Virtual reality simulation based training for endoscopy and laparoscopic surgery

Catedra Chirurgie nr.1 „N.Anestiadi”, Centrul Universitar de Simulare în Instruirea Medicală, USMF „Nicolae Testemiţanu”, Chişinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Centrul Universitar de Simulare în Instruirea Medicală (CUSIM) a fost creat cu scop de a spori siguranţa pacienţilor prin utilizarea instruirii prin simulare, a dezvolta noi modalităţi de instruire, a identifica cele mai bune practici şi a încuraja cercetarea şi colaborarea interdepartamentală şi interdisciplinară. Material şi metode: CUSIM este dotat cu 2 simulatoare cu realitate virtuală pentru chirurgia laparoscopică şi un simulator pentru bronhoscopie, endoscopie superioară şi inferioară. Curricula de instruire prin simulare este concepută să satisfacă necesităţile rezidenţilor şi specialiştilor indiferent de nivelul de competenţe şi facilitează obţinerea abilităţilor endoscopice şi de chirurgie laparoscopică pe parcursul rezidenţiatului şi a educaţiei medicale continue. Rezultate: Modulele incluse începînd cu abilităţile de bază şi esenţiale, continuînd apoi cu mediu anatomic complet pentru diverse intervenţii laparoscopice oferă obţinerea într-un mediu sigur a abilităţilor tehnice care pot fi transferate în sala de operaţii. Modulele de endoscopie includ atît procedee diagnostice, cît şi terapeutice pentru o gamă vastă de patologii. Rezultatele instruirii pot fi evaluate prin diferite categorii: economia mişcărilor; timpul de efectuare; ratele de erori şi scorul global al progresului. Concluzii: Instruirea prin simulare poate conduce la îmbunătăţire demonstrabilă a abilităţilor chirurgicale în condiţii clinice şi sala de operaţie. Feedback-ul obţinut sugerează că instruirea prin simulare reprezintă o modalitate sigură de învăţare a competenţelor practice endoscopice şi chirurgicale, de transfer al abilităţilor chirurgicale laparoscopice în sala de operaţ ie şi în final sporirea siguranţei pacienţilor; totuşi, sunt necesare studii ulterioare extinse pentru a determina dacă şi în ce mod simularea poate deveni o parte a curriculei chirurgicale.Introduction: University Center for Simulation in Medical Training was created to promote patient safety through the use of simulation, develop new education technologies, identify best practices, and encourage research and interdepartmental and interdisciplinary collaboration. Material and methods: University Center for Simulation in Medical Training is equipped with 2 virtual reality simulators for laparoscopic surgery and a simulator for bronchoscopy, upper and lower endoscopy. The simulation-based training curricula are designed to fit the needs of residents and specialists of any level of competence and facilitate the acquisition of endoscopic and laparoscopic surgery skills during residency and continuing medical education programs. Results: The included modules starting from basic and essential skills and going through complete anatomical settings of different laparoscopic interventions offer the acquisition of technical skills in a safe setting which could be translatable to the operating room (OR). The endoscopy modules include both diagnostic and therapeutic options for a variety of pathologies. The learning outcomes can be measured in different behavioral categories: economy of movement; performance time; error rates, and global progress rating. Conclusions: Simulation-based training can lead to demonstrable benefits of surgical skills in the OR environment and clinical settings. The received feedback suggests that simulation-based training is an effective way to teach endoscopy and laparoscopic surgery skills, increase translation of laparoscopic surgery skills to the OR, and increase patient safety; however, more research should be conducted to determine if and how simulation can become a part of surgical curriculum

A New Systolic Array Algorithm and Architecture for the VLSI Implementation of IDST Based on a Pseudo-Band Correlation Structure

In this paper a new linear VLSI array architecture for the VLSI implementation of a prime-length 1-D Inverse Discrete Sine Transform (IDST) is proposed. This new design approach uses a new efficient VLSI algorithm based on a regular and modular computational structure called pseudo-band correlation structure. It employs a new formulation of the inverse DST that is mapped on a linear systolic array. Using the proposed systolic array high computing speed is obtained with a low hardware complexity and low I/O cost. A highly efficient VLSI chip can be obtained characterized by a small number of I/O channels located at the two extreme ends of the array together with a low I/O bandwidth that is independent of the transform length N, a good topology with modular, regular and local connections

Supramolecular ABA triblocks : understanding reaction parameters and designing new materials

No abstract

(Metallo-supramolecular)block copolymers in solution : microscopic study of micellization

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Thin film characterization of metallosupramolecular assemblies

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Amphiphilic well-defined ABA ruthenium(II)-bis-terpyridine block copolymers

Self-recognition and self-assembly are the two main concepts on which supramol. chem. is based, involving weak and non-covalent interactions such as hydrogen bonding, van der Waals, coordinative and ionic interactions. From all the mentioned weak interactions, metal-ligand coordination gained a particular interest for the synthesis of supramol. structures due to the fact that the coordination bond is highly directional, a wide range of easily functionalized ligands such as terpyridines is available, and the interaction strength can be fine-tuned by choosing appropriate metal ions. Furthermore, the presence of a metal complex in the "supra-structure" introduces addnl. electrochem., photophys., catalytic and magnetic properties. In the present contribution we discuss the synthesizes, characterization and the properties of the amphiphilic ABA block copolymers obtained via Ru(II) terpyridine complexation. [on SciFinder (R)

Supramolecular self-assembled Ni(II), Fe(II) and Co(II) ABA triblock copolymers

The self-assembly of amphiphilic metallo-supramolecular A-b-B-b-A triblock copolymers containing a B block formed from a bisfunctional terpyridine monomer and an A block based on a monofunctional terpyridine polymer is described. These polymers have been prepared by a polycondensation approach, based on metal–ligand complexation, in which the molecular weight of the central B block has been controlled by the addition of a monofunctional chain-stopper A. Details for the preparation of the A-b-B-b-A triblock copolymers based on the tpy2Ni(II), tpy2Fe(II), and tpy2Co(II) connectivity are given. The influence of the different binding strength of Ni(II), Fe(II), and Co(II) metal ions with terpyridine ligands on the metallo-polycondensation reaction and on the micellization behavior of those materials was studied. Micelles of the obtained block copolymers were prepared and studied by DLS and cryo-TEM

Amphiphilic well-defined ABA ruthenium(II)-bis-terpyridine block copolymers

Self-recognition and self-assembly are the two main concepts on which supramol. chem. is based, involving weak and non-covalent interactions such as hydrogen bonding, van der Waals, coordinative and ionic interactions. From all the mentioned weak interactions, metal-ligand coordination gained a particular interest for the synthesis of supramol. structures due to the fact that the coordination bond is highly directional, a wide range of easily functionalized ligands such as terpyridines is available, and the interaction strength can be fine-tuned by choosing appropriate metal ions. Furthermore, the presence of a metal complex in the supra-structure introduces addnl. electrochem., photophys., catalytic and magnetic properties. In the present contribution we discuss the synthesizes, characterization and the properties of the amphiphilic ABA block copolymers obtained via Ru(II) terpyridine complexation. [on SciFinder (R)