Interactive Surgical Depiction for the Electronic Medical Record

Prior to the adoption of the electronic medical record (EMR), the written documentation of operations in patients’ paper charts were frequently supplemented by a sketch by the surgeon. is image enhanced the understanding of the operation, especially for complex or re-operative procedures. With the recent transition to comprehensive EMR systems, traditional paper charts are seldom used and less accessible to clinicians. Surgeons currently lack a means to include a drawing in the patient record to aid in the communication of post-operative anatomy. An accurate understanding of post-operative anatomy is critical to providing optimal care. Deprived of this knowledge, subsequent care providers expend considerable time and resources attempting to understand the patient’s current anatomy. is is particularly true when the patient falls under the care of a di erent doctor or team, or is transferred from another hospital. Ultimately, the patient’s safety is compromised, as they may be subjected to greater periods of time under anesthesia and unnecessary radiation dedicated solely to visualizing their altered anatomy. No tools are currently available that allow a meaningful depiction of post-operative anatomy to be included in the medical record. is thesis explores the design of a digital interactive tool to enable surgeons to quickly and accurately document the patient’s post- procedural anatomy in an image. is tool is unique in that it presents a pre-existing 3D model which the user may split, remove, move, and reconnect to represent changes to the patient’s GI tract. rough an intuitive interface, the surgeon will manipulate a 3D model of normal anatomy to accurately depict resections and reconnections of bowel at appropriate distances and con gurations and include elements such as drains, measurements, and annotations. e surgeon can then save the image with the post-operative note to follow the patient. As a part of the EMR, the image is available for viewing by practitioners responsible for post-operative care and subsequent diagnoses and procedures, contributing to overall patient safety. Over thirty user interviews provided feedback vital to the design of the user interface and features list during the development stage of this novel resource

Scaling regimes and fluctuations of observables in computer glasses approaching the unjamming transition

Under decompression, disordered solids undergo an unjamming transition where they become under-coordinated and lose their structural rigidity. The mechanical and vibrational properties of these materials have been an object of theoretical, numerical, and experimental research for decades. In the study of low-coordination solids, understanding the behavior and physical interpretation of observables that diverge near the transition is of particular importance. Several such quantities are length scales ($\xi$ or $l$) that characterize the size of excitations, the decay of spatial correlations, the response to perturbations, or the effect of physical constraints in the boundary or bulk of the material. Additionally, the spatial and sample-to-sample fluctuations ($\chi$) of macroscopic observables such as coordination number or elastic moduli diverge approaching unjamming. Here, we discuss important connections between all of these quantities, and present numerical results that characterize the scaling properties of sample-to-sample standard deviations $\chi$ in ensembles of low-coordination disordered sphere packings and spring networks. Overall, we highlight three distinct scaling regimes and two crossovers in $\chi_Z$ and $\chi_\mu$ ($\chi$ measured for the excess coordination $\delta z$ and the shear modulus $\mu$ respectively) as a function of system size $N$ and proximity to unjamming $\delta z$. Importantly, $\chi_\mu$ has been linked to experimentally accessible quantities that relate to sound attenuation and the density of vibrational states in glasses. We investigate similarities and differences in the behavior of $\chi_Z$ and $\chi_\mu$ near the transition and discuss the implications of our findings on current literature, unifying findings in previous studies

From moral indignation to affective citizenship: public shaming of celebrity emigration from Russia during the war against Ukraine

The paper analyses the public shaming campaigns that emerged around celebrity emigration following the Russian invasion in Ukraine. It examines how the individual commentators on social media have been conducting symbolic destruction of these celebrities’ moral character and social status while at the same time constituting the moral meaning of emigration from Russian Motherland as an act of betrayal and reconstructing a national civil contract of national belonging. Thus, through interpretation of the social media discourse on celebrity emigration we reveal the affective relations of Russian patriotic citizens to their nation and the state

Metronomic doses and drug schematic combination response tested within chambered coverslips for the treatment of breast cancer cells (JIMT-1)

Low-dose metronomic (LDM) chemotherapy is an alternative to conventional chemotherapy and is the most frequently used approach in low dose chemotherapy regimens. The selection of patients, drug dosages, and dosing intervals in LDM is empirical. In this study, we systematically examined the schedule-dependent interaction of drugs on a breast cancer cell line (BCC) cultured in chambered coverslips. The LDM studies were combined with cell staining in order to better characterize different cell states and cell death modes, including caspase-dependent apoptosis, caspase-independent cell death and autophagy-dependent cell death. Microscope images were examined using the Fiji Trainable Weka Segmentation plugin to analyse cell area in 7500 images showing different modes of cell death. Paclitaxel combined with LDM chemotherapy demonstrated a reduction in the area covered by live cells. In contrast, there was an induction of high levels of cell death due to caspase-dependent apoptosis.Fil: Rosero, Gustavo. Universidad Tecnológica Nacional; Argentina. Albert Ludwigs University of Freiburg; AlemaniaFil: Pattarone, Gisela. Albert Ludwigs University of Freiburg; AlemaniaFil: Peñaherrera Pazmiño, Ana Belén. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional; Argentina. Albert Ludwigs University of Freiburg; AlemaniaFil: Pilz, Julia. Albert Ludwigs University of Freiburg; AlemaniaFil: Bödecker, Joschka. Albert Ludwigs University of Freiburg; AlemaniaFil: Perez, Maximiliano Sebastian. Universidad de Buenos Aires; Argentina. Universidad Tecnológica Nacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Mertelsmann, Roland. Albert Ludwigs University of Freiburg; AlemaniaFil: Lerner, Betiana. Universidad de Buenos Aires; Argentina. Universidad Tecnológica Nacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Follo, Marie. Universidad de Buenos Aires; Argentin

Minimal-invasiv glaukomkirurgi (MIGS) for individer med glaukom. En metodevurdering

Source at https://www.fhi.no/en/publ/2021/Minimally-Invasive-Glaucoma-Surgery-MIGS-for-individuals-with-glaucoma/Key messages: This health technology assessment (HTA) summarises and supplements a 2019 Canadian HTA on the effectiveness and safety of micro-invasive glaucoma surgery (MIGS) versus other treatment options. Further, it contains cost-effectiveness analysis based on the Canadian HTA, in addition to patient partners’ considerations, organizational and ethical considerations relevant to discussions of MIGS’ role in Norwegian routine care. The Canadian evidence, which included 32 studies and 24 comparisons, was inconclusive due to very low to low certainty. Our supplementary findings show that: • MIGS with Hydrus Microstent combined with cataract surgery reduces intraocular pressure (IOP) at 24 months, compared with cataract surgery alone (high-certainty evidence) • MIGS with iStent inject combined with cataract surgery probably reduces IOP at 24 months, compared with cataract surgery alone (moderate-certainty evidence) • For other techniques there is either no or little difference between the MIGS and control interventions, or it is uncertain whether there is a difference in effectiveness • Neither MIGS procedures, nor alternative surgical strategies appear to be at high risk of adverse events • Lifetime total cost for glaucoma treatment ranged from NOK 30 000 to NOK 83 000 per patient, depending on treatment strategy and baseline disease stage. The incremental Quality adjusted life years (QALYs) for MIGS between comparators ranged between – 0.080 and 0.057 • MIGS is suitable as a outpatient surgery without hospital admission. Clinicians need training. Clear criteria for patient selection shuld be developed. Experts predict that the number of MIGS procedures may increase to twice as many in 2024 than today • The clinical evidence on MIGS is limited. The main reason for this is the lack of comparative studies. Our health economic evaluation shows some scenarios where MIGS may be cost-effective, depending on comparator and disease stage. Our analysis puts individuals with glaucoma in severity class 1.Hovedbudskap: Denne metodevurderingen (HTA) oppsummerer og supplerer en kanadisk HTA fra 2019 om effekt og sikkerhet ved minimal-invasiv glaukomkirurgi (MIGS). Videre gjorde vi kost-nytteanalyser basert på den kanadiske HTAen, i tillegg til brukerperspektiv, organisatoriske og etiske vurderinger som er relevante i en diskusjon om hvorvidt MIGS bør være et rutinetilbud i norsk praksis. Det kanadiske kunnskapsgrunnlaget, som omfattet 32 studier og 24 sammenlikninger, var usikkert på grunn av svært lav til lav tillit til resultatene. Våre supplerende funn viser at: • MIGS med Hydrus Microstent kombinert med kataraktkirurgi reduserer intraokulært trykk (IOP) etter 24 måneder, sammenliknet med kataraktkirurgi alene (høy tillit til resultatet) • MIGS med iStent inject og kataraktkirurgi reduserer trolig IOP etter 24 måneder, sammenliknet med kataraktkirurgi alene (middels tillit til resultatet) • Det er usikkert hvorvidt det er noen forskjell i effekt mellom MIGS og kontrollgruppene for andre sammenligninger • Det ser ikke ut til å være noen betydelig forskjell mellom MIGS og kontrollgruppene i risiko for uønskede hendelser/skader • Total livstidskostnad per pasient for glaukombehandling ble estimert mellom 30 000 norske kroner og 83 000 norske kroner avhengig av behandlingsstrategi og sykdomsstadie ved start. Inkrementell QALY for MIGS sammenlignet med komparatorer var mellom – 0.080 og 0.057 • MIGS egner seg for poliklinisk kirurgi. Øyeleger må ha opplæring for å utføre MIGS. Det bør utvikles klare kriterier for pasientseleksjon. Eksperter predikerer en dobling av antall MIGS prosedyrer i 2024 enn antallet i dag • Kunnskapsgrunnlaget for effekt og sikkerhet om MIGS er begrenset. Hovedgrunnen er mangel på sammenliknende studier. Vår helseøkonomiske vurdering viser at MIGS kan være kostnadseffektive, avhengig av sammenliknng og sykdomsutvikling. Vår analyse setter individer med glaukom i gruppe for alvorlighetsgrad 1

Induction level determines signature of gene expression noise in cellular systems

Noise in gene expression, either due to inherent stochasticity or to varying inter- and intracellular environment, can generate significant cell-to-cell variability of protein levels in clonal populations. We present a theoretical framework, based on stochastic processes, to quantify the different sources of gene expression noise taking cell division explicitly into account. Analytical, time-dependent solutions for the noise contributions arising from the major steps involved in protein synthesis are derived. The analysis shows that the induction level of the activator or transcription factor is crucial for the characteristic signature of the dominant source of gene expression noise and thus bridges the gap between seemingly contradictory experimental results. Furthermore, on the basis of experimentally measured cell distributions, our simulations suggest that transcription factor binding and promoter activation can be modelled independently of each other with sufficient accuracy

Experimental Philosophical Bioethics

There is a rich tradition in bioethics of gathering empirical data to inform, supplement, or test the implications of normative ethical analysis. To this end, bioethicists have drawn on diverse methods, including qualitative interviews, focus groups, ethnographic studies, and opinion surveys to advance understanding of key issues in bioethics. In so doing, they have developed strong ties with neighboring disciplines such as anthropology, history, law, and sociology. Collectively, these lines of research have flourished in the broader field of “empirical bioethics” for more than 30 years (Sugarman & Sulmasy 2010). More recently, philosophers from outside the field of bioethics have similarly employed empirical methods—drawn primarily from psychology, the cognitive sciences, economics, and related disciplines—to advance theoretical debates. This approach, which has come to be called experimental philosophy (or x-phi), relies primarily on controlled experiments to interrogate the concepts, intuitions, reasoning, implicit mental processes, and empirical assumptions about the mind that play a role in traditional philosophical arguments (Knobe et al. 2012). Within the moral domain, for example, experimental philosophy has begun to contribute to long-standing debates about the nature of moral judgment and reasoning; the sources of our moral emotions and biases; the qualities of a good person or a good life; and the psychological basis of moral theory itself (Alfano, Loeb, & Plakias 2018). We believe that experimental philosophical bioethics—or “bioxphi”—can similarly explain how it is distinct from empirical bioethics more broadly construed, and attempt to characterize how it might advance theory and practice in this area

Common and rare variant association analyses in amyotrophic lateral sclerosis identify 15 risk loci with distinct genetic architectures and neuron-specific biology

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with a lifetime risk of one in 350 people and an unmet need for disease-modifying therapies. We conducted a cross-ancestry genome-wide association study (GWAS) including 29,612 patients with ALS and 122,656 controls, which identified 15 risk loci. When combined with 8,953 individuals with whole-genome sequencing (6,538 patients, 2,415 controls) and a large cortex-derived expression quantitative trait locus (eQTL) dataset (MetaBrain), analyses revealed locus-specific genetic architectures in which we prioritized genes either through rare variants, short tandem repeats or regulatory effects. ALS-associated risk loci were shared with multiple traits within the neurodegenerative spectrum but with distinct enrichment patterns across brain regions and cell types. Of the environmental and lifestyle risk factors obtained from the literature, Mendelian randomization analyses indicated a causal role for high cholesterol levels. The combination of all ALS-associated signals reveals a role for perturbations in vesicle-mediated transport and autophagy and provides evidence for cell-autonomous disease initiation in glutamatergic neurons. A cross-ancestry genome-wide association meta-analysis of amyotrophic lateral sclerosis (ALS) including 29,612 patients with ALS and 122,656 controls identifies 15 risk loci with distinct genetic architectures and neuron-specific biology