Appendicoscopy using single-operator cholangioscope in the management of acute obstructive appendicitis: a novel alternative (with video).

BACKGROUND AND AIMS: The aim of this study was to investigate the safety and efficacy of appendicoscopy using a single-operator cholangioscope (SOC) for the management of acute obstructive appendicitis. METHODS: This study describes 110 cases of acute obstructive appendicitis managed with the use of appendicoscopy between January 2021 and June 2023. The success rate (technical + clinical), procedure time, time to abdominal pain relief according to a visual analog scale score, postoperative length of hospital stay, and adverse event rates were recorded and analyzed. RESULTS: The technical success rate of appendicoscopy was 96.4%, and the clinical success rate was 91.8%. The mean ± standard deviation procedure time was 20.9 ± 10 minutes. The abdominal pain score at 6 hours after the procedure was ≤3 (visual analog scale method) in 99.1% of patients. The average length of postoperative hospital stay was 3.5 ± 1.5 days. No adverse events occurred. CONCLUSIONS: Appendicoscopy seems to be a feasible and effective alternative therapy for the accurate diagnosis and treatment of acute obstructive appendicitis.

Single-operator cholangioscopy system for management of acute cholecystitis secondary to choledocholithiasis.

This study aimed to investigate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) + EyeMax (single-operator cholangioscopy system; SOC) (i.e., ERCP+SOC) for the treatment of choledocholithasis-associated acute cholecystitis. Twenty-five patients were evaluated between January 2022 and June 2023. The success rate (technical + clinical), procedure time, postoperative recovery, postoperative length of hospital stay, and complications rates were recorded. The procedure and clinical success rates were 92% (23/25) and 96% (24/25), respectively. The mean procedure time was 36.6±10 minutes (standard deviation [SD]). The average postoperative hospitalization was 2±0.8 days. No adverse events such as bleeding, perforation, or bile leakage occurred. Cholecystitis did not recur during the 2 to 18 months of follow-up. ERCP+SOC may be a feasible, safe, and effective alternative treatment for acute cholecystitis secondary to choledocholithiasis. ERCP+SOC was able to simultaneously resolve both biliary tract and gallbladder problems via natural orifice endoscopy. Its advantages included no skin wound, reduced postoperative pain, quick recovery, limited to no exposure to x-rays, and a short hospital stay.

Regularized Spectral Spike Response Model: A Neuron Model for Robust Parameter Reduction.

The modeling procedure of current biological neuron models is hindered by either hyperparameter optimization or overparameterization, which limits their application to a variety of biologically realistic tasks. This article proposes a novel neuron model called the Regularized Spectral Spike Response Model (RSSRM) to address these issues. The selection of hyperparameters is avoided by the model structure and fitting strategy, while the number of parameters is constrained by regularization techniques. Twenty firing simulation experiments indicate the superiority of RSSRM. In particular, after pruning more than 99% of its parameters, RSSRM with 100 parameters achieves an RMSE of 5.632 in membrane potential prediction, a VRD of 47.219, and an F1-score of 0.95 in spike train forecasting with correct timing (±1.4 ms), which are 25%, 99%, 55%, and 24% better than the average of other neuron models with the same number of parameters in RMSE, VRD, F1-score, and correct timing, respectively. Moreover, RSSRM with 100 parameters achieves a memory use of 10 KB and a runtime of 1 ms during inference, which is more efficient than the Izhikevich model.