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.

Development and mechanical testing of a short intramedullary nail for fixation of femoral rotational osteotomy in cerebral palsy patients

Background: Rotational osteotomy is frequently indicated to correct excessive femoral anteversion in cerebral palsy patients. Angled blade plate is the standard fixation device used when performed in the proximal femur, but extensile exposure is required for plate accommodation. The authors developed a short locked intramedullary nail to be applied percutaneously in the fixation of femoral rotational osteotomies in children with cerebral palsy and evaluated its mechanical properties. Methods: The study was divided into three stages. In the first part, a prototype was designed and made based on radiographic measurements of the femoral medullary canal of ten-year-old patients. In the second, synthetic femoral models based on rapid-prototyping of 3D reconstructed images of patients with cerebral palsy were obtained and were employed to adjust the nail prototype to the morphological changes observed in this disease. In the third, rotational osteotomies were simulated using synthetic femoral models stabilized by the nail and by the AO-ASIF fixed-angle blade plate. Mechanical testing was done comparing both devices in bending-compression and torsion. Results: The authors observed proper adaptation of the nail to normal and morphologically altered femoral models, and during the simulated osteotomies. Stiffness in bending-compression was significantly higher in the group fixed by the plate (388.97 +/- 57.25 N/mm) than in that fixed by the nail (268.26 +/- 38.51 N/mm) as torsional relative stiffness was significantly higher in the group fixed by the plate (1.07 +/- 0.36 Nm/degrees) than by the nail (0.35 +/- 0.13 Nm/degrees). Conclusions: Although the device presented adequate design and dimension to fit into the pediatric femur, mechanical tests indicated that the nail was less stable than the blade plate in bending-compression and torsion. This may be a beneficial property, and it can be attributed to the more flexible fixation found in intramedullary devices.

First stars XI. Chemical composition of the extremely metal-poor dwarfs in the binary CS 22876-032

Context. Unevolved metal-poor stars constitute a fossil record of the early Galaxy, and can provide invaluable information on the properties of the first generations of stars. Binary systems also provide direct information on the stellar masses of their member stars. Aims. The purpose of this investigation is a detailed abundance study of the double-lined spectroscopic binary CS 22876-032, which comprises the two most metal-poor dwarfs known. Methods. We used high-resolution, high-S/N ratio spectra from the UVES spectrograph at the ESO VLT telescope. Long-term radial-velocity measurements and broad-band photometry allowed us to determine improved orbital elements and stellar parameters for both components. We used OSMARCS 1D models and the TURBOSPECTRUM spectral synthesis code to determine the abundances of Li, O, Na, Mg, Al, Si, Ca, Sc, Ti, Cr, Mn, Fe, Co and Ni. We also used the (COBOLD)-B-5 model atmosphere code to compute the 3D abundance corrections, notably for Li and O. Results. We find a metallicity of [Fe/H] similar to -3.6 for both stars, using 1D models with 3D corrections of similar to -0.1 dex from averaged 3D models. We determine the oxygen abundance from the near-UV OH bands; the 3D corrections are large, -1 and -1.5 dex for the secondary and primary respectively, and yield [O/Fe] similar to 0.8, close to the high-quality results obtained from the [OI] 630 nm line in metal-poor giants. Other [alpha/Fe] ratios are consistent with those measured in other dwarfs and giants with similar [Fe/H], although Ca and Si are somewhat low ([X/Fe] less than or similar to 0). Other element ratios follow those of other halo stars. The Li abundance of the primary star is consistent with the Spite plateau, but the secondary shows a lower abundance; 3D corrections are small. Conclusions. The Li abundance in the primary star supports the extension of the Spite Plateau value at the lowest metallicities, without any decrease. The low abundance in the secondary star could be explained by endogenic Li depletion, due to its cooler temperature. If this is not the case, another, yet unknown mechanism may be causing increased scatter in A( Li) at the lowest metallicities.

Origin of primordial magnetic fields

Magnetic fields of intensities similar to those in our galaxy are also observed in high redshift galaxies, where a mean field dynamo would not have had time to produce them. Therefore, a primordial origin is indicated. It has been suggested that magnetic fields were created at various primordial eras: during inflation, the electroweak phase transition, the quark-hadron phase transition (QHPT), during the formation of the first objects, and during reionization. We suggest here that the large-scale fields similar to mu G, observed in galaxies at both high and low redshifts by Faraday rotation measurements (FRMs), have their origin in the electromagnetic fluctuations that naturally occurred in the dense hot plasma that existed just after the QHPT. We evolve the predicted fields to the present time. The size of the region containing a coherent magnetic field increased due to the fusion of smaller regions. Magnetic fields (MFs) similar to 10 mu G over a comoving similar to 1 pc region are predicted at redshift z similar to 10. These fields are orders of magnitude greater than those predicted in previous scenarios for creating primordial magnetic fields. Line-of-sight average MFs similar to 10(-2) mu G, valid for FRMs, are obtained over a 1 Mpc comoving region at the redshift z similar to 10. In the collapse to a galaxy (comoving size similar to 30 kpc) at z similar to 10, the fields are amplified to similar to 10 mu G. This indicates that the MFs created immediately after the QHPT (10(-4) s), predicted by the fluctuation-dissipation theorem, could be the origin of the similar to mu G fields observed by FRMs in galaxies at both high and low redshifts. Our predicted MFs are shown to be consistent with present observations. We discuss the possibility that the predicted MFs could cause non-negligible deflections of ultrahigh energy cosmic rays and help create the observed isotropic distribution of their incoming directions. We also discuss the importance of the volume average magnetic field predicted by our model in producing the first stars and in reionizing the Universe.

New measurements of radial velocities in clusters of galaxies-V

As a part of our galaxy-cluster redshift survey, we present a set of 79 new velocities in the 4 clusters Abell 376, Abell 970, Abell 1356, and Abell 2244, obtained at Haute-Provence observatory. This set now completes our previous analyses, especially for the first two clusters. Data on individual galaxies are presented, and we discuss some cluster properties. For A376, we obtained an improved mean redshift (z) over bar = 0.04750 with a velocity dispersion of sigma(V) = 860 km s(-1). For A970, we have (z) over bar = 0.05875 with sigma(V) = 881 km s(-1). We show that the A1356 cluster is not a member of the ""Leo-Virgo"" supercluster at a mean redshift (z) over bar = 0.112 and should be considered just as a foreground group of galaxies at (z) over bar = 0.0689, as well as A1435 at (z) over bar = 0.062. We obtain (z) over bar = 0.09962 for A2244 with sigma(V) = 965 km s(-1). The relative proximity of clusters A2244 and A2245 ((z) over bar = 0.08738, sigma(V) = 992 km s(-1)) suggests that these could be members of a supercluster that would include A2249; however, from X-ray data there is no indication of interaction between A2244 and A2245.

Self-bound models of compact stars and recent mass-radius measurements

The exact composition of a specific class of compact stars, historically referred to as ""neutron stars,'' is still quite unknown. Possibilities ranging from hadronic to quark degrees of freedom, including self-bound versions of the latter, have been proposed. We specifically address the suitability of strange star models (including pairing interactions) in this work, in the light of new measurements available for four compact stars. The analysis shows that these data might be explained by such an exotic equation of state, actually selecting a small window in parameter space, but still new precise measurements and also further theoretical developments are needed to settle the subject.

Comparative electron temperature measurements of Thomson scattering and electron cyclotron emission diagnostics in TCABR plasmas

We present the first simultaneous measurements of the Thomson scattering and electron cyclotron emission radiometer diagnostics performed at TCABR tokamak with Alfven wave heating. The Thomson scattering diagnostic is an upgraded version of the one previously installed at the ISTTOK tokamak, while the electron cyclotron emission radiometer employs a heterodyne sweeping radiometer. For purely Ohmic discharges, the electron temperature measurements from both diagnostics are in good agreement. Additional Alfven wave heating does not affect the capability of the Thomson scattering diagnostic to measure the instantaneous electron temperature, whereas measurements from the electron cyclotron emission radiometer become underestimates of the actual temperature values. (C) 2010 American Institute of Physics. [doi:10.1063/1.3494379]

X-ray phase measurements as a probe of small structural changes in doped nonlinear optical crystals

X-ray multiple diffraction experiments with synchrotron radiation were carried out on pure and doped nonlinear optical crystals: NH(4)H(2)PO(4) and KH(2)PO(4) doped with Ni and Mn, respectively. Variations in the intensity profiles were observed from pure to doped samples, and these variations correlated with shifts in the structure factor phases, also known as triplet phases. This result demonstrates the potential of X-ray phase measurements to study doping in this type of single crystal. Different methodologies for probing structural changes were developed. Dynamical diffraction simulations and curve fitting procedures were also necessary for accurate phase determination. Structural changes causing the observed phase shifts are discussed.

Cloud condensation nuclei in pristine tropical rainforest air of Amazonia: size-resolved measurements and modeling of atmospheric aerosol composition and CCN activity

Atmospheric aerosol particles serving as cloud condensation nuclei (CCN) are key elements of the hydrological cycle and climate. We have measured and characterized CCN at water vapor supersaturations in the range of S=0.10-0.82% in pristine tropical rainforest air during the AMAZE-08 campaign in central Amazonia. The effective hygroscopicity parameters describing the influence of chemical composition on the CCN activity of aerosol particles varied in the range of kappa approximate to 0.1-0.4 (0.16+/-0.06 arithmetic mean and standard deviation). The overall median value of kappa approximate to 0.15 was by a factor of two lower than the values typically observed for continental aerosols in other regions of the world. Aitken mode particles were less hygroscopic than accumulation mode particles (kappa approximate to 0.1 at D approximate to 50 nm; kappa approximate to 0.2 at D approximate to 200 nm), which is in agreement with earlier hygroscopicity tandem differential mobility analyzer (H-TDMA) studies. The CCN measurement results are consistent with aerosol mass spectrometry (AMS) data, showing that the organic mass fraction (f(org)) was on average as high as similar to 90% in the Aitken mode (D <= 100 nm) and decreased with increasing particle diameter in the accumulation mode (similar to 80% at D approximate to 200 nm). The kappa values exhibited a negative linear correlation with f(org) (R(2)=0.81), and extrapolation yielded the following effective hygroscopicity parameters for organic and inorganic particle components: kappa(org)approximate to 0.1 which can be regarded as the effective hygroscopicity of biogenic secondary organic aerosol (SOA) and kappa(inorg)approximate to 0.6 which is characteristic for ammonium sulfate and related salts. Both the size dependence and the temporal variability of effective particle hygroscopicity could be parameterized as a function of AMS-based organic and inorganic mass fractions (kappa(p)=kappa(org) x f(org)+kappa(inorg) x f(inorg)). The CCN number concentrations predicted with kappa(p) were in fair agreement with the measurement results (similar to 20% average deviation). The median CCN number concentrations at S=0.1-0.82% ranged from N(CCN,0.10)approximate to 35 cm(-3) to N(CCN,0.82)approximate to 160 cm(-3), the median concentration of aerosol particles larger than 30 nm was N(CN,30)approximate to 200 cm(-3), and the corresponding integral CCN efficiencies were in the range of N(CCN,0.10/NCN,30)approximate to 0.1 to N(CCN,0.82/NCN,30)approximate to 0.8. Although the number concentrations and hygroscopicity parameters were much lower in pristine rainforest air, the integral CCN efficiencies observed were similar to those in highly polluted megacity air. Moreover, model calculations of N(CCN,S) assuming an approximate global average value of kappa approximate to 0.3 for continental aerosols led to systematic overpredictions, but the average deviations exceeded similar to 50% only at low water vapor supersaturation (0.1%) and low particle number concentrations (<= 100 cm(-3)). Model calculations assuming aconstant aerosol size distribution led to higher average deviations at all investigated levels of supersaturation: similar to 60% for the campaign average distribution and similar to 1600% for a generic remote continental size distribution. These findings confirm earlier studies suggesting that aerosol particle number and size are the major predictors for the variability of the CCN concentration in continental boundary layer air, followed by particle composition and hygroscopicity as relatively minor modulators. Depending on the required and applicable level of detail, the information and parameterizations presented in this paper should enable efficient description of the CCN properties of pristine tropical rainforest aerosols of Amazonia in detailed process models as well as in large-scale atmospheric and climate models.

Remote sensing the vertical profile of cloud droplet effective radius, thermodynamic phase, and temperature

Cloud-aerosol interaction is a key issue in the climate system, affecting the water cycle, the weather, and the total energy balance including the spatial and temporal distribution of latent heat release. Information on the vertical distribution of cloud droplet microphysics and thermodynamic phase as a function of temperature or height, can be correlated with details of the aerosol field to provide insight on how these particles are affecting cloud properties and their consequences to cloud lifetime, precipitation, water cycle, and general energy balance. Unfortunately, today's experimental methods still lack the observational tools that can characterize the true evolution of the cloud microphysical, spatial and temporal structure in the cloud droplet scale, and then link these characteristics to environmental factors and properties of the cloud condensation nuclei. Here we propose and demonstrate a new experimental approach (the cloud scanner instrument) that provides the microphysical information missed in current experiments and remote sensing options. Cloud scanner measurements can be performed from aircraft, ground, or satellite by scanning the side of the clouds from the base to the top, providing us with the unique opportunity of obtaining snapshots of the cloud droplet microphysical and thermodynamic states as a function of height and brightness temperature in clouds at several development stages. The brightness temperature profile of the cloud side can be directly associated with the thermodynamic phase of the droplets to provide information on the glaciation temperature as a function of different ambient conditions, aerosol concentration, and type. An aircraft prototype of the cloud scanner was built and flew in a field campaign in Brazil. The CLAIM-3D (3-Dimensional Cloud Aerosol Interaction Mission) satellite concept proposed here combines several techniques to simultaneously measure the vertical profile of cloud microphysics, thermodynamic phase, brightness temperature, and aerosol amount and type in the neighborhood of the clouds. The wide wavelength range, and the use of multi-angle polarization measurements proposed for this mission allow us to estimate the availability and characteristics of aerosol particles acting as cloud condensation nuclei, and their effects on the cloud microphysical structure. These results can provide unprecedented details on the response of cloud droplet microphysics to natural and anthropogenic aerosols in the size scale where the interaction really happens.

Neutrino and antineutrino inclusive charged-current cross section measurements with the MINOS near detector

The energy dependence of the neutrino-iron and antineutrino-iron inclusive charged-current cross sections and their ratio have been measured using a high-statistics sample with the MINOS near detector exposed to the NuMI beam from the main injector at Fermilab. Neutrino and antineutrino fluxes were determined using a low hadronic energy subsample of charged-current events. We report measurements of nu-Fe ((nu) over bar - Fe) cross section in the energy range 3-50 GeV (5-50 GeV) with precision of 2%-8% (3%-9%) and their ratio which is measured with precision 2%-8%. The data set spans the region from low energy, where accurate measurements are sparse, up to the high-energy scaling region where the cross section is well understood.

Precise measurements of direct CP violation, CPT symmetry, and other parameters in the neutral kaon system

We present precise tests of CP and CPT symmetry based on the full data set of K -> pi pi decays collected by the KTeV experiment at Fermi National Accelerator Laboratory during 1996, 1997, and 1999. This data set contains 16 x 10(6) K -> pi(0)pi(0) and 69 x 10(6) K -> pi(+)pi(-) decays. We measure the direct CP violation parameter Re(epsilon'/epsilon) = (19.2 +/- 2.1) x 10(-4). We find the K(L) -> K(S) mass difference Delta m = (5270 +/- 12) x 10(6) (h) over tilde s(-1) and the K(S) lifetime tau(S) = (89.62 +/- 0.05) x 10(-12) s. We also measure several parameters that test CPT invariance. We find the difference between the phase of the indirect CP violation parameter epsilon and the superweak phase: phi(epsilon) - phi(SW) =(0.40 +/- 0.56)degrees. We measure the difference of the relative phases between the CP violating and CP conserving decay amplitudes for K -> pi(+)pi(-) (phi(+-)) and for K -> pi(0)pi(0) (phi(00)): Delta phi = (0.30 +/- 0.35)degrees. From these phase measurements, we place a limit on the mass difference between K(0) and (K) over bar (0): Delta M < 4.8 x 10(-19) GeV/c(2) at 95% C.L. These results are consistent with those of other experiments, our own earlier measurements, and CPT symmetry.

High-p(T) pi(0) production with respect to the reaction plane in Au plus Au collisions at s(NN)=200 GeV

Measurements of the azimuthal anisotropy of high-p(T) neutral pion (pi(0)) production in Au+Au collisions at s(NN)=200 GeV by the PHENIX experiment are presented. The data included in this article were collected during the 2004 Relativistic Heavy Ion Collider running period and represent approximately an order of magnitude increase in the number of analyzed events relative to previously published results. Azimuthal angle distributions of pi(0) mesons detected in the PHENIX electromagnetic calorimeters are measured relative to the reaction plane determined event-by-event using the forward and backward beam-beam counters. Amplitudes of the second Fourier component (v(2)) of the angular distributions are presented as a function of pi(0) transverse momentum (p(T)) for different bins in collision centrality. Measured reaction plane dependent pi(0) yields are used to determine the azimuthal dependence of the pi(0) suppression as a function of p(T), R(AA)(Delta phi,p(T)). A jet-quenching motivated geometric analysis is presented that attempts to simultaneously describe the centrality dependence and reaction plane angle dependence of the pi(0) suppression in terms of the path lengths of hypothetical parent partons in the medium. This set of results allows for a detailed examination of the influence of geometry in the collision region and of the interplay between collective flow and jet-quenching effects along the azimuthal axis.

Systematic studies of elliptic flow measurements in Au plus Au collisions at s(NN)=200 GeV

We present inclusive charged hadron elliptic flow (v(2)) measured over the pseudorapidity range vertical bar eta vertical bar < 0.35 in Au+Au collisions at s(NN)=200 GeV. Results for v(2) are presented over a broad range of transverse momentum (p(T)=0.2-8.0 GeV/c) and centrality (0-60%). To study nonflow effects that are correlations other than collective flow, as well as the fluctuations of v(2), we compare two different analysis methods: (1) the event-plane method from two independent subdetectors at forward (vertical bar eta vertical bar=3.1-3.9) and beam (vertical bar eta vertical bar>6.5) pseudorapidities and (2) the two-particle cumulant method extracted using correlations between particles detected at midrapidity. The two event-plane results are consistent within systematic uncertainties over the measured p(T) and in centrality 0-40%. There is at most a 20% difference in the v(2) between the two event-plane methods in peripheral (40-60%) collisions. The comparisons between the two-particle cumulant results and the standard event-plane measurements are discussed.

Cold nuclear matter effects on J/psi production as constrained by deuteron-gold measurements at root S(NN)=200 GeV

We present a new analysis of J/psi production yields in deuteron-gold collisions at root s(NN) =200 GeV using data taken from the PHENIX experiment in 2003 and previously published in S. S. Adler [Phys. Rev. Lett 96, 012304 (2006)]. The high statistics proton-proton J/psi data taken in 2005 are used to improve the baseline measurement and thus construct updated cold nuclear matter modification factors (R(dAu)). A suppression of J/psi in cold nuclear matter is observed as one goes forward in rapidity (in the deuteron-going direction), corresponding to a region more sensitive to initial-state low-x gluons in the gold nucleus. The measured nuclear modification factors are compared to theoretical calculations of nuclear shadowing to which a J/psi (or precursor) breakup cross section is added. Breakup cross sections of sigma(breakup)=2.8(-1.4)(+1.7) (2.2(-1.5)(+1.6)) mb are obtained by fitting these calculations to the data using two different models of nuclear shadowing. These breakup cross-section values are consistent within large uncertainties with the 4.2 +/- 0.5 mb determined at lower collision energies. Projecting this range of cold nuclear matter effects to copper-copper and gold-gold collisions reveals that the current constraints are not sufficient to firmly quantify the additional hot nuclear matter effect.