Novices Outperform Experienced Laparoscopists on Virtual Reality Laparoscopy Simulator

BACKGROUND AND OBJECTIVES: Virtual reality has been poorly studied among gynecologic surgeons. The aim of this study was to evaluate whether performance on the Minimally Invasive Surgery Trainer-Virtual Reality (MIST-VR) laparoscopic trainer reflects laparoscopic experience among gynecologic surgeons and trainees. METHODS: Twenty-six medical students, residents, and attending gynecologic surgeons completed a MIST-VR training program. A new simulated task was then presented to each participant, who repeated the task until proficiency was reached. RESULTS: Attending physicians performed poorly when compared with medical students, requiring more than twice the number of attempts to reach proficiency (Mann-Whitney P\u3c0.01). Among medical students and residents, there was an association between years of live laparoscopy experience and poor simulator performance (Spearman r P=0.01). CONCLUSION: Increased operating room experience and age were associated with worsening simulator performance. Several potential explanations for this trend are discussed, including lack of tactile and contextual feedback. Caution should be exercised when considering current virtual reality simulator technology as a measure of experience or ability among gynecologic surgeons

Reliable microsatellite genotyping of the Eurasian badger (Meles meles) using faecal DNA

The potential link between badgers and bovine tuberculosis has made it vital to develop accurate techniques to census badgers. Here we investigate the potential of using genetic profiles obtained from faecal DNA as a basis for population size estimation. After trialling several methods we obtained a high amplification success rate (89%) by storing faeces in 70% ethanol and using the guanidine thiocyanate/silica method for extraction. Using 70% ethanol as a storage agent had the advantage of it being an antiseptic. In order to obtain reliable genotypes with fewer amplification reactions than the standard multiple-tubes approach, we devised a comparative approach in which genetic profiles were compared and replication directed at similar, but not identical, genotypes. This modified method achieved a reduction in polymerase chain reactions comparable with the maximumlikelihood model when just using reliability criteria, and was slightly better when using reliability criteria with the additional proviso that alleles must be observed twice to be considered reliable. Our comparative approach would be best suited for studies that include multiple faeces from each individual. We utilized our approach in a well-studied population of badgers from which individuals had been sampled and reliable genotypes obtained. In a study of 53 faeces sampled from three social groups over 10 days, we found that direct enumeration could not be used to estimate population size, but that the application of mark–recapture models has the potential to provide more accurate results

A computerised test of perceptual ability for learning endoscopic and laparoscopic surgery and other image guided procedures: Score norms for PicSOr

Background: The aptitude to infer the shape of 3-D structures, such as internal organs from 2-D monitor displays, in image guided endoscopic and laparoscopic procedures varies. We sought both to validate a computer-generated task Pictorial Surface Orientation (PicSOr), which assesses this aptitude, and to identify norm referenced scores. Methods: 400 subjects (339 surgeons and 61 controls) completed the PicSOr test. 50 subjects completed it again one year afterwards. Results: Complete data was available on 396 of 400 subjects (99%). PicSOr demonstrated high test and re-test reliability (r = 0.807, p < 0.000). Surgeons performed better than controls' (surgeons = 0.874 V controls = 0.747, p < 0.000). Some surgeons (n = 22–5.5%) performed atypically on the test. Conclusions: PicSOr has population distribution scores that are negatively skewed. PicSOr quantitatively characterises an aptitude strongly correlated to the learning and performance of image guided medical tasks. Most can do the PicSOr task almost perfectly, but a substantial minority do so atypically, and this is probably relevant to learning and performing endoscopic tasks

Identifying Opportunities for Virtual Reality Simulation in Surgical Education: A Review of the Proceedings from the Innovation, Design, and Emerging Alliances in Surgery (IDEAS) Conference: VR Surgery

To conduct a review of the state of virtual reality (VR) simulation technology, to identify areas of surgical education that have the greatest potential to benefit from it, and to identify challenges to implementation

Development of a distributed international patient data registry for hairy cell leukemia

Hairy cell leukemia (HCL) is a rare lymphoproliferative disorder, comprising only 2% of all leukemias. The Hairy Cell Leukemia Foundation (HCLF) has developed a patient data registry to enable investigators to better study the clinical features, treatment outcomes, and complications of patients with HCL. This system utilizes a centralized registry architecture. Patients are enrolled at HCL Centers of Excellence (COE) or via a web-based portal. All data are de-identified, which reduces regulatory burden and increases opportunities for data access and re-use. To date, 579 patients have been enrolled in the registry. Efforts are underway to engage additional COE’s to expand access to patients across the globe. This international PDR will enable researchers to study outcomes in HCL in ways not previously possible due to the rarity of the disease and will serve as a platform for future prospective research

Subjet Multiplicity of Gluon and Quark Jets Reconstructed with the k⊥k_{\perp} Algorithm in ppˉp\bar{p} Collisions

The D0 Collaboration has studied for the first time the properties of hadron-collider jets reconstructed with a successive-combination algorithm based on relative transverse momenta ($k_{\perp}$) of energy clusters. Using the standard value D = 1.0 of the jet-separation parameter in the $k_{\perp}$ algorithm, we find that the $p_T$ of such jets is higher than the $E_T$ of matched jets reconstructed with cones of radius R = 0.7, by about 5 (8) GeV at $p_T \approx 90$ (240) GeV. To examine internal jet structure, the $k_{\perp}$ algorithm is applied within D = 0.5 jets to resolve any subjets. The multiplicity of subjets in jet samples at $\sqrt{s} = 1800$ GeV and 630 GeV is extracted separately for gluons ($M_g$) and quarks ($M_q$), and the ratio of average subjet multiplicities in gluon and quark jets is measured as $(M_{g} - 1) / (M_{q} - 1) = 1.84 \pm 0.15 (stat.) \pm ^{0.22}_{0.18} (sys.)$. This ratio is in agreement with the expectations from the HERWIG Monte Carlo event generator and a resummation calculation, and with observations in $e^+e^-$ annihilations, and is close to the naive prediction for the ratio of color charges of $C_A/C_F = 9/4 = 2.25$.Comment: Submitted to Phys.Rev.D. 24 pages, 31 figures. Updated references, minor text change

Measurement of the Higgs boson coupling properties in the H → ZZ* → 4 decay channel at √s = 13 TeV with the ATLAS detector

The coupling properties of the Higgs boson are studied in the four-lepton (e, μ) decay channel using 36.1 fb−1 of pp collision data from the LHC at a centre-of-mass energy of 13 TeV collected by the ATLAS detector. Cross sections are measured for the main production modes in several exclusive regions of the Higgs boson production phase space and are interpreted in terms of coupling modifiers. The inclusive cross section times branching ratio for H → ZZ∗ decay and for a Higgs boson absolute rapidity below 2.5 is measured to be 1. 73 − 0.23 + 0.24 (stat.) − 0.08 + 0.10 (exp.) ± 0.04(th.) pb compared to the Standard Model prediction of 1.34±0.09 pb. In addition, the tensor structure of the Higgs boson couplings is studied using an effective Lagrangian approach for the description of interactions beyond the Standard Model. Constraints are placed on the non-Standard-Model CP-even and CP-odd couplings to Z bosons and on the CP-odd coupling to gluons