Non-invasive laparoscopic detection of small tumors of the digestive tract using inductive sensors of proximity

The precise location of gastric and colorectal tumors is of paramount importance for the oncological surgeon as it dictates the limits of resection and the extent of lymphadenectomy. However, this task proves sometimes to be very challenging, especially in the laparoscopic setting when the tumors are small, have a soft texture, and do not invade the serosa. In this view, our research team has developed a new instrument adapted to minimally-invasive surgery, and manipulated solely by the operating surgeon which has the potential to locate precisely tumors of the digestive tract. It consists of an inductive proximity sensor and an electronic block encapsulated into an autoclavable stainless-steel cage that works in tandem with an endoscopic hemostatic clip whose structure was modified to increase detectability. By scanning the serosal side of the colon or stomach, the instrument is capable to accurately pinpoint the location of the clip placed previously during diagnostic endoscopy on the normal bowel mucosa, adjacent to the tumor. In the current in-vivo experiments performed on large animals, the modified clips were transported without difficulties to the point of interest and attached to the mucosa of the bowel. Using a laparoscopic approach, the detection rate of this system reached 65% when the sensor scanned the bowel at a speed of 0.3 cm/s, and applying slight pressure on the serosa. This value increased to 95% when the sensor was guided directly on the point of clip attachment. The detection rate dropped sharply when the scanning speed exceeded 1 cm/s and when the sensor-clip distance exceeded the cut-off value of 3 mm. In conclusion, the proposed detection system demonstrated its potential to offer a swift and convenient solution for the digestive laparoscopic surgeons, however its detection range still needs to be improved to render it useful for the clinical setting.

Time-Of-Flight monitoring reveals higher sediment redistribution rates related to burrowing animals than previously assumed

Burrowing animals influence surface microtopography and hillslope sediment redistribution, but changes often remain undetected due to a lack of autonomous high resolution field monitoring techniques. In this study we present a new approach to quantify microtopographic variations and surface changes caused by burrowing animals and rainfall-driven erosional processes applied to remote field plots in arid and mediterranean Chile. We compared the mass balance of redistributed sediment within plot areas affected and not affected by burrowing animals, quantified the cumulative sediment redistribution caused by animals and rainfall, and upscaled the results to the hillslope scale. The new instrument showed a very good detection accuracy. The cumulative sediment redistribution within areas affected by burrowing animals was higher (−10.44 cm3 cm−2 year−1) in the mediterranean than the arid climate zone ( −1.41 cm3 cm−2 year−1). Daily sediment redistribution during rainfall within areas affected by burrowing animals were up to 350 % / 40 % higher in the mediterranean / arid zone compared to the unaffected areas, and much higher than previously reported in studies not based on continuous microtopographic monitoring. Furthermore, 38 % of the sediment eroding from the burrows accumulated within the burrow entrance while 62 % was incorporated into overall hillslope sediment flux. The cumulative sediment excavation by the animals was 14.62 cm3 cm−2 year−1 in the mediterranean and 16.41 cm3 cm−2 year−1 in the arid climate zone. Our findings can be implemented into long-term soil erosion models that rely on soil processes but do not yet include animal-induced surface processes on microtopographical scales in their algorithms.

Inclusion at universities: Psychometric properties of an inclusive management scale as perceived by students

Introduction During the last century, the inclusion of all kinds of diversity became a social imperative in all social spaces but above all in some institutions such as the educational ones. Among these, inclusion has been least studied in the tertiary education organizations. This communication proposes and evaluates the psychometric properties of a new instrument, named Inclusive Management in Tertiary Institutions Scale (IMTIS), to assess inclusive management in universities. Method The researchers used a quantitative research model through survey. We based on the Index for Inclusion to design the IMTIS. We first submitted it to the assessment of experts. Then we applied the resulting version in an online survey including a sample of 1557 students from two universities and 121 different undergraduate careers. A panel of experts judged the content validity of the instrument. Participants answered the IMTIS after informed consent. We used confirmatory factor analysis to assess the construct validity of the instrument. We also evaluated the reliability of the measurements. Results From a kit of 33 originally proposed items, we obtained a version of 22 items with CVR between 0.60 and 1.00, and a IVC = 0.78. The confirmatory factor analysis showed that the six-factor solution had a better adjustment than the one and three factors solutions (RMSEA = 0.059; CFI = 0.947; TLI = 0.937). The McDonald ω coefficients were between 0.864 and 0.922. Conclusion The results deliver evidence that supports the validity and reliability of the IMTIS measurements to carry out research and diagnosis of inclusive management in higher education institutions.

The new EU Directive on Transparent and Predictable Working Conditions in the context of new forms of employment

The article examines the reach, protective effects and limitations of the recently adopted European Union (EU) Directive on Transparent and Predictable Working Conditions. After explaining the need for a new instrument, the article analyses the Directive’s protective provisions. Cases of the European Court of Justice are presented to provide the wider context and explain how the EU social acquis impacts upon the implementation of the Directive. Finally, new developments in the EU labour and social field are discussed, making recommendations of possible avenues for providing protection to a larger category of workers.

Development of a Game Communities of Inquiry Scale (GCoIS)

This article introduces a new instrument called the game communities of inquiry scale (GCoIS). It was inspired by the community of inquiry framework and its related questionnaires. The purpose of the scale is to explore game communities from an educational perspective. It was validated with 1,275 players inhabiting digital outlets like Twitch.tv, Reddit, and Discord. Exploratory and confirmatory factor analyses were completed, leading to a final scale composed of 14 items subdivided in three subscales: 1) community attractiveness, 2) community receptiveness, and 3) community cognition. The paper describes the development and testing of the instrument. It concludes with implications for scholars and practitioners who can employ this instrument for understanding game communities and their traits.

Sutureless Manual Extracapsular Cataract Extraction with Lollipop

Purpose: To evaluate the efficacy and safety of cataract extraction through small pupil with the help of a specially designed instrument called lollipop. Study Design: Interventional case series. Place and Duration of Study: Euro eye clinic from January 2019 to December 2019. Methods: Seventeen consecutive patients with pupil diameter of <4mm after maximal pharmacological dilatation were recruited for study. Inclusion criteria was patients with less than 4mm pupil size after maximum pharmacological dilation. Patient with previous anterior segment surgery and small pupil with posterior synechea were excluded. The instrument (lollipop) was originally designed for breaking posterior synechae. Sutureless Manual Extracapsular Cataract Extraction (SMECE), more commonly known as MSICS, was performed in all cases. After tunnel formation and capsulotomy, lollipop was used to bring lens edge out in pupillary margin. Lens was then maneuvered into anterior chamber and expressed out. Results: All 17 patients had successful SMECE. In one patient pupil was stretched before applying instrument. None of the patients had posterior capsular rupture or hyphaema. Conclusion: This instrument designed in Center of Ophthalmic Instrument and Equipment Designing (COIED) is very useful, safe and cost effective. In Extra Capsular Cataract Extraction (ECCE) or SMECE, surgeons usually do keyhole iridotomy, mechanical stretching or multiple sphincterotomies for managing small pupil. With this new instrument, cataract extraction can be done without surgical trauma to the pupil, thus preserving pupil shape. Key Words: Sutureless Manual Extra capsular Cataract Extraction (SMECE), Manual Small Incision Cataract Surgery (MSICS), Miosis.

Development and psychometric testing of a new measure of the determinants that influence the adoption of WhatsApp in hospitals

Background Healthcare contexts are witnessing a growing use of applications to support clinical processes and to communicate between peers and with patients. An increasing number of hospital professionals use instant-messaging applications such as WhatsApp in their daily work. Previous research has mainly focused on the advantages and risks of WhatsApp usage in different clinical settings, but limited evidence is available about whether and how individual and organizational determinants can influence the use of WhatsApp in hospitals. Moreover, instruments to explore this phenomenon are lacking. A theoretical four-factor model based on the ‘Technology Acceptance Model’ and the Institutional Theory, guided the development of a new measure of the individual and institutional determinants of WhatsApp usage in hospitals. Aim To develop and psychometrically test the questionnaire ‘Digital Innovation Adoption in Hospitals’. Method A panel of researchers and clinical experts generated an initial pool of 35 items by identifying and adapting items from existing measures. These items were assessed for content and face validity by fourteen experts. The final 28-item ‘Digital Innovation Adoption in Hospitals’ questionnaire comprising four sections (Perceived risks, Perceived usefulness, Regulative factors and Normative factors) was administered online to nurses and physicians. Construct validity was tested through confirmatory factor analysis. Results The sample included 326 hospital nurses and physicians. The theoretical four-factors model was confirmed and the confirmatory factor analysis yielded acceptable fit indexes. The correlations between the factors were significant and ranged from -0.284 to 0.543 (p < .01). Reliability in terms of internal consistency was satisfactory with Cronbach’s alpha coefficient ranging from 0.918–0.973. Conclusion This study is the first to provide a validated tool to evaluate the use of WhatsApp in hospitals. The new instrument shows reasonable psychometric properties and is a promising and widely applicable measure of factors that influence the use of WhatsApp in hospitals.

Public finance during the reign of Catherine the Great

Subject. We study the main directions and special aspects of the monetary system development during the reign of Catherine II. We discuss the monetary reform associated with the introduction of bank notes and the emergence of the banking system, as well as the creation of new financial systems. Objectives. We focus on identifying the economic reasons that propelled Catherine the Great to use a new instrument of State regulation of the financial system, on showing how the creation of the banking system, still within the conditions of serfdom, acquired its own specifics. Methods. We apply the logical, historical and diachronous approaches, economic research methods. We also use the principles of historical method, dialectics, the method of scientific abstraction and analysis, which determine the foundations of the financial reforms of Catherine the Great. Results. We revealed the role of creating the banking system and non-banking institutions during the second half of the eighteenth century, classified their types and goals, determined the main characteristics of paper money. The monetary reform of Catherine the Great, which created favorable conditions for external borrowings, ensured the recovery of public finance in general. Conclusions. The study concludes on important role of State regulation in the development of financial infrastructure, on the need to use the experience in the modern practice of private enterprise development and capital accumulation. The findings can be used in lectures and seminars for basic courses, like History of Finance and Economic History.