The factors predictive for readmission can help design individualized outpatient follow-up plans and programs for the reduction of readmissions.

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Abstract-The hand and eye coordination of the surgeon is one of the most important factor minimally invasive thoracic surgery. Virtual Simulation is a powerful training tool in surgery. At present, the main problems of the learning process are to reduce the learning time and to improve specific skills by the simulation. There are different options to perform tests: working with animals, with artificial tissues to simulate the pressure, and even simulators through joystick. The main disadvantage is the high cost of this systems and the complexity to replicate the situation during a real operations. In this paper, a virtual reality system is presented. This system allows to reduce the learning time and to improve the hand and eye coodination of the surgeon. Moreover, it is a low cost, portable and easy-to-use solution for future surgeons.

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Purpose Patients with lung cancer experience a variety of distressing symptoms which could adversely affect quality of life. The aim of this study was to determine whether psychological distress prior to surgery is associated to health status and symptom burden in lung cancer survivors. Methods A longitudinal observational study with 1‐year follow‐up was carried out. Health status was measured by the WHO Disability Assessment Scale (WHO-DAS 2.0), the Euroqol-5 dimensions (EQ-5D) and the Pittsburgh Sleep Quality Index (PSQI). Symptoms severity included dyspnoea (Multidimensional Profile of Dyspnoea); pain (Brief Pain Inventory); fatigue (Fatigue Severity Scale); and cough (Leicester Cough Questionnaire). Results One hundred seventy-four lung cancer patients were included. Patients in the group with psychological distress presented a worse self-perceived health status, functionality and sleep quality. The group with psychological distress also presented higher dyspnoea, fatigue and pain. Conclusion Patients with psychological distress prior surgery present with a greater symptom burden and a poorer self-perceived health status, lower functionality and sleep quality, than patients without distress 1 year after the lung resection.