Segmenting/Pre-Processing Data from Bone Screw Thread-Stripping Tests.

Bone screws must be appropriately tightened to achieve optimal patient outcomes. If over-torqued, the threads formed in the bone may break, compromising the strength of the fixation; and, if under-torqued, the screw may loosen over time, compromising the stability. Previous work has proposed a model-based system to automatically determine the optimal insertion torque. This system consists of a reverse-modelling step to determine strength, and a forward modelling step to determine maximum torque. These have previously been tested in isolation, however future work must test the combined system. To do so, the data must be segmented and pre-processed. This was done based on specific features of the recorded data. The methodology was tested on 50 screw-insertion data sets across 5 different materials. With the parameters used, all data sets were correctly segmented. This will form a basis for the further processing of the data and validating the combined systemClinical relevance: The system for torque limit determination must be tested in its entirety to properly asses its performance. This paper discusses some of the steps required to pre-process the data to make this assessment. If successful, this system may improve patient outcomes in orthopaedic surgery.

Influence of a Structural Prior Mask on EIT Image Reconstruction.

Electrical Impedance Tomography (EIT) is a low-cost imaging method with promising results in visualizing ventilation distribution within the lungs. However, in clinical settings, the interpretability of EIT images is often limited by blurred anatomical alignment and reconstruction artifacts. Integrating structural priors into the EIT reconstruction process can enhance the interpretability of EIT images. In this contribution, we introduced a patient-specific structural prior mask into the EIT reconstruction process. Such prior mask ensures that only conductivity changes within the lung regions are reconstructed. With the aim to investigate the influence of the structural prior mask on the EIT images, we conducted numerical simulations in terms of four different ventilation status. EIT images were reconstructed with Gauss-Newton algorithm and discrete cosine transform-based EIT algorithm. We carried out quantitative analysis including the reconstruction error and figures of merit for the evaluation. The results show that the morphological structures of the lungs introduced by the prior mask are preserved in the EIT images, and the reconstruction artefacts are also limited. In conclusion, the incorporation of the structural prior mask enhances the interpretability of EIT images in clinical settings.Clinical relevance-The correct interpretation of an EIT image is crucial for a clinical diagnosis. This research demonstrates that a structural prior mask might have the potential to improve the interpretability of an EIT image, which facilitates the clinicians with a better understanding of EIT results.

Sensor Selection for Tidal Volume Determination via Linear Regression-Impact of Lasso versus Ridge Regression.

The measurement of respiratory volume based on upper body movements by means of a smart shirt is increasingly requested in medical applications. This research used upper body surface motions obtained by a motion capture system, and two regression methods to determine the optimal selection and placement of sensors on a smart shirt to recover respiratory parameters from benchmark spirometry values. The results of the two regression methods (Ridge regression and the least absolute shrinkage and selection operator (Lasso)) were compared. This work shows that the Lasso method offers advantages compared to the Ridge regression, as it provides sparse solutions and is more robust to outliers. However, both methods can be used in this application since they lead to a similar sensor subset with lower computational demand (from exponential effort for full exhaustive search down to the order of O (n2)). A smart shirt for respiratory volume estimation could replace spirometry in some cases and would allow for a more convenient measurement of respiratory parameters in home care or hospital settings.

P-CSEM: An Attention Module for Improved Laparoscopic Surgical Tool Detection.

Minimal invasive surgery, more specifically laparoscopic surgery, is an active topic in the field of research. The collaboration between surgeons and new technologies aims to improve operation procedures as well as to ensure the safety of patients. An integral part of operating rooms modernization is the real-time communication between the surgeon and the data gathered using the numerous devices during surgery. A fundamental tool that can aid surgeons during laparoscopic surgery is the recognition of the different phases during an operation. Current research has shown a correlation between the surgical tools utilized and the present phase of surgery. To this end, a robust surgical tool classifier is desired for optimal performance. In this paper, a deep learning framework embedded with a custom attention module, the P-CSEM, has been proposed to refine the spatial features for surgical tool classification in laparoscopic surgery videos. This approach utilizes convolutional neural networks (CNNs) integrated with P-CSEM attention modules at different levels of the architecture for improved feature refinement. The model was trained and tested on the popular, publicly available Cholec80 database. Results showed that the attention integrated model achieved a mean average precision of 93.14%, and visualizations revealed the ability of the model to adhere more towards features of tool relevance. The proposed approach displays the benefits of integrating attention modules into surgical tool classification models for a more robust and precise detection.

Laparoscopic Video Analysis Using Temporal, Attention, and Multi-Feature Fusion Based-Approaches.

Adapting intelligent context-aware systems (CAS) to future operating rooms (OR) aims to improve situational awareness and provide surgical decision support systems to medical teams. CAS analyzes data streams from available devices during surgery and communicates real-time knowledge to clinicians. Indeed, recent advances in computer vision and machine learning, particularly deep learning, paved the way for extensive research to develop CAS. In this work, a deep learning approach for analyzing laparoscopic videos for surgical phase recognition, tool classification, and weakly-supervised tool localization in laparoscopic videos was proposed. The ResNet-50 convolutional neural network (CNN) architecture was adapted by adding attention modules and fusing features from multiple stages to generate better-focused, generalized, and well-representative features. Then, a multi-map convolutional layer followed by tool-wise and spatial pooling operations was utilized to perform tool localization and generate tool presence confidences. Finally, the long short-term memory (LSTM) network was employed to model temporal information and perform tool classification and phase recognition. The proposed approach was evaluated on the Cholec80 dataset. The experimental results (i.e., 88.5% and 89.0% mean precision and recall for phase recognition, respectively, 95.6% mean average precision for tool presence detection, and a 70.1% F1-score for tool localization) demonstrated the ability of the model to learn discriminative features for all tasks. The performances revealed the importance of integrating attention modules and multi-stage feature fusion for more robust and precise detection of surgical phases and tools.

Characterisation and Quantification of Upper Body Surface Motions for Tidal Volume Determination in Lung-Healthy Individuals.

Measurement of accurate tidal volumes based on respiration-induced surface movements of the upper body would be valuable in clinical and sports monitoring applications, but most current methods lack the precision, ease of use, or cost effectiveness required for wide-scale uptake. In this paper, the theoretical ability of different sensors, such as inertial measurement units, strain gauges, or circumference measurement devices to determine tidal volumes were investigated, scrutinised and evaluated. Sixteen subjects performed different breathing patterns of different tidal volumes, while using a motion capture system to record surface motions and a spirometer as a reference to obtain tidal volumes. Subsequently, the motion-capture data were used to determine upper-body circumferences, tilt angles, distance changes, movements and accelerations-such data could potentially be measured using optical encoders, inertial measurement units, or strain gauges. From these parameters, the measurement range and correlation with the volume signal of the spirometer were determined. The highest correlations were found between the spirometer volume and upper body circumferences; surface deflection was also well correlated, while accelerations carried minor respiratory information. The ranges of thorax motion parameters measurable with common sensors and the values and correlations to respiratory volume are presented. This article thus provides a novel tool for sensor selection for a smart shirt analysis of respiration.

Analysing multi-perspective patient-related data during laparoscopic gynaecology procedures.

Fusing data from different medical perspectives inside the operating room (OR) sets the stage for developing intelligent context-aware systems. These systems aim to promote better awareness inside the OR by keeping every medical team well informed about the work of other teams and thus mitigate conflicts resulting from different targets. In this research, a descriptive analysis of data collected from anaesthesiology and surgery was performed to investigate the relationships between the intra-abdominal pressure (IAP) and lung mechanics for patients during laparoscopic procedures. Data of nineteen patients who underwent laparoscopic gynaecology were included. Statistical analysis of all subjects showed a strong relationship between the IAP and dynamic lung compliance (r = 0.91). Additionally, the peak airway pressure was also strongly correlated to the IAP in volume-controlled ventilated patients (r = 0.928). Statistical results obtained by this study demonstrate the importance of analysing the relationship between surgical actions and physiological responses. Moreover, these results form the basis for developing medical decision support models, e.g., automatic compensation of IAP effects on lung function.