A handheld fiber-optic tissue sensing device for spine surgery.

The demographic shift has increased the demand for surgical interventions to address age-related degenerative diseases, such as spinal fusion. Accurate placement of pedicle screws, crucial for successful spinal fusion, varies widely with physician experience. Integrating tissue sensing into spine surgical instruments allows intraoperative examination of tissue properties, providing surgeons with additional information to prevent screw misplacement.

Imaging Photoplethysmography (iPPG) in Head and Neck Reconstructive Surgery: A Novel Technique for Noninvasive Flap Perfusion Monitoring.

Background: Evaluate imaging photoplethysmography (iPPG) as a novel noninvasive technique to assess flap perfusion in head and neck free flap reconstructive (FFR) surgeries.

Methods: Intraoperative iPPG was performed in 17 patients undergoing FFR surgery. Imaging consisted of a 30-s video from which perfusion maps were extracted, providing detailed information about blood flow and pulsatility in the flap microvasculature.

Safety and immunogenicity of the live-attenuated hRVFV-4s vaccine against Rift Valley fever in healthy adults: a dose-escalation, placebo-controlled, first-in-human, phase 1 randomised clinical trial.

Background: Rift Valley fever virus, a pathogen to ruminants, camelids, and humans, is an emerging mosquito-borne bunyavirus currently endemic to Africa and the Arabian Peninsula. Although animals are primarily infected via mosquito bites, humans mainly become infected following contact with infected tissues or fluids of infected animals. There is an urgent need for adequate countermeasures, especially for humans, because effective therapeutics or vaccines are not yet available.

Coronary circulation enhances the aerobic performance of wild Pacific salmon.

Female Pacific salmon often experience higher mortality than males during their once-in-a-lifetime up-river spawning migration, particularly when exposed to secondary stressors (e.g. high temperatures).

Chinook salmon depth distributions on the continental shelf are shaped by interactions between location, season, and individual condition.

Background: Ecological and physical conditions vary with depth in aquatic ecosystems, resulting in gradients of habitat suitability. Although variation in vertical distributions among individuals provides evidence of habitat selection, it has been challenging to disentangle how processes at multiple spatio-temporal scales shape behaviour.

Methods: We collected thousands of observations of depth from acoustically tagged adult Chinook salmon Oncorhynchus tshawytscha, spanning multiple seasons and years.

Enhancing Intraoperative Tissue Identification: Investigating a Smart Electrosurgical Knife's Functionality During Electrosurgery.

Objective: Detecting the cancerous growth margin and achieving a negative margin is one of the challenges that surgeons face during cancer procedures. A smart electrosurgical knife with integrated optical fibers has been designed previously to enable real-time use of diffuse reflectance spectroscopy for intraoperative margin assessment. In this paper, the thermal effect of the electrosurgical knife on tissue sensing is investigated.

Fiber-Optic Pedicle Probes to Advance Spine Surgery through Diffuse Reflectance Spectroscopy.

Diffuse Reflectance Spectroscopy (DRS) can provide tissue feedback for pedicle screw placement in spine surgery, yet the integration of fiber optics into the tip of the pedicle probe, a device used to pierce through bone, is challenging, since the optical probing depth and signal-to-noise ratio (SNR) are affected negatively compared to those of a blunt DRS probe. Through Monte Carlo simulations and optical phantom experiments, we show how differences in the shape of the instrument tip influence the acquired spectrum. Our findings demonstrate that a single bevel with an angle of 30∘ offers a solution to anticipate cortical breaches during pedicle screw placement.

How subjective CT image quality assessment becomes surprisingly reliable: pairwise comparisons instead of Likert scale.

Objectives: The aim of this study is to improve the reliability of subjective IQ assessment using a pairwise comparison (PC) method instead of a Likert scale method in abdominal CT scans.

Methods: Abdominal CT scans (single-center) were retrospectively selected between September 2019 and February 2020 in a prior study. Sample variance in IQ was obtained by adding artificial noise using dedicated reconstruction software, including reconstructions with filtered backprojection and varying iterative reconstruction strengths.

Impairing cardiac oxygen supply in swimming coho salmon compromises their heart function and tolerance to acute warming.

Climatic warming elevates mortality for many salmonid populations during their physically challenging up-river spawning migrations, yet, the mechanisms underlying the increased mortality remain elusive. One hypothesis posits that a cardiac oxygen insufficiency impairs the heart's capacity to pump sufficient oxygen to body tissues to sustain up-river swimming, especially in warm water when oxygen availability declines and cardiac and whole-animal oxygen demand increases. We tested this hypothesis by measuring cardiac and metabolic (cardiorespiratory) performance, and assessing the upper thermal tolerance of coho salmon (Oncorhynchus kisutch) during sustained swimming and acute warming.

What are the chances? Clinician scientist` career pathways in Germany.

Background: Germany faces a lack of clinician scientists. This problem is widely acknowledged, not just in Germany, as clinician scientists are crucial for medical translation and innovation: trained in medical practice and research they are capable of translating scientific problems into clinical application and vice versa, clinical problems into research. The implementation of nationwide clinician scientist programs (CSPs) in Germany is supposed to solve the lack of trained clinician scientists and, as consequence, to improve the translational relationship between biomedical research and clinical practice.

Shaken or Stirred? The Inconsistencies of Manual Contrast Media Dilution in Endovascular Interventions.

Materials And Methods: Phase I: Eleven radiological technologists were asked to fill a CM injector 3 times with 50% diluted CM (iopromide 300 mg I/mL). The dilution was injected (12 mL/s) through a Coriolis flowmeter, with CM concentration and total volume calculated. Interoperator, intraoperator, and intraprocedural variations were calculated as coefficients of variability.

Population variability in thermal performance of pre-spawning adult Chinook salmon.

Climate change is causing large declines in many Pacific salmon populations. In particular, warm rivers are associated with high levels of premature mortality in migrating adults. The Fraser River watershed in British Columbia, Canada, supports some of the largest Chinook salmon () runs in the world.

Exploratory Food Effect Assessment in Patients in Early Clinical Development of Oncology Drugs.

Instructions for administration with regard to food are a key aspect of how patients experience oral drugs. Through potential effects on pharmacokinetics, the food condition can influence safety and efficacy, and thereby is one of many dimensions of dose optimization. Regulatory guidance from major health authorities advocates for the early investigation of food effect (FE) in clinical development.

The Dutch Working Party on Antibiotic Policy (SWAB) guideline for the approach to suspected antibiotic allergy.

Objectives: Prudent handling of reported antibiotic allergies is an important aspect of antibiotic stewardship. The Dutch Working Party on Antibiotic Policy (SWAB) constituted a multidisciplinary expert committee to provide evidence-based recommendations for bedside decision-making in antibiotic therapy in patients that report an antibiotic allergy.

Methods: The guideline committee generated 12 key questions, most of which were population, intervention, comparison, and outcome questions relevant to both children and adults with suspected antibiotic allergies.

Diffuse reflectance spectroscopy of the spine: improved breach detection with angulated fibers.

Accuracy in spinal fusion varies greatly depending on the experience of the physician. Real-time tissue feedback with diffuse reflectance spectroscopy has been shown to provide cortical breach detection using a conventional probe with two parallel fibers. In this study, Monte Carlo simulations and optical phantom experiments were conducted to investigate how angulation of the emitting fiber affects the probed volume to allow for the detection of acute breaches.

Diffuse reflectance spectroscopy sensor to differentiate between glial tumor and healthy brain tissue: a proof-of-concept study.

Glial tumors grow diffusely in the brain. Survival is correlated to the extent of tumor removal, but tumor borders are often invisible. Resection beyond the borders as defined by conventional methods may further improve prognosis.

Imaging Photoplethysmography for Noninvasive Anastomotic Perfusion Assessment in Intestinal Surgery.

Introduction: Anastomotic leakage after gastrointestinal surgery has a high impact on patient's quality of life and its origin is associated with inadequate perfusion. Imaging photoplethysmography (iPPG) is a noninvasive imaging technique that measures blood-volume changes in the microvascular tissue bed and detects changes in tissue perfusion.

Materials And Methods: Intraoperative iPPG imaging was performed in 29 patients undergoing an open segment resection of the small intestine or colon.

Development of a CT-Compatible, Anthropomorphic Skull and Brain Phantom for Neurosurgical Planning, Training, and Simulation.

Background: Neurosurgical procedures are complex and require years of training and experience. Traditional training on human cadavers is expensive, requires facilities and planning, and raises ethical concerns. Therefore, the use of anthropomorphic phantoms could be an excellent substitute.

Tissue-mimicking phantom materials with tunable optical properties suitable for assessment of diffuse reflectance spectroscopy during electrosurgery.

Emerging intraoperative tumor margin assessment techniques require the development of more complex and reliable organ phantoms to assess the performance of the technique before its translation into the clinic. In this work, electrically conductive tissue-mimicking materials (TMMs) based on fat, water and agar/gelatin were produced with tunable optical properties. The composition of the phantoms allowed for the assessment of tumor margins using diffuse reflectance spectroscopy, as the fat/water ratio served as a discriminating factor between the healthy and malignant tissue.

Gravid uterine torsion after prone positioning in SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome.

A multiparous pregnant patient was admitted to the intensive care unit in her third trimester of pregnancy for prone positioning mechanical ventilation after developing SARS-CoV2 (COVID-19)-related acute respiratory distress syndrome. Repositioning in left lateral tilt was followed by uterine contractions and cardiotocography alterations. Preterm caesarean section was performed based on persistent foetal tachycardia and suspected foetal distress, followed by a per-operative diagnosis of uterine levotorsion.

Imaging PPG for In Vivo Human Tissue Perfusion Assessment during Surgery.

Surgical excision is the golden standard for treatment of intestinal tumors. In this surgical procedure, inadequate perfusion of the anastomosis can lead to postoperative complications, such as anastomotic leakages. Imaging photoplethysmography (iPPG) can potentially provide objective and real-time feedback of the perfusion status of tissues.

Performance of Centargo: A Novel Piston-Based Injection System for High Throughput in CE CT.

Purpose: To compare an investigational device (MEDRAD Centargo CT Injection System, "Centargo") to the currently available MEDRAD Stellant CT Injection System ("Stellant"), in terms of efficiency, injector performance, and user satisfaction.

Patients And Methods: A total of 425 patients at two sites were enrolled; 198 patients in phase one, a randomized study (98 Stellant and 100 Centargo). The second observational phase included 227 patients who were injected with Centargo.

Cues to improve antibiotic-allergy registration: A mixed-method study.

Background: Approximately 2% of patients in primary care practice and up to 25% of hospital patients are registered as being allergic to an antibiotic. However, up to 90% of these registrations are incorrect, leading to unnecessary prescription of 2nd choice antibiotics with the attendant loss of efficacy, increased toxicity and antibiotic resistance. To improve registration, a better understanding is needed of how incorrect labels are attributed.

Hyperspectral Imaging for Tissue Classification after Advanced Stage Ovarian Cancer Surgery-A Pilot Study.

The most important prognostic factor for the survival of advanced-stage epithelial ovarian cancer (EOC) is the completeness of cytoreductive surgery (CRS). Therefore, an intraoperative technique to detect microscopic tumors would be of great value. The aim of this pilot study is to assess the feasibility of near-infrared hyperspectral imaging (HSI) for EOC detection in ex vivo tissue samples.