Does Training Laparoscopic Skills in a Virtual Reality Simulator Improve Surgical Performance?

Background and Purpose: Several different methods of teaching laparoscopic skills have been advocated, with virtual reality surgical simulation (VRSS) being the most popular. Its effectiveness in improving surgical performance is not a consensus yet, however. The purpose of this study was to determine whether practicing surgical skills in a virtual reality simulator results in improved surgical performance. Materials and Methods: Fifteen medical students recruited for the study were divided into three groups. Group I (control) did not receive any VRSS training. For 10 weeks, group II trained basic laparoscopic skills (camera handling, cutting skill, peg transfer skill, and clipping skill) in a VRSS laparoscopic skills simulator. Group III practiced the same skills and, in addition, performed a simulated cholecystectomy. All students then performed a cholecystectomy in a swine model. Their performance was reviewed by two experienced surgeons. The following parameters were evaluated: Gallbladder pedicle dissection time, clipping time, time for cutting the pedicle, gallbladder removal time, total procedure time, and blood loss. Results: With practice, there was improvement in most of the evaluated parameters by each of the individuals. There were no statistical differences in any of evaluated parameters between those who did and did not undergo VRSS training, however. Conclusion: VRSS training is assumed to be an effective tool for learning and practicing laparoscopic skills. In this study, we could not demonstrate that VRSS training resulted in improved surgical performance. It may be useful, however, in familiarizing surgeons with laparoscopic surgery. More effective methods of teaching laparoscopic skills should be evaluated to help in improving surgical performance.

Building a Open Source Framework for Virtual Medical Training

This paper presents a framework to build medical training applications by using virtual reality and a tool that helps the class instantiation of this framework. The main purpose is to make easier the building of virtual reality applications in the medical training area, considering systems to simulate biopsy exams and make available deformation, collision detection, and stereoscopy functionalities. The instantiation of the classes allows quick implementation of the tools for such a purpose, thus reducing errors and offering low cost due to the use of open source tools. Using the instantiation tool, the process of building applications is fast and easy. Therefore, computer programmers can obtain an initial application and adapt it to their needs. This tool allows the user to include, delete, and edit parameters in the functionalities chosen as well as storing these parameters for future use. In order to verify the efficiency of the framework, some case studies are presented.

Revealing the whiteboard to blind students: An inclusive approach to provide mediation in synchronous e-learning activities

Promoting the inclusion of students with disabilities in e-learning systems has brought many challenges for researchers and educators. The use of synchronous communication tools such as interactive whiteboards has been regarded as an obstacle for inclusive education. In this paper, we present the proposal of an inclusive approach to provide blind students with the possibility to participate in live learning sessions with whiteboard software. The approach is based on the provision of accessible textual descriptions by a live mediator. With the accessible descriptions, students are able to navigate through the elements and explore the content of the class using screen readers. The method used for this study consisted of the implementation of a software prototype within a virtual learning environment and a case study with the participation of a blind student in a live distance class. The results from the case study have shown that this approach can be very effective, and may be a starting point to provide blind students with resources they had previously been deprived from. The proof of concept implemented has shown that many further possibilities may be explored to enhance the interaction of blind users with educational content in whiteboards, and further pedagogical approaches can be investigated from this proposal. (C) 2009 Elsevier Ltd. All rights reserved.

A Study of the Corporative Portals as a Tool of Explicit Knowledge Externalization in Universities

The corporative portals, enabled by Information Technology and Communication tools, provide the integration of heterogeneous data proceeding from internal information systems, which are available for access and sharing of the interested community. They can be considered an important instrument of explicit knowledge evaluation in the. organization, once they allow faster and,safer, information exchanges, enabling a healthful collaborative environment. In the specific case of major Brazilian universities, the corporate portals assume a basic aspect; therefore they offer an enormous variety and amount of information and knowledge, due to the multiplicity of their activities This. study aims to point out important aspects of the explicit knowledge expressed by the searched universities; by the analysis, of the content offered in their corporative portals` This is an exploratory study made through, direct observation of the existing contents in the corporative portals of two public universities as. Well as three private ones. A. comparative analysis of the existing contents in these portals was carried through;. it can be useful to evaluate its use as factor of optimization of the generated explicit knowledge in the university. As results, the existence of important differences, could be verified in the composition and in the content of the corporative portals of the public universities compared to the private institutions. The main differences are about the kind of services and the destination-of the,information that have as focus different public-target. It-could also be concluded that the searched private universities, focus, on the processes related to the attendance of the students, the support for the courses as well as the spreading of information to the public interested in joining the institution; whereas the anal public universities prioritize more specific information, directed to,the dissemination-of the research, developed internally or with institutional objectives.

Use of virtual screening, flexible docking, and molecular interaction fields to design novel HMG-CoA reductase inhibitors for the treatment of hypercholesterolemia

Dietary changes associated with drug therapy can reduce high serum cholesterol levels and dramatically decrease the risk of coronary artery disease, stroke, and overall mortality. Statins are hypolipemic drugs that are effective in the reduction of cholesterol serum levels, attenuating cholesterol synthesis in liver by competitive inhibition regarding the substrate or molecular target HMG-CoA reductase. We have herewith used computer-aided molecular design tools, i.e., flexible docking, virtual screening in large data bases, molecular interaction fields to propose novel potential HMG-CoA reductase inhibitors that are promising for the treatment of hypercholesterolemia.

Assessing deaf and hearing children`s communication in Brazil

In Brazil there are no specific tests for either signed or spoken language for deaf children. A protocol evaluating communicative abilities independent of modality of communication (sign language or spoken language), and comprising assessments of (a) pragmatic profile; (b) modality of communication and linguistic level; (c) complexity of communication; and (d) style and efficacy of communication between parent and child was administered to 127 deaf and hearing children. The children, aged 3-6 years old, were distributed in three groups: 20 with severe hearing loss, 40 with profound hearing loss and 67 normally hearing. Deaf children were found to be delayed, independent of their linguistic level and preferred modality of communication. The protocol in this study proved to be an useful instrument for gathering relevant information about the three groups of preschool children`s communicative abilities, and particularly suitable for use in countries where standardized assessments are not available. Learning outcomes: The reader will be introduced to the use of an assessment protocol comprising its development, application and data analysis. The reader will be informed about assessment of deaf children`s preferred modality of communication, by the participation of a bilingual (sign language user) professional. Communication abilities can be assessed independently of the linguistic modality. In developing countries in general, where simple and easy to administer assessments tools are scarce, such a protocol is of specific value. (c) 2010 Elsevier Inc. All rights reserved.