<caption><image_40>The image is a close-up of a surgical instrument, specifically a surgical device. The device appears to be a surgical scalpel, which is a type of surgical instrument used to perform surgical procedures. The image is taken from a top-down perspective, looking down on the device.

In the center of the image, there is a large, pinkish-red area with a yellowish-orange color. The area is surrounded by a thin, white membrane. On the left side of the device, there are several small, yellow-colored structures, which appear to be surgical instruments. The structures are arranged in a circular pattern, with some of them overlapping each other. The instruments are positioned in a way that suggests they are being used in a surgical procedure. The background is black, making the colors of the instruments stand out.</caption><transcript><audio_41> ...</transcript><caption><image_42>The image is a close-up of a piece of tissue, which appears to be a tissue sample. The tissue is pink and white in color, with small, glittery particles scattered throughout. The particles are of different sizes and colors, including pink, blue, and green. The image is taken from a top-down perspective, looking down on the tissue. The text on the image reads "Dr. William Otero, Boca Raton, California." The text is in black and is located on the top left corner of the image.</caption><transcript><audio_43> Y también quiero decir en este momento que el puntaje de burbujas no hace parte de indicadores de calidad, pero en nuestra experiencia hemos visto que esto es fundamental, que las burbujas no estén presentes.</transcript><transcript><audio_44> base en el puntaje de burbujas es similar exactamente igual al Boston pero con las burbujas tres puntos es que menos del 5% de la superficie tiene burbujas 2.525</transcript><caption><image_45>The image shows a man standing at a podium in front of a stage with two flags on either side. He is speaking into a microphone and appears to be giving a presentation. The background is dark and there is a large screen behind him. On the right side of the image, there are four circular images arranged in a grid-like pattern. Each image has a different color scheme - red, orange, yellow, and blue. The colors are labeled with text, and the text is written in a bold font. The image appears to have been taken at a conference or event, as there are people sitting in the audience visible in the background.</caption> that This magnificent video, however, is  He's saying some things, I can't repeat them but basically ch there and it looks like there is colon cancer at that moment that I don't know how to see properly and I also want to say at this moment that the bubble score is not part of quality indicators but  in our  From experience we have seen that this is essential that the bubbles are not present and they must be graded based on the bubble score. It is similar Exactly the same as Boston but with the three- point bubbles it is that less than 5% of the surface has two-point bubbles 25  It
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