Evaluation of Surgical Skill Using Machine Learning with Optimal Wearable Sensor Locations

Evaluation of surgical skills during minimally invasive surgeries is needed when recruiting new surgeons. Although surgeons’ differentiation by skill level is highly complex, performance in specific clinical tasks such as pegboard transfer and knot tying could be determined using wearable EMG and accelerometer sensors. A wireless wearable platform has made it feasible to collect movement and muscle activation signals for quick skill evaluation during surgical tasks. However, it is challenging since the placement of multiple wireless wearable sensors may interfere with their performance in the assessment. This study utilizes machine learning techniques to identify optimal muscles and features critical for accurate skill evaluation. This study enrolled a total of twenty-six surgeons of different skill levels: novice (n = 11), intermediaries (n = 12), and experts (n = 3). Twelve wireless wearable sensors consisting of surface EMGs and accelerometers were placed bilaterally on bicep brachii, tricep brachii, anterior deltoid, flexor carpi ulnaris (FCU), extensor carpi ulnaris (ECU), and thenar eminence (TE) muscles to assess muscle activations and movement variability profiles. We found features related to movement complexity such as approximate entropy, sample entropy, and multiscale entropy played a critical role in skill level identification. We found that skill level was classified with highest accuracy by i) ECU for Random Forest Classifier (RFC), ii) deltoid for Support Vector Machines (SVM) and iii) biceps for Naïve Bayes Classifier with classification accuracies 61%, 57% and 47%. We found RFC classifier performed best with highest classification accuracy when muscles are combined i) ECU and deltoid (58%), ii) ECU and biceps (53%), and iii) ECU, biceps and deltoid (52%). Our findings suggest that quick surgical skill evaluation is possible using wearables sensors, and features from ECU, deltoid, and biceps muscles contribute an important role in surgical skill evaluation

An approach for identifying gait events using wavelet denoising technique and single wireless IMU

A new approach is proposed to identify gait events in non-laboratory environments with a single inertial measurement unit (IMU) embedded inside shoe. The aim of our work is to develop a useful clinical tool for monitoring individuals walking disability and detect specific pathological gait patterns. Temporal parameters of gait are determined by classification of accelerations and angular velocities. Wavelets denoising of IMU signals allows for an important amount of information that is exploited in different manners for event identification. It was found that wavelet denoising enhanced specific turning points which could effectively identify gait events. The method is verified by comparing the results of video-based motion capture system and force plates as conventional standards. This portable gait-monitoring system allows for versatile application beyond gait laboratory

Effect of hand files, rotary protaper universal and protaper retreatment files on crack formation in dentin: An in vitro study

Background: The aim of the study was to compare the effect of hand files, rotary protaper universal files and protaper retreatment files on crack formation in dentin. Methods: Eighty mandibular premolar teeth with single canals are selected and mounted on resin blocks with simulated periodontal ligaments. The teeth were divided into four groups of twenty samples in each group. Un-instrumented group serves as control group while group two and three consists of hand file and rotary protaper universal file system respectively. Group 4 consists of retreatment group consisting of two sub groups of ten samples in each group. Subgroup 4a consist of samples prepared with hand file while subgroup 4b consist of samples prepared with rotary protaper universal system. Thereafter, retreatment is performed with protaper retreatment file system in both the sub groups. All the roots were sectioned perpendicular to the long axis at 4mm from apex using a low speed saw (Isomet) under water cooling. Digital images of each sections were captured at 25X magnification using a digital camera attached to a stereomicroscope and cracks were noted. Results: Although the result is statistically non significant, hand files show less number of cracks as compared to rotary protaper universal file

Effect of Hand Files, Rotary Protaper Universal and Protaper Retreatment Files on Crack Formation in Dentin: an in Vitro Study

Background: The aim of the study was to compare the effect of hand files, rotary protaper universal files and protaper retreatment files on crack formation in dentin. Methods: Eighty mandibular premolar teeth with single canals are selected and mounted on resin blocks with simulated periodontal ligaments. The teeth were divided into four groups of twenty samples in each group. Un-instrumented group serves as control group while group two and three consists of hand file and rotary protaper universal file system respectively. Group 4 consists of retreatment group consisting of two sub groups of ten samples in each group. Subgroup 4a consist of samples prepared with hand file while subgroup 4b consist of samples prepared with rotary protaper universal system. Thereafter, retreatment is performed with protaper retreatment file system in both the sub groups. All the roots were sectioned perpendicular to the long axis at 4mm from apex using a low speed saw (Isomet) under water cooling. Digital images of each sections were captured at 25X magnification using a digital camera attached to a stereomicroscope and cracks were noted. Results: Although the result is statistically non significant, hand files show less number of cracks as compared to rotary protaper universal file