Do absorption and realistic distraction influence performance of component task surgical procedure?

Background. Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance. Methods. Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting conditions (exposure to music, conversation, and nonoptimal handling of the laparoscope) versus nondistracting conditions (control condition) as part of a 2 x 2 within-subject experimental design. Results. Under distracting conditions, the medical interns showed a significant decline in task performance (overall task score, task errors, and operating time) and significantly increased levels of irritation toward both the assistant handling the laparoscope in a nonoptimal way and the sources of social distraction. Furthermore, individual differences in cognitive style (i.e., cognitive absorption and need for cognition) significantly influenced the levels of irritation experienced by the medical interns. Conclusion. The results suggest careful evaluation of the social and technological sources of distraction in the operation room to reduce irritation for the surgeon and provision of proper preclinical laparoscope navigation training to increase security for the patient.Industrial DesignIndustrial Design Engineerin

In Silico Prediction and Analysis of Caenorhabditis EF-hand Containing Proteins

Calcium (Ca+2) is a ubiquitous messenger in eukaryotes including Caenorhabditis. Ca+2-mediated signalling processes are usually carried out through well characterized proteins like calmodulin (CaM) and other Ca+2 binding proteins (CaBP). These proteins interact with different targets and activate it by bringing conformational changes. Majority of the EF-hand proteins in Caenorhabditis contain Ca+2 binding motifs. Here, we have performed homology modelling of CaM-like proteins using the crystal structure of Drosophila melanogaster CaM as a template. Molecular docking was applied to explore the binding mechanism of CaM-like proteins and IQ1 motif which is a ∼25 residues and conform to the consensus sequence (I, L, V)QXXXRXXXX(R,K) to serve as a binding site for different EF hand proteins. We made an attempt to identify all the EF-hand (a helix-loop-helix structure characterized by a 12 residues loop sequence involved in metal coordination) containing proteins and their Ca+2 binding affinity in Caenorhabditis by analysing the complete genome sequence. Docking studies revealed that F165, F169, L29, E33, F44, L57, M61, M96, M97, M108, G65, V115, F93, N104, E144 of CaM-like protein is involved in the interaction with IQ1 motif. A maximum of 170 EF-hand proteins and 39 non-EF-hand proteins with Ca+2/metal binding motif were identified. Diverse proteins including enzyme, transcription, translation and large number of unknown proteins have one or more putative EF-hands. Phylogenetic analysis revealed seven major classes/groups that contain some families of proteins. Various domains that we identified in the EF-hand proteins (uncharacterized) would help in elucidating their functions. It is the first report of its kind where calcium binding loop sequences of EF-hand proteins were analyzed to decipher their calcium affinities. Variation in Ca+2-binding affinity of EF-hand CaBP could be further used to study the behaviour of these proteins. Our analyses postulated that Ca+2 is likely to be key player in Caenorhabditis cell signalling

Effect of Supplementation with Zinc and Other Micronutrients on Malaria in Tanzanian Children: A Randomised Trial

Hans Verhoef and colleagues report findings from a randomized trial conducted among Tanzanian children at high risk for malaria. Children in the trial received either daily oral supplementation with either zinc alone, multi-nutrients without zinc, multi-nutrients with zinc, or placebo. The investigators did not find evidence from this study that zinc or multi-nutrients protected against malaria episodes

Applying the ALARA concept to the evaluation of vesicoureteric reflux

The voiding cystourethrogram (VCUG) is a widely used study to define lower urinary tract anatomy and to diagnose vesicoureteric reflux (VUR) in children. We examine the technical advances in the VCUG and other examinations for reflux that have reduced radiation exposure of children, and we give recommendations for the use of imaging studies in four groups of children: (1) children with urinary tract infection, (2) siblings of patients with VUR, (3) infants with antenatal hydronephrosis (ANH), and (4) children with a solitary functioning kidney. By performing examinations with little to no radiation, carefully selecting only the children who need imaging studies and judiciously timing follow-up examinations, we can reduce the radiation exposure of children being studied for reflux

Gelatinisation characteristics of cassava starch settled in the presence of different chemicals

Addition of chemicals during the extraction of cassava starch for enhancing the settling rate, whiteness and compactness of the settled starch is an accepted commercial practice. The effect of addition of selected chemicals such as acids (sulphuric and hydrochloric acids), bleaching and oxidising agents (sodium metabisulphite and sodium hypochlorite) and alum during settling on the thermal and pasting properties of the cassava starch was examined. Treatment with sulphuric acid produced a noticeable increase in all DSC gelatinisation parameters, viz. onset gelatinisation temperature (T-o), temperature at peak minimum (T-p) and end temperature (T-e), with increasing concentration of acid, while only a marginal shift could be obtained even at higher concentration of hydrochloric acid. However, no major effect resulted from treatment with sodium metabisulphite, sodium hypochlorite and alum. The gelatinisation enthalpy was hardly affected by the treatments. An exception was hydrochloric acid, which brought about a perceptible decrease in enthalpy at higher concentrations indicating that starch crystallinity is influenced to a small extent by hydrochloric acid. Pasting characteristics studied using a Rapid Visco Analyser showed that sulphuric acid, even at the lowest concentration (5 mM), considerably affected the structural characteristics of cassava starch, while hydrochloric acid induced similar effect only at higher concentrations. Alum reduced the paste viscosity while the bleaching agents (sodium metabisulphite and sodium hypochlorite) were not so effective in modifying the starch viscosity characteristics

Determination of amylose content in different starches using modulated differential scanning calorimetry

A simple calorimetric method for determination of amylose content in starch is reported. Starches were heated in the presence of two common surfactants, viz., sodium dodecyl sulphate (SDS) and cetyltrimethylammonium bromide (CTAB), and the enthalpies of melting of the amylose-surfactant complexes were determined using Modulated Differential Scanning Calorimetry (MDSC). A large number of native starches including cereal, root and pea starches were examined. The results were compared with those obtained by iodimetry and gel permeation chromatography (GPC) for all the starches. There was a good correlation between the values from iodimetry and GPC with those obtained using the surfactants. Both surfactants seemed to work equally well, even for those starches with about 40% amylose content. However, in case of SIDS higher standard deviations were usually obtained than for CTAB in the determination of transition enthalpies

Properties of arrowroot starch treated with aqueous HCl at ambient temperature

Arrowroot starch was acid-treated using 2.2 M HCl at 29 to 30degreesC for durations of 0 to 72 h, and properties of the control and modified samples were compared. Increasing length of acid treatment produced a progressive decline in amylose blue value, intrinsic viscosity, and swelling power, as well as an increase in free sugars and solubility. Differential scanning calorimetry (DSC) studies highlighted changes effected by acid-treatment in the gelatinization behavior of the starch samples. Gel permeation chromatography (GPC) studies on 32- and 72-h acid-treated samples Indicated a greater proportion of dextrins with a higher percentage of reducing sugars, compared to the control. While X-ray diffraction data suggested minor changes in the crystal phase impacted by acid-treatment, in vitro digestibility of both control and acid-treated samples did not show any appreciable change in overall patterns