567 research outputs found

    Application of Computer Vision and Mobile Systems in Education: A Systematic Review

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    The computer vision industry has experienced a significant surge in growth, resulting in numerous promising breakthroughs in computer intelligence. The present review paper outlines the advantages and potential future implications of utilizing this technology in education. A total of 84 research publications have been thoroughly scrutinized and analyzed. The study revealed that computer vision technology integrated with a mobile application is exceptionally useful in monitoring students’ perceptions and mitigating academic dishonesty. Additionally, it facilitates the digitization of handwritten scripts for plagiarism detection and automates attendance tracking to optimize valuable classroom time. Furthermore, several potential applications of computer vision technology for educational institutions have been proposed to enhance students’ learning processes in various faculties, such as engineering, medical science, and others. Moreover, the technology can also aid in creating a safer campus environment by automatically detecting abnormal activities such as ragging, bullying, and harassment

    What do nurses experience in communication when assisting in robotic surgery : an integrative literature review

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    Background. Communication in surgery is integral to the fundamentals of perioperative nursing practice and patient safety. Research exploring team communication in robotic-assisted surgery (RAS) is evident in the literature but little attention has been focused on how the experiences of operating room nurses' communication affect safety, practice and patient care outcomes. Objective. To synthesise current evidence regarding communication during robotic-assisted surgery as experienced by registered nurses. Design. An integrative literature review informed by Whittemore and Knafl's (2005) methodology was used to conduct a rigorous analysis and synthesis of evidence. Methods. A comprehensive database search was conducted using PRISMA guidelines. CINAHL, Pubmed, PsychINFO and British Nursing Web of Science databases were searched using a Boolean strategy. Results. Twenty-five relevant papers were included in this literature review. Thematic analysis revealed two main themes with four related subthemes. The two main themes are: ‘Adaptive operating room nursing in RAS’ and ‘RAS alters team dynamics’. The four subthemes are: ‘Navigating disruptions in RAS’, ‘RAS heightens interdependence on team working’, ‘Augmented communicative workflow in RAS’, and ‘Professional empowerment to speak up’. Conclusions. This integrative review identifies how current research largely focuses on communication in the wider OR team. However, current evidence lacks the input of nurses. Therefore, further evidence is needed to explore nurses' experiences to highlight their perspectives. Clinical Relevance. Robotics significantly benefit patients, and this review identifies different challenges that robotic-assisted surgery nurses encounter. A better understanding of the communication from the perspective of nurses is needed to guide future research, practice education, policy development and leadership/management

    The efficacy of virtual reality in professional soccer

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    Professional soccer clubs have taken an interest to virtual reality, however, only a paucity of evidence exists to support its use in the soccer training ground environment. Further, several soccer virtual reality companies have begun providing solutions to teams, claiming to test specific characteristics of players, yet supportive evidence for certain measurement properties remain absent from the literature. The aims of this thesis were to explore the efficacy of virtual reality being used in the professional football training ground environment. To do so, this thesis looked to explore the fundamental measurement properties of soccer specific virtual reality tests, along with the perceptions of professional coaches, backroom staff, and players that could use virtual reality. The first research study (Chapter 3) aimed to quantify the learning effect during familiarisation trials of a soccer-specific virtual reality task. Thirty-four professional soccer players age, stature, and body mass: mean (SD) 20 (3.4) years; 180 (7) cm; 79 (8) kg, participated in six trials of a virtual reality soccer passing task. The task required participants to receive and pass 30 virtual soccer balls into highlighted mini-goals that surrounded the participant. The number of successful passes were recorded in each trial. The one-sided Bayesian paired samples t-test indicated very strong evidence in favour of the alternative hypothesis (H1)(BF10 = 46.5, d = 0.56 [95% CI = 0.2 to 0.92]) for improvements in total goals scored between trial 1: 13.6 (3.3) and trial 2: 16 (3.3). Further, the Bayesian paired-samples equivalence t-tests indicated strong evidence in favour of H1 (BF10 = 10.2, d = 0.24 [95% CI = -0.09 to 0.57]) for equivalence between trial 4: 16.7 (3.7) and trial 5: 18.2 (4.7); extreme evidence in favour of H1 (BF10 = 132, d = -0.02 [95% CI = -0.34 to 0.30]) for equivalence between trials 5 and 6: 18.1 (3.5); and moderate evidence in favour of H1 (BF10 = 8.4, d = 0.26 [95% CI = -0.08 to 0.59]) for equivalence between trials 4 and 6. Sufficient evidence indicated that a learning effect took place between the first two trials, and that up to five trials might be necessary for performance to plateau in a specific virtual reality soccer passing task.The second research study (Chapter 4) aimed to assess the validity of a soccer passing task by comparing passing ability between virtual reality and real-world conditions. A previously validated soccer passing test was replicated into a virtual reality environment. Twenty-nine soccer players participated in the study which required them to complete as many passes as possible between two rebound boards within 45 s. Counterbalancing determined the condition order, and then for each condition, participants completed four familiarisation trials and two recorded trials, with the best score being used for analysis. Sense of presence and fidelity were also assessed via questionnaires to understand how representative the virtual environments were compared to the real-world. Results showed that between conditions a difference was observed (EMM = -3.9, 95% HDI = -5.1 to -2.7) with the number of passes being greater in the real-world (EMM = 19.7, 95% HDI = 18.6 to 20.7) than in virtual reality (EMM = 15.7, 95% HDI = 14.7 to 16.8). Further, several subjective differences for fidelity between the two conditions were reported, notably the ability to control the ball in virtual reality which was suggested to have been more difficult than in the real-world. The last research study (Chapter 5) aimed to compare and quantify the perceptions of virtual reality use in soccer, and to model behavioural intentions to use this technology. This study surveyed the perceptions of coaches, support staff, and players in relation to their knowledge, expectations, influences, and barriers of using virtual reality via an internet-based questionnaire. To model behavioural intention, modified questions and constructs from the Unified Theory of Acceptance and Use of Technology were used, and the model was analysed through partial least squares structural equation modelling. Respondents represented coaches and support staff (n = 134) and players (n = 64). All respondents generally agreed that virtual reality should be used to improve tactical awareness and cognition, with its use primarily in performance analysis and rehabilitation settings. Generally, coaches and support staff agreed that monetary cost, coach buy-in and limited evidence base were barriers towards its use. In a sub-sample of coaches and support staff without access to virtual reality (n = 123), performance expectancy was the strongest construct in explaining behavioural intention to use virtual reality, followed by facilitating conditions (i.e., barriers) construct which had a negative association with behavioural intention. This thesis aimed to explore the measurement properties of soccer specific virtual reality tests, and the perceptions of staff and players who might use the technology. The key findings from exploring the measurement properties were (1) evidence of a learning curve, suggesting the need for multiple familiarisation trials before collecting data, and (2) a lack of evidence to support the validity of a virtual reality soccer passing test as evident by a lack of agreement to a real-world equivalent. This finding raises questions on the suitability for virtual reality being used to measure passing skill related performance. The key findings from investigating the perceptions of users included, using the technology to improve cognition and tactical awareness, and using it in rehabilitation and performance analysis settings. Future intention to use was generally positive, and driven by performance related factors, yet several barriers exist that may prevent its widespread use. In Chapter 7 of the thesis, a reflective account is presented for the reader, detailing some of the interactions made with coaches, support staff and players in relation to the personal, moral, and ethical challenges faced as a practitioner-researcher, working and studying, respectively, in a professional soccer club

    Genomic insights for safety assessment of foodborne bacteria.

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    La sicurezza alimentare e l'accesso ad essa sono fondamentali per sostenere la vita e promuovere una buona salute. Gli alimenti non sicuri, contenenti microrganismi o sostanze chimiche nocive, sono causa di oltre 200 malattie, dalla diarrea al cancro, che colpiscono in particolare i neonati, i bambini piccoli, gli anziani e gli individui immunocompromessi. L'onere globale delle malattie di origine alimentare si ripercuote sulla salute pubblica, sulla società e sull'economia, pertanto è necessaria una buona collaborazione tra governi, produttori e consumatori per contribuire a garantire la sicurezza alimentare e sistemi alimentari più solidi. L'indagine più recente condotta dall'OMS (2015) ha evidenziato una stima di 600 milioni di individui malati e 420.000 decessi annui associati ad alimenti non sicuri. L'impatto economico è dovuto principalmente alla mancanza di alimenti sicuri nei Paesi a basso e medio reddito, con una perdita di 110 miliardi di dollari l'anno in termini di produttività e spese mediche. Le sfide principali per garantire la sicurezza alimentare rimangono legate alla nostra produzione alimentare e alla catena di approvvigionamento, dove fattori come la contaminazione ambientale, le preferenze dei consumatori, il rilevamento tempestivo e la sorveglianza dei focolai giocano un ruolo cruciale. Recentemente, le metodologie basate sul DNA per il rilevamento e l'indagine microbica hanno suscitato particolare interesse, soprattutto grazie allo sviluppo delle tecnologie di sequenziamento. Contrariamente ai metodi tradizionali dipendenti dalla coltura, le tecniche basate sul DNA, come il sequenziamento dell'intero genoma (WGS), mirano a risultati rapidi e sensibili a un prezzo relativamente basso e a tempi di elaborazione brevi. Inoltre, il WGS conferisce un elevato potere discriminatorio che consente di determinare importanti caratteristiche genomiche legate alla sicurezza alimentare, come la tassonomia, il potenziale patogeno, la virulenza e la resistenza antimicrobica e il relativo trasferimento genetico. La comprensione di queste caratteristiche è fondamentale per progettare strategie di rilevamento e mitigazione da applicare lungo l'intera catena alimentare secondo una prospettiva di "One Health", che porta ad acquisire conoscenze sul microbiota che influenza l'uomo, gli animali e l'ambiente. Lo scopo della tesi è quello di approfondire la genomica dei microbi di origine alimentare per la loro caratterizzazione e per creare o migliorare le strategie per la loro individuazione e i metodi di mitigazione. In particolare, questa tesi si concentra sulla valutazione del potenziale patogeno sulla base di analisi genomiche che includono studi di tassonomia, virulenza, resistenza agli antibiotici e mobiloma. Il secondo obiettivo è quello di trarre vantaggio dalle conoscenze genomiche per progettare dispositivi di rilevamento rapidi ed efficaci e metodi di mitigazione affidabili per affrontare i patogeni di origine alimentare. Più in dettaglio, saranno trattati i seguenti argomenti: La presenza di ceppi multiresistenti negli alimenti fermentati pronti al consumo rappresenta un rischio per la salute pubblica per la diffusione di determinanti AMR nella catena alimentare e nel microbiota intestinale dei consumatori. Le analisi genomiche hanno permesso di valutare accuratamente la sicurezza del ceppo UC7251 di E. faecium, in relazione alla sua virulenza e alla co-localizzazione dei geni di resistenza agli antibiotici e ai metalli pesanti in elementi mobili con capacità di coniugazione in diverse matrici. Questo lavoro sottolinea l'importanza di una sorveglianza della presenza di batteri AMR negli alimenti e di incitare lo sviluppo di strategie innovative per la mitigazione del rischio legato alla diffusione della resistenza antimicrobica negli alimenti. L'accuratezza dell'identificazione tassonomica guida le analisi successive e, per questo motivo, un metodo adeguato per identificare le specie è fondamentale. È stata studiata la riclassificazione delle specie di Enterococcus faecium clade B, utilizzando un approccio combinato di filogenomica, tipizzazione di sequenza multilocus, identità nucleotidica media e ibridazione digitale DNA-DNA. L'obiettivo è dimostrare come l'analisi del genoma sia più efficace e fornisca risultati più dettagliati riguardo alla definizione delle specie, rispetto all'analisi della sequenza del 16S rRNA. Ciò ha portato alla proposta di riclassificare tutto il clade B di E. faecium come E. lactis, riconoscendo che i due gruppi sono filogeneticamente separati, per cui è possibile definire una specifica procedura di valutazione della sicurezza, prima del loro utilizzo negli alimenti o come probiotici, compresa la considerazione per l'inclusione nella lista europea QPS. A partire da questa riclassificazione tassonomica, abbiamo sviluppato un metodo basato sulla PCR per la rapida individuazione e differenziazione di queste due specie e per discutere le principali differenze fenotipiche e genotipiche da una prospettiva clinica. A questo scopo, è stato utilizzato un allineamento del core-genoma basato sull'analisi del pangenoma. La differenza allelica tra alcuni geni del core ha permesso la progettazione di primer e l'identificazione della specie mediante PCR con una specificità del 100% e senza reattività crociata. Inoltre, i genomi clinici di E. lactis sono stati classificati come un rischio potenziale a causa della capacità di aumentare la traslocazione batterica. Gli agenti antimicrobici alternativi agli antibiotici sono una delle principali aree di sviluppo e miglioramento dell'attuale catena alimentare. Le nanoparticelle metalliche, come le nanoparticelle di platino (PtNPs), hanno suscitato interesse per le loro potenti attività catalitiche simili alle ossidasi e alle perossidasi che garantiscono forti effetti antimicrobici, e sono state proposte come potenziali candidati per superare gli inconvenienti degli antibiotici come la resistenza ai farmaci. L'obiettivo è studiare la modalità d'azione delle PtNPs in relazione alla capacità di formazione del biofilm, al meccanismo di contrasto delle specie reattive dell'ossigeno (ROS) e al quorum sensing utilizzando batteri di origine alimentare come Enterococcus faecium e Salmonella Typhimurium.Safe food and the access to it is key to sustaining life and promoting good health. Unsafe food containing harmful microorganisms or chemical substances causes more than 200 diseases, ranging from diarrhoea to cancers that particularly affect infants, young children, elderly and immunocompromised individuals. The global burden of foodborne disease affects public health, society, and economy, therefore good collaboration between governments, producers and consumers is needed to help ensure food safety and stronger food systems. The most recent survey conducted by WHO (2015) showed an estimated 600 million ill individuals and 420 000 yearly deaths associated to unsafe food. The economic impact is mainly due to the lack of safe food in low and middle income causing a US$ 110 billion is lost each year in productivity and medical expenses. The main challenges to assure food safety remain tied to our food production and supply chain, where factors like environmental contamination, consumer preferences, timely detection and surveillance of outbreaks play a crucial role. Recently, DNA-based methodologies for microbial detection and investigation have sparked special interest, mainly linked to the development of sequencing technologies. Contrary to the traditional culture-dependent methods, DNA-based techniques such as Whole Genome Sequencing (WGS) that targets fast and sensitive results at a relative low price and short processing time. Moreover, WGS confers high discriminatory power that allows to determine important genomic characteristics linked to food safety like taxonomy, pathogenic potential, virulence and antimicrobial resistance and the genetic transfer thereof. The understanding of these characteristics is fundamental to design detection and mitigation strategies to apply along the entire food-chain following a ‘One Health’ perspective, leading to gain knowledge about the microbiota that affect humans, animals, and environment. The aim of the thesis is to gain insight into the genomics of foodborne microbes for their characterization and to create or improve strategies for their detection and mitigation methods. Particularly, this thesis is focused on the assessment of the pathogenic potential based on genomic analyses including taxonomy, virulence, antibiotic resistance and mobilome studies. The second focus is to profit from the genomic insights to design rapid and time-effective detection devices and reliable mitigation methods to tackle foodborne pathogens. In more detail the following topics will be handled: The presence of multi-drug resistant strains in ready-to-eat fermented food represents a risk of public health for the spread of AMR determinants in the food chain and in the gut microbiota of consumers. Genomic analyses permitted to accurately assess the safety of E. faecium strain UC7251, with respect to its virulence and co-location of antibiotic and heavy metal resistance genes in mobile elements with conjugation capacity in different matrices. This work emphasizes the importance of a surveillance for the presence of AMR bacteria in food and to incite the development of innovative strategies for the mitigation of the risk related to antimicrobial resistance diffusion in food. The accuracy of taxonomic identification drives the subsequent analysis and, for this reason, a suitable method to identify species is crucial. The species re-classification of Enterococcus faecium clade B was investigated, using a combined approach of phylogenomics, multilocus sequence typing, average nucleotide identity and digital DNA–DNA hybridization. The goal is to show how the genome analysis is more effective and give more detailed results concerning the species definition, respect to the analysis of the 16S rRNA sequence. This led to the proposal to reclassify all the E. faecium clade B as E. lactis, recognizing the two groups are phylogenetically separate, where a specific safety assessment procedure can be designed, before their use in food or as probiotics, including the consideration for inclusion in the European QPS list. From this taxonomic re-classification, we developed a PCR-based method for rapid detection and differentiation of these two species and to discuss main phenotypic and genotypic differences from a clinical perspective. To this aim, core-genome alignment base on pangenome analysis was used. Allelic difference between certain core genes allowed primer design and species identification through PCR with 100% specificity and no cross-reactivity. Moreover, clinical E. lactis genomes categorised as a potential risk due to the ability of enhanced bacterial translocation. Antimicrobial agents alternative to antibiotics are one of the main areas of development and improvement in the current food chain. Metallic nanoparticles like Platinum nanoparticles (PtNPs), have awaken interest due to their potent catalytic activities similar to oxidases and peroxidases granting strong antimicrobial effects, have been proposed as potential candidates to overcome the drawbacks of antibiotics like drug resistance. The goal is to study the mode of action of PtNPs related to biofilm formation capacity, reactive oxygen species (ROS) coping mechanism and quorum sensing using foodborne bacteria like Enterococcus faecium and Salmonella Typhimurium

    Navigating the Cultures of Health Care and Health Insurance: Highly skilled migrants in the US

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    What are the barriers preventing migrants from accessing and successfully utilizing health care in their new home country? Do these barriers vary across different migrant origin countries? And are they still a problem for highly skilled migrants, who often have well-paid jobs and health insurance provided by their employers? Based on field research conducted in the Washington D.C. area, Navigating the Cultures of Health Care and Health Insurance takes a mixed methods, qualitative and quantitative approach to the study of foreign patients’ utilization and assessment of health care in the US. Through interviews with both health care providers and patients, attitudes towards US health insurance and medical treatment are compared for migrants from three countries with very different cultural backgrounds and health insurance systems: Germany, India and Japan. Combined with an in-depth literature review, historical and contemporary surveys of health care across countries and analysis of health-related terms in the media, the results of this research indicate that foreign patients’ barriers to good health care persist despite access to health care services and insurance coverage, and reveal recurring transnational care seeking patterns, such as bringing medicines from abroad, delaying treatment for medical visits, insurance juggling and more. By describing their difficulties in integrating into the US health care system, the migrants in this study show the challenges and the potential for improvements in providing the care that migrants need in their new home

    30th European Congress on Obesity (ECO 2023)

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    This is the abstract book of 30th European Congress on Obesity (ECO 2023

    Ergonomics in laparoscopic surgery: a work system analysis to reduce work-related musculoskeletal disorders across surgeons in Peruvian hospitals

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    Laparoscopic surgery, also called minimally invasive surgery, is a type of surgery in which the surgeon operates by viewing the surgery on a screen that projects images from a camera inserted into the patient's abdomen. Laparoscopic tools are long (usually up to 35 cm) and require fine motor skills and visual perception for manipulation, restricting the degrees of freedom to move within the patient. This restriction causes surgeons to operate with limited vision and restricted movement and force them to work with assistants who assist in conducting the cameras, acting as "the surgeons' eyes". Because of its minimally invasive nature, laparoscopic surgery is well accepted by patients but is challenging and complex for the surgeon. This is due to the restriction of movement and perception that forces surgeons to adopt awkward postures with high exposition, which increases the likelihood of work-related musculoskeletal disorders (WRMSD). WRMSDs are detrimental to surgeons' health and potentially may impact patient safety. Studies often highlight the problems of surgeons in high-income countries, whose solutions and clinical guides often cannot be applied to countries like Peru, which have severe deficiencies in its healthcare system. For this reason, the thesis proposes a contextualised investigation of the Peruvian surgical work system to investigate the main factors contributing to the development of WRMSD in laparoscopic surgeons, which may affect patient safety. The analysis aimed to propose possible recommendations to support redesigning the laparoscopic surgery work system in Peruvian hospitals. Five studies were developed to achieve the aims based on the Systems Engineering Initiative for patient safety model, an ergonomics model for healthcare systems analysis. The first three studies were developed parallel with a mixed convergent design approach concluding in an integrating study. The last two studies (study four and five) had a quantitative approach. The first study used a qualitative approach by collecting information through interviews with laparoscopic surgeons and observing their work in real surgeries. The second study adopted a quantitative approach through a questionnaire-based survey applied to 140 surgeons in Peru. The third study analysed the extent to which the postures adopted by surgeons in real surgeries increase the risk of WRMSD and their association with factors in the work system using the RULA method. The results of the three studies were integrated into an integrative study, concluding that the raised height of the operating table and other system factors related to tasks, person and technology raises the risk of WRMSD. Based on these results, the fourth study analysed the relationship between surgeons and operating tables to understand how many surgeons could reach suitable working heights. The study concluded that no operating table available in Peruvian hospitals nor in the market would be suitable for 90% of Peruvian surgeons. The tables were too high to accommodate surgeons with optimal working surface height to perform laparoscopic surgery. Then, a fifth study was conducted to determine an acceptable working height based on surgeon preferences and system factors and concluded that surgeons would accept a working height between 49 cm to 70 cm in height, which is lower than current operating tables. The lowest height was reached when surgeons had to operate on obese patients and perform intracorporeal suturing tasks. Finally, the thesis concludes with recommendations for redesigning working heights for 90% of the Peruvian medical population, considering work system elements of the Peruvian context

    Effectiveness and User Experience of Augmented and Mixed Reality for Procedural Task Training

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    Use of augmented reality (AR) and mixed reality (MR) technologies for training is increasing, due in part to opportunities for increased immersion, safer training, and reduced costs. However, AR/MR training effectiveness and user experience, particularly for head-mounted displays (HMDs), is not well understood. The purpose of this study is to investigate user perceptions and retention of AR/MR training delivered through a HMD for a procedural task. This two-part study utilized a within-subjects experimental design with 30 participants to determine how instruction method (paper vs. AR vs. MR) and time of procedure recall (immediate vs. post-test vs. retention) influenced completion time, perceived task difficulty, perceived confidence in successfully completing the task, workload, user experience, and trainee reactions. Results indicate differences between instruction methods for user experience and preference, with significantly higher user experience ratings for MR and lower preference rankings for AR. Findings also show decreased performance, increased perceived task difficulty, and decreased confidence as time since training increased, with no significant differences in these measures between instruction methods. Completion times and workload were also found to be comparable between instruction methods. This work provides insight into objective and subjective differences between paper-, AR-, and MR-based training experiences, which can be used to determine which type of training is best suited for a particular use case. Recommendations for appropriately matching training modalities and scenarios, as well as for how to successfully design AR/MR training experiences, are discussed
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