The Impact of Novel Nontechnical Stressors (Visual and Auditory) on Simulated Laparoscopic Task Performance Among Surgeons and Students.

Surgical training emphasizes technical competence. Growing evidence indicates that nontechnical skills are also significant in determining performance. Critically, surgeons should be aware how performance is affected by pressure or distraction.

Using Automated Continuous Instrument Tracking to Benchmark Simulated Laparoscopic Performance and Personalize Training.

Objective: Laparoscopic simulation is widely used in surgical training. However, the impact of training on performance is difficult to assess. Observation is time-intensive and subjective.

Paediatric abdominal pain in the time of COVID-19: a new diagnostic dilemma.

The diagnostic uncertainty for children with abdominal pain has increased during the COVID-19 pandemic with the additional consideration of both COVID-19 and paediatric inflammatory multisystem syndrome-temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS) alongside appendicitis, mesenteric adenitis and other less common causes of abdominal pain. We describe the cases of two children who presented with severe abdominal pain, non-bilious vomiting and high temperatures during the UK's first peak of the COVID-19 pandemic. Laboratory and abdominal ultrasound features were similar for both children but symptom progression in combination with cross-sectional abdominal imaging enabled differentiation between PIMS-TS and appendicitis with concurrent COVID-19.

Incentivising practice with take-home laparoscopic simulators in two UK Core Surgical Training programmes.

Introduction: Practice using simulators has been validated as a mean for surgical trainees to improve basic laparoscopic skills and free their attention for higher cognitive functions. However, mere provision of equipment does not result in frequent practice. This study assesses one approach to incentivising practice within core surgical training programmes and leads to further recommendations.

Does a 3D Image Improve Laparoscopic Motor Skills?

Aim: To quantitatively determine whether a three-dimensional (3D) image improves laparoscopic performance compared with a two-dimensional (2D) image.

Method: This is a prospective study with two groups of participants: novices (5) and experts (5). Individuals within each group undertook a validated laparoscopic task on a box simulator, alternating between 2D and a 3D laparoscopic image until they had repeated the task five times with each imaging modality.

The LEAP™ Gesture Interface Device and Take-Home Laparoscopic Simulators: A Study of Construct and Concurrent Validity.

Aim: To assess the potential of the LEAP™ infrared motion tracking device to map laparoscopic instrument movement in a simulated environment. Simulator training is optimized when augmented by objective performance feedback. We explore the potential LEAP has to provide this in a way compatible with affordable take-home simulators.

Accessible laparoscopic instrument tracking ("InsTrac"): construct validity in a take-home box simulator.

Introduction: Objective performance feedback has potential to maximize the training benefit of laparoscopic simulators. Instrument movement metrics are, however, currently the preserve of complex and expensive systems. We aimed to develop and validate affordable, user-ready software that provides objective feedback by tracking instrument movement in a "take-home" laparoscopic simulator.

Validating the use of smartphone-based accelerometers for performance assessment in a simulated neurosurgical task.

Background: Reductions in working hours affect training opportunities for surgeons. Surgical simulation is increasingly proposed to help bridge the resultant training gap. For simulation training to translate effectively into the operating theater, acquisition of technical proficiency must be objectively assessed.

In-lab three-dimensional printing: an inexpensive tool for experimentation and visualization for the field of organogenesis.

The development of the microscope in 1590 by Zacharias Janssenby and Hans Lippershey gave the world a new way of visualizing details of morphogenesis and development. More recent improvements in this technology including confocal microscopy, scanning electron microscopy (SEM) and optical projection tomography (OPT) have enhanced the quality of the resultant image. These technologies also allow a representation to be made of a developing tissue's three-dimensional (3-D) form.

The citric acid cough threshold and the ventilatory response to carbon dioxide on ascent to high altitude.

Ventilatory control undergoes profound changes on ascent to high altitude. We hypothesized that the fall in citric acid cough threshold seen on ascent to altitude is mediated by changes in the central control of cough and would parallel changes in central ventilatory control assessed by the hypercapnic ventilatory response (HCVR). Twenty-five healthy volunteers underwent measurements of HCVR and citric acid sensitivity at sea level and during a 9 day sojourn at 5200m.

Endogenous urate production augments plasma antioxidant capacity in healthy lowland subjects exposed to high altitude.

Background: Both tissue hypoxia in vitro, and whole-body hypoxia in vivo, have been found to promote the release of reactive oxygen species (ROS) that are potentially damaging to the cardiovascular system. Antioxidant systems protect against oxidative damage by ROS and may exhibit some degree of responsiveness to oxidative stimuli. Production of urate, a potent soluble antioxidant, is increased in hypoxic conditions.