DLS Group Research Articles

Safe gastric wall closure in dogs using a single-layer full-thickness simple continuous suture pattern.

To evaluate different suture patterns for gastrostomy closure, with a focus on major complications and survival time. We hypothesized that using a full-thickness single-layer simple continuous pattern would be as safe as the traditional double-layer pattern and would not be associated with more major complications. To our knowledge, this is the first study to compare the suture patterns used for gastric closure in clinical situations. 60 dogs that underwent gastrostomy for foreign body removal, with 20 dogs in each group. Dogs treated with gastrotomy from January 1, 2018, to January 1, 2023, were randomly assigned to groups based on the suture pattern used at the gastrotomy site. Gastrotomies were closed with a double-layer inverting continuous pattern (DLI) in the DLI group. Gastrotomies were closed using a double-layer simple continuous pattern (DLS) in the DLS group. Gastrotomies were closed with a full-thickness single-layer simple continuous pattern (SLS) in the SLS group. All dogs were discharged from hospitalization. The survival rate did not differ among the 3 groups 1 month postoperatively, and major complications were not observed. Using a full-thickness single-layer pattern is a safe alternative for gastrotomy closure.

Possibilities of Diffusion-Weighted MRI in Clarification of the Degree of Malignance of Recurrent Retroperitoneal Liposarcomas

Purpose: The aim of our study was to study the possibilities of DW-MRI in the differential diagnosis of recurrent retroperitoneal highly differentiated and dedifferentiated liposarcomas (WLS and DLS respectively). Material and methods: The study is based on the data of a retrospective study of 36 patients who underwent surgery on for retroperitoneal highly differentiated (n = 27) and dedifferentiated liposarcomas (n = 9). All patients received MRI of the abdominal cavity and pelvis without intravenous contrast enhancement with further assessment of size, shape, contours and structure. When analyzing DW-MRI and ADC maps, small soft tissue nodes were evaluated. Results: Morphological studies were performed in all patients. The results of the qualitative analysis showed statistically significant differences in the differential diagnosis of WLS recurrences from DPS in the presence of septa and pseudocapsule ( p = 0.0032 and p = 0.0028, respectively). The results of the study demonstrated differences in the ADC values in the solid component of recurrent tumors of WLS and DLS: the median ADC values in the WLS group were higher (1960×10 –6 mm 2 /s) than in the DLS group (1031×10 –6 mm 2 /s). The sensitivity of this sign in the differential diagnosis of WLS from DLS was 87.5 %, the specificity was 70 %.

Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P61. Clinical outcomes of microendoscopic decompression for lumbar canal stenosis: a comparison between patients with and without degenerative lumbar scoliosis

BACKGROUND CONTEXT The operative management of degenerative lumbar scoliosis includes decompression or decompression with fusion. However, there is currently no consensus on the criteria for the role of adjunctive fusion. We have performed microendoscopic decompression in patients with the chief complaint of radicular and/or cauda equina symptoms due to degenerative lumbar scoliosis. Although the surgical procedure almost improved leg symptoms, it seemed that the patients had severe low back pain postoperatively as compared with patients without degenerative lumbar scoliosis. PURPOSE To compare the clinical outcomes of microendoscopic decompression for lumbar canal stenosis between patients with and without degenerative lumbar scoliosis. METHODS A total of 75 patients with lumbar canal stenosis between March 2006 and December 2014 were included in this study. The patients who had disc herniation and foraminal stenosis were excluded. The patients were treated with microendoscopic decompression and followed more than two years after the surgery. Of those, 34 were males and 41 were females. The mean age at the time of the surgery was 73.1years (range, 61–86 year). The mean follow-up period was 48.1 months (range, 24–102 months). Twenty-seven patients had degenerative lumbar scoliosis with coronal curvature of more than 10° measured by Cobb's method (DLS group). The other 48 patients had neither degenerative lumbar scoliosis nor degenerative lumbar spondylolisthesis (nonDLS group). Clinical outcomes were assessed using the Japanese Orthopedic Association (JOA) score and Short-Form 36 (SF-36) preoperatively and at the final follow-up. Recovery rate of the JOA score was calculated as (postoperative score − preoperative score)/(29 − preoperative score)×100%. The visual analogue scale (VAS) for low back pain was also measured at the final follow-up. RESULTS In the DLS group, the JOA score significantly improved from 13.7 preoperatively to 23.4 postoperatively. Also in the nonDLS group, the preoperative JOA score of 15.7 significantly improved to 25.0 postoperatively. Recovery rate in the DLS and nonDLS group were 62.5% and 69.0%, respectively. There were no significant differences in preoperative and postoperative JOA scores between the two groups. At the final follow-up, VAS for low back pain in the DLS group (45.4 mm) was significantly higher than that in the nonDLS group (25.4 mm). As for the preoperative SF-36 score, there were no significant differences in all 8 subscales between the two groups. In the DLS group, a significant improvement was observed only in bodily pain scores after surgery. In the nonDLS group, all subscales except general health perception significantly improved after surgery. All postoperative subscales except social role function and mental health in the DLS group were significantly lower than in the nonDLS group. CONCLUSIONS This study showed that the patients with lumbar degenerative scoliosis had higher VAS for low back pain and lower QOL scores after microendoscopic decompression as compared with the patients without lumbar degenerative scoliosis. We might consider other surgical options in patients with lumbar canal stenosis due to degenerative lumbar scoliosis.

Clinical Outcome of Muscle-Preserving Interlaminar Decompression (MILD) for Lumbar Spinal Canal Stenosis: Minimum 5-Year Follow-Up Study.

Introduction Favorable short-term outcomes have been reported following muscle-preserving interlaminar decompression (MILD), a less invasive decompression surgery for lumbar spinal canal stenosis (LSCS). However, there are no reports of mid- to long-term outcomes. The purpose of this study was to evaluate the clinical outcomes five or more years after treatment of LSCS with MILD. Methods Subjects were 84 cases with LSCS (44 males; mean age, 68.7 years) examined five or more years after MILD. All patients had leg pain symptoms, with claudication and/or radicular pain. The patients were divided into three groups depending on the spinal deformity: 44 cases were without deformity (N group); 20 had degenerative spondylolisthesis (DS group); and 20 had degenerative scoliosis (DLS group). The clinical evaluation was performed using Japanese Orthopedic Association (JOA) scores, and revision surgeries were examined. Changes in lumbar alignment and stability were evaluated using plain radiographs. Results The overall JOA score recovery rate was 65.5% at final follow-up. The recovery rate was 69.5% in the N group, 65.2% in the DS group, and 54.0% in the DLS group, with the rate of the DLS group being significantly lower. There were 16 revision surgery cases (19.0%): seven in the N group (15.9%), three in the DS group (15.0%) and six in the DLS group (30.0%). There were no significant differences between pre- and postoperative total lumbar alignment or dynamic intervertebral angle in any of the groups, slip percentage in the DS group, or Cobb angle in the DLS group. Conclusions The mid-term clinical results of MILD were satisfactory, including in cases with deformity, and there was no major impact on radiologic lumbar alignment or stability. The clinical outcomes of cases with degenerative scoliosis were significantly less favorable and the revision rate was high. This should be taken into consideration when deciding on the surgical procedure.

Dynamization at the near cortex in locking plate osteosynthesis by means of dynamic locking screws: an experimental study of transverse tibial osteotomies in sheep.

Locking plates are widely used in fracture fixation, mainly for meta-diaphyseal fractures, comminuted fractures, fractures with a critical-size bone defect, periprosthetic fractures, osteotomies, and fractures in osteoporotic bone. The aim of this animal study was to evaluate the effect on bone-healing of dynamization of locking plate constructs by means of new 5.0-mm dynamic locking screws (in the DLS group), which allow near-cortex micromotion, compared with a more rigid construct utilizing standard bicortical locking-head screws (in the LS group). Use of dynamic locking screws allows modulation of the stiffness of existing locking compression plate systems via parallel interfragmentary micromotion. A standardized diaphyseal tibial osteotomy (90°, 3-mm fracture gap) was performed and stabilized with a six-hole large-fragment locking compression plate in twelve female sheep (six in each group). Radiographs were made postoperatively and then weekly from week three until sacrifice at nine weeks. Macroscopic, biomechanical, histologic, and radiographic assessments and microcomputed tomography were performed. The callus in the tested specimens in the DLS group had better biomechanical stability, with a significantly greater maximum failure moment (mean and standard deviation [SD] as a percentage of intact, 55.15 ± 20.65 compared with 26.80 ± 14.96 in the LS group; p = 0.021). The DLS group also had greater periosteal callus volume at the near cortex (mean volume and SD as a percentage of the tibial shaft volume, 36.21% ± 10.08% compared with 18.98% ± 8.61% in the LS group; p = 0.026) and in the intercortical region (mean volume and SD as a percentage of the bone volume of the tibial shaft, 3.56% ± 0.52% compared with 2.64% ± 0.98% in the LS group; p = 0.045), as shown by microcomputed tomography. The DLS group also had significantly greater torsional stiffness (mean and SD as a percentage of intact, 84.88 ± 13.51 compared with 58.89 ± 20.61 in the LS group; p = 0.027). Controlled micromotion and nearly homogeneous interfragmentary strain at the fracture site, together with the stable bicortical fixation achieved by the new dynamic locking screw, led to more uniform callus formation, significantly more callus formation at the near cortex, and biomechanically more competent bone-healing compared with use of rigid locking plate constructs with locking-head screws.

High-salt intake suppressed microRNA-133a expression in Dahl SS rat myocardium.

Salt-sensitive individuals show earlier and more serious cardiac damage than nonsalt-sensitive ones. Some studies have suggested that microRNA-133a could reduce cardiac hypertrophy and myocardial fibrosis. The current study aims to investigate the different functions of high-salt intake on salt-sensitive (SS) rats and Sprague-Dawley (SD) rats and the involvement of microRNA-133a in these roles. After high-salt intervention, the left ventricular mass (LVW) and left ventricular mass index (LVMI) of the salt-sensitive high salt (SHS) group were obviously higher than those of the salt-sensitive low salt (SLS) group. However, the difference between the Sprague-Dawley high salt (DHS) group and the Sprague-Dawley low salt (DLS) group was not significant. Compared with SLS group, collagen I and connective tissue growth factor (CTGF) in the heart of SHS group were significantly higher, whereas no statistical difference was observed between the DHS group and the DLS group. Compared with low-salt diet, microRNA-133a in the heart of both strains were significantly decreased, but that in the SHS group decreased more significantly. These results suggest that high salt intervention could down-regulate the expression of myocardial microRNA-133a, which may be one of the mechanisms involved in myocardial fibrosis in salt-sensitive hypertension.

Correlation of low back pain caused by lumbar spinal stenosis and depression in women: a clinical study

Low back pain (LBP) due to spinal stenosis may be one of the most debilitating symptoms to decrease the quality of life. The cause and effect association of LBP and depression is vague. Pain may also be a somatization symptom of depression. This is more frequent in the female population. This clinical study was designed to evaluate the correlation between the level of back pain caused by lumbar spinal stenosis and depression in the female population. The study included 50 consecutive female patients with spinal stenosis. The stenosis diagnosis is made by neurological examination and neuro-imaging. The study group was psychiatrically evaluated and grouped as those with and without depression. Visual analog scale (VAS), Oswestry disability index (ODI) and Hamilton Depression Scale (HDS) were utilized in initial evaluation of the group. Twenty-one patients with lumbar spinal stenosis had depression (DLS Group) and 29 did not (LSS Group). Mean HDS scores were 8.97 and 32.48 for Group LSS and Group DLS, respectively. There was a statistically significant difference between the VAS scores of the groups (the mean VAS scores were 5.6 and 7.6, for groups LSS and DLS, respectively). The mean ODI values for LSS (65.24±4.58) and DLS (75.1±6.7) groups were also significantly different. In Group DLS, there were positive correlations between ODI and VAS with HDS (p<0.001). Our findings indicated a relationship between lumbar spinal stenosis associated pain levels and depression. However, the cause and result relationship still needs to be established yet.

Air-Q the Intubating Laryngeal Airway: Comparative study of hemodynamic stress responses to tracheal intubation via Air-Q and direct laryngoscopy

Background: Tracheal intubation is the gold standard for securing airway. Tracheal intubation through DLS produces marked hemodynamic stress responses. The Air-Q is a new supraglottic airway device. The purpose of this study was to determine whether endotracheal intubation through Air-Q is associated with lesser hemodynamic stress responses.Methods: 60 patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation were randomly assigned into two groups. Direct laryngoscopy group and Air-Q group. Blood pressure and heart rate were recorded before, after induction, immediately after intubation and every minute for 4 min after intubation. The intubation time was recorded. Upon removal of the Air-Q, trauma to the upper airway was reported.Results: The intubation time was shorter in the DLS group compared with the Air-Q group (P value < 0.05). A significant reduction in BP was evident after the induction of anesthesia in both groups. Immediately after intubation, there was a significant increase in BP compared with the preintubation values. A decline was inspected between 1 and 4 min postintubation in both groups with significant difference immediately, at 1 and 2 min postintubation between the two groups. There were significant increase in HR immediately, at 1 and 2 min postintubation compared with the preintubation values, but there was no significant difference at each time point between two groups. Sore throat was more in the Air-Q group (P value <0.05).Conclusion: The hemodynamic stress response to intubation by Air-Q is less than that of DLS despite the longer duration of the former.

Efficacy of the new double-layer stent for unresectable distal malignant biliary obstruction: a single-center retrospective study.

Background and Aims. For distal malignant biliary obstruction in cases with short life expectancy, occlusion of plastic stents (PSs) does not usually occur before death, and the application of such a procedure is considered adequate from the viewpoint of cost-effectiveness. Methods and Setting. A new commercially available DLS with side holes, a conventional DLS, and, uncovered self-expanding metal stents (SEMSs) were retrospectively evaluated in patients with jaundice due to unresectable distal malignant biliary obstruction. Results. A total of 64 patients received endoscopic biliary stenting (23 patients with the new DLS, 24 patients with conventional DLS, and 17 patients with uncovered SEMS) from December 2002 to August 2009. Median patency time was found to be 198 days for the new DLS group and 99 days for the conventional DLS group, revealing a significant difference between devices. There was, however, no significant difference in median patency time between the new DLS and the uncovered SEMS (198 days versus 344 days). Conclusion. The new DLS is efficient and safe and may be considered the first choice for unresectable distal malignant obstruction in cases with short life expectancy.

Evaluation of a synchronous twin‐pulse technique for shock wave lithotripsy: a prospective randomized study of effectiveness and safety in comparison to standard single‐pulse technique

To asses the efficacy and safety of bidirectional synchronous twin-pulse extracorporeal shock wave lithotripsy (ESWL) compared with standard ESWL. Between March 2003 and December 2006, 240 patients with a radio-opaque single renal stone of <or=25 mm were randomized to treatment either by the Twinheads (TH) lithotripter (FMD, Lorton, Virginia, USA) or the Dornier Lithotripter S (DLS, Dornier MedTech Europe GmbH, Germering, Germany). Before and after ESWL, urinary N-acetyl-B-glucosaminidase (NAG) levels were assessed and patients were evaluated with dynamic MRI. The efficacy and complications were compared, with success defined as no residual fragments. For stones of >10 mm the rate for the failure of disintegration was 13.3% for the DLS vs 1.4% for the TH (P = 0.009). For stones of <or=10 mm the stone-free rate was 74.4% for the TH vs 67.7% for the DLS (P = 0.6), while for stones of >10 mm it was 78.1% and 66.7%, respectively (P = 0.14). The median (range) number of sessions in both groups was 2 (1-5). After ESWL urinary NAG levels were increased significantly in both groups; in the TH group it declined below the level before ESWL after 2 days, while in the DLS group it remained high after 7 days. In the DLS group four patients developed subcapsular or parenchymal haematoma after ESWL, vs none in the TH group. There was loss of corticomedullary differentiation after ESWL in three patients in the DLS group and only one in the TH group. In the DLS group there was a statistically significantly decrease in bilateral renal perfusion after ESWL, but no changes in the TH group. Synchronous twin-pulse ESWL has clinical advantages over standard ESWL in terms of safety and efficacy.

Visceral syndrome differentiation in traditional Chinese medicine and the changes of nutrition status or blood gas analysis in patients with chronic obstructive pulmonary disease

To investigate the relationship between visceral syndrome differentiation in traditional Chinese medicine (TCM) and the changes of nutrition status or blood gas analysis in patients with chronic obstructive pulmonary disease (COPD). Sixty patients with COPD in stable phase were divided into dysfunction of lung (DL, n=20) group, dysfunction of lung and spleen (DLS, n=16) group and dysfunction of lung, spleen and kidney (DLSK, n=24) group according to syndrome differentiation of TCM. Moreover, the basic electric rhythm, percentage of bradygastria in electrogastrogram (EGG), ratio of actual body weight (ABW) to ideal body weight (IBW) and serum albumin level were determined to evaluate the nutrition status of the patients with COPD. Blood gas analysis was made too. The basic electric rhythm values in the DL, DLS and DLSK groups were (56.20+/-13.24)%, (47.38+/-10.24)% and (41.35+/-10.01)%, respectively. Compared with the DL group, the basic electric rhythm values in the DLS and DLSK groups decreased obviously (P<0.05). The percentages of bradygastria in the DL, DLS and DLSK groups were (45.18+/-18.13)%, (46.31+/-15.83)% and (49.90+/-17.54)%, respectively, and there were no differences among the three groups (P>0.05). The incidence rates of ABW/IBW<90% in the DL, DLS and DLSK groups were 50%, 75% and 54.17%, respectively, and there were no differences among the three groups (P>0.05). The incidence rates of serum albumin less than 35 g/L were 20%, 37.5% and 54.17%, respectively, and there were no differences among the three groups (P>0.05). PO2 in the DLS group [(63.56+/-15.06) mmHg] and DLSK group [(63.17+/-19.05) mmHg] were decreased as compared with the DL group [(78.15+/-16.63) mmHg] (P<0.05). PCO2 in the DL, DLS and DLSK groups were (42.25+/-12.46) mmHg, (48.60+/-17.60) mmHg and (49.97+/-13.43) mmHg respectively, and there were no differences among the three groups (P>0.05). Several dysfunction organs described in TCM were involved in COPD followed by the increased severity, hypoxemia and PCO2. Dysfunction of gastrointestinal tract and malnourishment took place accordingly.

Biological Coating for Arterial Stents:The Next Evolutionary Change in Stents

To describe the in vivo results of a promising new stent-graft lined with peritoneum. Eighteen dogs underwent balloon angioplasty injury to the bilateral iliac arteries followed by placement of either an 8-mm x 5-cm glutaraldehyde-fixed bovine peritoneum- lined balloon-expandable stent (PLS) or a similarly sized, commercially prepared, polyester-lined self-expanding stent (DLS) as a control. Animals were sacrificed at 1 and 6 months. Biplanar arteriography and intravascular ultrasound were done at the time of sacrifice, and the vessels were harvested after perfusion fixation for histology/morphometry. Immunofluorescence with CD34 and factor VIII staining was used to evaluate endothelialization, while alpha-actin was used to quantify smooth muscle cell (SMC) deposition. At 1 month, all vessels were patent in both groups. At 6 months, 8 of 9 vessels were open in the PLS group versus 6 of 9 in the control DLS group. Vessel lumen diameter at 1 month was significantly greater in the PLS vessels compared to the DLS group at 1 cm above the stent (35.9 +/- 4.4 versus 29.4 +/- 4.7 mm2; p = 0.02) and 1 cm below the stent (37.2 +/- 7.1 versus 25.2 +/- 3.2 mm2; p = 0.005); these results persisted to 6 months. Histological morphometry demonstrated progression of neointimal hyperplasia in the DLS stent between 30 and 180 days (8.3 +/- 1.79 versus 14.9 +/- 6.6 mm2; p = 0.03), whereas the peritoneum-lined stent had no change during the same time period (4.62 +/- 0.98 versus 4.72 +/- 0.97 mm2; p = 0.85). The same patterns were true for the intima:media ratio. Immunohistochemistry demonstrated complete endothelialization at 6 months in both DLS and PLS. However, SMC staining with alpha-actin demonstrated more smooth muscle actin-positive cells in the DLS compared to the PLS (327 +/- 87 versus 262 +/- 73 counts/5 high-powered fields; p = 0.04). Peritoneum-lined stents offer a novel method to improve patency of lower extremity arterial stents.

Prospective Randomized Comparative Study of the Effectiveness and Safety of Electrohydraulic and Electromagnetic Extracorporeal Shock Wave Lithotriptors

We compared the efficacy of 2 shock wave energy sources, electrohydraulic (Dornier MFL 5000, Dornier MedTech, Wessling, Germany) and electromagnetic (DLS, Dornier Lithotriptor S, Dornier MedTech), for the treatment of urinary calculi. A prospective randomized study of 694 patients with urinary stones was conducted during 12 months to compare the efficacy of the 2 machines. Entrance criteria were radiopaque single or multiple stones at any location within the kidney or the ureter, 25 mm or smaller that had not previously been treated by any means. Patients with congenital anomalies were excluded from this study with all other contraindications for extracorporeal shock wave lithotripsy. Following lithotripsy a plain abdominal film and tomograms were done 1 week after each session to determine if there were residual stones and assess the need for re-treatment. Patients were evaluated 4 weeks after lithotripsy by plane abdominal x-ray and spiral computerized tomography. Success was defined as no residual stones. Univariate and multivariate statistical analyses were performed for different variables that may have an impact on the success rate, including the type of lithotriptor. Comparisons of treatment parameters, complications and success rate for both lithotriptors were done. Of 9 variables examined with univariate analysis 6 had a significant impact on the success rate. Of these 4 maintained their statistical impact on multivariate analysis. These were side, site of the stones, renal morphology and type of lithotriptor. Treatment time was significantly shortened for DLS (54 +/- 32.9 minutes compared to 65.7 +/- 44.7 for MFL, p <0.001). The re-treatment rate was lower for DLS at 34% versus 51.6% for the MFL (p <0.001). The overall success rate was 85.4%. It was 88.5% for DLS compared to 82.4% for MFL (p = 0.03). No statistically significant difference between the lithotriptors was noted for ureteral calculi (p >0.05). The success rate was higher in the DLS group for renal stones especially lower caliceal and pyelic stones (p <0.05). The success rate was higher in DLS group for stones 10 mm or smaller, 92.8% versus 85.3% for MFL (p = 0.03). The success rate was comparable in both groups for stones larger than 10 mm (81.8% for DLS versus 77.9% for MFL, p >0.05). No statistically significant difference was found in the complication rate for the groups. Steinstrasse were noted in 4% of patients treated with MFL and 3% of those treated with DLS. Subcapsular hematomas were noted in 2 patients in each group. No procedures after extracorporeal shock wave lithotripsy were needed in either group. The electromagnetic lithotriptor (Dornier lithotriptor S) has significant clinical advantages over the electrohydraulic lithotriptor (Dornier MFL 5000) in terms of treatment time, re-treatment rate and success rate, although there is no difference in the complication rate.

And then a miracle occurs! Ensuring the successful implementation of enterprisewide epss and E-learning from day one

And then a miracle occurs! Ensuring the successful implementation of enterprisewide epss and E-learning from day one

Performance support for knowledge workers: Practical strategies based on research and practice

Performance ImprovementVolume 36, Issue 3 p. 6-12 The Masters Series Performance support for knowledge workers: Practical strategies based on research and practice Deborah L. Stone, Deborah L. Stone Deborah Stone is President of DLS Group and has received 18 professional awards of excellence for her work in instructional design, technology-based training, and performance support systems. She was ISPI's 1991–93 Vice President of Technology Applications and serves on the Advisory Board of the University of Colorado's Graduate Division of Instructional Technology. She can be reached at 303–333–4513, or by fax at 303–321–1270. She will make a presentation on “Performance Support for Knowledge Workers: Practical Strategies Based on Research and Practice”, from 3 to 5 p.m. April 18.Search for more papers by this authorSteven W. Villachica, Steven W. Villachica Steven W. Villachica is a Senior Instructional Designer for DLS Group, where he specializes in creating and evaluating performance support systems for knowledge workers. He may be reached via telephone: (303) 333–4513; or E–mail: SVillach@dls.com. Mr. Villachica is not a presenter in the Masters Series.Search for more papers by this author Deborah L. Stone, Deborah L. Stone Deborah Stone is President of DLS Group and has received 18 professional awards of excellence for her work in instructional design, technology-based training, and performance support systems. She was ISPI's 1991–93 Vice President of Technology Applications and serves on the Advisory Board of the University of Colorado's Graduate Division of Instructional Technology. She can be reached at 303–333–4513, or by fax at 303–321–1270. She will make a presentation on “Performance Support for Knowledge Workers: Practical Strategies Based on Research and Practice”, from 3 to 5 p.m. April 18.Search for more papers by this authorSteven W. Villachica, Steven W. Villachica Steven W. Villachica is a Senior Instructional Designer for DLS Group, where he specializes in creating and evaluating performance support systems for knowledge workers. He may be reached via telephone: (303) 333–4513; or E–mail: SVillach@dls.com. Mr. Villachica is not a presenter in the Masters Series.Search for more papers by this author First published: 17 January 2008 https://doi.org/10.1002/pfi.4140360304 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume36, Issue31997Pages 6-12 RelatedInformation

The computer based training handbook

Performance + InstructionVolume 35, Issue 9 p. 28-28 Book Review The computer based training handbook Andrea K. Moore, Andrea K. Moore amoore@dls.com Andrea K. Moore is a Project Manager and Human Factors Engineer at DLS Group, Inc. A frequent presenter at the ISPI international conference. she may be reached at (303)333-4513Search for more papers by this author Andrea K. Moore, Andrea K. Moore amoore@dls.com Andrea K. Moore is a Project Manager and Human Factors Engineer at DLS Group, Inc. A frequent presenter at the ISPI international conference. she may be reached at (303)333-4513Search for more papers by this author First published: October 1996 https://doi.org/10.1002/pfi.4170350910 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume35, Issue9October 1996Pages 28-28 RelatedInformation