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These announcements are a key part of our continuing efforts to help our customers make their notes more useful by expanding how they can use their smartpens. The software update introduces a new way to share notes and pencasts, moving away from a file format with inconsistent behavior across devices and sharing methods that rely on custom links to external services. By transitioning to a standards-based PDF for exporting pencasts, customers will have more flexibility to share their notes and play back interactive audio-pencasts on a wider range of Macs, PCs and mobile devices. Customers will be able to export standard PDFs of their notebook pages and stand-alone audio files of their recordings as well. In addition, if someone does not have Livescribe software installed, they can open a Livescribe PDF file and play back the linked written and audio notes using the web-based Livescribe Player at www. Existing notes, custom notebooks and pencasts from Livescribe Desktop will still be available after Echo Desktop is installed.
This course has different teaching modalities such as live lectures, online components, electronic books, hands-on sessions on phantom models, simulation and case discussions.
During the course, three full days are dedicated to TEE, with approximately 14 h of TEE hands-on simulator training; the course schedule has been previously mentioned in earlier publications. This training program was organized into eight modules imparted over 4 weeks. Each training session started with 15 min of discussion or lectures about the topic and followed by a min hands-on training, with approximately h hands-on training over 4 weeks.
Other TEE exposure during the residency program included 12 annual echo simulator sessions during their PGY-3 and 4 years, a cardiac-thoracic rotation of 1 month and optional TEE rotation of 1 month. Traditional transesophageal echo training Anesthesia residents participated in a structured longitudinal simulator-based TEE educational program during the PGY-3 and 4 years.
It consists of an ultrasound training session 60 min of formal didactics and hands-on instruction with the TEE simulator every 3—4 weeks five total sessions. During this program, each trainee had approximately 20 h of hands-on TEE simulator training as well as access to our web-based training modules.
Components of the curriculum of the FUS educational program have been published previously Supplementary Table 2. During the FUS program, the PGY-1 trainees were exposed to a total of 14 h of dedicated and supervised hands-on TEE simulator training at the departmental ultrasound simulation laboratory as well as live and online didactics.
Image accuracy assessment was performed on the final day of the course. PGY-1 group: This group consisted of categorical anesthesia interns who participated in the FUS educational program during their internship year.
PGY-4 group: This group comprised graduating anesthesia residents who received the traditional TEE training as described previously during their residency along with exposure to ultrasound training during sub-specialty rotations but not the FUS program. Image accuracy testing was performed individually in the last month of their anesthesia training prior to their graduation from the residency program.
Images were determined using guidelines and common imaging planes used for assessment. Study protocol The study consisted of the following steps: An expert acquired standardized TEE images on a simulator as the reference images. The final image was observed and agreed upon by consensus of experts as the ideal standard image during acquisition.
The motion metric and the geometric positional data of the scan plane in the 3D space for each reference image was captured and stored.
Experts were invited to acquire the same images on the TEE simulator with simultaneous acquisition of the motion metric and final positional data of the scan plane. The final positional data of experts was analyzed to create a range of acceptable scan plane final positions in order to define an acceptable range of accuracy. The motion metric and final positional data were compared between the groups.
The methodology used for to capture the motion data has been described in previous studies Briefly, an experienced echocardiographer acquired 12 TEE images Supplementary Table 3 that is target cut planes TCPs that consisted of multiple upper, mid-esophageal and transgastric windows corresponding to a standard TEE images.
The 4-chamber 4C view was omitted, as it is the starting point for motion tracking in each exam. The TCPs were 1 mid-esophageal ME two chamber, 2 ME long axis, 3 ME ascending aorta long axis, 4 ME ascending aorta short axis, 5 ME aortic valve short axis, 6 ME right ventricular inflow—outflow, 7 ME bicaval, 8 transgastric mid-short axis, 9 descending aorta short axis, 10 descending aorta long axis, 11 deep transgastric long axis and 12 transgastric long axis.
Motion metric data collection and position tracking A participant was first asked to obtain a ME-4C view so that the starting point for all TCPs, across all participants, was similar. Metrics tracking was started by the instructor, and the participant was asked to capture the first TCP.
All of the commands above work on those too, in addition to a few TV-specific commands below. Time and date Set an alarm: "Alexa, set an alarm for 7 a. Later, it added another feature, called Drop In , that lets users call different Echo devices throughout their home, intercom style.
You can also call and message from the Alexa app, but no commands are needed. This year, Amazon has added new features like Announcements and the ability to send text messages with your voice.
Call another Echo user: "Alexa, call [name]. Just say "Alexa, find me a good smartphone on Amazon? Notifications To turn on notifications, open the Alexa app or go to alexa. Then your Echo speakers will light up yellow when you have new notifications. Check missed notifications: "Alexa, what did I miss?