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Subtle skills: Using objective structured clinical examinations to assess gastroenterology fellow performance in system based practice milestones

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World Journal of Gastroenterology 2020年第11期26卷 1221-1230页

作者： Marianna Papademetriou Gabriel Perrault Max Pitman Colleen Gillespie Sondra Zabar Elizabeth Weinshel Renee Williams Division of Gastroenterology Georgetown University Medical CenterWashingtonDC 20007United States Division of Gastroenterology Washington DC VA Medical CenterWashingtonDC 20422United States Department of Medicine New York University Medical CenterNew YorkNY 10016United States Division of Gastroenterology New York University Medical CenterNew YorkNY 10016United States Department of Medicine New York University School of MedicineNew YorkNY 10016United States Department of Gastroenterology VA New York Harbor Healthcare SystemNew YorkNY 10010United States

BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficult due to high volume, high acuity inpatient care, as well as inconsistent direct supervision. Nevertheless,structured assessment is required for training programs. We hypothesized that objective structured clinical examination(OSCE) would be an effective tool for assessment of SBP.AIM To develop a novel method for SBP milestone assessment of gastroenterology fellows using the OSCE.METHODS For this observational study, we created 4 OSCE stations: Counseling an impaired colleague, handoff after overnight call, a feeding tube placement discussion, and giving feedback to a medical student on a progress note. Twentysix first year fellows from 7 programs participated. All fellows encountered identical case presentations. Checklists were completed by trained standardized patients who interacted with each fellow participant. A report with individual and composite scores was generated and forwarded to program directors to utilize in formative assessment. Fellows also received immediate feedback from a faculty observer and completed a post-session program evaluation survey.RESULTS Survey response rate was 100%. The average composite score across SBP milestones for all cases were 6.22(SBP1), 4.34(SBP2), 3.35(SBP3), and 6.42(SBP4)out of 9. The lowest composite score was in SBP 3, which asks fellows to advocate for cost effective care. This highest score was in patient care 2, which asks fellows to develop comprehensive management plans. Discrepancies were identified between the fellows’ perceived performance in their self-assessments and Standardized Patient checklist evaluations for each case. Eighty-seven percent of fellows agreed that OSCEs are an important component of their clinical training,and 83% stated that the cases were similar to actual clinical encounters. All participating fellows stated that the

关键词： Objective structured clinical exams Medical education Medical error System based practice Milestones Gastroenterology

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Preparation optimization of multilayer-structured SnO_2–Sb–Ce/Ti electrode for efficient electrocatalytic oxidation of tetracycline in water

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Chinese Journal of Chemical Engineering 2018年第12期26卷 2622-2627页

作者： Kun Yang Yuyu Liu Jiawen Liu Jinli Qiao Institute of Sustainable Energy/College of Science Shanghai UniversityShanghai 200444China State Environmental Protection Engineering Center for Pollution Treatment and Control in Textile Industry College of Environmental Science and EngineeringDonghua UniversityShanghai 201620China ShanghaiJinyuan Senior High School Shanghai 200333China

In this study, electrodeposition and thermal decomposition were alternatively used for the fabrication of a series of novel multilayer-structured SnO_2–Sb–Ce/Ti(SSCT) electrodes, and their physiochemical and electrochemical properties were investigated for electrochemical oxidation of tetracycline(TC) in aqueous medium.Experimentally, after the SnO_2–Sb–Ce(SSC) composite was electrodeposited for 120 s on the titanium substrate in aqueous solution, the outer thermal coatings composed of SSC were synthesized by a hydrothermal method.Both influences of electrodeposition time(T_(ed)) and thermal decomposition time(Ttd) were investigated to obtain the optimum preparation. It was found that when increasing T_(ed)to a certain extent a longer lifetime of electrode can be achieved, which was attributed to a more solid interlayer structure. A notable SSCTT_(ed),Ttdelectrode,i.e., SSCT3,10, which was prepared through three times of 120 s' electrodeposition(T_(ed)= 3) and ten times of thermal decomposition(Ttd= 10) obtained the highest oxygen evolution potential 3.141 V vs. SCE. In this selected electrode, when 10 mg·L^(-1) initial TC concentration was added to this wastewater, the highest color removal efficiency and mineralization rate of TC were 72.4% and 41.6%, respectively, with an applied electricity density of 20 m A·cm^(-2) and treatment time of 1 h. These results presented here demonstrate that the combined application of electrodeposition and thermal decomposition is effective in realization of enhanced electrocatalytic oxidation activity.

关键词： Multilayer structured electrode Nano-hollow sphere Antibiotics Electro-oxidation

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RGBD Salient Object Detection by structured Low-Rank Matrix Recovery and Laplacian Constraint

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Transactions of Tianjin University 2017年第2期23卷 176-183页

作者： Chang Tang Chunping Hou School of Electrical and Information Engineering Tianjin University Tianjin 300072 China

A structured low-rank matrix recovery model for RGBD salient object detection is proposed. Firstly, the problem is described by a low-rank matrix recovery, and the hierarchical structure of RGB image is added to the sparsity term. Secondly, the depth information is fused into the model by a Laplacian regularization term to ensure that the image regions which share similar depth value will be allocated to similar saliency value. Thirdly, a variation of alternating direction method is proposed to solve the proposed model. Finally, both quantitative and qualitative experimental results on NLPR1000 and NJU400 show the advantage of the proposed RGBD salient object detection model.

关键词： RGBD saliency detection Low-rank matrix recovery Laplacian regularization structured sparsity

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An improved damaging model for structured clays

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Journal of Central South University 2008年第S2期15卷 76-80页

作者：姜岩雷华阳郑刚徐舜华 Department of Civil Engineering Tianjin University

An improved damaging model formulated within the framework of bounding surface for structured clays was proposed. The model was intended to describe the effects of structure degradation due to geotechnical loading. The predictive capability of the model was compared with those of triaxial compression test on Tianjin soft clays. The results show that, by incorporating a new damage function into the model, the reduction of elastic bulk and shear modulus with elastic deformations and the reduction of plastic bulk modulus and shear modulus with plastic deformations are able to be appreciable. Before the axial strain reaches 15%, the axial strain computed from the model is smaller than that from the test under the drained condition. Under the undrained condition, after the axial strain reaches 1%, the axial strain increases quickly because of the complete loss of structure and stiffness; and the result computed from the model is nearly equal to that from the model without the incorporation of the damage function due to less plastic strain under undrained condition test.

关键词： structured clays constitutive relation soil structure bounding surface damage function

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Fast 3D reconstruction of dental cast model based on structured light

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Optoelectronics Letters 2018年第6期14卷 457-460页

作者：宋丽梅林文伟杨燕罡朱新军郭庆华杨怀栋 Key Laboratory of Advanced Electrical Engineering and Energy Technology Tianjin Polytechnic University School of Mechanical Engineering Tianjin University of Technology and Education School of Electrical Computer and Telecommunications Engineering University of Wollongong Department of Precision Instrument Tsinghua University

To quickly obtain accurate 3D data of dental cast model, this paper proposes a 3D reconstruction method for dental cast model based on structured light. This method combines the structured light with the motor turntable to obtain a group of 3D data for the dental cast model from multiple angles, and automatically registers the dental 3D data from multiple angles through the ball calibration of turntable. Compared with the real data of the dental cast model, the maximum error of the 3D reconstruction results in this paper is 0.115 mm. The reconstruction time of this process is about 130s. The experimental results show that the method has high precision and high scanning speed for the 3D reconstruction of the dental cast model.

关键词： structured light dental cast model based 3D reconstruction

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Injection molding of nano structured 90W-7Ni-3Fe alloy powder prepared by high energy ball milling

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中国有色金属学会会刊：英文版 2000年第6期10卷 794-797页

作者：范景莲曲选辉黄伯云中南工业大学粉末冶金国家重点实验室湖南长沙

Blended elemental 90W 7Ni 3Fe (mass fraction, %) powder was mechanically alloyed in a planetary ball mill. Nano crystalline grains were obtained after 10 h milling. The nano structured powder was processed to full density by metal injection molding approach. Compacts from the optimal powder binder mixture were studied for molding and sintering behaviors. Milling significantly increases the maximum powder loading and homogeneity of the feedstock, and enhances the sintering densification process. When solid state sintered at 1 350～1 450 ℃, the alloy shows very fine grains (～3 μm), high tensile strength (>1 130 MPa) and almost no distortion. [

关键词： tungsten heavy alloy nano structured powder injection molding

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Effect of solution concentration on the structured order and optical properties of short-chain polyene biomolecules

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Science China(Physics,Mechanics & Astronomy) 2010年第9期53卷 1646-1650页

作者： OUYANG ShunLi1,2,SUN ChengLin1,2,ZHOU Mi1,2,LI DongFei2,WANG WeiWei1,2,QU GuanNan1,LI ZuoWei1,2,GAO ShuQin1 & YANG JianGe3 1 State Key Laboratory of Superhard Materials,Jilin University,Changchun 130012,China 2 College of Physics,Jilin University,Changchun 130023,China 3 The ordnance Engineering Department,Air Force Aviation University,Changchun 130022,China State Key Laboratory of Superhard Materials Jilin University Changchun China College of Physics Jilin University Changchun China The ordnance Engineering Department Air Force Aviation University Changchun China

We have measured the Raman spectra and UV-Vis absorption spectra of linear polyene biomolecules(β-carotene and lycopene) in CS2 at low concentrations(10-6-10-10 mol/L).With decreasing concentration,all the carbon-carbon vibrations form a coherent mode in ordered β-carotene and lycopene due to extended π-conjugation that gives strong electron-phonon coupling,which leads to an anomalous experimental phenomenon.We observed an extremely high Raman scattering cross section(RSCS) and the Raman activities in β-carotene and lycopene are characterized by intensive overtones and combinations.Further,the UV-Vis absorption bands become narrower.

关键词： molecular structured order Raman spectroscopy Raman scattering cross section

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Developing Agility from a structured Perspective

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Journal of Donghua University(English Edition) 2001年第3期18卷 80-82页

作者： Chen Jixiang(陈继祥) WangJianbao(王俭保) Management School Shanghai Jiaotong University Shanghai 200030 Management School Shanghai Jiaotong University Shanghai 200030

Modeling plays an important role in understanding and implementation of manufacturing system under changing competitive environment. Agile manuincturing is a new pattern of production. It is the issue to identify, analyze and evaluate agility for involved people, information,process and organization. There is no commonly accepted analytical structure. The essence of agility is investigated and a model to develop agility is elucidated.

关键词： agility, structured perspective, agile manufact uring .

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Visualization of structured Packing with Laser Induced Fluorescence Technique: Two-Dimensional Measurement of Liquid Concentration Distribution

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Transactions of Tianjin University 2016年第5期22卷 466-472页

作者：刘伯潭申言同张会书刘春江唐忠利袁希钢 State Key Laboratory of Chemical Engineering School of Chemical Engineering and TechnologyTianjin University Tianjin 300072 China College of Chemical Engineering and Materials Science Tianjin University of Science and TechnologyTianjin 300222 China Tianjin Key Laboratory of Marine Research and Chemistry Tianjin 300222 China

A method of using laser induced fluorescence(LIF)technique was applied to two-dimensional measurement of the liquid concentration distribution in the 250 Y structured packing sheet. The experimental structured packing sheet was made of perspex so that the laser could pass through it. The visualization of the distribution of the liquid concentration in the structured packing sheet was realized. The calibration of the thickness and liquid concentration was carried out firstly and the regression formula I=kcd was acquired, in which concentration c and the liquid film thickness d were both considered. Then the liquid feed of uniform tracer(rhodamine)concentration entered the perspex structured packing from the top under different spraying densities. The corresponding thickness of liquid film on the packing was calculated. Finally, tracer(rhodamine)with a high concentration was injected only at one fixed point of the structured packing under different spraying densities of the liquid. With the known liquid film thickness, the concentration distribution of the tracer can be calculated inside the structured packing sheet.

关键词： LIF visualization structured packing liquid distribution rhodamine

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Singular perturbation analysis of a two-site model for an epidemic in age-structured population

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International Journal of Biomathematics 2018年第7期11卷 83-107页

作者： Rodrigue Yves M'pika Massoukou Hermane Mambili-Mamboundou School of Mathematics Statistics and Computer Science University of KwaZulu-Natal145 King Edward Avenue PietermaritzburgKwaZulu-Natal 3209/ScottsvilleSouth Africa School of Mathematical and Statistical Sciences North-West University Mafikeng Campus Unit 5 Corner of Albert Luthuli and University Drive Mmabatho2735South Africa

We formulate a model describing the dynamics for the spatial propagation of an SIS epidemic within a population,with age structure,living in an environment divided into two sites.An analysis of the model is given.We prove the existence of a unique disease free equilibrium (DFE)and its (local and global)stability.Further,we assume that fast infection processes and fast migration processes take place in the above-mentioned model;i.***.such processes last only a few days (less than a week).In opposition to such processes,demographic processes such as birth,death and maturation last quite a lot of years.Such a gap between the time scales gives rise to a multiple time scales model,in particular a singularly perturbed model.Through a singular perturbation analysis,based on Tikhonov theorem,we prove that for certain classes of initial conditions the nonlinear perturbed model can be approximated with very good accuracy by lower-dimensional linear models.

关键词： SIS epidemic model age structured population spatial dynamics multiple time scales slow-fast system dynamical system Tikhonov theorem

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