Development and Validation of a Hybrid Virtual/Physical Nuss Procedure Surgical Trainer

With continuous advancements and adoption of minimally invasive surgery, proficiency with nontrivial surgical skills involved is becoming a greater concern. Consequently, the use of surgical simulation has been increasingly embraced by many for training and skill transfer purposes. Some systems utilize haptic feedback within a high-fidelity anatomically-correct virtual environment whereas others use manikins, synthetic components, or box trainers to mimic primary components of a corresponding procedure. Surgical simulation development for some minimally invasive procedures is still, however, suboptimal or otherwise embryonic. This is true for the Nuss procedure, which is a minimally invasive surgery for correcting pectus excavatum (PE) – a congenital chest wall deformity. This work aims to address this gap by exploring the challenges of developing both a purely virtual and a purely physical simulation platform of the Nuss procedure and their implications in a training context. This work then describes the development of a hybrid mixed-reality system that integrates virtual and physical constituents as well as an augmentation of the haptic interface, to carry out a reproduction of the primary steps of the Nuss procedure and satisfy clinically relevant prerequisites for its training platform. Furthermore, this work carries out a user study to investigate the system’s face, content, and construct validity to establish its faithfulness as a training platform

Simulation Modeling and Analysis of Complex Port Operations with Multimodal Transportation

AbstractWorld trade has been increasing dramatically in the past two decades, and as a result containers exchange has grown significantly. Accordingly, container terminals are expanding to meet this increase and new container ports have opened. Ports with one or more container terminals are considered complex systems in which many resources, entities and transporters interact to achieve the objective of safely moving containers delivered by ships inland as well as loading containers delivered by trucks and rail onto ships. Ports with multimodal transportation systems are in particular complex as they typically operate with ships arriving to one or more terminals, multiple quay cranes, rubber tyred gantry cranes, trains, and trucks delivering containers of different types to terminals.With several resources of different types working and interacting, the system can be so complex that it is not easy to predict the behavior of the system and its performance metrics without the use of simulation. In this paper, a generic discrete-event simulation that models port operations with different resource types including security gates, space, rubber tyred gantry cranes, trains, quay cranes, and arriving and departing ships, trucks, and trains is presented. The analysis will entail studying various scenarios motivated by changes in different inputs to measure their impact on the outputs that include throughput, resource utilization and waiting times

Serum Level of Tumor Marker In Breast Cancer Women In Different Age Groups

Breast cancer is the most common crucial cancer in women worldwide. The tumor marker Carcinoma Antigen 15-3 is frequently used for screening and monitoring breast cancer. Carcinoma antigen 15–3 (CA15-3) is used to monitor the prognosis for patients after treatment. This study aims to estimate the level of serum tumor marker CA15-3 in different age groups. Participants women diagnosed with breast cancer living in Iraq were admitted to the Middle East lab (private lab), Al-Harthia city. The study involves 176 females aged from 30 to 80 years. Data was collected from the period between March to November 2021. An automated electrochemistry luminescence immunoassay system (ROCHE E170, Germany) measured serum CA15-3 levels. When the CA15-3 marker level was above or below the cut-off value of 25 U/mL, the marker was counted positive or negative. The current study reveals that CA15-3 in the age group between (33-39) was the highest in 39 years (27.7 U/ml). Furthermore, 47 years exhibited the highest level of CA15-3 (150 U/ml) among (40-49 years) category. Meanwhile, 55 years participants showed the highest level of CA15-3 (101 U/ml) in (50-59 years) age group. 66 years old, on the other hand, showed an elevated level of CA15-3 (72 U/ml) compared to other participants in the (60-69) age group

Use of an Optical Scanning Device to Monitor the Progress of Noninvasive Treatments for Chest Wall Deformity: A Pilot Study

Background: The nonsurgical treatment of chest wall deformity by a vacuum bell or external brace is gradual, with correction taking place over months. Monitoring the progress of nonsurgical treatment of chest wall deformity has relied on the ancient methods of measuring the depth of the excavatum and the protrusion of the carinatum. Patients, who are often adolescent, may become discouraged and abandon treatment. Methods: Optical scanning was utilized before and after the intervention to assess the effectiveness of treatment. The device measured the change in chest shape at each visit. In this pilot study, patients were included if they were willing to undergo scanning before and after treatment. Both surgical and nonsurgical treatment results were assessed. Results: Scanning was successful in 7 patients. Optical scanning allowed a visually clear, precise assessment of treatment, whether by operation, vacuum bell (for pectus excavatum), or external compression brace (for pectus carinatum). Millimeter-scale differences were identified and presented graphically to patients and families. Conclusion: Optical scanning with the digital subtraction of images obtained months apart allows a comparison of chest shape before and after treatment. For nonsurgical, gradual methods, this allows the patient to more easily appreciate progress. We speculate that this will increase adherence to these methods in adolescent patients

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research