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Article Citation - WoS: 8Citation - Scopus: 10Evaluation of Ten Open-Source Eye-Movement Classification Algorithms in Simulated Surgical Scenarios(Ieee-inst Electrical Electronics Engineers inc, 2019) Dalveren, Gonca Gokce Menekse; Cagiltay, Nergiz ErcilDespite providing several insights into visual attention and evidence regarding certain brain states and psychological functions, classifying eye movements is a highly demanding process. Currently, there are several algorithms to classify eye movement events which use different approaches. However, to date, only a limited number of studies have assessed these algorithms under specific conditions, such as those required for surgical training programmes. This study presents an investigation of ten open-source eye-movement classification algorithms using the Eye Tribe eye-tracker. The algorithms were tested on the eye-movement records obtained from 23 surgical residents, who performed computer-based surgical simulation tasks under different hand conditions. The aim was to offer data for the improvement of surgical training programmes. According to the results, due to the different classification methods and default threshold values, the ten algorithms produced different results. Considering the fixation duration, the only common event for all of the investigated algorithms, the binocular-individual threshold (BIT) algorithm resulted in a different clustering compared to the other algorithms. Based on the other set of common events, three clusters were determined by eight algorithms (except BIT and event detection (ED)), distinguishing dispersion-based, velocity-based and modified versions of velocity-based algorithms. Accordingly, it was concluded that dispersion-based and velocity-based algorithms provided different results. Additionally, as it individually specifies the threshold values for the eye-movement data, when there is no consensus about the threshold values to be set, the BIT algorithm can be selected. Especially for such cases like simulation-based surgical skill-training, the use of individualised threshold values in the BIT algorithm can be more beneficial in classifying the raw eye data and thus evaluating the individual progress levels of trainees based on their eye movement behaviours. In conclusion, the threshold values had a critical effect on the algorithm results. Since default values may not always be suitable for the unique features of different data sets, guidelines should be developed to indicate how the threshold values are set for each algorithm.Article Breast Cancer Management During the Covid Pandemic(Coll Physicians & Surgeons Pakistan, 2024) Sariyildiz, Gulcin Turkmen; Ayhan, Fikriye FigenObjective: To explore the impact of COVID-19 among both the newly diagnosed patients and patients under follow-up for breast cancer by focusing on patients' accessibility to management and comparing the distribution of them before and during pandemic. Study Design: Single -centric retrospective study. Place and Duration of the Study: Department of General Surgery and Department of Physical Medicine and Rehabilitation, Atilim University, Medicana International Ankara Hospital, Ankara, Turkiye, from March 2018 to 2022. Methodology: The data were collected to analyse numbers and distributions of physician visits regarding breast cancer. Results: The mean age of patients was 55.98 +/- 12.60 years. The percentages of newly diagnosed cases showed similarity (7.37% vs. 9.79%) before and during the pandemic (p = 0.18). The number of imaging studies decreased by 53.33% in patients under follow-up (p = 0.006), despite screening tests showed a similar trend (p = 0.145). General surgery visits marked up (+44.6%), in contrast to plastic surgery visits (-42.04%, p <0.001). Patients' admissions decreased in many COVID-19 related clinics (pulmonology, emergency, internal medicine, and intensive care), but cardiology (+96.59%) and rehabilitation (+75%) admissions increased during the pandemic (p <0.001). The number of medical oncology and radiation oncology visits did not change (p >0.05). Conclusion: Total number of physician visits was similar before and during the pandemic despite the changing distribution. While COVID-19 led to markedly rising trends of surgical, cardiological, and rehabilitative management in patients with breast cancer, falling trends were seen in other specialities except oncology which showed a plateau during two years. The falling trends of visits to pulmonology, emergency, internal medicine, and intensive care clinics may be explained by crowded COVID-19 cases.Review Citation - WoS: 7Citation - Scopus: 7A Systematic Review on Classification and Assessment of Surgical Skill Levels for Simulation-Based Training Programs(Elsevier Ireland Ltd, 2023) Tonbul, Gokcen; Topalli, Damla; Cagiltay, Nergiz ErcilBackground: Nowadays, advances in medical informatics have made minimally invasive surgery (MIS) procedures the preferred choice. However, there are several problems with the education programs in terms of surgical skill acquisition. For instance, defining and objectively measuring surgical skill levels is a challenging process. Accordingly, the aim of this study is to conduct a literature review for an investigation of the current approaches for classifying the surgical skill levels and for identifying the skill training tools and measurement methods.Materials and Methods: In this research, a search is conducted and a corpus is created. Exclusion and inclusion criteria are applied by limiting the number of articles based on surgical education, training approximations, hand movements, and endoscopic or laparoscopic operations. To satisfy these criteria, 57 articles are included in the corpus of this study.Results: Currently used surgical skill assessment approaches have been summarized. Results show that various classification approaches for the surgical skill level definitions are being used. Besides, many studies are con-ducted by omitting particularly important skill levels in between. Additionally, some inconsistencies are also identified across the skill level classification studies.Conclusion: In order to improve the benefits of simulation-based training programs, a standardized interdisci-plinary approach should be developed. For this reason, specific to each surgical procedure, the required skills should be identified. Additionally, appropriate measures for assessing these skills, which can be defined in simulation-based MIS training environments, should be refined. Finally, the skill levels gained during the developmental stages of these skills, with their threshold values referencing the identified measures, should be redefined in a standardized manner.Article Right Renal Ectopia Following Major Weight Loss(BMJ Publishing Group, 2025) Abdulrasool, Amjed Safaa; Noack, Morten Westergaard; Overgaard, Ellen Kristine; Abdulrasool, MujtabaPresenting with severe stomach pain from sigmoid volvulus, a woman in her 90s was effectively treated with colonoscopic desufflation. Interestingly, serial imaging over 16 years demonstrated gradual cranial displacement of the right kidney to the hepato-diaphragmatic space without prior trauma, surgery or congenital abnormalities. The patient remained asymptomatic with respect to renal function despite significant anatomical displacement. No specific intervention was required for the ectopic kidney. It is important to recognise the potential for organ migration associated with ageing, significant weight loss or metabolic alterations, particularly in the context of increasing use of weight-loss medications. Awareness of such anatomical variants can prevent misinterpretation of incidental findings on clinically indicated imaging. Routine imaging solely to detect asymptomatic positional changes is not justified.
