A biomechanical analysis of surgeon’s gesture in a laparoscopic virtual scenario

Minimally invasive surgery (MIS) has become very common in recent years thanks to many advantages that patients can get. However, due to the difficulties surgeons encounter to learn and manage this technique, several training methods and metrics have been proposed in order to, respectively, improve surgeon's abilities and assess his/her surgical skills. In this context, this paper presents a biomechanical analysis method of the surgeon's movements, during exercise involving instrument tip positioning and depth perception in a laparoscopic virtual environment. Estimation of some biomechanical parameters enables us to assess the abilities of surgeons and to distinguish an expert surgeon from a novice. A segmentation algorithm has been defined to deeply investigate the surgeon's movements and to divide them into many sub-movements

Understanding expertise in surgical gesture by means of Hidden Markov Models

Minimally invasive surgery (MIS) has became very widespread in the last ten years. Due to the difficulties encountered by the surgeons to learn and manage this technique, a huge importance has the improvement of training procedures, the improvement of surgical instrumentation and the robotic automation of surgical gesture. All these purposes require the analysis of surgical performance with the aim to understand it and to define what is expertise in surgical gesture. In this paper for the first time the Hidden Markov Models (HMMs) are used as a tool for the understanding of surgical performance and of the human factors that characterize it. In our experiments we used position data concerning the tools movements during exercises performed on a surgical simulator. Using Hidden Markov theory, we create a model of the expert surgeon performance able to evaluate surgical capability and to distinguish between expert and non-expert surgeons. By analyzing the trained model of the expert surgeon performance we show that it is possible to deduce information about features characterizing the surgical expertise

A 3-D Mixed-Reality System for Stereoscopic Visualization of Medical Dataset

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Comparison of Control Modes of a Hand-Held Robot for Laparoscopic Surgery

Teleoperated robots for minimally invasive surgery make surgeons loose direct contact with the patient. We are developing a handheld, dexterous surgical robot that can be controlled with one hand only, while standing at the operating table. The instrument is composed of a master part (the handle) and a slave part (the tip). This work compares the performance of different control modes, i.e. different ways to map the degrees of freedom of the handle to those of the tip. We ask users to drive the tip along complex trajectories in a virtual environment, using the real master to drive a simulated slave, and assess their performance. Results show that, concerning time, users with no training in laparoscopy prefer a direct mapping of position and orientation, like in free hand motion. However, users trained in laparoscopy perform equally fast with our hand-held robot and, concerning precision, make a smaller number of errors

Surveillance for European bat lyssavirus in Swiss bats

Most countries in Western Europe are currently free of rabies in terrestrial mammals. Nevertheless, rabies remains a residual risk to public health due to the natural circulation of bat-specific viruses, such as European bat lyssaviruses (EBLVs). European bat lyssavirus types 1 and 2 (EBLV-1 and EBLV-2) are widely distributed throughout Europe, but little is known of their true prevalence and epidemiology. We report that only three out of 837 brains taken from bats submitted to the Swiss Rabies Centre between 1976 and 2009 were found by immunofluorescence (FAT) to be positive for EBLVs. All three positive cases were in Myotis daubentoni, from 1992, 1993 and 2002. In addition to this passive surveillance, we undertook a targeted survey in 2009, aimed at detecting lyssaviruses in live bats in Switzerland. A total of 237 bats of the species M. daubentoni, Myotis myotis, Eptesicus serotinus and Nyctalus noctula were captured at different sites in western Switzerland. Oropharyngeal swabs and blood from each individual were analysed by RT-PCR and rapid fluorescent focus inhibition test (RFFIT), respectively. RNA corresponding to EBLV-2 was detected from oropharyngeal swabs of a single M. daubentoni bat, but no infectious virus was found. Molecular phylogenetic analysis revealed that the corresponding sequence was closely related to the other EBLV-2 sequences identified in previous rabies isolates from Swiss bats (particularly to that found at Geneva in 2002). Three M. daubentoni bats were found to be seropositive by RFFIT. In conclusion, even though the prevalence is low in Switzerland, continuous management and surveillance are required to assess the potential risk to public healt

Fertilization with beneficial microorganisms decreases tomato defenses against insect pests

The adverse effects of chemical fertilizers on agricultural fields and the environment are compelling society to move toward more sustainable farming techniques. "Effective microorganisms” is a beneficial microbial mixture that has been developed to improve soil quality and crop yield while simultaneously dramatically reducing organic chemical application. Additional indirect benefits of beneficial microorganisms application may include increased plant resistance to herbivore attack, though this has never been tested till now. Tomato plants were grown in controlled greenhouse conditions in a full-factorial design with beneficial microorganisms inoculation and commercial chemical fertilizer application as main factors. We measured plant yield and growth parameters, as well as resistance against the generalist pest Spodoptera littoralis moth larval attack. Additionally, we measured plant defensive chemistry to underpin resistance mechanisms. Overall, we found that, comparable to chemical fertilizer, beneficial microorganisms increased plant growth fruit production by 35 and 61%, respectively. Contrary to expectations, plants inoculated with beneficial microorganisms sustained 25% higher insect survival and larvae were in average 41% heavier than on unfertilized plants. We explain these results by showing that beneficial microorganism-inoculated plants were impaired in the induction of the toxic glycoalkaloid molecule tomatine and the defense-related phytohormone jasmonic acid after herbivore attack. For the first time, we therefore show that biofertilizer application might endure unintended, pest-mediated negative effects, and we thus suggest that biofertilizer companies should incorporate protection attributes in their studies prior to commercialization

Direito e pandemia: mais uma tentativa de privatização da Constituição

Resumo: O presente trabalho objetiva estudar a decisão monocrática proferida pelo ministro Alexandre Moraes na ADI n. 6.357. Para tanto, esta decisão será analisada criticamente do ponto de vista da dogmática constitucional e das exigências paradigmáticas do Estado Democrático de Direito aplicáveis à jurisdição constitucional no exercício do controle de constitucionalidade das leis. Ao final, acredita-se ser possível demonstrar que essa decisão é contrária à ordem jurídico-constitucional vigente bem como seu déficit de legitimidade democrática