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Schraagen J.M.,Applied Scientific Research
British Journal of Surgery | Year: 2012

Background: The application of digital games for training medical professionals is on the rise. So-called 'serious' games form training tools that provide a challenging simulated environment, ideal for future surgical training. Ultimately, serious games are directed at reducing medical error and subsequent healthcare costs. The aim was to review current serious games for training medical professionals and to evaluate the validity testing of such games. Methods: PubMed, Embase, the Cochrane Database of Systematic Reviews, PsychInfo and CINAHL were searched using predefined inclusion criteria for available studies up to April 2012. The primary endpoint was validation according to current criteria. Results: A total of 25 articles were identified, describing a total of 30 serious games. The games were divided into two categories: those developed for specific educational purposes (17) and commercial games also useful for developing skills relevant to medical personnel (13). Pooling of data was not performed owing to the heterogeneity of study designs and serious games. Six serious games were identified that had a process of validation. Of these six, three games were developed for team training in critical care and triage, and three were commercially available games applied to train laparoscopic psychomotor skills. None of the serious games had completed a full validation process for the purpose of use. Conclusion: Blended and interactive learning by means of serious games may be applied to train both technical and non-technical skills relevant to the surgical field. Games developed or used for this purpose need validation before integration into surgical teaching curricula. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Basner M.,University of Pennsylvania | Babisch W.,Federal Environment Agency | Davis A.,Public Health England | Davis A.,University College London | And 4 more authors.
The Lancet | Year: 2014

Noise is pervasive in everyday life and can cause both auditory and non-auditory health effects. Noise-induced hearing loss remains highly prevalent in occupational settings, and is increasingly caused by social noise exposure (eg, through personal music players). Our understanding of molecular mechanisms involved in noise-induced hair-cell and nerve damage has substantially increased, and preventive and therapeutic drugs will probably become available within 10 years. Evidence of the non-auditory effects of environmental noise exposure on public health is growing. Observational and experimental studies have shown that noise exposure leads to annoyance, disturbs sleep and causes daytime sleepiness, affects patient outcomes and staffperformance in hospitals, increases the occurrence of hypertension and cardiovascular disease, and impairs cognitive performance in schoolchildren. In this Review, we stress the importance of adequate noise prevention and mitigation strategies for public health.

Van Buuren S.,Applied Scientific Research
Statistical Methods in Medical Research | Year: 2014

This article reviews and compares two types of growth charts for tracking human development over age. Both charts assume the existence of a continuous latent variable, but relate to the observed data in different ways. The D-score diagram summarizes developmental indicators into a single aggregate score measuring global development. The relations between the indicators should be consistent with the Rasch model. If true, the D-score is a measure with interval scale properties, and allows for the calculation of meaningful differences both within and across age. The stage line diagram describes the natural development of ordinal indicators. The method models the transition probabilities between successive stages of the indicator as smoothly varying functions of age. The location of each stage is quantified by the mid-P-value. Both types of diagrams assist in identifying early and delayed development, as well as finding differences in tempo. The relevant techniques are illustrated to track global development during infancy and early childhood (0-2 years) and Tanner pubertal stages (8-21 years). New reference values for both applications are provided. © 2013 The Author(s).

Hendriks H.F.J.,Applied Scientific Research
Proceedings of the Nutrition Society | Year: 2013

In this paper, the nutrigenomics approach is discussed as a research tool to study the physiological effects of nutrition and consequently how nutrition affects health and disease (endpoints). Nutrigenomics is the study of the effects of foods and food constituents on gene expression; the analyses include analysis of mRNA, proteins and metabolites. Nutrigenomics may be useful in dealing with the challenges that nutrition research is facing; by integrating the description of numerous active genes and metabolic pathways stronger evidence and new biomarkers for subtle nutritional effects may be obtained. Also, a new definition of disease and health may be needed. The use of tests challenging homoeostasis is being proposed to help define health. Challenge tests may be able to demonstrate in a better way subtle beneficial effects of nutrition on health. The paper describes some basic concepts relevant to nutrition research as well as some of the possibilities that are offered by nutrigenomics technology. Some of its applications are described. Copyright © The Author 2013.

Agency: Department of Defense | Branch: Army | Program: SBIR | Phase: Phase II | Award Amount: 735.63K | Year: 2012

The objective of this proposal is to develop an efficient user-friendly engineering toolkit consisting of a set of FORTRAN callable routines for desktop solution of variable-coefficient Poisson equations on shared-memory Multi-Core Processors (MCPs). The software design is highly modular, consisting of a flexible user interface linked to a set of hardware-optimized shared-memory Krylov solvers with multigrid and other preconditioners. During Phase I, using a benchmark of interest to the Army, various preconditioner-solver combinations were tested for optimal convergence and solution times, cache-aware data storage formats were examined for scalability, the bottleneck in MCP computing was identified, and the feasibility of a new proposed strategy was demonstrated successfully. For Phase II, the Krylov solvers and preconditioners will be optimized further using a range of information on the underlying MCP hardware. Each software module will be tested rigorously and the integrated system finally validated using applications of interest to the Army. Fast mixed-precision computations, efficient utility of the MCP memory hierarchy and distribution, flexible user interface, and dynamic solver adaptivity characterize the novel contributions of this project to the art of solving variable-coefficient Poisson equations on shared-memory MCPs.

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