Enhancing colorectal anastomotic safety with indocyanine green fluorescence angiography: An update.

Reducing anastomotic leak (AL) continues to be a main focus in colorectal research. Several new technologies have been developed with an aim to reduce this from mechanical devices to advanced imaging techniques. Fluorescence angiography (FA) with indocyanine green (ICG) in colorectal surgery is now a well-established technique and may have a role in reducing AL. By using FA, we are able to have a visual representation of perfusion which aids intraoperative decision making. The main impact is change in the level of bowel transection at the proximal side of an anastomosis and provide a more objective and confident assessment of bowel perfusion. Previous studies have shown that routine FA use is safe and reproducible. Recent results from randomized control trials and meta-analyses show that FA use reduces the rate of anastomotic leak. The main limitation of FA is its lack of ability to quantify perfusion. Novel technologies are being developed that will quantify tissue perfusion and oxygenation. Overall, FA is a safe and feasible technique which may have a role in reducing AL

A Time Variation of Proton-Electron Mass Ratio and Grand Unification

Astrophysical observations indicate a time variation of the proton-electron mass ratio and of the fine-structure constant. We discuss this phenomenon in models of Grand Unification. In these models a time variation of the fine-structure constant and of the proton mass are expected, if either the unified coupling constant or the scale of unification changes, or both change. We discuss in particular the change of the proton mass. Experiments in Quantum Optics could be done to check these ideas.Comment: 5 page

Indocyanine green fluorescence imaging in colorectal surgery: overview, applications, and future directions

Indocyanine green fluorescence imaging is a surgical tool with increasing applications in colorectal surgery. This tool has received acceptance in various surgical disciplines as a potential method to enhance surgical field visualisation, improve lymph node retrieval, and decrease the incidence of anastomotic leaks. In colorectal surgery specifically, small studies have shown that intraoperative fluorescence imaging is a safe and feasible method to assess anastomotic perfusion, and its use might affect the incidence of anastomotic leaks. Controlled trials are ongoing to validate these conclusions. The number of new indications for indocyanine green continues to increase, including innovative options for detecting and guiding management of colorectal metastasis to the liver. These advances could offer great value for surgeons and patients, by improving the accuracy and outcomes of oncological resections

AI in colonoscopy-detection and characterisation of malignant polyps

The medical technological revolution has transformed the nature with which we deliver care. Adjuncts such as artificial intelligence and machine learning have underpinned this. The applications to the field of endoscopy are numerous. Malignant polyps represent a significant diagnostic dilemma as they lie in an area in which mischaracterisation may mean the difference between an endoscopic procedure and a formal bowel resection. This has implications for patients’ oncological outcomes, morbidity and mortality, especially if post-procedure histopathology upstages disease. We have made significant strides with the applications of artificial intelligence to colonoscopic detection. Deep learning algorithms are able to be created from video and image databases. These have been applied to traditional, human-derived, classification methods, such as Paris or Kudo, with up to 93% accuracy. Furthermore, multimodal characterisation systems have been developed, which also factor in patient demographics and colonic location to provide an estimation of invasion and endoscopic resectability with over 90% accuracy. Although the technology is still evolving, and the lack of high-quality randomised controlled trials limits clinical usability, there is an exciting horizon upon us for artificial intelligence-augmented endoscopy

Stability of Coalescence Hidden variable Fractal Interpolation Surfaces

In the present paper, the stability of Coalescence Hidden variable Fractal Interpolation Surfaces(CHFIS) is established. The estimates on error in approximation of the data generating function by CHFIS are found when there is a perturbation in independent, dependent and hidden variables. It is proved that any small perturbation in any of the variables of generalized interpolation data results in only small perturbation of CHFIS. Our results are likely to be useful in investigations of texture of surfaces arising from the simulation of surfaces of rocks, sea surfaces, clouds and similar natural objects wherein the generating function depends on more than one variable