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Robot-assisted partial nephrectomy (RAPN) is a complex and index procedure that urologists need to learn how to perform safely. No validated performance metrics specifically developed for a RAPN training model (TM) exist. A Core Metrics Group specifically adapted human RAPN metrics to be used in a newly developed RAPN TM, explicitly defining phases, steps, errors, and critical errors. A modified Delphi meeting concurred on the face and content validation of the new metrics. One hundred percent consensus was achieved by the Delphi panel on 8 Phases, 32 Steps, 136 Errors and 64 Critical Errors. Two trained assessors evaluated recorded video performances of novice and expert RAPN surgeons executing an emulated RAPN in the newly developed TM. There were no differences in procedure Steps completed by the two groups. Experienced RAPN surgeons made 34% fewer Total Errors than the Novice group. Performance score for both groups was divided at the median score using Total Error scores, into HiError and LoError subgroups. The LowErrs Expert RAPN surgeons group made 118% fewer Total Errors than the Novice HiErrs group. Furthermore, the LowErrs Expert RAPN surgeons made 77% fewer Total Errors than the HiErrs Expert RAPN surgeons. These results established construct and discriminative validity of the metrics. The authors described a novel RAPN TM and its associated performance metrics with evidence supporting their face, content, construct, and discriminative validation. This report and evidence support the implementation of a simulation-based proficiency-based progression (PBP) training program for RAPN. [ABSTRACT FROM AUTHOR]

Experimental hydrogen loadings in titanium thin films were compared to the Mintz-Bloch model. 500 nm titanium thin films were deposited with an electron-beam evaporator onto sapphire substrates and were capped with a 10 nm palladium thin film. The titanium films were loaded with hydrogen in a custom Sievert apparatus where the pressure drop showed full hydriding at a hydrogen pressure of 2 bar and loading temperatures of 100 °C, 150 °C, 200 °C and 250 °C. Comparisons of X-ray diffractions of loaded and unloaded films showed the presence of titanium hydride in loaded films. The experimental loadings were compared to the Mintz-Bloch model where the Mintz-Bloch model overpredicted experimental loadings. This was due to the Mintz-Bloch assuming that hydride forms immediately upon hydrogen exposure in the metal. However, the difference between the experimental loading kinetics and Mintz-Bloch model was reduced as loading temperatures increased until the temperature reached 250 °C where some titanium hydride outgassing occurred. • Hydrogen loading of titanium thin films was successfully demonstrated at 100 °C, 150 °C, 200 °C, and 250 °C. • Pressure drops from Sievert apparatus show hydrogen absorption of stoichiometric ratio of 2 hydrogen atoms per titanium atom. • Hydrogen absorption in titanium was confirmed with X-ray diffraction of titanium hydride peak. • Loading kinetics of titanium films compared to Mintz-Bloch model and showed good correlation. [ABSTRACT FROM AUTHOR]