PicSOr - An objective test of perceptual skill that predicts laparoscopic technical skill in three initial studies of laparoscopic performance

Background: Laparoscopic surgery requires surgeons to infer the shape of 3-D structures, such as the internal organs of patients, from 2-D displays on a video monitor. Recent evidence indicates that the issue is not resolved by the use of contemporary 3-D camera systems. It is therefore crucial to find ways of measuring differences in aptitude for recovering 3-D structure from 2-D images, and assessing its impact on performance. Our aim was to test empirically for a relationship between laparoscopic ability and the perceptual skill of recovering information about 3-D structures from 2-D monitor displays.

Enhancement of positron annihilation on molecules due to vibrational Feshbach resonances

The zero-range potential model is used to investigate positron collisions and annihilation with molecules. The Kr dimer is considered as an example. It is shown that (i) although positrons do not bind to individual Kr atoms, they do form bound states with Kr. (ii) A sequence of vibrationally excited states of the positron-molecule complex extends into the positron continuum, where it manifests as vibrational Feshbach resonances. (iii) These resonances give a very large contribution to the positron annihilation rate. Even after averaging over the thermal positron energy distribution, the contribution of the lowest Feshbach resonance exceeds that of the non-resonant background by an order of magnitude. © 2002 Elsevier Science B.V. All rights reserved.

Safe eye surgery: non-technical aspects

The traditional training of surgeons focused exclusively on developing knowledge, clinical expertise, and technical (surgical) skills. However, analyses of the reasons for adverse events in surgery have revealed that many underlying causes originate from behavioural or non-technical aspects of performance (eg, poor communication among members of the surgical team) rather than from a lack of surgical (ie, technical) skills. Therefore, technical skills appear to be necessary but not sufficient to ensure patient safety. Paying attention to non-technical skills, such as team working, leadership, situation awareness, decision making, and communication, will increase the likelihood of maintaining high levels of error-free performance. Identification and training of non-technical skills has been developed for high-risk careers, such as civil aviation and nuclear power. Only recently, training in non-technical skills has been adopted by the surgical world and anaesthetists. Non-technical skills need to be tailored to the environment where they are used, and eye surgery has some substantial differences compared with other surgical areas, for example, high volume of surgery, use of local anaesthetics, and very sophisticated equipment. This review highlights the need for identification of the non-technical skills relevant to eye surgeons and promotion of their use in the training of eye surgeons.

Vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with no peeling for idiopathic full-thickness macular hole (FTMH)

Several observational studies have suggested the potential benefit of internal limiting membrane (ILM) peeling to treat idiopathic full-thickness macular hole (FTMH). However, no strong evidence is available on the potential benefit(s) of this surgical manoeuvre and uncertainty remains among vitreoretinal surgeons about the indication for peeling the ILM, whether to use it in all cases or in long-standing and/or larger holes. 

Fast recognition of musical sounds based on timbre

Human listeners seem to have an impressive ability to recognize a wide variety of natural sounds. However, there is surprisingly little quantitative evidence to characterize this fundamental ability. Here the speed and accuracy of musical-sound recognition were measured psychophysically with a rich but acoustically balanced stimulus set. The set comprised recordings of notes from musical instruments and sung vowels. In a first experiment, reaction times were collected for three target categories: voice, percussion, and strings. In a go/no-go task, listeners reacted as quickly as possible to members of a target category while withholding responses to distractors (a diverse set of musical instruments). Results showed near-perfect accuracy and fast reaction times, particularly for voices. In a second experiment, voices were recognized among strings and vice-versa. Again, reaction times to voices were faster. In a third experiment, auditory chimeras were created to retain only spectral or temporal features of the voice. Chimeras were recognized accurately, but not as quickly as natural voices. Altogether, the data suggest rapid and accurate neural mechanisms for musical-sound recognition based on selectivity to complex spectro-temporal signatures of sound sources.

Examining the Spectator Experience

Drawing on a model of spectator understanding of error in
performance in the literature, we document a qualitative
experiment that explores the relationships between domain
knowledge, mental models, intention and error recognition
by spectators of performances with electronic instruments.
Participants saw two performances with contrasting instruments,
with controls on their mental model and understanding
of intention. Based on data from a subsequent structured
interview, we identify themes in participants’ judgements
and understanding of performance and explanations
of their spectator experience. These reveal both elements
of similarity and difference between the two performances,
instruments and between domain knowledge groups. From
these, we suggest and discuss implications for the design of
novel performative interactions with technology

The establishment of a 3D breast photography service in medical illustration

This paper aims to describe the development of a 3D breast photography service managed by the Medical Illustration Department, in the Belfast Health and Social Care Trust, Northern Ireland. Dedicated 3D breast photography equipment was installed in Medical Illustration for 18 months. Women were referred for a variety of indications including pre- and post-surgical assessment. A dedicated 3D breast photography protocol was developed locally and this requires further refinement to allow reproducibility in other centres. There are image/data artefacts associated with this technology and special techniques are required to reduce these. Specialist software is necessary for clinicians and scientists to use 3D breast photography data in surgical planning and measurement of surgical outcome.

Development of Disulfiram-Loaded Vaginal Rings for the Localised Treatment of Cervical Cancer

Cervical cancer is the third most prevalent cancer in women and disproportionately affects those in low resource settings due to limited programs for screening and prevention. In the developed world treatment for the disease in the non-metastasised state usually takes the form of surgical intervention and/or radiotherapy. In the developing world such techniques are less widely available. This paper describes the development of an intravaginal ring for the localised delivery of a chemotherapeutic drug to the cervix that has the potential to reduce the need for surgical intervention and will also provide a novel anti-cancer therapy for women in low resource settings. Disulfiram has demonstrated antineoplastic action against prostate, breast and lung cancer. Both PEVA and silicone elastomer were investigated for suitability as materials in the manufacture of DSF eluting intravaginal rings. DSF inhibited the curing process of the silicone elastomer, therefore PEVA was chosen as the material to manufacture the DSF-loaded vaginal rings. The vaginal rings had an excellent content uniformity while the DSF remained stable throughout the manufacturing process. Furthermore, the rings provided diffusion controlled release of DSF at levels well in excess of the IC50 value for the HeLa cervical cancer cell line.

Streptococcus bovis bacteraemia: an evaluation of the long-term effect on cardiac outcomes

Introduction: Streptococcus bovis can lead to bacteraemia, septicaemia, and ultimately endocarditis. The objective of this study was to evaluate the long-term implications of S. bovis endocarditis on cardiac morbidity and mortality. 

Methods: A retrospective cohort study was performed between January 2000 and March 2009 to assess all patients diagnosed with S. bovis bacteraemia from the Belfast Health and Social Care Trust. The primary end-point for cardiac investigations was the presence of endocarditis. Secondary end-points included referral for cardiac surgery and overall mortality. 

Results: Sixty-one positive S. bovis blood cultures from 43 patients were included. Following echocardiography, seven patients were diagnosed with infective endocarditis (16.3 % of total patients); four patients (9.3 %) had native valve involvement while three (7.0 %) had prosthetic valve infection. Five of these seven patients had more than one positive S. bovis culture (71.4 %). Three had significant valve dysfunction that warranted surgical repair/replacement, one of whom was unfit for surgery. There was a 100 % recurrence rate amongst the valve replacement patients (n = 2) and six patients with endocarditis had colorectal pathology. Patients with endocarditis had similar long-term survival as those with non-endocarditic bacteraemia (57.1 % alive vs. 50 % of non-endocarditis patients, p = 0.73). 

Conclusion: Streptococcus bovis endocarditis patients tended to have pre-existing valvular heart disease and those with prosthetic heart valves had higher surgical intervention and relapse rates. These patients experienced a higher rate of co-existing colorectal pathology but currently have reasonable long-term outcomes. This may suggest that they represent a patient population that merits consideration for an early surgical strategy to maximise long-term results, however, further evaluation is warranted. © 2013 The Japanese Association for Thoracic Surgery.

Two-year survival of ART restorations placed in elderly patients: A randomised controlled clinical trial

OBJECTIVES: Older dentate adults are a high caries risk group who could potentially benefit from the use of the atraumatic restorative treatment (ART). This study aimed to compare the survival of ART and a conventional restorative technique (CT) using rotary instruments and a resin-modified glass-ionomer for restoring carious lesions as part of a preventive and restorative programme for older adults after 2 years.

METHODS: In this randomised controlled clinical trial, 99 independently living adults (65-90 years) with carious lesions were randomly allocated to receive either ART or conventional restorations. The survival of restorations was assessed by an independent and blinded examiner 6 months, 1 year and 2 years after restoration placement.

RESULTS: Ninety-six (67.6%) and 121 (76.6%) restorations were assessed in the ART and CT groups, respectively, after 2 years. The cumulative restoration survival percentages after 2 years were 85.4% in the ART and 90.9% in the CT group. No statistically significant between group differences were detected (p=0.2050, logistic regression analysis).

CONCLUSIONS: In terms of restoration survival, ART was as effective as a conventional restorative approach to treat older adults after 2 years. This technique could be a useful tool to provide dental care for older adults particularly in the non-clinical setting. (Trial Registration number: ISRCTN 76299321).

CLINICAL SIGNIFICANCE: The results of this study show that ART presented survival rates similar to conventional restorations in older adults. ART appears to be a cost-effective way to provide dental care to elderly patients, particularly in out of surgery facilities, such as nursing homes.

The Use of ART in Elderly Patients after 2 years

Caries experience is high in the elderly, and barriers to care for older adults include fear and cost. Access to care is especially problematic in the case of frail and homebound elderly. Objective: to compare the survival of restorations placed using Atraumatic Restorative Treatment (ART) and a conventional technique using rotary instruments and a resin-modified glass-ionomer (CT) to treat carious lesions in older patients. Methods: In this randomised clinical trial, 99 independently living adults (65-90 yrs) with carious lesions were recruited from a geriatric day hospital and a community centre and randomly allocated to receive either ART or conventional restorations. They received tailored oral hygiene instructions and scaling and polishing of teeth prior to restoration placement. The survival of restorations was assessed 6, 12 and 24 months after restoration placement by an independent examiner. Results: Ninety-nine patients participated in the trial, 46 males and 53 females, with a mean age of 73.2 (SD: 6.8). In total, 300 restorations were placed, 142 ART in 51 patients and 158 conventional restorations in 48 patients, with an average of 2.8 ART (SD: 1.83) and 3.2 conventional (SD: 2.62) restorations placed per patient. After 2 years, 88 ART and 117 conventional restorations were assessed. The restoration survival percentages were 93.1% and 94%, respectively. Conclusion: ART was found to be as effective as a conventional restorative approach to treat older adults after 2 years and could be a useful tool to provide dental care for older dentate adults.

Fluence dependence of the surface roughness of InP after N2 + bombardment

InP(1 0 0) surfaces were sputtered under ultrahigh vacuum conditions by 5 keV N2+ ions at an angle of incidence of 41° to the sample normal. The fluence, φ, used in this study, varied from 1 × 10¹⁴ to 5 × 10¹⁸ N2+ cm^-2. The surface topography was investigated using field emission scanning electron microscopy (FE-SEM) and atomic force microscopy (AFM). At the lower fluences (φ ≤ 5 × 10¹⁶ N2+ cm^-2) only conelike features appeared, similar in shape as was found for noble gas ion bombardment of InP. At the higher fluences, ripples also appeared on the surface. The bombardment-induced topography was quantified using the rms roughness. This parameter showed a linear relationship with the logarithm of the fluence. A model is presented to explain this relationship. The ripple wavelength was also determined using a Fourier transform method. These measurements as a function of fluence do not agree with the predictions of the Bradley-Harper theory. © 2004 Elsevier B.V. All rights reserved.

Cidade Museu

Through the concept of sonic resonance, the project Cidade Museu – Museum City explores five derelict or transitional spaces in the city of Viseu. The activation and capture of these spaces develops an audio- visual memory that reflects architectures, stories and experiences, while creating a sense of place through sounds and images.

The project brings together musicians with a background in contemporary music, electroacoustic music and improvisation and a visual artist focusing on photography and video.

Each member of the collective explores the selected spaces in order to activate them with the help of their respective instruments and through sound projection in an iterative process in which the source of activation gradually gives way to the characteristics of each space, their resonances and acoustic characteristics. The museum city (a nickname for the city of Viseu), in this performance, exposes the contrast between the grandeur and multi-faceted architecture of Viseu’s Cathedral with spaces that spread throughout the city waiting for a new future.

The performance in the Cathedral (Sé) is characterised by a trio ensemble, an eight channel sound system and video projecting audio recordings and images made in each of the five spaces. The audience is invited to explore the relations between the various buildings and their stories while being immersed in their resonances and visual projections.

The performance explores the following spaces in Viseu: the old Orfeão (music hall), an old wine cellar, a mansion home to the national road services, a house with its grounds in Rua Silva Gaio and an old slaughterhouse.

Multi-wavelength observations of Proxima Centauri

Aims: We report simultaneous observations of the nearby flare star Proxima Centauri with VLT/UVES and XMM-Newton over three nights in March 2009. Our optical and X-ray observations cover the star's quiescent state, as well as its flaring activity and allow us to probe the stellar atmospheric conditions from the photosphere into the chromosphere, and then the corona during its different activity stages. Methods: Using the X-ray data, we investigate variations in coronal densities and abundances and infer loop properties for an intermediate-sized flare. The optical data are used to investigate the magnetic field and its possible variability, to construct an emission line list for the chromosphere, and use certain emission lines to construct physical models of Proxima Centauri's chromosphere. Results: We report the discovery of a weak optical forbidden Fe xiii line at 3388 Å during the more active states of Proxima Centauri. For the intermediate flare, we find two secondary flare events that may originate in neighbouring loops, and discuss the line asymmetries observed during this flare in H i, He i, and Ca ii lines. The high time-resolution in the Hα line highlights strong temporal variations in the observed line asymmetries, which re-appear during a secondary flare event. We also present theoretical modelling with the stellar atmosphere code PHOENIX to construct flaring chromospheric models. Based on observations collected at the European Southern Observatory, Paranal, Chile, 082.D-0953A and on observations obtained with XMM-Newton, an ESA science mission with instruments and contributions directly funded by ESA Member states and NASA.Full Table 6 is only available at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/534/A133