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Background: Quality performance indicators for the management of oesophagogastric cancer can be used to objectively measure and compare the performance of individual units and capture key elements of patient care to improve patient outcomes. Methods: Two systematic reviews were completed to identify evidence‐based quality performance indicators for the surgical management of oesophagogastric cancer. Based on the indicators identified, a two‐round modified Delphi process with invitations was sent to all members of the Australia and Aotearoa New Zealand Gastric and Oesophageal Surgery Association. The expert working group discussed each suggested indicator and either removed, added, or adjusted the list of indicators of oesophagogastric cancer. Results: The final list of both OG cancer indicators included Specialized Multi‐disciplinary team discussion, Endoscopy documentation, Staging Contrast CT Chest/Abdomen and Pelvis, Neoadjuvant or Adjuvant chemo/radiotherapy administered in accordance with the Local multi‐disciplinary team, Pathological margin clearance (R0 Resection), Lymphadenectomy retrieving 15 or more nodes, Formal review of pathological findings and documentation, Postoperative complications, 30‐day and 90‐day postoperative mortality, clinical surveillance and Specialized Dietetic guidance. Indicators specific to gastric cancer included Preoperative biopsy for pathological diagnosis and Staging Laparoscopy. Indicators specific to oesophageal cancer include positron emission tomography scan if CT negative for metastasis, Perioperative Oesophagectomy Care Pathway, length of stay of 21 days or more, and Unplanned readmission within 30 days. Conclusions: The results of this study present a core set of indicators for the surgical management of oesophagogastric cancer that can be used to measure quality and compare performance between different units. [ABSTRACT FROM AUTHOR]

Background: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract. The New Zealand (NZ) population incidence has not previously been documented nor has the potential effect of ethnicity been reviewed. We furthermore wanted to assess the difference between those undergoing a wedge resection versus a more extensive operation which we hypothesised would correlate with recurrence and mortality. Methods: All patients (n = 103) with a GIST diagnosed and treated at Te Whatu Ora Waitematā (Auckland, New Zealand) between 2012 and 2021 are presented. Patient demographics, method of GIST detection, management approach, index surgery, histological features, use of adjuvant and neoadjuvant imatinib, follow‐up, recurrence and mortality rates were analysed. Results: This paper reports the largest NZ GIST cohort to date and estimates an incidence of 17 cases per million per year. Eighty‐four patients underwent surgical resection, 58 received a wedge resection and 17 received a more extensive operation. Five‐year disease‐free survival rates were 100% in the low/very low risk, 90% in the intermediate and 59% in the high risk groups as determined by the modified NIH criteria. Our overall 5‐year GIST‐specific survival rate was 83%; it was 91% in those who underwent a wedge resection and 60% in the extensive operation group. There is evidence that Māori have higher rates of GIST recurrence compared to non‐Māori and are more likely to require an extensive surgical resection. [ABSTRACT FROM AUTHOR]

Problem Statement: The critical step in laparoscopic surgery is the primary trocar insertion because it is executed with limited visibility of organs inside. Over-insertion frequently occurs due to either inability to stop a breaching trocar or by failure to accurately judge depth of insertion.  Background: Laparoscopic Surgery is a minimally invasive surgical procedure that offers patients benefits that are more favorable than traditional open surgery. The benefits include minimal scarring, less pain and discomfort, and fast recovery. However, this procedure gives surgeons many drawbacks, such as a confined working space, reduced dexterity, and obscured vision. With five million laparoscopic procedures done worldwide in 2013, three million in the US alone, it is a necessity to address the issues surgeons are facing in order to meet the patients' growing demands for laparoscopic surgery.  Advisor(s): Dr. Samir Shreim; Dr. Michelle Khine; Dr. Albert Yee. Graduate Student Advisors: Elena Liang, Phil Thomas. UCI Dean's Choice Award

Computing-in-memory (CIM) is a promising candidate for highly energy-efficient neural networks, alleviating the well-known bottleneck in Von Neumann architecture. MRAM has garnered significant attention in the CIM field, providing advantages in terms of non-volatility, high speed, and endurance. However, most existing MRAM-CIM primarily support low-precision operations, which poses a challenge in fulfilling the requirements of complex neural network models for high inference accuracy. To resolve this dilemma, an in-memory Booth Multiplier is proposed with the aim of enhancing the energy efficiency of neural networks performing multi-bit multiply-and-accumulate (MAC) operations. The MRAM array stores the multiplicand, while the multiplier is encoded by a Booth encoder into corresponding control signals, which perform negation and shift operations, reducing half of the partial products and accelerating the overall processing. Simulation results demonstrate at least a 17.3% improvement in energy efficiency compared to the previous in-SRAM counterpart in 8-bit multiplication. [ABSTRACT FROM AUTHOR]

Background: Advanced‐staging radiography is used inconsistently for patients with early‐stage (stage I + II) breast cancer. However, accurate and appropriate staging of newly diagnosed breast cancer may significantly impact treatment decisions. Methods: Four hundred and ninety‐nine patients with stages II and III breast cancer were seen in the breast service at Waitemata DHB, New Zealand from 2013 to 2018 were enrolled in the study and audited for radiological staging. Results: One hundred and two stage II patients had computed tomography (CT) at baseline; 88 of 102 (86%) of stage II patients were node‐positive (≥N1) with six patients (6.8%) having distant metastatic disease, and were upstaged to stage IV. Fifty‐two stage III patients out of 72 (72%) had baseline staging CTs. Nine out of 52 patients (17%) of stage III patients were upstaged to stage IV. Despite guideline recommendations, baseline staging for T4 disease (stage IIIB) was poor, with only 7 out of 13 patients with stage IIIB disease radiologically staged. Conclusion: Consideration for baseline radiological staging should be given to stages II and III, cN1 breast cancer patients, in which diagnosis of distant metastatic disease would change the treatment plan. Regional guidelines for baseline radiological staging for breast cancer patients may have an impact on patient management in breast cancer patients. [ABSTRACT FROM AUTHOR]