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AIM: To assess the repeatability and agreement of higher-order aberration obtained by adaptive optics visual simulator(VAO)compared with OPD-Scan Ⅲ.METHODS: A cross-sectional study was conducted from August to September 2023, including a total of 204 patients(204 eyes)with myopia whose right eyes were measured. The examinations were performed by the same skilled examiner using both devices separately. The VAO device was used to measure higher order aberrations of orders 3 to 6 at a pupil diameter of 4.5 mm, while both the VAO and OPD-Scan Ⅲ devices were utilized to measure total higher-order aberration(tHOA), spherical aberration(SA), coma aberration(Coma), and trefoil aberration(Trefoil)of the entire eye at pupil diameters ranging from 3 to 6 mm. Furthermore, the repeatability of whole eye aberration measurements obtained with the VAO device was evaluated and the agreement of the two devices was assessed.RESULTS: The whole-eye higher-order aberrations measured by VAO demonstrated excellent repeatability(0.767≤ICC≤0.941, Sw<0.01 μm, TRT<0.1 μm). There was no statistically significant difference in Coma measured by VAO or OPD-Scan Ⅲ for pupil diameters ranging from 4 to 6 mm(P>0.05), while a statistically significant difference was observed in whole-eye tHOA of other pupil diameters(all P<0.05). The agreement of aberration measurements for each order between VAO and OPD-Scan Ⅲ for 3 mm pupil diameters, SA at 4 and 5 mm pupil diameter and Coma at 4 mm pupil diameter showed a 95% limit of agreement(LoA)<0.1, indicating good agreement; however, poor agreement was found for the remaining aberration measurements at different pupil diameters, with a 95%LoA>0.1, and there were significant differences in higher-order aberrations measured by two devices under a pupil diameter of 3 mm(r=0.218-0.317, P<0.01), 4 mm(r=0.406-0.672, P<0.01), 5 mm(r=0.538-0.839, P<0.01 and r=0.030-0.109, P>0.01)and 6 mm(r=0.369-0.766, P<0.01).CONCLUSION: The VAO demonstrates favorable repeatability when assessing whole-eye higher order aberration under pupil diameters of 3-6 mm. However, there is inadequate agreement and interchangeability in whole-eye higher order aberration at 3-6 mm pupil diameter between VAO and OPD-Scan Ⅲ for clinical purposes.
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Purpose: To profile vitreoretinal (VR) fellows?in?training from India exposed to the Eyesi surgical simulator, to identify potential barriers to voluntary use, and enumerate the most preferred tools and tasks before incorporating them into a formal skill?transfer curriculum. Methods: A questionnaire consisting of 22 questions was designed and circulated through an online portal (surveymonkey.com) to four different institutes of India having a VR surgical fellowship program and using a functional Eyesi (Haag–Streit) simulator. All fellows and trainees who were exposed to the simulator were eligible to participate, irrespective of time spent on the simulator and exposure to training steps on real patients. The responses collected were private and anonymous. Results: Of the 37 respondents, most (n = 25, 68%) considered surgical simulators to be the best training tool before operating on the human eye. A majority (n = 35, 94.5%) of participants spent <3 h per week on the simulator, which, most (n = 30, 81%) felt was not enough time. The main reasons for this underutilization were work?hour limitations (54.8%), lack of a structured training program (19.3%), or a dedicated supervisor (16.1%). Again, the majority (n = 33, 89%) of participants responded that VR surgical skills acquired during simulator training were transferrable to the operating room, which was reflected by their response (n = 31, 83.7%) that simulator?based training should be made mandatory before operating room exposure. Conclusion: This study gives an insight into the overall practice patterns and preferences in simulation training of surgical VR fellows?in?training across India. It indicates that the simulator is extremely helpful to fellows and if adopted, VR surgical simulators with organized, directed, and supervised sessions will considerably improve the surgical training experience.
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Objective:To evaluate the efficacy of neonatal resuscitation simulation exercise for perinatal medical personnel.Methods:From August 2020 to July 2021, perinatal medical personnel receiving simulated training of neonatal resuscitation in our hospital were prospectively enrolled. The professional backgrounds of the trainees were collected and their performances on both knowledge skills and behavioral skills were scored. The knowledge skills included pre-resuscitation preparation, initial resuscitation, positive pressure ventilation, tracheal intubation, chest compression and umbilical vein catheterization. The behavioral skills included situational awareness, problem solving, resource utilization, communication and leadership. SPSS 26.0 was used for data analysis.Results:Among the 200 participants, 127(63.5%) were neonatal/pediatric doctors and nurses, 65(32.5%) were obstetricians and midwives, 8(4.0%) were anesthesiologists and the ratio of doctors to nurses was 1.74∶1. The score of knowledge skills was (19.52±2.92) at the beginning of the simulation exercise and (27.02±2.72) at the end. The scores on preparation before resuscitation, initial resuscitation and positive pressure ventilation were significantly improved ( P<0.05). The score of behavioral skills was (16.60±2.34) at the beginning and (20.58±1.77) at the end. The scores of resource utilization, communication and leadership were significantly improved ( P<0.05). Conclusions:The simulation exercise provides multidisciplinary teamwork training for perinatal medical personnel, may significantly improve neonatal resuscitation skills and is worth promoting.
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Objective@#To investigate the current situation of using virtual simulation technology in undergraduate schools of stomatology in China, analyze the problems and put forward corresponding improvement suggestions. @*Methods@# A questionnaire survey was conducted among 672 teachers and 3 849 students in undergraduate schools of stomatology in China. @*Results @#25.81% of all participants had took part in dental virtual simulation courses, and 37.80% of the participants from “Double First-Class” universities had participated in dental virtual simulation courses. 92.12% of the virtual simulation courses were established for undergraduates. "Traditional course + virtual simulation model demonstration" is the main teaching form of virtual simulation courses. Most of the participants were satisfied with the virtual simulation courses offered by their schools. At present, there are also some deficiencies in the virtual simulation courses, such as lack of teaching resources, insufficient interaction and simulation.@*Conclusion@#There is difference in the application of virtual simulation technology in undergraduate schools of stomatology in China. The virtual simulation technology is more widely used in "Double First-Class" universities than in ordinary universities. Undergraduates are the main teaching objects of virtual simulation courses. Stomatological schools in China should pay attention to the development and utilization of virtual simulation curriculum resources by cooperation, enrich the form of virtual simulation courses and strengthen the promotion and application of virtual simulation technology in stomatological education.
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AIM:To investigate the effectiveness of surgical simulator-based small-incision extracapsular cataract extraction training for young ophthalmologists.METHODS:Prospective and controlled study. A total of 48 young participants who had completed at least 3a standardized residency training or had obtained the attending certificate in the He Eye Specialist Hospital from 2020 to 2022 were enrolled. All the participants were randomly divided into simulator surgical operation training group(experimental group, n=24)and real animal eye operation training group(control group, n=24)after passing the theoretical training and assessment of small incision extracapsular cataract extraction. The participants in the experimental group and control group were trained with the surgical simulator and pig eyes respectively. After training, the overall effectiveness of training in both groups was rated using the simulator and pig eye operation was evaluated.RESULTS: The participants in the experimental group used less time than the participants in the control group on simulator assessment(all P<0.05). The scores of injecting viscoelastics during keratonyxis, nucleus delivery and hydrate the paracentesis site steps were not different on simulator assessment between the two groups(P>0.05). For the rest of the steps, the scores of experimental group were higher than those of the control group(all P<0.05). Participants in the experimental group had significantly higher scores than control group on pig eye operation assessment(all P<0.05). In the experimental group, the scores of the scleral groove dissection, tunnel dissection, continuous circular capsulorhexis, hydrodissection and hydro-prolapse and nucleus delivery steps had no significant difference between the surgical simulator and pig eye operation(P=0.068, 0.126, 0.960, 0.520, 0.206). The scores of injecting viscoelastics during keratonyxis, tunnel puncture into anterior chamber and hydrate the paracentesis site steps were significantly lower on simulator assessment than pig eye operation(P=0.007, 0.014, <0.01). The scores of the cortex removal and intraocular lens(IOL)implantation were significantly higher on simulator assessment than eye of real animal(P=0.035, <0.01).CONCLUSION:The application of surgical simulator on training small incision extracapsular cataract extraction skills for young ophthalmologists could significantly improve their skills in cataract surgery operation, providing a new mode and idea for the establishment of standardized cataract surgery training for young ophthalmologists.
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OBJECTIVE@#Invent a simulator which provides a simulation of heart rate and respiratory rate to the intelligent sleep monitoring devices based on precision pressure sensors.@*METHODS@#The simulator was composed of control part and simulated silicone doll. The simulated silicone doll contains heartbeat simulator and breathing simulation airbag. Heartbeat and breathing combination pressure signal can be produced according to frequency set values. Frequencies of pressure signal of the simulator were compared with the monitoring results of intelligent sleep monitoring devices with known accuracy to verify the frequency accuracy of pressure signal of the simulator. Verified the repeatability and stability of the simulator with a stopwatch.@*RESULTS@#The heart rate of the simulator was with in ±2 beats per minute of the monitoring results of intelligent sleep monitoring devices and the respiratory rate of the simulator was with in ±2 times per minute of the monitoring results. The repeatability and stability of the simulator was better than ±5% according to results with a stopwatch.@*CONCLUSIONS@#It's practicable to use the simulator which provides a simulation of heart rate and respiratory rate to the accuracy test of the intelligent sleep monitoring devices based on precision pressure sensor.
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Objective: To develop a low-cost simulator model and a colonoscope with materials that are easily accessible to offer training on colonoscopy skills during undergraduate studies. Since this is the procedure of choice for colorectal cancer screening, the general practitioner must be able to recognize its main indications, preparation, and complications. Methods: Using materials such as a mannequin, a vehicle inspection camera, a conduit, polyvinyl chloride (PVC) pipe, acrylic, wood, and red paint, we built a simulator and a 150-cm long and 20-to-25-mm thick colonoscope. The colonoscope's handle and handhold were made of acrylic, the colonoscope's mobile end was made with articulated PVC rings, and the up and down movements were performed according to the traction of the steel cables. The camera attached to its distal end enables connection to a smartphone to view the image. In the simulator, the conduit was inserted into the mannequin to simulate the curvatures of the colon. Red spray paint was used to simulate the staining of the colonic mucosa in the inner region of the mannequin and the adventitial layer in the outer region. Results: We were able to build a simulator and a colonoscope with a total amount of R $ 182.82 (roughly US$ 36.50). Both were tested and proved to be useful in the acquisition of psychomotor and cognitive skills in colonoscopy. Conclusion The simulator and colonoscope developed by us are cost-effective, useful in the acquisition of psychomotor and cognitive skills in colonoscopy, and can facilitate the structuring of a training program for undergraduate students. (AU)
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Colonoscopy/education , Education, Medical, Undergraduate , Simulation Training , Colorectal Neoplasms/diagnosis , Low Cost TechnologyABSTRACT
Purpose: The purpose of this study was to evaluate trainee performance across six modules of a virtual reality (VR) simulator. Methods: A retrospective observational study was conducted on 10 manual small-incision cataract surgery (MSICS) trainees who practiced cataract surgery on an MSICS VR simulator for one month. They were assessed in six major steps which included scleral groove, tunnel dissection, keratome entry, capsulorhexis, nucleus delivery, and intraocular lens (IOL) insertion under a trainer抯 supervision. The information included in their score metrics was collected, and their overall performance was evaluated. Results: Thirty attempts were evaluated for scleral groove, tunnel dissection, and capsulorhexis and 15 attempts for keratome entry. Candidates had varied results in the dimensional aspects and their rates of complications with a mean satisfactory score of 3.1 � 4.17, 6.8 � 5.75, 5.8 � 7.74, and 1.8 � 2.57, respectively. Nucleus delivery (n = 5) had more of iris pull and IOL insertion (n = 5) had more of lost IOL as complications but both had a higher satisfactory outcome. Conclusion: A VR simulator is a useful tool for training surgeons before their entry into live surgery. It is an effective method for evaluating objectively the structural characteristics of each phase in MSICS and their associated complications, helping them anticipate it earlier during live surgery by giving them a near real world experience.
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Purpose: Phacoemulsification surgery requires the use of both hands; however, some surgeons may not be comfortable using their non?dominant hand, especially in critical steps such as chopping. This work aims at assessing whether a virtual reality simulator can help cataract surgeons train their non?dominant hand using the capsulorhexis module. Methods: This was a prospective observational study including thirty ophthalmic surgeons; none of them had previous training on the EyeSi surgical simulator. Twenty?three were experienced, and seven were intermediate surgeons. Surgeons were asked to perform capsulorhexis three times using their dominant hand and then using their non?dominant hand. A performance score based on efficiency, target achievement, instrument handling, and tissue treatment was calculated by the simulator. Results: A significant improvement in the score of surgeons using their non?dominant hand from the first trial (69.57 ± 18.9) to the third trial (84.9 ± 9.2) (P < 0.001) was found, whereas such improvement was not noted with the dominant hand (P = 0.12). Twenty?six surgeons managed to reach 90% of the mean score achieved by dominant hand by using their non?dominant hand, 11 (36.7%) from the first trial, seven (23.3%) from the second, and eight (26.7%) from the third. Conclusion: Cataract surgeons showed significant improvement in the scores of their non?dominant hands with simulator training. Thus, it is possible to safely train non?dominant hands for difficult tasks away from the operating room, which would be a fruitful addition to residency training programs
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Purpose: The COVID?19 pandemic has brought medical and surgical training to a standstill across the medical sub?specialties. Closure of outpatient services and postponement of elective surgical procedures have dried up opportunities for training vitreoretinal trainees across the country. This “loss” has adversely impacted trainees’ morale and mental health, leading to feelings of uncertainty and anxiety. Therefore, there is an urgent need to redraw the surgical training program. We aimed to describe a systematic stepwise approach to vitreoretinal surgical training. Methods: We introduced a three?pronged approach to vitreoretinal surgical training comprising learn from home, wet lab and simulator training, and hands?on transfer of surgical skills in the operating room in our institute. Results: Encouraging results were obtained as evaluated by feedback from the trainees about the usefulness of this three?pronged approach in developing surgical skills and building their confidence. Conclusion: The disruption caused by the COVID?19 global pandemic should be used as an opportunity to evolve and reformulate surgical training programs to produce competent vitreoretinal surgeons of the future.
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La pandemia ocasionada por el virus de la COVID-19 determinó que se tomaran medidas sanitarias que afectaron el normal desarrollo, no solo de las actividades laborales sino también de las académicas. La prohibición de la presencialidad en las universidades, específicamente en las facultades de odontología donde la actividad clínica en los últimos tres años de estudio es fundamental para el desarrollo de las competencias procedimentales y actitudinales quedaron totalmente suspendidas. El presente artículo tiene como objetivo revisar el uso de los simuladores pospandemia, como una tecnología que permita, gracias a sus alcances, suplir la presencia de los pacientes. Para ello se realizó una búsqueda de artículos científicos en las siguientes bases de datos: Google académico, MEDLINE/Pub-Med, SciELO, Scopus y LILACS, durante los años 2020-2021; los artículos recolectados estuvieron relacionados con la importancia del uso de simuladores en el desarrollo de las competencias requeridas. De acuerdo con los resultados obtenidos se pudo determinar que el uso de esta tecnología permitió básicamente desarrollar habilidades, destreza y confianza en los estudiantes sin tener que poner en riesgo la salud e integridad física del paciente, con la posibilidad de evaluar y repetir los procedimientos realizados indeterminadamente.
The pandemic caused by the COVID-19 virus led to the adoption of sanitary measures that affected the normal development of not only work activities but also academic ones. The close down of universities, specifically in dental schools where clinical activity in the last three years of study is essential for the development of procedural and attitudinal competencies, was totally suspended. The aim of this article is to review the post-pandemic use of simulators to make up for the presence of patients. For this purpose, a search of scientific articles was performed in the databases Google Scholar, MEDLINE/Pub- Med, SCIelo, Scopus, LILACS, during the years 2020-2021. It is necessarily essential for the faculties to adapt their clinical environments to the installation of this technology, as well as training in its use. The review will seek to show the importance of its use in the development of the required competencies. According to the results, it was determined that the use of this technology, basically allows the development of skills, dexterity and confidence in the students without having to put the health and physical integrity of the patient at risk, with the possibility of evaluating and repeating the procedures performed indefinitely.
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Objective:To evaluate the difference and agreement of cycloplegic refraction between adaptive optics visual simulator (VAO) and conventional refraction methods.Methods:A diagnostic test study was conducted.Thirty-one eyes of 31 healthy subjects including 15 males and 16 females were enrolled in November, 2019 in Affiliated Hospital of North Sichuan Medical College.Mean age of the subjects was (20.1±1.0) years, and the right eye was taken for data analysis.Cycloplegic refraction was measured by VAO and conventional refraction methods, respectively.Spherical power, cylindrical power, Jackson cross-cylinder power at axis 90° and 180° (J 0) and Jackson cross-cylinder power at axis 45° and 135° (J 45) vector powers were recorded.Paired t-test was used to compare the refractive parameters between different refraction methods, and the intraclass correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between VAO and conventional refraction methods.This study adhered to the Declaration of Helsinki, and the research protocal was approved by an Ethics Committee of Affiliated Hospital of North Sichuan Medical College (No.2020ER[A]018). Written informed consent was obtained from each subject prior to any medical examination. Results:For subjective refraction, the ICC for spherical power, cylindrical power, J 0 and J 45 between VAO and phoropter were 0.97, 0.75, 0.84 and 0.09, respectively.For objective refraction, the ICC for spherical power, cylindrical power, J 0 and J 45 between VAO and autorefractor were 0.98, 0.70, 0.74 and 0.61, respectively.The mean differences in spherical power, cylindrical power, J 0 and J 45 between VAO and phoropter were (0.05±0.32), (-0.23±0.28), (-0.10±0.14) and (-0.04±0.16)D, respectively, and the differences in cylindrical power and J 0 were statistically significant (both at P<0.01), whereas no significant differences in spherical power and J 45 were found ( P=0.41, 0.18). The mean differences in spherical power, cylindrical power, J 0 and J 45 measured by VAO and autorefractor were (-0.70±0.26), (-0.07±0.46), (-0.03±0.27) and (0.01±0.12)D, respectively, and the spherical power measurement by VAO was significantly more negative than the autorefractor ( t=15.09, P<0.01), while no significant differences in cylindrical power, J 0 and J 45 were found ( P=0.39, 0.59, 0.63). No significant difference values in spherical power, cylindrical power, J 0 and J 45 were found between the two objective refraction methods and phoropter subjective refraction (all at P>0.05). Conclusions:With cycloplegia, spherical power obtained by VAO objective refraction is more negative compared with autorefractor.There is a good agreement of spherical power and astigmatism vector values measured by VAO and phoropter subjective refraction, and the measurement differences are clinically acceptable.
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Introduction：The relationship between the results of a driving simulator test and a paper-based evaluation of higher brain function were examined.Subjects：The subjects of this study were 203 patients with brain injury who received support to resume driving during hospitalization or outpatient treatment at our hospital between April 1, 2014 and December 31, 2018.Methods：The sex, age, and results of various higher brain function tests of the patients were investigated using medical records and the outcomes of the driving resumption support. The performance on a driving simulator test was compared between patients judged able to and those judged unable to resume driving.Results：In the group of 165 patients who passed the paper-based evaluation of higher brain function, 34 were judged unable to resume driving based on a driving simulator test. In the group that did not pass the paper-based evaluation of higher brain function, 4 patients were also judged unable to resume driving based on a driving simulator test. The results of the higher brain function evaluation were significantly better in the group permitted to resume driving compared with the group not permitted to resume driving in all items except for the Visual Reproduction subtest of the Wechsler Memory Scale-Revised.Conclusions：Evaluations of actual automobile driving using driving simulators or other means are important in assessing driving resumption. Driving requires the use of various higher brain functions and the results of this study suggest that a higher level of ability is required for safe driving.
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@#AIM: To investigate the application and effect of virtual-reality surgery exercise in minimally invasive cataract surgery training for ophthalmology residents.<p>METHODS:Twenty ophthalmology residents with equal seniority who had completed 3a standardized residency training in the Affiliated Eye Hospital of Nanjing Medical University from 2019 to 2021 were prospectively enrolled. After passing the theoretical examination, residents were randomly divided into virtual surgery exercise(Dry-lab)group(<i>n</i>=10)and real animal surgery exercise(Wet-lab)group(<i>n</i>=10). Dry-lab and Wet-lab group residents performed training using the Eye SI surgical simulator and pig eye respectively. At the end of the training, the overall training effects of the residents in both groups were rated using the Eye SI surgical simulator and the real pig eye operation, and the module training effects of the residents in both groups were rated using the virtual surgical simulator. Furthermore, a questionnaire survey was used to objectively evaluate the two training methods.<p>RESULTS:Residents in Dry-lab group had significantly higher total scores on both operation assessments,simulator assessment and real pig eye operation assessment than Wet-lab group(88.03±1.34 <i>vs</i> 80.35±2.87, 87.50±3.03 <i>vs</i> 77.60±5.62, 88.57±1.89 <i>vs</i> 83.10±3.22, all <i>P</i><0.01). The simulator module assessment results showed that the residents in Dry-lab group scored significantly better than Wet-lab group in terms of scores and completion time on each module(<i>P</i><0.01). The questionnaire results showed that Dry-lab group rated better than Wet-lab group in terms of the novelty of training, the proximity to the real surgical experience, the degree of help to the improvement of microsurgery skills, the confidence to perform real surgery, and the overall satisfaction of surgical training(<i>P</i><0.05). <p>CONCLUSION:Applying virtual-reality surgery exercise to cataract surgery skills training for ophthalmology residents can significantly improve the cataract skills, increase overall training satisfaction, and help residents enhance their confidence, psychological quality, decision-making, and processing ability during real surgery at the initial stage of practice. This provides a new standard and model for establishing a formal and standardized cataract surgery training system for ophthalmology residents.
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Resumen Introducción: La exploración cardiaca es una competencia clínica fundamental que requiere exposición o entrenamiento continuo. La baja disponibilidad y accesibilidad de pacientes con patología cardiaca constituye una barrera para adquirir esta competencia. Se han documentado inadecuadas habilidades de auscultación cardiaca en estudiantes de medicina, residentes y médicos graduados. Objetivo: Elaborar y validar un simulador de alta fidelidad y bajo costo para exploración cardiaca. Métodos: Se diseñó y elaboró un simulador para exploración cardiaca, realista y de bajo costo capaz de reproducir ruidos cardiacos normales. Posteriormente se realizó la validación del simulador por un grupo de expertos que emitieron su opinión de acuerdo con una escala tipo Likert. Resultados: El 94 % afirmó que el simulador motiva el aprendizaje de la exploración cardiaca y 92 % lo consideró un modelo realista; 91 % consideró que el simulador es una herramienta atractiva para fortalecer el aprendizaje y 98 % recomendó seguir utilizándolo. Conclusiones: El uso del simulador facilita la adquisición de competencias y estimula el aprendizaje en el estudiante, lo cual puede ser atribuido a la práctica deliberada, a un mayor tiempo de exposición y a la interacción cognitiva.
Abstract Introduction: Heart exploration is an essential clinical competence that requires continuous training and exposure. Low availability and accessibility to patients with heart disease constitutes a barrier to acquiring this competence. Inadequate cardiac auscultation skills in medical students, residents, and graduate physicians have been documented. Objective: To develop and validate a low-cost, high-fidelity simulator for heart exploration. Methods: A low-cost, high-fidelity heart examination simulator capable of reproducing normal cardiac sounds was designed and developed. Subsequently, the simulator was validated by a group of experts who gave their opinion according to a Likert scale. Results: Ninety-four percent agreed that the simulator motivates the learning of heart exploration, and 92 % considered it to be a realistic model; 91 % considered that the simulator is an attractive tool to reinforce learning and 98 % recommended its further use. Conclusions: The use of the simulator facilitates the acquisition of skills and stimulates learning in the student, which can be attributed to repeated practice, longer exposure time and cognitive interaction.
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Humans , Phonocardiography/instrumentation , Heart Sounds , Equipment Design/economics , High Fidelity Simulation Training/methods , Phonocardiography/economics , Reproducibility of Results , High Fidelity Simulation Training/economicsABSTRACT
In view of the problems and shortcomings of the domestic ophthalmic microsurgery training system, drawing lessons from the training programs of famous ophthalmic centers abroad, our hospital has explored a set of hierarchical comprehensive training system for ophthalmic microsurgery. Through the four levels-eight scales microsurgery training, the hierarchical comprehensive training system organically integrates the multimedia theoretical teaching, the microscopic practice of Wet-Lab laboratory, microscopic training of surgical simulator and the clinical practice to achieve a better teaching effect in clinical practice, being widely praised by teachers and students.
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Objective@#To observe the migration of 4,4＇-diaminostilbene-2,2＇-disulfonc acid-based fluorescent whitening agents ( DSD-FWAs ) in food packaging paper, so as to provide evidence for quality and safety supervision for paper packaging materials.@*Methods@#Forty-one paper samples with DSD-FWAs positive were made into 6 cm2 pieces and were soaked in four food simulants ( distilled water, 3% acetic acid, 10% ethanol and 95% ethanol, 10 mL each ). The experiment was carried out at the specified soaking temperature and time. The migration amounts of eleven DSD-FWAs were detected by high performance liquid chromatography-fluorescence detection. @*Results@#C.I.220, C.I.24, C.I.210, C.I.85, C.I.113, C.I.264, C.I.353 and C.I.357 were found in all the four food simulants. At the same time and temperature, the migration amount was highest in 10% ethanol, followed by distilled water, 3% acetic acid and 95% ethanol. C.I.220 was dissolved in all four food simulants, in the range of 20-90 ℃, the migration amount increased with soaking temperature; at 20 ℃, 40 ℃ and 60 ℃, the migration amount increased first and then stabilized over time.@*Conclusion@#The higher the storage temperature and the longer the storage time of paper packaging, the easier the DSD-FWAs in packaging paper migrate to food.
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Accurate CT simulation is the key link of precision radiotherapy, and the performance of the localization couch of CT simulator directly affects the accuracy of radiotherapy. With the rapid development of precision radiotherapy, conventional large aperture radiotherapy special CT simulator is difficult to meet the needs of precision radiotherapy localization, so most radiotherapy centers choose high-end diagnostic CT machines equipped with a flat tabletop for radiotherapy localization. In clinical work, the performance testing of the CT simulator localization couch is easy to be ignored. In addition, there are some problems such as insufficient precision in transforming the cradle-shaped couch top of diagnostic CT into a special flat couch top for radiotherapy. This paper provided an in-depth description of the improved design and performance test of the localization couch of the first special GE Revolution CT simulator for radiotherapy introduced by West China Hospital of Sichuan University. After the improvement, all the acceptance tests of the localization couch are in line with the standard, and the performance meets the high-precision radiotherapy localization needs of patients with different body weight in the center.
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Humans , China , Computer Simulation , Phantoms, Imaging , Radiotherapy Planning, Computer-Assisted , Tomography, X-Ray ComputedABSTRACT
La sutura y el anudado laparoscópico intracorpóreo son las habilidades más difíciles de aprender, las mismas son esenciales para realizar procedimientos laparoscópicos avanzados. Los modelos de entrenamiento laparoscópico permiten facilitar la curva de aprendizaje en un ambiente seguro y sin riesgo para el paciente. La impresión 3D ha revolucionado muchos campos industriales, el presente estudio buscar enlazar la tecnología de impresión 3D con la creación de un modelo anatómico de un estómago inorgánico, para simular una gastrostomía laparoscópica con fines didácticos para los residentes de cirugía general y los cirujanos en formación. Objetivo: Desarrollar un modelo inorgánico de simulación de gastrostomía laparoscópica mediante impresión 3D, como herramienta para la adquisición de habilidades y destrezas en sutura y anudado intracorpóreo. Métodos: Se realizó un estudio de tipo prospectivo, experimental y longitudinal. El autor del presente trabajo, realizó 16 prácticas en caja negra con el modelo de entrenamiento laparoscópico creado y fueron evaluadas mediante la escala GOALS y medición del tiempo de ejecución. Resultados: La puntuación obtenida en la escala GOALS fue de 19 puntos en la primera práctica e incrementó hasta 23 puntos en las últimas prácticas (Tau-C de Kendall=0,89) siendo estadísticamente significativo (p<0,00001). El tiempo disminuyó de la primera practica de 18:30 hasta 6:56 minutos en la última (Tau-C de Kendall=-0,49) siendo estadísticamente significativo (p=0,01). Conclusión: El modelo de entrenamiento creado con impresión 3D permite recrear los pasos para realizar una gastrostomía laparoscópica, y demostró ser una herramienta eficaz en la adquisición de habilidades en sutura y anudado intracorpóreo(AU)
Intracorporeal laparoscopic suturing and knotting are the most difficult skills to learn, and they are essential for performing advanced laparoscopic procedures. Laparoscopic training models facilitate the learning curve in a safe environment without risk for the patient. 3D printing has revolutionized many industrial fields, the present study seeks to link 3D printing technology with the creation of an anatomical model of an inorganic stomach, to simulate a laparoscopic gastrostomy for educational purposes for general surgery residents and surgeons in training. Objetive: develop an inorganic simulation model of laparoscopic gastrostomy using 3D printing, as a tool for the acquisition of skills and abilities in suturing and intracorporeal knotting. Methods: A prospective, experimental and longitudinal study was carried out. The author of this work performed 16 black box practices with the laparoscopic training model created and they were evaluated using the GOALS scale and measurement of execution time. Results: The score obtained on the GOALS scale was 19 points in the first practice and increased to 23 points in the last practices (Kendall's Tau-C = 0.89), being statistically significant (p <0.00001). The time decreased from the first practice from 18:30 to 6:56 minutes in the last one (Kendall's Tau-C = -0.49) being statistically significant (p = 0.01). Conclusion: The training model created with 3D printing allows to recreate the steps to perform a laparoscopic gastrostomy, and proved to be an effective tool in the acquisition of skills in suturing and intracorporeal knotting(AU)
Subject(s)
Longitudinal Studies , Laparoscopy , Printing, Three-Dimensional , Models, Anatomic , Patients , General Surgery , Gastrostomy , Simulation TrainingABSTRACT
Introducción: El uso de simuladores para la enseñanza-aprendizaje de medicina es cada vez más común y actualmente forma parte de la formación médica. Objetivo: Elaborar un simulador y describir la percepción de estudiantes de medicina de la Escuela Superior Politécnica de Chimborazo de un simulador de cateterización venosa de miembro superior. Metodología: Se trata de un estudio transversal, que incluyó 40 estudiantes de cuarto nivel del período académico 2019 quienes evaluaron el simulador. Resultados: El nivel de satisfacción de los estudiantes con el simulador fue del 85%. Los estudiantes consideraron que el simulador les permite aprender la técnica de cateterización venosa periférica previo al conocimiento teórico y de esta manera mejorar su aprendizaje. El 80% considera que los materiales usados fueron los adecuados. El 93% de los estudiantes refieren haber mejorado su seguridad y confianza. Conclusiones: El uso de simuladores en la enseñanza médica mejora la experiencia de aprendizaje de los estudiantes.