Doorway to the Deep: Memoirs of Enduring Endometriosis and Embracing Life After Loss

No one is spared grief. Yet while it is universal in nature, it is painfully specific in experience. Many people describe grief in terms of water, and often refer to it as coming in waves, while others have drifted so far from the proverbial shore that they are drowning in it. Doorway to the Deep explores this concept through personal reflections and private diary and journal entries. The story commences on December 17, 1993 with my first diary entry when I was eleven years old. After enduring many years of endometriosis, the story climaxes on May 12, 2014 with my fourth and final surgery at the age of thirty-one. In the aftermath of a complete hysterectomy and bilateral salpingo oophorectomy, the story continues. In their entirety, these entries encapsulate my spiritual, emotional, physical, and medical journey. Doorway to the Deep also offers a psychological perspective commensurate with my academic and professional background as a licensed mental health therapist. Therefore, the content will alternate between personal memoir and professional opinion on topics such as grief, chronic pain, pain management, making helpful meaning of loss, forming healthy relationships, the interplay of spirituality and health, and women’s psychological issues that can attend infertility and childlessness

Vibrational Biospectroscopy: An Alternative Approach to Endometrial Cancer Diagnosis and Screening

Endometrial cancer (EC) is the sixth most common cancer and the fourth leading cause of death among women worldwide. Early detection and treatment are associated with a favourable prognosis and reduction in mortality. Unlike other common cancers, however, screening strategies lack the required sensitivity, specificity and accuracy to be successfully implemented in clinical practice and current diagnostic approaches are invasive, costly and time consuming. Such limitations highlight the unmet need to develop diagnostic and screening alternatives for EC, which should be accurate, rapid, minimally invasive and cost-effective. Vibrational spectroscopic techniques, Mid-Infrared Absorption Spectroscopy and Raman, exploit the atomic vibrational absorption induced by interaction of light and a biological sample, to generate a unique spectral response: a “biochemical fingerprint”. These are non-destructive techniques and, combined with multivariate statistical analysis, have been shown over the last decade to provide discrimination between cancerous and healthy samples, demonstrating a promising role in both cancer screening and diagnosis. The aim of this review is to collate available evidence, in order to provide insight into the present status of the application of vibrational biospectroscopy in endometrial cancer diagnosis and screening, and to assess future prospects

Endoscopy

Endoscopy is a fast moving field, and new techniques are continuously emerging. In recent decades, endoscopy has evolved and branched out from a diagnostic modality to enhanced video and computer assisting imaging with impressive interventional capabilities. The modern endoscopy has seen advances not only in types of endoscopes available, but also in types of interventions amenable to the endoscopic approach. To date, there are a lot more developments that are being trialed. Modern endoscopic equipment provides physicians with the benefit of many technical advances. Endoscopy is an effective and safe procedure even in special populations including pediatric patients and renal transplant patients. It serves as the tool for diagnosis and therapeutic interventions of many organs including gastrointestinal tract, head and neck, urinary tract and others

Real-time hybrid cutting with dynamic fluid visualization for virtual surgery

It is widely accepted that a reform in medical teaching must be made to meet today's high volume training requirements. Virtual simulation offers a potential method of providing such trainings and some current medical training simulations integrate haptic and visual feedback to enhance procedure learning. The purpose of this project is to explore the capability of Virtual Reality (VR) technology to develop a training simulator for surgical cutting and bleeding in a general surgery

Appearance Modeling of Living Human Tissues

This is the peer reviewed version of the following article: Nunes, A.L.P., Maciel, A., Meyer, G.W., John, N.W., Baranoski, G.V.G., & Walter, M. (2019). Appearance Modeling of Living Human Tissues, Computer Graphics Forum, which has been published in final form at https://doi.org/10.1111/cgf.13604. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-ArchivingThe visual fidelity of realistic renderings in Computer Graphics depends fundamentally upon how we model the appearance of objects resulting from the interaction between light and matter reaching the eye. In this paper, we survey the research addressing appearance modeling of living human tissue. Among the many classes of natural materials already researched in Computer Graphics, living human tissues such as blood and skin have recently seen an increase in attention from graphics research. There is already an incipient but substantial body of literature on this topic, but we also lack a structured review as presented here. We introduce a classification for the approaches using the four types of human tissues as classifiers. We show a growing trend of solutions that use first principles from Physics and Biology as fundamental knowledge upon which the models are built. The organic quality of visual results provided by these Biophysical approaches is mainly determined by the optical properties of biophysical components interacting with light. Beyond just picture making, these models can be used in predictive simulations, with the potential for impact in many other areas

Obstetric and perinatal outcomes of women treated for subfertility and children born after in vitro fertilisation

The use of assisted reproductive technologies has increased over the past decades. To date, 8 million children have been born worldwide following assisted reproductive technologies. In Switzerland, this refers to around 2-2.5% of newborn’s every year, this were 2’188 children in 2017. The introduction of this thesis gives an overview of the reasons for increasing global infertility, and of the use of medically assisted reproduction. It also presents the treatment options available today, and the risks associated with them for mothers and offspring. It goes on to describe the methods and data used in the research projects conducted for this thesis. In the following section, the four publications included in this thesis are presented. The first article on children within the Bern IVF Cohort compares the birthweights and birthweight percentiles of children born after natural cycle in vitro fertilisation, to those born after conventional in vitro fertilisation. This shows that the increased risk of small-for-gestational age infants being born may be associated with hyperstimulation of oocyte growth in conventional in vitro fertilisation, especially when high estradiol levels are reached on the day of ovulation induction. The second article uses follow-up data on breastfeeding collected within the Bern IVF Cohort. Breastfeeding prevalence and duration is compared to data from the Swiss Infant Feeding Study, which served as a control population. The findings demonstrate that women after fertility treatment breastfeed their children as much and for as long as mothers in the control population. This suggests that fertility treatment does not affect the potential and ability to breastfeed in Switzerland. The third article relates to the endometrium in natural cycle in vitro fertilisation, where the endometrium is not affected by hormonal stimulation. Data on endometrial thickness was collected from women during their first treatment cycle and the outcome measured, was successful pregnancy. It was shown that both very thin but also thick endometrium is associated with adverse pregnancy outcomes in natural cycle in vitro fertilisation. The fourth article analyses data from a historical cohort of women under treatment due to repeated implantation failure and recurrent pregnancy loss from 2014-2018. The two conditions seem to be associated with chronic endometritis, and their discussion is controversial: so far, no agreement on a standardised diagnosis or treatment has been reached. The aim was to assess the effect of endometrial diagnostic biopsy on subsequent treatment in cases of chronic endometritis, which was introduced in 2016, compared to hysteroscopic assessment alone. This demonstrated that diagnostic endometrial biopsy and subsequent treatment of chronic endometritis shortens time-to-pregnancy and live birth