Assessment of Robotic Console Skills (ARCS): construct validity of a novel global rating scale for technical skills in robotically assisted surgery.

Background: Skill assessment during robotically assisted surgery remains challenging. While the popularity of the Global Evaluative Assessment of Robotics Skills (GEARS) has grown, its lack of discrimination between independent console skills limits its usefulness. The purpose of this study was to evaluate construct validity and interrater reliability of a novel assessment designed to overcome this limitation.

A review of training research and virtual reality simulators for the da Vinci surgical system.

Unlabelled: PHENOMENON: Virtual reality simulators are the subject of several recent studies of skills training for robot-assisted surgery. Yet no consensus exists regarding what a core skill set comprises or how to measure skill performance. Defining a core skill set and relevant metrics would help surgical educators evaluate different simulators.

Muscle contributions to support and progression over a range of walking speeds.

Muscles actuate walking by providing vertical support and forward progression of the mass center. To quantify muscle contributions to vertical support and forward progression (i.e.

Myth: nephrolithiasis and medical expulsive therapy.

There is a medical myth that ureteral stones larger than 5 mm will not pass spontaneously and require urological intervention for removal. Recent findings indicate that medical expulsive therapy can facilitate spontaneous passage for stones up to 10 mm. For the management of ureteral stones, we recommend administering tamsulosin and a corticosteroid (deflazacort or prednisone) along with the standard therapy of analgesics, antibiotics and hydration.

Characterization of the N-deacetylase domain from the heparan sulfate N-deacetylase/N-sulfotransferase 2.

Heparin and heparan sulfate are linear sulfated polysaccharides that exert a multitude of biological functions. Heparan sulfate glucosaminyl N-deacetylase/N-sulfotransferase isoform 2 (NDST-2), a key enzyme in the biosynthesis of heparin, contains two distinct activities. This bifunctional enzyme removes the acetyl group from N-acetylated glucosamine (N-deacetylase activity) and transfers a sulfuryl group to the unsubstituted amino position (N-sulfotransferase activity).

Muscles that support the body also modulate forward progression during walking.

The purpose of this study was to characterize the contributions of individual muscles to forward progression and vertical support during walking. We systematically perturbed the forces in 54 muscles during a three-dimensional simulation of walking, and computed the changes in fore-aft and vertical accelerations of the body mass center due to the altered muscle forces during the stance phase. Our results indicate that muscles that provided most of the vertical acceleration (i.

The role of estimating muscle-tendon lengths and velocities of the hamstrings in the evaluation and treatment of crouch gait.

Persons with cerebral palsy frequently walk with excessive knee flexion during terminal swing and stance. This gait abnormality is often attributed to "short" or "spastic" hamstrings that restrict knee extension, and is often treated by hamstrings lengthening surgery. At present, the outcomes of these procedures are inconsistent.

Do the hamstrings operate at increased muscle-tendon lengths and velocities after surgical lengthening?

Children with crouch gait frequently walk with improved knee extension during the terminal swing and stance phases following hamstrings lengthening surgery; however, the mechanisms responsible for these improvements are unclear. This study tested the hypothesis that surgical lengthening enables the hamstrings of persons with cerebral palsy to operate at longer muscle-tendon lengths or lengthen at faster muscle-tendon velocities during walking. Sixty-nine subjects who had improved knee extension after surgery were retrospectively examined.