Changes in Gaze Behavior during the Learning of the Epidural Technique with a Simulator in Anesthesia Novices

Background: Current literature demonstrates the ability of eye tracking to provide reliable quantitative data as an objective assessment tool, with potential applications to medical and surgical training to improve performance. Objective: The aim of this study was to evaluate the changes in gaze behavior in anesthesia novice trainees when performing a simulated epidural technique before and after a hands-on training on the epidural simulator. Methods: We enrolled 48 novice trainees who had never previously performed an epidural block. After a standardized learning module, each trainee practiced the epidural procedure on the epidural simulator while wearing a pair of eye tracking glasses (Tobii Pro Glasses 50 Hz wearable wireless eye tracker). After this baseline recording, each trainee spent two hours practicing with the epidural simulator and afterwards once again performed the eye tracking epidural procedure. Eye tracking metrics and epidural learning (duration of the procedure and number of attempts) before and after the simulated practice were recorded. Results: The duration of the epidural procedure and of the epidural needle advancement phase (P < 0.05) and the number of epidural attempts (P < 0.001) were reduced after the tutorial. When considering the eye tracking metrics, after the tutorial, the number of visit counts decreased and their duration increased (P < 0.05). The number of epidural needle insertions (additional attempts) showed a significant positive correlation with the visits number (aOR = 2.02 (95% CI = 1.26 - 3.55;P = 0.008)) and a significant negative correlation with the visit duration (aOR = 0.65 (95% CI = 0.39 - 0.99;P = 0.05)). Conclusion: We observed significant changes in gaze behavior associated with increased performance during the epidural technique learning with a simulator in anesthesia trainees who had never previously performed an epidural block. These results may create a prototype for future studies on eye tracking technique as a teaching and evaluating tool in simulation.

Review of eye diagnosis in traditional Chinese medicine:Modernization and future prospects

This article reviews the basic theories, methods, and clinical applications of eye diagnosis in traditional Chinese medicine(TCM). It introduces cutting-edge methods and applications and explains that the modernization of TCM eye diagnosis includes “equipment-assisted diagnosis” and “artificial intelligencebased diagnosis”. The article also notes that while there are many recent studies of the static attributes of eyes in modern TCM eye diagnosis, modern application research on the dynamic attributes of eyes in TCM diagnosis theory is relatively rare. We propose, therefore, that introducing advanced eye-movement detection technology into TCM clinical diagnosis could help to further modernize TCM eye diagnosis.

Robust and High Accuracy Algorithm for Detection of Pupil Images

Recently,many researchers have tried to develop a robust,fast,and accurate algorithm.This algorithm is for eye-tracking and detecting pupil position in many applications such as head-mounted eye tracking,gaze-based human-computer interaction,medical applications(such as deaf and diabetes patients),and attention analysis.Many real-world conditions challenge the eye appearance,such as illumination,reflections,and occasions.On the other hand,individual differences in eye physiology and other sources of noise,such as contact lenses or make-up.The present work introduces a robust pupil detection algorithm with and higher accuracy than the previous attempts for real-time analytics applications.The proposed circular hough transform with morphing canny edge detection for Pupillometery(CHMCEP)algorithm can detect even the blurred or noisy images by using different filtering methods in the pre-processing or start phase to remove the blur and noise and finally the second filtering process before the circular Hough transform for the center fitting to make sure better accuracy.The performance of the proposed CHMCEP algorithm was tested against recent pupil detection methods.Simulations and results show that the proposed CHMCEP algorithm achieved detection rates of 87.11,78.54,58,and 78 according to´Swirski,ExCuSe,Else,and labeled pupils in the wild(LPW)data sets,respectively.These results show that the proposed approach performs better than the other pupil detection methods by a large margin by providing exact and robust pupil positions on challenging ordinary eye pictures.

Transplantation of corneal stem cells cultured on amniotic membrane for corneal burn: experimental and clinical study

OBJECTIVE: To investigate the proliferation and differentiation of cultured corneal stem cells and determine the effect of corneal stem cells cultured on amniotic membranes on the limbal area for treating corneal burns. METHODS: The proliferation and differentiation of corneal stem cells in vitro had been examined using colony-forming efficiency and immunohistochemistry. The stem cells had been cultured on amniotic membranes and transplanted to the limbal area for treating corneal burns. RESULTS: Corneal stem cells had a high proliferation capacity in primary and first passage, cytokeratin 3 was not expressed in primary culture but partly in first passage. The stem cells could proliferate to form cell layer on an amniotic membrane. When transplanted, stem cells could survive on limbus. After transplantation, ocular inflammation resolved, the cornea re-epithelialized, the stromal opacity reduced, the superficial neovascularity was lessened and the conjunctival fornix re-established. CONCLUSIONS: Ocular surface conditions could be improved by allograft of corneal stem cells cultured on amniotic membranes.