基于眼动训练的腹腔镜手术培训方法的研究

目前国内腹腔镜训练的相关研究中,研究者侧重于研究手眼协调关系中器械的移动路径,忽视了视觉在腹腔镜训练中的引导作用。其它领域已有研究表明,通过注视训练,可以提高训练者的知觉-运动技能水平。本文旨在探讨视线追踪技术在腹腔镜模拟训练中的有效性,分析不同训练方式下受试者的注视策略。本文利用Tobii X1 Light型号眼动仪追踪受试者在手术训练箱中进行左右移环任务时的注视点位置,获取表征注视策略方面的指标:任务完成的效率,以及视觉搜索、视觉加工和基于马尔可夫链模型的注视转移分析。研究结果表明,经过眼动训练后,受试者的末次完成时间较首次完成时间减少了101.5 s。与视频训练方式相比,眼动组训练前后,注视行为有显著变化;受试者的注视与眼跳时间的比值增加38%,对目标区域的注视时间增加,眼跳幅度增大0.58°,受试者的注视点转移到器械的概率减小15%。本文研究结果表明,可以将视线追踪技术应用领域扩展到腹腔镜模拟培训中,通过学习专家的注视策略,提高受试者的技能水平,缩短学习曲线。     

基于眼动和脑电指标评价腹腔镜训练效果

本研究旨在客观评价训练者在不同专注度下的腹腔镜模拟训练效果。利用Brain Link采集脑电信号,计算样本熵和θ/β值来评价专注度;利用Tobii眼动仪采集眼动信号,计算完成时间、错误数、注视点个数来评价腹腔镜模拟训练效果。招募20名志愿者,其样本熵值小于0.77的为A组,大于0.77的为B组。结果表明,A组的样本熵值均小于B组,且变化较为平缓;而B组的样本熵值在前5次训练中变化较为平缓,后5次训练过程中变化较大。A组θ/β值较B组小,且整体变化趋势较为平缓。A组操作完成时间短,错误数少,注视点个数下降更快。本研究表明,训练者的专注度会影响训练效果。专注状态较好的A组,腹腔镜模拟训练技能水平提升快,学习效率高;而B组腹腔镜技能水平虽然也在提升,但达到学习稳定期所需要的时间更长。     

大学生对社会暴力信息注意偏向的眼动研究

目的:探讨个体对社会暴力信息的注意偏向特点。方法:方便选取32名男性大学本科生为被试,运用自我评价方法对6对国际情绪图片系统中的暴力和非暴力图片,进行暴力信息等级评定,并采用EyelinkⅡ型眼动仪同时记录被试眼动数据。以兴趣区第一个注视点开始时间、兴趣区第一个注视点序列号、首次注视点在兴趣区比率、兴趣区注视点比率、兴趣区注视点总数、图片注视点总数、兴趣区注视时间、兴趣区最大瞳孔直径等作为眼动指标,并用配对t检验对数据结果进行统计分析。结果:被试在非暴力图片兴趣区第一注视点开始时间长于暴力图片,在兴趣区第一个注视点序列号大于暴力图片,在首次注视点在兴趣区比率小于暴力图片,在图片注视点总个数多于暴力图片,在兴趣区的注视时间多于暴力图片,在兴趣区瞳孔最大直径小于暴力图片,且非暴力图片与暴力图片相比均具有显著差异。但是兴趣区注视点总数差异无统计学意义。结论:社会暴力信息能够引起个体明显的情绪改变并吸引个体的注意,产生注意偏向。但是否影响个体注意的维持或注意解除有待进一步研究。     

动态与静态面部表情加工的比较:来自眼动的证据

目的采用眼动技术,比较动态和静态呈现面部表情即时加工特点。方法选取17名被试进行实验,采用2(呈现方式:动态、静态)×3(面部表情:高兴、中性、生气)的两因素被试内设计。使用ASL504型眼动仪记录被试观看不同面部表情图片(每种条件各10张)的眼动情况,眼动分析指标包括总注视时间、注视百分比、注视点个数和凝视点个数。结果反应时出现了面部表情主效应(F(2,32)=5.27,P=0.011)。事后比较(LSD)显示,中性表情比高兴表情和生气表情反应时更长(P0.05)。注视点个数出现了呈现方式主效应(F(1,16)=14.34,P=0.002),动态呈现方式的注视点比静态呈现方式更少。凝视点个数出现面部表情主效(F(2,32)=5.14,P=0.012)。事后比较显示,中性面部表情比高兴和生气面部表情的凝视点更多(P0.05)。结论在同等时间内动态呈现面部表情的加工更有效率,进而证明了面部表情加工中的动态优势。     

基于EEG与眼动的腹腔镜训练疲劳分析

本研究主要对比分析新手在腹腔镜训练箱和模拟器训练过程中不同疲劳水平下的训练效果。20名志愿者,随机均分成A、B组;A组使用训练箱训练,B组使用模拟器训练。首次采用脑电信号评价训练过程中的脑力疲劳,定义状态指标F量化疲劳水平;采用眼动特征和完成时间、错误数来评价训练效果。分析两组F值曲线,第1~5次训练两组斜率均为0.17;第6~15次训练斜率分别为0.114、0.078;第16~20次训练斜率分别为0.54、0.24。研究结果表明,对于A组训练者,脑力疲劳的发生更容易影响其完成时间和注视点个数;对于B组训练者更容易影响错误数、注视时间百分比和注视/眼跳百分比。相同任务下,腹腔镜训练箱相对于模拟器更易于使训练者疲劳,两种训练器都对训练效果有提升,但训练效果不随着训练次数的增加而一直在提高。当疲劳发生时,训练效果会呈下降的趋势。     

腹腔镜模拟训练效果的客观评价

目的目前国内尚无结合腹腔镜模拟训练者的手眼运动特征对其训练效果进行客观评价的研究。本文主要利用Micron Tracker双目视觉导航仪和眼动仪,通过分析训练者的手眼运动特征对腹腔镜模拟手术的训练效果进行评价。方法利用Micron Tracker双目视觉导航仪采集并记录器械尖端运动的三维坐标,计算器械运动的总路径长度;利用眼动仪采集并记录训练者的操作时间和眼动信息,并计算出注视率、眼跳率和眼跳幅度,来评价腹腔镜手术训练效果。结果随着操作次数的增加,训练者的熟悉程度增加。第30次训练操作与第1次训练操作相比较:操作时间减小了58.18%,呈现减小趋势,并趋于稳定;右手器械总路径长度减少了63.95%,左手器械总路径长度减少了56.28%,左手器械总路径长度小于右手器械总路径长度,且均呈减少趋势并趋于稳定;眼跳率减小了20.81%,呈现减小的趋势;眼跳幅度增大了28.39%,呈现增大趋势;而眼动注视率和注视持续时间平均值并没有显著性变化(P0.05)。结论基于手眼运动特征的参数(操作时间、左右手总路径长度、眼跳率和眼跳幅度等)可以作为腹腔镜手术技能培训效果的客观评价指标。     

基于脑电信号腹腔镜手术培训的实时疲劳分析

实时评价模拟腹腔镜训练者训练时的疲劳值,并分析疲劳与训练效果的关系。基于MATLAB平台设计了数据采集模块和疲劳分析模块。在训练过程中,Brainlink采集脑电数据,通过蓝牙将数据发送到数据采集模块,然后通过盲源分离的方法去除伪迹,应用小波变换提取4种节律波,采用马氏距离的半监督回归模型得出疲劳值。采用ROC曲线确定模型的阈值,当超过阈值时表示疲劳事件发生,报警提示终止训练;利用Tobii眼动仪采集眼动信号,计算完成时间,错误数,注视点个数,注视时间百分比以及注视/眼跳时间百分比来评价训练效果。在1~6次训练中,疲劳值略微上升但疲劳还未发生时,训练效果逐渐变好;在7~15次中,疲劳值略微上升,训练效果趋于稳定;在16~20次中,疲劳值呈上升趋势,疲劳发生时,训练效果下降。训练者的疲劳程度对训练效果有一定的影响。当疲劳发生时,训练效果下降,当疲劳值达到疲劳阈值10时,应终止训练。     

3～6岁自闭症儿童面部表情识别的眼动实验

目的:探讨3~6岁自闭症儿童面部表情识别的影响因素。方法:采用眼动技术,观察高言语水平组与低语言水平组对不同情绪类型的陌生者面部表情和熟悉者面部表情图片的注视情况。结果:(1)在注视时间、注视点个数、注视率3项因变量指标上,言语能力的主效应均不显著(P0.05);(2)在注视点个数以及注视率上,表情性质的主效应显著(F=6.35,3.97;P0.05);(3)在注视时间上,面孔分区与熟悉度的交互作用显著(F=6.43,P0.05);(4)在注视点个数和注视率上,熟悉度与表情性质的交互作用显著(F=4.29,P0.05;F=6.73,P0.01)。结论:言语能力对自闭症儿童面部表情识别的影响较小;自闭症儿童对熟悉面孔的识别能力较好;自闭症儿童整体表现出对积极表情和消极情表情的注意偏好。     

抑郁缓解者正性注意偏向的实验操纵:来自眼动的证据

目的:了解正性注意偏向训练能否使复发性抑郁缓解个体对情绪图片的消极信息产生回避。方法:采用改版的点探测注意训练任务分别对正性词训练和中性词训练条件下的复发性抑郁缓解者各15例进行注意偏向的训练,训练前后通过眼动仪记录被试对情绪图片负性信息的注视次数和注视时间。结果:在积极词训练条件下,被试训练之后对图片消极部分的注视次数和注视时间比训练前明显减少;中性词训练条件下对图片消极部分的注视次数和注视时间在训练前后差异不显著。结论:积极信息关注的注意力训练能使复发性抑郁缓解者学会对负性信息的回避。     

心理健康对大学生认知加工过程的影响

目的考察不同心理健康水平对大学生加工视觉佶息的影响。方法采用症状自评量表（SCL-90）对150名大学生进行测试,区分出心理健康水平高分组和低分组,应用ASLS04型眼动仪记录其观看不同性质图片时的眼动模式。结集在注视次数上不同组与不同性质图片间的交互作用显著;在注视点的个数上,不同组与不同性质图片的交互作用显著。结论心理健康水平对大学生加工不同性质图片的过程影响显著。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.