Augmented reality system for digital rectal examination training and assessment: system validation

Background: Digital rectal examination is a difficult examination to learn and teach because of limited opportunities for practice; however, the main challenge is that students and tutors cannot see the finger when it is palpating the anal canal and prostate gland inside the patients. Objective: This paper presents an augmented reality system to be used with benchtop models commonly available in medical schools with the aim of addressing the problem of lack of visualization. The system enables visualization of the examining finger, as well as of the internal organs when performing digital rectal examinations. Magnetic tracking sensors are used to track the movement of the finger, and a pressure sensor is used to monitor the applied pressure. By overlaying a virtual finger on the real finger and a virtual model on the benchtop model, students can see through the examination and finger maneuvers. Methods: The system was implemented in the Unity game engine (Unity Technologies) and uses a first-generation HoloLens (Microsoft Inc) as an augmented reality device. To evaluate the system, 19 participants (9 clinicians who routinely performed digital rectal examinations and 10 medical students) were asked to use the system and answer 12 questions regarding the usefulness of the system. Results: The system showed the movement of an examining finger in real time with a frame rate of 60 fps on the HoloLens and accurately aligned the virtual and real models with a mean error of 3.9 mm. Users found the movement of the finger was realistic (mean 3.9, SD 1.2); moreover, they found the visualization of the finger and internal organs were useful for teaching, learning, and assessment of digital rectal examinations (finger: mean 4.1, SD 1.1; organs: mean 4.6, SD 0.8), mainly targeting a novice group. Conclusions: The proposed augmented reality system was designed to improve teaching and learning of digital rectal examination skills by providing visualization of the finger and internal organs. The initial user study proved its applicability and usefulness

Tracially Complete C*-Algebras

We introduce a new class of operator algebras -- tracially complete C*-algebras -- as a vehicle for transferring ideas and results between C*-algebras and their tracial von Neumann algebra completions. We obtain structure and classification results for amenable tracially complete C*-algebras satisfying an appropriate version of Murray and von Neumann's property gamma for II_1 factors. In a precise sense, these results fit between Connes' celebrated theorems for injective II_1 factors and the unital classification theorem for separable simple nuclear C*-algebras. The theory also underpins arguments for the known parts of the Toms-Winter conjecture.Comment: 130 page

Seasonal variations of carcass characteristics, meat quality and nutrition value in iberian wild red deer

Aim of study: The effects of hunting season (autumn vs. winter) on carcass characteristics and meat quality of Iberian wild red deer were assessed. Area of study: A total of 100 males of wild red deer of Iberian genetic line (Cervus elaphus) were hunted on Ciudad Real (south central Spain). Material and methods: Yields for shoulder (with bone), neck, backbone, loin, tenderloin, leg (with bone), short plate and flank were determined. In addition, samples of Longissimus thoracis et lumborum and Rectus abdominis muscles were collected. Then, pH48, colour measurements, chemical composition, cooking loss, Warner Bratzler shear blade, fatty acid and amino acid profiles and mineral content were analyzed. Main results: Deer hunted in autumn (n=50) had higher (p<0.01) yields of shoulder, backbone and short plate and higher contents of intramuscular fat (IMF), cholesterol and K, Fe and Mn but lower (p<0.001) pH48 and Na, Mg, Zn and Cu contents than deer hunted in winter (n=50). Shear force tended (p=0.05) to be lower for meat collected in autumn than for meat collected in winter. However, loin yield was 59.2% higher (p<0.001) for winter than for autumn carcasses. Deer hunted in winter had higher α-linoleic acid (p<0.05) and long chain n-3 polyunsaturated (p<0.001) percentages than deer hunted in autumn Research highlights: Autumn hunting is recommended to obtain carcasses with higher yields of shoulder, backbone and short plate and meat with higher IMF. Conversely, winter hunting is advisable for higher loin yield and for a profile richer in polyunsaturated fatty acids

Calidad de la espirometría en un laboratorio de función pulmonar

Introduction: Spirometry is a principal test to study the pulmonar pathology and phisiology. Our aim is to test our spi- rometry quality. Material and methods: Cross-sectional descriptive study of 103 patients. Spirometries were classified on grades from A to F. Results: 66% of our spirometries have a good quality (A or B grades) and 76,7 % an aceptable quality (C grade). Conclusion: Our quality results are good, but we must improve them

Creación de un instrumento de medida de la comunicación médico-paciente. Validación para residentes

Crear y validar en nuestro país un Cuestionario base que permita su uso para el análisis de la comunicación medico-paciente que pueda ser utilizado en diferentes circunstancias. Validación para su uso en residentes con pacientes estandarizados (PE)

Synthesis of Bio-Compatible SPION–based Aqueous Ferrofluids and Evaluation of RadioFrequency Power Loss for Magnetic Hyperthermia

Bio-compatible magnetic fluids having high saturation magnetization find immense applications in various biomedical fields. Aqueous ferrofluids of superparamagnetic iron oxide nanoparticles with narrow size distribution, high shelf life and good stability is realized by controlled chemical co-precipitation process. The crystal structure is verified by X-ray diffraction technique. Particle sizes are evaluated by employing Transmission electron microscopy. Room temperature and low-temperature magnetic measurements were carried out with Superconducting Quantum Interference Device. The fluid exhibits good magnetic response even at very high dilution (6.28 mg/cc). This is an advantage for biomedical applications, since only a small amount of iron is to be metabolised by body organs. Magnetic field induced transmission measurements carried out at photon energy of diode laser (670 nm) exhibited excellent linear dichroism. Based on the structural and magnetic measurements, the power loss for the magnetic nanoparticles under study is evaluated over a range of radiofrequencies

Small renal masses in Latin-American population : Characteristics and prognostic factors for survival, recurrence and metastasis - A multi-institutional study from LARCG database

To evaluate demographic, clinical and pathological characteristics of small renal masses (SRM) (≤ 4 cm) in a Latin-American population provided by LARCG (Latin-American Renal Cancer Group) and analyze predictors of survival, recurrence and metastasis. A multi-institutional retrospective cohort study of 1523 patients submitted to surgical treatment for non-metastatic SRM from 1979 to 2016. Comparisons between radical (RN) or partial nephrectomy (PN) and young or elderly patients were performed. Kaplan-Meier curves and log-rank tests estimated 10-year overall survival. Predictors of local recurrence or metastasis were analyzed by a multivariable logistic regression model. PN and RN were performed in 897 (66%) and 461 (34%) patients. A proportional increase of PN cases from 48.5% (1979-2009) to 75% (after 2009) was evidenced. Stratifying by age, elderly patients (≥ 65 years) had better 10-year OS rates when submitted to PN (83.5%), than RN (54.5%), p = 0.044. This disparity was not evidenced in younger patients. On multivariable model, bilaterality, extracapsular extension and ASA (American Society of Anesthesiologists) classification ≥3 were predictors of local recurrence. We did not identify significant predictors for distant metastasis in our series. PN is performed in Latin-America in a similar proportion to developed areas and it has been increasing in the last years. Even in elderly individuals, if good functional status, sufficiently fit to surgery, and favorable tumor characteristics, they should be encouraged to perform PN. Intending to an earlier diagnosis of recurrence or distant metastasis, SRM cases with unfavorable characteristics should have a more rigorous follow-up routine

Benefits for Dominant Red Deer Hinds under a Competitive Feeding System: Food Access Behavior, Diet and Nutrient Selection

Social dominance is widely known to facilitate access to food resources in many animal species such as deer. However, research has paid little attention to dominance in ad libitum access to food because it was thought not to result in any benefit for dominant individuals. In this study we assessed if, even under ad libitum conditions, social rank may allow dominant hinds to consume the preferred components of food. Forty-four red deer hinds (Cervus elaphus) were allowed to consume ad libitum meal consisting of pellets of sunflower, lucerne and orange, and seeds of cereals, corn, cotton, and carob tree. The meal was placed only in one feeder, which reduced accessibility to a few individuals simultaneously. During seven days, feeding behavior (order of access, time to first feeding bout, total time spent feeding, and time per feeding bout) were assessed during the first hour. The relative abundance of each meal component was assessed at times 0, 1 and 5 h, as well as its nutritional composition. Social rank was positively related to the amount of time spent feeding during the 1st h (P = 0.048). Selection indices were positively correlated with energy (P = 0.018 during the 1st h and P = 0.047 from 1st to 5th) and fat (only during the 1st h; P = 0.036), but also negatively with certain minerals. Thus, dominant hinds could select high energy meal components for longer time under an ad libitum but restricted food access setting. Selection indices showed a higher selectivity when food availability was higher (1st hour respect to 1st to 5th). Finally, high and low ranking hinds had longer time per feeding bout than mid ones (P = 0.011), suggesting complex behavioral feeding tactics of low ranking social ungulates

Dietary intake, lung function and airway inflammation in Mexico City school children exposed to air pollutants

<p>Abstract</p> <p>Introduction</p> <p>Air pollutant exposure has been associated with an increase in inflammatory markers and a decline in lung function in asthmatic children. Several studies suggest that dietary intake of fruits and vegetables might modify the adverse effect of air pollutants.</p> <p>Methods</p> <p>A total of 158 asthmatic children recruited at the Children's Hospital of Mexico and 50 non-asthmatic children were followed for 22 weeks. Pulmonary function was measured and nasal lavage collected and analyzed every 2 weeks. Dietary intake was evaluated using a 108-item food frequency questionnaire and a fruit and vegetable index (FVI) and a Mediterranean diet index (MDI) were constructed. The impact of these indices on lung function and interleukin-8 (IL-8) and their interaction with air pollutants were determined using mixed regression models with random intercept and random slope.</p> <p>Results</p> <p>FVI was inversely related to IL-8 levels in nasal lavage (p < 0.02) with a significant inverse trend (test for trend p < 0.001), MDI was positively related to lung function (p < 0.05), and children in the highest category of MDI had a higher FEV₁(test for trend p < 0.12) and FVC (test for trend p < 0.06) than children in the lowest category. A significant interaction was observed between FVI and ozone for FEV₁and FVC as was with MDI and ozone for FVC. No effect of diet was observed among healthy children.</p> <p>Conclusion</p> <p>Our results suggest that fruit and vegetable intake and close adherence to the Mediterranean diet have a beneficial effect on inflammatory response and lung function in asthmatic children living in Mexico City.</p