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PubMed2001

Studying man-machine interfaces in the operating room.

The concept of interface as a system-linking device is introduced and examples of manmachine interfaces in the operating room are given. Studying effectiveness of these systems links requires input from multiple professionals, including surgeons and engineers. Video recording performances of operators is a valuble research methodology. Using behavioural observation coding of actions seen on videotapes allows computational analysis of selected actions. One experience with introducing a video study is related. The future holds promise for a wide range of technologically aided performance improvements in the surgical suite. Some improvements will be appropriated from other fields. Participating in the research and development of these new products will be a rewarding role in the medical world.

Journal Article↗

PubMed2006

Effects of nonabsorbable packing in middle meatus after sinus surgery.

OBJECTIVES/HYPOTHESIS: The aim of this study was to evaluate the effects of a nonabsorbable packing (NAP) in the middle meatus (MM) for 5 days after sinus surgery. STUDY DESIGN: A randomized, partly blinded, controlled clinical trial. METHODS: Sixty-one patients (M/F = 30/31, mean age 42, range 18-72) with chronic or acute recurrent rhinosinusitis were included. Fifty-nine underwent surgery. Thirty-one had NAP in the MM for 5 days, and 28 served as controls with daily saline irrigations postoperatively. Primary outcome variables were nasal congestion, nasal pain, and headache the first 2 weeks rated on visual analogue scales (VAS; 0-100) and the amount of postoperative bleeding recorded on an ordinal scale (1-4). Secondary outcome variable was the extent of adhesions in MM 10 to 14 weeks after surgery judged by blinded evaluation of endoscopic video recordings. RESULTS: Fifty-eight patients completed a diary. No significant differences in primary outcome variables between the groups were found. Nasal congestion decreased most the first 5 to 7 days postoperatively. Removal of the NAP caused little pain (mean 23 on VAS). Temporary bleeding occurred in three patients. Bilateral adhesions were observed in 10 control patients but in none with NAP. Unilateral adhesions were found in nine control patients and in seven with NAP (exact P < .001). CONCLUSIONS: NAP in the MM for 5 days significantly reduced the extent of adhesions in MM compared with saline irrigation alone. NAP did not cause additional discomfort.

Adolescent↗

PubMed1989

Effects of EGF and indomethacin on rabbit corneal endothelial wound closure in excised corneas.

Corneal endothelial cells of rabbit corneas stored in M-K medium at 37 degrees C were wounded by touching them lightly with a micropipet under video specular microscope observation. Three groups were studied: control, with EGF, and with EGF + indomethacin. The wound closure process (initial wound area about 8500 microns 2) was observed and recorded with time-lapse videography for 6 hr. The recorded video images were digitized and computer assisted morphometric analysis was performed. (1) Addition of either EGF (10 ng/ml) + indomethacin (1 microM), or EGF (10 ng/ml) alone to the M-K medium statistically significantly shortened the wound closure time as compared with the control group. (2) Both EGF + indomethacin and EGF alone resulted in a greater average percent relative change of the shape factor, more than three times greater with EGF + indomethacin and more than two times greater with EGF alone, than in the control group 150 min after wounding. (3) The maximum cell shape change occurred at about 150 min after wounding in the groups EGF + indomethacin and EGF alone, and at about 200 min in the control group. After this time in all three groups the cells began to approach a normal shape. (4) The cells near the wound boundary moved faster in the EGF + indomethacin and the EGF groups as compared with the control group. These results suggest that EGF and indomethacin may be of therapeutic value in promoting closure of traumatized human corneal endothelium.

Animals↗

PubMed1985

Reproducibility of left ventricular area and volume measurements using a computer endocardial edge-detection algorithm in normal subjects.

The variability of serially recorded 2-dimensional echocardiograms in normal subjects was determined. During a 2-week period, 10 normal subjects underwent echocardiography 5 times, in 2 laboratories, with use of different ultrasonographs. The video recordings were analyzed using a computer image analysis system (Quantic 1200) to provide standardized left ventricular short-axis areas and area ejection fraction (EF). Left ventricular volumes and volume EF were calculated. The 95% confidence limits of the percent difference for end-diastolic area and volume between 2 samples in a given subject were +/- 16.8 and +/- 16.7%, respectively. The limits for end-systolic area and volume were +/- 15.8 and +/- 17.0%, respectively. The 95% confidence limits for differences of area and volume EF between 2 recordings were +/- 12.8 and +/- 9.7%, respectively. No correlation was found between clinical grade (image quality) and the variability of area measurements. A good correlation (r = 0.98) was found between area and volume EF for any given subject over the 5 observations. These confidence limits are narrower than those previously recorded.

Adult↗

PubMed1997

Patterns of body temperature, activity, and reproductive behavior in a tropical murid rodent, Arvicanthis niloticus.

Nile grass rats (Arvicanthis niloticus), are murid rodents from tropical Africa that exhibit diurnal patterns of wheel-running. In the present paper we describe the temporal organization of several other behaviors in these animals, as well as daily rhythms in their body temperature. In the first experiment, we characterized rhythms of gross motor activity and core body temperature in four adult females implanted with telemetry transmitters and kept on a 12:12 light:dark (LD) cycle. In all animals body temperature and gross motor activity were clearly diurnal, with peaks often occurring around dawn and dusk. In the second experiment we recorded the times of mating and parturition in eight mating couples housed in a 12:12 LD cycle. We monitored animals 24 h a day using a time-lapse video recording system, beginning when males and females were paired, and ending after the birth of the second litter and the associated post-partum copulation. Mating almost always began just before the lights came on, and parturition generally occurred in an "anticrepuscular" pattern, outside of the periods around dawn and dusk. Thus, these animals exhibit an interesting mosaic of temporal adaptations, with some crepuscular tendencies expressed within a predominantly diurnal pattern.

Animals↗

PubMed1982

Inexpensive quality television camera suitable for use with operating microscope.

Video monitoring and video recording are useful in ophthalmic microsurgery for self-instruction and improvement, increased interest by operating room personnel, transfer of useful information to other physicians and improvement of technique. Specialized video cameras for such use are expensive. There is, however, a newly-marketed, inexpensive and light-weight video camera, which was designed for electronic newsgathering purposes, and which can be modified for microsurgery application, providing excellent results.

Costs and Cost Analysis↗

PubMedDate not supplied

Digitized longitudinal tomography.

An analog video longitudinal tomographic system has been converted to a digital format that reconstructs the tomographic section through the use of matrixes representing the gray scale values of the analog-recorded video images. This was done so that some simple preprocessing could be used to eliminate electronic noise and thereby increase the effective signal to noise ratio. Signal to noise was also increased by the elimination of the analog image displacement circuits (ramp generators). In addition to an improvement in the diagnostic quality (gray scale) of anatomic images, a capability to image contrast differentials as low as 1% has been achieved. A display system provides the ability to use windows having both variable central levels and widths.

Technology, Radiologic↗

PubMed2004

Translating teamwork behaviours from aviation to healthcare: development of behavioural markers for neonatal resuscitation.

Improving teamwork in healthcare may help reduce and manage errors. This paper takes a step toward that goal by (1) proposing a set of teamwork behaviours, or behavioural markers, for neonatal resuscitation; (2) presenting a data form for recording observations about these markers; and (3) comparing and contrasting different sets of teamwork behaviours that have been developed for healthcare. Data from focus groups of neonatal providers, surveys, and video recordings of neonatal resuscitations were used to identify some new teamwork behaviours, to translate existing aviation team behaviours to this setting, and to develop a data collection form. This behavioural marker audit form for neonatal resuscitation lists and defines 10 markers that describe specific, observable behaviours seen during the resuscitation of newborn infants. These markers are compared with those developed by other groups. Future research should determine the relations among these behaviours and errors, and test their usefulness in measuring the impact of team training interventions.

Aviation↗

PubMed1996

A play-based methodology for assessing idiom comprehension in children with semantic-pragmatic difficulties.

In response to the lack of suitable material for assessing idiom comprehension in children with semantic-pragmatic difficulties, a new, play-based methodology is presented. The child listens to a tape-recorded story into which are embedded a range of idiomatic expressions. The child then acts out the story as it is played again, sentence by sentence. The play is video-recorded and transcribed. Actions for each idiom are categorised and are then amenable to within-child, between-child, and between-group analyses. The results of a pilot project indicate that this methodology overcomes may of the problems inherent in assessing children identified as having semantic-pragmatic difficulties.

Acting Out↗

PubMed2000

The mechanics of prey prehension in chameleons.

Iguanian lizards generally use their tongue to capture prey. Because lingual prehension is based on surface phenomena (wet adhesion, interlocking), the maximal prey size that can be captured is small. However, published records show that prey items eaten by chameleons include small vertebrates such as lizards and birds, indicating that these lizards are using a different prey prehension mechanism. Using high-speed video recordings, cineradiography, electromyography, nerve transection and stimulation experiments, we investigated the function of the tongue during prey capture. The results of these experiments indicate that chameleons have modified the primitive iguanian system by including a suction component in their prehension mechanism. Suction is generated by the activity of two modified intrinsic tongue muscles that pull the tongue pad inwards. Moreover, we demonstrate that the mechanism described here is a prerequisite for successful feeding.

Animals↗

PubMed2003

Measuring nursing workload in intensive care: an observational study using closed circuit video cameras.

BACKGROUND: There is an increasing demand for intensive care provision in the United Kingdom (UK), partly because of a national shortage of intensive care beds. The problem is compounded by the current method for calculating the nurse: patient ratio using a Nurse Workload Patient Category scoring system or similar adaptations used in many intensive care units. This ratio is calculated by using patient category or dependency scales, which operate on the assumption that the more critically ill the patient, the more nurse time is needed to care for the patient. However, many mechanically ventilated critically ill patients (allocated a high category of care) may need less nursing care than patients who are self-ventilating and allocated a lower level of dependence. PURPOSE: In this study, a video recorder was used to document nurse activity for 48 continuous shifts in two intensive care units to determine the accuracy of the Nursing Workload Patient Category scoring system in measuring nurse workload. METHODS: The video data were correlated later with the Patient Category allocated to the patient by the nurse at the time. RESULTS: The results of this observational study demonstrated that, despite complex care needs, a high percentage of nursing activities observed in each unit consisted of low skill activity. Furthermore, nurses spent less time with patients categorized as in need of intensive care than those in need of high dependency care in both units. CONCLUSION: The findings suggest that existing nurse:patient ratio classifications may be inappropriate, since nurses spent less time with critically ill patients. Radical reconsideration of nursing levels and skill mix might make it possible to increase intensive care provision because fewer nurses would be needed to staff each bed. The findings support alternative and more flexible systems for assessing workload and the use of different nurse:patient ratios.

Adult↗

PubMed1991

Effects of okadaic acid and ATP gamma S on cell length and Ca(2+)-channel currents recorded in single smooth muscle cells of the guinea-pig taenia caeci.

1. The effects of inhibiting phosphatase activity on Ca(2+)-channel currents and cell shortening in single cells of the guinea-pig taenia caeci were investigated by whole-cell voltage clamp and video recording techniques. 2. Ca(2+)-channel currents were isolated by use of pipette solutions containing Cs, tetraethylammonium and adenosine triphosphate (ATP) (3 mM). Ca2+ or Ba2+ (7.5 mM) in the bathing solution acted as the charge carrier during inward current flow. 3. Ca(2+)-channel currents in 7.5 mM Ba2+ (IBa) were recorded at potentials positive to -40 mV, were maximal near 0 mV and reversed near +60 mV. Both the inward and outward flow of current was blocked by 100 microM Cd2+. 4. Addition of the ATP analogue, adenosine 5'-O(3-thiotriphosphate) (ATP gamma S) (1 mM) to the pipette solution (containing 3 mM ATP) caused cell shortening to 23 +/- 2% (n = 5) of their initial length within 5 min. Control cells (containing 4 mM ATP) did not contract during recording periods up to 60 min in duration. 5. IBa, recorded 1-2 min after membrane rupture, was 134 +/- 19 (n = 13) pA, compared with 209 +/- 25 (n = 5) pA in control cells, otherwise there were no significant time-dependent effects of ATP gamma S. In particular, ATP gamma S did not prevent the decrease in amplitude, nor the acceleration of inactivation when Ca2+ (7.5 mM) replaced Ba2+ as the permeating ion. 6. Okadaic acid (OA) (50 microM), a chemical inhibitor of phosphatase activity, produced similar effects when applied intracellularly. When OA (25,microM) was applied extracellularly the rate of rundown of 'Ba was slowed. 7. Isoprenaline (1 microM) alone had no effect on 'Ba, but induced a small increase in IBa in the presence of OA (25 microM). 8. Thus, our results indicate that (1) the contractions in ATP gamma S and OA may well arise from the activation of a kinase which phosphorylates myosin at low concentrations of Ca2 +, and (2) changes in the state of phosphorylation of Ca2+ channels, or associated proteins, in the taenia caeci modulate their function, but probably not via mechanisms involving cyclic AMP-dependent protein kinases.

Adenosine Triphosphate↗

PubMed1994

Scalp EEG recording: interictal/ictal location and spreading of epileptiform events.

The relevance of scalp EEG recording on the selection of patients for epilepsy surgery usually is based on the concordance between the location of the epileptogenic focus and the presumed ictal origin of clinical seizures visually identified or video recorded. Bilateralisation and/or spreading of the epileptiform events are among the causes of the relative lack of agreement between scalp topography and origin of EEG potentials. Computer methods mainly if they are adaptive and use multistrategic approaches improve the accuracy on the detection of the epileptogenic focus, extracting relevant information on the location and spreading of epileptiform events.

Brain↗

PubMed2005

Automated method for tracking individual red blood cells within capillaries to compute velocity and oxygen saturation.

OBJECTIVE: The authors present a new method to track individual red blood cells (RBCs) as they move through capillaries. This method uses a recently developed Measurement and Analysis System for Capillary Oxygen Transport (MASCOT) and the concept of space-time images to track RBCs between consecutive frames of video recordings of the microcirculation. METHODS: A space-time image displays in a single static image for a single capillary the location of all RBCs as a function of time. Analysis is performed on video tapes of RBC flow through capillaries to obtain velocity of individual cells as they traverse the capillary of interest. A space-time image is generated to track RBCs from one frame to the next and their velocities are computed. Based on the optical density values of each cell obtained from synchronized videotapes at two wavelengths, the oxygen saturation of a cell can be determined. In this manner, oxygen saturation can be tracked for the same cells as they move through the capillary. RESULTS AND CONCLUSIONS: These measurements, taken together, allow one to determine how much and how fast oxygen is being delivered to the surrounding tissue. This method provides, for the first time, a way to track individual RBCs flowing through capillary networks and study their RBC dynamics and oxygenation.

Algorithms↗

PubMed1989

Modern vestibular function testing.

Current tests of vestibular function concentrate on the horizontal semicircular canal-ocular reflex because it is the easiest reflex to stimulate (calorically and rotationally) and record (using electro-oculography). Tests of the other vestibulo-ocular reflexes (vertical semicircular canal and otolith) and of the vestibulospinal reflexes have yet to be shown useful in the clinical setting. Digital video recording of eye movements and vestibular-evoked responses are promising new technologies that may affect clinical testing in the near future.

Electronystagmography↗

PubMed1975

Effects of varying laboratory conditions on behavioral-state organization in two- and eight-week-old infants.

Previous studies have found that laboratory conditions influence sleep-waking behavior in older infants, children, and adults. The present study employed videotape recordings to monitor continuous 24-hr sleep-waking activity in 2- and 8-week-old infants before, during, and after 12 hr of polygraphic recordings. Sleep- and waking-state organization were affected by laboratory conditions. At both age levels, increased fussy-crying and decreased alertness occurred during the first 4 hr in the laboratory when they were video recorded only and during the first 4 hr that the leads were in place. Decreased fussy-crying and increased alertness were noted in the following periods, indicating adaptation. Latency to sleep was shorter, and drowsiness increased and active sleep decreased while the leads were in place. At 8 weeks, quiet sleep increased and active sleep decreased while the leads were in place. These data suggest that the unfamiliar laboratory conditions inherent in both observational and polygraphic studies are stressful and that time for adaptation is needed.

Adaptation, Psychological↗

PubMed1994

The validity of visual observation to assess posture in a laboratory-simulated, manual material handling task.

A wide range of methods to evaluate posture in work situations relies on simple, unaided visual observation. In the present study the validity of visual observation to assess posture in a dynamic job was evaluated. Postural aspects were observed and recorded during a manual materials handling job simulated in a laboratory. The results from these observations, concerning gross body posture, torso flexion, arms and legs position, and load to be handled, were compared to the results obtained by direct opto-electronic recording. The agreement on a sample-to-sample basis (expressed by Cohen's kappa) was poor for the variables torso flexion (mean value for kappa = 0.38), position of arms (kappa = 0.43) and legs (kappa = 0.46) and load to be handled (kappa = 0.50) and acceptable only for the gross body posture (kappa = 0.79). Moreover, for each variable except gross body posture, the crude distributions of all observations and recordings across categories (irrespective of time) were significantly different. The results demonstrate that the observations are not valid. It is concluded that dynamic work situations require less simple, more time consuming methods (e.g., analyzing film or video records of the job) than a posture registration method based on direct visual observation.

Adult↗

PubMed2000

Validity of ambulatory accelerometry to quantify physical activity in heart failure.

The purpose was to assess the validity of a novel Activity Monitor to quantify physical activity in congestive heart failure. The Activity Monitor is based on long-term ambulatory monitoring of signals from body-fixed accelerometers. Information can be obtained on which mobility-related activity is performed, when, how intense, and for how long. Ten patients performed several functional activities. Continuous registrations of accelerometer signals were made and the output was compared with visual analysis of simultaneously made video recordings (reference method). Overall results showed an agreement between both methods of 90%. Percentages of sensitivity and predictive value were higher than 80% for most activities. Overall number of transitions was determined well (Activity Monitor, 153; video, 149; p = 0.33). It was concluded that the Activity Monitor is a valid instrument to quantify several aspects of everyday physical activity in congestive heart failure.

Exercise↗