Motion Analysis in the Assessment of Surgical Skill

Abstract

Manual skill is now widely recognised as an important aspect of training in surgery. However, measurement of the skill of a surgeon has in the past been rather subjective in nature, relying on the judgement of experts in the analysis of videotapes. Objective measurements can be made by analysing the velocities of a surgeon's hands during a procedure. In particular, we have found that the number of movements made during a typical procedure will decrease as the surgeon's skill increases. Velocity traces display purposeful movements corrupted by uncorrelated noise from sources such as hand tremor and measurement artefacts. However, we have found that it is possible to filter the noise effectively. Furthermore, we have shown that the skill measurement obtained by counting movements is highly robust to over or under filtering.     

Seasonal changes in the biochemistry of lake seston

1. The quantity of seston was measured and the elemental carbon, nitrogen and phosphorus (C, N, P) and biochemical composition (carbohydrate, protein, lipid) of the < 53 μm size fraction in three temperate lakes during one year was analysed. The lakes differed in nutrient concentration and were characterized as oligotrophic, mesotrophic and eutrophic. Linear regression analyses defined associations between seston composition and either lake trophic status, depth or season. 2. The concentration of particulate organic seston was greatest during spring and autumn and lowest during the clear water period in early summer. Seasonal patterns in seston elemental and biochemical percentage composition (quality) were observed to be independent of differences in seston quantity. 3. Concentrations of seston C, N and P were high in most cases in the spring and autumn and low in summer. Concentrations of P were particularly high during late summer and early autumn in the metalimnion, perhaps because of recovery of P from anaerobic sediments and hypolimnetic waters. Because seston C and N did not increase as markedly as P, C : P and N : P ratios both declined in the autumn. Primary production was thought to be co-limited by N and P in all three of these lakes; however, the data suggested that N might be more important as a major limiting nutrient in the eutrophic lake as the metalimnion increased in depth in late summer and autumn. 4. Concentrations of protein, carbohydrate, polar lipid and triglyceride generally increased with lake type as expected (greatest in the eutrophic lake), but showed no relationship with water depth. As the year progressed, no significant changes were measured in protein and carbohydrate concentrations; however, the concentration of polar lipid decreased and triglyceride increased significantly with time of year. 5. The biochemical composition of seston varied during the year and among lakes; for example, in Lake Waynewood the proportion of protein composing the seston (percentage protein by weight) varied from < 10% to > 40%. No statistically significant patterns in the percentage protein or carbohydrate were found. However, the proportion of seston comprised of triglyceride decreased with lake type and increased during the year; whereas the proportion of seston as polar lipid increased with lake type and decreased during the year. Triglyceride comprised most of the lipid. Both protein : lipid and protein : carbohydrate ratios tended to be greatest in summer and lowest in the spring and autumn. 6. Relationships between samples and biochemical composition analysed by Canonical Correspondence Analysis (Canoco) indicated similar patterns in seasonal changes in seston biochemistry for the three lakes, with samples separated primarily by vectors for lake type (oligotrophic to eutrophic) and the percentage polar lipid (proportion of total lipid) and secondarily by vectors for date and water depth (epilimnion or metalimnion). 7. These seasonal biochemical changes in the seston food base were compared with biochemical changes known to occur in algae grown under N-or P-limited conditions in the laboratory, and the resultant quality of this algal food for suspension-feeding consumers (zooplankton). It was concluded that zooplankton were likely to be physiologically challenged by these distinct seasonal shifts in the quality of lake seston.     

IN VITRO EFFECT OF HORMONES ON THE BARK OF PLUMERIA RUBRA LINN. VAR. ACTUIFOLIA BAILEY

Young bark (with cambium) of Plumeria rubra Linn. var. acutifolia Bailey was cultured in solid media (i) without hormone, (ii) Kinetin (K), (iii) with GA₃ and (iv) with IAA at concentrations of 0.05, 0.10, 0.15 and 0.20 mg per litre. The nutrients of the media were fed laterally through the cambium zone. The amount of the phloem zone was increased considerably by GA₃, less by K and IAA. The lignified secondary wall of the pericyclic living fibres was dissolved by each of the hormones. Sieve tube member length decreased in all treatments, more in higher concentrations. K decreased the frequency of sieve tubes (most at 0.10 mg/α) and increased the frequency of parenchyma cells (optimum at 0.10 mg/α). GA₃ also favoured formation of parenchyma cells and decrease of the frequency of sieve tubes, progressively with the increase of concentration. IAA also increased the parenchyma cell frequency progressively with concentration and decreased slightly the sieve tube frequency. IAA and GA₃ increased ray frequency and decreased parenchyma cell diameter, much at high concentration. But K had less effect on ray frequency and increased parenchyma cell diameter progressively with concentrations.