ALICE is the heavy-ion experiment at the CERN Large Hadron Collider. The experiment continuously took data during the first physics campaign of the machine from fall 2009 until early 2013, using proton and lead-ion beams. In this paper we describe the running environment and the data handling procedures, and discuss the performance of the ALICE detectors and analysis methods for various physics observables.

Objective To assess the effect of virtual reality training on an actual laparoscopic operation.Design Prospective randomised controlled and blinded trial.Setting Seven gynaecological departments in the Zeeland region of Denmark.Participants 24 first and second year registrars specialising in gynaecology and obstetrics.Interventions Proficiency based virtual reality simulator training in laparoscopic salpingectomy and standard clinical education (controls).Main outcome measure The main outcome measure was technical performance assessed by two independent observers blinded to trainee and training status using a previously validated general and task specific rating scale. The secondary outcome measure was operation time in minutes.Results The simulator trained group (n=11) reached a median total score of 33 points (interquartile range 32-36 points), equivalent to the experience gained after 20-50 laparoscopic procedures, whereas the control group (n=10) reached a median total score of 23 (22-27) points, equivalent to the experience gained from fewer than five procedures (P<0.001). The median total operation time in the simulator trained group was 12 minutes (interquartile range 10-14 minutes) and in the control group was 24 (20-29) minutes (P<0.001). The observers’ inter-rater agreement was 0.79.Conclusion Skills in laparoscopic surgery can be increased in a clinically relevant manner using proficiency based virtual reality simulator training. The performance level of novices was increased to that of intermediately experienced laparoscopists and operation time was halved. Simulator training should be considered before trainees carry out laparoscopic procedures.Trial registration ClinicalTrials.gov NCT00311792.

Background. Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade. Objective. To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals. Data sources. In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Limits: Controlled trials. Study eligibility criteria. All randomized controlled trials investigating the effect of VR training in laparoscopy, with outcome measured as surgical performance. Methods. A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants. Results. Operation time was reduced by 17–50% by VR training, depending on simulator type and training principles. Proficiency‐based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training. Conclusions. Skills in laparoscopic surgery can be increased by proficiency‐based procedural VR simulator training. There is substantial evidence (grade IA – IIB) to support the use of VR simulators in laparoscopic training.

The panel recommends screening patients with lung cancer for bone metastases at the initial staging of disease to assess symptomatic bone metastases and screen for asymptomatic bone metastases and to allow accurate monitoring of bone disease progression and initiate bone-specific therapy. Bone assessment should be based on positron emission tomography (if available) or bone scan. BPs should be added to the treatment of patients with lung cancer (with non-small cell lung cancer or small cell lung cancer) who develop bone metastases. In such patients, BPs must be considered part of metastatic lung cancer treatment to prevent and delay the occurrence of further bone metastases and skeletal-related events and to relieve pain where present. BP treatment should continue for as long as it is practically feasible in the absence of any significant adverse effects.