A rack for use in an operating room during surgery to hold surgical instruments. The pretreatment of the patient with the nebulized lidocaine or a lidocaine-like compound improves airway tolerance and deposition of the agent in the lungs and makes such deposition more safe, efficacious, controllable and predictable. A supporting layer is applied to at least one of the upper side and the bottom side of the substrate at an area not covered by the patterns to reinforce the substrate. The next approximate nearest neighbor is incrementally retrieved based on a state of one or more of the object priority queue and the cell priority queue. The rotary actuator may include inner and outer rotors which rotate relative to each other and may be free to rotate relative to the exoskeleton.