Central ligation or partial preservation of the right gastric artery does not seem to affect conduit or anastomotic perfusion during robot-assisted resection of gastroesophageal junction cancer: a randomized clinical trial.

The gastric conduit can be created with partial preservation or a central ligation of the right gastric artery. Central ligation may facilitate complete removal of lymph node (LN) station 3; however, whether this influences conduit and anastomotic perfusion is unknown. Hence this study investigated whether a central ligation of the right gastric artery would affect conduit or anastomotic perfusion compared with partial preservation (local standard) during robot-assisted resection of gastroesophageal junction cancer.

Automated performance metrics and surgical gestures: two methods for assessment of technical skills in robotic surgery.

The objective of this study is to compare automated performance metrics (APM) and surgical gestures for technical skills assessment during simulated robot-assisted radical prostatectomy (RARP). Ten novices and six experienced RARP surgeons performed simulated RARPs on the RobotiX Mentor (Surgical Science, Sweden). Simulator APM were automatically recorded, and surgical videos were manually annotated with five types of surgical gestures.

Computer-aided quality assessment of endoscopist competence during colonoscopy: a systematic review.

Background And Aims: Endoscopists' competence can vary widely, as shown in the variation in the adenoma detection rate (ADR). Computer-aided quality assessment (CAQ) can automatically assess performance during individual procedures. In this review we identified and described different CAQ systems for colonoscopy.

AI supported fetal echocardiography with quality assessment.

This study aimed to develop a deep learning model to assess the quality of fetal echocardiography and to perform prospective clinical validation. The model was trained on data from the 18-22-week anomaly scan conducted in seven hospitals from 2008 to 2018. Prospective validation involved 100 patients from two hospitals.

Developing a phantom for simulating robotic-assisted complete mesocolic excision using 3D printing and medical imaging.

Background: Robotic-assisted complete mesocolic excision is an advanced procedure mainly because of the great variability in anatomy. Phantoms can be used for simulation-based training and assessment of competency when learning new surgical procedures. However, no phantoms for robotic complete mesocolic excision have previously been described.

Development and Usability of an Inexpensive and Reusable Phantom for Ultrasound-Guided Needle Cannulation.

Introduction Ultrasound-guided peripheral venous catheter placement (UG-PVCP) is a key skill for establishing intravenous access, especially in patients with anatomical challenges. Ultrasound is highly operator-dependent, and it is essential to ensure a sufficient level of competence when educating healthcare professionals. Competence can be acquired through simulation-based training (SBT) using phantoms or simulators.

Surgical gestures can be used to assess surgical competence in robot-assisted surgery : A validity investigating study of simulated RARP.

To collect validity evidence for the assessment of surgical competence through the classification of general surgical gestures for a simulated robot-assisted radical prostatectomy (RARP). We used 165 video recordings of novice and experienced RARP surgeons performing three parts of the RARP procedure on the RobotiX Mentor. We annotated the surgical tasks with different surgical gestures: dissection, hemostatic control, application of clips, needle handling, and suturing.

Model of Oxygen Conditions within Aquaculture Sea Cages.

To ensure optimal feed intake, growth, and general fish health in aquaculture sea cages, interactions between drivers that affect oxygen conditions need to be understood. The main drivers are oxygen consumption and water exchange, caused by flow through the cage. Swimming energetics in rainbow trout () in normoxia and hypoxia at 10, 15, and 20 °C were determined.

Comparing Simulator Metrics and Rater Assessment of Laparoscopic Suturing Skills.

Background: Laparoscopic intracorporeal suturing is important to master and competence should be ensured using an optimal method in a simulated environment before proceeding to real operations. The objectives of this study were to gather validity evidence for two tools for assessing laparoscopic intracorporeal knot tying and compare the rater-based assessment of laparoscopic intracorporeal suturing with the assessment based on simulator metrics.

Methods: Twenty-eight novices and 19 experienced surgeons performed four laparoscopic sutures on a Simball Box simulator twice.

Acquisition and usage of robotic surgical data for machine learning analysis.

Background: The increasing use of robot-assisted surgery (RAS) has led to the need for new methods of assessing whether new surgeons are qualified to perform RAS, without the resource-demanding process of having expert surgeons do the assessment. Computer-based automation and artificial intelligence (AI) are seen as promising alternatives to expert-based surgical assessment. However, no standard protocols or methods for preparing data and implementing AI are available for clinicians.

Using Virtual Reality Head-Mounted Displays to Assess Skills in Emergency Medicine: Validity Study.

Background: Many junior doctors must prepare to manage acutely ill patients in the emergency department. The setting is often stressful, and urgent treatment decisions are needed. Overlooking symptoms and making wrong choices may lead to substantial patient morbidity or death, and it is essential to ensure that junior doctors are competent.

Building low-cost simulators for invasive ultrasound-guided procedures using the V-model.

The use of medical simulators for training technical and diagnostic skills has rapidly increased over the past decade. Yet, most available medical simulators have not been developed based on a structured evaluation of their intended uses but rather out of expected commercial value. Moreover, educators often struggle to access simulators because of cost or because no simulators have been developed for a particular procedure.

Physiological effects of temperature on Greenland halibut Reinhardtius hippoglossoides shows high vulnerability of Arctic stenotherms to global warming.

Global warming affects the metabolism of ectothermic aquatic breathers forcing them to migrate and undergo high-latitudinal distribution shifts to circumvent the temperature-induced mismatch between increased metabolic demand and reduced water oxygen availability. Here the authors examined the effects of temperature on oxygen consumption rates in an Arctic stenotherm, the Greenland halibut Reinhardtius hippoglossoides, and calculated the optimal temperature for maximum aerobic scope, AS(T ), which was found to be 2.44°C.

Learning insertion of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) catheter: Is clinical experience necessary? A prospective trial.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging and potentially life-saving procedure, necessitating qualified operators in an increasing number of centres. The procedure shares technical elements with other vascular access procedures using the Seldinger technique, which is mastered by doctors not only in endovascular specialties but also in trauma surgery, emergency medicine, and anaesthesiology. We hypothesised that doctors mastering the Seldinger technique (experienced anaesthesiologist) would learn the technical aspects of REBOA with limited training and remain technically superior to doctors unfamiliar with the Seldinger technique (novice residents) given similar training.

The fundamentals of Artificial Intelligence in medical education research: AMEE Guide No. 156.

The use of Artificial Intelligence (AI) in medical education has the potential to facilitate complicated tasks and improve efficiency. For example, AI could help automate assessment of written responses, or provide feedback on medical image interpretations with excellent reliability. While applications of AI in learning, instruction, and assessment are growing, further exploration is still required.

Laser Speckle Contrast Imaging-based diagnosis of severe mesenteric traction syndrome: Hemodynamics and prostacyclin - A prospective cohort study.

Brief Abstract: Today, the diagnosis and grading of mesenteric traction syndrome relies on a subjective assessment of facial flushing. However, this method has several limitations. In this study, Laser Speckle Contrast Imaging and a predefined cut-off value are assessed and validated for the objective identification of severe mesenteric traction syndrome.

Preparing for Reality: A Randomized Trial on Immersive Virtual Reality for Bronchoscopy Training.

Background: Bronchoscopy is an essential procedure in the diagnosis and treatment of pulmonary diseases. However, the literature suggests that distractions affect the quality of bronchoscopy and affect inexperienced doctors more than experienced.

Objectives: The objective of the study was as follows: does simulation-based bronchoscopy training with immersive virtual reality (iVR) improve the doctors' ability to handle distractions and thereby increase the quality, measured in procedure time, structured progression score, diagnostic completeness (%), and hand motor movements of a diagnostic bronchoscopy in a simulated scenario.

Multi-centre deep learning for placenta segmentation in obstetric ultrasound with multi-observer and cross-country generalization.

The placenta is crucial to fetal well-being and it plays a significant role in the pathogenesis of hypertensive pregnancy disorders. Moreover, a timely diagnosis of placenta previa may save lives. Ultrasound is the primary imaging modality in pregnancy, but high-quality imaging depends on the access to equipment and staff, which is not possible in all settings.

Anastomotic perfusion assessment with indocyanine green in robot-assisted low-anterior resection, a multicenter study of interobserver variation.

Background: Securing sufficient blood perfusion to the anastomotic area after low-anterior resection is a crucial factor in preventing anastomotic leakage (AL). Intra-operative indocyanine green fluorescent imaging (ICG-FI) has been suggested as a tool to assess perfusion. However, knowledge of inter-observer variation among surgeons in the interpretation of ICG-FI is sparse.

Ultrasound Transducer Pressure: An Unexplored Source of Abdominal Aortic Aneurysm Measurement Error.

This study was aimed at quantifying the abdominal aortic aneurysm (AAA) compression phenomenon and assessing the use of a new tool to estimate transducer pressure in vivo. In this cross-sectional study, 47 participants with AAA and a median anterior-to-posterior (AP) AAA diameter of 46 mm (range: 30-76 mm) were included. The majority of the patients were overweight with body mass indexes >25 (33/47, 70%).

Genetic variants associated with two major bovine milk fatty acids offer opportunities to breed for altered milk fat composition.

Background: Although bovine milk is regarded as healthy and nutritious, its high content of saturated fatty acids (FA) may be harmful to cardiovascular health. Palmitic acid (C16:0) is the predominant saturated FA in milk with adverse health effects that could be countered by substituting it with higher levels of unsaturated FA, such as oleic acid (C18:1cis-9). In this work, we performed genome-wide association analyses for milk fatty acids predicted from FTIR spectroscopy data using 1811 Norwegian Red cattle genotyped and imputed to a high-density 777k single nucleotide polymorphism (SNP)-array.

Defining medical simulators for simulation-based education in EUS: Theoretical approach and a narrative review.

Choosing the right simulator for tasks in simulation-based education in medicine will affect the trainees' skills. However, there is a shortage in the vocabularies used for describing medical simulators and the contextual usage of simulators. We propose methods for approaching the task of choosing and defining the simulators needed, regardless of it being an acquisition or development process.

Expertise in colonoscopy intubation does not predict diagnostic accuracy: a simulation-based study.

 Studies have linked cecal intubation rate with adenoma detection rate; however, the direct association between technical performance during colonoscopy intubation and withdrawal has never been explored. Thus, it remains unclear whether gentle and efficient intubation predicts superior mucosal inspection. The aim of this study was to investigate the correlation between performance during intubation and withdrawal in a simulation-based setup.

A study on accuracy and precision of fluid volume measurements by nurses, patients and healthy persons in a clinical setting.

Aim: To evaluate the accuracy and precision for assessing fluid intake by examining the ability of nurses, patients and healthy people to visually estimate fluid volumes, thereby reflecting the fluid monitoring process in clinical practice.

Design: A cross-sectional study.

Methods: This study used the convenience sampling method and involved twenty-five participants from three groups; nurses, patients and healthy people.