搜索结果：Journal of CME

OBJECTIVES: Despite the broad range of continuing medical education (CME) offerings aimed at educating practicing physicians through the provision of up-to-date clinical information, physicians commonly overuse, under-use, and misuse therapeutic and diagnostic interventions. It has been suggested that the ineffective nature of CME either accounts for the discrepancy between evidence and practice or at a minimum contributes to this gap. Understanding what CME tools and techniques are most effective in disseminating and retaining medical knowledge is critical to improving CME and thus diminishing the gap between evidence and practice. The purpose of this review was to comprehensively and systematically synthesize evidence regarding the effectiveness of CME and differing instructional designs in terms of knowledge, attitudes, skills, practice behavior, and clinical practice outcomes. REVIEW METHODS: We formulated specific questions with input from external experts and representatives of the Agency for Healthcare Research and Quality (AHRQ) and the American College of Chest Physicians (ACCP) which nominated this topic. We systematically searched the literature using specific eligibility criteria, hand searching of selected journals, and electronic databases including: MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, The Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Abstracts of Reviews of Effects (DARE), PsycINFO, and the Educational Resource Information Center (ERIC). Two independent reviewers conducted title scans, abstract reviews, and then full article reviews to identify eligible articles. Each eligible article underwent double review for data abstraction and assessment of study quality. RESULTS: Of the 68,000 citations identified by literature searching, 136 articles and 9 systematic reviews ultimately met our eligibility criteria. The overall quality of the literature was low and consequently firm conclusions were not possible. Despite this, the literature overall supported the concept that CME was effective, at least to some degree, in achieving and maintaining the objectives studied, including knowledge (22 of 28 studies), attitudes (22 of 26), skills (12 of 15), practice behavior (61 of 105), and clinical practice outcomes (14 of 33). Common themes included that live media was more effective than print, multimedia was more effective than single media interventions, and multiple exposures were more effective than a single exposure. The number of articles that addressed internal and/or external characteristics of CME activities was too small and the studies too heterogeneous to determine if any of these are crucial for CME success. Evidence was limited on the reliability and validity of the tools that have been used to assess CME effectiveness. Based on previous reviews, the evidence indicates that simulation methods in medical education are effective in the dissemination of psychomotor and procedural skills. CONCLUSIONS: Despite the low quality of the evidence, CME appears to be effective at the acquisition and retention of knowledge, attitudes, skills, behaviors and clinical outcomes. More research is needed to determine with any degree of certainty which types of media, techniques, and exposure volumes as well as what internal and external audience characteristics are associated with improvements in outcomes.

The continuing medical education (CME) program in Plastic and Reconstructive Surgery began in 1999. Why? The Editorial Board of the Journal wanted to offer an updated compendium of all topics in plastic and reconstructive surgery, written by the current leaders in the field on each topic. As a result, the Journal began publishing monthly CME articles to meet a need among plastic surgeons. Convenience and the offer of 1 hour of Category 1 Credit resulted in the program's initial and ongoing success. The CME program moved along more or less under the general guidance of the Journal's editorial office until October of 2008. In that month's issue, Don Lalonde et al. unveiled a formal, unified, and comprehensive plan for the CME program.1 That editorial served as his first “state of the union” statement on the CME; Dr. Lalonde had just been confirmed as the Journal's CME/Maintenance of Certification (MOC) section editor. He provided a history of the CME program in the Journal, delineated the difference between CME credit and MOC-Plastic Surgery credit and CMEs, and looked forward to the formal creation of a new series of 36 CME articles that would cover the spectrum of plastic and reconstructive surgery (including cosmetic surgery). That new CME series started in April of 2010. HOW IS THE NEW CME SERIES DIFFERENT? The following list details how the new CME series is different from that which preceded it. Up to 40 minutes of video learning from the experts with every article. Watch Fred Menick perform nasal reconstruction in the first new CME article in the April 2010 issue.3 You can watch this master of nasal surgery perform three different phases of reconstruction and describe his technique in three videos with just a click on the www.PRSJournal.com Web site. These videos are 5 to 10 minutes long and provide the latest educational delivery capabilities of surgical techniques. Single sign-on for all American Society of Plastic Surgeons (ASPS) members. No cumbersome multiple logins are needed to view a CME article and take a CME test. Extensive posttest answer discussions and references. Just as with the ASPS in-service examination, all of the new series of CME articles provide posttest discussions of the questions and answers, complete with references. Because of the posttest discussions, the CME articles, answer discussions, and references are ideal study guides for board examinations. Automatic recording of CME credits for members. All members of the ASPS who successfully complete a CME test activity have credit for that activity automatically recorded with the ASPS. All third-party record keeping is eliminated, and certificates for successful completion of CME activities can be easily generated. Convenience of obtaining credit. As in the past, each CME test continues to represent a convenient way to obtain 1 hour of Category 1 CME credit. Members take the tests online; they can take tests in the privacy of their own offices or at home any time, day or night, any day of the year. No travel to an educational course (along with associated travel costs and course registration fees) is necessary. Because test taking is conducted through the ASPS Online Education Center, there is no messy or cumbersome (or slow) filling out of any forms and faxing in of hard-copy test answers, and recording of credit occurs instantaneously. Wide range of topics. The CME tests cover a wide variety of topics, spanning the breadth and depth of plastic and reconstructive surgery in a 3-year rotating cycle. Quality content and tests. Every Plastic and Reconstructive Surgery CME article and test has been rigorously peer reviewed and represents the highest quality in articles and test content. Articles present current, state-of-the-art material for the most up-to-date information. TOPICS AND VIDEO HIGHLIGHTS Three essential components of the new CME program are (1) comprehensive topics that cover the entire spectrum of plastic surgery; (2) CME authors who are recognized surgical experts in their designated article topics; and (3) critical educational content that is provided in a multimedia format. A sampling of the topics and authors is provided in Table 1. Reconstructive and cosmetic topics in addition to those shown in Table 1 include:Table 1: CME Topics and Authors: A Sampling Cosmetic medicine: fat injection, facial resurfacing, fillers Cleft lip and velopharyngeal incompetence Craniofacial syndromes and surgery Head and neck reconstruction Scalp, skull, orbit, and maxilla reconstruction Ear deformities and reconstruction Burns and burn reconstruction Body contouring Augmentation mammaplasty Breast reduction Breast reconstruction after breast cancer Lower extremity and perineal reconstruction Nerve entrapment, repair, and brachial plexus disorders Wrist surgery Hand fractures/joint injuries Safe perioperative management in plastic surgery Just as important as providing comprehensive coverage of critical topics by subject experts is the highly educational, multimedia delivery of CME article content.2 The new CME articles take full advantage of the new PRSJournal.com Web site platform to provide figure-rich articles. Absolutely essential to these new CME articles is the integral incorporation of online videos. Each CME article offers numerous stand-alone videos, so you can see the operations instead of imagining them. The videos free up the written part of the articles to provide “pearls” to keep you out of trouble, as the written word no longer has to describe the surgery you can see live on film. Procedural videos, surgical techniques, and running commentaries by the authors progressively download to your computer screen at the click of your mouse. Where else can you see live the crux of a nasal reconstruction as masterfully done by Fred Menick? Where else can you watch Mark Codner complete a blepharoplasty so elegantly? Nowhere! The new CME articles represent one of the real jewels of Plastic and Reconstructive Surgery and of all of plastic surgery as a specialty. The Journal editors, staff, authors, publisher, and the ASPS Online Education team have all worked diligently in concert to create a highly intuitive, enjoyable, and incredibly educational experience for you. The CME program represents a quiet culmination of much of what is good and possible in plastic surgery, and it's all there for you for the reading and watching. We urge you to go online, read the articles, view the videos, and take the CME tests. As you do, you can rest assured that we are continuing to refine and improve the CME program, so that it will be ever better and better.

Anesthesiology's journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA's Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.Purpose: The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.Target Audience: Physicians and other medical professionals whose medical specialty is the practice of anesthesia.Learning Objectives: After reading this article, participants should have a better understanding of what unplanned admission to an intensive care unit can tell us about the process of care and health care safety in patients having surgery.Authors –Guy Haller, M.D., Paul S. Myles, M.B.B.S., M.P.H., M.D., F.C.A.R.C.S.I., F.A.N.Z.C.A., Rory Wolfe, B.Sc., Ph.D., Anthony M. Weeks, M.B.B.S., F.A.N.Z.C.A., Johannes Stoelwinder, M.B.B.S., M.D., F.R.C.A.M.A., F.A.C.H.S.E., F.F.P.H.M., and John McNeil, M.B.B.S., Ph.D., F.R.A.C.P.Grants or research support: Supported by the Swiss National Science Foundation, Bern, Switzerland; the Count Eugenio Litta Foundation, Vaduz, Liechtenstein; a Monash University Postgraduate Research Scholarship, Melbourne, Australia (to Dr. Haller); and an Australian National Health and Medical Research Council Practitioner's Fellowship, Canberra, Australia (to Dr. Myles).Consultantships or honoraria: NoneQuestion Writer –Peter L. Bailey, M.D. Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.Based on the article by Haller et al. entitled “Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=103&issue=6&spage=1121&part=fulltext in the December issue of Anesthesiology, choose the one correct answer for each question:1. Which of the following is least likely to provide useful information concerning the process of care when patients suffer an adverse outcome?A. Critical incident analysis techniquesB. Monitoring mortality ratesC. Organizational safety culture assessmentD. Incident reporting2. A “near miss” is an incident where an act of commission or omission could have harmed a patient but did not. Which of the following is least likely to explain why a potentially harmful incident results only in a near miss?A. Chance alone prevented harm from being caused.B. Steps were taken to prevent harm.C. Steps were taken to reduce any harm.D. Other more serious outcomes rendered the near miss irrelevant.3. Which of the following statements concerning the analysis of patient care when unintended admission to an intensive care unit occurs after surgery is most likely true?A. It can provide specific information on the safety of patient care.B. It requires the use of risk-adjusted models.C. Peer review is necessary in order to properly determine a relationship between adverse outcomes and a safety issue.D. An electronic information system is necessary for proper analysis.4. Which of the following is least likely to be associated with increased risk of an unplanned intensive care unit admission after surgery?A. Duration of surgeryB. Time of day of surgeryC. Female genderD. Obesity5. Which of the following statements concerning patients who experience an unplanned intensive care unit admission after surgery is least likely true?A. Overall, they will experience a significant increase in mortality.B. They frequently (50% of the time) will have had an intraoperative near miss.C. The impact of the unplanned intensive care unit admission will be most negligible for patients who had minor surgery.D. For patients undergoing most surgeries, the hospital length of stay increases significantly.6. Unplanned intensive care unit admission after surgery is least likely to involve which of the following?A. Complications of vascular line insertionB. HypothermiaC. HypotensionD. Uncontrolled hypertension

The geo-effectiveness of Coronal Mass Ejections (CMEs) is a critical area of study in space weather, particularly in the lesser-explored domain of CME-CME interactions and their geomagnetic consequences. This study leverages the SWASTi framework to perform 3D MHD simulation of a range of CME-CME interaction scenarios within realistic solar wind conditions. The focus is on the dynamics of the initial magnetic flux, speed, density, and tilt of CMEs, and their individual and combined impacts on the disturbance storm time (Dst) index. Additionally, the kinematic, magnetic, and structural impacts on the leading CME, as well as the mixing of both CMEs, are analyzed. Time series in-situ studies are conducted through virtual spacecraft positioned along three different longitudes at 1 AU. Our findings reveal that CME-CME interactions are non-uniform along different longitudes due to the inhomogeneous ambient solar wind conditions. A significant increase in the momentum and kinetic energy of the leading CME is observed due to collisions with the trailing CME, along with the formation of reverse shocks in cases of strong interaction. These reverse shocks lead to complex wave patterns inside C

Fast (V$_{\rm CME}$>1000${\rm \,km\,s^{-1}}$) coronal mass ejections (CMEs) capable of accelerating protons beyond 300MeV are thought to trigger hours-long sustained $γ$-ray emission (SGRE) after the impulsive flare phase. Meanwhile, CME-CME interactions can cause enhanced proton acceleration, increasing the fluxes of solar energetic particles. This study explores the role of fast CME interactions in SGRE production during CME clusters, which we define as a series of CMEs linked to >C-class flares with waiting times <$\,$1$\,$day from the same active region (AR). We focus on clusters in major CME-productive ARs (major ARs), by defining a major AR as one that produced >$\,$1 CME-associated major (>M-class) flare. The study identified 76 major ARs between 2011 and 2019, of which 12 produced all SGRE events. SGRE-producing ARs exhibit higher median values for the speed of their fastest CMEs (2013 vs. 775${\rm \,km\,s^{-1}}$) and the class of their strongest flares (X1.8 vs. M5.8), compared to SGRE-lacking ARs. They also produced relatively faster CMEs (median speed: 1418 vs. 1206.5${\rm \,km\,s^{-1}}$), with the SGRE-associated CMEs occurring during periods of higher CM

This is the second paper of the statistical study of coronal mass ejection (CME) source locations, in which the relationship between CMEs and active regions (ARs) is statistically studied on the basis of the information of CME source locations and the ARs automatically extracted from magnetic synoptic charts of Michelson Doppler Imager (MDI) during 1997 -- 1998. It is found that about 63% of the CMEs are related with ARs, at least about 53% of the ARs produced one or more CMEs, and particularly about 14% of ARs are CME-rich (3 or more CMEs were generated) during one transit across the visible disk. Several issues are then tried to clarify: whether or not the CMEs originating from ARs are distinct from others, whether or not the CME kinematics depend on AR properties, and whether or not the CME productivity depends on AR properties. The statistical results suggest that (1) there is no evident difference between AR-related and non-AR-related CMEs in terms of CME speed, acceleration and width, (2) the size, strength and complexity of ARs do little with the kinematic properties of CMEs, but have significant effects on the CME productivity, and (3) the sunspots in all the most productiv

Accurate estimation of propagation characteristics of coronal mass ejections (CMEs) is crucial for predicting their geoeffectiveness. Stereoscopic techniques to study the kinematics of CMEs generally have been carried out using remote sensing observations from three viewpoints, i.e. STEREO-A, STEREO-B, and SOHO. Since the loss of STEREO-B in 2014, stereoscopic reconstruction of CMEs has been restricted to the observations from only two viewpoints, i.e., STEREO-A and SOHO. When the angle of separation between STEREO-A and SOHO is small, it leads to larger uncertainties in the CME kinematics derived using stereoscopic techniques. In this paper, we demonstrate how this limitation can be addressed and how uncertainties in the estimation of CME kinematics and propagation direction can be reduced. For this purpose, we selected the CME of April 21, 2023, which was observed by two spacecraft, i.e. STEREO-A and SOHO, separated by a small 10 degree angle. Using the Graduated Cylindrical Shell (GCS) model on the remote-sensing observations near the Sun and the Advanced Drag-Based Model (ADBM) in the heliosphere, we estimated the arrival time of the CME at different locations in the heliospher

Height-time plots of the leading edge of coronal mass ejections (CME) have often been used to study CME kinematics. We propose a new method to analyze the CME kinematics in more detail by determining the radial mass transport process throughout the entire CME. Thus our method is able to estimate not only the speed of the CME front but also the radial flow speed inside the CME. We have applied the method to a slow CME with an average leading edge speed about 480 km s$^{-1}$. In the Lagrangian frame, the speed of the individual CME mass elements stay almost constant within 2 and 15 R$_S$, the range over which we analyzed the CME. Hence we have no evidence of net radial forces acting on parts of the CME in this range nor of a pile-up of mass ahead of the CME. We find evidence that the leading edge trajectory obtained by tie-pointing may gradually lag behind the Lagrangian front-side trajectories derived from our analysis. Our results also allow a much more precise estimate of the CME energy. Compared with conventional estimates using the CME total mass and leading-edge motion, we find that the latter may overestimate the kinetic energy and the gravitational potential energy.

We compare the network of aggregated journal-journal citation relations provided by the Journal Citation Reports (JCR) 2012 of the Science and Social Science Citation Indexes (SCI and SSCI) with similar data based on Scopus 2012. First, global maps were developed for the two sets separately; sets of documents can then be compared using overlays to both maps. Using fuzzy-string matching and ISSN numbers, we were able to match 10,524 journal names between the two sets; that is, 96.4% of the 10,936 journals contained in JCR or 51.2% of the 20,554 journals covered by Scopus. Network analysis was then pursued on the set of journals shared between the two databases and the two sets of unique journals. Citations among the shared journals are more comprehensively covered in JCR than Scopus, so the network in JCR is denser and more connected than in Scopus. The ranking of shared journals in terms of indegree (that is, numbers of citing journals) or total citations is similar in both databases overall (Spearman's \r{ho} > 0.97), but some individual journals rank very differently. Journals that are unique to Scopus seem to be less important--they are citing shared journals rather than bein

Earlier studies on Coronal Mass Ejections (CMEs), using remote sensing and in situ observations, have attempted to determine some of the internal properties of CMEs, which were limited to a certain position or a certain time. For understanding the evolution of the internal thermodynamic state of CMEs during their heliospheric propagation, we improve the self-similar flux rope internal state (FRIS) model, which is constrained by measured propagation and expansion speed profiles of a CME. We implement the model to a CME erupted on 2008 December 12 and probe the internal state of the CME. It is found that the polytropic index of the CME plasma decreased continuously from 1.8 to 1.35 as the CME moved away from the Sun, implying that the CME released heat before it reached adiabatic state and then absorbed heat. We further estimate the entropy changing and heating rate of the CME. We also find that the thermal force inside the CME is the internal driver of CME expansion while Lorentz force prevented the CME from expanding. It is noted that centrifugal force due to poloidal motion decreased with the fastest rate and Lorentz force decreased slightly faster than thermal pressure force as C

The culmination of solar cycle 24 by the end of 2019 has created the opportunity to compare the differing properties of coronal mass ejections (CMEs) between two whole solar cycles: Solar cycle 23 (SC 23) and Solar cycle 24 (SC 24). We report on the width evolution of limb CMEs in SC 23 and 24 in order to test the suggestion by Gopalswamy et al. (2015a) that CME flux ropes attain pressure balance at larger heliocentric distances in SC 24. We measure CME width as a function of heliocentric distance for a significantly large number of limb CMEs (~1000) and determine the distances where the CMEs reach constant width in each cycle. We introduced a new parameter: the transition height (hc) of a CME defined as the critical heliocentric distance beyond which the CME width stabilizes to a quasi-constant value. Cycle and phase-to-phase comparisons are based on this new parameter. We find that the average value of hc in SC 24 is 62% higher than in SC 23. SC 24 CMEs attain their peak width at larger distances from the Sun as compared to SC 23 CMEs. The enhanced transition height in SC 24 is new observational ratification of the anomalous expansion. The anomalous expansion of SC 24 CMEs which

Rankings of scholarly journals based on citation data are often met with skepticism by the scientific community. Part of the skepticism is due to disparity between the common perception of journals' prestige and their ranking based on citation counts. A more serious concern is the inappropriate use of journal rankings to evaluate the scientific influence of authors. This paper focuses on analysis of the table of cross-citations among a selection of Statistics journals. Data are collected from the Web of Science database published by Thomson Reuters. Our results suggest that modelling the exchange of citations between journals is useful to highlight the most prestigious journals, but also that journal citation data are characterized by considerable heterogeneity, which needs to be properly summarized. Inferential conclusions require care in order to avoid potential over-interpretation of insignificant differences between journal ratings. Comparison with published ratings of institutions from the UK's Research Assessment Exercise shows strong correlation at aggregate level between assessed research quality and journal citation `export scores' within the discipline of Statistics.

This study examines the social media uptake of scientific journals on two different platforms - X and WeChat - by comparing the adoption of X among journals indexed in the Science Citation Index-Expanded (SCIE) with the adoption of WeChat among journals indexed in the Chinese Science Citation Database (CSCD). The findings reveal substantial differences in platform adoption and user engagement, shaped by local contexts. While only 22.7% of SCIE journals maintain an X account, 84.4% of CSCD journals have a WeChat official account. Journals in Life Sciences & Biomedicine lead in uptake on both platforms, whereas those in Technology and Physical Sciences show high WeChat uptake but comparatively lower presence on X. User engagement on both platforms is dominated by low-effort interactions rather than more conversational behaviors. Correlation analyses indicate weak-to-moderate relationships between bibliometric indicators and social media metrics, confirming that online engagement reflects a distinct dimension of journal impact, whether on an international or a local platform. These findings underscore the need for broader social media metric frameworks that incorporate locally dom

An exploratory, descriptive analysis is presented of the national orientation of scientific, scholarly journals as reflected in the affiliations of publishing or citing authors. It calculates for journals covered in Scopus an Index of National Orientation (INO), and analyses the distribution of INO values across disciplines and countries, and the correlation between INO values and journal impact factors. The study did not find solid evidence that journal impact factors are good measures of journal internationality in terms of the geographical distribution of publishing or citing authors, as the relationship between a journal's national orientation and its citation impact is found to be inverse U-shaped. In addition, journals publishing in English are not necessarily internationally oriented in terms of the affiliations of publishing or citing authors; in social sciences and humanities also USA has their nationally oriented literatures. The paper examines the extent to which nationally oriented journals entering Scopus in earlier years, have become in recent years more international. It is found that in the study set about 40 per cent of such journals does reveal traces of internati

We study the interaction of two successive coronal mass ejections (CMEs) during the 2010 August 1 events using STEREO/SECCHI COR and HI data. We obtain the direction of motion for both CMEs by applying several independent reconstruction methods and find that the CMEs head in similar directions. This provides evidence that a full interaction takes place between the two CMEs that can be observed in the HI1 field-of-view. The full de-projected kinematics of the faster CME from Sun to Earth is derived by combining remote observations with in situ measurements of the CME at 1 AU. The speed profile of the faster CME (CME2; (is) approximately 1200 km s1) shows a strong deceleration over the distance range at which it reaches the slower, preceding CME (CME1; (is) approximately 700 km s1). By applying a drag-based model we are able to reproduce the kinematical profile of CME2 suggesting that CME1 represents a magnetohydrodynamic obstacle for CME2 and that, after the interaction, the merged entity propagates as a single structure in an ambient flow of speed and density typical for quiet solar wind conditions. Observational facts show that magnetic forces may contribute to the enhanced deceleration of CME2. We speculate that the increase in magnetic tension and pressure, when CME2 bends and compresses the magnetic field lines of CME1, increases the efficiency of drag.

This study aims to present a scientometric analysis of the journal titled Cognition for a period of 20 years from 1999 to 2018. The present study was conducted with an aim to provide a summary of research activity in current journal and characterize its most aspects. The research coverage includes the year wise distribution of articles, authors, institutions, countries and citation analysis of the journal. The analysis showed that 2870 papers were published in journal of Cognition from 1999 to 2018. The study identified top 20 prolific authors, institutions and countries of the journal. Researchers from USA have been made the most percentage of contributions.

Predicting the impacts of coronal mass ejections (CMEs) is a major focus of current space weather forecasting efforts. Typically, CME properties are reconstructed from stereoscopic coronal images and then used to forward model a CME's interplanetary evolution. Knowing the uncertainty in the coronal reconstructions is then a critical factor in determining the uncertainty of any predictions. A growing number of catalogs of coronal CME reconstructions exist, but no extensive comparison between these catalogs has yet been performed. Here we develop a Living List of Attributes Measured in Any Coronal Reconstruction (LLAMACoRe), an online collection of individual catalogs, which we intend to continually update. In this first version, we use results from 24 different catalogs with 3D reconstructions using STEREO observations between 2007--2014. We have collated the individual catalogs, determining which reconstructions correspond to the same events. LLAMACoRe contains 2954 reconstructions for 1862 CMEs. Of these, 511 CMEs contain multiple reconstructions from different catalogs. Using the best-constrained values for each CME, we find that the combined catalog reproduces the generally know

This work studies the kinematics of the leading edge and the core of 6 Coronal Mass Ejections (CMEs) in the combined field of view of Sun Watcher using Active Pixel System detector and Image Processing (SWAP) on-board PRoject for On-Board Autonomy (PROBA-2) and the ground-based K-Cor coronagraph of the Mauna Loa Solar Observatory (MLSO). We report, for the first time, on the existence of a critical height h$_\mathrm{c}$, which marks the onset of velocity dispersion inside the CME. This height for the studied events lies between 1.4-1.8 R$_{\odot}$, in the inner corona. We find the critical heights to be relatively higher for gradual CMEs, as compared to impulsive ones, indicating that the early initiation of these two classes might be different physically. We find several interesting imprints of the velocity dispersion on CME kinematics. The critical height is strongly correlated with the flux-rope minor radius and the mass of the CME. Also, the magnitude of velocity dispersion shows a reasonable positive correlation with the above two parameters. We believe these results will advance our understanding of CME initiation mechanisms and will help provide improved constraints to CME i