Realidade aumentada num simulador virtual de tomada de decisão clínica

A presente investigação teve como objetivo verificar se a Realidade Aumentada (RA) potencia o desenvolvimento de competências de tomada de decisão clínica no diagnóstico e tratamento de feridas crónicas, aumenta a motivação dos estudantes e a usabilidade do simulador virtual e-FER. O e-FER é um simulador online de tomada de decisão clínica utilizado na formação inicial de enfermeiros, permitindo simular o diagnóstico e tratamento de casos clínicos virtuais de feridas crónicas. Para o presente estudo foi acrescentada uma componente de RA com novos casos clínicos, no sentido de investigar os seus efeitos na motivação, usabilidade e desenvolvimento de competências no diagnóstico e tratamento de feridas crónicas. Desenvolveu-se um estudo quase-experimental com uma amostra de 54 estudantes a frequentar o primeiro ano de Enfermagem. Realizou-se uma análise comparativa entre o desempenho dos grupos experimental (que utilizou o e-FER tradicional e depois com RA) e de controlo (que utilizou apenas o e-FER tradicional), com base nos dados extraídos a partir do simulador virtual e-FER. Os dados relativos à motivação dos estudantes e usabilidade do sistema foram recolhidos através de questionário. Os resultados obtidos permitem concluir que a RA potenciou o desempenho dos estudantes, particularmente nos parâmetros de diagnóstico da ferida, com diferenças estatisticamente muito significativas (p<0,001) nos testes de Mann-Whitney U e Wilcoxon, registando-se ainda índices elevados de motivação e usabilidade do simulador, mesmo com a introdução de um dispositivo adicional na atividade.The goal of this investigation was to verify if Augmented Reality (AR) enhances the development of clinical decision-making skills in wound diagnosis and treatment, increases student motivation and the usability of the e-FER virtual simulator. The e-FER is an online clinical decision-making simulator used in the initial training of nurses, allowing to simulate the diagnosis and treatment of virtual clinical cases of chronic wounds. In this study an AR component was added with new clinical cases, in order to investigate its effects on motivation, usability and the development of wound diagnosis and treatment skills. A quasi-experimental study was conducted with a sample of 54 students attending the first year of a Nursing program. A comparative analysis between the progress of the experimental group (who used the traditional e-FER and then with AR) and the control group (who used only the traditional e-FER) was made using the data extracted from the e-FER virtual simulator. Data on student's motivation and system usability were collected through a questionnaire. The results showed that AR enhanced student performance, particularly in wound diagnostic parameters, with highly statistically significant differences (p<0,001) in the Mann-Whitney U and Wilcoxon tests, and registering high levels of motivation and simulator usability, even with the introduction of an additional device in the activity

Feasibility of the Epiduroscopy Simulator as a Training Tool: A Pilot Study

Epiduroscopy is a type of spinal intervention that visualizes the epidural space through the sacral hiatus using a fiberoptic scope. However, it is technically difficult to perform compared to conventional interventions and susceptible to complications. Surgery simulator has been shown to be a promising modality for medical education. To develop the epiduroscopy simulator and prove its usefulness for epiduroscopy training, we performed a case-control study including a total of 20 physicians. The participants were classified as the expert group with more than 30 epiduroscopy experiences and the beginner group with less experience. A virtual simulator (EpiduroSIM™, BioComputing Lab, KOREATECH, Cheonan, Republic of Korea) for epiduroscopy was developed by the authors. The performance of the participants was measured by three items: time to reach a virtual target, training score, and number of times the dura and nerve are violated. The training score was better in the expert group (75.00 vs. 67.50; P < 0.01). The number of violations was lower in the expert group (3.50 vs. 4.0; P < 0.01). The realism of the epidural simulator was evaluated to be acceptable in 40%. Participants improved their simulator skills through repeated attempts. The epiduroscopy simulator helped participants understand the anatomical structure and actual epiduroscopy.ope

Basic science232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function

Background: Cardiovascular disease is a major comorbidity of rheumatoid arthritis (RA) and a leading cause of death. Chronic systemic inflammation involving tumour necrosis factor alpha (TNF) could contribute to endothelial activation and atherogenesis. A number of anti-TNF therapies are in current use for the treatment of RA, including certolizumab pegol (CZP), (Cimzia ®; UCB, Belgium). Anti-TNF therapy has been associated with reduced clinical cardiovascular disease risk and ameliorated vascular function in RA patients. However, the specific effects of TNF inhibitors on endothelial cell function are largely unknown. Our aim was to investigate the mechanisms underpinning CZP effects on TNF-activated human endothelial cells. Methods: Human aortic endothelial cells (HAoECs) were cultured in vitro and exposed to a) TNF alone, b) TNF plus CZP, or c) neither agent. Microarray analysis was used to examine the transcriptional profile of cells treated for 6 hrs and quantitative polymerase chain reaction (qPCR) analysed gene expression at 1, 3, 6 and 24 hrs. NF-κB localization and IκB degradation were investigated using immunocytochemistry, high content analysis and western blotting. Flow cytometry was conducted to detect microparticle release from HAoECs. Results: Transcriptional profiling revealed that while TNF alone had strong effects on endothelial gene expression, TNF and CZP in combination produced a global gene expression pattern similar to untreated control. The two most highly up-regulated genes in response to TNF treatment were adhesion molecules E-selectin and VCAM-1 (q 0.2 compared to control; p > 0.05 compared to TNF alone). The NF-κB pathway was confirmed as a downstream target of TNF-induced HAoEC activation, via nuclear translocation of NF-κB and degradation of IκB, effects which were abolished by treatment with CZP. In addition, flow cytometry detected an increased production of endothelial microparticles in TNF-activated HAoECs, which was prevented by treatment with CZP. Conclusions: We have found at a cellular level that a clinically available TNF inhibitor, CZP reduces the expression of adhesion molecule expression, and prevents TNF-induced activation of the NF-κB pathway. Furthermore, CZP prevents the production of microparticles by activated endothelial cells. This could be central to the prevention of inflammatory environments underlying these conditions and measurement of microparticles has potential as a novel prognostic marker for future cardiovascular events in this patient group. Disclosure statement: Y.A. received a research grant from UCB. I.B. received a research grant from UCB. S.H. received a research grant from UCB. All other authors have declared no conflicts of interes

European Distance and E-Learning Network (EDEN). Conference Proceedings

Erasmus+ Programme of the European UnionThe powerful combination of the information age and the consequent disruption caused by these unstable environments provides the impetus to look afresh and identify new models and approaches for education (e.g. OERs, MOOCs, PLEs, Learning Analytics etc.). For learners this has taken a fantastic leap into aggregating, curating and co-curating and co-producing outside the boundaries of formal learning environments – the networked learner is sharing voluntarily and for free, spontaneously with billions of people.Supported by Erasmus+ Programme of the European Unioninfo:eu-repo/semantics/publishedVersio

Pseudo National Security System of Health in Indonesia

ABstRACt Adolescence is a crucial period where one tends to identify who they are as an individual. However, as a teenager is struggling to find his/her place in this world, it is also a time where they are prone to engaging in risk behaviors, which tend to have an extreme psychological impact. The objective was to explore the experiences of an adolescent who engages in risk behaviors and to understand their level of personal fables. The study was a qualitative design with content analysis with semi-structured interviews of ten male adolescents aged 16-18 years. The major findings of the study indicated that adolescent’s pattern of thinking revolves around the fact that they are invincible and invulnerable. Furthermore, adolescents are aware of the risks they are putting themselves through and how in the process they are hurting others. The implications of the study are to conduct more life skill programs in schools; greater awareness has to be created on the impact and harmful effects of such behaviors

Building the Future Internet through FIRE

The Internet as we know it today is the result of a continuous activity for improving network communications, end user services, computational processes and also information technology infrastructures. The Internet has become a critical infrastructure for the human-being by offering complex networking services and end-user applications that all together have transformed all aspects, mainly economical, of our lives. Recently, with the advent of new paradigms and the progress in wireless technology, sensor networks and information systems and also the inexorable shift towards everything connected paradigm, first as known as the Internet of Things and lately envisioning into the Internet of Everything, a data-driven society has been created. In a data-driven society, productivity, knowledge, and experience are dependent on increasingly open, dynamic, interdependent and complex Internet services. The challenge for the Internet of the Future design is to build robust enabling technologies, implement and deploy adaptive systems, to create business opportunities considering increasing uncertainties and emergent systemic behaviors where humans and machines seamlessly cooperate

Building the Future Internet through FIRE

The Internet as we know it today is the result of a continuous activity for improving network communications, end user services, computational processes and also information technology infrastructures. The Internet has become a critical infrastructure for the human-being by offering complex networking services and end-user applications that all together have transformed all aspects, mainly economical, of our lives. Recently, with the advent of new paradigms and the progress in wireless technology, sensor networks and information systems and also the inexorable shift towards everything connected paradigm, first as known as the Internet of Things and lately envisioning into the Internet of Everything, a data-driven society has been created. In a data-driven society, productivity, knowledge, and experience are dependent on increasingly open, dynamic, interdependent and complex Internet services. The challenge for the Internet of the Future design is to build robust enabling technologies, implement and deploy adaptive systems, to create business opportunities considering increasing uncertainties and emergent systemic behaviors where humans and machines seamlessly cooperate