Does bench model fidelity interfere in the acquisition of suture skills by novice medical students?

OBJETIVO: Embora vários modelos de bancada inanimados tenham sido descritos para o treinamento de habilidades de sutura, até o momento, não existe um método ideal para esse ensino e aprendizagem durante a formação médica. O objetivo foi avaliar se a fidelidade dos modelos de bancada interfere na aquisição de habilidades de sutura em estudantes de medicina iniciantes na prática cirúrgica. MÉTODOS: 36 estudantes de medicina sem exposição prévia a habilidades cirúrgicas foram randomizados em três grupos (n = 12): treinamento de suturas baseado em materiais didáticos (controle); treinamento de suturas em modelo de baixa-fidelidade (modelo de bancada de etileno vinil acetato); ou treinamento de suturas em modelo de alta-fidelidade (modelo de bancada de pele de pata de porco). Foram aplicados pré e pós-testes (realização de pontos simples e pontos subdérmicos invertidos em língua de boi). Três ferramentas (Global Rating Scale com avaliação cega, tamanho do efeito e autopercepção da confiança baseada em uma escala de Likert) foram utilizadas para mensurar todas as performances de sutura. RESULTADOS: A análise após o treinamento demonstrou que os estudantes que treinaram nos modelos tiveram um melhor (p < 0.0000) desempenho na avaliação pela Global Rating Scale, quando comparados com o controle, independente da fidelidade do modelo. A magnitude do efeito (treinamento) foi considerada grande (> 0.80) em todas as mensurações. Após o treinamento os alunos sentiram-se mais confiantes (p < 0.0000) para executarem os dois tipos de suturas. CONCLUSÃO: A aquisição de habilidades de suturas no modelo de baixa fidelidade foi semelhante à prática no modelo de alta fidelidade, sendo que a melhora no desempenho dos participantes que treinaram nesses dois modelos foi superior à aprendizagem baseada em materiais didáticos.

Dietary intervention with narrow-leaved cattail rhizome flour (Typha angustifolia L.) prevents intestinal inflammation in the trinitrobenzenesulphonic acid model of rat colitis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Some comments on the numerical simulation of self-synchronization of four non-ideal exciters

In this paper, self-synchronization of four non-ideal exciters is examined via numerical simulation. The mathematical model consists of four unbalanced direct Current motors with limited power supply mounted on a flexible Structural frame support. (c) 2004 Elsevier B.V. All rights reserved.

Short comments on self-synchronization of two non-ideal sources supported by a flexible portal frame structure

A practical problem of synchronization of a non-ideal (i.e. when the excitation is influenced by the response of the system) and non-linear vibrating system was posed and investigated by means of numerical simulations. Two rotating unbalanced motors compose the mathematical model considered here with limited power supply mounted on the horizontal beam of a simple portal frame. As a starting point, the problem is reduced to a four-degrees-of-freedom model and its equations of motion, derived elsewhere via a Lagrangian approach, are presented. The numerical results show the expected phenomena associated with the passage through resonance with limited power. Further, for a two-to-one relationship between the frequencies associated with the first symmetric mode and the sway mode, by using the variation of torque constants, the control of the self-synchronization and synchronization (in the system) are observed at certain levels of excitations.

On an Optimal Linear Control Applied to a Non-Ideal Load Transportation System, Modeled with Periodic Coefficients

In this paper, a load transportation system in platforms or suspended by cables is considered. It is a monorail device and is modelled as an inverted pendulum built on a car driven by a DC motor. The governing equations of motion were derived via Lagrange's equations. In the mathematical model we consider the interaction between the DC motor and the dynamical system, that is, we have a so-called non-ideal periodic problem. The problem is analysed and we also developed an optimal linear control design to stabilize the problem.

Control and chaos for vibro-impact and non-ideal oscillators

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

On an Non-Ideal Global and Local Energy Transfer, Using an Electro-Magneto and Magneto-Rheological Dampers

In this paper, we investigated the nonlinear vibrations of a Non-ideal (NIS) electromechanical absorber (NEVA), taking into account a modified mathematical model of (MR) Damper. We observed the presence of the Sornmerfeld effect (it is the steady state frequencies of the DC motor, which it will usually increasing as more power (Voltage) is given to it, in a step-by-step fashion. When a resonance condition it is reached, the better part of this energy it is consumed to generate large amplitude vibrations of the foundation, without sensible change of the motor frequency). The obtained results, by using numerical and analytical simulations, were discussed, in details.

On a nonlinear and chaotic non-ideal vibrating system with shape memory alloy (SMA)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Nonlinear Dynamics and Control of an Ideal/Nonideal Load Transportation System With Periodic Coefficients

In this paper, a loads transportation system in platforms or suspended by cables is considered. It is a monorail device and is modeled as an inverted pendulum built on a car driven by a dc motor the governing equations of motion were derived via Lagrange's equations. In the mathematical model we consider the interaction between the dc motor and the dynamical system, that is, we have a so called nonideal periodic problem. The problem is analyzed, qualitatively, through the comparison of the stability diagrams, numerically obtained, for several motor torque constants. Furthermore, we also analyze the problem quantitatively using the Floquet multipliers technique. Finally, we devise a control for the studied nonideal problem. The method that was used for analysis and control of this nonideal periodic system is based on the Chebyshev polynomial exponsion, the Picard iterative method, and the Lyapunov-Floquet transformation (L-F transformation). We call it Sinha's theory.

On a control of a non-ideal mono-rail system with periodics coefficients

In this work, the problem in the loads transport (in platforms or suspended by cables) it is considered. The system in subject is composed for mono-rail system and was modeled through the system: inverted pendulum, car and motor and the movement equations were obtained through the Lagrange equations. In the model, was considered the interaction among of the motor and system dynamics for several potencies motor, that is, the case studied is denominated a non-ideal periodic problem. The non-ideal periodic problem dynamics was analyzed, qualitatively, through the comparison of the stability diagrams, numerically obtained, for several motor torque constants. Furthermore, one was made it analyzes quantitative of the problem through the analysis of the Floquet multipliers. Finally, the non-ideal problem was controlled. The method that was used for analysis and control of non-ideal periodic systems is based on the Chebyshev polynomial expansion, in the Picard iterative method and in the Lyapunov-Floquet transformation (L-F trans formation). This method was presented recently in [3-9].

Applying a new methodology to verify transmission line model performance - the equivalent impedance test

The objective of this paper is to present a methodology to analyze a transmission line model used in electromagnetic transitory simulators, called equivalent impedance test. Initially the definition of equivalent impedance reference test is shown. Soon after this methodology is applied to a transmission line model, the Quasi-Modes model. The studies were accomplished in a hypothetical non-transposed three-phase transmission fine of 440 kV. The line length is 500 km, and it was modeled through cascades of pi-circuits (with 50 pi's circuits, each with 10 km length).

Temperature and concentration dependence of heat capacity of model aqueous solutions

Heat capacities of binary aqueous solutions of different concentrations of sucrose, glucose, fructose, citric acid, malic acid, and inorganic salts were measured with a differential scanning calorimeter in the temperature range from 5degreesC to 65degreesC. Heat capacity increased with increasing water content and increasing temperature. At low concentrations, heat capacity approached that of pure water, with a less pronounced effect of temperature, and similar abnormal behavior of pure water with a minimum around 30degreesC-40degreesC. Literature data, when available agreed relatively well with experimental values. A correction factor, based on the assumption of chemical equilibrium between liquid and gas phase in the Differential Scanning Calorimeter, was proposed to correct for the water evaporation due to temperature rise. Experimental data were fitted to predictive models. Excess molar heat capacity was calculated using the Redlich-Kister equation to represent the deviation from the additive ideal model.

Use of ideal protein concept for precision formulation of amino acid levels in fish-meal-free diets for juvenile Nile tilapia (Oreochromis niloticus L.)

This study was undertaken in a closed system with Nile tilapia (Oreochromis niloticus) to examine the effects of total replacement of fish meal (FM) by soybean meal. Nile tilapia fingerlings with an average weight of 5.34+/-0.08 g were hand-fed one of the five isoenergetic (approximate to13.5 MJ digestible energy kg(-1)) and isoproteic (approximate to31% of digestible protein) experimental diets to satiation, six times a day during 85 days in eight replicate fibreglass tanks (six fish per tank). The control diet containing FM was substituted by soybean meal, with and without essential amino acids (lysine, methionine and threonine) or dicalcium phosphate supplementation. The supplemental amino acids were added at levels to simulate the reference amino acid profile of Nile tilapia carcass protein, based on the ideal protein concept. The results showed that soybean meal diet supplemented only with dicalcium phosphate was inferior to the control diet with FM and soybean meal diets supplemented with dicalcium phosphate and essential amino acids. Multiple essential amino acids and dicalcium phosphate incorporation in soybean meal diets was associated with performance, whole-body composition and carcass yield equal to that of the fish fed with the control diet containing FM. These data suggest that a diet with all plant protein source, supplemented with essential amino acids, based on tissue amino acid profile, can totally replace FM in a diet for Nile tilapia, without adverse effects on the growth performance, carcass yield and composition.

Intrauterine dentistry: an integrated model of prevention.

Intrauterine Dentistry is a highly relevant subject of our time. The use of preventive measures in the intrauterine stage can avoid several diseases, among these, dental caries. The WHO advises that from the 4th month of pregnancy, women should avoid the intake of sugar, so that the fetus, future child, does not develop an exaggerated attraction for these types of foods, thus being susceptible to caries. Through questionnaires sent to gynecologist-obstetricians and dentists, this research investigated the information they have about this subject and how they instruct their patients. Questionnaires were also sent to pregnant women requesting information about the instructions they had received for the prevention of oral diseases of their fetus. Seventy-one percent of the dentists and 80% of the gynecologist-obstetricians reported having instructed the pregnant women to reduce the intake of sugar. However, only 13.6% of the dentists and no gynecologist-obstetrician instructed the reduction of sugar intake between the 12th and 18th week of pregnancy. A total of 42.2% of the pregnant women referred to these instructions, but none received instruction as to the specific period of the 12th and 18th week. An ideal model of treatment for pregnant women must include integrated and multiprofessional treatment, in which general dentists and gynecologist-obstetricians work together with the participation of the patient.

On non-ideal and non-linear portal frame dynamics analysis using Bogoliubov averaging method

We apply the Bogoliubov Averaging Method to the study of the vibrations of an elastic foundation, forced by a Non-ideal energy source. The considered model consists of a portal plane frame with quadratic nonlinearities, with internal resonance 1:2, supporting a direct current motor with limited power. The non-ideal excitation is in primary resonance in the order of one-half with the second mode frequency. The results of the averaging method, plotted in time evolution curve and phase diagrams are compared to those obtained by numerically integrating of the original differential equations. The presence of the saturation phenomenon is verified by analytical procedures.