HoloLens in Breast Reconstruction: What Is the Future?

Autologous breast reconstruction using the deep inferior epigastric perforator flap has been established as the standard for perforator-based free-flap breast reconstruction. This technique relies on the surgeon's ability to identify the patient's relevant abdominal vasculature to facilitate accurate dissection, optimize surgical outcomes, and minimize morbidity. A technique is described in which the authors incorporate augmented reality using HoloLens technology in their surgical planning to identify epigastric arteries and perforators.

Using Mixed Reality Headsets to Deliver Remote Bedside Teaching During the COVID-19 Pandemic: Feasibility Trial of HoloLens 2.

Background: COVID-19 has had a catastrophic impact in terms of human lives lost. Medical education has also been impacted as appropriately stringent infection control policies precluded medical trainees from attending clinical teaching. Lecture-based education has been easily transferred to a digital platform, but bedside teaching has not.

Feasibility and Effect of Reiki on the Physiology and Self-perceived Stress of Nurses in a Large US Hospital.

Nurses experience stress in the workplace. We evaluated the feasibility and effect of Reiki to relieve stress of staff nurses during a work shift. All Reiki treatments were completed without interruption and lasted 30 minutes.

Climate Mismatch between Introduced Biological Control Agents and Their Invasive Host Plants: Improving Biological Control of Tropical Weeds in Temperate Regions.

Many weed biological control programs suffer from large-scale spatial variation in success due to restricted distributions or abundances of agents in temperate climates. For some of the world's worst aquatic weeds, agents are established but overwintering conditions limit their survival in higher latitudes or elevations. The resulting need is for new or improved site- or region-specific biological control tools.

Comparing the Invertebrate Communities and the Decomposition Dynamics Between Dead Native and Non-Native Trees in a Seasonal Everglades Wetland.

A 6-year time-series study in the Western Everglades region of Florida, United States examined the influence of woody debris from two tree species on invertebrate richness, abundance, and diversity, as well as tree debris mass loss, fragmentation, and residence time. Samples of decomposing fine woody debris and coarse woody debris (CWD) from non-native Melaleuca quinquenervia (Cav.) Blake and native Pinus elliottii Englem trees were removed from a field site every six months and processed to capture data on biotic and abiotic variables.

Augmented reality simulator for CT-guided interventions.

Introduction: CT-guided interventions are taught using a mentored approach on real patients. It is well established that simulation is a valuable training tool in medicine. This project assessed the feasibility and acceptance of replicating a CT-guided intervention using a bespoke software application with an augmented reality head-mounted display (ARHMD).

Biological and Host Range Characteristics of (Coleoptera: Chrysomelidae), a Candidate Biological Control Agent of Invasive spp. (Onagraceae) in the USA.

Exotic water primroses ( spp.) are aggressive invaders in aquatic ecosystems worldwide. To date, management of exotic spp.

A remote access mixed reality teaching ward round.

Background: Heterogeneous access to clinical learning opportunities and inconsistency in teaching is a common source of dissatisfaction among medical students. This was exacerbated during the COVID-19 pandemic, with limited exposure to patients for clinical teaching.

Methods: We conducted a proof-of-concept study at a London teaching hospital using mixed reality (MR) technology (HoloLens2™) to deliver a remote access teaching ward round.

The Efficacy of Antihistamines in Preventing Reactions to Infliximab in Patients With Crohn Disease/Ulcerative Colitis: A Review of the Evidence.

Inflammatory bowel diseases, including Crohn disease and ulcerative colitis, are most often diagnosed during adolescence and young adulthood, with a rising incidence in pediatric populations. Infliximab is an effective treatment option for Crohn disease and ulcerative colitis. The most common adverse event with infliximab is an infusion reaction.

The Biology of (Lepidoptera: Oecophoridae), a Stem-Boring Moth of (Myrtaceae): Descriptions of the Previously Unknown Adult Female and Immature Stages, and Its Potential as a Biological Control Candidate.

is a perennial shrub native to Southeast Asia and is invasive in South Florida and Hawai'i, USA. During surveys of in Hong Kong from 2013-2018 for potential biological control agents, we collected larvae of the stem borer, . Larvae were shipped in stems to a USDA-ARS quarantine facility where they were reared and subjected to biology studies and preliminary host range examinations.

Use of the HoloLens2 Mixed Reality Headset for Protecting Health Care Workers During the COVID-19 Pandemic: Prospective, Observational Evaluation.

Background: The coronavirus disease (COVID-19) pandemic has led to rapid acceleration in the deployment of new digital technologies to improve both accessibility to and quality of care, and to protect staff. Mixed-reality (MR) technology is the latest iteration of telemedicine innovation; it is a logical next step in the move toward the provision of digitally supported clinical care and medical education. This technology has the potential to revolutionize care both during and after the COVID-19 pandemic.

Visual behaviour in robotic surgery-Demonstrating the validity of the simulated environment.

Background: Eye metrics provide insight into surgical behaviour allowing differentiation of performance, however have not been used in robotic surgery. This study explores eye metrics of robotic surgeons in training in simulated and real tissue environments.

Methods: Following the Fundamentals of Robotic Surgery (FRS), training curriculum novice robotic surgeons were trained to expert-derived benchmark proficiency using real tissue on the da Vinci Si and the da Vinci skills simulator (dVSS) simulator.

Medication errors during simulated paediatric resuscitations: a prospective, observational human reliability analysis.

Introduction: Medication errors during paediatric resuscitation are thought to be common. However, there is little evidence about the individual process steps that contribute to such medication errors in this context.

Objectives: To describe the incidence, nature and severity of medication errors in simulated paediatric resuscitations, and to employ human reliability analysis to understand the contribution of discrepancies in individual process steps to the occurrence of these errors.

Tritrophic Interactions Between an Invasive Weed (Lepidium latifolium), an Insect Herbivore (Bagrada hilaris), and a Plant Pathogenic Fungus (Albugo lepidii).

Perennial pepperweed, Lepidium latifolium L. (Brassicales: Brassicaceae), is an invasive weed that can form dense stands and displace native species. Bagrada hilaris Burmeister (Hemiptera: Pentatomidae) is a serious economic pest of Brassicaceae vegetable crops.

Patient-Specific Simulation of Pneumoperitoneum for Laparoscopic Surgical Planning.

Gas insufflation in laparoscopy deforms the abdomen and stretches the overlying skin. This limits the use of surgical image-guidance technologies and challenges the appropriate placement of trocars, which influences the operative ease and potential quality of laparoscopic surgery. This work describes the development of a platform that simulates pneumoperitoneum in a patient-specific manner, using preoperative CT scans as input data.

Evaluating the impact of image guidance in the surgical setting: a systematic review.

Background: Image guidance has been clinically available for over a period of 20 years. Although research increasingly has a translational emphasis, overall the clinical uptake of image guidance systems in surgery remains low. The objective of this review was to establish the metrics used to report on the impact of surgical image guidance systems used in a clinical setting.

Into the weeds: Matching importation history to genetic consequences and pathways in two widely used biological control agents.

The intentional introduction of exotic species through classical biological control programs provides unique opportunities to examine the consequences of population movement and ecological processes for the genetic diversity and population structure of introduced species. The weevils and (Coleoptera: Curculionidae) have been introduced globally to control the invasive floating aquatic weed, , with variable outcomes. Here, we use the importation history and data from polymorphic microsatellite markers to examine the effects of introduction processes on population genetic diversity and structure.

Improved Antibody Response to Three Additional Hepatitis B Vaccine Doses Following Primary Vaccination Failure in Patients with Inflammatory Bowel Disease.

Background: Studies have shown the efficacy of hepatitis B (HBV) vaccination in patients with inflammatory bowel disease (IBD) is impaired, but few data exist regarding the effectiveness of revaccination strategies following primary vaccination failure. Our aim was to analyze the association between administration of additional vaccine doses and hepatitis B surface antibody (HBsAb) seroconversion.

Methods: This is a retrospective cohort study.

Subject-specific modelling of pneumoperitoneum: model implementation, validation and human feasibility assessment.

Purpose: The aim of this study is to propose a model that simulates patient-specific anatomical changes resulting from pneumoperitoneum, using preoperative data as input. The framework can assist the surgeon through a real-time visualisation and interaction with the model. Such could further facilitate surgical planning preoperatively, by defining a surgical strategy, and intraoperatively to estimate port positions.

Intraoperative ultrasound for improved 3D tumour reconstruction in robot-assisted surgery: An evaluation of feedback modalities.

Background: Intraoperative ultrasound scanning induces deformation on the tissue in the absence of a feedback modality, which results in a 3D tumour reconstruction that is not directly representative of real anatomy.

Methods: A biomechanical model with different feedback modalities (haptic, visual, or auditory) was implemented in a simulation environment. A user study with 20 clinicians was performed to assess which modality resulted in the 3D tumour volume reconstruction that most resembled the reference configuration from the respective computed tomography (CT) scans.

Current and Future Use of Radiological Images in the Management of Gynecological Malignancies - A Survey of Practice in the UK.

Background/aim: Radiology provides increasingly accurate and complex information. Understanding the clinicians' interpretation of scans could improve surgical planning, decision-making; informed training and development of augmented imaging. This was a survey exploring the interpretation of imaging by clinicians and its use in operative preparation and prediction.

Transoral Robotic Surgery: Image Guidance and Augmented Reality.

Transoral robotic surgery (TORS) is being used increasingly as an alternative to conventional open procedures, as its minimally invasive approach results in significant benefits for the patient. This includes faster recovery times and better functional outcomes, less postoperative pain and morbidity associated with open access, shorter operative times, and a reduction in the risk of infection. However, the confined working spaces and sensory deficit, due to a lack of haptic sensation, and proximity to critical vasculature and other vitally important anatomical structures bestow significant challenges on the surgeon.

Perfect Registration Leads to Imperfect Performance: A Randomized Trial of Multimodal Intraoperative Image Guidance.

Objective: To compare surgical safety and efficiency of 2 image guidance modalities, perfect augmented reality (AR) and side-by-side unregistered image guidance (IG), against a no guidance control (NG), when performing a simulated laparoscopic cholecystectomy (LC).

Background: Image guidance using AR offers the potential to improve understanding of subsurface anatomy, with positive ramifications for surgical safety and efficiency. No intra-abdominal study has demonstrated any advantage for the technology.