Optimising the use of virtual and conventional simulation: a clinical and economic analysis

Background and purpose: Currently, optimal use of virtual simulation for all treatment sites is not entirely clear. This study presents data to identify specific patient groups for whom conventional simulation may be completely eliminated and replaced by virtual simulation. Sampling and method: Two hundred and sixty patients were recruited from four treatment sites (head and neck, breast, pelvis, and thorax). Patients were randomly assigned to be treated using the usual treatment process involving conventional simulation, or a treatment process differing only in the replacement of conventional plan verification with virtual verification. Data were collected on set-up accuracy at verification, and the number of unsatisfactory verifications requiring a return to the conventional simulator. A micro-economic costing analysis was also undertaken, whereby data for each treatment process episode were also collected: number and grade of staff present, and the time for each treatment episode. Results: The study shows no statistically significant difference in the number of returns to the conventional simulator for each site and study arm. Image registration data show similar quality of verification for each study arm. The micro-costing data show no statistical difference between the virtual and conventional simulation processes. Conclusions: At our institution, virtual simulation including virtual verification for the sites investigated presents no disadvantage compared to conventional simulation.

Social networks applied to training

In this article, we address the importance and relevance that social networks exhibit in their use as an educational resource.  This relevance relies in the possibility of implementing new learning resources or increasing the level of the participant's connectivity, as well as developing learning communities.  Also, the risk entailed from their use is discussed, especially for the students that have a low technological education or those having excessive confidence on the media.  It is important to highlight that the educational use of social networks is not a simple extension or translation of the student's habitual, recreational use, but that it implies an important change in the roles given to teachers as well as learners; from accommodative learning environments that only encourage memorization to other environments that demand an active, reflective, collaborative and proactive attitude, that require the development/acquisition of technological as well as social abilities, aptitudes and values.  It is also important to highlight that a correct implementation and adequate use will not only foment formal learning, but also informal and non-formal learning.

Impulsive electric fields driven by high-intensity interactions

The interaction of high-intensity laser pulses with matter releases instantaneously ultra-large currents of highly energetic electrons, leading to the generation of highly-transient, large-amplitude electric and magnetic fields. We report results of recent experiments in which such charge dynamics have been studied by using proton probing techniques able to provide maps of the electrostatic fields with high spatial and temporal resolution. The dynamics of ponderomotive channeling in underdense plasmas have been studied in this way, as also the processes of Debye sheath formation and MeV ion front expansion at the rear of laser-irradiated thin metallic foils. Laser-driven impulsive fields at the surface of solid targets can be applied for energy-selective ion beam focusing.

T-cell-rich histiocyte-rich B-cell lymphoma of parotid gland

We describe a malignant lymphoma of the parotid gland arising in a patient with Sjögren's syndrome. Diagnosis was established on needle biopsy which showed a mixed population of lymphoid cells. Immunohistochemistry revealed B-lymphoid cells, T-lymphoid cells and histiocytes. Clonal immunoglobulin heavy chain gene rearrangement was demonstrated using the polymerase chain reaction. Within the confines of the small biopsy, the lesion qualifies for the designation T-cell-rich histiocyte-rich B-cell lymphoma. The value of molecular techniques in the diagnosis of malignant lymphoma on limited tissue samples is highlighted by this case.

The distribution of Fasciola hepatica and Fasciola gigantica within southern Tanzania - constraints associated with the intermediate host

In East Africa, Fasciola gigantica is generally the causative agent of fasciolosis but there have been reports of F. hepatica in cattle from highland regions of Kenya, Ethiopia, Uganda and Zaire. The topography of the Southern Highlands of Tanzania provides an environment where the climatic conditions exist for the sustenance of lymnaeid species capable of Supporting both Fasciola hepatica and F. gigantica. Theoretically this would allow interaction between fasciolid species and the possible creation of hybrids. In this report we present molecular data confirming the existence of the snail, Lymnaea truncatula, at high altitude on the Kitulo Plateau of the Southern Highlands, Tanzania, along with morphometric and molecular data confirming the presence of F. hepatica in the corresponding area. At lower altitudes, where climatic conditions were unfavourable for the existence of L. truncatula, the presence of its sister species L. natalensis was confirmed by molecular data along with its preferred fasciolid parasite, F. gigantica. Analysis based on a 618 bp sequence of the 28S rRNA gene did not reveal the presence of hybrid fasciolids in our fluke samples.

The major tegumental antigen of Fasciola hepatica contains repeated elements

In order to provide a better understanding of the interaction between the liver fluke (Fasciola hepatica) and the immune system of its mammalian host immunoreactive ? bacteriophage clones containing F. hepatica cDNA have been isolated. Plasmids from these clones were sequenced and found to encode a family of proteins containing certain common elements. All the clones contained a coding repeating sequence (RRRXCA) which is conserved at the nucleic acid level followed by a non-repeating element coding for the C terminal used by the proteins which shows conservation of amino acids at certain positions. Antisera raised against a ß-galactosidase fusion protein with one of these sequences as a terminal extension was used to localize the immunoreactive antigens. Binding was predominantly in the tegument of the juvenile fluke but was reduced in the adult tegument. The wall of the uterus showed strong reactivity in the adult. Rats immunized with the ß-galactosidase fusion protein showed enhanced resistance to challenge infections. The role of these antigens in the host response to infection by F. hepatica is discussed.

Proton Probing Measurement of Electric and Magnetic Fields Generated by ns and ps Laser-Matter Interactions

The use of laser-accelerated protons as a particle probe for the detection of electric fields in plasmas has led in recent years to a wealth of novel information regarding the ultrafast plasma dynamics following high intensity laser-matter interactions. The high spatial quality and short duration of these beams have been essential to this purpose. We will discuss some of the most recent results obtained with this diagnostic at the Rutherford Appleton Laboratory (UK) and at LULI - Ecole Polytechnique (France), also applied to conditions of interest to conventional Inertial Confinement Fusion. In particular, the technique has been used to measure electric fields responsible for proton acceleration from solid targets irradiated with ps pulses, magnetic fields formed by ns pulse irradiation of solid targets, and electric fields associated with the ponderomotive channelling of ps laser pulses in under-dense plasmas.