Development of a synchronous motion-tracking and video capture tool for flexible ureteroscopy.

Introduction: Hand/instrument motion-tracking in surgical simulation provides valuable data to improve psychomotor skills and can serve as a formative evaluation tool. Motion analysis has been well-studied in laparoscopic surgery; however, there are essentially no studies looking at motion-tracking for flexible ureteroscopy (fURS ), a common surgical procedure requiring hand dexterity and 3D spatial awareness. We aimed to design a synchronized motion-tracking and video capture system for fURS capable of collecting objective metrics for use in surgical skills training.

A Novel Ureteroscopy Training Platform That Utilizes CT Urograms to Replicate Complex Renal Collecting System Anatomies.

Flexible ureteroscopy (fURS) is a one-person surgical technique, limiting trainees' ability to practice intraoperatively. Although well suited for simulation training, few existing fURS simulators can accurately reproduce complex renal collecting system anatomies. We developed an anatomically accurate fURS simulator using three-dimensional (3D) reconstruction of CT urograms and 3D printing technology to address this need.

Refining How We Define Laparoscopic Expertise.

Background: Traditional stratification of expertise in laparoscopic simulation assigns participants to novice, intermediate, or expert groups based on case numbers. We hypothesized that expert video assessment might refine this discrimination of psychomotor expertise, especially in light of new measurable parameters.

Materials And Methods: One hundred five participants performed a defined intracorporeal suturing task in the pediatric laparoscopic surgery simulator armed with force-sensing capabilities.

Effectiveness of discovery learning using a mobile otoscopy simulator on knowledge acquisition and retention in medical students: a randomized controlled trial.

Background: Portable educational technologies, like simulators, afford students the opportunity to learn independently. A key question in education, is how to pair self-regulated learning (SRL) with direct instruction. A cloud-based portable otoscopy simulator was employed to compare two curricula involving SRL.

Refinement in the analysis of motion within low-cost laparoscopic simulators of differing size: Implications on assessing technical skills.

Background: Simulation is becoming more important in the teaching and assessment of technical skills. The purpose of this study was to refine the use of motion analysis parameters (MAPs) to assess performance of a defined task in low-cost pediatric laparoscopic simulators of differing size.

Methods: 105 participants performed a defined intracorporeal suturing task in large and small pediatric laparoscopic simulators.

Comparison of Adult and Pediatric Surgeons: Insight into Simulation-Based Tools That May Improve Expertise Among Experts.

Background: Laparoscopic models are increasingly recognized as important tools in surgical training. The purpose of this study was to compare pediatric and adult laparoscopic surgical skills, and gain insight into the upskilling in both groups.

Materials And Methods: Adult- and pediatric-sized laparoscopic simulators were fitted with custom-built motion tracking hardware and software.

Educational Role for an Advanced Suturing Task in the Pediatric Laparoscopic Surgery Simulator.

Background: Laparoscopic models are recognized as important training tools. Lower fidelity systems are used mainly for simpler tasks; an advanced suturing task may allow for additional training of experts. The purpose of this study was to explore the educational role of an advanced suturing task using motion analysis and establish the task's construct validity.

Video assessment of laparoscopic skills by novices and experts: implications for surgical education.

Background: Previous investigators have shown that novices are able to assess surgical skills as reliably as expert surgeons. The purpose of this study was to determine how novices and experts arrive at these graded scores when assessing laparoscopic skills and the potential implications this may have for surgical education.

Methods: Four novices and four general laparoscopic surgeons evaluated 59 videos of a suturing task using a 5-point scale.

Analysis of motion in laparoscopy: the deconstruction of an intra-corporeal suturing task.

Background: This study analyzes instrument motion for segments of a defined intra-corporeal suturing task in a laparoscopic simulator. We describe a system providing real-time velocity and acceleration assessment in the performance of this task. Analysis of the deconstructed task segments allows targeted assessment and teaching.

Objective Evaluation of Otoscopy Skills Among Family and Community Medicine, Pediatric, and Otolaryngology Residents.

Introduction: The objective of this study is to evaluate and compare the perceived need for otolaryngology training and otoscopy diagnostic skills in primary care (Family and Community Medicine, Pediatric Medicine), and Otolaryngology Head and Neck Surgery (OTO-HNS) postgraduate trainees. Participant otoscopy skills were evaluated using the OtoSim simulator.

Methods: Family and Community Medicine, Pediatric, and OTO-HNS residents were recruited.

Evaluation of an otoscopy simulator to teach otoscopy and normative anatomy to first year medical students.

Objective/hypothesis: Our study evaluates the effectiveness of the OtoSim as an educational tool for teaching otoscopy and normal middle ear anatomy to first-year medical students.

Study Design: Cross-sectional survey design.

Methods: A large group otoscopy simulator teaching session was held in January 2014 for 29 first-year medical students at the University of Toronto.

Construct validity and educational role for motion analysis in a laparoscopic trainer.

Background: Laparoscopic models for ex vivo up-skilling are becoming increasingly important components of surgical education. This study aims to establish the construct validity and possible educational role of a new laparoscopic box trainer equipped with a motion-tracking device.

Methods: A structured questionnaire was used to assign participants into novice, intermediate, or expert categories according to level of experience in minimal access surgery (MAS).

Motion analysis in the pediatric laparoscopic surgery (PLS) simulator: validation and potential use in teaching and assessing surgical skills.

Background: Construct validity for the pediatric laparoscopic surgery (PLS) simulator has been established through a scoring system based on time and precision. We describe the development and initial validation of motion analysis to teach and assess skills related to pediatric minimal access surgery (MAS).

Methods: Participants were asked to perform a standardized intracorporeal suturing task.

The Pediatric Laparoscopic Surgery (PLS) simulator: methodology and results of further validation.

Background: The Pediatric Laparoscopic Surgery (PLS) simulator is the only validated tool for pediatric Minimal Access Surgery. Construct validity (the ability to discriminate between novice, intermediate and expert) for the PLS simulator had previously been established on the basis of the total PLS score, as well as the individual performance on three of the five tasks. We describe the process and methods used to establish independent construct validity for a fourth task: pattern-cutting.

Accurate samples for testing mass spectrometry based peptide quantification algorithms.

Quantitative proteomic experiments use algorithms to estimate peptide abundances from spectra. The efficacy of these algorithms is usually tested against a contrived mixture of proteins. However, the numerous error sources in mass spectrometry based proteomics experiments must be accounted for to evaluate novel algorithms in an unbiased manner.

Methods for combining peptide intensities to estimate relative protein abundance.

Motivation: Labeling techniques are being used increasingly to estimate relative protein abundances in quantitative proteomic studies. These techniques require the accurate measurement of correspondingly labeled peptide peak intensities to produce high-quality estimates of differential expression ratios. In mass spectrometers with counting detectors, the measurement noise varies with intensity and consequently accuracy increases with the number of ions detected.

A Bayesian approach to peptide identification using accurate mass and time tags from LC-FTICR-MS proteomics experiments.

In high-throughput proteomics, one promising approach presently being explored is the Accurate Mass and Time (AMT) tag approach, in which reversed-phase liquid chromatography coupled to high accuracy mass spectrometry provide measurements of both the masses and chromatographic retention times of tryptic peptides in complex mixtures. These measurements are matched to the mass and predicted retention times of peptides in library. There are two varieties of peptides in the library: peptides whose retention time predictions are derived from previous peptide identifications and therefore are of high precision, and peptides whose retention time predictions are derived from a sequence-based model and therefore have lower precision.

Quantification of uncertainty of peptide retention time predictions from a sequence-based model in LC-MS/MS proteomics experiments.

In high-throughput mass spectrometry-based proteomics, it is necessary to employ separations to reduce sample complexity prior to mass spectrometric peptide identification. Interest has begun to focus on using information from separations to aid in peptide identification. One of the most common separations is reversed-phase liquid chromatography, in which peptides are separated on the basis of their chromatographic retention time.

Methods for peptide identification by spectral comparison.

Background: Tandem mass spectrometry followed by database search is currently the predominant technology for peptide sequencing in shotgun proteomics experiments. Most methods compare experimentally observed spectra to the theoretical spectra predicted from the sequences in protein databases. There is a growing interest, however, in comparing unknown experimental spectra to a library of previously identified spectra.

Multicomponent internal recalibration of an LC-FTICR-MS analysis employing a partially characterized complex peptide mixture: systematic and random errors.

In high-throughput proteomics, a promising current approach is the use of liquid chromatography coupled to Fourier transform ion cyclotron resonance mass spectrometry (LC-FTICR-MS) of tryptic peptides from complex mixtures of proteins. To apply this method, it is necessary to account for any systematic measurement error, and it is useful to have an estimate of the random error expected in the measured masses. Here, we analyze by LC-FTICR-MS a complex mixture of peptides derived from a sample previously characterized by LC-QTOF-MS.

Increasing peptide identification in tandem mass spectrometry through automatic function switching optimization.

Comprehensive proteomic studies that employ MS directed peptide sequencing are limited by optimal peptide separation and MS and tandem MS data acquisition routines. To identify the optimal parameters for data acquisition, we developed a system that models the automatic function switching behavior of a mass spectrometer using an MS-only dataset. Simulations were conducted to characterize the number and the quality of simulated fragmentation as a function of the data acquisition routines and used to construct operating curves defining tandem mass spectra quality and the number of peptides fragmented.