Immersive Medical Practice and Clinical Training: Virtual and Mixed Reality in Pharmacy and Orthopedic Surgery

Extended‑reality (XR) technologies including virtual reality (VR) and mixed reality (MR) offer new ways to improve training and surgical precision. This thesis evaluates their educational and clinical impact through two complementary studies. Specific Aim 1 compared an immersive 360° video VR module with conventional training for teaching USP \u3c 797\u3e sterile‑compounding skills to second‑year PharmD students (N = 36). VR trainees raised their knowledge from 6.14 ± 1.55 to 8.69 ± 1.07, yet the overall post‑test advantage versus control was not statistically significant (U = 71.50, p = 0.21). Item‑level McNemar testing showed significant VR‑exclusive gains on three critical questions (K5, K6, K10; p ≤ 0.004). Self‑perceived confidence (U = 130.00, p = 0.284) and rubric‑based performance (U = 136.00, p = 0.41) were comparable between groups. NASA‑TLX scores confirmed the intervention was well‑tolerated, with high perceived performance (mean = 90) and very low frustration (mean = 7.5). Specific Aim 2 employed a randomized crossover design in which three PGY‑4 orthopedic residents placed guide‑wires in 3D‑printed scapulae under free‑hand and MR‑guided conditions, yielding 15 paired observations. MR guidance (Microsoft HoloLens 2 plus custom planning software) reduced positional error from 22.46 ± 14.38 mm to 12.23 ± 8.98 mm (t = 2.34, p = 0.027), while rotational and overall Euclidean errors showed non‑significant but favorable trends. Descriptive NASA‑TLX data suggested lower mental and physical demand with MR support. Conclusions. VR delivered item‑specific sterile‑compounding knowledge gains. MR significantly improved positional accuracy in simulated shoulder arthroplasty. Together these findings demonstrate that XR can both enrich learning and improve precision, underscoring its promise for widespread adoption in pharmacy education and surgical practice

Avaliação das alterações nos zoneamentos do Plano Diretor de Ordenamento Territorial (PDOT) do Distrito Federal, nos anos de 2009 e 2012

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Campus Planaltina, 2014.O ordenamento territorial não é fenômeno recente na história humana, na capital do Brasil a diretriz básica para o mesmo é o Plano Diretor de Ordenamento Territorial – PDOT, ao qual requer atualizações periódicas. Esse estudo observa a Lei Complementar (LC) 803 do ano de 2009 e as modificações advindas da LC 854 de 2012. Para tanto, identificou-se as áreas delimitadas em 2009 e suas revisões em 2012 através de dados espacializados, o PDOT é dividido em três Macrozoneamentos: Proteção Integral, Urbano e Rural, os dois últimos são subdivididos em mais oito Zoneamentos, com a sobreposição das diferenças desses anos foi possível identificar alteração de 3.865 hectares (ha) ao nível de Zoneamento, com um crescimento das áreas destinadas ao uso rural sobre a destinação urbana, nos Macrozoneamentos a soma das alterações chega a 22.266 ha, o maior rearranjo nesse nível que o anterior, mostra o acréscimo de áreas urbanas com maior limite de densidade a ocupação. Das áreas alteradas avaliou-se a mudança na cobertura de terra pelo índice de vegetação NDVI (Normalized Difference Vegetation Index), para tanto foi adquirido imagens dos anos anteriores a criação das LCs, onde os números digitais foram convertidos em radiância e depois em reflectância com o algoritmo FLAASH (Fast Line-of-sight Atmospheric Analysis of Spectral Hypercubes). 98,72% de todas poligonais estudadas tiveram redução da atividade fotossintética, não apenas em regiões urbanas. Nas considerações finais foi sugerido replicar o mesmo estudo anualmente, gerando assim um monitoramento do PDOT que poderia servir de gestão do mesmo pelo Governo do Distrito Federal. _____________________________________________________________________________ ABSTRACTThe spatial planning is not a recent phenomenon in human history, in the capital of Brazil, Distrito Federal (DF) the basic guideline for the land order is the “Plano Diretor de Ordenamento Territorial – PDOT (Master Plan for Land Use) which requires periodic updates. This study observes the Supplementary Law (SL) 803 of the year 2009 and the resulting modifications of the SL 854 2012. To do so, was identified areas demarcated in 2009 and its revisions of 2012 using spatial information, PDOT is divided into three Macrozones: “Proteção Integral” Full Protection, Urban and Rural, the last two are subdivided into eight zonings, with the overlap of the differences from those years, it was possible to identify changes of 3,865 hectares (ha) in terms of zoning, with a growth of rural areas over urban destination, in Macrozones the sum of the changes reaches 22,266ha, the biggest rearrangement at this level than the previous shows the increase of urban areas with higher density limit of occupation. The land cover in these regions was assessed by the Normalized Difference Vegetation Index – NDVI), for both images was acquired the previous years from creation of LCs, where the digital numbers were converted to radiance and then to reflectance using the FLAASH algorithm (Fast Line-of-sight Atmospheric Analysis of Spectral Hypercubes).98.72% of all polygonal studied had reduced photosynthetic activity, not only in urban areas. The final considerations suggested replicate the same study annually, to monitoring the PDOT, that could serve as a management of the same by the Government of the Distrito Federal

Acute Fish Oil supplementation and Aspirin treatment modulates lipid profile in Platelet Rich Plasma: a randomized pilot trial

Aims: Platelet rich plasma (PRP) has been used in tissue repair to treat numerous inflammatory pathophysiologies. Recent studies have elucidated that the bioactive lipid fraction of PRP significantly contributes towards the resolution of inflammation. There has been great interest in how therapeutics could modulate the PRP lipidome to formulate a more pro-resolving matrix. Many of the pathways used to produce either pro-resolving or pro-inflammatory lipids are shared between ω-3 and ω-6 polyunsaturated fatty acids (PUFA). Here, we explored the separate and interacting effects acute exogenous ω-3 PUFA supplementation and aspirin had on the lipidome of PRP within 6 hours. Methods:PRP from 45 patients was obtained at baseline and after 6-hours from either control or those receiving one 1400 mg fish oil tablet, Bayer low-dose aspirin (81mg), or combinational therapy. Lipids were acquired by liquid chromatography mass spectrometry. Spearman rank correlation analysis visually assessed what effects treatments had on the relative abundance of PUFA derivatives. The control group was referenced for lipid selection across groups; lipids were selected on the basis that they significantly (p Results: Fish oil ω-3 PUFA supplementation and aspirin had separate and interacting effects on oxylipin and neutral lipid correlations. Strongly correlated (rho \u3e 0.65) ω-6 PUFA metabolites were reversed or reduced in magnitude following either treatment. A total of 24 lipid species were significantly modulated in the fish oil treatment group, with notable (p4), and lipoxin A4 (LXA4). Conclusion: We can confirm that fish oil supplementation and aspirin do exert modulatory effects on the lipid fraction of PRP within a short period of time (6-hours). The PUFAs composing fish oil impacted a wide range of the lipidome – possibly though a mechanism of ω-3/ω-6 enzymatic competition. Our results support that ω-3 PUFA supplementation may improve the efficacy of PRP for short-term use

ESTUDO SOBRE A COBERTURA VEGETAL DO PARQUE RECREATIVO SUCUPIRA, PLANALTINA (DF)

This work aimed to evaluate the vegetation cover of the Sucupira Recreative Park (SRP), Planaltina (FD) and its Direst Infl uence Zone (DIZ) between 1996 and 2013, using multisensory and multitemporal approach. The SRP has 124.44 hectares in the Administrative Region VI – Planaltina. The park boundary was obtained from Brasília Environmental Institute (Ibram, in Portuguese) and the respective DIZ was generated buffering 500 meters from that boundary. The fi rst stage was the generation of the land cover map from the 2013 aero photography mosaic, obtained from the Federal District Planning Company (Codeplan, in Portuguese), and followed by the screen digital vectoring. Is was used another aero photography mosaic from 2009. There were used Landsat 5-TM images from 1996, 1999, 2003 and 2007, registered by the aero photography mosaic. The thematic map construction was based on a hybrid classifi cation divided in 3 categorical levels adapted from different sources due to the Cerrado specifi cations. The results evidenced about 50 % planted vegetation cover in the SRP core region by 2013, with 35.33 % of pasture, corresponding 17.58 % in 17 years, what indicated 1.03 ha/year. The DIZ had 337.16 hectares of which about 42 % was covered by building in 2013. In the DIZ allotment and pasture showed the higher variations through the study period with 17.36 % and 6.03 % increasing respectively. In both areas (PRS and DIZ) there were evidenced reductions in the disturbed areas, which does not mean conservation spreading, but the anthropic occupation. It was fi nd out that this human occupation starts with the withdrawal of trees, followed by the remain vegetation suppression and the allotment demarcation. This approach allowed the anthropic occupation dynamics comprehension in the Federal District that could be used as reference for the Cerrado, as territorial ordering subsidy for agro pastures activities and urban areas.O objetivo desse trabalho foi estudar a cobertura vegetal do Parque Recreativo Sucupira (PRS), Planaltina (DF) e de sua Zona de Infl uência Direta (ZID) entre os anos de 1996 e 2013, utilizando a abordagem multisensor e multitemporal. O PRS possui uma área de 124,44 hectares, estando localizado dentro da Região Administrativa VI de Planaltina. Os limites desse parque foram disponibilizados pelo Instituto Brasília Ambiental (Ibram) e sua ZID foi gerada a partir de raio de 500 metros ao redor desse limite. A primeira etapa foi a geração do mapa de cobertura da terra referente ao ano de 2013, gerado em função no mosaico de fotografi a aéreas, fornecido pela Companhia de Planejamento do Distrito Federal (Codeplan), utilizados para a vetorização digital em tela. A imagem de 2009, também foi um outro mosaico aerofotográfi co. Para os anos de 1996, 1999, 2003 e 2007 foram utilizadas imagens do sensor Landsat 5-TM, registradas em função dos mosaicos de fotografi a aéreas. Foi empregado um sistema de classifi cação híbrido em 3 níveis categóricos, adaptado de diferentes fontes para as características do Cerrado. Os resultados indicaram que a área interna do PRS apresentou cerca de 50 % de sua área por cobertura vegetal plantada em 2013, dominada por pastagem, abrangendo 35,33%, com um crescimento de 17,58 % dessa em 17 anos, o que corresponde a uma taxa de 1,03 ha/ano. Sua ZID possuiu uma área de 337,16 hectares, dos quais cerca de 42 % estavam cobertos por áreas construídas em 2013. Na ZID o loteamento e a pastagem apresentaram as maiores variações ao longo do período estudado, com incremento de 17,36 % e 6,03 %, respectivamente. Em ambas as áreas (PRS e ZID) foram observadas reduções da vegetação perturbada, fato que não indica necessariamente a ampliação da conservação, mas a ocupação por outros usos antrópicos. Constatou-se que essa ocupação humana tem início com a retirada das árvores, seguida pela supressão da vegetação remanescente, tendo posterior demarcação de lotes. Essa abordagem favoreceu a compreensão da dinâmica da ocupação antrópica no Distrito Federal, podendo servir para o entendimento em relação ao Cerrado, servindo como subsídio para o ordenamento territorial, tanto para atividades agropastoris, quanto para áreas urbanas

Examining the effects of the HIV‐1 protein Tat and morphine on antiretroviral accumulation and distribution within the brain

Abstract Despite combination antiretroviral therapy effectively suppressing HIV within the periphery, neuro‐acquired HIV (neuroHIV) remains a significant problem and approximately half of people living with HIV will experience HIV‐associated neurocognitive disorders (HAND). Concurrent opioid use exacerbates neuroHIV by promoting neuroinflammation, neuronal injury and synaptodendritic culling, viral replication, and potentially altering antiretroviral concentrations within the brain. The present study examined the effects of HIV and morphine co‐exposure on the accumulation and spatial distribution of antiretroviral drugs across multiple regions within the brain in an HIV‐1 Tat transgenic mouse model by using infrared‐matrix‐assisted laser desorption electrospray ionization mass spectrometry imaging (IR‐MALDESI MSI). Morphine exposure uniquely decreased antiretroviral concentrations in anterior cerebral (primary motor and somatosensory) cortices, corpus collosum (anterior forceps), caudoputamen, nucleus accumbens, and posterior regions including the hippocampus, corpus callosum (main body), cerebral cortex (somatosensory and auditory cortices), thalamus, and hypothalamus. Interestingly, male mice experienced greater morphine‐associated decreases in antiretroviral concentrations than females. The study also assessed whether changes in antiretroviral concentrations were linked with inflammation in astroglia, assessed through the measurement of astroglial activation using glial fibrillary acidic protein (GFAP) as a marker. Alterations in antiretroviral concentrations co‐registering with areas of astroglial activation exhibited sex‐specific treatment differences. This study highlights the intricate interplay between HIV, opioids, and antiretroviral drugs within the CNS, elucidating distinct regional and sex variations in responsiveness. Our findings emphasize the identification of vulnerabilities within the neural landscape and underscore the necessity of carefully monitoring opioid use to maintain the efficacy of antiretroviral therapies