Simulator training and residents' first laparoscopic hysterectomy : A randomized controlled trial

Background Hysterectomy rates are decreasing in many countries, and virtual reality simulators bring new opportunities into residents' surgical education. The objective of this study was to evaluate the effect of training in laparoscopic hysterectomy module with virtual reality simulator on surgical outcomes among residents performing their first laparoscopic hysterectomy. Methods This randomized study was carried out at the Department of Obstetrics and Gynecology in Helsinki University Hospital and Hyvinkaa Hospital. We recruited twenty residents and randomly signed half of them to train ten times with the laparoscopic hysterectomy module on a virtual reality simulator, while the rest represented the control group. Their first laparoscopic hysterectomy was video recorded and assessed later by using the Objective Structured Assessment of Technical Skills (OSATS) forms and Visual Analog Scale (VAS). The scores and surgical outcomes were compared between the groups. Results The mean OSATS score for the Global Rating Scale (GRS) was 17.0 (SD 3.1) in the intervention group and 11.2 (SD 2.4) in the control group (p = 0.002). The mean procedure-specific OSATS score was 20.0 (SD 3.3) and 16.0 (SD 2.8) (p = 0.012), and the mean VAS score was 55.0 (SD 14.8) and 29.9 (SD 14.9) (p = 0.001). Operative time was 144 min in the intervention group and 165 min in the control group, but the difference did not reach statistical significance (p = 0.205). There were no differences between the groups in blood loss or direct complications. Conclusion Residents training with a virtual reality simulator prior to the first laparoscopic hysterectomy seem to perform better in the actual live operation. Thus, a virtual reality simulator hysterectomy module could be considered as a part of laparoscopic training curriculum.Peer reviewe

Which probes are most useful when undertaking cognitive interviews?

This paper reports the use of verbal probes in cognitive interviews (CIs) undertaken to test the usefulness, validity and reliability of survey questions. Through examining the use of probes by three interviewers undertaking interviews as part the piloting of a cross-national crime survey, we examine which of the various types of probes used in CIs produce the most useful information. Other influences on interview quality are examined, including differences between interviewers and respondents themselves. The analyses rely on multi-level modelling and suggest that anticipated, emergent and conditional probes provide the most useful data. Furthermore, age, gender and educational levels appear to have no bearing on the quality of the data generated

Acute fulminant necrotizing myopathy in a dog caused by co-infection with ultrastructural Sarcocystis caninum and Sarcocystis svanai-like apicomplexan protozoa

Abstract Typically, carnivores are the definitive and herbivores the intermediate hosts for protozoan Sarcocystis spp. In the definitive host, the parasite has sexual multiplication in the intestine. Asexual phases occur in the musculature of different intermediate hosts. Although intestinal sarcocystosis is common in dogs, muscular symptomatic sarcocystosis is rarely reported. Here we report a fatal dual Sarcocystis spp. infection in a dog. The dog had acute onset of non-ambulatory tetraparesis. While neurological findings suggested a generalized neuromuscular disease with peripheral neuropathy concordant with the neurological deficits, the highly elevated muscle enzymes were more suggestive of a myopathy. Despite supportive therapy, the dog died three days after the onset of clinical signs. Necropsy revealed severe monophasic multifocal myodegeneration with severe pyogranulomatous inflammation. Histology revealed multiple sarcocysts in skeletal muscles and a smaller number in the heart. In light microscopy, both thin-walled and very thin-walled sarcocysts were found in skeletal muscles. Transmission electron microscopy confirmed the presence of two types of mature sarcocysts. Morphologically, cysts were indistinguishable from Sarcocystis caninum and Sarcocystis svanai, which were previously reported in a dog from USA. A region of the 18S rRNA gene sequence confirmed the presence of one species, S. arctica/caninum, without evidence for a dual infection. This is the first report of muscular sarcocystosis in a dog in Europe and, intriguingly, revealed morphologically similar species across the Atlantic.Peer reviewe

Dialogue based interfaces for universal access.

Conversation provides an excellent means of communication for almost all people. Consequently, a conversational interface is an excellent mechanism for allowing people to interact with systems. Conversational systems are an active research area, but a wide range of systems can be developed with current technology. More sophisticated interfaces can take considerable effort, but simple interfaces can be developed quite rapidly. This paper gives an introduction to the current state of the art of conversational systems and interfaces. It describes a methodology for developing conversational interfaces and gives an example of an interface for a state benefits web site. The paper discusses how this interface could improve access for a wide range of people, and how further development of this interface would allow a larger range of people to use the system and give them more functionality

Isomeric states close to doubly magic 132^{132}Sn studied with JYFLTRAP

The double Penning trap mass spectrometer JYFLTRAP has been employed to measure masses and excitation energies for $11/2^-$ isomers in $^{121}$Cd, $^{123}$Cd, $^{125}$Cd and $^{133}$Te, for $1/2^-$ isomers in $^{129}$In and $^{131}$In, and for $7^-$ isomers in $^{130}$Sn and $^{134}$Sb. These first direct mass measurements of the Cd and In isomers reveal deviations to the excitation energies based on results from beta-decay experiments and yield new information on neutron- and proton-hole states close to $^{132}$Sn. A new excitation energy of 144(4) keV has been determined for $^{123}$Cd$^m$. A good agreement with the precisely known excitation energies of $^{121}$Cd$^m$, $^{130}$Sn$^m$, and $^{134}$Sb$^m$ has been found.Comment: 10 pages, 6 figures, submitted to Phys. Rev.

Precision mass measurements of radioactive nuclei at JYFLTRAP

The Penning trap mass spectrometer JYFLTRAP was used to measure the atomic masses of radioactive nuclei with an uncertainty better than 10 keV. The atomic masses of the neutron-deficient nuclei around the N = Z line were measured to improve the understanding of the rp-process path and the SbSnTe cycle. Furthermore, the masses of the neutron-rich gallium (Z = 31) to palladium (Z = 46) nuclei have been measured. The physics impacts on the nuclear structure and the r-process paths are reviewed. A better understanding of the nuclear deformation is presented by studying the pairing energy around A = 100.Comment: 4 pages and 4 figures, RNB7 conf. pro

Q_EC values of the Superallowed beta-Emitters 10-C, 34-Ar, 38-Ca and 46-V

The Q_EC values of the superallowed beta+ emitters 10-C, 34-Ar, 38-Ca and 46-V have been measured with a Penning-trap mass spectrometer to be 3648.12(8), 6061.83(8), 6612.12(7) and 7052.44(10) keV, respectively. All four values are substantially improved in precision over previous results.Comment: 9 pages, 7 figures, 5 table