selecciones nacionales. La muestra consta de 48 jugadoras de voleibol de élite de cuatro equipos nacionales diferentes que participaron en las clasificaciones del campeonato europeo. Las variables estudiadas fueron: altura corporal, masa, índice de masa corporal, alcance de pie y alcance de remate. Los resultados muestran diferencias en el índice de masa corporal, el alcance de pie y el alcance de punta. Estas diferencias están relacionadas con las necesidades de los distintos cargos en cuanto a las acciones que ejecutan. En conclusión, los parámetros morfológicos son componentes importantes del rendimiento en muchos deportes (voleibol). Las diferentes disciplinas deportivas requieren diferentes parámetros corporales y estructuras corporales para un rendimiento máximo.

Surgical decisions and outcomes of rhegmatogenous retinal detachment during the coronavirus disease 2019 pandemic: Data from a tertiary referral center in Taiwan

Purpose: To assess changes in surgical decisions and outcomes of rhegmatogenous retinal detachment (RRD) during the COVID?19 pandemic at a tertiary center in Taiwan. Methods: Patients undergoing pars plana vitrectomy (PPV) or scleral buckling (SB) for primary RRD during Taiwan’s first wave of domestic COVID?19 cases surge between May and July 2021 (COVID cohort, n = 100) were compared to controls in the closest pre?COVID year, 2019 (pre?COVID cohort, n = 121). Results: The COVID cohort had significantly worse RRD presentation, received more PPV (alone or combined with SB (PPV + SB)) and less SB alone, and had comparable single?surgery anatomic success (SSAS) rates. In patients who underwent PPV, more underwent PPV + SB instead of PPV alone. The decision to combine SB in PPV surgery was significantly affected by the COVID pandemic (odds ratio [OR], 3.1860 [95% confidence interval (CI), 1.1487–8.8361]). However, a shorter duration of symptoms before the first presentation (0.9857 [95% CI, 0.9720–0.9997]) was the only factor related to SSAS, whereas the surgical method had no association. The SSAS rate remained close to or over 90% in patients with a duration of symptoms before surgery ?4 weeks but dropped to 83.3% in patients with duration >4 weeks. Conclusion: During the COVID?19 pandemic, worse RRD presentations led to a shift in preference for PPV over SB alone as the primary surgery. The pandemic affected surgeons’ decision to combine SB during PPV. Nevertheless, SSAS was only associated with the duration of symptoms but not with surgical methods.

Análise das gestações ectópicas íntegras tratadas com o protocolo de dose única de metotrexato / Analysis of unruptured ectopic pregnancies treated with single-dose methotrexate protocol

Objetivo: Avaliar o índice de sucesso do tratamento da gravidez ectópica com o protocolo de dose única do metotrexato e verificar sua correlação com variáveis clínicas e dados dos exames complementares. Métodos: É um estudo epidemiológico observacional, analítico, retrospectivo, de delineamento transversal. Foi realizado de janeiro de 2014 a agosto de 2020 em um hospital público, de ensino, em nível terciário, do Sul do Brasil. Em 73 casos com diagnóstico de gestação ectópica íntegra, foi utilizado o protocolo de dose única de metotrexato intramuscular, com a dose de 50 mg/m2 de superfície corporal. As variáveis do estudo foram relacionadas ao sucesso do tratamento e abordaram as características clínicas na admissão, dos exames complementares e do tratamento realizado. As variáveis foram comparadas por análise de regressão de Poisson. O nível de significância estabelecido foi de p < 0,05. Resultados: O índice de sucesso foi de 83,6%, e em nove casos foi necessária uma segunda dose da medicação. Nível de ß-hCG inicial superior a 5.000 mUI/mL foi relacionado a menor chance de sucesso (odds ratio ajustado de 0,20 [0,05-0,95]). Tamanho da imagem anexial, presença de líquido livre na cavidade abdominal e demais variáveis estudadas não afetaram a chance de sucesso do tratamento. Conclusão: O protocolo de dose única de metotrexato mostrou-se uma opção válida para o tratamento da gestação ectópica íntegra, notadamente quando o nível de ß-hCG inicial é inferior 5.000 mUI/mL.

Objective: The purpose of the present study is to evaluate the success rate of treatment of ectopic pregnancy with the single-dose methotrexate protocol and to verify its correlation with clinical variables and complementary exam data. Methods: This is a retrospective epidemiological observational analytical cross-sectional study. It was carried out from January 2014 to August 2020 in a tertiary level teaching hospital in southern Brazil. In 73 cases with a diagnosis of intact ectopic pregnancy, the intramuscular methotrexate single-dose protocol was applied with a dose of 50 mg/m2 of body surface. The study variables were related to the success of the treatment and addressed the clinical characteristics on admission, the complementary exams and the treatment performed. The variables were compared by Poisson regression analysis. The level of significance was set at p < 0.05. Results: The success rate was 83.6%, and in nine cases a second dose of the medication was necessary. An initial ß-hCG level greater than 5,000 mIU/mL was related to a lower chance of success (adjusted odds ratio of 0.20 [0.05- 0.95]). The size of the adnexal image, the presence of free fluid in the abdominal cavity and other variables studied did not affect the chance of a successful treatment. Conclusion: The methotrexate single-dose protocol proved to be a valid option for the treatment of intact ectopic pregnancy, notably when the initial ß-hCG level is below 5,000 mIU/mL.

Cataract versus combined surgery in pseudoexfoliation glaucoma

Purpose: Pseudoexfoliation glaucoma (XFG) is often associated with a higher rate of intraoperative complications and failure. This study aims to compare the long?term clinical and surgical outcomes of cataract surgery alone versus combined surgery in XFG. This was a retrospective comparative case series. Methods: All patients with XFG who underwent either cataract surgery alone [group 1: either phacoemulsification, PHACO/small?incision cataract surgery (SICS), n = 35] or combined surgery (group 2: phacotrabeculectomy, PHACOT or SICS + trabeculectomy, n = 46) from 2013 to 2018 by a single trained surgeon were screened and recalled for a detailed clinical examination, including Humphrey visual field analysis at 3?monthly intervals for a minimum of 3 years. Surgical success (intraocular pressure, IOP, <21 mm Hg and >6 mm Hg with (qualified success) or without medicines, complete success, survival rates, visual field changes, and need for additional procedures/medicines for IOP control were compared between groups. Results: A total of 81 eyes of 68 patients with XFG were included in this study (groups 1–35 eyes and groups 2–46 eyes each). Both groups achieved 27–40% IOP reduction from preoperative IOP levels, P < 0.001. Surgical success rates were similar in both groups (complete success 66% vs 55%, P = 0.4), qualified success 17% vs 24%, P = 0.8, in groups 1 and 2). Kaplan–Meier analysis showed a marginally better survival rate for group 1, 75% (55–87%), than group 2, 66% (50–78%), at 3 and 5 years which was not significantly different. The number of eyes that progressed at 5 years after surgery (5–6%) was similar in both groups. Conclusion: Cataract surgery can be as effective as combined surgery in XFG eyes with regards to final visual acuity, long?term IOP profile, and visual field progression, and complications/survival rates are comparable between the two procedures.

Efficacy of a biosimilar ranibizumab monotherapy for the treatment of retinopathy of prematurity

Purpose: To evaluate the efficacy of a biosimilar ranibizumab (Razumab) on outcomes of retinopathy of prematurity (ROP) for the first time. Methods: This retrospective study included infants presenting with stage 3+ ROP either in zone 1 or zone 2 posterior or aggressive posterior ROP (APROP). All eligible infants received intravitreal razumab (0.25 mg/0.025 ml) monotherapy. Follow?up was continued monthly till complete retinal vascularization was achieved while retreatment with razumab was given when recurrent neovascularization was noted. In case of no recurrence but incomplete vascularization, laser photocoagulation was done to the residual avascular retina. Results: We included 118 eyes of 59 infants with a median gestational age of 30 weeks and median birth weight of 1250 grams. At presentation, APROP was found in 28 eyes (24%) of 14 babies while stage 3 disease was seen in zone 1 in another 28 eyes (24%) and the remaining 62 eyes (52%) had stage 3 ROP in zone 2 posterior region. Complete resolution of ROP along with complete vascularization was seen in 22 eyes (19%) at a median of 55 days (IQR = 31–56 days) and 42 eyes (35%) showed a recurrent neovascularization at a median of 51 days post razumab (IQR = 42– 55 days). The cumulative incidence of recurrence of neovascularization (21%, 95% CI = 14%–29%) peaked at seven weeks and was significantly higher in eyes with APROP (43%, 95% CI = 27%–63%) compared to eyes without APROP (13.4%, 95%CI, 8%?22%) (P < 0.001). Conclusion: Razumab appears to be safe and effective in treating ROP, with about a third requiring reinjection at seven weeks after the first dose.

Duodenal Papilla Morphology and ERCP Cannulation difficulties, failure and complications in Manila Doctors Hospital, a tertiary private hospital: A cross-sectional study

BACKGROUND/OBJECTIVE@#Different major duodenal papilla morphology pose various challenges of cannulation and development of ERCP complications. These morphologies may guide the endoscopist in his cannulation approach and complication prevention. The aim of this study is to determine the major duodenal papilla morphologies of ERCP patients in Manila Doctors Hospital and their associated cannulation difficulties, failure, and complications. @*METHODS@#This is a retrospective cross-sectional study of 246 ERCPs at the Manila Doctors Hospital from January 2017 to December 2018 with naive duodenal papillae classified according to Watanabe (2019) as follows: oral protrusion (small, regular, large) and papilla pattern (annular, unstructured, longitudinal, isolated, gyrate). Association of papilla morphology with cannulation difficulties, failure, and complications were analyzed using logistic regression.@*RESULTS@#Among protrusions, small oral protrusions were more difficult to cannulate compared to regular (OR 0.493, p=0.017) and large protrusions (OR 0.702, p=0.426). Large protrusions had the highest risk for failed cannulation (OR 2.04, p=0.445). Among papilla patterns, unstructured papilla patterns had the highest risk for difficult (OR 3, p=0.008) and failed cannulation (OR 7.08, p=0.020). Complications developed in 7 in- patients with 3 (1.73%) post-ERCP pancreatitis, 1 (0.58%) post- sphincterotomy bleeding, and 1 (0.58%) cholangitis and 2 (1.16%) mortalities. One had myocardial infarction 2 days post-ERCP and another had septic shock after 2 days despite endoscopic biliary drainage and antibiotics.@*CONCLUSION@#Among protrusions, small oral protrusions had the highest risk for difficult cannulation while large protrusions had the highest risk for failed cannulation. Among papilla patterns, unstructured papilla patterns had the highest risk for difficult and failed cannulation.

Preliminary Framework of Lean Healthcare Sustainability Performance Measurement for Health Sector

@#Introduction: Lean sustainability has gained prominence in the health sector for operational and business advantages. However, understanding the link between lean and healthcare sustainability, especially in social and environmental aspects, remains limited. This study introduces a preliminary framework for measuring lean healthcare sustainability in hospitals. The framework aligns Critical Success Factors (CSFs) with sustainability objectives and business strategies to ensure successful and enduring lean deployment. Methods: The study was conducted among 52 Lean Agile Hospitals in Malaysia using a cross-sectional approach. The validated questionnaire was employed for data collection. A reliability test and Exploratory Factor Analysis (EFA) were also performed to assess and validate the framework using Statistical Package for Social Sciences (SPSS) version 27. Results: The content validation was 0.9, which indicates that the instrument is sufficient to measure the research objective. The data screening test was performed to eliminate problem observation. The overall reliability value was over 0.830 which depicts data consistency and stability. The Kaiser-Meyer-Olkin exceeded 0.6, Bartlett’s test was under 0.001 and factor loading was between 0.507 to 0.948, thus indicating a significant correlation matrix among at least some of the variables. Therefore, the latent factors were significant to specific items of the research. Conclusion: It is concluded that important CSF is aligned with the strategic level influence of lean deployment in healthcare, which has a specific impact on certain sustainability performance. Thus, this paper proposed a generic preliminary framework to measure lean healthcare sustainability.

The efficacy of the combination of radiofrequency ablation and endoscopic metal stent in the treatment of 44 patients with unresectable cholangiocarcinoma / 中华消化杂志

Objective:To explore the efficacy of the combination of radiofrequency ablation(RFA) and endoscopic metal stent in the treatment of patients with unresectable cholangiocarcinoma.Methods:From January 3, 2012 to June 30, 2019, at the Department of Endoscopic of the Third Affiliated Hospital of Naval Medical University, the clinical data of 44 patients with unresectable cholangiocarcinoma who were treated by the combination of RFA and endoscopic metal stent were retrospectively collected, which included age, gender, location of cholangiocarcinoma(hilar cholangiocarcinoma and distal cholangiocarcinoma), etc. Postoperative evaluation was conducted based on the follow-up, including clinical success rate, postoperative complication rate, time of stent patency and overall survival time (OS). The Kaplan-Meier method and log-rank test were used to analyze the difference of OS between patients with hilar cholangiocarcinoma and distal cholangiocarcinoma. Mann-Whitney U test was used for statistical analysis. Results:The age of the 44 patients with cholangiocarcinoma was (70.3±11.6) years old, with 20 males (45.5%). There were 22 patients (50.0%) with hilar cholangiocarcinoma and 22 patients (50.0%) with distal cholangiocarcinoma. The clinical success rate of 44 patients was 93.2%(41/44). A total of 5 patients(11.4%) had postoperative complications, which were all improved by appropriate treatment. The median time of follow-up of the 44 patient was 9.2 months(ranged from 3.1 to 57.6 months), the median time of stent patency was 7.0 months (ranged from 5.8 to 8.2 months). Thirty-two patients (72.7%) died during the follow-up, and the median OS was 10.9 months(ranged from 9.0 to 12.8 months). The median OS of patients with hilar cholangiocarcinoma was 7.8 months(ranged from 4.6 to 11.0 months) and that of patients with distal cholangiocarcinoma was 12.5 months(ranged from 5.7 to 19.4 months), and there was no statistically significant difference( P>0.05). Conclusion:RFA combined with endoscopic metal stent is safe and effective in the treatment of patients with unresectable cholangiocarcinoma.

A comparative study on the success rate and safety between computed tomography-guided gastrostomy and endoscopic gastrostomy / 中华消化杂志

Objective:To compare and analyze the technical success rate and safety between computed tomography(CT)-percutaneous radiological gastrostomy (PRG) and percutaneous endoscopic gastrostomy (PEG).Methods:From January 2017 to January 2022, at the First Affiliated Hospital of Zhengzhou University, the data of 76 patients who underwent gastrostomy due to inability to eat orally were collected, including 38 patients in PEG group and 38 patients in CT-PRG group. Surgical outcomes and complications were compared between the PEG and CT-PRG groups. Surgical outcomes included technical success rate, operation time, postoperative body mass index and hospital stay; while complications included minor complications (such as perifistula infection, granulation tissue proliferation, leakage, pneumoperitoneum, fistula tube obstruction, fistula tube detachment and persistent pain) and serious complications (such as bleeding, peritonitis, colonic perforation and death within 30 d). Independent sample t test, chi-square test, and Fisher exact probability test were used for statistical analysis. Results:The technical success rate of CT-PRG group was higher than that of the PEG group (100.0%, 38/38 vs. 78.9%, 30/38), and the operation time was shorter than that of the PEG group ((17.16±8.52) min vs. (29.33±16.22) min), and the differences were statistically significant ( χ2=1.19, t=2.36; P=0.038 and 0.011). There were no significant differences in postoperative body mass index ((16.29±3.56) kg/m 2 vs. (16.12±3.17) kg/m 2) and hospital stay ((4.13±1.26) d vs. (3.52±1.13) d) between PEG group and CT-PRG group (both P>0.05). The incidence of minor complications in the PEG group was 42.1% (16/38), including 6 cases of perifistulal infection, 1 case of leakage, 5 cases of fistula tube obstruction, 1 case of fistula tube detachment, and 3 cases of persistent pain. The incidence of serious complications was 5.3% (2/38), including 1 case of bleeding and 1 case of colonic perforation. The incidence of minor complications in the CT-PRG group was 39.5% (15/38), including 5 cases of perifistula infection, 1 case of granulation tissue proliferation, 3 cases of pneumoperitoneum, 3 cases of fistula tube obstruction, 2 cases of fistula tube detachment, and 1 case of persistent pain. The incidence of serious complications was 0. There was no significant difference in the incidence of minor complications between the PEG group and the CT-PRG group ( P>0.05), while the incidence of serious complications in the CT-PRG group was lower than that of the PEG group, and the difference was statistically significant (Fisher exact probability test, P=0.043). Conclusion:PEG is a safe and effective method of gastrostomy, but for patients with esophageal obstruction, CT-PRG can be an effective supplement to PEG.

Influence of effective liver drainage volume on overall survival in patients with malignant hilar biliary obstruction: a multicenter study / 中华消化内镜杂志

Objective:To investigate the influence of liver drainage volume on overall survival time in patients with unresectable malignant hilar bile duct obstruction.Methods:Data of 633 patients with unresectable malignant hilar bile duct obstruction (BismuthⅡ-Ⅳ) who underwent endoscopic stent drainage in 3 endoscopy centers from January 2002 to May 2019 were retrospectively analyzed. Main observation indicators included clinical success rate, stent patency, overall survival, the effective liver drainage volume, and complication incidence.Results:The clinical success rates of patients with liver drainage volume <30%, 30%-50%, and >50% were 56.8% (25/44), 77.3% (201/260) and 84.2% (277/329) respectively. The incidences of early cholangitis were 31.8% (14/44), 18.8% (49/260) and 16.1% (53/329). The median stent patency time was 4.5 (95% CI: 1.8-7.2) months, 5.6 (95% CI: 5.0-6.2) months and 6.6 (95% CI: 5.2-8.0) months. The overall survival time was 2.4 (95% CI: 1.8-3.0) months, 4.0 (95% CI: 3.4-4.6) months and 4.9 (95% CI:4.4-5.4) months, respectively. The clinical success rate ( χ 2=8.28, P=0.012), median stent patency period ( χ 2=18.87, P=0.015) and overall survival time ( χ 2=6.93, P=0.024) of 30%-50% liver drainage volume group were significantly higher than those of <30% group. Further multivariate cox regression analysis showed that the disease type (hepatocellular carcinoma VS hilar cholangiocarcinoma: HR=1.50, 95% CI:1.18-1.91, P=0.001; gallbladder carcinoma VS hilar cholangiocarcinoma: HR=1.45, 95% CI:1.14-1.85, P=0.002; metastatic cholangiocarcinoma VS hilar cholangiocarcinoma: HR=1.48, 95% CI:1.08-2.04, P=0.015), bilirubin level >200 μmol/L ( HR=1.35, 95% CI:1.14-1.60, P<0.001),metal stents ( HR=0.67, 95% CI:0.56-0.79, P<0.001), liver drainage volume (volume 30%-50% VS <30%: HR=0.64, 95% CI: 0.45-0.90, P=0.010; volume>50% VS <30%: HR=0.58, 95% CI:0.41-0.81, P=0.002) and anti-tumor therapy ( HR=0.51, 95% CI:0.42-0.61, P<0.001) were independent predictors for overall survival time of patients with unresectable malignant hilar bile duct obstruction. Conclusion:When endoscopic stent drainage is performed for patients with unresectable malignant hilar bile duct obstruction, at least 30% liver volume is required for better overall survival. In addition, the use of metal stent drainage and anti-tumor therapy may increase survival benefits.

Influence of donor and pancreatic characteristics on the success rate of islet isolation / 中华内分泌代谢杂志

Objective:To explore the selection criteria of the donor for islet transplantation of Chinese people by analyzing the correlation between pancreas characteristics and success rate of islets isolation.Methods:Data from 113 cases of human islet isolation were collected. According to the result of islet isolation, the donors were divided into two groups, the success group(IEQ≥250 000, purification≥30%, and viability≥80%), and the failure group(IEQ<250 000, or purification<30%, or viability<80%). The modified Ricordi method was used to digest pancreas tissue, and the continuous density gradient method was performed to purify islets. The islets were identified by staining with the Dithizone(DTZ), the islets were analyzed for cell viability and purity.Results:The donor age in success group was significantly younger than failure group in the range of age eligible for this study( t=2.479, P=0.015). Pearson correlation showed that donor age was positively corelated with islet yield( r=-0.214, P=0.047). There was more fat on the pancreas surface in the successful islet isolation group( z=-2.007, P=0.045). The digestibility( t=2.133, P=0.035) and recovery rate( t=5.912, P=0.001) were elevated in success group. Conclusion:The pancreases from younger donors could obtain the higher-yielding islet, the pancreas with more surface fat or with higher weight was associated with islet isolation success in the scope covered by the inclusion criteria of this study.

Estimation du succès fonctionnel et esthétique des implants dentaires / Estimation of the functional and aesthetic success of dental implants

Les implants dentaires ont révolutionné la réhabilitation orale partielle et totale. Des taux de succès allant de 80% à 100% à travers le monde (Buser, 2019) Le succès du traitement implantaire doit répondre à deux objectifs pour être validé. Le premier est le concept d'ostéointégration et le second sur l'aspect esthétique des tissus autour de l'implant. notre objectif était d'estimer le taux de succès fonctionnel, en se basant sur les critères de succès d'Albrektsson et coll (Albrektsson,1986 ) ainsi qu'une évaluation esthétique par le PES (Belser, 2009) sur un échantillon de 50 patients dont 107 implants posés au secteur antérieur où le profil esthétique joue un rôle important. Le taux de succès fonctionnel était estimé à 94% voire 03 échecs sur 50 patients, avec une différence significative entre le succès implantaire et le degré d'hygiène bucco dentaire (p=0.00001) ; ainsi que le degré d'inflammation (p=0.0000) et la maladie parodontale p=0.04. On a eu 100% de succès chez les patients à qui on a procédé à un enfouissement total de l'implant. Enfin le succès esthétique était bon chez 42(84%) patients pour un score de 8 à10, et favorable chez les 5(10 %) restants pour un score de 5 à 7

Dental implants have revolutionized partial and total oral rehabilitation. Success rates ranging from 80% to 100% worldwide (Buser, 2019) The success of the implant treatment must meet two objectives to be validated. The first is the concept of osseointegration and the second on the aesthetic appearance of the tissues around the implant. Our objective was to estimate the functional success rate, based on the success criteria of Albrektsson et al (Albrektsson, 1986) as well as an aesthetic evaluation by the PES (Belser, 2009) on a sample of 50 patients including 107 implants placed in the anterior sector where the aesthetic profile plays an important role. The functional success rate was estimated at 94% or even 03 failures out of 50 patients, with a significant difference between the implant success and the degree of oral hygiene (p=0.00001); as well as the degree of inflammation (p=0.00001) and finally the periodontal disease (p=0.04). We have had 100% success in patients who have undergone total burying of the implant Finally, aesthetic success was good in 42 (84%) patients for a score of 8 to 10, and favorable in the remaining 5 (10%) for a score of 5 to 7.

Dental students' satisfaction with their course and how it is associated to their satisfaction with life and career outlook / Satisfação com o curso de Odontologia e suas associações com a satisfação com a vida e perspectiva de carreira

ABSTRACT Identifying factors that influence the satisfaction of undergraduate dental students can contribute to establishing strategies for improving the educational process, furthering student development, and enhancing students' academic and professional achievements. Aim: the present study investigated associations between undergraduate students' satisfaction with the dental course and their satisfaction with life, perception of professional career and sociodemographic factors. Materials and method: this was a cross-sectional study on 512 dental students from a Brazilian School of Dentistry. Students were asked to respond to three questionnaires about sociodemographic characteristics, academic, and professional perceptions. Satisfaction with life was measured using the Brazilian version of the Satisfaction with Life Scale, which comprises five statements with responses scored on a seven-point Likert scale ranging from "I strongly disagree" to "I strongly agree". Unadjusted and adjusted multiple logistic regression analyses were performed to test associations between satisfaction with the dental course and key variables. Results: most participants were female (73.2%), single (99.8%) and with mean age 21.77 (±2.71) years. Approximately three quarters had a family income over three times higher than the national monthly minimum wage. Higher satisfaction with the course was associated with more optimistic perception of the job market (OR=2.44; 95% CI: 1.36-4.40), better academic performance (OR=1.65; 95% CI: 1.00-2.74) and greater satisfaction with life (OR=1.10; 95% CI: 1.06-1.15). Students' sex and family income did not have significant impact on satisfaction with the dental course. Conclusions: satisfaction with the dental course is related to an optimistic perception of the job market, academic performance and satisfaction with life.

RESUMO Identificar os fatores que influenciam na satisfação dos estudantes de odontologia pode contribuir para o estabelecimento de estratégias que aprimorem o processo educacional, favorecendo o desenvolvimento dos alunos e potencializando suas conquistas acadêmicas e profissionais. Objetivo: o presente estudo investigou as associações entre a satisfação de estudantes de graduação com o curso de odontologia e sua satisfação com a vida, percepção da carreira profissional e fatores sociodemográficos. Materiais e método: um estudo transversal foi realizado com 512 estudantes de Odontologia de uma Faculdade Brasileira de Odontologia. Três questionários foram aplicados aos alunos, com o objetivo de avaliar as características sociodemográficas, percepções acadêmicas e profissionais. A satisfação com a vida foi mensurada pela versão brasileira da Escala de Satisfação com a Vida, que compreende cinco afirmações com respostas pontuadas em uma escala Likert de sete pontos, variando de "discordo totalmente" a "concordo totalmente". A análise de regressão logística foi realizada para testar associações entre a satisfação com o curso de Odontologia e as demais variáveis. Análises de regressão logística múltipla não-ajustada e ajustada foram realizadas para testar associações entre a satisfação com o curso de odontologia e variáveis-chave. Resultados: A maioria dos participantes era do sexo feminino (73,2%), solteiros (99,8%) e com média de idade de 21,77 (±2,71) anos. Aproximadamente três quartos tinham renda familiar três vezes superior ao salário-mínimo nacional. A maior satisfação dos alunos com o curso foi associada a maior percepção otimista do mercado de trabalho (OR=2,44; IC 95%: 1,36-4,40), desempenho acadêmico (OR=1,65; IC 95%: 1,00-2,74) e satisfação com a vida (OR =1,10; IC 95%: 1,06-1,15). O sexo dos alunos e a renda familiar não apresentaram impacto significativo na satisfação com o curso de odontologia. Conclusão: a satisfação com o curso de odontologia está relacionada com a percepção otimista do mercado de trabalho, desempenho acadêmico e satisfação com a vida.

Survival and Success of Immediate Implant Placement Followed by Tooth Extraction a Retrospective Study

Background: Dental Implant originally utilized for aesthetic and functional rehabilitation, this treatment option have transformed oral rehabilitation techniques and are now regarded as the gold standard of treatment for replacing single, partial, and full-arch teeth. With improvements in osteotomy technique, implant macro- and micro-geometry, surface treatment, types of implant prosthetic connections, and other aspects, the overall treatment duration has also been greatly shortened.Material & Methods:This study was carried out in two implant centers and is retrospective and descriptive. It was done in the Implant Surgery Centers of Banasree Dental and German Dental, Dhaka, Bangladesh. The research was carried out from January 2010 to June 2022. 63 people made up the entire sample for this study.Results:Most of the patients 21(33.3%) were aged between 51-60 years where most of the patients 36(57%) were female and 27(43%) were male. Maxilla was done in 45(71.4%) patients, mandible was done in 48(76.2%). 69(74.2%) implants were done on the anterior site and 24(25.8%) was done on posterior site. All the patients had a good primary stability of implant with an insertion torque of 30 N/cm or more. There were 100% survival rate after the implants and in good functional condition. All patients were happy with their implant.Conclusion:This approach of osteotomy preparation’s greater primary stability appears to have a minimal detrimental effect on implant success.

Habilidades prelectoras en niños uruguayos de diferente nivel socioeconómico / Differential pre-literacy skills development in Uruguayan children from different socioeconomic backgrounds

Resumen El objetivo del presente estudio fue comparar las habilidades prelectoras en 50 preescolares uruguayos de 5 años de edad de diferente nivel socioeconómico (NSE) y analizar el impacto de estas habilidades en el aprendizaje de la lectura. Para ello, se evaluó a los niños mediante pruebas de vocabulario receptivo, conciencia fonológica, conocimiento sobre el nombre y el sonido de las letras, y denominación rápida de objetos a fin del nivel preescolar Tiempo 1 (T1). Un año más tarde, se evaluó a un subgrupo de la muestra inicial mediante una prueba de lectura de palabras Tiempo 2 (T2). Los resultados señalaron la existencia de correlaciones significativas entre los predictores (T1) y la lectura de palabras (T2) y entre todas las variables evaluadas y el nivel socioeconómico de los niños. La comparación del desempeño intergrupal señaló la existencia de diferencias significativas en todas las habilidades evaluadas a favor del nivel socioeconómico medio. Sin embargo, el desempeño en la lectura de palabras de ambos grupos fue bajo. Por otra parte, un análisis de regresión mostró que, para los niños de nivel socioeconómico bajo, el nivel de conciencia fonológica fue el que explicó la mayor parte de la varianza en la eficiencia lectora. El nivel de lectura de los niños de nivel socioeconómico medio fue mayormente explicado por el conocimiento del nombre de las letras. Los resultados ponen en evidencia la importancia de atender a las diferencias que se generan temprano en el desarrollo de habilidades lingüísticas fundamentales para aprender a leer.

Abstract Learning to read transforms lives. Reading contributes to knowledge acquisition, cultural engagement, and success in the school. The unequal distribution of literacy skills in a society is associated with economic and social inequalities as a result, children with a poor foundation in literacy before entering formal schooling are more likely to struggle academically and to drop out of school. For these reasons, there has been an intense scientific interest for decades in understanding how children learn to read. It is well established that in the early stages of reading development, phonological awareness, letter name-sounds knowledge, and the naming speed are three independent longitudinal predictors of children's later word-reading skills in alphabetic-writing systems. Phonological awareness constitutes the ability to recognize and manipulate the sounds of their own language, meanwhile letter knowledge promotes the discovery of systematic relationships between writing and oral language. As early readers develop some level of phonological awareness and some level of letter knowledge, they can recognize written words through phonological recoding processes, in which graphemes are recoded as phonemes and assembled to pronounce words. In addition, rapid naming expresses the speed at which phonological information is accessed from a graphic label. Phonological processing and letter knowledge are powerfully affected by the experience, stimulation, and support that children receive before beginning formal education. Most children acquire these abilities relatively effortlessly during early childhood. However, there is a significant number of children in Latin America who experience difficulties in their pre-literacy skills development. This study examined the cognitive profiles of a total of 50 Uruguayan preschoolers from different socioeconomic backgrounds from two public schools in Montevideo, Uruguay. Twenty-six children from low-income households were compared to peers from middle-income. At the end of the pre-schooling period (time 1) receptive vocabulary, phonological awareness, letter name-sounds knowledge, and object naming speed tests were administered to children. One year later (time 2), word -reading of a subgroup of children was measured. Significant correlations were observed between all predictors at time 1; between predictors at time 1 and word reading at time 2; and between all measured abilities and socioeconomic status. Comparative analysis between children of different socioeconomic status showed that children growing up in poverty contexts performed more poorly than their peers from middle-income families in all the tests. Nonetheless, both groups performed poorly in word reading. Descriptive statistics indicated that, out of a total of 26 words, low SES children correctly read a total of 7 words per minute, and medium SES children a total of 14 words. Finally, regression analyses indicated that phonological awareness contributed 30 % variance in predicting the total score achieved in a reading-word test in children of low-income families, meanwhile letter name knowledge contributed 74 % variance in predicting the total score achieved in a reading-word test in their peers from middle-income families. In general terms, results of pre-reading skills and reading performance seem to indicate that children of different socioeconomic status use different word recognition strategies according to their level of letter-knowledge of and phonological processing. Discussion considers international literature pointing out that children who enter elementary school with limited reading-related skills are unlikely to be able to keep pace with their peers. These findings warn about the importance to elaborate systematic and high-quality educational proposals to try to reduce the gap in reading development for children from low-income families. Developing literacy and language skills before formal schooling sets a child up for success in school and life. Results also suggest the importance of analyzing the variables that affect reading development in populations that are not the majority described.

School motivation: theoretical approaches to the learning process / Motivação escolar: abordagens teóricas do processo de aprendizagem / Motivación escolar: aproximaciones teóricas al proceso de aprendizaje

Abstract The present theoretical reflection attempts to find out to what extent motivation can influence the student´s learning processes. To this end, the links between the most important theoretical models - the Theory of Attribution of Causality, the Theory of Self-determination, and the Theory of Achievement Goals - are established. Students' participation in school content depends on various factors that are individually and contextually related to motivation. prevailing cognitive theories of motivation stimulate and guide the study of the individual's beliefs, values, and emotions since they consider these variables to be mediators of behaviour and have a strong influence on the motivation process. From a literature review, it is important to bear in mind that motivation in the school context has been assessed as a critical determinant of the level and quality of learning and performance. It can also be concluded that the relationship between learning and motivation goes beyond any established assumption, it is reciprocal and therefore motivation can influence learning and performance in the same way that learning can interfere with motivation. In consequence, a change of school practices is essential, promoting students' involvement in the learning process through challenging tasks, engaging students in appropriate strategies, and striving to develop new comprehension and proficiency skills. Some guidelines for educational practice are indicated.

Resumo Esta reflexão teórica procura saber até que ponto a motivação pode influenciar os processos de aprendizagem dos alunos, estabelecendo os pontos de ligação entre os modelos teóricos mais importantes - a Teoria da Atribuição de Causalidade, a Teoria da Autodeterminação e a Teoria das Metas de Realização. A participação dos alunos nos conteúdos escolares depende de vários fatores que estão individual e contextualmente relacionados à motivação. As recorrentes teorias cognitivas da motivação estimulam e orientam o estudo das crenças, valores e emoções do indivíduo, uma vez que consideram essas variáveis como mediadoras do comportamento e têm forte influência no processo de motivação. Da análise da literatura, fica claro que é importante ter em mente que a motivação no contexto escolar tem sido avaliada como um determinante crítico do nível e da qualidade da aprendizagem e do desempenho. A partir disso, pode-se concluir também que a relação entre aprendizagem e motivação vai além de qualquer suposição estabelecida de que seja recíproca e, portanto, a motivação pode influenciar a aprendizagem e o desempenho da mesma forma que a aprendizagem pode interferir na motivação. Assim, é imprescindível uma mudança de prática nas escolas, promovendo o envolvimento dos alunos no processo de aprendizagem através de tarefas desafiadoras, usando estratégias apropriadas e procurando desenvolver novas habilidades de compreensão e domínio. São indicadas algumas orientações para a prática educativa.

Resumen Esta reflexión teórica busca conocer en qué medida la motivación puede influir en los procesos de aprendizaje de los estudiantes, estableciendo los puntos de conexión entre los modelos teóricos más importantes - la Teoría de la Atribución de Causalidad, la Teoría de la Autodeterminación y la Teoría de las Metas de Logro. La participación de los estudiantes en los contenidos escolares depende de varios factores que se relacionan individual y contextualmente con la motivación. Las teorías cognitivas recurrentes de la motivación estimulan y orientan el estudio de las creencias, valores y emociones del individuo, ya que consideran estas variables como mediadoras de la conducta y con fuerte influencia en el proceso de motivación. A partir de una revisión de la literatura, se desprende que es importante tener en cuenta que la motivación en el contexto escolar ha sido valorada como un determinante crítico del nivel y la calidad del aprendizaje y del rendimiento. También se puede concluir que la relación entre aprendizaje y motivación va más allá de cualquier suposición establecida de que es recíproca y, por lo tanto, la motivación puede influir en el aprendizaje y el desempeño de la misma manera que el aprendizaje puede interferir en la motivación. Por lo tanto, un cambio de práctica en las escuelas es esencial, promoviendo la participación de los estudiantes en el proceso de aprendizaje a través de tareas desafiantes, utilizando estrategias adecuadas y buscando desarrollar nuevas habilidades de comprensión y dominio. Se indican algunas pautas para la práctica educativa.