Evaluating surgical skills from kinematic data using convolutional neural networks

The need for automatic surgical skills assessment is increasing, especially because manual feedback from senior surgeons observing junior surgeons is prone to subjectivity and time consuming. Thus, automating surgical skills evaluation is a very important step towards improving surgical practice. In this paper, we designed a Convolutional Neural Network (CNN) to evaluate surgeon skills by extracting patterns in the surgeon motions performed in robotic surgery. The proposed method is validated on the JIGSAWS dataset and achieved very competitive results with 100% accuracy on the suturing and needle passing tasks. While we leveraged from the CNNs efficiency, we also managed to mitigate its black-box effect using class activation map. This feature allows our method to automatically highlight which parts of the surgical task influenced the skill prediction and can be used to explain the classification and to provide personalized feedback to the trainee.Comment: Accepted at MICCAI 201

Recent Data to the Distribution of Western Corn Rootworm (Diabrotica virgifera virgifera LeConte) in Hungary

The Hungarian plant protection organization has been performing western corn rootworm moni- toring over the past four years.In 1998 three different trapping activities were carried out at 150 monitoring sites.Hungarian pheromone traps and Multigard ®(yellow sticky)traps were used from July 1 to September 30.The number of catches and the average catches/trap in 1998 were lower than the catch numbers in 1997. In 1998,the pest spread to a lesser degree than in 1997

Practical use of dabigatran etexilate for stroke prevention in atrial fibrillation.

Atrial fibrillation (AF) is associated with an increased risk of thromboembolism, and is the most prevalent factor for cardioembolic stroke. Vitamin K antagonists (VKAs) have been the standard of care for stroke prevention in patients with AF since the early 1990s. They are very effective for the prevention of cardioembolic stroke, but are limited by factors such as drug-drug interactions, food interactions, slow onset and offset of action, haemorrhage and need for routine anticoagulation monitoring to maintain a therapeutic international normalised ratio (INR). Multiple new oral anticoagulants have been developed as potential replacements for VKAs for stroke prevention in AF. Most are small synthetic molecules that target thrombin (e.g. dabigatran etexilate) or factor Xa (e.g. rivaroxaban, apixaban, edoxaban, betrixaban, YM150). These drugs have predictable pharmacokinetics that allow fixed dosing without routine laboratory monitoring. Dabigatran etexilate, the first of these new oral anticoagulants to be approved by the United States Food and Drug Administration and the European Medicines Agency for stroke prevention in patients with non-valvular AF, represents an effective and safe alternative to VKAs. Under the auspices of the Regional Anticoagulation Working Group, a multidisciplinary group of experts in thrombosis and haemostasis from Central and Eastern Europe, an expert panel with expertise in AF convened to discuss practical, clinically important issues related to the long-term use of dabigatran for stroke prevention in non-valvular AF. The practical information reviewed in this article will help clinicians make appropriate use of this new therapeutic option in daily clinical practice

Evaluation of a web-based ECG-interpretation programme for undergraduate medical students

<p>Abstract</p> <p>Background</p> <p>Most clinicians and teachers agree that knowledge about ECG is of importance in the medical curriculum. Students at Karolinska Institutet have asked for more training in ECG-interpretation during their undergraduate studies. Clinical tutors, however, have difficulties in meeting these demands due to shortage of time. Thus, alternative ways to learn and practice ECG-interpretation are needed. Education offered via the Internet is readily available, geographically independent and flexible. Furthermore, the quality of education may increase and become more effective through a superior educational approach, improved visualization and interactivity.</p> <p>Methods</p> <p>A Web-based comprehensive ECG-interpretation programme has been evaluated. Medical students from the sixth semester were given an optional opportunity to access the programme from the start of their course. Usage logs and an initial evaluation survey were obtained from each student. A diagnostic test was performed in order to assess the effect on skills in ECG interpretation. Students from the corresponding course, at another teaching hospital and without access to the ECG-programme but with conventional teaching of ECG served as a control group.</p> <p>Results</p> <p>20 of the 32 students in the intervention group had tested the programme after 2 months. On a five-graded scale (1- bad to 5 – very good) they ranked the utility of a web-based programme for this purpose as 4.1 and the quality of the programme software as 3.9. At the diagnostic test (maximal points 16) by the end of the 5-month course at the 6th semester the mean result for the students in the intervention group was 9.7 compared with 8.1 for the control group (p = 0.03).</p> <p>Conclusion</p> <p>Students ranked the Web-based ECG-interpretation programme as a useful instrument to learn ECG. Furthermore, Internet-delivered education may be more effective than traditional teaching methods due to greater immediacy, improved visualisation and interactivity.</p

Body mass estimation from footprint size in hominins.

Although many studies relating stature to foot length have been carried out, the relationship between foot size and body mass remains poorly understood. Here we investigate this relationship in 193 adult and 50 juvenile habitually unshod/minimally shod individuals from five different populations-Machiguenga, Daasanach, Pumé, Hadzabe, and Samoans-varying greatly in body size and shape. Body mass is highly correlated with foot size, and can be predicted from foot area (maximum length × breadth) in the combined sample with an average error of about 10%. However, comparisons among populations indicate that body shape, as represented by the body mass index (BMI), has a significant effect on foot size proportions, with higher BMI samples exhibiting relatively smaller feet. Thus, we also derive equations for estimating body mass from both foot size and BMI, with BMI in footprint samples taken as an average value for a taxon or population, estimated independently from skeletal remains. Techniques are also developed for estimating body mass in juveniles, who have relatively larger feet than adults, and for converting between foot and footprint size. Sample applications are given for five Pliocene through Holocene hominin footprint samples from Laetoli (Australopithecus afarensis), Ileret (probable Homo erectus), Happisburgh (possible Homo antecessor), Le Rozel (archaic Homo sapiens), and Barcin Höyük (H. sapiens). Body mass estimates for Homo footprint samples appear reasonable when compared to skeletal estimates for related samples. However, estimates for the Laetoli footprint sample using the new formulae appear to be too high when compared to skeletal estimates for A. afarensis. Based on the proportions of A.L. 288-1, this is apparently a result of relatively large feet in this taxon. A different method using a ratio between body mass and foot area in A.L. 288-1 provides estimates more concordant with skeletal estimates and should be used for A. afarensis

Assessing competency in Evidence Based Practice: strengths and limitations of current tools in practice

<p>Abstract</p> <p>Background</p> <p>Evidence Based Practice (EBP) involves making clinical decisions informed by the most relevant and valid evidence available. Competence can broadly be defined as a concept that incorporates a variety of domains including knowledge, skills and attitudes. Adopting an evidence-based approach to practice requires differing competencies across various domains including literature searching, critical appraisal and communication. This paper examines the current tools available to assess EBP competence and compares their applicability to existing assessment techniques used in medicine, nursing and health sciences.</p> <p>Discussion</p> <p>Only two validated assessment tools have been developed to specifically assess all aspects of EBP competence. Of the two tools (<it>Berlin </it>and <it>Fresno </it>tools), only the <it>Fresno </it>tool comprehensively assesses EBP competency across all relevant domains. However, both tools focus on assessing EBP competency in medical students; therefore neither can be used for assessing EBP competency across different health disciplines. The Objective Structured Clinical Exam (OSCE) has been demonstrated as a reliable and versatile tool to assess clinical competencies, practical and communication skills. The OSCE has scope as an alternate method for assessing EBP competency, since it combines assessment of cognitive skills including knowledge, reasoning and communication. However, further research is needed to develop the OSCE as a viable method for assessing EBP competency.</p> <p>Summary</p> <p>Demonstrating EBP competence is a complex task – therefore no single assessment method can adequately provide all of the necessary data to assess complete EBP competence. There is a need for further research to explore how EBP competence is best assessed; be it in written formats, such as the <it>Fresno </it>tool, or another format, such as the OSCE. Future tools must also incorporate measures of assessing how EBP competence affects clinician behaviour and attitudes as well as clinical outcomes in real-time situations. This research should also be conducted across a variety of health disciplines to best inform practice.</p

Tomorrow’s Digital Worker : A Critical Review and Agenda for Building Digital Competency Models

In competency management studies, scholars call for the importance of digital savviness to hire, train, and develop new digital workers. Yet, the knowledge about the development of such a competence is still scarce. For this endeavor, we followed a systematic literature review to identify a sample of 103 published scientific articles and book chapters dealing with the development and implementation of competency tools in the past 10 years. To our surprise, our review suggests that the landscape of competency tools is surprisingly obsolete and that contemporary requirements of digitization have not yet been incorporated into updated usable competency tools. Through this review our hope is to provide competency managers and researchers with a framework to advance and upgrade their competency tools to address the gap between existing know how and the needed expertise of the digital world.© 2020 Springer. This is a post-peer-review, pre-copyedit version of an article published in Advances in Human Factors, Business Management and Leadership Proceedings of the AHFE 2020 Virtual Conferences on Human Factors, Business Management and Society, and Human Factors in Management and Leadership, July 16-20, 2020, USA. The final authenticated version is available online at: https://doi.org/10.1007/978-3-030-50791-6_14fi=vertaisarvioitu|en=peerReviewed