Image-Guided Surgical e-Learning in the Post-COVID-19 Pandemic Era: What Is Next?

The current unprecedented coronavirus 2019 (COVID-19) crisis has accelerated and enhanced e-learning solutions. During the so-called transition phase, efforts were made to reorganize surgical services, reschedule elective surgical procedures, surgical research, academic education, and careers to optimize results. The intention to switch to e-learning medical education is not a new concern. However, the current crisis triggered an alarm to accelerate the transition. Efforts to consider e-learning as a teaching and training method for medical education have proven to be efficient. For image-guided therapies, the challenge requires more effort since surgical skills training is combined with image interpretation training, thus the challenge is to cover quality educational content with a balanced combination of blended courses (online/onsite). Several e-resources are currently available in the surgical scenario; however, further efforts to enhance the current system are required by accelerating the creation of new learning solutions to optimize complex surgical education needs in the current disrupted environment

The status of the world's land and marine mammals: diversity, threat, and knowledge

Knowledge of mammalian diversity is still surprisingly disparate, both regionally and taxonomically. Here, we present a comprehensive assessment of the conservation status and distribution of the world's mammals. Data, compiled by 1700+ experts, cover all 5487 species, including marine mammals. Global macroecological patterns are very different for land and marine species but suggest common mechanisms driving diversity and endemism across systems. Compared with land species, threat levels are higher among marine mammals, driven by different processes (accidental mortality and pollution, rather than habitat loss), and are spatially distinct (peaking in northern oceans, rather than in Southeast Asia). Marine mammals are also disproportionately poorly known. These data are made freely available to support further scientific developments and conservation action

Percutaneous Radiofrequency Assisted Liver Partition with Portal Vein Embolization for Staged Hepatectomy (Pralpps)

BACKGROUND: When a major hepatic resection is necessary, sometimes the future liver remnant is not enough to maintain sufficient liver function and patients are more likely to develop liver failure after surgery. AIM: To test the hypothesis that performing a percutaneous radiofrecuency liver partition plus percutaneous portal vein embolization (PRALPPS) for stage hepatectomy in pigs is feasible. METHODS: Four pigs (Sus scrofa domesticus) both sexes with weights between 25 to 35 kg underwent percutaneous portal vein embolization with coils of the left portal vein. By contrasted CT, the difference between the liver parenchyma corresponding to the embolized zone and the normal one was identified. Immediately, using the fusion of images between ultrasound and CT as a guide, radiofrequency needles were placed percutaneouslyand then ablated until the liver partition was complete. Finally, hepatectomy was completed with a laparoscopic approach. RESULTS: All animals have survived the procedures, with no reported complications. The successful portal embolization process was confirmed both by portography and CT. In the macroscopic analysis of the pieces, the depth of the ablation was analyzed. The hepatic hilum was respected. On the other hand, the correct position of the embolization material on the left portal vein could be also observed. CONCLUSION: "Percutaneous radiofrequency assisted liver partition with portal vein embolization" (PRALLPS) is a feasible procedure

Resilience, Digital Tools, and Knowledge Management Systems in the Pandemic Era: The IHU Strasbourg Experience

Disasters like the recent COVID-19 pandemic can benefit from the use of digital tools and Knowledge Management Systems (KMSs) to manage the emergency and improve the resilience of the system. Such KMSs must prove the quality of the system, service, situation, and knowledge which is gathered, transferred and shared. However, KMSs must cope with the presence of knowledge barriers, which limit to manage data and information successfully. Our chapter wants to deepen such a topic through the analysis of the case study of a web application developed by the IHU Strasbourg, one research and clinical centre, to collect and share knowledge between the end-users (citizens) and healthcare institutions, decision-makers, and public entities during the COVID-19 pandemic. Our findings highlight the need to ensure that not only the KMS possesses the recommended quality standards, but that specific features are put in place to cope with the presence of knowledge barriers, and the need for speed in the information flows to enhance resilience

Digital transformation in healthcare. The challenges of translating knowledge in a primary research, educational and clinical centre

The global healthcare system is currently facing an increasing technological swift, also driven by the need to engage the patients and other stakeholders in developing healthcare products and services. Knowledge Translation (KT) is getting increasing attention both from scholars as well as managers and professionals, due to its crucial role in fostering innovation, when most actors share different backgrounds, competencies, and skills. Such features represent severe challenges to the sharing and transfer of knowledge. The various actors need effective KT enablers to share, transfer, and create new knowledge. This paper aims to investigate such dynamics through a qualitative case, analyzing how KT is managed at IHU Strasbourg, the Institute of Image-Guided Surgery, one primary research, clinical, and educational centre, together with the Research Institute Against Digestive Cancers (IRCAD), the surgical minimally-invasive training centre. At such Institutes, several digital technologies are implemented and adopted to foster innovation in new surgical tools and methodologies. Findings demonstrate that KT at IHU Strasbourg/IRCAD can be defined at four different levels, corresponding to the Institutes’ aims: education, innovation, technological transfer, and care. For each dimension, a galaxy of stakeholders, KT processes and flows, and instruments emerge. KT enablers vary, from the ones more linked to digital technologies and procedures to the ones that are more creative and based on the soft and interpersonal skills of the professionals involved. Results suggest a mix of different methods, and the search for always new techniques