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.

Comparative Study of the Changes in Partial Pressure of Plasma Carbon Dioxide During Carbon Dioxide Insufflation into the Intraperitoneal and Preperitoneal Spaces

Background: We aimed to compare plasma concentrations of carbon dioxide (CO(2)) in dogs that underwent intra- and preperitoneal CO(2) insufflation. Materials and Methods: Thirty dogs were studied. Ten formed a control group, 10 underwent intraperitoneal CO(2) insufflation, and 10 underwent preperitoneal CO(2) insufflation. General anesthesia with controlled ventilation was standardized for all dogs. After stabilizing the anesthesia, blood samples were collected at predetermined times and were sent for immediate gasometric analysis. Analysis of variance was used for comparing variables. Results: The plasma CO(2) concentration in the intraperitoneal insufflation group increased significantly more than in the preperitoneal insufflation group and was significantly greater than in the control group (P < 0.05). The pH values in the intraperitoneal group were lower than in the preperitoneal group (P < 0.05). Conclusion: The data from this study suggest that a greater plasma concentration of CO(2) is achieved by insufflation at constant pressure into the intraperitoneal space than into the preperitoneal space.

Quantum fields with noncommutative target spaces

Quantum field theories (QFT's) on noncommutative spacetimes are currently under intensive study. Usually such theories have world sheet noncommutativity. In the present work, instead, we study QFT's with commutative world sheet and noncommutative target space. Such noncommutativity can be interpreted in terms of twisted statistics and is related to earlier work of Oeckl [R. Oeckl, Commun. Math. Phys. 217, 451 (2001)], and others [A. P. Balachandran, G. Mangano, A. Pinzul, and S. Vaidya, Int. J. Mod. Phys. A 21, 3111 (2006); A. P. Balachandran, A. Pinzul, and B. A. Qureshi, Phys. Lett. B 634,434 (2006); A.P. Balachandran, A. Pinzul, B.A. Qureshi, and S. Vaidya, arXiv:hep-th/0608138; A.P. Balachandran, T. R. Govindarajan, G. Mangano, A. Pinzul, B.A. Qureshi, and S. Vaidya, Phys. Rev. D 75, 045009 (2007); A. Pinzul, Int. J. Mod. Phys. A 20, 6268 (2005); G. Fiore and J. Wess, Phys. Rev. D 75, 105022 (2007); Y. Sasai and N. Sasakura, Prog. Theor. Phys. 118, 785 (2007)]. The twisted spectra of their free Hamiltonians has been found earlier by Carmona et al. [J. M. Carmona, J. L. Cortes, J. Gamboa, and F. Mendez, Phys. Lett. B 565, 222 (2003); J. M. Carmona, J. L. Cortes, J. Gamboa, and F. Mendez, J. High Energy Phys. 03 (2003) 058]. We review their derivation and then compute the partition function of one such typical theory. It leads to a deformed blackbody spectrum, which is analyzed in detail. The difference between the usual and the deformed blackbody spectrum appears in the region of high frequencies. Therefore we expect that the deformed blackbody radiation may potentially be used to compute a Greisen-Zatsepin-Kuzmin cutoff which will depend on the noncommutative parameter theta.

Shared information in stationary states of stochastic processes

We present four estimators of the shared information (or interdepency) in ground states given that the coefficients appearing in the wave function are all real non-negative numbers and therefore can be interpreted as probabilities of configurations. Such ground states of Hermitian and non-Hermitian Hamiltonians can be given, for example, by superpositions of valence bond states which can describe equilibrium but also stationary states of stochastic models. We consider in detail the last case, the system being a classical not a quantum one. Using analytical and numerical methods we compare the values of the estimators in the directed polymer and the raise and peel models which have massive, conformal invariant and nonconformal invariant massless phases. We show that like in the case of the quantum problem, the estimators verify the area law with logarithmic corrections when phase transitions take place.

COMPLETE ISOMORPHIC CLASSIFICATIONS OF SOME SPACES OF COMPACT OPERATORS

This paper is a continuation and a complement of our previous work on isomorphic classification of some spaces of compact operators. We improve the main result concerning extensions of the classical isomorphic classification of the Banach spaces of continuous functions on ordinals. As an application, fixing an ordinal a and denoting by X(xi), omega(alpha) <= xi < omega(alpha+1), the Banach space of all X-valued continuous functions defined in the interval of ordinals [0,xi] and equipped with the supremum, we provide complete isomorphic classifications of some Banach spaces K(X(xi),Y(eta)) of compact operators from X(xi) to Y(eta), eta >= omega. It is relatively consistent with ZFC (Zermelo-Fraenkel set theory with the axiom of choice) that these results include the following cases: 1.X* contains no copy of c(0) and has the Mazur property, and Y = c(0)(J) for every set J. 2. X = c(0)(I) and Y = l(q)(J) for any infinite sets I and J and 1 <= q < infinity. 3. X = l(p)(I) and Y = l(q)(J) for any infinite sets I and J and 1 <= q < p < infinity.

ON ISOMORPHIC CLASSIFICATIONS OF SPACES OF COMPACT OPERATORS

We prove an extension of the classical isomorphic classification of Banach spaces of continuous functions on ordinals. As a consequence, we give complete isomorphic classifications of some Banach spaces K(X,Y(n)), eta >= omega, of compact operators from X to Y(eta), the space of all continuous Y-valued functions defined in the interval of ordinals [1, eta] and equipped with the supremum norm. In particular, under the Continuum Hypothesis, we extend a recent result of C. Samuel by classifying, up to isomorphism, the spaces K(X(xi), c(0)(Gamma)(eta)), where omega <= xi < omega(1,) eta >= omega, Gamma is a countable set, X contains no complemented copy of l(1), X* has the Mazur property and the density character of X** is less than or equal to N(1).

ON SPACES OF COMPACT OPERATORS ON C(K, X) SPACES

This paper concerns the spaces of compact operators kappa(E,F), where E and F are Banach spaces C([1, xi], X) of all continuous X-valued functions defined on the interval of ordinals [1, xi] and equipped with the supremun norm. We provide sufficient conditions on X, Y, alpha, beta, xi and eta, with omega <= alpha <= beta < omega 1 for the following equivalence: (a) kappa(C([1, xi], X), C([1, alpha], Y)) is isomorphic to kappa(C([1,eta], X), C([1, beta], Y)), (b) beta < alpha(omega). In this way, we unify and extend results due to Bessaga and Pelczynski (1960) and C. Samuel (2009). Our result covers the case of the classical spaces X = l(p) and Y = l(q) with 1 < p, q < infinity.

COUNTABLE GROUPS OF ISOMETRIES ON BANACH SPACES

A group G is representable in a Banach space X if G is isomorphic to the group of isometrics on X in some equivalent norm. We prove that a countable group G is representable in a separable real Banach space X in several general cases, including when G similar or equal to {-1,1} x H, H finite and dim X >= vertical bar H vertical bar or when G contains a normal subgroup with two elements and X is of the form c(0)(Y) or l(p)(Y), 1 <= p < +infinity. This is a consequence of a result inspired by methods of S. Bellenot (1986) and stating that under rather general conditions on a separable real Banach space X and a countable bounded group G of isomorphisms on X containing -Id, there exists an equivalent norm on X for which G is equal to the group of isometrics on X. We also extend methods of K. Jarosz (1988) to prove that any complex Banach space of dimension at least 2 may be renormed with an equivalent complex norm to admit only trivial real isometries, and that any complexification of a Banach space may be renormed with an equivalent complex norm to admit only trivial and conjugation real isometrics. It follows that every real Banach space of dimension at least 4 and with a complex structure may be renormed to admit exactly two complex structures up to isometry, and that every real Cartesian square may be renormed to admit a unique complex structure up to isometry.

POLAR ACTIONS ON CERTAIN PRINCIPAL BUNDLES OVER SYMMETRIC SPACES OF COMPACT TYPE

We study polar actions with horizontal sections on the total space of certain principal bundles G/K -> G/H with base a symmetric space of compact type. We classify such actions up to orbit equivalence in many cases. In particular, we exhibit examples of hyperpolar actions with cohomogeneity greater than one on locally irreducible homogeneous spaces with nonnegative curvature which are not homeomorphic to symmetric spaces.

Extremal problems on sum-free sets and coverings in tridimensional spaces

Given a prime power q, define c (q) as the minimum cardinality of a subset H of F 3 q which satisfies the following property: every vector in this space di ff ers in at most 1 coordinate from a multiple of a vector in H. In this work, we introduce two extremal problems in combinatorial number theory aiming to discuss a known connection between the corresponding coverings and sum-free sets. Also, we provide several bounds on these maps which yield new classes of coverings, improving the previous upper bound on c (q)

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.

Evaluation of plaque composition by intravascular ultrasound ""virtual histology"": the impact of dense calcium on the measurement of necrotic tissue

Aims: We aimed to evaluate if the co-localisation of calcium and necrosis in intravascular ultrasound virtual histology (IVUS-VH) is due to artefact, and whether this effect can be mathematically estimated. Methods and results: We hypothesised that, in case calcium induces an artefactual coding of necrosis, any addition in calcium content would generate an artificial increment in the necrotic tissue. Stent struts were used to simulate the ""added calcium"". The change in the amount and in the spatial localisation of necrotic tissue was evaluated before and after stenting (n=17 coronary lesions) by means of a especially developed imaging software. The area of ""calcium"" increased from a median of 0.04 mm(2) at baseline to 0.76 mm(2) after stenting (p<0.01). In parallel the median necrotic content increased from 0.19 mm(2) to 0.59 mm(2) (p<0.01). The ""added"" calcium strongly predicted a proportional increase in necrosis-coded tissue in the areas surrounding the calcium-like spots (model R(2)=0.70; p<0.001). Conclusions: Artificial addition of calcium-like elements to the atherosclerotic plaque led to an increase in necrotic tissue in virtual histology that is probably artefactual. The overestimation of necrotic tissue by calcium strictly followed a linear pattern, indicating that it may be amenable to mathematical correction.

Molecular dynamics, density functional, ADMET predictions, virtual screening, and molecular interaction field studies for identification and evaluation of novel potential CDK2 inhibitors in cancer therapy

In this work, we have used molecular dynamics, density functional theory, virtual screening, ADMET predictions, and molecular interaction field studies to design and propose eight novel potential inhibitors of CDK2. The eight molecules proposed showed interesting structural characteristics that are required for inhibiting the CDK2 activity and show potential as drug candidates for the treatment of cancer. The parameters related to the Rule of Five were calculated, and only one of the molecules violated more than one parameter. One of the proposals and one of the drug-like compounds selected by virtual screening indicated to be promising candidates for CDK2-based cancer therapy.

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.

Molecular dynamics, flexible docking, virtual screening, ADMET predictions, and molecular interaction field studies to design novel potential MAO-B inhibitors

Monoamine oxidase is a flavoenzyme bound to the mitochondrial outer membranes of the cells, which is responsible for the oxidative deamination of neurotransmitter and dietary amines. It has two distinct isozymic forms, designated MAO-A and MAO-B, each displaying different substrate and inhibitor specificities. They are the well-known targets for antidepressant, Parkinson`s disease, and neuroprotective drugs. Elucidation of the x-ray crystallographic structure of MAO-B has opened the way for the molecular modeling studies. In this work we have used molecular modeling, density functional theory with correlation, virtual screening, flexible docking, molecular dynamics, ADMET predictions, and molecular interaction field studies in order to design new molecules with potential higher selectivity and enzymatic inhibitory activity over MAO-B.