Reality In Terms Research Articles

Face, content, and construct validity of a simulator for training in endovascular procedures

Aim: In recent years the interest in structured training programs in endovascular surgical procedures has increased. In this study we assess face, content, and construct validity of a simulator to teach basic skills of endovascular surgery.Material and methods: A cohort of 21 medical students, 26 residents, and 14 expert surgeons participated in the study. Experts assessed face and content validity. Then, they executed four tasks once, while medical students and residents were allowed two attempts to reach a five-minute threshold under expert supervision. Medical students and residents repeated the same exercises during a second session plus three new additional ones, without expert supervision.Results: The simulator was rated as good by experts (four out of five on a Likert scale) in terms of realism (face validity) and usefulness as training tool for the training of basic skills (content). For construct validity, experts outperformed with a statistically significant difference (p < .05) medical students and residents in all tasks, except cannulation of upper mesenteric (p = .053). Differences between novices and intermediates persisted in the second session in the same four tasks and in the three additional ones, with statistically significant difference (p < .05) in the last four exercises.Conclusions: This study showed face, content, and construct validity of BEST simulator.

Team training and assessment in mixed reality-based simulated operating room : Current state of research in the field of simulation in spine surgery exemplified by the ATMEOS project

Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions. Using amixed reality approach, asynthetic patient model, real surgical instruments and radiation-free virtual X‑ray imaging are combined into asimulation of spinal surgery. In previous research studies, the concept was evaluated in terms of realism, plausibility and immersiveness. In the current research, assessment measurements for technical and non-technical skills are developed and evaluated. The aim is to observe multidisciplinary surgical teams in the simulated operating room during minimally invasive spinal surgery and objectively assess the performance of the individual team members and the entire team. Moreover, the effectiveness of training methods and surgical techniques or success critical factors, e. g. management of crisis situations, can be captured and objectively assessed in the controlled environment.

Virtual Reality as an Educational and Training Tool for Medicine.

Until very recently, we considered Virtual Reality as something that was very close, but it was still science fiction. However, today Virtual Reality is being integrated into many different areas of our lives, from videogames to different industrial use cases and, of course, it is starting to be used in medicine. There are two great general classifications for Virtual Reality. Firstly, we find a Virtual Reality in which we visualize a world completely created by computer, three-dimensional and where we can appreciate that the world we are visualizing is not real, at least for the moment as rendered images are improving very fast. Secondly, there is a Virtual Reality that basically consists of a reflection of our reality. This type of Virtual Reality is created using spherical or 360 images and videos, so we lose three-dimensional visualization capacity (until the 3D cameras are more developed), but on the other hand we gain in terms of realism in the images. We could also mention a third classification that merges the previous two, where virtual elements created by computer coexist with 360 images and videos. In this article we will show two systems that we have developed where each of them can be framed within one of the previous classifications, identifying the technologies used for their implementation as well as the advantages of each one. We will also analize how these systems can improve the current methodologies used for medical training. The implications of these developments as tools for teaching, learning and training are discussed.

Continuous-time general link transmission model with simplified fanning, Part I: Theory and link model formulation

The kinematic wave theory is widely used to simulate traffic flows on road segments. Link transmission models are methods to find a solution to the kinematic wave model, however, their computational efficiency heavily relies on the shape of the fundamental diagram that is used as input. Despite the limitations and drawbacks of triangular and piecewise linear fundamental diagrams, they remain popular because they result in highly efficient algorithms. Using smooth nonlinear branches is often preferred in terms of realism and other desirable properties, but this comes at a significantly higher computational cost and requires time discretization to find an approximate solution. In this paper we consider a nonlinear fundamental diagram as input and propose on-the-fly multi-step linearization techniques to simplify expansion fans. This leads to two simplified link transmission models that can be solved exactly in continuous time under the assumption of piecewise stationary travel demand. One of the models simplifies to shockwave theory in case of a single step. We show that embedding shockwave theory in the link transmission model allows for finding an exact solution in continuous time and we discuss the potential for the design of efficient event-based algorithms for general networks.

Seeing is Believing? Comparing Negative Affect, Realism and Presence in Visual Versus Written Guardianship Scenarios

ABSTRACTWe compared participant responses on three written guardianship scenarios versus visualized versions of the same scenarios in terms of realism, presence, negative affect elicited by the situation, perceived risk, and the choice to intervene. We find that people who received the visual scenarios report higher presence, but not realism, than those who received the written version. Furthermore, visual scenarios elicited stronger negative affect and resulted in a lower likelihood to intervene. Finally, presence, but not negative affect, mediated the relation between condition and the choice to intervene. Implications of the visual scenario method for future research are discussed.

The Realities of 'Reality' - Part I: It All Starts from Within

If this year was the year 202018, meaning 200,000 years from now and I was writing about reality, where would I begin? What would be the basis that I would use for my arguments? Would I still be able to talk about philosophy, psychology, art, mathematics, chemistry, physics and quantum mechanics? Would I be able to talk about the brain and the mind the same way I do today? Would I be able to speculate about life and death? Would these topics still be relevant in the grand scheme of things? 200,000 years from now, would it still be necessary to speculate about reality anyway? Although the answers to such questions can be either ‘may be’ or ‘may be not’, one thing is certain: 200,000 years from now, humans, if we’re still around, will be different, so different that the disparity will be similar to an insect’s egg and the final stage of its metamorphosis: an imago, the larva and pupa stages being in between. Well, in terms of reality, when the first Homo Sapiens emerged 200,000 years ago, he had no idea what reality would be like today in 2018. His reality was limited to trying to survive in a harsh environment. He had to first learn how to make fire, gather, then grown his own food and hunt just to survive. Say our species is still around 200,000 years from now, what we are capable of in 2018, compared to what we will be capable of then is comparable to the first humans’ reality 200,000 years ago. The fact is, humans’ reality is not constant. It’s variable, fluid… This series looks at reality in different angles. It goes back and forth in time to explain the versatility of reality. Through the topics that I will discuss, I will attempt to explain why Man is still puzzled by reality after 200,000 years of existence.

New Advanced Bench Model for Flexible Ureteroscopic Training: The Smart Simulator.

Smart Simulator is a new advanced bench training model for achieving proficiency in flexible ureteroscopy (fURS). Its important features are portability and the ability to simulate breathing-induced kidney movements, model pyelocalices similar to those in humans, create a situation closely resembling a fURS field, and create papillae of a size equivalent to that of the access sheath. Smart Simulator thus creates a situation more closely resembling that in a clinical setting than the other bench training models for fURS. Sixteen urologists experienced in fURS assessed the Smart Simulator for face validity and content validity. The model was acceptable in terms of realism, acceptability, and feasibility. Trainees can use it to practice laser manipulation for kidney stone fragmentation and retrieval in accord with breathing-induced movements and various other created fields sometimes confronted during fURS. Training in situations in nearly real fURS surgical fields may improve trainees' technical skills.

Why do some countries grow and others stagnate?

Why does some countries’ economy keep developing and why does some countries’ economy fall into stagnation? Actually the two situations are essentially “two sides of a coin”. People’s cognition of these questions has experienced a long developing history. There are many factors which have an impact on economic growth and development in terms of reality. Although economic growth and development are different, economic growth is undoubtedly the core of economic development. In terms of the relationship with economic growth, the factors that affect economic growth can be divided into total factors and structural factors. Total factors include savings, investment, human capital accumulation, technology progress, population and natural resources, etc. Structural factors include foreign trade, income distribution, institutional system and industrial policy, etc. It should be noted that factors mentioned above can affect a country’s economic growth and development, but they don’t work automatically or mechanically. A mechanism is necessary for these factors to work alone or interactively. Generally, human society could progress in three patterns, namely, revolution, evolution and involution. Looking back over the past few hundreds of years, it is found that these three patterns have appeared in both the West and the East and have performed completely different results. It is necessary to mention Chinese economy when it comes to economic development or economic stagnation. Since reform and opening up, Chinese economy has achieved rapid progress resulting from “open door policy” and “marketization and liberalization policy”. “Open door policy” means active communication with foreign countries. “Marketization and liberalization policy” generally refers to a variety of domestic economic reforms, including establishment of price incentives, institutional incentives and other incentives. “Marketization and liberalization policy” also encourages the market mechanism to play a leading role in resources distribution. Like many other countries, after several years of rapid growth, Chinese economy is also facing the constraint of “negative feedback mechanism” and its economic growth is going to pace into a “new normal”. Without firm reactions, China could fall into the “middle income trap”. Thus China should pay more attention to encouraging leading technology innovation, changing the economic growth, compensating the parity of income distribution and so on. In general, economic growth and development are a very complex issue. It is difficult to answer accurately that what factors determine the prosperity and decline of these countries. Each country should summarize experience of other countries and combine their own specified conditions with the experience so as to form a development pattern which is suited to their economy situation. At the same time, the countries should pay attention to adjustment and innovation of the development pattern during the process in order to move forward.

Model-Based Generation of Large Databases of Cardiac Images: Synthesis of Pathological Cine MR Sequences From Real Healthy Cases.

Collecting large databases of annotated medical images is crucial for the validation and testing of feature extraction, statistical analysis, and machine learning algorithms. Recent advances in cardiac electromechanical modeling and image synthesis provided a framework to generate synthetic images based on realistic mesh simulations. Nonetheless, their potential to augment an existing database with large amounts of synthetic cases requires further investigation. We build upon these works and propose a revised scheme for synthesizing pathological cardiac sequences from real healthy sequences. Our new pipeline notably involves a much easier registration problem to reduce potential artifacts, and takes advantage of mesh correspondences to generate new data from a given case without additional registration. The output sequences are thoroughly examined in terms of quality and usability on a given application: the assessment of myocardial viability, via the generation of 465 synthetic cine MR sequences (15 healthy and 450 with pathological tissue viability [random location, extent, and grade, up to myocardial infarct]). We demonstrate that: 1) our methodology improves the state-of-the-art algorithms in terms of realism and accuracy of the simulated images and 2) our methodology is well-suited for the generation of large databases at small computational cost.

Lip syncing method for realistic expressive 3D face model

Lip synchronization of 3D face model is now being used in a multitude of important fields. It brings a more human, social and dramatic reality to computer games, films and interactive multimedia, and is growing in use and importance. High level of realism can be used in demanding applications such as computer games and cinema. Authoring lip syncing with complex and subtle expressions is still difficult and fraught with problems in terms of realism. This research proposed a lip syncing method of realistic expressive 3D face model. Animated lips requires a 3D face model capable of representing the myriad shapes the human face experiences during speech and a method to produce the correct lip shape at the correct time. The paper presented a 3D face model designed to support lip syncing that align with input audio file. It deforms using Raised Cosine Deformation (RCD) function that is grafted onto the input facial geometry. The face model was based on MPEG-4 Facial Animation (FA) Standard. This paper proposed a method to animate the 3D face model over time to create animated lip syncing using a canonical set of visemes for all pairwise combinations of a reduced phoneme set called ProPhone. The proposed research integrated emotions by the consideration of Ekman model and Plutchik’s wheel with emotive eye movements by implementing Emotional Eye Movements Markup Language (EEMML) to produce realistic 3D face model.

Uneven development, suburban futures and the urban region: The case of an Irish ‘sustainable new town’

This paper seeks to situate narratives of sustainable urban development within the wider context of political economic urban transformations shaping urban city regions. In drawing upon the development of a master-planned sustainable development called Adamstown, situated on the outskirts of Dublin, Ireland, the paper will unpack the relationship between ideals of urban and suburban sustainability within the context of Ireland’s recent economic boom and bust, along with its repackaging via national and international actors. The paper demonstrates the shortcomings of the ideal of sustainability in the context of neoliberal urban development dominated by private actors, and facilitated by state-led governance mechanisms. It argues that while the official invocation of urban sustainable communities attempts to highlight them as ‘different’ and ‘unique’, they remain inextricably intertwined with wider urban regional processes, which are themselves becoming increasingly internationalized in terms of reality.

Perception of simulation training in emergencies for dental sedation practitioners.

Simulation education is an important part of health care education and training. There is growing evidence to support the usefulness of simulation, especially in training for infrequently occurring situations, such as medical emergencies seen by dental practitioners. There are, however, few data on the longer term effects of simulation, including usefulness, relevance, emotional effect and ability to affect changes to daily practice. Dentists and dental nurses who had undergone simulation training in medical emergencies for dental sedation practitioners undertook a semi-structured interview about their perception of the simulation experience. They explored recollection of the experience and its emotional weight, perception of usefulness and relevance, specific learning outcomes and changes to practice prompted by the simulation session. Participants reported finding the simulation sessions worthwhile, realistic, challenging and almost universally emotionally positive. Insitu simulation training was particularly well received, both in terms of realism, as well as identifying system flaws in emergency drugs and equipment. Participants reported gaining both increased clinical knowledge and human factors skills, which were reflected in subsequent changes to their practice. There are few data on the longer term effects of simulation DISCUSSION: Our results support the usefulness and applicability of simulation education to training in medical emergencies for dental sedation practitioners. In particular, specific benefits reported from insitu sessions and in human factors concepts will prompt us to review the structure of our teaching to maximise the benefit to participants.

Thought Experiments in Philosophy of Religion: The Virtues of Phenomenological Realism and Values

Abstract We present a criterion for the use of thought experiments as a guide to possibilia that bear on important arguments in philosophy of religion. We propose that the more successful thought experiments are closer to the world in terms of phenomenological realism and the values they are intended to track. This proposal is filled out by comparing thought experiments of life after death by Peter van Inwagen and Dean Zimmerman with an idealist thought experiment. In terms of realism and values we contrast an exemplary thought experiment by Iris Murdoch with one we find problematic by William Irwin.

Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study.

The 3D volume-rendering technique (VRT) is commonly used in forensic radiology. Its main function is to explain medical findings to state attorneys, judges, or police representatives. New visualization algorithms permit the generation of almost photorealistic volume renderings of CT datasets. The objective of this study is to present and compare a variety of radiologic findings to illustrate the differences between and the advantages and limitations of the current VRT and the physically based cinematic rendering technique (CRT). Seventy volunteers were shown VRT and CRT reconstructions of 10 different cases. They were asked to mark the findings on the images and rate them in terms of realism and understandability. A total of 48 of the 70 questionnaires were returned and included in the analysis. On the basis of most of the findings presented, CRT appears to be equal or superior to VRT with respect to the realism and understandability of the visualized findings. Overall, in terms of realism, the difference between the techniques was statistically significant (p < 0.05). Most participants perceived the CRT findings to be more understandable than the VRT findings, but that difference was not statistically significant (p > 0.05). CRT, which is similar to conventional VRT, is not primarily intended for diagnostic radiologic image analysis, and therefore it should be used primarily as a tool to deliver visual information in the form of radiologic image reports. Using CRT for forensic visualization might have advantages over using VRT if conveying a high degree of visual realism is of importance. Most of the shortcomings of CRT have to do with the software being an early prototype.

Representing and enacting movement: The body as an instructional resource in a simulator-based environment

Simulators are used to practice in a safe setting before training in a safety-critical environment. Since the nature of situations encountered in high-risk domains is complex and dynamic, it is considered important for the simulation to resemble conditions of real world tasks. For this reason, simulation-based training is often discussed in terms of realism in relation to real world work practices. However, regardless of the realism of the simulator, there are always glitches in the perception of the simulation as a realistic work setting. In this study video-recorded data is used to explore these glitches between a simulation and the real world. The analysis is focused on maritime instructors’ use of body and talk to represent aspects of the real world missing in high-fidelity simulators. Moreover, the study explores the role of these representations in developing the students’ understanding of the ship’s movements in manoeuvring also in a simulator environment. Results show that instructions given in the simulator have the potential to facilitate students’ learning of the ship’s movements by using the body as an instructional resource. In the study, a combination of bodily conduct and instructive talk that are coupled towards the simulator, as well as aspects of an imagined real world, is used to address glitches in the simulator. The results contribute to a growing corpus of research, which show that realism in simulator-based training is an instructional achievement rather than a matter of technical fidelity of the simulator.

The Taxonomy of Clinics: The Realities and Risks of All Forms of Clinical Legal Education

As clinical legal education (CLE) is becoming an increasingly popular form of teaching in law schools across the globe,2 it is important for institutions to consider the realities and risks of each kind of model. Certain kinds of CLE may be a very realistic portrayal or simulative of practice, but carry more risks to those involved. This article explores the realities and risks3 of all kinds of CLE by using an ordinal scale to measure them. This scale was tested at the 8th Worldwide GAJE Conference in Turkey. Those who attended the session became the scale themselves, moving and discussing the kinds of CLE to where they believed they were in terms of reality and risk. This article analyzes the results of that session, exploring what some clinicians from across the globe think of the realities and risks of CLE, and whether we can balance them together to provide students with a sound educational experience. As clinicians, we aim to expose our students to the realities of practice whilst keeping the risks involved to an absolute minimum so that they gain a practical legal education without any adverse effects.

Realização de visita técnica na formação de acadêmicos de enfermagem: estudo descritivo

Aim: to identify, according to the perception of nursing students, whether the technical visits contribute to training and management in nursing. Method: this is a descriptive study whose data has been obtained in semi-structured interviews with eleven (11) students of the nursing undergraduate course. After transcribing the interviews, we used content analysis. Results: The technical visit is an effective tool in the teaching and learning of the nursing administration process. It assists scholars in the perception of the relation between theory and practice, provides the development of a critical and reflexive view in terms of reality and fosters awareness regarding the relation between management and nursing care/patient care. Conclusion: The technical visit was considered an effective teaching tool to promote an approach to the reality of the labor market by decreasing the distance between theory and practice.

Les neuroprothèses

IntroductionNeuroprostheses are electronic or electromechanical devices connected to the nervous system to replace a defective organ. This article aims to review the state of the art of these devices. MethodsThis article successively presents various neuroprostheses. While cochlear implants have existed now for almost 60 years, in the last decade, technological solutions to restore other senses, such as sight with artificial retinas, and touch with artificial skins, have made significant progress. Similarly, myoprostheses, brain-machine interfaces and exoskeletons, which aim to restore the control of a limb, often make headlines in the news. Myoprostheses are intended to compensate for the lack of an amputated upper limb by registering nerve impulses transmitted to the muscles from the skin surface to control a prosthetic hand. Brain-computer interfaces register neural activity within the motor cortex, or more rarely from the surface of the scalp, to decode the motor order and transmit it to a motorized limb. Finally, exoskeletons are mechanical structures enveloping all or part of the body to animate it. ResultsCochlear implants and myoelectric prosthetics are now regularly offered for people with severe or profound hearing loss and for forearm amputees. Increasing the resolution of artificial retinas should help in the medium term to offer a basic visual perception of their environment, if not to people blind from birth, at least to macular degeneration sufferers. Finally, non-invasive motor neuroprostheses are now being included in rehabilitation programs for stroke. Invasive neuroprostheses actually able to decode the direction of movement will still require many years of research, in particular to integrate sensory feedback. DiscussionThus, beyond the spectacular aspect of communications on the subject to get the attention of the public and funders, and the enthusiasm for novelty of journalists, the real issues are the expectations of potential users, the disappointments and satisfactions of patients, the actual number of people equipped, and cost and scope for use of such devices outside the laboratories. ConclusionThis article aims to position these new technologies in terms of reality and fiction, in terms of the expectations of people with a disability and fantasies of the augmented human, and in terms of the scientific difficulties encountered.

Validation of a virtual reality-based simulator for shoulder arthroscopy.

This study was to determine face and construct validity of a new virtual reality-based shoulder arthroscopy simulator which uses passive haptic feedback. Fifty-one participants including 25 novices (<20 shoulder arthroscopies) and 26 experts (>100 shoulder arthroscopies) completed two tests: for assessment of face validity, a questionnaire was filled out concerning quality of simulated reality and training potential using a 7-point Likert scale (range 1-7). Construct validity was tested by comparing simulator metrics (operation time in seconds, camera and grasper pathway in centimetre and grasper openings) between novices and experts test results. Overall simulated reality was rated high with a median value of 5.5 (range 2.8-7) points. Training capacity scored a median value of 5.8 (range 3-7) points. Experts were significantly faster in the diagnostic test with a median of 91 (range 37-208) s than novices with 1177 (range 81-383) s (p<0.0001) and in the therapeutic test 102 (range 58-283) s versus 229 (range 114-399) s (p<0.0001). Similar results were seen in the other metric values except in the camera pathway in the therapeutic test. The tested simulator achieved high scores in terms of realism and training capability. It reliably discriminated between novices and experts. Further improvements of the simulator, especially in the field of therapeutic arthroscopy, might improve its value as training and assessment tool for shoulder arthroscopy skills. II.

Znamiona realizmu w koncepcji pedagogicznej Edmunda Bojanowskiego oraz w podstawach procesu jej zmian adaptacyjnych i zachowania tożsamości

Opening orphanages, E. Bojanowski created and perfected his pedagogical concept of education. He shaped its philosophical base in terms of realism, which is only possible in a context that is consistent with a factual reading of the world in which people and things exist. He based his thinking on philosophical anthropology, the Bible, and the Church's teachings, which indicated that man is a unity of body and soul, a person, a child of God. This integral and realistic conception of man resulted in the need for his integral development and education. Bojanowski created a system of early education that takes into account the achievements, in thought and practice, of the Church in education, culture, history and tradition, as well as the specificity of the natural environment, the overall factors influencing the child's upbringing and the organization of institutions. Fidelity to accepted assumptions still ensures the continuation and implementation of adaptive changes while maintaining the identity of the concept and the reconstruction of his integral pedagogy in relation to realistic Thomistic philosophy.