Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentor–trainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons’ psychomotor skills. Ongoing development of tracking systems and software solutions has allowed for the expansion of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentals of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as well as optimize their already overloaded training schedules

Hexagons, Kinks and Disorder in Oscillated Granular Layers

Experiments on vertically oscillated granular layers in an evacuated container reveal a sequence of well-defined pattern bifurcations as the container acceleration is increased. Period doublings of the layer center of mass motion and a parametric wave instability interact to produce hexagons and more complicated patterns composed of distinct spatial domains of different relative phase separated by kinks (phase discontinuities). Above a critical acceleration, the layer becomes disordered in both space and time.Comment: 4 pages. The RevTeX file has a macro allowing various styles. The appropriate style is "myprint" which is the defaul

Procedimiento automático para el calibrado de cámaras: Estudio comparativo de la distorsión en diferentes combinaciones de cámaras y ópticas laparoscópicas

En este trabajo se propone un método de calibración automático para el cálculo y corrección de la distorsión en imágenes producida por las lentes de los sistemas de captura. Este procedimiento ha sido empleado como herramienta para analizar la distorsión provocada por diversos sistemas de cámara y óptica laparoscópica, de modo que podamos determinar el sistema que proporciona una imagen más fiable al cirujano

E-MIS validity applied to TELMA enhanced learning environment

Enhanced learning environments are arising with great success within the field of cognitive skills training in minimally invasive surgery (MIS) because they provides multiple benefits since they avoid time, spatial and cost constraints. TELMA [1,2] is a new technology enhanced learning platform that promotes collaborative and ubiquitous training of surgeons. This platform is based on four main modules: an authoring tool, a learning content and knowledge management system, an evaluation module and a professional network. TELMA has been designed and developed focused on the user; therefore it is necessary to carry out a user validation as final stage of the development. For this purpose, e-MIS validity [3] has been defined. This validation includes usability, contents and functionality validities both for the development and production stages of any e-Learning web platform. Using e-MIS validity, the e-Learning is fully validated since it includes subjective and objective metrics. The purpose of this study is to specify and apply a set of objective and subjective metrics using e-MIS validity to test usability, contents and functionality of TELMA environment within the development stage

Behavior of Cu-Y2O3 and CuCrZr-Y2O3 composites before and after irradiation

ABSTRACT: The Cu-Y2O3 and CuCrZr-Y2O3 materials have been devised as thermal barriers in nuclear fusion reactors. It is expected that in the nuclear environments, the materials should be working on extreme conditions of irradiation. In this work the Cu-Y2O3 and CuCrZr-Y2O3 were prepared and then irradiated in order to understand the surface irradiation resistance of the material. The composites were prepared in a glove box and consolidated with spark plasma sintering. The microstructures revealed regions of Y2O3 dispersion and Y2O3 agglomerates both in the Cu matrix and in the CuCrZr. The irradiated samples did not show any surface modification indicating that the materials seem to be irradiation resistant in the present situation. The thermal conductivity values for all the samples measured are lower than pure Cu and higher than pure W, however are higher than those expected, and therefore, the application of these materials as thermal barriers is compromised.info:eu-repo/semantics/publishedVersio

Adaptación de la usabilidad del entorno de formación TELMA a las necesidades de los cirujanos expertos

Uno de los principales inconvenientes manifestados por los cirujanos a la hora de llevar a cabo su formación continuada es la elevada carga asistencial que les limita la posibilidad de asistir a cursos y estancias presenciales. Por tanto, los cirujanos necesitan otros métodos formativos distintos a la formación in situ y para ello son de gran utilidad las tecnologías web, como es el caso de la plataforma de e-Learning TELMA, que ofrezcan contenidos didácticos adaptados a cada usuario para que puedan complementar su formación con contenidos multimedia online. Estudios previos de validación de TELMA detectaron diferentes problemas respecto a su diseño y usabilidad, propiciando mayores dificultades de accesibilidad para los cirujanos expertos en relación a los cirujanos noveles. Para corregirlos, en este trabajo se han analizado las deficiencias encontradas y se han propuesto una serie de medidas fundamentadas en un conjunto de directivas de diseño web que se deberían adoptar en futuras versiones de la plataforma TELMA para tratar de solventar estas desigualdades, ofreciendo a todos los usuarios tanto expertos como noveles, las mismas facilidades de accesibilidad