David J. Slutsky MD Assistant Professor of Orthopedics Harbor-UCLA The Hand & Wrist Institute Torrance, CA Creating Images and Video for Publication COPYRIGHT

David J. Slutsky MD

Assistant Professor of Orthopedics

Harbor-UCLAThe Hand & Wrist InstituteTorrance, CA

Creating Images and Video for Publication

COPYRIGHT DAVID J. SLUTSKY MD 2012


STEPS IN CONSTRUCTING A MEDICAL VIDEO• Editing photographs/figures

• Addiing captured video

• adding figures/photographs

• Adding artwork

• Editing the time line

• Cutting and cropping frames

• Inserting transitions

• Adding titles

• Recording a voice over

• Saving Video to different File Formats


PHOTOGRAPHY

19902000

2010

Film/slide media, Macro lens, ring flash 6 MP Digital SLR , ¼ CCD

Macro lens, no flash12 MP, ¾ CCDHD video

12 MP, HD video


ELECTRONIC ART GUIDELINES Acceptable Not AcceptableFORMATS BMP, TIFF files*

Adobe Illustrator EPS files*Adobe Photoshop EPS files*

Artwork should be created with only one figure on each document, even if the

figure is very small

PowerPoint filesJPEG files

MacDraw or paint programsBusiness graphic programs

(PowerPoint, Persuasion, Harvard Graphics, AutoCAD)

FTP filesRGB files

Art merged with Microsoft Word or WordPerfect programs

PDF files

*Resolution for all images must be 300 dpi for halftones and 1200 dpi for line drawings

Figure size must be at least 2 x 2 inches at 600 DPI


PHOTOSHOP EDITING• Crop image

• Adjust brightness/contrast, color saturation

• Resizing – 2x2 inches at 600 DPI is sufficient for print publication – avoid 12MB files!

• Save as Indexed color or grayscale image – not RGB (increased file size)

• Add labels

• Save as .TIFF or .BMP – avoid .jpeg (too compressed)

• Powerpoint – 96 dpi is maximum screen resolution so reduce file size before inserting



CAMCORDER TYPES• Three Chip 2/3 Inch -- Professional -- Best -- Panasonic AJD-700/AJD-610WA,

Sony DXD-35W/DSR-570 • Three Chip 1/2 inch -- Professional -- Excellent -- Panasonic

AJD-400/410A/DVC-200, Sony DSR-370 • Three Chip 1/3 inch -- Professional/Prosumer -- Very Good/Excellent -- Sony

VX-1000/2000/DSR-PDX10/DSR-250/PD-150, Panasonic AJD-215, Canon XL-1S

• Three Chip 1/4 inch -- Consumer -- Very Good/Good -- Panasonic AG-DVC15, Canon GL2

• Single Chip 1/3 inch -- Prosumer/Consumer -- Very Good/Fair -- Sony DCR-PC7

• Single Chip 1/4 inch -- Prosumer/Consumer -- Good/Fair/Poor -- Canon Optura 200MC

• New to Market -- Hitachi DVD-RAM Camcorder DZ-MV100/200 uses DVD-RAM format . disks, not a widely accepted format


VIDEO STORAGE FORMATS• Digital Betacam: Best, professional

•DVCPro/DVCAM -- Excellent/Very Good -- Professional

•Mini DV -- Good/Very Good -- Prosumer/Consumer. Connects to computer with an IEEE cable.

•Mini DVD-RAM -- Good --

• Hard drive storage – connects to computer with a USB cable

•


SHOOTING VIDEO IN THE O.R.

• White balance the camera each time you turn it on.

• Use plenty of diffuse light -- always avoid shadows.

• Avoid using overhead OR lights (yellow). Use room fluorescent lights

• Do not overexpose the image -- a bit under is preferable.

• Use a tripod. This is especially important in tight close-ups.

• Avoid excessive zooming.

• Don't shoot against a bright background or window. Don't allow a light source to be in the frame.

• Avoid boosting the camera gain to brighten the image -- it will add noise. Try to add more ambient light.


SHOOTING VIDEO IN THE O.R. • Make sure everyone understands the importance of staying clear

of the sightline of the camera. This is especially important to assistants working close to the field, but also to the operating surgeon.

• Instruct assistants to minimize reaching across the field, minimize suction tip in and out of the field.

• White gloves will reflect light and cause glare on the video. If possible use brown/darker colored gloves.

• Be slow and deliberate in all movements.

• If you need to show a particular instrument or similar, hold the instrument still in one spot (on top of or just in front of the hand) and demonstrate there.


SHOOTING INTRAOPERATIVE VIDEO

• Tripod behind your right shoulder

• Use Remote control

• Swivel LCD screen to face you


SHOOTING VIDEO IN THE CLINIC.

• Avoid showing faces unless signed permission is provided by the patient

• Keep footage to 30 seconds and do multiple takes

• Add-on voice over is preferable to conversation with the patient since it is easier to edit the timeline

• Use ambient fluorescent lights – avoid backlighting with windows


AUDIO

• If you intend to record the surgeon voice-over during the surgery use a hard-wired microphone as electrocautery will interfere with a wireless system.

• In the clinic, the on-camera mic may be sufficient but a lava-mic gives the best voice quality.


X-RAY IMAGES

• Import into the video editing program as .jpeg, .tiff files rather than shooting off lightbox

• CT scans/MRI on CDs – can be captured using the screenshot utility (PC)

• Avoid shooting off CRT fluoro monitor due to scan lines – not a problem with LED screens.

• Exception – orthoscan/fluroscan live DVR mode


EDITING PROCESS

• Import each video clip on to the time line 10-15 seconds/frame is optimal

• Add in x-rays and clinical footage. As a general rule 10-15 second clips are sufficient.

• Add labels or arrows where needed – 5 seconds is sufficient. Font size 22 to 36.

• Use transitions between clips or between different parts of the video i.e. intraop v.s x-ray v.s clinical


EDITING PROCESS

• Avoid using powerpoint slides – this is a video not a powerpoint presentation

• Powerpoint has a built-in limitation of 96 dpi so the slide always appear fuzzy – bettter to import the images directly and then add labels or titles on the image

• Add the voice over after all of the editing is completed.

• Use slugs to fill space or still images as necessary if more time is needed for the voice over.


VOICE OVER

• Use lava microphone attached to camcorder for best sound quality

• Use moving coil microphone attached to computer mixer (boosts sound levels and reduces background noise/hiss) vs. plugging into sound card directly.

• Use foam cushion to reduce “popping”. Increase gain, use high and low noise filters in editing software if necessary

• Avoid real time voice over – a scripted storyboard is preferable.

• Adjust voice over timeline to video footage and transitions.


EDITING PROCESS

• Save as an .AVI or quicktime file for DVD publication

• streaming video for online viewing - maximum resolution 640x480

• Make 2-3 minute MPEG-1 for powerpoint presentations. If the file size is larger than 25 MB it may not run in a powerpoint presentation.

• 5-10 minutes for companion DVD for a book or online website

• 30 minutes for full featured video.


CODECS

• Codecs are compression technologies with two components; an encoder to compress the file in your studio or office and a decoder to decode the file when played by the remove viewer.

• Still image codecs i.e. JPEG

• audio codecs i.e. MP3

• video codecs i.e. MPEG-1 (most common for powerpoint embedding), H.264 and MPEG-2 (network and satellite, Blu-ray), VP6, Windows Media and Sorenson Spark in the streaming space.


CODECS

• QuickTime. FLASH and Video for Windows are development environments that support a number of codecs, including DV, MPEG-2, AVCHD and DVCPROHD.

• AVI file = Video for Windows file; MOV = QuickTime.

• Windows Media, Flash and QuickTime are the most widely used distribution environments, and each can contain multiple codecs. For example, each can deliver video encoded with the H.264 codec


VIDEO EDITING

PC editing – Windows Media File

• Files type: .AVI uncompressed format, highest resolution, largest file size – best for DVD publication

• MPEG1 – most compressed, smallest file size, plays with windows Media Player, best for powerpoint presentations

• MPEG 4 – better resolution, intermediate file size, not always supported by Windows Media Player.

• Editing software : Pinnacle Studio HD, Avid Studio


VIDEO EDITING

MAC

• Files type .MOV uncompressed format, highest resolution, largest file size – best for DVD publication

• Plays with Quicktime player


HD VIDEO EDITING• MTS format is a high-definition MPEG, AVC, H.264

transport stream video file format which commonly used by HD camcorders such as Sony, Canon, Panasonic hard drive camcorders connect with USB cable but no audio is transferred

• Camcorders make use of MTS in the form of AVCHD, a recording format made specifically for camcorders.

• These files are also present on Blu-ray disc compilations, therefore they are capable of storing quite a large amount of information and data tracks.


HD VIDEO EDITING• MTS file format which is an AVCHD file

(Advanced Video codec High Definition) cannot be edited with i-movie or Final cut pro.

• An MTS file converter program is needed to convert MTS to MOV, AVI, etc.

• MTS Converter converts .mts to audio in the format of MP3, WAV etc..


BANDWIDTH

• Bandwidth is the viewer's connection speed to the Internet.

• controls your viewer's ability to retrieve and play video smoothly over the Internet.

• Higher delivery bandwidths, like those enabled with cable and DSL, allow you to stream higher quality video to your viewer.

• Jan Over, Video Compression for Flash, Apple Devices and HTML


BANDWIDTH

• most videos max out at 640x480 resolution at around 600-700 kbps, even though many viewers have the capacity to watch higher bit rate streams.

• producers have to pay for their bandwidth and have decided that 640x480 video at 600-700 kbps provides a sufficiently high quality experience to meet their viewer's needs.

Jan Over, Video Compression for Flash, Apple Devices and HTML


DATA RATE

• The Data Rate (or bit rate) is the size of the video file per second of data. i.e. 600Kbps means that each one-second chunk of audio and video comprises about 600 kilobits of data.

• Data rate is the most important factor in streaming video quality.

• The more you compress, the more quality you lose



FRAME RATE

• Most video is captured at 29.97 or 24 frames per second (fps) but many producers deliver at 15 fps to save bandwidth.

• At 15 fps, high motion video will look noticeably choppy to many viewers. In addition, tight facial shots, where lip synch is critical, often a look a bit out of sorts at 15 fps as well.



VIDEO RESOLUTION

• Resolution is the height and width of the video in pixels. Most video is original stored at either 720x480 (standard definition) or 1920x1080 (high definition), but gets sampled down to smaller resolutions for streaming, usually 640x480 resolution or smaller.

• That's because as the number of pixels in the file increase, you have to allocate more data rate to maintain the same quality.



• 320x240 video has 76,800 pixels in each frame, while a 640x480 video file has 307,200, or 4X more

• That means you have to apply 4X the compression to achieve the same data rate, which usually means noticeably reduced quality.

RESOLUTION



DELIVERY MODES: STREAMING

• Video delivered via streaming is delivered via a streaming server.

• You click the button on a website, the video starts playing immediately to the end.

• the data rate must be smaller than the bandwidth capacity of the remote viewer; otherwise, the video will frequently stop playing.

• Eg. With a broadband connection, the videos will stream smoothly from start to finish. If you connect via a 28.8Kbps modem, the video will stop and start.



DELIVERY MODES: PROGRESSIVE DOWNLOAD

• video is delivered by a regular HTTP web server, and is delivered using this technique then is stored on the viewer’s hard drive as it’s received by the server, and then played from the hard drive.

• The benefit of progressive download is that though the initial playback may not be that smooth, if you wait long enough, the video will play smoothly because you've got a local copy stored to your disk.



DELIVERY MODES: DOWNLOAD AND PLAY

• The viewer has to completely download the video file before they can play it.

• there are typically no production specific requirements for these files.


Documents

David J. Slutsky MD Assistant Professor of Orthopedics Harbor-UCLA The Hand & Wrist Institute Torrance, CA Creating Images and Video for Publication COPYRIGHT