Pheophorbide Esters A and B Isolated from Acai Berries as Activators of Apoptosis

Undergraduate Basi

Deconstructing an Assumed Shared Identity: Developing Self-Identification, Articulating Family, and Exploring Varied Experiences of College-Aged Women Adopted from China and Raised in the United States.

Much scholarship focuses on the general topic of transnational and transracial adoption, especially regarding female Chinese adoptees to the United States. This focus is usually explained by China’s one-child policy that went into effect in 1979 and ended in 2015. Most of this scholarship focuses on the adoptive parents or younger adoptive children, and commonly refers to a singular “adoptee experience.” This ethnography utilizes reflective participant observation and interviews both in person and over video call as methods to collect and produce knowledge. Three major themes emerged in the search for organized knowledge of college-aged, female-identifying, Chinese adoptees: the role of family, identity, and the connection of both to theories of ethnic and racial essentialism, compounded by the endorsement of stereotypes of transnational and transracial adoptees. The informants’ categorically different descriptions of their experiences prove that the “adoptee experience” cannot be essentialized. This essay analyzes instances of misrecognition, reactions to opportunities or a lack of opportunity to explore Chinese ancestry, and the impact of these factors on identity formation. Additionally, this essay introduces a much larger conversation around identity politics and how assumptions can lead to categories of solidarity

Interprofessional Development and Evaluation of a Virtual Reality Haptic Surgical Training System for Retropubic Midurethral Slings

Purpose and background: Procedures like the midurethral sling, performed without open visual or camera access rely on the surgeon’s spatial orientation of anatomical landmarks and haptic sensation. The “Blind” nature of this technique can results in serious complications^1–4. Surgeons are typically trained via an apprenticeship on live patients, static models, or, cadaver labs. These methods carry higher potential risks for patient safety, significant expense, often require travel, and are limited by distortion of anatomy after multiple uses. Adding haptics and AI to VR simulators has been shown to improve fidelity, realism, and educational value^ 5–10.We formed a transdisciplinary team to develop an innovative, low-risk, cost-effective method to teach operations that require “learning by feel”. The objective of this study was to evaluate the usability and potential of this SlingVR training system. Description of Innovative Practice: SlingVR Development. A transdisciplinary team of surgeons, engineers, motor control scientists, human factors experts, and programmers representing the College of Engineering, School of Medicine, and College of Health Professions was assembled. A clear development plan was created including required expertise, resource availability, and communication schedule to facilitate collaboration. To begin, deidentified CT/MRI images using artificial intelligence algorithms to provide high accuracy of anatomy in a 3D VR model. High-resolution haptic and visual alerts were then integrated to provide real-time feedback when approaching at-risk anatomy and generate a competency score. Weekly surgeon feedback lead to iterative development and generated a prototype for broader user evaluation. SlingVR EvaluationPilot evaluation was conducted using multi-trial testing to collect initial perceptions from subject matter expert surgeons. A cognitive task analysis using a think aloud protocol was used to understand how design characteristics impacted learning and fidelity of the SlingVR system. Qualitative comments and investigator observations during the sessions were reviewed and summarized into themes by the study investigators. Results: Three surgeons participated in feedback sessions: Two were expert subspecialists: fellowship-trained and board-certified in urogynecology with 5 and 7 years of community practice experience. Third surgeon was a PGY3 urology resident from an academic center. Both experts are high-volume, performing weekly retropubic slings, but trained at different programs with different approaches (gynecology focused vs urology focused) and currently used different manufacturers’ devices. The resident has assisted and performed many retropubic slings using the device and technique featured in the curriculum. 6 main themes were initially identified. Cognitive tasks, instruction, knowledge improvement I would break down steps for each level even further: like lighting the optimal pathway initially for a novice to follow exactly” System Feedback amount and type (ex. Continuous vs. intermittent, audio vs. visual) “I like continuous visual and audio alerts but would save the scoring feedback until a final one at the end” Scoring and Competency “I would like to see a comparison of the perfect pathway vs. mine at the end” Immersion and Realism “I would like to feel with my nondominant hand too, I use that one more during a case” Design elements and Aesthetics “I am colorblind and can’t read that shade of green well” Gestalt/Impression “This technology is great, the haptics add a lot, it could be used for hernias or trigger point injections too” Conclusion: Most valuable in evaluation was including surgeons with diverse training, practice settings, procedure approaches and commercial products used. All 3 consense in the key elements of learning the procedure and the importance of realistic haptics. Our transdisciplinary team and diverse participants are key to successfully identifying themes that provide the blueprint for next steps in the iterative device development of SlingVR

W. J. Rorabaugh, The Alcoholic Republic: An American Tradition

Book review by Paul Siff. Rorabaugh, W. J. The Alcoholic republic: an American tradition. New York: Oxford University Press, 1979

The Use of Interactive Holographic Technology to Teach Surgical Anatomy and Improve Self-Perceived Preparedness for Surgery in Urogynecology

Abstract Purpose: One of the biggest challenges teaching urogynecologic surgery is developing a spatial understanding of the 3-Dimensional relationships of musculature, ligamentous supports and neurovasculature of the pelvic floor. Therefore, we created an innovative curriculum to improve trainee-preparedness for complex vaginal surgery. The aim of the study is to determine if an interactive holographic curriculum will improve self-perceived preparedness, surgical knowledge and learner-satisfaction compared to usual self-study. Methods: This is a prospective study of 18 OB/GYN residents. Participants prepared like they were “scrubbing into a case of uterosacral ligament suspension (USLS) and sacrospinous ligament fixation (SSLF).” They then completed a self-perceived preparedness survey and knowledge-test of surgical anatomy and intraoperative complications. Each participant used the HoloLens curriculum independently and surveys were re-administered. Data were analyzed with paired non-parametric statistics. Results: 16/18 residents were females at a median PGY3 level (range 1-6). Self-perceived preparedness score ranged 7-35 with a median baseline score 22 for USLS and 20.5 for SSLF. These scores increased significantly for both procedures after using the modules: mean difference USLS 3.6 points p=.0001 and SSLF 3.7 points p=.0034. Knowledge scores also improved from baseline median 42.5% (range 25-85%) to 82.5% (55-100%): mean difference 35% p\u3c.0001. Compared to usual preparation, 88% ranked the modules as “much” or “very much better” and 81% would be “likely” or “very likely” to use HoloLens to prepare for surgery. Discussion: This interactive holographic curriculum significantly improved self-perceived preparedness, surgical knowledge and trainee-satisfaction in urogynecologic surgery compared to usual self-study