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Anatomy education has been revolutionized through digital media, resulting in major advances in realism, portability, scalability, and user satisfaction. However, while such approaches may well be more portable, realistic, or satisfying than traditional photographic presentations, it is less clear that they have any superiority in terms of student learning. In this study, it was hypothesized that virtual and mixed reality presentations of pelvic anatomy will have an advantage over two-dimensional (2D) presentations and perform approximately equal to physical models and that this advantage over 2D presentations will be reduced when stereopsis is decreased by covering the non-dominant eye. Groups of 20 undergraduate students learned pelvic anatomy under seven conditions: physical model with and without stereo vision, mixed reality with and without stereo vision, virtual reality with and without stereo vision, and key views on a computer monitor. All were tested with a cadaveric pelvis and a 15-item, short-answer recognition test. Compared to the key views, the physical model had a 70% increase in accuracy in structure identification; the virtual reality a 25% increase, and the mixed reality a non-significant 2.5% change. Blocking stereopsis reduced performance on the physical model by 15%, on virtual reality by 60%, but by only 2.5% on the mixed reality technology. The data show that virtual and mixed reality technologies tested are inferior to physical models and that true stereopsis is critical in learning anatomy.

Healthcare-associated infections are a significant concern in acute care facilities across the US. Studies have shown the importance of a hygienic patient environment in reducing the risk of such infections. This has caused an increased interest in ultraviolet (UV-C) light disinfectant technology as an adjunct technology to provide additional pathogen reduction to environmental surfaces and patient care equipment (i.e., surfaces). It is also well known that UV-C light can cause premature degradation of materials, particularly certain plastic materials. However, there is little information in the literature regarding characterizing this degradation of plastics and other materials used for surfaces in healthcare. This study aims to evaluate multiple characterization techniques and propose a systematic approach to further understand early onset degradation of plastics due to UV-C exposure. Susceptibility and modes of degradation of multiple plastic materials were compared using the techniques evaluated. Ten grades of plastic materials were exposed to UV-C light in a manner consistent with standards given in the healthcare and furniture industry to achieve disinfection. These materials were characterized for visual appearance, chemical composition, surface roughness and hardness using light microscopy, spectrophotometry, contact angle analysis, infrared spectroscopy, profilometry and nanoindentation. All characterization methods were able to identify one or more specific degradation features from UV-C exposure covering different aspects of physicochemical properties of the surfaces. However, these methods showed different sensitivity and applicability to identify the onset of surface damage. Different types of surface materials showed different susceptibility and modes to degradation upon UV-C light exposure. UV-C disinfection can cause detectable damage to various surfaces in healthcare. A characterization approach consisting of physical and chemical characterizations is proposed in quantifying surface degradation of a material from UV-C exposure to address the complexity in modes of degradation and the varied sensitivity to UV-C from different materials. Methods with high sensitivity can be used to evaluate onset of damage or early stage damage.

There remains great controversy as to the indications and true benefits for pulmonary metastasectomy. The number of metastatic lesions, length of disease-free interval, and unilaterality has shown to be important prognostic factors on overall survival. In this review, we evaluate a number of clinical trials and critically assess the rational to perform pulmonary metastasectomy, which is a local treatment for a systemic disease process.

TECHNIQUE Port placement is described in Table 1 and Figure 1. This standardized port configuration can be used for all segmental resections. On the left, the port arrangement is shifted slightly posterior to account for the heart/mediastinum. A metal 10-mm port is introduced for the camera at the level of the 7th interspace in the midaxillary line. Instruments/staplers are introduced through the remaining incisions without ports, unless required. Rib spreading is avoided.1