Augmented Reality and Human Factors Applications for the Neurosurgical Operating Room

The virtual overlay of patient-specific anatomies onto a surgical site through Augmented Reality (AR) technologies has been thought to be a potentially ideal neuronavigational system for use in neurosurgery. Although impressive and futuristic, there are many design considerations that must be taken into account, including surgeon reception, perceived utility, intuitive control and manipulation design, and overall system accuracy during surgery. To implement AR into the neurosurgical Operating Room (OR), a gradual approach of evolutionary design to ensure widespread adoption may be considered. This thesis presents a potential pathway for the introduction of AR technologies into the neurosurgical OR. The thesis is divided into three parts: incorporation of AR features into existing platforms for improved functionality and introduction of AR concepts to surgical environments, observation and evaluation of surgeon perception of AR overlays and AR headsets to inform display methods and designs, and quantification of virtual object placement accuracy in a clinical environment. The findings presented show that AR integrated systems improve OR workflow when conventional tracked tools are unavailable, user preference of AR overlays onto the surgical site change depending on operator experience level, and the placement accuracy of state-of-the-art AR head mounted displays are suitable for presurgical planning and very close to accuracy needed for surgical guidance. These three elements are key to developing a pathway for adoption of AR technologies in the OR, and help to inform designs for future headsets to assist surgeons and improve patient care.

Augmented Reality and Human Factors Applications for the Neurosurgical Operating Room

The virtual overlay of patient-specific anatomies onto a surgical site through Augmented Reality (AR) technologies has been thought to be a potentially ideal neuronavigational system for use in neurosurgery. Although impressive and futuristic, there are many design considerations that must be taken into account, including surgeon reception, perceived utility, intuitive control and manipulation design, and overall system accuracy during surgery. To implement AR into the neurosurgical Operating Room (OR), a gradual approach of evolutionary design to ensure widespread adoption may be considered. This thesis presents a potential pathway for the introduction of AR technologies into the neurosurgical OR. The thesis is divided into three parts: incorporation of AR features into existing platforms for improved functionality and introduction of AR concepts to surgical environments, observation and evaluation of surgeon perception of AR overlays and AR headsets to inform display methods and designs, and quantification of virtual object placement accuracy in a clinical environment. The findings presented show that AR integrated systems improve OR workflow when conventional tracked tools are unavailable, user preference of AR overlays onto the surgical site change depending on operator experience level, and the placement accuracy of state-of-the-art AR head mounted displays are suitable for presurgical planning and very close to accuracy needed for surgical guidance. These three elements are key to developing a pathway for adoption of AR technologies in the OR, and help to inform designs for future headsets to assist surgeons and improve patient care.

484 Solriamfetol Titration & AdministRaTion (START): Physician titration strategies in a hypothetical patient with narcolepsy

Introduction Solriamfetol (Sunosi®), a dopamine/norepinephrine reuptake inhibitor, is approved (US and EU) to treat excessive daytime sleepiness (EDS) in adults with narcolepsy (75–150 mg/day) or obstructive sleep apnea (OSA) (37.5–150 mg/day). Patient characteristics, comorbidities, and other EDS medications can influence treatment strategies. To understand factors physicians consider when initiating solriamfetol, this study analyzed titration strategies for a hypothetical patient. Methods This virtual, descriptive, cross-sectional, qualitative survey enrolled US-based physicians treating patients with EDS due to OSA and/or narcolepsy. Responses to 4 open-ended questions regarding a hypothetical patient were recorded. Patient scenario: 32-year-old woman with narcolepsy (Epworth Sleepiness Scale score=8) using an amphetamine stimulant (35 mg/day) and sodium oxybate (6 g/night) for 6 months and occasionally experiencing non-use-limiting but bothersome adverse events (AEs) with the stimulant. Content analysis of the recordings identified themes in the responses; a trained linguist captured language choices/patterns. Results Twenty-six physicians (neurologists, n=7 [27%]; internists/family practitioners, n=7 [27%]; pulmonologists, n=6 [23%]; psychiatrists, n=5 [19%]; otolaryngologists, n=1 [4%]) representing 781 patients on stable solriamfetol doses participated; 19 (73%) were board-certified in sleep disorders. Physicians had been treating narcolepsy a mean 15.7±6.6 years. Most (21 [81%]) thought the patient appropriate for solriamfetol, 3 (12%) thought not appropriate, and 2 (8%) thought appropriateness depended on other factors. Sixteen physicians (62%) suggested adjusting her stimulant, 3 (12%) the stimulant and sodium oxybate, and 1 (4%) neither. Nineteen (73%) would titrate solriamfetol per the label, with 13 (50%) aiming for 75 mg/day and 8 (31%) for 150 mg/day. Physicians emphasized stopping the stimulant before starting solriamfetol: 10 (39%) would taper down before starting solriamfetol, 7 (27%) while starting solriamfetol, and 1 (4%) while aiming to eventually switch; 8 (31%) would discontinue abruptly. Nineteen physicians (73%) would not change their approach if the stimulant dose were 60 mg/day. Most clinicians would change their approach if AEs occurred while starting solriamfetol by taking a slower or more gradual approach, while some would titrate off the stimulant more aggressively. Conclusion Physicians considered existing medications and potential AEs in their titration strategy when initiating solriamfetol. Support (if any) Jazz Pharmaceuticals

Comparing and Contrasting Travelling Wave Behaviour for Groundwater Flow and Foam Drainage

Liquid drainage within foam is generally described by the foam drainage equation which admits travelling wave solutions. Meanwhile, Richards’ equation has been used to describe liquid flow in unsaturated soil. Travelling wave solutions for Richards equation are also available using soil material property functions which have been developed by Van Genuchten. In order to compare and contrast these solutions, the travelling waves are expressed as dimensionless height, $$ {\hat{\xi }} $$ ξ ^ , versus moisture content, $$ \varTheta $$ Θ . For low moisture content, $$ {{\hat{\xi }}} $$ ξ ^ exhibits an abrupt change away from the dry state in Richards equation compared to a much more gradual change in foam drainage. When moisture content nears saturation, $$ {\hat{\xi }} $$ ξ ^ reaches large values (i.e. $$ {\hat{\xi }} \gg 1 $$ ξ ^ ≫ 1 ) for both Richards equation and foam drainage, implying a gradual approach of $$ \varTheta $$ Θ towards the saturated state. The $$ {\hat{\xi }} $$ ξ ^ values in Richards equation tend, however, to be larger than those in the foam drainage equation, implying an even more gradual approach towards saturation. The reasons for the difference between foam drainage and Richards equation solutions are traced back to soil material properties and in particular a soil specific parameter “m” which is determined from the soil-water retention curve.

LAS RAÍCES EMPIRIOCRITICISTAS DEL CONCEPTO DE MUNDO NATURAL EN E. HUSSERL

En este artículo queremos investigar la relación entre las filosofías de Edmund Husserl y Richard Avenarius. A pesar de que este tema ha sido prácticamente ignorado por los estudiosos de Husserl, es de suma importancia si uno quiere iluminar los orígenes del pensamiento fenomenológico de Husserl. Nuestra tesis es que el concepto de Husserl de actitud natural y su correlato, el mundo natural (Umwelt) -tal y como ellos surgen en diferentes conferencias durante la década de 1910 y especialmente en Ideas I con respecto a la reducción fenomenológica- se derivan de una temprana confrontación con el punto de vista del empiriocriticismo de Avenarius como fue expuesto en su libro Der menschliche Weltbegriff. Con el fin de mantener esta afirmación, discutiremos el acercamiento gradual de Husserl a las teorías del filósofo suizo-alemán así como su última crítica al mismo. Aunque, de hecho, Husserl concibió el punto de vista den Avenarius como un principio valioso, al final de sus reflexiones pone en cuestión algunas de las premisas de la filosofía empiriocriticista.In this paper I investigate the relationship between the philosophies of Edmund Husserl and Richard Avenarius. Despite this tapie has been almost disregarded by Husserlian scholars, it is of uttermost importance if one aims at illuminating the origins of Hus­serl's phenomenological thinking. My thesis is that Husserl's concept of natural attitude and its correlate, the natural world (Umwe/t) -as they emerge in various lectures during the 1910s and especially in Ideen I with respectmto the phenomenological reduction- stem from an early confrontation with Avenarius' "empiriocriticist" standpoint as laid out in his book Der menschliche Weltbegriff. In order to up­ hold this claim, I will discuss in my paper Husserl's gradual approach to the theories of the Swiss-German philosopher as well as his late critique of the same. Although Husserl in fact conceived of Avenarius' standpoint as a valuable beginning, he was decisively prompted in his late reflections to call into question sorne of the premises of the "empirio-criticist" philosophy.

The Role of the EU in Facilitating a Hard Implementation Dialogue

The European Union (EU) plays a facilitating role in the normalization of relations between Kosovo and Serbia. The EU has applied a proactive approach to normalization through several agreements, initially of a technical and later of a political nature. This gradual approach has produced a relative success in the easing of relations between the parties and in creating the conditions for a final agreement, which, however, still remains far from being reached. The main argument of this article is that both sides hold diametrically opposed positions and the EU still remains a powerless actor in pushing the parties to find a long-term solution to the conflict between them.

Ethical Reading of the Tractatus Logico-Philosophicus

The hundred-year history of interpretations of Wittgenstein’s Tractatus Logico-Philosophicus we examine in the article through a gradual approach (through the refusal of researchers from obviously erroneous interpretations) to an ethical (or metaphilosophical) reading of the work. The latter explains Wittgenstein’s unambiguous indication of ethical meaning as the main meaning of the Tractatus and consistently reconciles various parts of the work (ontology, figurative theory of meaning, rejection of the theory of types and logical constants, etc.) with the latest so-called ethical and mystical statements of the Tractatus and with demanding silence. An ethical (metaphilosophical) reading explains the continuing influence and relevance of the Tractatus and is presented in the article as a necessary condition for understanding the continuity between the works of early and late Wittgenstein.

15 Years of Intelligent Container Research

Food losses in the cool chain, which are mostly caused by temperature deviations, can be reduced by remote monitoring of transport conditions. The project ‘Intelligent Container’ was begun 15 years ago to provide the necessary sensor system, communication and automated evaluation of data. If transport and delivery planning are adjusted according to the actual quality or the predicted remaining shelf life, more products arrive with sufficient quality at the customers. This paper summarizes the project results and highlights current trends in industrial application and research, such as commercial remote container monitoring and standards for data exchange, sub-GHz communication, the increasing availability of biological and computational fluid dynamics models and digital twins. Open research topics include the development of specialized sensors. To overcome obstacles hindering the industrial application of sensor quality monitoring, we suggest a gradual approach, with lower company resources required for the first action points. Food losses can be reduced, even if the complete system, including permanent remote access and adaptive stock rotation, is not applied.

Formation of communicative universal educational actions in the study of speech

The formation of the communicative competence of students involves the ability to create written texts of certain styles and genres. The communicative orientation of the Russian language course in a modern school should contribute to the resolution of a long-standing linguodidactic contradiction: the study of the language system as an abstract, clearly structured set of isolated linguistic units and at the same time the development of students’ speech, the formation of communicative competence that allows using the acquired knowledge in the communication process. Speech learning can be built on the study of various communication strategies and tactics. In the process of working on creating a text, a communication strategy is a generalized plan of actions typical of constructing a text of a certain type. Communicative tactics – specific methods of unfolding thought – can be different and are determined both by the specifics of the task and by the speech skills of the writer. Using the text-description as an example, the article discusses various communicative tactics: enumeration of the most important features of the object; description based on one of the most striking features that determine other qualities; the gradual approach of the subject, the discovery of new features as one gets closer to the subject; the use of the effect of disappointed expectations (first impression, and then its destruction), etc. The study, description of these strategies and tactics, and most importantly, their use in the practice of teaching the Russian language will contribute to the speech development of students.

Imitation, network size, and efficiency

A number of theoretical results have provided sufficient conditions for the selection of payoff-efficient equilibria in games played on networks when agents imitate successful neighbors and make occasional mistakes (stochastic stability). However, those results only guarantee full convergence in the long-run, which might be too restrictive in reality. Here, we employ a more gradual approach relying on agent-based simulations avoiding the double limit underlying these analytical results. We focus on the circular-city model, for which a sufficient condition on the population size relative to the neighborhood size was identified by Alós-Ferrer & Weidenholzer [(2006) Economics Letters, 93, 163–168]. Using more than 100,000 agent-based simulations, we find that selection of the efficient equilibrium prevails also for a large set of parameters violating the previously identified condition. Interestingly, the extent to which efficiency obtains decreases gradually as one moves away from the boundary of this condition.