reimagining stem education and training with e real 3d and holographic visualization immersive and interactive learning for an effective flipped classroom

While the 19th and the 20th centuries were, in education, mainly about standardization, the 21st century is about visualization, interaction, customization, gamification and flipped teaching. What today we know about learning from cognitive psychology is that people learn by practicing, with feedback to tell them what they're doing right and wrong and how to get better. For STEM education, that means they need to practice thinking like a scientist in the field. So e-REAL is a cornerstone: developed as workplace learning system in a number of fields (from medical simulation to soft skills development within the continuing education), it's an ideal solution to root a practical – but not simplicistic - approach for STEM education.</p

Virtual worlds and augmented reality: The enhanced reality lab as a best practice for advanced simulation and immersive learning

e-REAL is enhanced reality for immersive simulation. It is a system where physical and digital objects co-exist and interact in real time, in a real place and not within a headset. e-REAL allows for an advanced simulation within a multisensory scenario, based on challenging situations developed by visual storytelling techniques. The e-REAL immersive setting is fully interactive with 3D holographic visualization, talking avatars, electronically writable surfaces and more: people can take notes, cluster key-concepts or fill questionnaires directly on the projected surfaces. Learners rapidly circle between deliberate practice and direct feedback within a simulation scenario until mastery is achieved. So far, the early findings show that visualization, if linked in interactive ways to the learners, allows for better neural processes related to learning and behavior change. Mondi virtuali e realtà aumentata: l’Enhanced Reality Lab come best practice per la simulazione avanzata e l’apprendimento immersivoe-REAL è realtà potenziata per la simulazione immersiva. E’ un sistema dove oggetti fisici e virtuali coesistono e interagiscono in tempo reale, in un luogo reale e non all’interno di un visore. e-REAL consente una simulazione avanzata all’interno di uno scenario multisensoriale, basato su situazioni sfidanti progettate attraverso tecniche di storytelling visuale. Il setting immersivo di e-REAL è pienamente interattivo con visualizzazioni olografiche in 3D, avatars parlanti, superfici sulle quali è possibile scrivere elettronicamente e altro ancora: le persone possono prendere note, raggruppare concetti-chiave, compilare questionari direttamente sulle superfici proiettate. L’applicazione della tecnica denominate Rapid Cicle Deliberate Practice (RCDP), basata su feedback diretti e mirati, consente di migliorare le performance già nel corso della simulazione. I primi risultati mostrano che la visualizzazione interattiva potenzia i processi neurali associati all’apprendimento e al cambiamento comportamentale

Estimulaçao VDD com Cabo Unico

Com o objetivo de avaliar a eficiência da estimulaçao sincrônica VDD com cabo único, sao analisados 30 pacientes, 18 do sexo feminino e 12 do masculino, com idades entre 43 e 83 anos. Todos apresentavam funçao sinusal normal com bloqueio atrioventricular de 2º grau (5 casos) ou total (25 casos), sendo utilizados marcapassos VDD com cabos únicos quadripolares, num seguimento médio de 17,2 ± 8,5 meses. Avaliou-se a confiabilidade do procedimento pela captaçao da atividade atrial e pela mensuraçao da onda P em 8 posiçoes e/ou decúbitos, e a sua eficiência pela verificaçao da elevaçao da freqüência de estimulaçao constatada no Holter. A estimulaçao VDD foi inefetiva em apenas um paciente (3,3%), tendo nos demais confiabilidade de 96,1%, e elevado a freqüência de 68 a 130%, com manutençao do sincronismo atrioventricular. Por ser confiável, eficiente e apresentar resposta de freqüência com manutençao do sincronismo AV, a estimulaçao VDD deve ser recomendada, nos pacientes com funçao sinusal nornal, em substituiçao à VVI e VVI.R

Estimulaçao VDD com Cabo Unico

Com o objetivo de avaliar a eficiência da estimulaçao sincrônica VDD com cabo único, sao analisados 30 pacientes, 18 do sexo feminino e 12 do masculino, com idades entre 43 e 83 anos. Todos apresentavam funçao sinusal normal com bloqueio atrioventricular de 2º grau (5 casos) ou total (25 casos), sendo utilizados marcapassos VDD com cabos únicos quadripolares, num seguimento médio de 17,2 ± 8,5 meses. Avaliou-se a confiabilidade do procedimento pela captaçao da atividade atrial e pela mensuraçao da onda P em 8 posiçoes e/ou decúbitos, e a sua eficiência pela verificaçao da elevaçao da freqüência de estimulaçao constatada no Holter. A estimulaçao VDD foi inefetiva em apenas um paciente (3,3%), tendo nos demais confiabilidade de 96,1%, e elevado a freqüência de 68 a 130%, com manutençao do sincronismo atrioventricular. Por ser confiável, eficiente e apresentar resposta de freqüência com manutençao do sincronismo AV, a estimulaçao VDD deve ser recomendada, nos pacientes com funçao sinusal nornal, em substituiçao à VVI e VVI.R

Servicios de acompañamiento y asistencia psicológica desarrollados durante la pandemia (COVID-19) en Argentina y Chile

La pandemia de COVID-19 provocó que los estados adopten, entre otras medidas, el aislamiento como modo de prevenir el esparcimiento del virus. Esto generó que los ciudadanos deban aprender a vincularse de un modo alternativo con los sistemas de educación y salud. Por otra parte, esta nueva condición de funcionamiento cívico impactó directamente sobre la subjetividad y la salud mental de la población. Como respuesta a la emergencia generada por la pandemia y las estrategias de asilamiento, surgieron diferentes espacios dirigidos a orientar, contener, acompañar y asistir a diferentes segmentos de la población: contagiados, familiares, trabajadores de la salud, trabajadores esenciales, etcétera. La construcción de estos dispositivos tuvo como desafíos definir un encuadre de trabajo eficaz para la situación descripta y establecer un modo de contacto y asistencia adecuado a la situación de aislamiento social. Objetivos: Presentar y discutir las experiencias de trabajo de diferentes servicios y dispositivos de asistencia vinculados a salud mental construidos en respuesta a la pandemia de COVID-19 en las ciudades de Córdoba y Catamarca (Argentina) y en la ciudad de Chillán, en la región del Bío-Bío (Chile). Exponer datos e información en relación a las características de consultantes, motivos de consulta, modos de intervención y principales fortalezas y debilidades de los dispositivos. Contribuciones: Desde las diferentes perspectivas teórico-metodológicas y considerando las distintas poblaciones a las cuales se dirigieron los dispositivos, los modos de abordar el padecimiento subjetivo durante la pandemia aportan información relevante y reflexiones sobre la forma en la cual se responde a las emergencias en salud mental. Por otra parte, abren la discusión sobre modos novedosos de definir los encuadres de intervención e incluir la tecnología como un aliado en la asistencia psicológica en general.Fil: Rossi, Alejandra Noemí. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Rossi, Alejandra Noemí. Ministerio de Salud de la Provincia de Córdoba, Argentina.Fil: González, María Cristina. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Ponce, Luciano Federico. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Ferrero, Cecilia. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Barrera Scholtis; Mariana. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Salvetti, Marcela Alejandra. Universidad Nacional de Córdoba. Facultad de Psicología. Servicio Cuidando a Quienes Cuidan: Servicio de Contención Virtual para Efectores/as de la Salud, Docentes y No docentes; Argentina.Fil: Chávez Lorena. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.Fil: Moreno Frías, Ana Virginia. Universidad Nacional de Córdoba. Facultad de Psicología. Servicio Cuidando a Quienes Cuidan: Servicio de Contención Virtual para Efectores/as de la Salud, Docentes y No docentes; Argentina.Fil: Suárez, Coral. Salugénica; Argentina.Fil: Roldán, Fernando. Salugénica; Argentina.Fil: Reyes, Ana María. Universidad del Bío-Bío; Chile.Fil: Rey, Ricardo. Universidad del Bío-Bío; Chile.Fil: Zicavo Martínez, Nelson. Universidad del Bío-Bío; Chile

National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio : a pooled analysis of 458 population-based studies in Asian and Western countries

Background: Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and nonHDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries. Methods: We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group. Results: Since similar to 1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at similar to 0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as similar to 0.7 per decade in Swiss men (equivalent to similar to 26% decline in coronary heart disease risk per decade). The ratio increased in China. Conclusions: HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.Peer reviewe

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p &lt; 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Liver trauma: WSES 2020 guidelines

Abstract: Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines