Supervised classification of minimally invasive surgery psychomotor competence based on instruments motion analysis

Background Objective assessment of psychomotor skills has become an important challenge in the training of minimally invasive surgical (MIS) techniques. Currently, no gold standard defining surgical competence exists for classifying residents according to their surgical skills. Supervised classification has been proposed as a means for objectively establishing competence thresholds in psychomotor skills evaluation. This report presents a study comparing three classification methods for establishing their validity in a set of tasks for basic skills’ assessment. Methods Linear discriminant analysis (LDA), support vector machines (SVM), and adaptive neuro-fuzzy inference systems (ANFIS) were used. A total of 42 participants, divided into an experienced group (4 expert surgeons and 14 residents with >10 laparoscopic surgeries performed) and a nonexperienced group (16 students and 8 residents with <10 laparoscopic surgeries performed), performed three box trainer tasks validated for assessment of MIS psychomotor skills. Instrument movements were captured using the TrEndo tracking system, and nine motion analysis parameters (MAPs) were analyzed. The performance of the classifiers was measured by leave-one-out cross-validation using the scores obtained by the participants. Results The mean accuracy performances of the classifiers were 71 % (LDA), 78.2 % (SVM), and 71.7 % (ANFIS). No statistically significant differences in the performance were identified between the classifiers. Conclusions The three proposed classifiers showed good performance in the discrimination of skills, especially when information from all MAPs and tasks combined were considered. A correlation between the surgeons’ previous experience and their execution of the tasks could be ascertained from results. However, misclassifications across all the classifiers could imply the existence of other factors influencing psychomotor competence.

Influencia del cereal y el nivel de inclusión de fibra en el pienso sobre la productividad en pollitas de 0 a 17 semanas de edad.

La fibra ha sido considerada como un diluyente del pienso en monogástricos con efectos negativos sobre consumo y la digestibilidad de los nutrientes (Jansen and Carré, 1985). Sin embargo, estudios recientes (Mateos et al., 2012) han mostrado que la inclusión de cantidades moderadas de fibra en el pienso podría mejorar tanto la digestibilidad de los nutrientes como el crecimiento de las aves. La inclusión de fibra en piensos para broilers podría incrementar el tiempo de retención de la digesta en la parte superior del tracto digestivo, estimulando el funcionamiento de la molleja (Hetland et al. 2005) y la producción de HCl en el proventrículo (Duke, 1986). Un descenso del pH de la molleja favorece la producción de pepsina e incrementa la solubilidad de las sales minerales (Jiménez-Moreno et al. 2009). Por lo tanto, la inclusión de cantidades adecuadas de fibra podría beneficiar el desarrollo del tracto gastrointestinal (Mateos et al., 2012). Sin embargo, la información disponible sobre los efectos beneficiosos de la fibra dietética en pollitas es escasa (Frikha et al., 2009). De hecho, los autores no han encontrado ningún estudio publicado sobre los efectos de la inclusión de fibra sobre el crecimiento de pollitas de 0 a 17 sem de edad. La influencia de fuentes de fibra tales como la cascarilla de avena, pulpa de remolacha (PRE) o cascarilla de soja sobre el desarrollo del tracto gastrointestinal ha sido bien estudiada en broilers (González-Alvarado el al., 2010). Sin embargo, la información disponible sobre el uso de paja de cereales (PCE) en dietas para avicultura es muy limitada; aun siendo una fuente de fibra abundante. La hipótesis del presente ensayo fue que la inclusión de cantidades moderadas de fibra en piensos de pollitas podría mejorar el rendimiento productivo con una mejora de la utilización de los nutrientes. El objetivo del presente trabajo fue estudiar el efecto de la inclusión de diversas fuentes de fibra a diferentes niveles en el pienso de pollitas sobre los rendimientos productivos de 0 a 17 sem de edad.

O PAPEL DA COMUNICAÇÃO FACE A FACE NAS ORGANIZAÇÕES NO CONTEXTO DA SOCIEDADE MIDIATIZADA

Este estudo trata da comunicação face a face nas organizações sob diferentes abordagens teóricas. Considera a perspectiva da simultaneidade dos meios, já que as empresas utilizam diversos canais para dialogar com seus públicos de interesse. Leva em conta o fenômeno da midiatização, que reestrutura o modo como as pessoas se relacionam na sociedade contemporânea. O objetivo geral da pesquisa é sistematizar papeis potencialmente exercidos pela interação face a face e conhecer algumas circunstâncias que envolvem sua prática nas organizações. Por se tratar de uma tese teórica, a pesquisa bibliográfica se apresenta como um dos principais procedimentos metodológicos; análises de casos empíricos e um estudo de caso desenvolvido na Embrapa Pantanal constituem situações ilustrativas. Conclui-se que a comunicação face a face nas empresas ocorre de forma simultânea e combinada a outros canais de comunicação, porém, ela proporciona resultados práticos e filosóficos ainda pouco explorados. É rara a utilização estratégica de contatos presenciais como mecanismo para estabelecer relacionamentos, conhecer as reações alheias e ajustar a comunicação, aliar o discurso corporativo às práticas empresariais e avaliar o contexto onde se desenvolvem as interações, o que pode ser decisivo para a comunicação organizacional.

MÍDIAS SOCIAIS DIGITAIS: ESPAÇO DE RELACIONAMENTO E COMUNICAÇÃO ESTRATÉGICA

O trabalho tem como proposta avaliar a postura das organizações nas mídias sociais digitais, considerando o fato de que esses novos ambientes virtuais têm modificado drasticamente a maneira pela qual elas promovem o relacionamento com seus públicos estratégicos. O objetivo principal da pesquisa é identificar e compreender como as organizações se posicionam diante de comentários desfavoráveis nas mídias sociais digitais que possam impactar sua imagem e reputação, bem como mostrar a importância de monitorar constantemente o consumidor e dialogar com ele nos canais digitais para evitar riscos à marca. A metodologia aplicada denomina-se Estudo de Casos Múltiplos, por meio da qual analisaram-se os comentários desfavoráveis às marcas: Vivo, Tim e Oi, na página do Facebook, durante o mês de setembro de 2015. Construiu-se um protocolo de pesquisa, e realizou-se o acompanhamento dessas marcas analisando-lhes os posts e os comentários desfavoráveis coletados no período. Constatou-se, após tais procedimentos que as operadoras apresentam frequentemente dificuldades para se relacionar com os públicos nas mídias sociais digitais, o que as coloca em risco quanto à sua imagem e reputação.

Feasibility and utility of population-level geospatial injury profiling : prospective, national cohort study

The Health Services Research Unit receives funding from the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The opinions expressed in this article are those of the authors alone. The GEOS study was funded by the North of Scotland Planning Group.

Intraoperative changes in platelet function in relation to moderate haemorrhage

Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved. Funding The study was funded by TENOVUS Scotland (G12/14). Jan Jansen is in receipt of salary support through the NHS Research Scotland (NRS) fellowship scheme. Acknowledgements The authors are extremely grateful for the expert assistance and contributions of Dr Neil Scott (Medical Statistician, University of Aberdeen), Win Culley (Research Nurse, Woodend Hospital), Dr Karen Cranfield (Consultant Anaesthetist), and Ms Sharon Wood, (Research Technician, Rowett Institute of Nutrition and Health) for fibrinogen measurement.

Molecular evidence for multiple origins of woodiness and a New World biogeographic connection of the Macaronesian Island endemic Pericallis (Asteraceae: Senecioneae)

The prevalence of woody species in oceanic islands has attracted the attention of evolutionary biologists for more than a century. We used a phylogeny based on sequences of the internal-transcribed spacer region of nuclear ribosomal DNA to trace the evolution of woodiness in Pericallis (Asteraceae: Senecioneae), a genus endemic to the Macaronesian archipelagos of the Azores, Madeira, and Canaries. Our results show that woodiness in Pericallis originated independently at least twice in these islands, further weakening some previous hypotheses concerning the value of this character for tracing the continental ancestry of island endemics. The same data suggest that the origin of woodiness is correlated with ecological shifts from open to species-rich habitats and that the ancestor of Pericallis was an herbaceous species adapted to marginal habitats of the laurel forest. Our results also support Pericallis as closely related to New World genera of the tribe Senecioneae.

Novel Ras antagonist blocks human melanoma growth

During past decades, knowledge of melanoma biology has increased considerably. Numerous therapeutic modalities based on this knowledge are currently under investigation. Advanced melanoma, nevertheless, remains a prime example of poor treatment response that may, in part, be the consequence of activated N-Ras oncoproteins. Besides oncogenic Ras, wild-type Ras gene products also play a key role in receptor tyrosine kinase growth factor signaling, known to be of importance in oncogenesis and tumor progression of a variety of human neoplasms, including malignant melanoma; therefore, it is reasonable to speculate that a pharmacological approach that curtails Ras activity may represent a sensible approach to inhibit melanoma growth. To test this concept, the antitumor activity of S-trans, trans-farnesylthiosalicylic acid (FTS), a recently discovered Ras antagonist that dislodges Ras from its membrane-anchoring sites, was evaluated. The antitumor activity of FTS was assessed both in vitro and in vivo in two independent SCID mouse xenotransplantation models of human melanoma expressing either wild-type Ras (cell line 518A2) or activated Ras (cell line 607B). We show that FTS (5–50 μM) reduces the amounts of activated N-Ras and wild-type Ras isoforms both in human melanoma cells and Rat-1 fibroblasts, interrupts the Ras-dependent extracellular signal-regulated kinase in melanoma cells, inhibits the growth of N-Ras-transformed fibroblasts and human melanoma cells in vitro and reverses their transformed phenotype. FTS also causes a profound and statistically significant inhibition of 518A2 (82%) and 607B (90%) human melanoma growth in SCID mice without evidence of drug-related toxicity. Our findings stress the notion that FTS may qualify as a novel and rational treatment approach for human melanoma and possibly other tumors that either carry activated ras genes or rely on Ras signal transduction more heavily than nonmalignant cells.

CD19 and CD22 expression reciprocally regulates tyrosine phosphorylation of Vav protein during B lymphocyte signaling

B cell development and humoral immune responses are controlled by signaling thresholds established through the B lymphocyte antigen receptor (BCR) complex. BCR signaling thresholds are differentially regulated by the CD22 and CD19 cell surface receptors in vivo. B cells from CD22-deficient mice exhibit characteristics of chronic stimulation and are hyper-responsive to BCR crosslinking with augmented intracellular Ca2+ responses. By contrast, B cells from CD19-deficient mice are hypo-responsive to transmembrane signals. To identify signaling molecules involved in the positive and negative regulation of signaling thresholds, the signal transduction pathways activated after BCR crosslinking were examined in CD22- and CD19-deficient B cells. These comparisons revealed that tyrosine phosphorylation of Vav protein was uniquely augmented after BCR or CD19 crosslinking in CD22-deficient B cells, yet was modest and transient after BCR crosslinking in CD19-deficient B cells. Ligation of CD19 and CD22 in vivo is likely to positively and negatively regulate BCR signaling, respectively, because CD19 crosslinking was more efficient than BCR crosslinking at inducing Vav phosphorylation. However, simultaneous crosslinking of CD19 with the BCR resulted in a substantial decrease in Vav phosphorylation when CD22 was expressed. Thus, the differential regulation of Vav tyrosine phosphorylation by CD19 and CD22 may provide a molecular mechanism for adjusting BCR signaling thresholds.

The affected gene underlying the class K glycosylphosphatidylinositol (GPI) surface protein defect codes for the GPI transamidase

The final step in glycosylphosphatidylinositol (GPI) anchoring of cell surface proteins consists of a transamidation reaction in which preassembled GPI donors are substituted for C-terminal signal sequences in nascent polypeptides. In previous studies we described a human K562 cell mutant, termed class K, that accumulates fully assembled GPI units but is unable to transfer them to N-terminally processed proproteins. In further work we showed that, unlike wild-type microsomes, microsomes from these cells are unable to support C-terminal interaction of proproteins with the small nucleophiles hydrazine or hydroxylamine, and that the cells thus are defective in transamidation. In this study, using a modified recombinant vaccinia transient transfection system in conjunction with a composite cDNA prepared by 5′ extension of an existing GenBank sequence, we found that the genetic element affected in these cells corresponds to the human homolog of yGPI8, a gene affected in a yeast mutant strain exhibiting similar accumulation of GPI donors without transfer. hGPI8 gives rise to mRNAs of 1.6 and 1.9 kb, both encoding a protein of 395 amino acids that varies in cells with their ability to couple GPIs to proteins. The gene spans ≈25 kb of DNA on chromosome 1. Reconstitution of class K cells with hGPI8 abolishes their accumulation of GPI precursors and restores C-terminal processing of GPI-anchored proteins. Also, hGPI8 restores the ability of microsomes from the mutant cells to yield an active carbonyl in the presence of a proprotein which is considered to be an intermediate in catalysis by a transamidase.

O juiz e o princípio da efetividade no novo CPC

Número dedicado ao Novo Código de Processo Civil.