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Violin is one of the most complex musical instruments to learn. The learning process requires constant training and many hours of exercise and is primarily based on a student-teacher interaction where the latter guides the beginner through verbal instructions, visual demonstrations, and physical guidance. The teacher's instruction and practice allow the student to learn gradually how to perform the correct gesture autonomously. Unfortunately, these traditional teaching methods require the constant supervision of a teacher and the interpretation of non-real-time feedback provided after the performance. To address these limitations, this work presents a novel interface (Visual Interface for Bowing Evaluation-VIBE) to facilitate student's progression throughout the learning process, even in the absence of direct teacher intervention. The proposed interface allows two key parameters of bowing movements to be monitored, namely, the angle between the bow and the string (i.e., α angle) and the bow tilt (i.e., ß angle), providing real-time visual feedback on how to correctly move the bow. Results collected on 24 beginners (12 exposed to visual feedback, 12 in a control group) showed a positive effect of the real-time visual feedback on the improvement of bow control. Moreover, the subjects exposed to visual feedback judged the latter as useful to correct their movement and clear in terms of the presentation of data. Although the task was rated as harder when performed with the additional feedback, the subjects did not perceive the presence of a violin teacher as essential to interpret the feedback.

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Metacognition is essential in the musical learning process as it involves understanding the purpose of each task, its planning, execution and evaluation. Considering the relevance of metacognitive processes, our objective in this study was to investigate how expert and beginner musicians manifest and verbalize their metacognitive processes in the context of preparing repertoire for a performance. The method used was a multi-case study carried out in two different contexts: with the five members of a brass quintet made up of professional musicians and with three beginner university violin students. The results obtained indicated that even at different levels of expertise, metacognitive processes were present in the musical practices of participants in the two contexts investigated. It was found that in both cases time management is a component of the preparation process in metacognitive regulation, however, for the beginner violinists in our sample it was a significantly more complex task than for the professional brass players. Regarding the learning monitoring and evaluation processes, it was possible to verify that beginner instrumentalists as well as professional musicians used declarative, conditional and procedural knowledge to carry out and reflect on their musical practices. These results have implications for both the individual and collective study process and for teaching processes. It is also observed that reflective thinking must accompany the processes of individual and collective interpretative-musical practices, considering that the musical results desired by musicians are related to the quality of cognitive, behavioral, affective and motivational undertakings pertinent to control and regulation of metacognitive processes.

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The current text provides a comprehensive introduction to essential oils, their biosynthesis, naming, analysis, and chemistry. Importantly, this text quickly brings the reader up to a level of competence in the authentication of essential oils and their components. It gives detailed descriptions of enantiomers and other forms of stereoisomers relevant to the study of natural volatiles and essential oils. The text also describes GC-MS work and provides tips on rapid calculation of arithmetic indices, how to interpret suggested names from the NIST mass spectral library, and what additional efforts are required to validate essential oils and defeat sophisticated adulteration tactics. In brief, essential oils are mixtures of volatile organic compounds that were driven out of the raw plant material in distillation, condensed into an oil that is strongly aroma emitting, and collected in a vessel as the top layer (uncommonly bottom layer) of two phase separated liquids: oil and water. Essential oils commonly include components derived from two biosynthetic groups, being terpenes (monoterpenes, sesquiterpenes and their derivatives) and phenylpropanoids (aromatic ring with a propene tail). The current text provides details of how terpenes and phenylpropanoids are further categorised according to their parent skeleton, then recognised by the character of oxidation, which may be from oxygen, nitrogen, or sulphur, or the presence/absence of a double bond. The essential oil's science niche is an epicentre of individuals from diverse backgrounds, such as aromatherapy, pharmacy, synthetic and analytical chemistry, or the hobbyist. To make the science more accessible to the curious student or researcher, it was necessary to write this fundamentals-level introduction to the chemistry of essential oils (i.e., organic chemistry in the context of essential oils), which is herein presented as a comprehensive and accessible overview. Lastly, the current review constitutes the only resource that highlights common errors and explains in simplistic detail how to correctly interpret GC-MS data then accurately present the respective chemical information to the wider scientific audience. Therefore, detailed study of the contents herein will equip the individual with prerequisite knowledge necessary to effectively analyse an essential oil and make qualified judgement on its authenticity.

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CONTEXT: Vitiligo is a common primary acquired pigmentary disorder due to loss of epidermal functioning melanocytes. Many surgical techniques have evolved over the years for its treatment and the need of a cost-effective modality has always been put forward. AIM: The aim of the study was to compare the efficacy of non-cultured epidermal cell suspension with that of epidermal curettage in repigmentation of stable vitiligo. SETTINGS AND DESIGN: It was a prospective randomized non-controlled study. SUBJECTS AND METHODS: Forty lesions were selected in patients of stable, recalcitrant vitiligo belonging to different age-groups and genders. After histopathological confirmation, the patients were taken up for surgery after obtaining written consent and were divided into two groups for two different procedures, that is, non-cultured epidermal cell suspension (Group A) and epidermal curettage (Group B). Follow-up was carried out at 2, 4, 8, and 12 weeks of procedure to assess the repigmentation achieved. STATISTICAL ANALYSIS: Statistical Package for Social Sciences (SPSS) software, version 21.0, was used. RESULTS: At the end of the study, >50% repigmentation was achieved in 95% (19 of 20) lesions of Group A and 85% (17 of 20) lesions in Group B, whereas >75% repigmentation was achieved in 60% (12 of 20) in both Groups A and B. The color matching with surrounding skin and yield of graft was better in epidermal cell suspension technique than that in epidermal curettage. The difference was not statistically significant. CONCLUSION: Though both the surgical techniques of melanocyte transplantation are effective in achieving uniform pigmentation, epidermal curettage has an extra edge of being simpler and more cost-effective.

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An effective visual perception strategy helps a fencer quickly react to an opponent's actions. This study aimed to examine and compare visual perception strategies used by high-performance foil fencers (experts) and beginners. In an eye tracking experiment, we analysed to which areas beginning and expert fencers paid attention during duels. Novices paid attention to all examined areas of interest comprising the guard, foil (blade and tip), armed hand, lower torso, and upper torso of their opponents. Experts, however, paid significantly less attention to the foil, picking up information from other areas, mainly the upper torso and the armed hand. These results indicate that expert fencers indeed engage different visual perception strategies than beginners. The present findings highlight the fact that beginner fencers should be taught already in the early stages of their careers how to pick up information from various body areas of their opponents.

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BACKGROUND: Training beginners of the pedicle screw instrumentation technique in the operating room is limited because of issues related to patient safety and surgical efficiency. Three-dimensional (3D) printing enables training or simulation surgery on a real-size replica of deformed spine, which is difficult to perform in the usual cadaver or surrogate plastic models. The purpose of this study was to evaluate the educational effect of using a real-size 3D-printed spine model for training beginners of the free-hand pedicle screw instrumentation technique. We asked whether the use of a 3D spine model can improve (1) screw instrumentation accuracy and (2) length of procedure. METHODS: Twenty life-size 3D-printed lumbar spine models were made from 10 volunteers (two models for each volunteer). Two novice surgeons who had no experience of free-hand pedicle screw instrumentation technique were instructed by an experienced surgeon, and each surgeon inserted 10 pedicle screws for each lumbar spine model. Computed tomography scans of the spine models were obtained to evaluate screw instrumentation accuracy. The length of time in completing the procedure was recorded. The results of the latter 10 spine models were compared with those of the former 10 models to evaluate learning effect. RESULTS: A total of 37/200 screws (18.5%) perforated the pedicle cortex with a mean of 1.7 mm (range, 1.2-3.3 mm). However, the latter half of the models had significantly less violation than the former half (10/100 vs. 27/100, p < 0.001). The mean length of time to complete 10 pedicle screw instrumentations in a spine model was 42.8 ± 5.3 min for the former 10 spine models and 35.6 ± 2.9 min for the latter 10 spine models. The latter 10 spine models had significantly less time than the former 10 models (p < 0.001). CONCLUSION: A life-size 3D-printed spine model can be an excellent tool for training beginners of the free-hand pedicle screw instrumentation.

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BACKGROUND: High reproducibility and low intra- and interobserver variability are important strengths of cardiac magnetic resonance (CMR). In clinical practice a significant learning curve may however be observed. Basic CMR courses offer an average of 1.4 h dedicated to lecturing and demonstrating left ventricular (LV) function analysis. The purpose of this study was to evaluate the effect of initial teaching on complete and intermediate beginners' quantitative measurements of LV volumes and function by CMR. METHODS: Standard clinical cine CMR sequences were acquired in 15 patients. Five observers (two complete beginners, one intermediate, two experienced) measured LV volumes. Before initial evaluation beginners read the SCMR guidelines on CMR analysis. After initial evaluation, beginners participated in a two-hour teaching session including cases and hands-on training, representative for most basic CMR courses, after which it is uncertain to what extent different centres provide continued teaching and feedback in-house. Dice Similarity Coefficient (DSC) assessed delineations. Agreement, accuracy, precision, repeatability and reliability were assessed by Bland-Altman, coefficient of variation, and intraclass correlation coefficient methods. RESULTS: Endocardial DSC improved after teaching (+0.14 ± 0.17;p < 0.001) for complete beginners. Low intraobserver variability was found before and after teaching, however with wide limits of agreement. Beginners underestimated volumes by up to 44 ml (EDV), 27 ml (ESV) and overestimated LVM by up to 53 g before teaching, improving to an underestimation of up to 9 ml (EDV), 7 ml (ESV) and an overestimation of up to 30 g (LVM) after teaching. For the intermediate beginner, however, accuracy was quite high already before teaching. CONCLUSIONS: Initial teaching to complete beginners increases accuracy for assessment of LV volumes, however with high bias and low precision even after standardised teaching as offered in most basic CMR courses. Even though the intermediate beginner showed quite high accuracy already before teaching, precision did generally not improve after standardised teaching. To maintain CMR as a technique known for high accuracy and reproducibility and low intra- and inter-observer variability for quantitative measurements, internationally standardised training should be encouraged including high-quality feedback mechanisms. Objective measurements of training methods, training duration and, above all, quality of assessments are required.

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Dendritic cells (DCs) are immune sentinels of the body and play a key role in the orchestration of the communication between the innate and the adaptive immune systems. DCs can polarize innate and adaptive immunity toward a variety of functions, sometimes with opposite roles in the overall control of immune responses (e.g., tolerance or immunosuppression versus immunity) or in the balance between various defense mechanisms promoting the control of different types of pathogens (e.g., antiviral versus antibacterial versus anti-worm immunity). These multiple DC functions result both from the plasticity of individual DC to exert different activities and from the existence of various DC subsets specialized in distinct functions. Functional genomics represents a powerful, unbiased, approach to better characterize these two levels of DC plasticity and to decipher its molecular regulation. Indeed, more and more experimental immunologists are generating high-throughput data in order to better characterize different states of DC based, for example, on their belonging to a specific subpopulation and/or on their exposure to specific stimuli and/or on their ability to exert a specific function. However, the interpretation of this wealth of data is severely hampered by the bottleneck of their bioinformatics analysis. Indeed, most experimental immunologists lack advanced computational or bioinformatics expertise and do not know how to translate raw gene expression data into potential biological meaning. Moreover, subcontracting such analyses is generally disappointing or financially not sustainable, since companies generally propose canonical analysis pipelines that are often unadapted for the structure of the data to analyze or for the precise type of questions asked. Hence, there is an important need of democratization of the bioinformatics analyses of gene expression profiling studies, in order to accelerate interpretation of the results by the researchers at the origin of the research project, of the data and who know best the underlying biology. This chapter will focus on the analysis of DC subset transcriptomes as measured by microarrays. We will show that simple bioinformatics procedures, applied one after the other in the framework of a pipeline, can lead to the characterization of DC subsets. We will develop two tutorials based on the reanalysis of public gene expression data. The first tutorial aims at illustrating a strategy for establishing the identity of DC subsets studied in a novel context, here their in vitro generation in cultures of human CD34(+) hematopoietic progenitors. The second tutorial aims at illustrating how to perform a posteriori bioinformatics analyses in order to evaluate the risk of contamination or of improper identification of DC subsets during preparation of biological samples, such that this information is taken into account in the final interpretation of the data and can eventually help to redesign the sampling strategy.

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With the stringent regulations from various academic bodies making it desirable for a post graduate resident to have submitted an original article prior to appearance for their exams or those working in teaching institutions to have published articles to claim credit for applying for promotions and private practitioners to increase their visibility on the academic front, paper, everyone is on a publishing spree. In this article, we attempt to elucidate the processes involved in publication; approaching it in a systematic and practical manner, incorporating some tips and tricks. This collection of pearls is aimed to serve as a beginner's guide to scientific writing and publications. The pearls cover assorted topics like- benefits of publications, collecting resources, various tools available and technical processes related to how a manuscript is processed.

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PURPOSE: It was hypothesized that surgical time of beginners would be much longer than that of experts. Our purpose was to investigate and clarify the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty (TKA) as a multicentre study. METHODS: A total of 300 knees in 248 patients (averaged 74.6 years) were enrolled. All TKAs were done using the same instruments and the same measured resection technique at 14 facilities by 25 orthopaedic surgeons. Surgeons were divided into three surgeon groups (four experts, nine medium-volume surgeons and 12 beginners). The surgical technique was divided into five phases. Detailed surgical time and ratio of the time in each phase to overall surgical time were recorded and compared among the groups in each phase. A total of 62, 119, and 119 TKAs were done by beginners, medium-volume surgeons, and experts, respectively. RESULTS: Significant differences in surgical time among the groups were seen in each phase. Concerning the ratio of the time, experts and medium-volume surgeons seemed cautious in fixation of the permanent component compared to other phases. Interestingly, even in ratio, beginners and medium-volume surgeons took more time in exposure of soft tissue compared to experts. (0.14 in beginners, 0.13 in medium-volume surgeons, 0.11 in experts, P < 0.05). CONCLUSION: Beginners took more time in exposure and closure of soft tissue compared to experts. Improvement in basic technique is essential to minimize surgical time among beginners. First of all, surgical instructors should teach basic techniques in primary TKA for beginners. LEVEL OF EVIDENCE: Therapeutic studies, Level IV.

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BACKGROUND: This study assessed the results of robotic thyroidectomy by fellowship-trained surgeons in their initial independent practice, and whether standard fellowship training for robotic surgery shortens the learning curve. METHODS: This prospective cohort study evaluated outcomes in 125 patients who underwent robotic thyroidectomy using gasless transaxillary single-incision technique by 2 recently graduated fellowship-trained surgeons. Learning curves were analyzed by operation time, with proficiency defined as the point at which the slope of the time curve became less steep. RESULTS: Of the 125 patients, 113 underwent robotic less-than-total thyroidectomy, 9 underwent robotic total thyroidectomy and 3 underwent robotic total thyroidectomy with modified radical neck dissection. Mean total times for these 3 operations were 100.8 ± 20.6 minutes, 134.2 ± 38.7 minutes, and 284.7 ± 60.4 minutes, respectively. For both surgeons, the operation times gradually decreased, reaching a plateau after 20 robotic less-than-total thyroidectomies. CONCLUSION: The surgical learning curve for robotic thyroidectomy performed by recently graduated fellowship-trained surgeons with little or no experience in endoscopic surgery showed excellent results compared with those in a large series of more experienced surgeons.

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BACKGROUND: Understanding how novice nurses perceive their career in the psychiatric ward can be helpful for nurse educators and managers to gain insight into psychiatric nursing care and adding applicable knowledge to the development of support strategies for this group. The aim of this study was to describe and illuminate experiences of new graduated nurses working at a psychiatric ward in an Iranian context. MATERIALS AND METHODS: A descriptive phenomenology has been chosen. Participants with baccalaureate degrees in nursing were selected purposefully and they all had less than 6 months of work experience in psychiatric wards beforehand. The study was conducted at the Razi Hospital in Iran. Data were collected through unstructured individual in-depth interviews and analyzed according to the Colaizzi method by means of Husserlian phenomenology. RESULTS: Three main themes were found in this study, of which six sub-themes were constructed as follows: Being in the world of fear and complaint, which has been abstracted by having mixed feelings of conflict and compliant on entry to the psychiatric ward, doubt about adequacy of being a psychiatric nurse and working in psychiatric ward and a frightening and non-supportive environment; A sense of imprisoned and confined, which has been constructed by different experience with different environmental milieu in psychiatric ward, as a lock sense; Becoming a psychiatric nurse, which has been constructed as a sense of usefulness, a sense of sympathy and compassion for patients and a sense of professional identity. CONCLUSIONS: This study identified areas that require modification by providing insight into lived experiences of beginners' nurses as the value in psychiatric ward. New graduated nurses may face negative perceptions and feelings due to confrontation with a new environment, patients and colleagues as well as shortcomings in the preparation.

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Transradial approach in cardiac catheterization is increasing. In daily practice, coronary angiography via radial artery is usually performed by using catheters designed for femoral approach. The aim of this study was to evaluate advantages in the use of a workbench reshaped AR1 mod catheter, in terms of procedural duration time, number of catheters per procedure, fluoroscopy time, contrast agent administered volume, images quality and costs. Two hundred patients, submitted to coronary angiography via right radial artery in our institution, have been retrospectively reviewed. Patients have been divided in two groups, depending on whether a workbench reshaped Cordis Amplatz AR1 mod catheter (rAR1 mod), or catheters in their original shape (OC) have been employed. In the rAR1 mod group (100 patients) a lower number of catheters per procedure (1.07 ± 0.25 vs. 1.47 ± 1.65; p < 0.001), a more frequent right coronary selective engagement (76.76% vs. 53.12%; p < 0.001), a smaller amount of contrast agent (63.02 ± 27.77 vs. 80.85 ± 29.22 ml, p < 0.001), a reduced fluoroscopy and global procedural time (4.19 ± 2.91 vs. 5.69 ± 3.85 min, p = 0.004; and 34.58 ± 17.05 vs. 42.58 ± 17.26 min, p = 0.001, respectively) were observed. According to our experience, when right coronary angiography via right radial approach is performed, the utilization of rAR1 mod catheter correlates with multiple advantages in terms of procedural parameters.