Box trainers equipped with sensors may help in acquiring objective information about a trainee's performance while performing training tasks with real instruments. The main aim of this study is to investigate the added value of force parameters with respect to commonly used motion and time parameters such as path length, motion volume, and task time. Two new dynamic bimanual positioning tasks were developed that not only requiring adequate motion control but also appropriate force control successful completion. Force and motion data for these tasks were studied for three groups of participants with different experience levels in laparoscopy (i.e., 11 novices, 19 intermediates, and 12 experts). In total, 10 of the 13 parameters showed a significant difference between groups. When the data from the significant motion, time, and force parameters are used for classification, it is possible to identify the skills level of the participants with 100% accuracy. Furthermore, the force parameters of many individuals in the intermediate group exceeded the maximum values in the novice and expert group. The relatively high forces used by the intermediates argue for the inclusion of training and assessment of force application during tissue handling in future laparoscopic skills training programs.
Three types of respiratory masks viz N95, non-woven fabric and double layer cotton cloth are being used as an essential inhalation protective measure against COVID-19 by suppressing the entry of respiratory droplets. The ltering e ciency of these masks were tested before and after sterilization using gamma radiation for the two ow rate conditions corresponding normal breath rate (20 lpm) and during sneezing/coughing (90 lpm). Sterilization is carried out using a gamma irradiator containing Co-60 source for the two dose exposures viz. 15kGy and 25kGy. The ltering e ciency for surgical (non-woven fabric) and double layer cotton cloth mask is found to vary from 18% to 22% for the cumulative particle of size ≥ 0.3µm in both un-irradiated and irradiated condition.The ltration e ciency of N95 mask is found to be reduced to 70% for the most penetrating particle size (0.3 µm) with the ow rate of 20 lpm and further reduced for particles in the range of 0.1 and 0.2µm with ow rate of 90 lpm. The reduction in e ciency after gamma sterilization is associated with reduction of electrostatic interaction of lter medium with particles laden in the air stream.Even with reduced ltering e ciency due to gamma sterilization, the N95 masks are much superior than the surgical and cloth masks.Instead of disposing N95 mask after single use, they can be reused a few times as N70 mask during this pandemic crisis after sterilization using gamma radiation.
Summary Background There is a worldwide shortage of medical-grade face masks. Donning masks can play an important role in curbing the spread of SARS-CoV-2. Aim To conclude whether there is an effective mask for the population to wear in public that could easily be made during a medical face mask shortage using readily available materials. Methods We determined the effectiveness of readily available materials and models for making a face mask. The outcomes were compared with N95/FFP2/KN95 masks that entered the Netherlands in April–May 2020. Masks were tested to determine whether they filtered a minimum of 35% of 0.3-μm particles, are hydrophobic, seal on the face, are breathable, and can be washed. Findings Fourteen of the 25 (combinations of) materials filtered at least 35% of 0.3-μm particles. Four of the materials proved hydrophobic, all commercially manufactured filters. Two models sealed the face. Twenty-two of the 25 materials were breathable at <0.7 mbar. None of the hydrophobic materials stayed intact after washing. Conclusions It would be possible to reduce the reproduction rate of SARS-CoV-2 from 2.4 to below one if 39% of the population would wear a mask made from ePM₁ 85% commercially manufactured filter fabric and in a duckbill form. This mask performs better than 80% of the imported N95/FFP2/KN95 masks and provides a better fit than a surgical mask. Two layers of quilt fabric with a household paper towel as filter is also a viable choice for protecting the user and the environment.
When equipped with motion and force sensors, box-trainers can be good alternatives for relatively expensive Virtual Reality (VR) trainers. As in VR trainers, the sensors in a box trainer could provide the trainee with objective information about his performance. Recently, multiple tracking systems were developed for classification of participants based on motion and time parameters. The aim of this study is the development of force parameters that reflect the trainee's performance in a suture task. Our second goal is to investigate if the level of the participant's skills can be classified as experts or novice level. In the experiment, experts (n = 11) and novices (n = 21) performed a two-handed needle driving and knot tying task on artificial tissue inside a box trainer. The tissue was mounted on the Force platform that was used to measure the force, which the subject applied on the tissue in three directions. We evaluated the potential of 16 different performance parameters, related to the magnitude, direction, and variability of applied forces, to distinguish between different levels of surgical expertise. Nine of the parameters showed significant differences between experts and novices. Principal Component Analysis was used to convert these nine partly correlating parameters, such as peak force, mean force, and main direction of force, into two uncorrelated variables. By performing a Leave-One-Out-Cross Validation with Linear Discriminant Analysis on each participants' score on these two variables, it was possible to correctly classify 84 percent of all participants as an expert or novice. We conclude that force measurements in a box trainer can be used to classify the level of performance of trainees and can contribute to objective assessment of suture skills.
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