Femur fracture is a frequently occurred injury and usually treated by surgeries. However, the treatment of femur fracture exhibits many problems such as excessive radiation exposure to both surgeons and patients and mal-alignment in reduction. In order to overcome these problems, robot-assisted reduction surgery has been researched in recent years. One hybrid robot is introduced in this paper for femur fracture reduction. In order to train the surgeon for pre-operative planning or for intra-operative manipulation, we developed a tele-operation and simulation system for the newly developed hybrid robot. In this system, we construct the virtual hybrid robot by V-Realm Builder 2.0 based on VRML language, use MATLAB Simulink and the virtual reality toolbox to build the simulation model, and tele-operation of the virtual hybrid robot is implemented using the Phantom haptic interface. The virtual system presented in this paper creates a realistic environment for demonstration and provides facilities for good quality rendering. The tele-operation system shows that it is convenient and powerful in defining a 3D path. The approach utilized in this paper can also be used to study other types of robot.
Because of the advent of highly effective treatments, routine screening for HIV and hepatitis C virus (HCV) has been recommended for many Americans. This study explored the perceived barriers surrounding routine HIV and HCV screening in a diverse sample of community health centers (CHCs). The Community Health Applied Research Network (CHARN) is a collaboration of CHCs, with a shared clinical database. In July, 2013, 195 CHARN providers working in 12 CHCs completed a survey of their attitudes and beliefs about HIV and HCV testing. Summary statistics were generated to describe the prevalence of HIV and HCV and associated demographics by CHCs. HIV and HCV prevalence ranged from 0.1% to 5.7% for HIV and from 0.1% to 3.7% for HCV in the different CHCs. About 15% of the providers cared for at least 50 individuals with HIV and the same was true for HCV. Two-thirds saw less than 10 patients with HIV and less than half saw less than 10 patients with HCV. Less than two-thirds followed USPHS guidelines to screen all patients for HIV between the ages of 13 and 64, and only 44.4% followed the guidance to screen all baby boomers for HCV. Providers with less HIV experience tended to be more concerned about routine screening practices. More experienced providers were more likely to perceive lack of time being an impediment to routine screening. Many US CHC providers do not routinely screen their patients for HIV and HCV. Although additional education about the rationale for routine screening may be indicated, incentives to compensate providers for the additional time they anticipate spending in counseling may also facilitate increased screening rates.
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