17 research outputs found
Facteurs de risque de mort encéphalique des patients hospitalisés en réanimation pour accident vasculaire cérébral
No full textLE KREMLIN-B.- PARIS 11-BU Méd (940432101) / SudocSudocFranceF
Formation par compagnonnage en réalité virtuelle : multimodalité et collaboration à distance.
No full textInternational audienceDepuis la réforme des études médicales suite au rapport de la Haute Autorité de Santé de 2012 dont la conclusion était « jamais la première fois sur un patient », l’utilisation de la simulation comme outil de formation est devenue une nécessité. Dans ce contexte, la réalité virtuelle peut jouer un rôle important pour construire les programmes de formation médicale de demain. Cette technologie offre notamment plusieurs avantages comme la possibilité de dispenser des formations en personne ou à distance, de limiter l’utilisation de certaines ressources physiques à usage unique, de mesurer objectivement et d’une manière automatique les performances des apprenants, mais surtout de limiter les risques pour les patients puisque l’apprentissage se déroule dans un environnement virtuel et non plus sur de vrais patients. Néanmoins, les outils disponibles actuellement se limitent souvent à un entraînement en autonomie et ne supportent pas les interactions entre le formateur et l’apprenant, rompant ainsi le modèle de compagnonnage bien établie en médecine. En effet, des études ont montré que la présence d’un instructeur est très importante, surtout pendant les premières phases de la formation médicale.Pour résoudre cette problématique, nous proposons de concevoir des interfaces de formation en réalité virtuelle permettant les interactions multi-utilisateurs. Ces interfaces seront capables de supporter des interactions multimodales visant à améliorer la communication dans les environnements virtuels de simulation, partagés en présentiel ou à distance entre l’apprenant et le formateur. Notre démarche innovante se base sur une approche immersive, multimodale et multisensorielle permettant d’exploiter au mieux les technologies de la réalité virtuelle. Ceci permettra une meilleure communication apprenant-formateur et de fait un meilleur apprentissage des compétences médicales. Le cadre applicatif pour ce travail est l’apprentissage des gestes techniques en anesthésie locorégionale échoguidée. Une approche de conception centrée-utilisateur impliquant les différentes parties prenantes du domaine est utilisée afin de répondre au mieux aux besoins de formation des professionnels de santé. Nos premiers résultats ont permis de décrire le contexte d’usage et les compétences à acquérir. Nous avons également développé un premier prototype pour évaluer la communication multimodale apprenant-expert. Des études observationnelles en cours permettront également de définir un modèle d’interaction apprenant-expert afin de guider la conception de nos interfaces multimodales. Les résultats de ces travaux sont très encourageants et permettent déjà de formuler un certain nombre de recommandations pour la conception des simulateurs immersifs pour la formation par compagnonnage
Analyse de la tâche pour la conception d’un simulateur virtuel pour l’anesthésie locorégionale échoguidée
No full textInternational audiencePour donner suite aux directives de la Haute Autorité de Santé, la simulation fait partie intégrante des nouvelles techniques d’enseignements en médecine. Cependant, dans certaines spécialités comme l’anesthésiologie, les outils de simulations à disposition ne répondent pas encore aux attentes des praticiens. Afin de remédier à ces problématiques, de nouveaux outils utilisant les nouvelles technologies pourraient être une solution. Néanmoins, leur conception nécessite une attention particulière afin que celle-ci satisfasse les besoins des praticiens. Dans l’intention de concevoir un simulateur en réalité virtuelle dédié à l’apprentissage de la procédure de l’anesthésie locorégionale échoguidée, nous avons adopté une approche centrée-utilisateur. La première étape consistait donc à réaliser une analyse des tâches effectuées par les opérateurs et des compétences pour leur réalisation. Cet article a pour but de proposer un modèle de tâches basé sur le formalisme MAD. Une association entre les tâches recensées et les compétences est également présentée
"Efeito da preparação dentária ultrassónica na resistência adesiva por microtração utilizando diferentes estratégias adesivas"
No full textTrabalho Final do Mestrado Integrado em Medicina Dentária apresentado à Faculdade de MedicinaIntrodução: Preparações dentárias intracoronárias ou extracoronárias são convencionalmente realizadas com brocas diamantadas. No entanto, esses instrumentos possuem algumas limitações, daí novos dispositivos terem sido propostos, tal como instrumentos ultrassónicos. Esta nova tecnologia parece ser vantajosa, à luz da literatura atual, no que concerne à morfologia da superfície dentária, embora a sua influência nos procedimentos adesivos ainda precise de mais estudos. O objetivo deste estudo foi avaliar e comparar duas técnicas distintas de preparação dentária (pontas diamantadas CVD vs brocas diamantadas convencionais), quanto à adesão dentinária obtida com duas estratégias distintas (autocondicionamento vs condicionamento total), por meio de um teste de resistência adesiva por microtração (μTBS).Materiais e métodos: Um total de 16 molares permanentes intactos foram recolhidos e divididos em duas metades com um disco de diamante. Em seguida, foram distribuídos em quatro grupos, de acordo com o método de preparação e o sistema adesivo utilizado. Depois, uma metade foi preparada com a ponta CVD e a outra com uma broca diamantada. Um único operador realizou todas as preparações dentárias e todos os procedimentos restauradores. Em seguida, os dentes foram seccionados para obtenção de bastonetes uniformes que foram então submetidos ao teste de microtração (μTBS), utilizando uma máquina de testes universal. A análise estatística dos valores obtidos foi realizada pelos testes Shapiro-Wilk e Leven. A influência de ambas as variáveis foi analisada utilizando Two-way ANOVA. Resultados: Não houve diferenças estatisticamente significativas entre os valores médios de força de adesão no que toca ao sistema adesivo (F (1,24) = 1,004, p = 0,326), nem quanto ao tipo de corte (F (1,24) = 2,505, p = 0,127), nem no que diz respeito à interação entre os dois fatores (F (1,24) = 0,040, p = 0,840). Conclusão: Ambas as estratégias adesivas apresentaram valores similares de μTBS, portanto podem ser igualmente eficazes independentemente da técnica de preparação. Em relação ao método de preparação, os grupos em que foram utilizados instrumentos ultrassónicos apresentaram os maiores valores de força de adesão, independentemente da estratégia adesiva, embora sem significância estatística. É imprescindível a realização de mais estudos, com aplicação de metodologias standard, para clarificar as relações entre as variáveis testadas.Introduction: Intracoronal or extracoronal tooth preparations are conventionally performed with diamond burs. However, these instruments have some limitations, thus new devices have been suggested, such as ultrasonic instruments. This new technology seems advantageous throughout the available literature regarding tooth surface morphology, yet its influence on bonding procedures still needs further research. The aim of this study was to evaluate and compare two different tooth preparation techniques (CVD diamond ultrasound tips vs conventional diamond burs) regarding the dentin adhesion obtained with two different strategies (self-etch vs etch-and-rinse) by means of micro-tensile bond strength testing (μTBS). Materials and Methods: A total of 16 intact permanent molars were collected and divided into two halves by a diamond disk. Then they were distributed into four groups, according to the preparation method and adhesive system used. Afterwards, one half of each tooth was prepared with the CVD tip and the other with a diamond bur. A single operator carried out all tooth preparations, as well as all restoration procedures. Then, the teeth were sectioned to obtain uniform sticks that were then submitted to micro-tensile testing (μTBS) using a universal testing machine. Data statistical analysis was performed using Shapiro-Wilk and Leven test. The influence of both variables was analyzed using Two-way ANOVA. Results: There were no statistically significant differences between the means of micro-tensile bond strength concerning the adhesive system (F (1,24) = 1.004, p = 0.326), nor regarding the type of cut (F (1,24) = 2,505, p = 0.127), neither in what concerns to the interaction between both factors (F (1,24) = 0.040, p = 0.840). Conclusions: Both adhesive strategies presented similar μTBS values and therefore might be equally effective regardless the preparation technique. Concerning the preparation method, ultrasound groups showed the highest values of micro-tensile bond strength independently of the adhesive strategy, although not statistically significant. Further studies in this line of research are needed with standardized experimental protocols to establish clear relations between the evaluated parameters
Design and evaluation of UltRASim: An immersive simulator for learning ultrasound-guided regional anesthesia basic skills
No full textInternational audienceVirtual reality shows great promise as a technology for training healthcare professionals within a secure simulated environment. This work presents the design, development, and assessment of UltRASim: an immersive simulator for ultrasound-guided regional anesthesia. First, task and skills analyses were performed with domain experts to build the task model of the procedure and determine the simulator’s learning objectives and design constraints. Then, a face and content validity study was conducted with eighteen anesthesiologists to assess the simulator’s prototype. The responses to seven of eleven face validity questions were predominantly positive, indicating a favorable reception. The primary concerns pertained to the fidelity of haptic feedback during needle insertion. This suggests incorporating a higher fidelity haptic device in future design iterations. Conversely, responses to all six questions related to the content validity were predominantly positive. Participants found that the simulator held significant potential as a training tool, particularly for developing hand–eye coordination skills. These findings validate several design choices and highlight areas for improvement in subsequent iterations of UltRASim before its formal validation as a training tool
ULTRASIM : simulateur immersif pour l’anesthésie locorégionale échoguidée
No full textLa réalité virtuelle présente un grand potentiel en tant que technologie pour former les professionnels de la santé dans un environnement simulé sécurisé. Ce travail présente UltRASim : un simulateur immersif pour l’anesthésie régionale guidée par échographie. Les principales préoccupations portaient sur la fidélité du retour haptique lors de l’insertion de l’aiguille. Dans notre étude, les participants ont constaté que le simulateur avait un potentiel significatif en tant qu’outil de formation, notamment pour le développement des compétences de coordination main-oeil. Nous proposons de faire essayer ce simulateur aux participants d’IHM 2024
Validation de l’aspect et du contenu d’un simulateur immersif pour la formation des opérateurs en anesthésie locorégionale échoguidée
No full textInternational audienceVirtual reality is a promising technology for training healthcare professionals in a safe simulation environment. In this work, we present the design and evaluation of an immersive simulator for training ultrasound-guided locoregional anesthesia operators. Eighteen anesthesiologists participated in a face and content validation study of the first prototype of the system. Responses to seven of the eleven questions on face validity were predominantly positive. The main raised issue concerns the fidelity of the needle haptic feedback, suggesting the use of a six degrees of freedom haptic feedback arm in the future prototypes. Responses to all six questions on content validity were predominantly positive. Participants find that the simulator is a promising training tool particularly suited for developing hand-eye coordination skills. These results support our design choices and suggest improvements for our simulator before its validation as a training tool.La réalité virtuelle est une technologie prometteuse pour former les professionnels de santé dans un environnement de simulation sécurisé. Dans ce travail, nous présentons la conception et l'évaluation d'un simulateur immersif pour la formation de l’anesthésie locorégionale échoguidée. Dix-huit anesthésistes ont participé à la validation de l’aspect et du contenu du premier prototype du système. Les réponses à sept des onze questions sur la validité de l’aspect étaient positives. La problématique soulevée concerne la fidélité du rendu haptique de l'aiguille, suggérant l'utilisation d'un bras haptique à six degrés de liberté dans les futurs prototypes. Les réponses aux six questions sur la validité du contenu étaient positives. Les participants trouvent que le simulateur est un outil de formation prometteur particulièrement adapté pour développer les compétences de coordination œil-main. Ces résultats confortent nos choix de conception et suggèrent des améliorations pour notre simulateur avant sa validation comme outil de formation
Consciousness complexity
No full textCopyright © 2015 by author and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0
Naturalizing institutions: Evolutionary principles and application on the case of money
No full textIn recent extensions of the Darwinian paradigm into economics, the replicator-interactor duality looms large. I propose a strictly naturalistic approach to this duality in the context of the theory of institutions, which means that its use is seen as being always and necessarily dependent on identifying a physical realization. I introduce a general framework for the analysis of institutions, which synthesizes Searle's and Aoki's theories, especially with regard to the role of public representations (signs) in the coordination of actions, and the function of cognitive processes that underly rule-following as a behavioral disposition. This allows to conceive institutions as causal circuits that connect the population-level dynamics of interactions with cognitive phenomena on the individual level. Those cognitive phenomena ultimately root in neuronal structures. So, I draw on a critical restatement of the concept of the meme by Aunger to propose a new conceptualization of the replicator in the context of institutions, namely, the replicator is a causal conjunction between signs and neuronal structures which undergirds the dispositions that generate rule-following actions. Signs, in turn, are outcomes of population-level interactions. I apply this framework on the case of money, analyzing the emotions that go along with the use of money, and presenting a stylized account of the emergence of money in terms of the naturalized Searle-Aoki model. In this view, money is a neuronally anchored metaphor for emotions relating with social exchange and reciprocity. Money as a meme is physically realized in a replicator which is a causal conjunction of money artefacts and money emotions. --Generalized Darwinism,institutions,replicator/interactor,Searle,Aoki,naturalism,memes,emotions,money
Control biológico de plagas agrícolas en Venezuela: los logros históricos de la empresa Servicio Biológico (SERVBIO)
No full textServicio Biológico (SERVBIO), a company located in the Turbio valley, state of Lara, Venezuela and founded by the author between 1977 and 2008, was dedicated to the production of biological controllers and their use in Venezuelan agriculture. SERVBIO began controlling sugarcane borers of the genus Diatraea, with the amazonian fly, Lydella (=Metagonistylum) minense (Diptera: Tachinidae), which was used exclusively up to 1988. After six years of country-wide releases, Cotesia flavipes (Hymenoptera: Braconidae) was established in 1987 in two locations: Ureña (state of Táchira) and Cariaco (state of Sucre), with its massive production starting in 1988. From 1962 to 2011, infestation intensity percentages were reduced from 15 % to 1.68 % in the area of the Rio Turbio Sugar Factory, showing the cost-benefit of biological control from 41.25 to 1. SERVBIO ventured in the production of different biological controllers, especially developing production techniques and applying them to integrated pest management (IPM) programs. The introduction of Telenomus remus (Hymenoptera: Braconidae), a parasitoid of Spodoptera frugiperda (Lepidoptera: Noctuidae), showed since the beginning effectiveness with high parasitism results and savings in the use of pesticides. T. remus is currently used in IPM programs for corn and other grasses. SERVBIO also experimented with the use of the nematode Heterorhabditis bacteriophora to control the “candelilla” or sugarcane spittlebug, Aeneolamia varia, achieving 80 % of control in a farm in Turen (state of Portuguesa); consequently, it is currently implemented in sugarcane IPM. Therefore, efficient biological controllers are used for the key pests of this crop (Diatraea spp. and A. varia). SERVBIO provides educational services, conducts research projects, and offers professional internships, graduate thesis, and internships for undergraduate and graduate students. SERVBIO has also provided advisory services on the installation of laboratories. Servicio Biológico, SERVBIO, empresa situada no vale do Turbio, no estado de Lara, Venezuela, fundada pelo autor entre 1977 a 2008, dedicou-se à produção de controladores biológicos e seu uso na agricultura venezuelana, iniciando-se no controle das brocas da cana-de-açúcar, com a mosca amazônica, Lydella (=Metagonistylum) minense (Diptera: Tachinidae), usada exclusivamente até o ano 1988. Depois de seis anos de ter realizado liberações em todo o território, Cotesia flavipes (Hymenoptera: Braconidae) se estabeleceu em 1987 em Ureña (estado Táchira) e Cariaco (estado Sucre), razão pela qual sua produção massiva começou em 1988. Entre 1962 e 2011, houve a redução das porcentagens de intensidade de infestação de 15% a 1,68% na área da Açucareira rio Turbio e obteve-se um benefício: custo do controle biológico de 41,25 a 1. A SERVBIO explorou a produção de diferentes controladores biológicos; em particular, desenvolveu técnicas de produção, e sua aplicação nos programas de manejo integrado de plagas (MIP). A introdução de Telenomus remus (Hymenoptera: Braconidae), parasitoide de Spodoptera frugiperda (Lepidoptera: Noctuidae) mostrou, desde o início, efetividade nos resultados, de alto parasitismo, e economia no uso de pesticidas. T. remus é utilizado atualmente nos programas de MIP do milho e de outras gramíneas. Adicionalmente, a SERVBIO experimentou a utilização do nematoide Heterorhabditis bacteriophora para o controle da cigarrinha-das-raízes da cana de açúcar, Aenolamia varia, alcançando 80% de controle em uma fazenda em Turen (estado português); razão pelo qual é adotado atualmente para o MIP da cana de açúcar. Portanto, para as pragas-chave deste cultivo, são utilizados controladores biológicos eficientes. A SERVBIO é uma empresa que tem fornecido trabalhos educacionais, que dirige trabalhos de pesquisa e estágios profissionais, teses, e práticas para estudantes de pré-graduação e pós-graduação. Além de fornecer assessorias para a instalação de laboratórios. Servicio Biológico, SERVBIO, empresa situada en el valle del Turbio, estado Lara, Venezuela, fundada por el autor entre 1977 a 2008, se dedicó a la producción de controladores biológicos y su uso en la agricultura venezolana, iniciándose en el control de los taladradores de la caña de azúcar del género Diatraea, con la mosca amazónica, Lydella (=Metagonistylum) minense (Diptera: Tachinidae), la cual se utilizó exclusivamente hasta el año 1988. Después de seis años de haber realizado liberaciones en todo el territorio, Cotesia flavipes (Hymenoptera: Braconidae) se estableció en 1987 en Ureña (estado Táchira) y Cariaco (estado Sucre), por lo que se inició en 1988 su producción masiva. Entre 1962 y 2011, se disminuyeron los porcentajes de intensidad de infestación de 15 % hasta 1.68 % en el área de la Azucarera río Turbio y se tuvo un beneficio: costo del control biológico de 41.25 a 1. SERVBIO incursionó en la producción de diferentes controladores biológicos; en particular, desarrolló técnicas de producción, y su aplicación en los programas de manejo integrado de plagas (MIP). La introducción de Telenomus remus (Hymenoptera: Braconidae), parasitoide de Spodoptera frugiperda (Lepidoptera: Noctuidae), desde un inicio, mostró efectividad con resultados, de alto parasitismo, y ahorro del uso de plaguicidas. T. remus es utilizado en la actualidad en los programas de MIP del maíz y otras gramíneas. También SERVBIO experimentó la utilización del nematodo Heterorhabditis bacteriophora para el control de la candelilla o salivazo de la caña de azúcar, Aenolamia varia, lográndose 80 % de control en una hacienda en Turen (estado Portuguesa); por lo cual es adoptado actualmente para el MIP de la caña de azúcar. Por lo tanto, para las plagas clave de este cultivo, se cuenta con controladores biológicos eficientes. SERVBIO ha sido una empresa que ha prestado una labor educacional, que conduce trabajos de investigación y pasantías profesionales, tesis de grado, y prácticas para estudiantes de pregrado y posgrado. También ha prestado asesorías para instalación de laboratorios.
