Visualization, navigation, augmentation. The ever-changing perspective of the neurosurgeon

Introduction: The evolution of neurosurgery coincides with the evolution of visualization and navigation. Augmented reality technologies, with their ability to bring digital information into the real environment, have the potential to provide a new, revolutionary perspective to the neurosurgeon. Research question: To provide an overview on the historical and technical aspects of visualization and navigation in neurosurgery, and to provide a systematic review on augmented reality (AR) applications in neurosurgery. Material and methods: We provided an overview on the main historical milestones and technical features of visualization and navigation tools in neurosurgery. We systematically searched PubMed and Scopus databases for AR applications in neurosurgery and specifically discussed their relationship with current visualization and navigation systems, as well as main limitations. Results: The evolution of visualization in neurosurgery is embodied by four magnification systems: surgical loupes, endoscope, surgical microscope and more recently the exoscope, each presenting independent features in terms of magnification capabilities, eye-hand coordination and the possibility to implement additional functions. In regard to navigation, two independent systems have been developed: the frame-based and the frame-less systems. The most frequent application setting for AR is brain surgery (71.6%), specifically neuro-oncology (36.2%) and microscope-based (29.2%), even though in the majority of cases AR applications presented their own visualization supports (66%). Discussion and conclusions: The evolution of visualization and navigation in neurosurgery allowed for the development of more precise instruments; the development and clinical validation of AR applications, have the potential to be the next breakthrough, making surgeries safer, as well as improving surgical experience and reducing costs

Measurement of the front-end dead-time of the LHCb muon detector and evaluation of its contribution to the muon detection inefficiency

A method is described which allows to deduce the dead-time of the front-end electronics of the LHCb muon detector from a series of measurements performed at different luminosities at a bunch-crossing rate of 20 MHz. The measured values of the dead-time range from 70 ns to 100 ns. These results allow to estimate the performance of the muon detector at the future bunch-crossing rate of 40 MHz and at higher luminosity

COVID-19 Vaccine Hesitancy among Italian Healthcare Workers: Latent Profiles and Their Relationships to Predictors and Outcome

Vaccine hesitancy and conspiracy beliefs among healthcare workers (HCWs) represent operational priorities that require urgent attention. Identifying and classifying specific subpopulation of hesitancy is crucial to customize educational and intervention strategies to enhance the acceptance and uptake rate of vaccination. Thus, the main purpose of our study was to empirically identify latent profiles of vaccine hesitancy among Italian HCWs adopting a person-centered approach and investigating their relationships with antecedents and intention to get a fourth dose of COVID-19 vaccine. We conducted latent profile analyses (LPA) to identify different configurations of vaccine hesitancy based on five antecedents of vaccination: confidence, complacency, constraints, calculation, and collective responsibility among a sample of Italian HCWs (n = 573). LPA revealed four distinct profiles: believer (61.5%), middler (24.7%), hesitant (9.00%), and rejecter (4.7%). Having conspiracy beliefs was associated with a greater likelihood of membership in all but believer. Finally, the likelihood of intention to get a fourth dose of COVID-19 vaccine was lowest in the rejector and hesitant profiles. Theoretical contributions and implications for practice are discussed

Efficacy and safety of flexible versus rigid endoscopic third ventriculostomy in pediatric and adult populations: a systematic review and meta-analysis

Endoscopic third ventriculostomy (ETV) is a well-established surgical procedure for hydrocephalus treatment, but there is sparse evidence on the optimal choice between flexible and rigid approaches. A meta-analysis was conducted to compare efficacy and safety profiles of both techniques in pediatrics and adults. A comprehensive search was conducted on PubMED, EMBASE, and Cochrane until 11/10/2019. Efficacy was evaluated comparing incidence of ETV failure, while safety was defined by the incidence of perioperative complications, intraoperative bleedings, and deaths. Random-effects models were used to pool the incidence. Out of 1365 studies, 46 case series were meta-analyzed, yielding 821 patients who underwent flexible ETV and 2918 who underwent rigid ETV, with an age range of [5 days-87 years]. Although flexible ETV had a higher incidence of failure in adults (flexible: 54%, 95%CI: 22-82% vs rigid: 20%, 95%CI: 22-82%) possibly due to confounding due to etiology in adults treated with flexible, a smaller difference was seen in pediatrics (flexible: 36%, pediatric: 32%). Safety profiles were acceptable for both techniques, with a certain degree of variability for complications (flexible 2%, rigid 18%) and death (flexible 1%, rigid 3%) in pediatrics as well as complications (rigid 9%, flexible 13%), death (flexible 4%, rigid 6%) and intra-operative bleeding events (rigid 6%, flexible 8%) in adults. No clear superiority in efficacy could be depicted between flexible and rigid ETV for hydrocephalus treatment. Safety profiles varied by age but were acceptable for both techniques. Well-designed comparative studies are needed to assess the optimal endoscopic treatment option for hydrocephalus

The Extreme Energy Events HECR array: status and perspectives

The Extreme Energy Events Project is a synchronous sparse array of 52 tracking detectors for studying High Energy Cosmic Rays (HECR) and Cosmic Rays-related phenomena. The observatory is also meant to address Long Distance Correlation (LDC) phenomena: the network is deployed over a broad area covering 10 degrees in latitude and 11 in longitude. An overview of a set of preliminary results is given, extending from the study of local muon flux dependance on solar activity to the investigation of the upward-going component of muon flux traversing the EEE stations; from the search for anisotropies at the sub-TeV scale to the hints for observations of km-scale Extensive Air Shower (EAS).Comment: XXV ECRS 2016 Proceedings - eConf C16-09-04.

The ALICE Zero Degree Calorimeters

In the ALICE experiment at Cern LHC, a set of hadron calorimeters will be used to determine the centrality of the Pb-Pb collision. The spectator protons and neutrons, will be separated from the ion beams, using the separator magnet (D1) of the LHC beam optics and respectively detected by a proton (ZP) and a neutron (ZN) "Zero-degree Calorimeter" (ZDC). The detectors will be placed in front of the separator D2 magnet, 115 meters away from the beam intersection point. The ZDCs are quartz-fiber spaghetti calorimeters that exploit the Cherenkov light produced by the shower particles in silica optical fibers.This technique offers the advantages of high radiation hardness (up to several Grad), fast response and reduced lateral dimension of the detectable shower. In addition, quartz-fiber calorimeters are intrinsically insensitive to radio-activation background, which produces particles below the Cherenkov threshold.The ALICE ZDC should have an energy resolution comparable with the intrinsic energy fluctuations, which range from about 20 0.000000or central events to about 5 0.000000or peripheral ones, according to simulations that use HIJING as event generator. The fiber-to-absorber filling ratio must be chosen as a good compromise between the required energy resolution and the fiber cost.The design of the proposed calorimeter will be discussed, together with the expected performances. Whenever possible, the simulated results will be compared with the experimental ones, obtained with the built prototypes and with the NA50 ZDC, which can be considered as a working prototype for the ALICE neutron calorimeter

Zero degree Cherenkov calorimeters for the ALICE experiment

International audienceThe collision centrality in the ALICE experiment will be determined by the Zero Degree Calorimeters (ZDCs) that will measure the spectator nucleons energy in heavy ion collisions. The ZDCs detect the Cherenkov light produced by the fast particles in the shower that cross the quartz fibers, acting as the active material embedded in a dense absorber matrix. Test beam results of the calorimeters are presented