Non-contact respiratory monitoring during sleep: comparison of the touchless flow signal with RIP signal to assess respiratory events.

Study Objectives: A non-intrusive sleep monitoring technology based on the data from a commercially available depth sensing camera has been utilized for respiratory monitoring and shown to have good performance in assessing respiratory rates across a range of rates. This non-contact, or , technology allows continuous respiratory monitoring without attaching probes to the patient. We have noticed a strikingly similar morphology between the touchless flow signal (NCM) and the flow signal derived using the chest and abdomen respiratory inductance plethysmography (RIP) bands.

Monitoring Respiratory Rate Continuously Without Attaching a Sensor During a Challenging Ramped Protocol.

Introduction: Respiratory rate (RR) is a crucial vital sign in patient monitoring and is often the best marker of the deterioration of a sick patient. It can be used to help diagnose numerous medical conditions and has been demonstrated to be an independent predictor of patient outcomes in various critical care settings and is incorporated in many clinical early warning scores. Here, we report on the performance of depth-camera-based system for the noncontact monitoring of RR during a ramped RR protocol.

Real-World Experience of Fluocinolone Acetonide 0.19 mg in the Management of Non-Infectious Uveitis.

Purpose: This study aims to evaluate the real-world efficacy and safety profile of fluocinolone acetonide (FAc) implants for the treatment of non-infectious uveitis (NIU).

Methods: A retrospective, observational study was conducted at Moorfields Eye Hospital, London, involving patients who received FAc 0.19 mg implants (Iluvien®) for NIU.

Distribution and host ranges of and (Diptera: Tephritidae) in South Africa.

Two fruit fly (Diptera: Tephritidae) species of economic importance: Karsch and De Meyer, Mwatawala & Virgilio are present in South Africa. The two species were considered as one species prior to 2016, but were subsequently separated. In this study, the distribution and abundance of the two species were quantified in seven provinces in South Africa through trapping with Enriched Ginger Oil as an attractant.

Robotic resection of presacral tumors.

Background: Presacral tumors are a rare entity typically treated with an open surgical approach. A limited number of minimally invasive resections have been described. The aim of the study is to evaluate the safety and efficacy of roboticresection of presacral tumors.

Development of a multi-entry identification key for economically important fruit fly larvae (Diptera, Tephritidae, Dacinae).

Identification of fruit fly larvae is difficult due to the limited morphological characteristics present. However, this is the stage at which fruit flies are intercepted at ports of entry through horticultural imports. Molecular tools are useful but are time-consuming and expensive compared to morphological identifications.

Accurate and continuous respiratory rate using touchless monitoring technology.

Purpose: Respiratory rate is a commonly used vital sign with various clinical applications. It serves as a crucial marker of acute health issues and any significant alteration in respiratory rate may be an early warning sign of major issues such as infections in the respiratory tract, respiratory failure, or cardiac arrest. Timely recognition of changes in respiratory rate enables prompt medical action, while neglecting to detect a change may lead to adverse patient outcomes.

Near-Infrared Spectroscopy Monitoring to Detect Changes in Cerebral and Renal Perfusion During Hypovolemic Shock, Volume Resuscitation, and Vasoconstriction.

Introduction: Rapidly changing hemodynamic conditions, such as uncontrolled hemorrhage and the resulting hypovolemic shock, are a common contributor to active duty military deaths. These conditions can cause cerebral desaturation, and outcomes may improve when regional cerebral oxygen saturation (CrSO2) is monitored using near-infrared spectroscopy (NIRS) and desaturation episodes are recognized and reversed. The purpose of this porcine study was to investigate the ability of NIRS monitoring to detect changes in regional cerebral and regional renal perfusion during hypovolemia, resuscitation by volume infusion, and vasoconstriction.

Kinematic metrics and surgeon experience in robotic cholecystectomies: a pilot study on breaking down technical performance.

Background: Recent studies have correlated surgical skill measured by video-based assessment with improved clinical outcomes. Certain automated measures of operative performance in robotic surgery can be gathered beyond video review called objective performance indicators (OPIs). We explore the relationship between OPIs, surgeon experience, and postoperative recovery, hypothesizing that more efficient dissection will be associated with experience.

Kinematic data profile and clinical outcomes in robotic inguinal hernia repairs: a pilot study.

Background: Surgical training requires clinical knowledge and technical skills to operate safely and optimize clinical outcomes. Technical skills are hard to measure. The Intuitive Data Recorder (IDR), (Sunnyvale, CA) allows for the measurement of technical skills using objective performance indicators (OPIs) from kinematic event data.

Robust Non-Contact Monitoring of Respiratory Rate using a Depth Camera.

Purpose: Respiratory rate (RR) is one of the most common vital signs with numerous clinical uses. It is an important indicator of acute illness and a significant change in RR is often an early indication of a potentially serious complication or clinical event such as respiratory tract infection, respiratory failure and cardiac arrest. Early identification of changes in RR allows for prompt intervention, whereas failing to detect a change may result in poor patient outcomes.

The Surgical Learning Curve: Does Robotic Technical Skill Explain Differences in Operative Performance?

Prior studies on technical skills use small collections of videos for assessment. However, there is likely heterogeneity of performance among surgeons and likely improvement after training. If technical skill explains these differences, then it should vary among practicing surgeons and improve over time.

The Benefits and Drawbacks of Staging Pelvic Pouches.

Since the mid-20th century, physicians have searched for way to improve the lives of patients with ulcerative colitis (UC). Early attempts of curative resection left the patients with a permanent stoma with only primitive stoma appliances available. Gradually, stoma care improved and operations were devised to give the patient bowel continuity without the need for a permanent ostomy.

Does Surgeon Experience Correlate with Crowd-Sourced Skill Assessment in Robotic Bariatric Surgery?

Background: The Global Evaluative Assessment of Robotic Skills (GEARS) rubric provides a measure of skill in robotic surgery. We hypothesize surgery performed by more experienced operators will be associated with higher GEARS scores.

Method: Patients undergoing sleeve gastrectomy from 2016 to 2020 were analyzed.

Outcome prediction in bariatric surgery through video-based assessment.

Introduction: The relationship between intraoperative surgical performance scores and patient outcomes has not been demonstrated at a single-case level. The GEARS score is a Likert-based scale that quantifies robotic surgical proficiency in 5 domains. Given that even highly skilled surgeons can have variability in their skill among their cases, we hypothesized that at a patient level, higher surgical skill as determined by the GEARS score will predict individual patient outcomes.

Objective assessment of robotic surgical skills: review of literature and future directions.

Background: Evaluation of robotic surgical skill has become increasingly important as robotic approaches to common surgeries become more widely utilized. However, evaluation of these currently lacks standardization. In this paper, we aimed to review the literature on robotic surgical skill evaluation.

Blinded intraoperative skill evaluations avoid gender-based bias.

Introduction: Gender bias has been identified consistently in written performance evaluations. Qualitative tools may provide a standardized way to evaluate surgical skill and minimize gender bias. We hypothesized that there is no difference in operative time or GEARS scores in robotic hysterectomy for men vs women surgeons.

Hypoglycemia and Dysautonomia After Bariatric Surgery: a Systematic Review and Perspective.

Introduction: With the increasing performance of bariatric surgery, rare complications are becoming prevalent. We review the diagnosis and treatment of dysautonomia after bariatric surgery and the limited treatment options available. We summarize the suggested mechanisms and explain why a complete understanding of the etiology has yet to be determined.

Sustained postoperative plasma elevations of plasminogen activator inhibitor-1 following minimally invasive colorectal cancer resection.

Plasminogen activator inhibitor-1 (PAI-1) is a serine protease inhibitor that inhibits urokinase-type plasminogen activator and tissue-type plasminogen activator. PAI-1 participates in angiogenesis, wound healing and tumor invasion, and additionally regulates endothelial cell proliferation, angiogenesis and tumor growth. The purpose of the present study was to measure plasma PAI-1 levels perioperatively in patients with colorectal cancer (CRC) undergoing minimally invasive colorectal resection (MICR).

Therapeutic Lymphangiography for Persistent Lymphatic Leak After Kidney Transplant: A Novel Technique.

Lymphatic leakage is a common and well-described complication after kidney transplantation, occurring in up to 25% of patients. Accumulation of lymph is due to the surgical disruption of recipient lymphatic channels accompanying the external iliac vessels, complicated by lower extremity edema, wound breakdown, infection, and, if unresolved, graft loss due to extrinsic compression. In this report, we describe the novel use of diagnostic and therapeutic lymphangiography to successfully treat lymphatic leak after renal transplant that was resistant to drain placement, sclerotherapy, and laparoscopic peritoneal window creation.

Intellectual property and data ownership in the age of video recording in the operating room.

Background: Recording intraoperative videos has become commonplace during surgery, with applications in video-based assessment, education and research. These videos can be both manually and automatically analyzed for performance analysis. A number of commercial entities providing video acquisition and processing has flourished over the recent years.