CyberWalk : a web-based distributed virtual walkthrough environment

A distributed virtual walkthrough environment allows users connected to the geometry server to walk through a specific place of interest, without having to travel physically. This place of interest may be a virtual museum, virtual library or virtual university. There are two basic approaches to distribute the virtual environment from the geometry server to the clients, complete replication and on-demand transmission. Although the on-demand transmission approach saves waiting time and optimizes network usage, many technical issues need to be addressed in order for the system to be interactive. CyberWalk is a web-based distributed virtual walkthrough system developed based on the on-demand transmission approach. It achieves the necessary performance with a multiresolution caching mechanism. First, it reduces the model transmission and rendering times by employing a progressive multiresolution modeling technique. Second, it reduces the Internet response time by providing a caching and prefetching mechanism. Third, it allows a client to continue to operate, at least partially, when the Internet is disconnected. The caching mechanism of CyberWalk tries to maintain at least a minimum resolution of the object models in order to provide at least a coarse view of the objects to the viewer. All these features allow CyberWalk to provide sufficient interactivity to the user for virtual walkthrough over the Internet environment. In this paper, we demonstrate the design and implementation of CyberWalk. We investigate the effectiveness of the multiresolution caching mechanism of CyberWalk in supporting virtual walkthrough applications in the Internet environment through numerous experiments, both on the simulation system and on the prototype system

Prelamination of Neourethra with Uterine Mucosa in Radial Forearm Osteocutaneous Free Flap Phalloplasty in the Female-to-Male Transgender Patient

Radial forearm free flap phalloplasty is the most commonly performed flap for neophallus construction in the female-to-male (FtM) transgender patient. Urological complications, however, can arise quite frequently and can prevent the patient from urinating in the standing position, an important postsurgical goal for many. Using mucosa to construct the fixed urethra and to prelaminate the penile urethra has been successful in reducing urologic complications, particularly strictures and fistulas. Until now, only buccal, vaginal, colonic, and bladder sites have been described as sources for these mucosal grafts. We present the successful use of uterine mucosa for prelamination of the neourethra in an FtM patient who underwent hysterectomy and vaginectomy at the prelamination stage of a radial forearm phalloplasty. Three months postoperatively, the patient was able to void while standing and showed no evidence of stricture or fistula on retrograde cystogram. These results suggest that uterine mucosa may be used for prelamination of the penile neourethra in patients undergoing phalloplasty

An interpretive investigation of trust and workflow in advertising communities

Adopting a socio–economic perspective and a multimethod field research approach this thesis investigates the correlation between trust and workflow in advertising communities of practice. Using a semiotic mode of analysis a comparative examination of offline and online communities will be conducted to inspect the practices of trust when multiple stakeholders follow the creative workflow process to fulfil creative briefs. The motivation to lead the research stems from a current lack of understanding of how trust is operationalized in online creative communities. Shortcomings from the literature 1) do not account for the significance of constructed workplace settings in the offline domain, 2) focus on providing generalisations through quantification, while fail to offer insights through qualitative methods and 3) overlook the weaknesses of trust in professional relationships. To address these shortcomings the thesis provides an extensive literature review to explicate the complexity of trust. The review forms the foundation of the thesis from which it makes original theoretical, analytical and empirical contributions. It 1) introduces a conceptual framework that correlates trust with workflow in offline and online advertising communities; 2) presents a novel thematic–narrative analytical method to interpret and map trust and workflow at the granular level; 3) reports from three sequential field studies that explores trust and workflow in professional relationships. These contributions highlight the operationalization of trust and that trust is an active determinant of workflow. The findings have implications to the study of trust and virtual workspaces in the digital economy that will influence their design, development and utilization. The first study examines trust and workflow in an offline advertising community. The findings indicate a positive correlation: trust is strongly aligned to workflow, inferred by strongly embedded situational and trust–warranting properties. The second and third studies examine trust and workflow in online advertising communities. The former indicates a negative correlation: trust is mediumly misaligned to workflow, inferred by weakly embedded situational properties. The findings of the latter also indicate a negative correlation: trust is strongly misaligned to workflow, inferred by weakly embedded situational and trust–warranting properties. In short, trust and workflow have a negative correlation online compared to the offline domain and is deficient in situational and trust–warranting properties. As a consequence the online domain does not perform to the same professional standard as the offline domain

An interpretive investigation of trust and workflow in advertising communities

Adopting a socio–economic perspective and a multimethod field research approach this thesis investigates the correlation between trust and workflow in advertising communities of practice. Using a semiotic mode of analysis a comparative examination of offline and online communities will be conducted to inspect the practices of trust when multiple stakeholders follow the creative workflow process to fulfil creative briefs. The motivation to lead the research stems from a current lack of understanding of how trust is operationalized in online creative communities. Shortcomings from the literature 1) do not account for the significance of constructed workplace settings in the offline domain, 2) focus on providing generalisations through quantification, while fail to offer insights through qualitative methods and 3) overlook the weaknesses of trust in professional relationships. To address these shortcomings the thesis provides an extensive literature review to explicate the complexity of trust. The review forms the foundation of the thesis from which it makes original theoretical, analytical and empirical contributions. It 1) introduces a conceptual framework that correlates trust with workflow in offline and online advertising communities; 2) presents a novel thematic–narrative analytical method to interpret and map trust and workflow at the granular level; 3) reports from three sequential field studies that explores trust and workflow in professional relationships. These contributions highlight the operationalization of trust and that trust is an active determinant of workflow. The findings have implications to the study of trust and virtual workspaces in the digital economy that will influence their design, development and utilization. The first study examines trust and workflow in an offline advertising community. The findings indicate a positive correlation: trust is strongly aligned to workflow, inferred by strongly embedded situational and trust–warranting properties. The second and third studies examine trust and workflow in online advertising communities. The former indicates a negative correlation: trust is mediumly misaligned to workflow, inferred by weakly embedded situational properties. The findings of the latter also indicate a negative correlation: trust is strongly misaligned to workflow, inferred by weakly embedded situational and trust–warranting properties. In short, trust and workflow have a negative correlation online compared to the offline domain and is deficient in situational and trust–warranting properties. As a consequence the online domain does not perform to the same professional standard as the offline domain

Urban Myths in Plastic Surgery: Postoperative Management of Surgical Drains

Surgical patients are frequently discharged with surgical drains to assist in wound closure that could be disrupted by postoperative hematomas, lymphoceles, or seromas. In clinical practice, duration of drain use is typically dependent on daily output. The aim of this paper was to examine the origins and justifications of drain removal criteria. The authors considered factors that may influence recommendations such as duration, area of surgical site, and risk of infection. A literature review was performed regarding the indications for drain removal in patients undergoing reconstructive and breast surgeries. PubMed was queried for publications up to May 2015 with the following search terms: drain removal, hematomas, lymphoceles, seroma, volume, reconstruction, and mastectomy. Clinical trials, retrospective reviews, meta-analyses, and literature reviews were included. Most plastic surgeons remove drains based on volume criteria; however, some evidence supports early, fixed-duration drain removal. Patients who produce large volumes of fluid from the surgical site are more likely to continue to do so after drain removal and may require increased duration of drain use. Surgical site surface area may also be a factor to consider when pulling a drain. Though drain-associated infection rates are low and appear unaffected by duration, poor outcomes such as implant loss and need for reoperation may be mitigated by antisepsis strategies

Collagenase Injection and Closed Release for Dupuytren’s Contracture

This chapter describes in detail the steps for performing collagenase injections with closed release for Dupuytren’s contracture. The procedures for metacarpophalangeal and proximal interphalangeal contracture injection and release are included. Indications, surgical steps, postoperative care, an operative dictation template, and suggested readings/references are included

Smoking as a risk factor for breast reduction: An analysis of 13,503 cases

Reduction mammaplasty is one of the most common reconstructive procedures performed by plastic surgeons. Over 100,000 procedures are performed annually. Although important for relieving the painful symptoms associated with macromastia, complication rates of this procedure are not insignificant. They are reported in up to half the cases. Reported risk factors for adverse outcomes include obesity, preoperative wound infection, and advanced American Society of Anesthesiologists status. Smoking has been described as a risk factor for breast reduction. There is disagreement in the literature regarding the effect of smoking on patient outcomes. To further describe and investigate smoking as a risk factor, we undertook the largest multicenter retrospective study on this subject. Data on 13,984 patients was identified from the 2009–2014 American College of Surgeons National Surgical Quality Improvement Program. Smoker and nonsmoker cohorts were compared to assess unadjusted differences in demographics, comorbidities, intraoperative details, 30-day outcomes, and readmission rates. Univariate analysis was performed using chi-square or Fisher's exact and Wilcoxon signed-rank tests. A multivariate logistic regression model was created to identify independent risk factors for complications and readmission. Odds ratios were computed at the 95% confidence interval. After adjusting for potential confounders, smokers had a higher likelihood of any wound complication (OR 1.72; p = 0.001) following reduction mammaplasty compared to nonsmokers. Smoking has been shown to be a significant risk factor for wound complications following reduction mammaplasty. Comprehensive preoperative counseling and documentation should be performed with patients who smoke regarding the potential for increased risk of adverse outcomes

Guidelines for the Standardization of Genital Photography

Plastic surgery relies on photography for both clinical practice and research. The Photographic Standards in Plastic Surgery laid the foundation for standardized photography in plastic surgery. Despite these advancements, the current literature lacks guidelines for genital photography, thus resulting in a discordance of documentation. The authors propose photographic standards for the male and female genitalia to establish homogeneity in which information can be accurately exchanged. All medical photographs include a sky-blue background, proper lighting, removal of distractors, consistent camera framing, and standard camera angles. We propose the following guidelines to standardize genital photography. In the anterior upright position, feet are shoulder-width apart, and arms are placed posteriorly. The frame is bounded superiorly by the xiphoid-umbilicus midpoint and inferiorly by the patella. For circumferential documentation, frontal 180 degree capture via 45 degree intervals is often sufficient. Images in standard lithotomy position should be captured at both parallel and 45 degrees above the horizontal. Images of the phallus should include both the flaccid and erect states. Despite the increasing incidence of genital procedures, there lacks a standardized methodology in which to document the genitalia, resulting in a substantial heterogeneity in the current literature. Our standardized techniques for genital photography set forth to establish a uniform language that promotes more effective communication with both the patient as well as with colleagues. The proposed photography guidelines provide optimal visualization and standard documentation of the genitalia, allowing for accurate education, meaningful collaborations, and advancement in genital surgery