Articles: cations.
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Anesthesia and analgesia · Dec 2024
An Evaluation of the Transfer of Skills and Knowledge from Two World Federation of Societies of Anaesthesiologists Fellowship Programs.
Subspecialist training is an important part of developing human resources for health and for some learners, may require taking place in another, higher-resourced country. Despite effective learning of skills and knowledge in a different, more highly resourced context, transfer of these skills and knowledge back to a more poorly resourced context can be a challenge. We aimed to evaluate the transfer of skills and knowledge in 2 World Federation of Societies of Anaesthesiologists (WFSA) fellowship programs. ⋯ Our study found that the 2 fellowship programs had variable success in the transfer of learned skills and knowledge back to the fellows' "home" institutions. Contextual differences between the fellowship institution and the home institution were the main source of barriers to transfer, and fellows from different countries had diverse needs. Supporting the transfer of knowledge and skills should be an explicit goal of these fellowship programs, and as such, should be considered in the recruitment of fellows, curriculum development, and in how the success of a fellowship is evaluated. Curricula should not just focus on medical knowledge and skills, but also skills in leading change and in education.
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Treatment selection for brain arteriovenous malformations (BAVMs) is complicated by BAVM size, location, and hemodynamics. Quantitative digital subtraction angiography is used to quantify the hemodynamic impact of BAVMs on cerebral circulation. This study investigated the association between cerebral circulation time and the complete obliteration (CO) rate of BAVMs after stereotactic radiosurgery (SRS). ⋯ The hemodynamic impact of high-flow BAVM demonstrated by a shortened mCCT is associated with a lower BAVM CO rate after SRS.
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Adults with achondroplasia are more vulnerable to suffer from neurogenic claudication because of a congenital narrow spinal canal, which makes them susceptible to lumbar spinal stenosis (LSS). The study aims to investigate the correlations between sagittal alignment parameters and the degree of LSS in patients with achondroplasia with LSS. ⋯ The upper LSS may be attributed to an increased kyphosis of the thoracolumbar spine. On the contrary, the lower LSS seemed to be correlated with a more backward tilt of the pelvis.
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There is a rich literature describing the loss of dorsal root ganglion (DRG) neurons following peripheral axotomy, but the vulnerability of discrete subpopulations has not yet been characterised. Furthermore, the extent or even presence of neuron loss following injury has recently been challenged. In this study, we have used a range of transgenic recombinase driver mouse lines to genetically label molecularly defined subpopulations of DRG neurons and track their survival following traumatic nerve injury. ⋯ We show that this subpopulation is almost entirely lost following spared nerve injury and severely depleted (by roughly 50%) following sciatic nerve crush. Finally, we used an in vitro model of DRG neuron survival to demonstrate that nonpeptidergic nociceptor loss is likely dependent on the absence of neurotrophic support. Together, these results profile the extent to which DRG neuron subpopulations can survive axotomy, with implications for our understanding of nerve injury-induced plasticity and pain.