Fellow Groups Research Articles

Solidaritas Sosial Antar Pedagang Kaki Lima di Taman Batu 10 Kota Tanjungpinang

Relationships that can strengthen fellow individuals or groups require a sense of togetherness that arises in the soul of each individual so that a moral bond is formed between each individual. Street vendors are traders who mostly sell by using the roadside area. With the number of traders in Taman Batu 10 as many as 30 people, including 22 men and 8 women, the street vendors also have different ethnicities, namely Javanese, Minangkabau, Sundanese and Malay. One manifestation of this form of street vendor solidarity is providing assistance to assist with buying and selling transactions if one of the traders is going to perform prayers or has a momentary need. In the Taman Batu 10 PKL community there is a structure, namely chairman, deputy chairman, treasurer and secretary. This research method was qualitative by interviewing 10 street vendors. The results of this research show that the solidarity that exists between street vendors in Taman Batu 10 is more dominant in organic solidarity than mechanical. Organic solidarity is a structured division of labor, where the street vendor community in Taman Batu 10 has a management structure which includes a chairman, deputy chairman, secretary and treasurer. In giving punishment or sanctions it is restitutive, namely providing sanctions in the form of returning the situation to its original state. If there is a problem within the Taman Batu 10 PKL community, it will be resolved through deliberation. The feeling of dependency is high as street vendors need other traders to help them lend small money.

The Values of The Ukhwah Trilogy in The Qur’an and Its Relevance for Deradicalization Efforts

The value of ukhuwah is often understood as a teaching of brotherhood that applies to fellow groups or religions only. The main focus in this study is the values of the Ukhuwwah Trilogy: ukhuwwah Islamiyyah (brotherhood among Muslims), ukhuwwah basyariyyah (brotherhood among mankind), as well as ukhuwwah wathaniyah (brotherhood in national bonds). This research is a literature study using descriptive methods and a contextual interpretation approach. The result provides that the verses of the Qur’an talking about ukhuwah has implications for the meaning of social relations which are not only about teachings and rules relating to fellow Muslims, but also the values of brotherhood among human beings which are an important factor in creating internal and inter-religious harmony. So that the values contained in the ukhuwah verses can be used as guidelines in deradicalization efforts. These verses also have implications for meaning as guidelines for living side by side by establishing good communication with anyone based on humanity (basyariyyah). The main goal is also to maintain good relations between citizens based on nationalism.

How Many Operative Performance Ratings Does a Pediatric Surgery Fellow Need to Be Deemed Practice Ready?

PurposeIdentifying the number of cases required for a fellow to achieve competence has been challenging. Workplace-based assessment (WBA) systems make collecting performance data practical and create the opportunity to translate WBA ratings into probabilistic statements about a fellow's likelihood of performing to a given standard on a subsequent assessment opportunity. MethodsWe compared data from two pediatric surgery training programs that used the performance rating scale from the Society for Improving Medical Professional Learning (SIMPL). We used a Bayesian generalized linear mixed effects model to examine the relationship past and future performance for three procedures: Laparoscopic Inguinal Hernia Repair, Laparoscopic Gastrostomy Tube Placement, and Pyloromyotomy. ResultsFor site one, 26 faculty assessed 9 fellows on 16 procedures yielding 1094 ratings, of which 778 (71%) earned practice-ready ratings. For site two, 25 faculty rated 3 fellows on 4 unique procedures yielding 234 ratings of which 151 (65%) were deemed practice-ready. We identified similar model-based future performance expectations, with prior practice-ready ratings having a similar average effect across both sites (Site one, B = 0.25; Site two, B = 0.25). Similar prior practice-ready ratings were needed for Laparoscopic G-Tube Placement (Site one = 13; Site two = 14), while greater differences were observed for Laparoscopic Inguinal Hernia Repair (Site one = 10; Site two = 15) and Pyloromyotomy (Site one = 10; Site two = 15). ConclusionOur approach to modeling operative performance data is effective at determining future practice readiness of pediatric surgery fellows across multiple faculty and fellow groups. This method could be used to establish minimum case number requirements. Type of StudyOriginal manuscript, Study of Diagnostic Test. Level of EvidenceII.

Active control time: an objective performance metric for trainee participation in robotic surgery.

Trainee participation and progression in robotic general surgery remain poorly defined. Computer-assisted technology offers the potential to provide and track objective performance metrics. In this study, we aimed to validate the use of a novel metric-active control time (ACT)-for assessing trainee participation in robotic-assisted cases. Performance data from da Vinci Surgical Systems was retrospectively analyzed for all robotic cases involving trainees with a single minimally invasive surgeon over 10months. The primary outcome metric was percent ACT-the amount of trainee console time spent in active system manipulations over total active time from both consoles. Kruskal-Wallis and Mann-Whitney U statistical tests were applied in analyses. A total of 123 robotic cases with 18 general surgery residents and 1 fellow were included. Of these, 56 were categorized as complex. Median %ACT was statistically different between trainee levels for all case types taken in aggregate (PGY1s 3.0% [IQR 2-14%], PGY3s 32% [IQR 27-66%], PGY4s 42% [IQR 26-52%], PGY5s 50% [IQR 28-70%], and fellow 61% [IQR 41-85%], p = < 0.0001). When stratified by complexity, median %ACT was higher in standard versus complex cases for PGY5 (60% vs. 36%, p = 0.0002) and fellow groups (74% vs. 47%, p = 0.0045). In this study, we demonstrated an increase in %ACT with trainee level and with standard versus complex robotic cases. These findings are consistent with hypotheses, providing validity evidence for ACT as an objective measurement of trainee participation in robotic-assisted cases. Future studies will aim to define task-specific ACT to guide further robotic training and performance assessments.

Connecting for success: Egocentric network types among underrepresented minority students at college

This study investigates the egocentric networks of underrepresented minority students. Adjustment to college for underrepresented minority students often means balancing between the origin (i.e., low-status family) and host (i.e., academic) environments, requiring students to develop different coping strategies. The analysis included 124 Roma university students. We employed the contact diary method and the EgoNet program for mapping students’ egocentric networks. We explored classification among egocentric networks by cluster analysis based on the network proportion of the origin, fellow, and host groups. Three clusters were distinguished. The Host-based cluster proved to be the most advantageous, while the Balancing cluster appeared to be the most disadvantageous in terms of network resources, well-being, and trust. Partners’ ethnicity and educational attainment showed a strong connection with cluster membership. Our results highlight that small fellow communities can successfully interconnect the origin and host groups in students’ egocentric networks.

Does pre-fellowship experience alter success rates of endoscopic treatment of vesicoureteral reflux during pediatric urology fellowship?

Learning curve is a well-known factor that affects the success rate of endoscopic injection for vesicoureteral reflux (VUR). To our knowledge, the significance of pre-fellowship training has not been studied. In the present study, our aim was to investigate the effect of pre-fellowship training on the endoscopic treatment success rates of pediatric urology fellows. A total of 78 patients aged 2-16 years (132 renal units) who underwent subureteric injection for the treatment of primary VUR by four pediatric urology fellows between 2014 and 2020 were retrospectively evaluated. Fellows were grouped into two as experienced and non-experienced according to the presence of pre-fellowship experience (defined as a minimum of 20 procedures). Patients in both groups were divided into two subgroups as non-dilating (grade I-II) and dilating VUR (grade III-V). Also, the change in success rate throughout the fellowship was analyzed. HIT or Double HIT method was used in all interventions. Experienced fellows carried out subureteric injection in 54 (40.9%) renal units while non-experienced fellows performed in 78 (59.1%). There was no success rate difference between experienced and non-experienced fellow groups in non-dilating VUR (100% vs. 88%, respectively p=0.268), whereas the success rate of the experienced group was significantly higher in dilated VUR (78.9% vs. 50.9%, p=0.006). Moreover, the amount of material used in the treatment of non-dilating VUR were similar between two fellow groups (0.6ml vs. 0.6ml, p=0.500), while experienced group achieved higher success rates in dilating VUR by statistically significant less amount of injected volume (0.7ml vs. 0.9ml, p=0.026).Overall complete VUR resolution rates were similar throughout the fellowship period in the experienced fellows (81.5% vs. 88.9%, p=0.444), while it significantly increased in the non-experienced group implicating the completion of the learning curve (51.3% vs. 74.4%, p=0.035). There has been no published reports on the effect of pre-fellowship experience on subureteric injection success. While many researchers reported on the importance of learning curve, various studies assessed the effect of injected volume on success rate implicating contradictory results. Furthermore, others indicated that the ideal technique providing accurate needle placement and obtaining proper depth during injection which is associated with surgical experience is more important than the injected volume in achieving success. Our results implicate that similar success rates in non-dilating VUR can be achieved regardless of previous subureteric injection training. However, higher failure rates may be expected when the procedures are performed by non-experienced pediatric urology fellows at the beginning of their fellowship in dilating VUR.

Profil Kohesivitas Kelompok Mahasiswa yang Bermukim di Perkotaan

This study aimed to find out how the cohesive profile of student groups living in urban areas is. This research uses a qualitative approach to literature (Library Research), namely by collecting data related to the theme of the research problem using Google Scholar and set 24 journal articles as data sources, then analyzed with descriptive qualitative. The results of the study found that the mobility of people moving to the city was unavoidable. It was the movement of students to continue their higher education in urban areas, approaching the college campus while students were studying. Group cohesiveness is an essential part for students who live in urban areas. Students are expected to be able to establish interactions between their fellow groups in order to achieve the group's goals. The cohesiveness of student groups living in urban areas can be seen from the organizations they participate in, both internal and external campus organizations. The level of cohesiveness will significantly affect organizational commitment. It depends on how far the group's goals are similar to the organization. Group cohesiveness is established through interactions in the form of good communication between group members. The existence of mutual liking and having a sense of mutual interest will make the group strong. Â

ANALISIS PROGRAM BANTUAN STIMULAN PERUMAHAN SWADAYA (BSPS) DALAM MENYEDIAKAN RUMAH LAYAK HUNI DI KELURAHAN BEROHOL KECAMATAN BAJENIS KOTA TEBING TINGGI

This study aims to determine the implementation of Self-Help Housing Stimulant Assistance (BSPS) in providing livable houses in Berohol Village, Bajenis District, Tebing Tinggi City. Self-Help Housing Stimulant Assistance (BSPS) is a government facility in the form of stimulant assistance for the construction / improvement of housing quality provided to low-income people. Low-Income Communities (MBR) are people who have limited purchasing power so they need government support to get a decent house to live in. Self-Help Housing are houses built on the initiative and efforts of the community, either individually or in groups. This type of research is a descriptive qualitative research. In collecting research data using interview techniques, observation, and documentation using informants as a source of information. The results of this study indicate that the implementation of the Self-Help Housing Stimulant Assistance Program in providing Liveable Homes in Berohol Village, Bajenis District, Tebing Tinggi City has not been optimal. Including the distribution of BSPS that has not been on target, lack of participation and public awareness and lack of knowledge about the BSPS program. In addition, in the development stage, it should be carried out cooperatively with fellow groups that have been determined but in reality it is still done individually. Researchers also see that the implementors in the implementation of the BSPS Program in Kelurahan Berohol still do not have firmness because they still allow the community to work individually. Even though they understand what the concept and purpose of the BSPS program actually is.

Social Support for Diet Communities in Social Media

The number of users of social media in Indonesia has the potential to control global epidemiological problems including obesity. Does the group formed on social media, that consists of people who do not know each other, but because of the similarity of interest in losing weight, will help increase the motivation of the group members? The purpose of this study was to find a relationship between friend sup- port on social media with increased motivation in weight loss. This research is descriptive analytic, with cross sectional design. A sample of 110 people was selected using a purposive sampling technique. The research instrument was adopted from the Treatment Self-Regulation Questionnaire (TSRQ) and the Ballatine questionnaire. The results showed 88.2% of respondents were women, 85.5% were aged 20-40 years, most were housewives (50.9%), the period of joining groups on social media between 1-4 months (45.5%). About 49.1% of respon- dents felt strongly supported and motivated by members in fellow groups on social media. The statistical test results show that there is a relationship between social support and motivation for weight loss (pValue 0.019). This study shows that groups on social media can help maintain the motivation of their members to carry out a diet. It is recommended that health promotion personnel to use social media as an alternative to disseminating health program information.

How Big is the Hole? Measuring Intra- and Inter-Individual Agreement in Macular Hole Size Measurements

ABSTRACT Purpose The size of a macular hole helps determine treatment planning and postoperative prognosis. The aim of this study was to examine intra- and inter-individual agreement in the measurement of full thickness macular hole (FTMH) size using optical coherence tomography (OCT) images. Methods Thirty OCT scans of FTMHs were reviewed by three vitreoretinal consultants and three vitreoretinal fellows. The FTMH size was recorded by each clinician independently and they repeated the measurements 3 weeks later. The repeatability of measurements was analysed using techniques of agreement measurement. Results The Coefficients of Repeatability (CR) for the intra-individual agreement were 46 µm, 73 µm and 60 µm for the consultant group and 44 µm, 60 µm and 57 µm for the fellow group. The Coefficients of Variation (CoV) of intra-individual repeatability were 3.8%, 5.9%, and 5.1% for the consultants and 3.5%, 5.2%, and 4.9% for the fellows. The CR for inter-individual agreement varied from 62 µm to 122 µm. There was no significant difference in repeatability of measurements between the consultant and the fellow groups (chi-squared, p = .95). Conclusions Manual OCT FTMH diameter measurements show poor intra- and inter-individual repeatability. Future work should aim to develop an automated method for measuring macular holes.

Polahi Tribe Inbreeding Culture in Gorontalo

The Polahi tribe, a primitive tribe in the interior of Gorontalo that has a culture of inbreeding, or incest marriage system that is genetically dangerous for offspring born. They are accustomed to having a inbreeding system where this marriage allows each family member to be free to marry a fellow family member who has blood ties. This marriage system has been going on for a long time since the Dutch colonial era. And even though it is considered unusual or even strange, but that culture still exists today and may remain, as long as there has not been a change in the mindset of the people. In this study the method used is normative approach, namely by using data such as books, literature, articles and newspapers, and describes the data obtained then analyzed. This study tries to explore deeper about the inbreeding system that has been carried down from generation to generation by the Polahi tribe, looking at the culture of inbreeding, then being associated with different aspects and perspectives, both from the aspects of religion, law and law, health, social and cultural. From the results of the study that incest marriage for the tribe of Polahi is not due to customs, but understanding and knowledge is very lacking, even barely knowing anything about the association of fellow groups, so they do inbreeding among themselves.

Surgeons Cannot Predict Pilon Fracture Outcomes Based on Initial Radiographs.

This study sought to determine (1) whether surgeons can accurately predict functional outcomes of operative fixation of pilon fractures based on injury and initial postoperative radiographs, (2) whether the surgeon's level of experience is associated with the ability to successfully predict outcome, and (3) the association between patients' demographic and clinical characteristics and surgeons' prediction scores. A blinded, randomized provider survey was conducted at a level I trauma center. Seven fellowship-trained orthopedic traumatologists and 4 orthopedic trauma fellows who were blinded to outcome reviewed data regarding 95 pilon fractures in random order. Injury ankle radiographs, initial postoperative fixation radiographs, and brief patient histories were assessed. Midterm follow-up functional outcome scores obtained a mean 4.9 years after surgery were available for all patients. Main outcome measures were Pearson correlation coefficient-assessed functional outcomes and surgeon-predicted outcomes. A mixed-effect model determined the association between patients' characteristics and surgeons' prediction scores. Minimal positive correlation was observed between functional outcomes and prediction scores. No difference was noted between the attending and fellow groups in prediction ability. When surgeons' prediction confidence level was greater than 1 SD above the mean confidence level, correlation between functional outcome and prediction improved, although poor correlation was still observed. AO/OTA type 43C fractures, high-energy mechanisms, and older patient age were characteristics associated with lower prediction scores. Surgeons had poor ability to predict functional outcomes of patients with pilon fractures based on injury and initial postoperative radiographs, and level of experience was not associated with ability to predict outcome. [Orthopedics. 2020; 43(1): e43-e46.].

333 Identifying the Link Between Adenoma and Serrated Polyp Detection Rates and the Effect of Withdrawal Time on Both During Screening Colonoscopies

INTRODUCTION: Adenoma detection rate (ADR) and its surrogate marker, mean withdrawal time (WT) of ≥ 6 min, is the current golden metric for colonoscopy quality. Serrated polyp detection rate (SPDR) is also an important marker for CRC. Longer WTs are linked with higher ADRs. We aim to assess if there is a correlation between SPDR and ADR, and if the same link exists between WTs and SPDR, as it exists for WT on ADR. METHODS: Screening colonoscopies between 2012 and 2017 were evaluated. Endoscopists with &lt; 40 colonoscopies and procedures with polyps &gt;6 mm, and/or WTs &gt;30 min were excluded. Data was grouped into fellow (FG) and attending (AG) groups. The bivariate association of SPDR and ADR was calculated by correlation coefficients. Statistical analysis was performed using chi-squared tests, two-sample t-tests, and ANOVA t-testing. RESULTS: A total of 5951 procedures performed by 51 fellows and 13 attendings were assessed. The MWT was 15.4 min, SD 4.72, average total procedure time (TT) was 28.3 min, and average ADR was 40%. WT had a strong positive correlation with ADR and TT. The average SPDR was 0.1, SD 0.056. SPDR had a positive correlation with WT and ADR. There were significant differences between FG and AG in ADR, WT, TT and in regression models between the two for TT. There was no difference in the mean SPDR between groups. SPDR had a strong positive correlation with ADR and WT in the AG. There was no significant difference between bowel prep vs. SPDR between groups. CONCLUSION: Our study demonstrates a strong linear relationship between WT, ADR and TT. While FG have a higher ADR compared with AG at the cost of a longer WT, how much ADR changes as WT increases is not significant. AG and FG had similar SPDRs, however, only for AG were SPDR positively correlated with longer WTs and higher ADRs. We postulate that given the increased technical difficulty in detecting sessile polyps, AG are better equipped to improve SPDRs with increased WT. Bowel prep scores had no effect on SPDR, explained by exclusion criteria including only fully completed colonoscopies, and therefore subpar prep patients were likely pre-excluded. Our study highlights the importance of expertise and training in the identification of sessile polyps, the association between high ADR and SPDR, and the positive effect of WT on SPDR. Kahi et al., identified variability in SPDR ranging from 1% to 18%, compared with much less variability seen in ADRs. As a result, our findings are worthy of validation in larger multiple center studies.

Back to Bedside: Defining Success.

Back to Bedside: Defining Success.

PROSES PERJODOHAN DAN KRITERIA KAFA’AH DALAM PERKAWINAN ANGGOTA LDII DESA MEDAENG KECAMATAN WARU KABUPATEN SIDOARJO

This paper is a bibliographical research on the process of marriage and kafa'ah criteria in LDII’s members in Medaeng, Waru, Sidoarjo under the perspective of Islamic law. This study aims to answer the questions of how the matchmaking process in the marriage system of LDII’s members in Medaeng, Waru, Sidoarjo and how the application of the concept of kafa'ah in LDII’s members in Medaeng, Waru, Sidoarjo and how the maslahah analysis of the process of matchmaking and the concept of kafa'ah in LDII’s members in Medaeng, Waru, Sidoarjo. This data of the research is obtained from the board of LDII of Medaeng, Waru, Sidoarjo which become the object of research. Technique of collecting data of this research are descriptive verikatif technique and deductive mindset. From the result of the research, it is concluded that kafa'ah match and criteria in LDII’s members are more inclined to fellow members or groups. According to Islamic law, it does’t matter to marry such a model as long as it aims to benefit and rejects the danger, because the main purpose of the Islamic law is promoting benefit for the people. In addition, during the process of matchmaking, it doesn’t against the syari’ah, then it can be done. Nevertheless, it is expected that LDII’s members in Medaeng, Waru, Sidoarjo are more open in understanding kafa'ah, because what is meant by kafa'ah in Islam is not limited to certain group of the people.

Impact of fellowship training level on colonoscopy quality and efficiency metrics

Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by level of training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of level of training on moderate sedation use. We performed a retrospective review of 2024 patients (mean age, 60.9 ± 10 years; 94% men) who underwent outpatient colonoscopy between June 2012 and December 2014 at our Veterans Affairs Medical Center. Colonoscopies were divided into 5 groups. The first 2 groups were first-year fellows in the first 6 months and last 6 months of the training year. Second- and third-year fellows and attending-only procedures accounted for 1 group each. We collected data on doses of sedatives used, frequency of adjunctive agent use, procedural times, and location, size, and histology of polyps. We defined the adenoma management efficiency index as average time required per adenoma resected during withdrawal. Of the colonoscopies performed, 1675 involved a fellow and 349 were performed by the attending alone. There was no difference in ADR between fellows according to level of training (P= .8) or between fellows compared with attending-only procedures (P= .67). Procedural times decreased consistently during training and declined further for attending-only procedures. This translated into improvement in the adenoma management efficiency index (fellow groups by ascending level of training: 23.5 minutes vs 18.3 minutes vs 13.7 minutes vs 13.4 minutes vs attending group 11.7 minutes; P< .001). There was no difference in the average doses of midazolam and fentanyl used among fellow groups (P= .16 and P= .1, respectively). Compared with attending-only procedures, fellow involvement was associated with higher doses of fentanyl and midazolam and more frequent use of diphenhydramine and glucagon (P< .0001, P= .0002, P< .0001, and P= .01, respectively). ADR was similar at different stages of fellowship training and comparable with the attending group. Efficiency of detecting and resecting polyps improved throughout training without reaching the attending level. Fellow involvement led to a greater use of moderate sedation, which may relate to a longer procedure duration and an evolving experience in endoscopic technique.

Roma Undergraduates’ Personal Network in the Process of College Transition. A Social Capital Approach

Roma university students’ personal networks become unstable in the process of college transition. We describe the personal networks of these students using the model set up by Brandes et al. (in: Proceedings of the IEEE pacific visualization symposium (Pacific Vis’08), IEEE Computer Society Press, 2008) and analyse the identified groups utilizing the social capital approach. We mapped seventy-six students’ networks applying contact diary. Origin, host and fellow groups significantly differ in their composition; they provide different (‘bonding’ or ‘bridging’) type of resources, and their availability to the Roma students is also different. We found significant differences between the students in their tendency to rely on certain groups in the process of academic adjustment.

Comparison of phacoemulsification parameters between manual and femtosecond laser-assisted cataract surgery

ObjectiveTo compare the nucleus removal time (NRT) and cumulative dissipated energy (CDE) outcomes of traditional phacoemulsification and femtosecond laser-assisted cataract surgery (FLACS) performed by cornea attendings and fellows. DesignProspective nonrandomized comparative study. ParticipantsA total of 410 eyes of 410 patients. MethodsNucleus removal time and CDE were recorded from patients who underwent cataract surgery using either FLACS (Catalys, LenSx, or Victus) or traditional phacoemulsification technique performed by 3 cornea attendings and 4 cornea fellows. One-way analysis of variance with Bonferroni post hoc tests and unpaired t tests were used to determine the differences between groups. ResultsThere was no statistically significant difference in cataract grade between groups. NRT was significantly lower only when using the Catalys system compared with the LenSx and Victus platforms and the traditional surgery, in both the attending group (p = 0.006, p = 0.002, p < 0.000, respectively) and the fellow group (p = 0.049, p = 0.038, p = 0.011, respectively). With respect to CDE, there was no significant difference when using the laser systems compared with the traditional surgery in both attending and fellow groups (p > 0.05). NRT and CDE were significantly higher in the fellow group (NRT = 269.10 ± 117.67, CDE = 7.30 ± 4.83) compared with the attending group (NRT = 218.87 ± 109.67, CDE = 5.76 ± 3.66) in traditional cases; however, in FLACS cases, there was no significant difference in NRT and CDE between the fellow group and the attending group. ConclusionsInexperienced surgeons seem to require more time and use more ultrasound energy during traditional phacoemulsification when compared with experienced surgeons. The use of FLACS seems to significantly improve the NRT of experienced and inexperienced surgeons.

Impact of Trainee Involvement on Complication Rates Following Pelvic Reconstructive Surgery.

Trainee involvement in surgical procedures has been associated with longer surgical times and increased rates of certain complications. There has been limited study of the impact trainee involvement has on outcomes in urogynecologic surgery. We sought to determine the impact of resident and fellow involvement in pelvic reconstructive surgeries on 30-day complication rates. Using the American College of Surgeons National Surgical Quality Improvement Program database, patients who underwent pelvic floor surgery were identified between 2010 and 2015. Patients were stratified into 3 groups: no trainee, resident, or fellow involvement. The primary outcome was the composite complication rate. Three-group comparison was performed using Kruskal-Wallis analysis. If statistically significant, then pairwise analysis was performed between the reference group (attending alone) and experimental groups (resident or fellow). Additional pairwise analysis was performed between the fellow and resident groups. Logistic regression was used to identify factors associated with an increased risk of complications. Seven thousand seven hundred fifty-two surgical cases met all criteria for inclusion; 2440 (31.4%) included residents, and 646 (8.3%) included fellows. The median operating times were significantly higher in the resident and fellow groups compared with the attending-alone group (109 minutes [interquartile range, 55-164 minutes) compared with 110 minutes [interquartile range, 61-174 minutes] compared with 72 minutes [interquartile range, 38-113 minutes], P < 0.001). After multivariable logistic regression, trainee participation did not result in an increase in complication rate. Preoperative transfusion (adjusted odds ratio [aOR], 7.82; 95% confidence interval [CI], 2.03-30.09), coagulopathy (aOR, 3.18; 95% CI, 1.74-5.82), nonwhite race (aOR, 1.57; 95% CI, 1.31-1.89), insulin-dependent diabetes (aOR, 1.68; 95% CI, 1.03-2.72), American Society of Anesthesiologists class greater than 2 (aOR, 1.46; 95% CI, 1.21-1.77), length of stay (aOR, 1.04, 95%CI:1.02-1.06), operating time (aOR, 1.01; 95% CI, 1.00-1.03), and undergoing a sling procedure (aOR, 1.18; 95% CI, 1.01-1.41) were associated with higher complication rates. Resident and fellow involvement during pelvic reconstructive surgery is associated with longer operating times but does not increase the risk of complications within 30 days of the procedure.

Study on the difference of binocular accommodative response between atients with intermittent exotropia under different viewing condition

Objective: To evaluate the accommodative response of patients with intermittent exotropia (IXT) objectively, and study the changes of accommodative response of intermittent exotropia patients when maintaining binocular fusion. Methods: The prospective cohort study was used in this study. Twenty-four patients diagnosed with basic intermittent exotropia who visited the eye hospital of Wenzhou Medical University during October 2016 through January 2017 together with 24 normal volunteers were included, the 48 participants aged from 10 to 27 years old. The participants were divided into the case group and the control group. There were 11 males and 13 females in the case group, and 7 males and 17 females in the control group. The Open-filed autorefractor WAM-5500 (Grand Seiko, Japan) was used to measure the accommodative response of each eye under binocular and monocular viewing conditions at 5 m and 40 cm respectively. During the measurement, patients wore full correction spectacles to achieve distant best-corrected visual acuity of both eyes. The accommodative responses of each eye under binocular and monocular viewing conditions at distance or near between fellow eyes and groups were compared. Results: Under near fixation (40cm) binocular viewing conditions, the accommodative response of the fixating eye (-1.915±0.301)D was different from the deviating eye -1.649(-2.020, -0.304)D in the case group (Z=-3.714, P<0.001). Under near fixation monocular viewing conditions, the accommodative response of the fixating eye (-1.653±0.271)D was also different from the deviating eye -1.565 (-2.031, -0.667)D in the case group (Z=-2.971, P=0.003). During binocular viewing, the asymmetric value of the accommodative response between both eyes of the case group was 0.389(0.102, 1.458)D which was more significant than the normal controls' 0.155(0.009, 0.573)D (Z=-3.505, P<0.001), but during monocular viewing, there was no significant difference between the groups (Z=-1.908, P=0.056). Under near viewing conditions, the variation value of the fixating eyes of the case group was -0.228(-0.796, 0.382)D, which was greater than the variation value -0.086(-0.606, 0.628)D of the right eye of the normal controls, such difference is of statistical significance (Z=-2.279, P=0.023). Under distance viewing conditions, there was no significant difference in the accommodative response between fixating eyes and deviating eyes in case group neither during monocular viewing nor binocular viewing (t=-1.525, -1.729, P>0.05). Besides, the asymmetric values of accommodative response between groups were not significantly different (Z=-1.433, P=0.152. Z=-0.938, P=0.348). Under distance viewing conditions, the changes in accommodative response of each eye during both monocular viewing and binocular viewing were not significantly different between case group and normal controls (Z=-0.041, P=0.967. Z=-1.433, P=0.152). Conclusions: The accommodative responses of the fixating eye and deviating eye of patients with intermittent exotropia were asymmetric under near fixation binocular viewing conditions, and the accommodative response of the deviating eye tends to decrease. Besides, the change of accommodative response of the patients with intermittent exotropia when maintaining binocular fusion is more significant than that of the normal controls. (Chin J Ophthalmol, 2018, 54: 55-61).