Uniportal fully robotic-assisted bronchovascular sleeve bilobectomy

info:eu-repo/semantics/publishedVersio

Концептуальные основы модернизации образовательного процесса в среднем медицинском образовании

Colegiul Naţional de Medicină şi Farmacie, Chişinău, Conferinţa Ştiinţifico-Practică „Medicina modernă, actualităţi şi perspective”, consacrată aniversării de 40 de ani ai Spitalului Clinic al Ministerului Sănătăţii, 27-28 mai, 2010, Chişinău, Republica MoldovaPost-secondary medical education is an essential step of medical education in Moldova. The strategy’s mission is to integrate youth into an effective system of education, including the initial and further training of specialists in medicine in accordance with the principles of a democratic society as well as the ideas of increasing and strengthening the health services and the health of the nation. This strategy is to modernize the process of post-secondary training in medical education by training medical professionals in accordance with the current and future needs of the medical society. The proposed strategy is compatible with European Union directives from the period 2007 – 2008.Среднее медицинское образование является важной ступенью медицинского образования в Молдове. Стратегия заключается в интеграции молодежи в эффективную систему образования и направлена на укрепление национальной системы здравоохранения и здоровье нации. Цель стратегии состоит в модернизации процесса проектирования послешкольного обучения медицинским наукам в соответствии с текущими и будущими потребностями общества. Стратегия совместима с директивами Европейского Союза 2007 - 2008 г. на предмет признания профессиональной квалификации

Scheduling access to shared space in multi-robot systems

Through this study, we introduce the idea of applying scheduling techniques to allocate spatial resources that are shared among multiple robots moving in a static environment and having temporal constraints on the arrival time to destinations. To illustrate this idea, we present an exemplified algorithm that plans and assigns a motion path to each robot. The considered problem is particularly challenging because: (i) the robots share the same environment and thus the planner must take into account overlapping paths which cannot happen at the same time; (ii) there are time deadlines thus the planner must deal with temporal constraints; (iii) new requests arrive without a priori knowledge thus the planner must be able to add new paths online and adjust old plans; (iv) the robot motion is subject to noise thus the planner must be reactive to adapt to online changes. We showcase the functioning of the proposed algorithm through a set of agent-based simulations

Uniportal pure robotic-assisted thoracic surgery—technical aspects, tips and tricks

The uniportal access for robotic thoracic surgery presents itself as a natural evolution of minimally invasive thoracic surgery (MITS). It was developed by surgeons who pioneered the uniportal video-assisted thoracic surgery (U-VATS) in all its aspects following the same principles of a single incision by using robotic technology. The robotic surgery was initially started as a hybrid procedure with the use of thoracoscopic staplers by the assistant. However, due to the evolution of robotic modern platforms, the staplers can be nowadays controlled by the main surgeon from the console. The pure uniportal robotic-assisted thoracic surgery (U-RATS) is defined as the robotic thoracic surgery performed through a single intercostal (ic) incision, without rib spreading, using the robotic camera, robotic dissecting instruments and robotic staplers. There are presented the advantages, difficulties, the general aspects and specific considerations for U-RATS. For safety reasons, the authors recommend the transition from multiportal-RATS through biportal-RATS to U-RATS. The use of robotic dissection and staplers through a single incision and the rapid undocking with easy emergent conversion when needed (either to U-VATS or to thoracotomy) are safety advantages over multi-port RATS that cannot be overlooked, offering great comfort to the surgeon and quick and smooth recovery to the patient.info:eu-repo/semantics/publishedVersio

Модернизация обучающей программы по практической подготовке специалистов со средним медицинским образованием путем внедрения семейной медицины

National College of Medicine and Pharmacy, Center of Medical Continued Education of Medical and Pharmaceutical Assistants, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaAdapting the system of training specialists with secondary medical education in family medicine to current and future needs of the health care system is done by upgrading the didactic process of preparing nurses capable to provide quality services to the population in the framework of family medicine. In this context, the modernization of the educational program of practical nurse education becomes a strategic necessity.Адаптация системы подготовки специалистов со средним медицинским образованием в области семейной медицины к актуальным и перспективным запросам системы здравоохранения осуществляется путем модернизации дидактического процесса подготовки средних медицинских работников, способной оказать качественные услуги населению в системе семейной медицины. В этом контексте, модернизация обучающей программы по практической подготовке медицинских сестер становится стратегической необходимостью

Three embeddings of the Klein simple group into the Cremona group of rank three

We study the action of the Klein simple group G consisting of 168 elements on two rational threefolds: the three-dimensional projective space and a smooth Fano threefold X of anticanonical degree 22 and index 1. We show that the Cremona group of rank three has at least three non-conjugate subgroups isomorphic to G. As a by-product, we prove that X admits a Kahler-Einstein metric, and we construct a smooth polarized K3 surface of degree 22 with an action of the group G.Comment: 43 page

Comparison of uniportal robotic-assisted thoracic surgery pulmonary anatomic resections with multiport robotic-assisted thoracic surgery: a multicenter study of the European experience

Background: Robotic-assisted thoracic surgery (RATS) has seen increasing interest in the last few years, with most procedures primarily being performed in the conventional multiport manner. Our team has developed a new approach that has the potential to convert surgeons from uniportal video-assisted thoracic surgery (VATS) or open surgery to robotic-assisted surgery, uniportal-RATS (U-RATS). We aimed to evaluate the outcomes of one single incision, uniportal robotic-assisted thoracic surgery (U-RATS) against standard multiport RATS (M-RATS) with regards to safety, feasibility, surgical technique, immediate oncological result, postoperative recovery, and 30-day follow-up morbidity and mortality. Methods: We performed a large retrospective multi-institutional review of our prospectively curated database, including 101 consecutive U-RATS procedures performed from September 2021 to October 2022, in the European centers that our main surgeon operates in. We compared these cases to 101 consecutive M-RATS cases done by our colleagues in Barcelona between 2019 to 2022. Results: Both patient groups were similar with respect to demographics, smoking status and tumor size, but were significantly younger in the U-RATS group [M-RATS =69 (range, 39-81) years; U-RATS =63 years (range, 19-82) years; P<0.0001]. Most patients in both operative groups underwent resection of a primary non-small cell lung cancer (NSCLC) [M-RATS 96/101 (95%); U-RATS =60/101 (59%); P<0.0001]. The main type of anatomic resection was lobectomy for the multiport group, and segmentectomy for the U-RATS group. In the M-RATS group, only one anatomical segmentectomy was performed, while the U-RATS group had twenty-four (24%) segmentectomies (P=0.0006). All M-RATS and U-RATS surgical specimens had negative resection margins (R0) and contained an equivalent median number of lymph nodes available for pathologic analysis [M-RATS =11 (range, 5-54); U-RATS =15 (range, 0-41); P=0.87]. Conversion rate to thoracotomy was zero in the U-RATS group and low in M-RATS [M-RATS =2/101 (2%); U-RATS =0/101; P=0.19]. Median operative time was also statistically different [M-RATS =150 (range, 60-300) minutes; U-RATS =136 (range, 30-308) minutes; P=0.0001]. Median length of stay was significantly lower in U-RATS group at four days [M-RATS =5 (range, 2-31) days; U-RATS =4 (range, 1-18) days; P<0.0001]. Rate of complications and 30-day mortality was low in both groups. Conclusions: U-RATS is feasible and safe for anatomic lung resections and comparable to the multiport conventional approach regarding surgical outcomes. Given the similarity of the technique to uniportal VATS, it presents the potential to convert minimally invasive thoracic surgeons to a robotic-assisted approach.info:eu-repo/semantics/publishedVersio

Quality of life measurement in alopecia areata. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes

New treatment options may lead to an increased interest in using reliable and sensitive instruments to assess health-related quality of life in people with alopecia areata (AA). The purpose of this paper is to present current knowledge about quality of life assessment in AA. The dermatology-specific Dermatology Life Quality Index (DLQI) was the most widely reported health-related quality of life instrument used in AA. Three AA-specific (Alopecia Areata Symptom Impact Scale, Alopecia Areata Quality of Life Index and Alopecia Areata Patients'' Quality of Life) and three hair disease-specific instruments (Hairdex, Scalpdex and ‘hair-specific Skindex-29’) were identified with a range of content and validation characteristics: there is little evidence yet of the actual use of these measures in AA. Scalpdex is the best-validated hair disease-specific instrument. Further extensive validation is needed for all of the AA-specific instruments. The European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes recommends the use of the dermatology-specific DLQI questionnaire, hair disease-specific Scalpdex and the alopecia areata-specific instruments the Alopecia Areata Symptom Impact Scale or Alopecia Areata Quality of Life Index, despite the limited experience of their use. We hope that new treatment methods will be able to improve both clinical signs and health-related quality of life in patients with AA. In order to assess the outcomes of trials on these new treatment methods, it would be helpful when further development and validation of AA-specific instruments is being encouraged and also conducted. © 2021 European Academy of Dermatology and Venereology

Empirical analysis and modeling of Argos Doppler location errors in Romania

Background Advances in wildlife tracking technology have allowed researchers to understand the spatial ecology of many terrestrial and aquatic animal species. Argos Doppler is a technology that is widely used for wildlife tracking owing to the small size and low weight of the Argos transmitters. This allows them to be fitted to small-bodied species. The longer lifespan of the Argos units in comparison to units outfitted with miniaturized global positioning system (GPS) technology has also recommended their use. In practice, large Argos location errors often occur due to communication conditions such as transmitter settings, local environment, and the behavior of the tracked individual. Methods Considering the geographic specificity of errors and the lack of benchmark studies in Eastern Europe, the research objectives were: (1) to evaluate the accuracy of Argos Doppler technology under various environmental conditions in Romania, (2) to investigate the effectiveness of straightforward destructive filters for improving Argos Doppler data quality, and (3) to provide guidelines for processing Argos Doppler wildlife monitoring data. The errors associated with Argos locations in four geographic locations in Romania were assessed during static, low-speed and high-speed tests. The effectiveness of the Douglas Argos distance angle filter algorithm was then evaluated to ascertain its effect on the minimization of localization errors. Results Argos locations received in the tests had larger associated horizontal errors than those indicated by the operator of the Argos system, including under ideal reception conditions. Positional errors were similar to those obtained in other studies outside of Europe. The errors were anisotropic, with larger longitudinal errors for the vast majority of the data. Errors were mostly related to speed of the Argos transmitter at the time of reception, but other factors such as topographical conditions and orientation of antenna at the time of the transmission also contributed to receiving low-quality data. The Douglas Argos filter successfully excluded the largest errors while retaining a large amount of data when the threshold was set to the local scale (two km). Discussion Filter selection requires knowledge about the movement patterns and behavior of the species of interest, and the parametrization of the selected filter typically requires a trial and error approach. Selecting the proper filter reduces the errors while retaining a large amount of data. However, the post-processed data typically includes large positional errors; thus, we recommend incorporating Argos error metrics (e.g., error ellipse) or use complex modeling approaches when working with filtered data

Drama and discounting in the relational dynamics of corporate social responsibility

Employing theoretical resources from Transactional Analysis (TA) and drawing from interviews with managers dealing with social or environmental issues in their role, we explain how CSR activity provides a context for dramas in which actors may ignore, or discount aspects of self, others, and the contexts of their work as they maintain and reproduce the roles of Rescuers, Persecutors and Victims. In doing so, we add to knowledge about CSR by providing an explanation for how the contradictions of CSR are avoided in practice even when actors may be aware of them. Specifically, we theorise how CSR work can produce dramatic stories where adversity is apparently overcome, whilst little is actually achieved at the social level. We also add to the range of psychoanalytic tools used to account for organisational behaviours, emphasising how TA can explain the relational dynamics of CSR