Feasibility and tolerability of ophthalmic virtual reality as a medical communication tool in children and young people

Purpose Virtual reality (VR) can be useful in explaining diseases and complications that affect children in order to improve medical communications with this vulnerable patient group. So far, children and young people’s responses to high-end medical VR environments have never been assessed. Methods An unprecedented number of 320 children and young people were given the opportunity to interact with a VR application displaying original ophthalmic volume data via a commercially available tethered head-mounted display (HMD). Participants completed three surveys: demographics and experience with VR, usability and perceived utility of this technology and the Simulator Sickness Questionnaire. The second survey also probed participants for suggestions on improvements and whether this system could be useful for increasing engagement in science. Results A total of 206 sets of surveys were received. 165 children and young people (84 female) aged 12–18 years (mean, 15 years) completed surveys that could be used for analysis. 69 participants (47.59%) were VR-naïve, and 76 (52.41%) reported that they had previous VR experience. Results show that VR facilitated understanding of ophthalmological complications and was reasonably tolerated. Lastly, exposure to VR raised children and young people’s awareness and interest in science. Conclusions The VR platform used was successfully utilized and was well accepted in children to display and interact with volume-rendered 3D ophthalmological data. Virtual reality (VR) is suitable as a novel image display platform in ophthalmology to engage children and young people

Fatty-Acid Preference Changes during Development in Drosophila melanogaster

Fatty-acids (FAs) are required in the diet of many animals throughout their life. However, the mechanisms involved in the perception of and preferences for dietary saturated and unsaturated FAs (SFAs and UFAs, respectively) remain poorly explored, especially in insects. Using the model species Drosophila melanogaster, we measured the responses of wild-type larvae and adults to pure SFAs (14, 16, and 18 carbons) and UFAs (C18 with 1, 2, or 3 double-bonds). Individual and group behavioral tests revealed different preferences in larvae and adults. Larvae preferred UFAs whereas SFAs tended to induce both a strong aversion and a persistent aggregation behavior. Adults generally preferred SFAs, and laid more eggs and had a longer life span when ingesting these substances as compared to UFAs. Our data suggest that insects can discriminate long-chain dietary FAs. The developmental change in preference shown by this species might reflect functional variation in use of FAs or stage-specific nutritional requirements, and may be fundamental for insect use of these major dietary components

La chirurgia oncoplastica: l\u2019esperienza della scuola universitaria udinese

I benefici emozionali e psicologici della chirurgia conservativa mammaria sono stati ampiamente dimostrati: il successo della chirurgia conservativa mammaria \ue8 basato sull\u2019intento di garantire una completa escissione del tumore preservando la forma naturale della mammella. I dati di Letteratura riportano un tasso del 20-30% di risultati estetici scarsi e deformit\ue0 della mammella trattata in caso di BCS. Per fronteggiare tali problematiche \ue8 emerso negli anni il concetto di chirurgia oncoplastica come nuovo approccio per permettere grandi escissioni senza compromettere la naturale forma ed il contorno della ghiandola: l\u2019applicazione di tecniche ricostruttive avanzate amplia le indicazioni alla chirurgia mammaria conservativa migliorandone i risultati estetici. MATERIALI E METODI e RISULTATI Le principali opzioni ricostruttive proposte nel corso degli anni vedono l\u2019utilizzo di lembi locali, lembi a distanza e tecniche di mastoplastica riduttiva. Gli Autori, nell\u2019ambito di un approccio integrato alla patologia mammaria, presentano la casistica interna all\u2019Istituto, dal novembre 2005 al dicembre 2010, in maniera sistematica, analizzando benefici e complicanze delle principali tecniche utilizzate in base alle loro indicazioni di applicazione. CONCLUSIONI Le indicazioni variano in relazione all\u2019entit\ue0 della resezione correlata al volume mammario iniziale ed alla localizzazione del tumore. Per tale motivo, le tecniche applicabili sono numerose e non vi \ue8 concordanza tra i vari Autori sulle migliori tecniche da utilizzare e sullo sviluppo di un algoritmo comune. Nella nostra esperienza il tasso di deformit\ue0 \ue8 risultato inferiore alla percentuale riportata in Letteratura in tutti i modelli ricostruttivi. Il tasso di complicanze a breve e lungo termine si mantiene in linea con i dati della comunit\ue0 scientifica. Riteniamo che sia da incentivare l\u2019utilizzo di tecniche di chirurgia oncoplastica come valido approccio ricostruttivo dopo chirurgia mammaria conservativa

Oncoplastic surgery and cancer relapse: cosmetic and oncological results in 489 patients

During the past 20 years, breast conservation has become the preferred treatment modality for breast carcinoma, and in recent times there is an increased expectation from breast cancer patients to retain their "normal breast appearance". For large tumor-to-breast ratio excision, the subspecialty of oncoplastic surgery is born, helping to achieve a good oncologic and esthetic result. In our study we have considered 767 patients undergone a mastectomy or quadrantectomy, and especially 489 undergone quadrantectomy. We have used our protocol for breast reshaping and analyzed our data in terms of oncologic safety and esthetic results. Considering the lesions, they were placed like this: 214 (44%) in the SEQ, 58 lesions (12%) in the SIQ, 54 lesions (11%) in the IEQ, 24 lesions (5%) in the IIQ, 45 lesions (9%) respectively in the CQ and between the SQ, 39 lesions (8%) between the EQ, 5 lesions (1%) respectively between the internal quadrants and between the inferior quadrants. We have chosen simple breast reshapings in case of operations on the superior quadrants, while, in case of operations on the inferior quadrants, we have chosen complex techniques, like reshapings according to a "key hole" reductive mammaplasty, which requires also a contralateral reshaping. We have done simple and monolateral reshapings respectively in 372 (76%) and 296 (60.5%) cases. We have had early complications in 98 (20%) cases: 12 infections (2.4%), 10 hematomas (2%), 11 seromas (2.2%), 65 liponecrosis. As late complications, we have found scar retractions and minus areas in 20 cases (4.08%), while we have found asymmetries and bigger deformities in 34 cases (6.95%). We have not found any cancer relapse after one year of follow up, while we have had 3 cases of relapse (0.6%) after 5 years of follow up, respectively after 5, 4 and 2 years. This result has to be attributed to our preoperatory project of surgery derived from many factors, among which stands out the MRI done in all the cases. We think that an immediate breast reshaping following quadrantectomy is the best esthetic and psychologic option for breast cancer patients

About locoregional recurrence risk after lipofilling in breast cancer patients: our experience.

Aim. Lipofilling is a part of the clinical practice for breast reshaping in patients who underwent surgery for breast cancer. A strong debate in the Literature is open about a higher risk of cancer relapse caused by growth factors produced by adipocyte stem cells after their engraftment in the recipient tissue. Nowadays there is no agreement over the use of autologous fat tissue for the correction of aesthetic defects following breast conservative surgery. Methods. We have considered 151 patients who underwent a breast conservative surgery in the period April 2004-April 2009, followed by one or more lipofilling sessions in the period June 2006-August 2012. A careful pre-operative evaluation of the tumor characteristics has been made, through imaging exams, MRI included. An intraoperative evaluation of the tumor dimensions and its distance from the surgical edges has also been made, followed by a microscopic analysis through a shaving technique. Lipofilling has been offered to all the patients on average 24 months after surgery. Results. We have found no cancer relapses after a mean follow up of 45 months (17-76) after lipofilling and of 69 (27-100) months after surgery. Conclusions. Considering oncologic surgery, we can affirm that lipofilling is safe for the risk of cancer relapses, if performed using all the parameters included in our clinical protocol

Statistical framework for validation without ground truth of choroidal thickness changes detection

201910 bcmaVersion of RecordPublishe

High-Performance Virtual Reality Volume Rendering of Original Optical Coherence Tomography Point-Cloud Data Enhanced With Real-Time Ray Casting

Purpose: Feasibility testing of a novel volume renders technology to display optical coherence tomography data (OCT) in a virtual reality (VR) environment. Methods: A VR program was written in C++/OpenGL to import and display volumetric OCT data in real time with 180 frames per second using a high-end computer and a tethered head-mounted display. Following exposure, participants completed a Simulator Sickness Questionnaire (SSQ) to assess for nausea, disorientation, and oculomotor disturbances. A user evaluation study of this software was conducted to explore the potential utility of this application. Results: Fifty-seven subjects completed the user testing (34 males and 23 females). Mean age was 48.5 years (range, 21–77 years). Mean acquired work experience of the 35 ophthalmologists (61.40%) included in the group was 15.46 years (range, 1–37 years). Twenty-nine participants were VR-naïve. The SSQ showed a mean total score of 5.8 (SD = 9.44) indicating that the system was well tolerated and produced minimal side effects. No difference was reported between VR-naïve participants and experienced users. Overall, immersed subjects reported an enjoyable VR-OCT presence effect. Conclusions: A usable and satisfying VR imaging technique was developed to display and interact with original OCT data. Translational Relevance: An advanced high-end VR image display method was successfully developed to provide new views and interactions in an ultra high-speed projected digital scenery using point-cloud OCT data. This represents the next generation of OCT image display technology and a new tool for patient engagement, medical education, professional training, and telecommunications