Augmented Reality to Assist Skin Paddle Harvesting in Osteomyocutaneous Fibular Flap Reconstructive Surgery: A Pilot Evaluation on a 3D-Printed Leg Phantom

BackgroundAugmented Reality (AR) represents an evolution of navigation-assisted surgery, providing surgeons with a virtual aid contextually merged with the real surgical field. We recently reported a case series of AR-assisted fibular flap harvesting for mandibular reconstruction. However, the registration accuracy between the real and the virtual content needs to be systematically evaluated before widely promoting this tool in clinical practice. In this paper, after description of the AR based protocol implemented for both tablet and HoloLens 2 smart glasses, we evaluated in a first test session the achievable registration accuracy with the two display solutions, and in a second test session the success rate in executing the AR-guided skin paddle incision task on a 3D printed leg phantom.MethodsFrom a real computed tomography dataset, 3D virtual models of a human leg, including fibula, arteries and skin with planned paddle profile for harvesting, were obtained. All virtual models were imported into Unity software to develop a marker-less AR application suitable to be used both via tablet and via HoloLens 2 headset. The registration accuracy for both solutions was verified on a 3D printed leg phantom obtained from the virtual models, by repeatedly applying the tracking function and computing pose deviations between the AR-projected virtual skin paddle profile and the real one transferred to the phantom via a CAD/CAM cutting guide. The success rate in completing the AR-guided task of skin paddle harvesting was evaluated using CAD/CAM templates positioned on the phantom model surface.ResultsOn average, the marker-less AR protocol showed comparable registration errors (ranging within 1-5 mm) for tablet-based and HoloLens-based solution. Registration accuracy seems to be quite sensitive to ambient light conditions. We found a good success rate in completing the AR-guided task within an error margin of 4 mm (97% and 100% for tablet and HoloLens, respectively). All subjects reported greater usability and ergonomics for HoloLens 2 solution.ConclusionsResults revealed that the proposed marker-less AR based protocol may guarantee a registration error within 1-5 mm for assisting skin paddle harvesting in the clinical setting. Optimal lightening conditions and further improvement of marker-less tracking technologies have the potential to increase the efficiency and precision of this AR-assisted reconstructive surgery.

A Novel Method for Source Tracking of Chemical Gas Leakage: Outlier Mutation Optimization Algorithm

Chemical industrial parks, which act as critical infrastructures in many cities, need to be responsive to chemical gas leakage accidents. Once a chemical gas leakage accident occurs, risks of poisoning, fire, and explosion will follow. In order to meet the primary emergency response demands in chemical gas leakage accidents, source tracking technology of chemical gas leakage has been proposed and evolved. This paper proposes a novel method, Outlier Mutation Optimization (OMO) algorithm, aimed to quickly and accurately track the source of chemical gas leakage. The OMO algorithm introduces a random walk exploration mode and, based on Swarm Intelligence (SI), increases the probability of individual mutation. Compared with other optimization algorithms, the OMO algorithm has the advantages of a wider exploration range and more convergence modes. In the algorithm test session, a series of chemical gas leakage accident application examples with random parameters are first assumed based on the Gaussian plume model; next, the qualitative experiments and analysis of the OMO algorithm are conducted, based on the application example. The test results show that the OMO algorithm with default parameters has superior comprehensive performance, including the extremely high average calculation accuracy: the optimal value, which represents the error between the final objective function value obtained by the optimization algorithm and the ideal value, reaches 2.464e-15 when the number of sensors is 16; 2.356e-13 when the number of sensors is 9; and 5.694e-23 when the number of sensors is 4. There is a satisfactory calculation time: 12.743 s/50 times when the number of sensors is 16; 10.304 s/50 times when the number of sensors is 9; and 8.644 s/50 times when the number of sensors is 4. The analysis of the OMO algorithm’s characteristic parameters proves the flexibility and robustness of this method. In addition, compared with other algorithms, the OMO algorithm can obtain an excellent leakage source tracing result in the application examples of 16, 9 and 4 sensors, and the accuracy exceeds the direct search algorithm, evolutionary algorithm, and other swarm intelligence algorithms.

IMPLEMENTING THE ARCS MOTIVATIONAL INSTRUCTIONAL DESIGN MODEL TO IMPROVE LEARNING SUPPORT OF DISTANT LEARNING STUDENTS

This study aims to elaborate the use of an instructional design model to enhance the effectiveness of conducting face-to-face students' learning support in the distance education system. Universitas Terbuka (UT) provides various learning supports for its students. The students can use both online and face-to-face tutorial programs to improve their learning process. UT must find the appropriate instructional strategy that enables to enhance students’ motivation in learning. One of the instructional design models that focus on the effort of improving students’ motivation in learning is the ARCS, motivational instructional design model. This model entails essential components that will support the process of learning such as Attention, Relevance, Confidence, and Satisfaction. The study involved 32 distant education students who participated in a face-to-face tutorial program. A pre and post-test session was conducted to get information regarding the impact of using the ARCS instructional design model to facilitate students’ learning. This research has implications for educators or trainers related to designing learning scenarios or developing learning design models.

Comparison of Methamphetamine and MDMA Extended Access Self-administration: Acquisition, Maintenance, and Response Patterns

<p>Rationale. 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine are two amphetamine derivatives with contrasting pharmacological profiles. Therefore, self- administration profiles might be expected to reflect these differences. Objectives. This study compared the latency and proportion to acquire self-administration, maintenance of self-administration, and within-session response patterns. Methods. Rats were given extended access (8-hour daily sessions) to either methamphetamine, MDMA or vehicle self-administration over a period of 10 consecutive days. A criterion based on the performance of the vehicle control group was used to determine acquisition of reliable MDMA and methamphetamine self-administration. In conjunction, for MDMA self-administration the infusion dose was halved for each rat that achieved a total of 85mg/kg for the remaining sessions. Temporal patterns of responding were assessed using hourly data of the first day of self-administration, the day following acquisition, and the final day of self-administration. Results. A greater proportion of rats in the methamphetamine group acquired self- administration and self-administration was acquired with a shorter latency compared to the MDMA group. Responding maintained by methamphetamine on day one was high. By the third day a pattern developed that was maintained throughout testing. The greatest proportion of responding occurring within the first hour of each daily test session. A progressive escalation of intake was also observed within the methamphetamine group. Responding maintained by MDMA was low on the first day, but by day 5 responding had increased with most of the responding within the session occurring during the first three hours. On day 10 the greatest amount of responding occurred during the first hour. No escalation of intake as a function of test day was observed for MDMA self-administration.</p>

Comparison of Methamphetamine and MDMA Extended Access Self-administration: Acquisition, Maintenance, and Response Patterns

<p>Rationale. 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine are two amphetamine derivatives with contrasting pharmacological profiles. Therefore, self- administration profiles might be expected to reflect these differences. Objectives. This study compared the latency and proportion to acquire self-administration, maintenance of self-administration, and within-session response patterns. Methods. Rats were given extended access (8-hour daily sessions) to either methamphetamine, MDMA or vehicle self-administration over a period of 10 consecutive days. A criterion based on the performance of the vehicle control group was used to determine acquisition of reliable MDMA and methamphetamine self-administration. In conjunction, for MDMA self-administration the infusion dose was halved for each rat that achieved a total of 85mg/kg for the remaining sessions. Temporal patterns of responding were assessed using hourly data of the first day of self-administration, the day following acquisition, and the final day of self-administration. Results. A greater proportion of rats in the methamphetamine group acquired self- administration and self-administration was acquired with a shorter latency compared to the MDMA group. Responding maintained by methamphetamine on day one was high. By the third day a pattern developed that was maintained throughout testing. The greatest proportion of responding occurring within the first hour of each daily test session. A progressive escalation of intake was also observed within the methamphetamine group. Responding maintained by MDMA was low on the first day, but by day 5 responding had increased with most of the responding within the session occurring during the first three hours. On day 10 the greatest amount of responding occurred during the first hour. No escalation of intake as a function of test day was observed for MDMA self-administration.</p>

Feasibility of the ACTPlan Program for African American Dementia Caregivers: A Self-Directed Multimedia Delivery

African Americans (AA) are less likely than White Americans to complete advance care plans or end-of-life treatment documents. They face significantly greater risk of Alzheimer’s Disease, a silent epidemic for this population, and other dementias. The healthcare system’s lack of dementia support for AAs contributes to disparate care. A four-session caregiver group education program was conducted on advance care planning for AA dementia family providers. The program was based on Kolb’s Experiential Learning Model and initially found effective in an R01 study using in-person delivery by a professional. The present pilot assessed feasibility of delivering the program in a self-directed multimedia format without professional facilitation, using Session 1 on tube feeding decisions as the test session. Twenty-six AA dementia caregivers completed the session in groups of 5 to 8 at a church equipped with a large TV screen. On-screen prompts guided navigation through the program which included recorded lecture, slides, short videos on decision-making, and group discussions. Using quantitative and qualitative methods, pre-and post-survey instruments were administered and interviews conducted. Usability ratings averaged 84%. Knowledge and self-efficacy gains exceeded those of the R01, with a 35% increase in correct responses on knowledge items, versus 18% for the R01 subjects; and increase in perceived decisional self-efficacy of 31% versus 30% for the R01 subjects. Qualitative feedback was universally positive. These findings confirm the feasibility of the self-guided multimedia approach to delivery of the program. A large RCT is planned which, if successful, will support wide dissemination to AA caregivers in need.

PENINGKATAN PEMAHAMAN KEPADA CALON JAKSA TERHADAP KEBIJAKAN HUKUM PIDANA DI BIDANG LINGKUNGAN HIDUP

The environment is a public interest that must be guarded and protected by the state. One form of protection provided by the state is through the mechanism of the criminal justice system. In carrying out this system, prosecutors play an important role in prosecuting cases in the environmental field. Therefore, an understanding of criminal law policies in the environmental field is important. This time the provision of understanding on criminal law policies in the environmental field was given to prospective prosecutors through classes held by the Education and Training Agency of the Attorney General's Office of the Republic of Indonesia. This activity is carried out using zoom media. The lecture method was chosen as part of the way to carry out community service activities this time. In addition to the lecture, at the end of the session, a question-and-answer discussion was held and a test session was held for each participant. This is done to obtain information whether the participants have understood the material that has been given. This level of understanding needs to be known as an indicator of increasing environmental law awareness among prospective prosecutors. After giving the material, the prospective prosecutors will get an increased understanding of the offense in the environmental field, the criminal sanctions that can be imposed on the offense and how to prosecute the offense.Lingkungan hidup merupakan kepentingan publik yang harus dijaga dan dilindungi oleh negara. Salah satu bentuk perlindungan yang diberikan oleh negara adalah melalui mekanisme sistem peradilan pidana. Dalam memainkan sistem tersebut, jaksa memegang peranan penting dalam melakukan penuntutan terhadap perkara di bidang lingkungan hidup. Oleh sebab itu, pemahaman tentang kebijakan hukum pidana di bidang lingkungan hidup menjadi penting. Pemberian pemahaman mengenai kebijakan hukum pidana di bidang lingkungan hidup kali ini diberikan kepada para calon jaksa melalui kelas yang diadakan oleh Badan Pendidikan dan Pelatihan Kejaksaan Republik Indonesia. Kegiatan ini dilakukan dengan menggunakan media zoom. Metode ceramah dipilih sebagai bagian dari cara melaksanakan kegiatan pengabdian kepada masyarakat kali ini. Selain ceramah, diakhir sesi diadakan kegiatan diskusi tanya-jawab dan adanya sesi ujian bagi setiap peserta. Hal ini dilakukan untuk mendapatkan informasi apakah para peserta telah memahami materi yang telah diberikan. Tingkat pemahaman tersebut perlu diketahui sebagai bahan penilaian indicator meningkatnya kesadaran hukum lingkungan diantara para calon jaksa.Setelah pemberian materi selesai dilakukan para calon jaksa mendapatkan peningkatan pemahaman terkait dengan delik di bidang lingkungan hidup, sanksi pidana yang dapat dikenakan terhadap delik tersebut dan bagaimana melakukan tindakan penuntutan terhadap delik tersebut.

Preface

2021 The 4th International Conference on Renewable Energy and Environment Engineering (REEE 2021) was successfully held online on August 27-30, 2021. The conference aims to provide an international platform for experts, scholars and business managers in the fields of Renewable Energy and Environment Engineering to share their latest research achievements. The conference was scheduled to be held in Florence, Italy. In view of long impact of COVID-19 and travel restrictions implemented by governments, we were forced to move the conference online. REEE 2021 used ZOOM as the platform holding online conference. Because there may be some emergencies and limitations existing, the test session was arranged to help authors learn some ZOOM basic functions and test their presentation slides or videos on the first day. Back-up videos were also collected in advance, if some presenter encountered the internet problem during presentation, the staff in zoom will help to play the video. List of Committees are available in this pdf.

Improving second language vocabulary learning and retention by leveraging memory enhancement techniques: A multidomain pedagogical approach

We investigated whether learning and retaining vocabulary in a second language (L2) can be improved by leveraging a combination of memory enhancement techniques. Specifically, we tested whether combining retrieval practice, spacing, and related manipulations in a ‘multidomain’ pedagogical approach enhances vocabulary acquisition as compared to a typical learning approach. In a classroom-laboratory design, 48 Turkish university students studying L2 English were trained on 64 English words over 17 days. They were assigned to either a ‘typical’ study regimen of (re)studying the words on the first day (initial study) and last day (cramming) of training, or an ‘optimized’ regimen of retrieval practice (retrieving the words), moreover with feedback, spaced throughout the period, moreover with expanding gaps. The target words were tested before training (pre-test) and one and 11 days afterwards (post-tests). Mixed-effects modeling revealed a training-group by test-session interaction, due to greater improvements from optimized training (a striking 18 percentage-point accuracy increase from pre-test to both post-tests) than typical training (an 8 percentage-point increase). Further analyses showed that the optimized training advantages were mainly driven by high (rather than low) frequency words. Overall, the results suggest that a multidomain approach of combining different memory enhancement techniques can lead to substantial gains in both the learning and retention of L2 words, as compared to a typical study pattern. The findings have implications for L2 learning and pedagogy.

Dimensions of Skill Use in the Unified Protocol: Exploring Unique Effects on Anxiety and Depression

Objective: Although the Unified Protocol contains multiple distinct skills to target anxiety, depression, and related conditions, researchers have yet to establish if patients' use of these skills contributes to symptom change. Using data from the first-stage randomization of a sequential multiple assignment randomized trial, we tested whether general skillfulness, defined by skill knowledge, frequency, quality, and effectiveness, predicted within- or between-person changes in anxiety and depression. We further tested whether use of particular UP skills (e.g., mindfulness, behavior change) predicted changes in these outcomes. Method: Participants (N = 70; Mage = 33.74, 67% female, 74% white) completed six sessions of core UP modules and reported on their skillfulness and specific skill use using two novel measures, along with their symptoms of anxiety (OASIS) and depression (ODSIS) before each session, and their alliance (WAI) after each session. We disaggregated between- from within-person effects to test session- to-session effects of skillfulness, skill use, and the alliance on symptom change. Results: Greater within-person skillfulness predicted decreases in anxiety and depression. More frequent within- person use of all UP skills predicted decreases in anxiety, whereas more frequent within-person use of alternative actions specifically predicted decreases in depression. Conclusions: This pattern of results provides guidance on the specific aspects of skill training to prioritize in transdiagnostic treatments depending on whether therapists are targeting anxiety or depression.