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INTRODUCTION: Surgical education has seen a transition in the delivery of training, with increased use of online platforms to facilitate remote learning. Simulation training can increase access to education and reduce cost implications, while reducing patient risk. This study aims to compare commercially available digital microscopes, alongside a standard binocular surgical microscope, and determine whether they can be used as an alternative tool for remote microsurgery simulation. METHODS: Data were collected for a total of four microscopes, including three commercially available digital microscopes, smartphone, and a binocular table microscope. Product characteristics were collated, and a subjective assessment was conducted using an 11-criteria questionnaire, graded with a 5-point scale. Results of digital microscopes were compared with the table binocular microscope.The Kruskal-Wallis test was used to compare the performance of digital microscopes to the standard binocular microscope RESULTS: The questionnaire was completed by 31 participants: two consultants, nine surgical registrars, fourteen junior trainees, and six medical students. Digital microscopes were found to be significantly more affordable and convenient for trainees; however, the cost of the smartphone was significant. Overall, the Pancellant Digital Microscope performed the poorest, with trainees commenting on its unsuitability for surgical practice; the Plugable USB Digital Microscope (PLDM) was rated overall most like the binocular table microscope. The Depth of field was shallow in all digital microscopes. CONCLUSION: With the increasing role of remote learning and simulation training in surgical education, the PLDM can provide a cheaper, more accessible alternative for junior trainees, in their pursuit of microsurgical skill acquisition.
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Few international studies have investigated factors affecting domiciliary non-invasive ventilation (D-NIV) compliance, and data from the UK are limited. We assessed compliance (defined as ≥ 4 h/night for at least 70% of the time) in a retrospective UK population study, at three time points (0-1 month, 3-4 months and 11-12 months), for all patients commenced on D-NIV over a 5-year period. A total of 359 patients were included. Non-compliant vs. compliant patients were significantly younger (median age 64 (IQR 52-72) vs. 67 (58-75) years, p = 0.032) and more likely to have schizophrenia, consistent at both 3-4 months (5% vs. 1%, p = 0.033) and 11-12 months (5% vs. 2%, p = 0.049). Repeated measures ANOVA demonstrated that the minutes [median (IQR)] of D-NIV used significantly increased at the three time points (0-1 month, 3-4 months and 11-12 months) for patients with hypertension [310 (147.5-431) vs. 341 (89-450) vs. 378 (224.5-477.5), p = 0.003]; diabetes [296.5 (132.5-417.5) vs. 342.5 (94.5-438.5) vs. 382 (247.5-476.25), p = 0.002] and heart failure [293 (177-403) vs. 326 (123-398) vs. 365 (212-493), p = 0.04]. In conclusion, younger and comorbid schizophrenic patients have lower D-NIV compliance rates, and our data suggest that persistence with D-NIV over a year may improve overall use.