Development of a Virtual Laparoscopic Trainer using Accelerometer Augmented Tools to Assess Performance in Surgical training

Previous research suggests that virtual reality (VR) may supplement conventional training in laparoscopy. It may prove useful in the selection of surgical trainees in terms of their dexterity and spatial awareness skills in the near future. Current VR training solutions provide levels of realism and in some instances, haptic feedback, but they are cumbersome by being tethered and not ergonomically close to the actual surgical instruments for weight and freedom of use factors. In addition, they are expensive hence making them less accessible to departments than conventional box trainers. The box trainers in comparison, although more economical, lack tangible feedback and realism for handling delicate tissue structures. We have previously reported on the development of a modified digitally enhanced surgical instrument for laparoscopic training, named the Parkar Tool. This tool contains wireless accelerometer and gyroscopic sensors integrated into actual laparoscopic instruments. By design, it alleviates the need for both tethered and physically different shaped tools thereby enhancing the realism when performing surgical procedures. Additionally the software (Valhalla) has the ability to digitally record surgical motions, thereby enabling it to remotely capture surgical training data to analyse and objectively evaluate performance. We have adapted and further developed our initial single training tool method as used with a laparoscopic pyloromyotomy scenario, to an enhanced method using multiple Parkar wireless tools simultaneously, for use in several different case scenarios. This allows the use and measurement of right and left handed dexterity with the benefit of using several tasks of differing complexity. The development of a 3D tissue-surface deformations solution written in OpenGL gives us several different virtual surgical training scenario approximations to use with the instruments. The trainee can start with learning simple tasks e.g. incising tissue, grasping, squeezing and stretching tissue, to more complex procedures such as suturing, herniotomies, bowel anastomoses, as well as the original pyloromyotomy as used in the first model

Power loss in open cavity diodes and a modified Child Langmuir Law

Diodes used in most high power devices are inherently open. It is shown that under such circumstances, there is a loss of electromagnetic radiation leading to a lower critical current as compared to closed diodes. The power loss can be incorporated in the standard Child-Langmuir framework by introducing an effective potential. The modified Child-Langmuir law can be used to predict the maximum power loss for a given plate separation and potential difference as well as the maximum transmitted current for this power loss. The effectiveness of the theory is tested numerically.Comment: revtex4, 11 figure

Feasibility of collecting oral fluid samples in the home setting to determine seroprevalence of infections in a large-scale cohort of preschool-aged children

Oral fluid is a non-invasive biological sample, which can be returned by post, making it suitable for large-scale epidemiological studies in children. We report our experience of oral fluid collection from 14 373 preschool-aged children in the UK Millennium Cohort Study. Samples were collected by mothers in the home setting following the guidance of trained interviewers, and posted to the laboratory. Samples were received from 11698 children (81.4 %). Children whose mothers were of Black Caribbean ethnicity and who lived in non-English-speaking households were less likely to provide a sample, and those with a maternal history of asthma more likely to provide a sample [adjusted risk ratio (95 % CI) 0.85 (0.73-0.98), 0.87 (0.77-0.98) and 1.03 (1.00-1.05) respectively]. Collection of oral fluid samples is feasible and acceptable in large-scale child cohort studies. Formal interpreter support may be required to increase participation rates in surveys that collect biological samples from ethnic minorities

Measuring nonadiabaticity of molecular quantum dynamics with quantum fidelity and with its efficient semiclassical approximation

We propose to measure nonadiabaticity of molecular quantum dynamics rigorously with the quantum fidelity between the Born-Oppenheimer and fully nonadiabatic dynamics. It is shown that this measure of nonadiabaticity applies in situations where other criteria, such as the energy gap criterion or the extent of population transfer, fail. We further propose to estimate this quantum fidelity efficiently with a generalization of the dephasing representation to multiple surfaces. Two variants of the multiple-surface dephasing representation (MSDR) are introduced, in which the nuclei are propagated either with the fewest-switches surface hopping (FSSH) or with the locally mean field dynamics (LMFD). The LMFD can be interpreted as the Ehrenfest dynamics of an ensemble of nuclear trajectories, and has been used previously in the nonadiabatic semiclassical initial value representation. In addition to propagating an ensemble of classical trajectories, the MSDR requires evaluating nonadiabatic couplings and solving the Schr\"{o}dinger (or more generally, the quantum Liouville-von Neumann) equation for a single discrete degree of freedom. The MSDR can be also used to measure the importance of other terms present in the molecular Hamiltonian, such as diabatic couplings, spin-orbit couplings, or couplings to external fields, and to evaluate the accuracy of quantum dynamics with an approximate nonadiabatic Hamiltonian. The method is tested on three model problems introduced by Tully, on a two-surface model of dissociation of NaI, and a three-surface model including spin-orbit interactions. An example is presented that demonstrates the importance of often-neglected second-order nonadiabatic couplings.Comment: 14 pages, 4 figures, submitted to J. Chem. Phy

Wave Mechanics of a Two Wire Atomic Beamsplitter

We consider the problem of an atomic beam propagating quantum mechanically through an atom beam splitter. Casting the problem in an adiabatic representation (in the spirit of the Born-Oppenheimer approximation in molecular physics) sheds light on explicit effects due to non-adiabatic passage of the atoms through the splitter region. We are thus able to probe the fully three dimensional structure of the beam splitter, gathering quantitative information about mode-mixing, splitting ratios,and reflection and transmission probabilities

State-to-state rotational transitions in H2_2+H2_2 collisions at low temperatures

We present quantum mechanical close-coupling calculations of collisions between two hydrogen molecules over a wide range of energies, extending from the ultracold limit to the super-thermal region. The two most recently published potential energy surfaces for the H$_2$-H$_2$ complex, the so-called DJ (Diep and Johnson, 2000) and BMKP (Boothroyd et al., 2002) surfaces, are quantitatively evaluated and compared through the investigation of rotational transitions in H$_2$+H$_2$ collisions within rigid rotor approximation. The BMKP surface is expected to be an improvement, approaching chemical accuracy, over all conformations of the potential energy surface compared to previous calculations of H$_2$-H$_2$ interaction. We found significant differences in rotational excitation/de-excitation cross sections computed on the two surfaces in collisions between two para-H$_2$ molecules. The discrepancy persists over a large range of energies from the ultracold regime to thermal energies and occurs for several low-lying initial rotational levels. Good agreement is found with experiment (Mat\'e et al., 2005) for the lowest rotational excitation process, but only with the use of the DJ potential. Rate coefficients computed with the BMKP potential are an order of magnitude smaller.Comment: Accepted by J. Chem. Phy

The quality of different types of child care at 10 and 18 months. A comparison between types and factors related to quality.

The quality of care offered in four different types of non-parental child care to 307 infants at 10 months old and 331 infants at 18 months old was compared and factors associated with higher quality were identified. Observed quality was lowest in nurseries at each age point, except that at 18 months they offered more learning activities. There were few differences in the observed quality of care by child-minders, grandparents and nannies, although grandparents had somewhat lower safety and health scores and offered children fewer activities. Cost was largely unrelated to quality of care except in child-minding, where higher cost was associated with higher quality. Observed ratios of children to adults had a significant impact on quality of nursery care; the more infants or toddlers each adult had to care for, the lower the quality of the care she gave them. Mothers' overall satisfaction with their child's care was positively associated with its quality for home-based care but not for nursery settings

Space Charge Limited 2-d Electron Flow between Two Flat Electrodes in a Strong Magnetic Field

An approximate analytic solution is constructed for the 2-d space charge limited emission by a cathode surrounded by non emitting conducting ledges of width Lambda. An essentially exact solution (via conformal mapping) of the electrostatic problem in vacuum is matched to the solution of a linearized problem in the space charge region whose boundaries are sharp due to the presence of a strong magnetic field. The current density growth in a narrow interval near the edges of the cathode depends strongly on Lambda. We obtain an empirical formula for the total current as a function of Lambda which extends to more general cathode geometries.Comment: 4 pages, LaTex, e-mail addresses: [email protected], [email protected]

Association of Body Mass Index of HIV-1-Infected Pregnant Women and Infant Weight, Body Mass Index, Length, and Head Circumference: The NISDI Perinatal Study.

This study assessed the relationship between the body mass index (BMI) of HIV-1-infected women and their infants' perinatal outcomes. The study population consisted of women enrolled in the NICHD International Site Development Initiative (NISDI) Perinatal Study with data allowing calculation of the BMI adjusted for length of gestation (adjBMI), who delivered singleton infants. Outcome variables included infant growth parameters at birth (weight, BMI, length and head circumference) and gestational age. Of 697 women from Argentina, the Bahamas, Brazil and Mexico who were included in the analysis, the adjBMI was classified as underweight for 109 (15.6%), normal for 418 (60.0%), overweight for 88 (12.6%) and obese for 82 (11.8%). Median infant birth weight, BMI, birth length and head circumference differed significantly according to maternal adjBMI (P</=0.0002). Underweight mothers gave birth to infants with lower weight, lower BMI, shorter length and smaller head circumference, while infants born to normal, overweight and obese mothers were of similar size

Reduced dimensionality spin-orbit dynamics of CH3 + HCl reversible arrow CH4 Cl on ab initio surfaces

A reduced dimensionality quantum scattering method is extended to the study of spin-orbit nonadiabatic transitions in the CH3 + HCl reversible arrow CH4 + Cl(P-2(J)) reaction. Three two-dimensional potential energy surfaces are developed by fitting a 29 parameter double-Morse function to CCSD(T)/IB//MP2/cc-pV(T+d)Z-dk ab initio data; interaction between surfaces is described by geometry-dependent spin-orbit coupling functions fit to MCSCF/cc-pV(T+d)Z-dk ab initio data. Spectator modes are treated adiabatically via inclusion of curvilinear projected frequencies. The total scattering wave function is expanded in a vibronic basis set and close-coupled equations are solved via R-matrix propagation. Ground state thermal rate constants for forward and reverse reactions agree well with experiment. Multi-surface reaction probabilities, integral cross sections, and initial-state selected branching ratios all highlight the importance of vibrational energy in mediating nonadiabatic transition. Electronically excited state dynamics are seen to play a small but significant role as consistent with experimental conclusions. (C) 2011 American Institute of Physics. [doi:10.1063/1.3592732