Virtually Possible: Enhancing Quality Control of 3D-Printed Medicines with Machine Vision Trained on Photorealistic Images.

Three-dimensional (3D) printing is an advanced pharmaceutical manufacturing technology, and concerted efforts are underway to establish its applicability to various industries. However, for any technology to achieve widespread adoption, robustness and reliability are critical factors. Machine vision (MV), a subset of artificial intelligence (AI), has emerged as a powerful tool to replace human inspection with unprecedented speed and accuracy. Previous studies have demonstrated the potential of MV in pharmaceutical processes. However, training models using real images proves to be both costly and time consuming. In this study, we present an alternative approach, where synthetic images were used to train models to classify the quality of dosage forms. We generated 200 photorealistic virtual images that replicated 3D-printed dosage forms, where seven machine learning techniques (MLTs) were used to perform image classification. By exploring various MV pipelines, including image resizing and transformation, we achieved remarkable classification accuracies of 80.8%, 74.3%, and 75.5% for capsules, tablets, and films, respectively, for classifying stereolithography (SLA)-printed dosage forms. Additionally, we subjected the MLTs to rigorous stress tests, evaluating their scalability to classify over 3000 images and their ability to handle irrelevant images, where accuracies of 66.5% (capsules), 72.0% (tablets), and 70.9% (films) were obtained. Moreover, model confidence was also measured, and Brier scores ranged from 0.20 to 0.40. Our results demonstrate promising proof of concept that virtual images exhibit great potential for image classification of SLA-printed dosage forms. By using photorealistic virtual images, which are faster and cheaper to generate, we pave the way for accelerated, reliable, and sustainable AI model development to enhance the quality control of 3D-printed medicines.

Urology boot camp for medical students: Using virtual technology to enhance undergraduate education.

Objectives: The study aims to describe the methodology of converting the urology boot camp for medical students into a virtual course with key take home points for a successful conversion and to present quantitative and qualitative data demonstrating the impact of the boot camp on improving delegates' knowledge and clinical acumen. Materials and methods: The face-to-face boot camp was converted to a virtual format employing a variety of techniques including; utilizing an online platform to deliver live screened lectures, using online polling software to foster an interactive learning environment and displaying pre-recorded videos to teach practical skills. Validated Multiple Choice Questionnaires (MCQs) were used prior to and after the course. This enabled the assessment of delegates' knowledge of urology according to the national undergraduate curriculum, and paired t tests were used to quantify the level of improvement. Thematic analysis was carried out on post-course delegate feedback to identify highlights of the course and ways of improving future iterations. Results: In total, 131 delegates took part in the pilot virtual course. Of these, 105 delegates completed the pre- and post-course MCQs. There was a statistically significant improvement in the assessment following the course (p = <0.001) with mean score increasing from 47.5% pre-course to 65.8% post-course. All delegates who attended the most recent implementation of the virtual course (n = 31) felt it improved their knowledge and confidence in urology. Twenty delegates (64.5%) felt that it prepared them for both final year medical school examinations and working as a foundation year doctor. Positive themes in feedback were identified, which included the interactive nature of the course, the quality of teaching, the level and content of information provided and the high yield, concise organization of the teaching schedule. Conclusion: Using virtual technology and innovative educational frameworks, we have demonstrated the successful conversion of the urology boot camp for medical students to a virtual format. At a national level, with support from the British Association of Urological Surgeons, the face-to-face component of the course will continue to run in parallel with the virtual course with the aim of standardizing and improving UK undergraduate urological education. The virtual course has been implemented on an international scale, and this has already shown promising results.

Influence of preoperative simulation on the reduction quality and clinical outcomes of open reduction and internal fixation for complex proximal humerus fractures.

PURPOSE: Proximal humerus fractures (PHFs) are common. With the development of locking plates, open reduction and internal fixation (ORIF) of the proximal humerus can provide excellent clinical outcomes. The quality of fracture reduction is crucial in the locking plate fixation of proximal humeral fractures. The purpose of this study was to determine the impact of 3-dimensional (3D) printing technology and computer virtual technology assisted preoperative simulation on the reduction quality and clinical outcomes of 3-part and 4-part proximal humeral fractures. METHOD: A retrospective comparative analysis of 3-part and 4-part PHFs undergoing open reduction internal fixation was performed. Patients were divided into 2 groups according to whether computer virtual technology and 3D printed technology were used for preoperative simulation: the simulation group and the conventional group. Operative time, intraoperative bleeding, hospital stay, quality of fracture reduction, Constant scores, American Society for Shoulder and Elbow Surgery (ASES) scores, shoulder range of motion, complications, and revision surgeries were assessed. RESULTS: This study included 67 patients (58.3%) in the conventional group and 48 patients (41.7%) in the simulation group. The patient demographics and fracture characteristics were comparable in these groups. Compared with the conventional group, the simulation group had shorter operation time and less intraoperative bleeding (P < 0.001, both). Immediate postoperative assessment of fracture reduction showed a higher incidence of greater tuberosity cranialization of < 5 mm, neck-shaft angle of 120° to 150°, and head shaft displacement of < 5 mm in the simulation group. The incidence of good reduction was 2.6 times higher in the simulation group than in the conventional group (95% CI, 1.2-5.8). At the final follow-up, the chance of forward flexion > 120° (OR 5.8, 95% CI 1.8-18.0) and mean constant score of > 65 (OR 3.4, 95% CI 1.5-7.4) was higher in the simulation group than the conventional group, as well as a lower incidence of complications in the simulation group was obtained (OR 0.2, 95% CI 0.1-0.6). CONCLUSIONS: This study identified that preoperative simulation assisted by computer virtual technology and 3D printed technology can improve reduction quality and clinical outcomes in treatment of 3-part and 4-part PHFs.

Near-peer mentoring and virtual reality for adult basic life support education in high school students.

Bystander cardiopulmonary resuscitation (CPR) can improve cardiac arrest survival; however, lack of willingness or community training lead to low bystander CPR rates. Virtual Reality (VR) Cardiopulmonary Resuscitation (CPR) training among high-school students is an innovative method to train bystander CPR skills. VR is well received by "technology natives" inherent among high school students and induces a greater sense of presence and agency compared to office-based CPR training. We describe a pilot trial with high school students using a near-peer mentoring framework using a single- player VR CPR training software (CBS, TetraSignum, Seoul, KR) in which both students collaboratively coach each other while performing in-VR CPR. Our pilot program recruited 3 pairs (n = 6) high school students during a local summer camp. During each 1.5-hour session, each pair learned about CPR and basic life support through a VR avatar either in-VR or displayed on a TV screen. The in-VR student practiced on the manikin while the other student could take notes on paper. Then each student was assessed on their CPR skills in-VR on a cardiac arrest avatar superimposed onto a real QCPR manikin, coached by the other student who could visualize CPR quality projected on the TV screen. The students then switched roles and debriefed about their experience. Overall, the students universally performed well and appreciated the collaborative nature of the learning experience. Further study is needed to explore barriers and enablers to implementation of VR CPR training at the high school level.

Confronting a post-pandemic new-normal-threats and opportunities to trust-based relationships in natural resource science and management.

Natural resource governance is inherently complex owing to the socio-ecological systems in which it is embedded. Working arrangements have been fundamentally transformed throughout the COVID-19 pandemic with potential negative impacts on trust-based social networks foundational to resource management and transboundary governance. To inform development of a post-pandemic new-normal in resource management, we examined trust relationships using the Laurentian Great Lakes of North America as a case study. 82.9% (n = 97/117) of Great Lakes fishery managers and scientists surveyed indicated that virtual engagement was effective for maintaining well-established relationships during the pandemic; however, 76.7% (n = 89/116) of respondents indicated in-person engagement to be more effective than virtual engagement for building and maintaining trust. Despite some shortcomings, virtual or remote engagement presents opportunities, such as: (1) care and nurturing of well-established long-term relationships; (2) short-term (1-3 years) trust maintenance; (3) peer-peer or mentor-mentee coordination; (4) supplemental communications; (5) producer-push knowledge dissemination; and, if done thoughtfully, (6) enhancing diversity, equity, and inclusion. Without change, pre-pandemic trust-based relationships foundational to cooperative, multinational, resource management are under threat.

Virtual Engagement of Families in the Intensive Care Unit During COVID-19: A Descriptive Survey of Family Members of Patients and Health Care Workers.

Introduction: Traditional face-to-face family member visits in the intensive care unit (ICU) are challenged during the coronavirus disease pandemic with time-critical visiting of the ICU patient being impossible. Objective: This study aimed to explore reported experiences and satisfaction surrounding the use of technology for virtual visits and virtual family meetings in the ICU setting. Two groups were surveyed: (1) family members of critically ill patients in the ICU and (2) health care workers caring for these patients. Design: The study, conducted in the 36-bed ICU of a speciality metropolitan acute care facility in Australia, used a pragmatic post-test survey design. Data were analyzed descriptively. Results: Of health care worker subjects, 106 completed the survey and the majority of communication episodes favored virtual visits (79.2%, n = 84). Of family member subjects, 69 completed the survey, with the majority participating in virtual family meetings (40.6%, n = 28). Both groups indicated satisfaction with virtual communication. Conclusions: We found virtual communication was positively received.

Effects of modern technology (exergame and virtual reality) assisted rehabilitation vs conventional rehabilitation in patients with Parkinson's disease: a network meta-analysis of randomised controlled trials.

BACKGROUND: Modern technological applications, including exergames and virtual technology-assisted rehabilitation (VTAR) programmes, are promising for Parkinson's disease (PD) rehabilitation. However, evidence regarding their efficacy for rehabilitation is inconclusive. OBJECTIVES: This network meta-analysis (NMA) investigated the efficacy of exergames and VTAR on gait and balance outcomes and acceptability for patients with PD. DATA SOURCES: ClinicalKey, Cochrane CENTRAL, Embase, ProQuest, PubMed, ScienceDirect, Web of Science and ClinicalTrials.gov. STUDY SELECTION: Randomised controlled trials (RCTs) investigating changes in gait or balance parameters were included in this study. STUDY APPRAISAL AND SYNTHESIS METHODS: In the NMA, standardised mean differences with 95% confidence intervals were calculated using a frequentist model. GRADE ratings were used to evaluate the quality of evidence in this study. RESULTS: Twenty-three RCTs with 949 participants were included. Exergames and VTAR were associated with significantly better improvements in balance and gait outcomes than usual treatment and other active control interventions. However, exergames were not associated with changes in depressive symptoms. The evaluation of acceptability results indicated that all exergames and VTAR were adequately tolerated, as indicated by the low drop-out rates. LIMITATIONS: Small sample sizes and heterogeneity were the key limitations of this study. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: This NMA confirmed that exergames are associated with more favourable gait and balance outcomes in patients with PD compared with usual treatment and other active control interventions. GRADE ratings revealed that most direct, indirect and overall network evidence was of low to medium quality. Larger-scale studies with longer follow-up periods are warranted.

[CT imaging measurement of sacral related anatomical parameters].

OBJECTIVE: To investigate the CT measurement of sacral anatomical parameters and understand the safe nail placement channel of DenisⅠ area with a new sacral butterfly plate. METHODS: The CT data of 101 normal adult sacrum from January 2020 to June 2020 were retrospectively analyzed, including 49 females and 52 males, aged(49.11±15.02) years old. Firstly, the three-dimensional model of sacrum was reconstruct, the three-dimensional model according to the plane was re segment to be measured, and data measurement and statistical analysis were carried out. RESULTS: The vertical distance from the lower edge of superior sacral articular process to the lower edge of S2 posterior sacral foramen was (42.55±4.73) mm;The horizontal distance from the lateral sacral crest of S1, S2 and S3 hole plane to the sacroiliac joint surface was (19.09±3.07) mm, (15.34±2.69) mm and (8.29±2.48) mm respectively;The plane of S1 hole moves forward from the lateral sacral ridge, the inner and outer angles are (7.49±7.49)° and (24.07±4.89)° respectively;The inside and outside angles of S2 hole plane are (-3.10±8.95)° and (24.95±5.74)° respectively. There were significant differences between different genders except S1 horizontal distance and S1 medial angle, and there was no correlation between age and all data. CONCLUSION: The new sacral butterfly plate has enough safe nail placement range in DenisⅠ area;There are differences in sacral morphology among adults. The differences are mainly related to gender but not age.

Virtual reality intervention as a support method during wound care and rehabilitation after burns: A systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to analyze and synthesize the evidence on the effectiveness of virtual reality (VR) interventions in the prevention of pain, fear and anxiety during burn wound care procedures. METHODS: In September and October 2021, PubMed, Scopus, Cochrane Library and Web of Science were searched for relevant randomized controlled and crossover studies. Two independent authors described the following inclusion criteria for the search: patients undergoing burn wound care with applied VR treatment compared to any other or non-VR intervention. From a total of 1171 records, 25 met the inclusion criteria. After full-text screening, seven publications were excluded. The risk of bias was assessed for 18 studies by two independent authors. RevMan 5.4 was used for the statistical analysis, meta-analysis and visual presentation of the results. RESULTS: The meta-analysis showed a significant difference between VR treatment and standard care when analyzing pain outcome during wound care procedures (SMD = -0.49; 95% CI [-0.78, -0.15]; I2 = 41%) and in subgroup analysis when immersive VR was incorporated (SMD = -0.71; 95% CI [-1.07, -0.36]; I2 = 0%). No significant differences were found between VR treatment and standard care for range of motion outcome (SMD = 0.44; 95% CI [-0.23, 1.11]; I2 = 50%). CONCLUSIONS: VR seems to be an effective therapeutic support in burn wound care procedures for reducing pain. However, this systematic review and meta-analysis highlights the need for more research into the use of VR as a distraction method. Studies on larger groups using similar conditions can provide unequivocal evidence of the effectiveness of VR and enable the inclusion of such intervention in standard medical procedures.

[Effect of computer virtual technique combined with pelvic reduction frame in the treatment of type C pelvic fracture].

OBJECTIVE: To investigate the short-term clinical effect of the computer virtual technique combined with pelvic reduction frame in the treatment of complex pelvic fractures. METHODS: Thirty patients with Tile C pelvic fractures treated by percutaneous minimally invasive pelvic reduction frame from April 2018 to April 2020 were retrospectively analyzed, including 21 males and 9 females, aged from 19 to 57 (39.40±9.85) years old. The patient's pelvic CT DICOM data were imported into Mimics software to reconstruct the virtual fracture model. Virtual reduction and nail placement were carried out on the fracture model, and then simulated fluoroscopy was carried out to record the ideal fluoroscopy orientation and angle to guide the correct fluoroscopy during operation. The operation time, fluoroscopy times and intraoperative blood loss were recorded. The quality of fracture reduction was evaluated by Matta image score standard, and the postoperative function was evaluated by Majeed function score standard. RESULTS: All 30 patients achieved closed reduction and percutaneous screw fixation. According to Matta score, the excellent and good rate of fracture reduction was 93.3%(28/30). A total of 67 channel screws were inserted, and the excellent and good rate was 98.5%(66/67). The operation time was (173.54±79.31) min, fluoroscopy time was (90.81±41.11) times, intraoperative blood loss was (81.21±43.97) ml. All incisions healed at one stage without broken nails or re-displacement of fractures. All patients were followed up for 12 months. At the final follow-up, Majeed function score was 73 to 94(85.66±5.33) scores. CONCLUSION: Computer virtual technology combined with pelvic reduction frame could rapidly, accurately and safely reduce and fix unstable pelvic fractures. Computer virtualization could help surgeons to recognition and understanding pelvic fractures, pelvic reduction frame could improve the surgeon's ability to manage complex and unstable pelvic injuries.

Virtual Technology's Critical Role in Sustaining Coordinated Specialty Care in Texas During the COVID-19 Pandemic.

OBJECTIVE: This report examined challenges and adaptations to sustaining multidisciplinary team-based coordinated specialty care (CSC) for early-onset psychosis during the COVID-19 pandemic in Texas. METHODS: In June 2020, team leaders from 23 Texas CSC sites participated in semistructured phone interviews about CSC implementation barriers and adaptations. Transcripts were analyzed with thematic analysis. RESULTS: CSC implementation barriers included difficulty delivering critical CSC components (i.e., community education and vocational exploration) and client recruitment limitations. Virtual technology integration (i.e., texting and videoconferencing) largely sustained CSC outreach, service delivery, and client engagement. However, sites faced virtual competency and accessibility issues, exhaustion from virtual technology use, lack of structural support, and unanticipated disengagement. CONCLUSIONS: The surveyed sites rapidly integrated virtual technology into CSC delivery. This integration promoted CSC engagement during the pandemic, especially in rural areas, and increased insight into what resources and policies are needed to sustain virtual technology use among community mental health providers.

Teaching Toolbox: Breaking Bad News with Virtual Technology in the Time of COVID.

Breaking bad news is a key component of the physicians' work. Traditionally, breaking bad news has been encouraged to be performed in person whenever possible (Monden et al. Proc (Bayl Univ Med Cent) 29(1):101-102, 2016; Nickson 2019). The common practice prior to the pandemic can be summarized by "The first rule of breaking bad news is: do not do it over the phone." It is important to be present with the family and provide support through compassion and empathy. Until recently, virtual communication technology for serious medical discussions was rare and primarily used when compelled by circumstances such as distance. The COVID-19 pandemic has transformed our ability to deliver news in person and has required the medical community to increase the utilization of telephone and video conferencing to communicate with patients and their family members. Breaking bad news through virtual media is a new skill in need of further guidance and education regarding how to set up the conversation, provide empathy, and lend support (Wolf et al., Oncologist 25(6):e879-e880, 2020). Therefore, we have created a teaching toolbox to help educate healthcare providers on how to deliver bad news by phone or video.

Effect of computer virtual technique combined with pelvic reduction frame in the treatment of type C pelvic fracture / 中国骨伤

OBJECTIVE@#To investigate the short-term clinical effect of the computer virtual technique combined with pelvic reduction frame in the treatment of complex pelvic fractures.@*METHODS@#Thirty patients with Tile C pelvic fractures treated by percutaneous minimally invasive pelvic reduction frame from April 2018 to April 2020 were retrospectively analyzed, including 21 males and 9 females, aged from 19 to 57 (39.40±9.85) years old. The patient's pelvic CT DICOM data were imported into Mimics software to reconstruct the virtual fracture model. Virtual reduction and nail placement were carried out on the fracture model, and then simulated fluoroscopy was carried out to record the ideal fluoroscopy orientation and angle to guide the correct fluoroscopy during operation. The operation time, fluoroscopy times and intraoperative blood loss were recorded. The quality of fracture reduction was evaluated by Matta image score standard, and the postoperative function was evaluated by Majeed function score standard.@*RESULTS@#All 30 patients achieved closed reduction and percutaneous screw fixation. According to Matta score, the excellent and good rate of fracture reduction was 93.3%(28/30). A total of 67 channel screws were inserted, and the excellent and good rate was 98.5%(66/67). The operation time was (173.54±79.31) min, fluoroscopy time was (90.81±41.11) times, intraoperative blood loss was (81.21±43.97) ml. All incisions healed at one stage without broken nails or re-displacement of fractures. All patients were followed up for 12 months. At the final follow-up, Majeed function score was 73 to 94(85.66±5.33) scores.@*CONCLUSION@#Computer virtual technology combined with pelvic reduction frame could rapidly, accurately and safely reduce and fix unstable pelvic fractures. Computer virtualization could help surgeons to recognition and understanding pelvic fractures, pelvic reduction frame could improve the surgeon's ability to manage complex and unstable pelvic injuries.

The use of three-dimensional model construction of virtual technology in orthopedic treatment.

OBJECTIVE: The objective of this study is to explore the construction of a digital three-dimensional model of virtual technology that plays an auxiliary role in orthopedic treatment. METHODS: Three fracture patients were selected, with no abnormality was observed in bone examination, no musculoskeletal disease in the past; and spiral CT scan of the spine and pelvis, upper limbs, and lower limbs was performed. The virtual technology was used to build a digital 3D model, mainly using the editing software Mimics10.0 software. In addition, the virtual three-dimensional model was verified by virtual surgery, data storage security, work efficiency of the model, model validity, three-dimensional characteristics of the model, the interaction mode of the model, and the data accuracy of the model were studied. RESULTS: The digital 3D model was successfully established by Mimics10.0 software. The data fitting efficiency was very high. The data storage security of the 3D model was greatly improved compared with the 2D model, and the work efficiency was improved by at least 50%. There was also a significant change in the accuracy and interaction of data acquisition. Therefore, the detection of digital 3D model work through virtual surgery simulation fully demonstrated the positive auxiliary role of 3D model in orthopedic treatment. CONCLUSION: The digital 3D model based on Mimics10.0 software is efficient and accurate in obtaining data. It is very effective for subsequent adjuvant therapy in the field of orthopedics, reducing the probability of misdiagnosis by doctors, saving time and improving efficiency, reducing patient's physical pain and unnecessary economic expenses.

Diabetic retinopathy screening using a virtual reading center.

AIMS: To summarize the effects of centralization of diabetic fundus photograph interpretation into a virtual reading center. METHODS: In 2016 Kaiser Permanente Northern California, a large, membership-based health plan with an ethnically and racially diverse population, centralized diabetic retinopathy screening into a virtual reading center. Retina screens were based on single field, 45-degree fundus photographs. We compared the accuracy of photography interpretation the year before centralization to the year after using masked reads performed by retina specialists of 1000 randomly selected screens from each time period. RESULTS: In all, 1902 patient screens with adequate quality images were included in the primary analysis. Images from pre-centralization screens were largely read by ophthalmologists (76.2%), while screens post-centralization were mainly read by optometrists (84.6%). Despite being interpreted by readers with lower levels of professional training, the sensitivity of screening increased from 43.9% (95% CI 38.0-49.8%) to 66.0% (95% CI 60.5-71.4%). CONCLUSION: A move to a centralized virtual reading center was associated with improved accuracy of diabetic retinopathy screening.

Virtual Rehabilitation Training System Based on Surface EMG Feature Extraction and Analysis.

Aiming at the characteristics that electromyography (EMG) signals can reflect the human body's motive intention and the information of muscle's motive state, this paper makes a thorough study on the evaluation of surface electromyography signals' motive state. At the same time, EMG signals can reflect the characteristics of limb movement and its changing rules, and can acquire the functional characteristics of limb movement so as to accurately evaluate the rehabilitation status of patients. In this paper, EMG signal analysis and feedback control are introduced into the virtual rehabilitation system to study the methods of EMG parameter identification and dynamic feature extraction, and obtain the EMG characteristics and variation rules related to human motion patterns. In this paper, a rehabilitation training system based on EMG feedback and virtual reality is built, and the validity of the system is verified by patient experiment. The feasibility of the system is verified by the methods of validity of the algorithm, recognition rate of the system action pattern and fatigue evaluation.

The optimal pathway for S1 sacroiliac screwing: 3D imaging study and clinical application / 中华创伤骨科杂志

Objective To determine the optimal pathway for S1 sacroiliac screwing based on the largest safe zone in Chinese population using 3D imaging models and observe its clinical application in patients with sacroiliac joint fracture or dislocation.Methods Pelvic CT scans of 54 Chinese adults were obtained to create reconstruction 3D models of the right hemi-pelvis.After the models were transparentized and rotated to the axial view of the S1 pedicle,the angle was slightly adjusted to maximize the translucent safe zone.Next,simulative insertion into the center of this zone was conducted with one virtual screw,as large as possible and tangent to the boundary.Measured were the diameter and length of the screw,the vertical distances from the entry point to the horizontal tangent line of the greater sciatic notch and to the vertical tangent line of the posterior superior iliac spine,and from the exit point to the S1 superior endplate and to the anterior cortex.The differences between males and females were analyzed.The above parameters of the optimal pathway for S1 sacroiliac screwing were used in insertion of 16 screws in the 12 patients with sacroiliac joint fracture or dislocation from January 2014 to January 2016 at Department of Orthopaedics and Traumatology,Nanfang Hospital.They were 8 males and 4 females,from 16 to 47 years of age (average,34 years).According to the Tile classification,6 cases belonged to Type Ⅱ and 6 ones to Type Ⅲ.The efficacy of S1 sacroiliac screwing was observed.Results In all the pelvic 3D imaging models,an oval translucent area for safe screw insertion could be easily identified from the S1 pedicle axial view.The maximum diameter and length of the optimal intraosseous pathway were 13.66 ±2.04 mm and 77.66 ±4.25 rmm;the vertical distances from the entry point to the horizontal tangent line of the greater sciatic notch and to the vertical tangent line of the posterior superior iliac spine were 32.77 ± 4.55 mm and 49.57 ± 5.24 mm;the vertical distances from the exit point to the S1 superior endplate and to the anterior cortex were 9.30 ± 1.54 mm and 15.85 ± 2.12 mm.The differences were of statistical significance between males and females regarding the maximum diameter,the distance from the entry point to the vertical axis,and the distance from the exit point to the anterior cortex (P ＜ 0.05).All the 16 screws were safely implanted in the 12 patients.Conclusion The optimal screw pathway can be easily identified and its parameters can be measured in pelvic 3D imagingmodels using computer virtual technology.The clinical application has proved that the parameters can serve as a theoretical basis for safe placement of S1 sacroiliac screws.

Effect of a perspective-taking intervention on the consideration of pain assessment and treatment decisions.

OBJECTIVES: Pain is often poorly managed, highlighting the need to better understand and treat patients' pain. Research suggests that pain is assessed and treated differently depending on patient sex, race, and/or age. Perspective-taking, whereby one envisions the perspective of another, has been found to reduce racial disparities in pain management. This study used virtual human (VH) technology to examine whether a perspective-taking intervention impacts pain management decisions. METHODS: Ninety-six participants were randomized to an online treatment or control group and viewed 16 video clips of VHs with standardized levels of pain. Participants provided ratings on the VHs' pain intensity and their willingness to administer opioids to them. The intervention group received a brief perspective-taking intervention that consisted of having participants imagine how the patient's suffering could affect his/her life, whereas the control group was asked to wait for the next VH videos to load. A LENS model analysis was used to investigate both group level (nomothetic) and individual level (idiographic) decision policies. A LENS model of analysis is typically used as an analog method for capturing how groups of people and individuals use information in their environment to form judgments. RESULTS: Nomothetic results found that participants rated pain higher and were more likely to prescribe opioids to VHs postintervention, irrespective of group. Idiographic results, however, found that the use of cues to make pain management decisions was mitigated by the perspective-taking group. The participants in the perspective-taking group were more likely to think about pain and the patients' perspective during the intervention, while control participants were more likely to reflect on the VHs' sex, race, or age. CONCLUSION: A brief intervention may alter participants' pain management decisions. These results indicate that a brief intervention might be an initial step toward aligning observers' pain management ratings with those of the patient. Future research is needed to replicate findings in a health care population.

The construction of visualization system for the meridians and acupoints of human body using three-dimensional virtual technology / 国际中医中药杂志

Objective The solution for the cross-platform of visualizing human meridian acupoints by three-dimensional (3D) virtual technology was explored based on existing researches to improve interactive method.Methods 3D virtual technology was utilized to construct a 3D visualization model of human meridians and acupoints.The cross-platform 3D visualization system was realized by integrating the existing relevant standards and clinical knowledge.Results The system can visually and dynamically show the meridians and acupoints of human body.Moreover, it can reveal the details including part meridian circulation, the spatial structure of acupoints, etc which fail to be reflected by the real acupuncture model and two-dimensional (2D) planar chart.Meanwhile, the system can be employed to realize the visualization interaction between meridians model and human beings, and the multi-screen cross-platform user scenarios in the whole network.Conclusion It is expected to be widely applied in fields, such as teaching of traditional Chinese medicine (TCM), scientific research, science popularization, etc.