Simulation to become a better neurosurgeon. An international prospective controlled trial: The Passion study.

Introduction: Surgical training traditionally adheres to the apprenticeship paradigm, potentially exposing trainees to an increased risk of complications stemming from their limited experience. To mitigate this risk, augmented and virtual reality have been considered, though their effectiveness is difficult to assess. Research question: The PASSION study seeks to investigate the improvement of manual dexterity following intensive training with neurosurgical simulators and to discern how surgeons' psychometric characteristics may influence their learning process and surgical performance. Material and methods: Seventy-two residents were randomized into the simulation group (SG) and control group (CG). The course spanned five days, commencing with assessment of technical skills in basic procedures within a wet-lab setting on day 1. Over the subsequent core days, the SG engaged in simulated procedures, while the CG carried out routine activities in an OR. On day 5, all residents' technical competencies were evaluated. Psychometric measures of all participants were subjected to analysis. Results: The SG demonstrated superior performance (p < 0.0001) in the brain tumour removal compared to the CG. Positive learning curves were evident in the SG across the three days of simulator-based training for all tumour removal tasks (all p-values <0.05). No significant differences were noted in other tasks, and no meaningful correlations were observed between performance and any psychometric parameters. Discussion and conclusion: A brief and intensive training regimen utilizing 3D virtual reality simulators enhances residents' microsurgical proficiency in brain tumour removal models. Simulators emerge as a viable tool to expedite the learning curve of in-training neurosurgeons.

Molecular design for moisture insensitivity of compositionally graded hybrid films.

Effective bonding of organic/inorganic interfaces especially in high humidity environments is paramount to the structural reliability of modern multilayer device technologies, such as flexible electronics, photovoltaics, microelectronic devices, and fiber-metal laminates used in aerospace applications. We demonstrate the ability to design compositionally graded hybrid organic/inorganic films with an inorganic zirconium network capable of forming a moisture-insensitive bond at the interface between an oxide and organic material. By controlling the chemistry of the deposited films and utilizing time-dependent debonding studies, we were able to correlate the behavior of the hybrid films at high humidity to their underlying molecular structure. As a result, an outstanding threefold improvement in adhesion of silicon/epoxy interfaces can be obtained with the introduction of these films even in high humidity environments.

Heterogeneous solution deposition of high-performance adhesive hybrid films.

Interfaces between organic and inorganic materials are of critical importance to the lifetime of devices found in microelectronic chips, organic electronics, photovoltaics, and high-performance laminates. Hybrid organic/inorganic materials synthesized through sol-gel processing are best suited to address these challenges because of the intimate mixing of both components. We demonstrate that deposition from heterogeneous sol-gel solutions leads to the unique nanolength-scale control of the through-thickness film composition and therefore the independent optimization of both the bulk and interfacial film properties. Consequently, an outstanding 3-fold improvement in the adhesive/cohesive properties of these hybrid films can be obtained from otherwise identical precursors.