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Purpose
Supporting the surgeon during surgery is one of the main goals of intelligent ORs. The OR-Pad project aims to optimize the information flow within the perioperative area. A shared information space should enable appropriate preparation and provision of relevant information at any time before, during, and after surgery.
Methods
Based on previous work on an interaction concept and system architecture for the sterile OR-Pad system, we designed a user interface for mobile and intraoperative (stationary) use, focusing on the most important functionalities like clear information provision to reduce information overload. The concepts were transferred into a high-fidelity prototype for demonstration purposes. The prototype was evaluated from different perspectives, including a usability study.
Results
The prototype’s central element is a timeline displaying all available case information chronologically, like radiological images, labor findings, or notes. This information space can be adapted for individual purposes (e.g., highlighting a tumor, filtering for own material). With the mobile and intraoperative mode of the system, relevant information can be added, preselected, viewed, and extended during the perioperative process. Overall, the evaluation showed good results and confirmed the vision of the information system.
Conclusion
The high-fidelity prototype of the information system OR-Pad focuses on supporting the surgeon via a timeline making all available case information accessible before, during, and after surgery. The information space can be personalized to enable targeted support. Further development is reasonable to optimize the approach and address missing or insufficient aspects, like the holding arm and sterility concept or new desired features.
The global demand for resources such as energy, land, or water is constantly increasing. It is therefore not sur- prising that research on the Food-Energy-Water (FEW) nexus has become a scientific as well as a general focus in recent years. A significant increase in publications since 2015 can be observed, and it can be expected that this trend will continue. A multilevel (macro, meso, and micro) perspective is essential, as the FEW nexus has cross- sectoral interdependencies. Several review studies on the FEW nexus can be found in the literature, in general, it can be concluded that the FEW nexus is a multi-disciplinary and complex topic. The studies examined identify essential fields of action for research, policy, and society. However, questions such as what are the main research fields at each level? Is it possible to divide the research into specific clusters? and do the clusters correlate with the levels, and what are the methods of modeling used in the clusters and levels? are still not fully discussed in the literature. An extensive literature review was conducted to get insight into the existing research areas. Especially in such fields as the FEW nexus, the amount of literature can get huge, and a human could get lost analyzing the literature manually. For that, we created word clouds and performed a cluster- and network-analysis to support the selection of most relevant papers for a detailed reading. In 2021, the most publications were published, with 173 publications, which corresponds to a share of 26.6 %. There has been a significant increase since 2015, and it can be expected that this trend will continue in the coming years. Most of the first authors come from the USA (25.4 %), followed by China with 22.4 %. From the word cloud and the top 20 words, which appear in the title and abstract, it can be deduced that the topic water is the most represented. However, the terms system, resource, model, study, change, development, and management also appear to be very important, which indi- cates the importance of a holistic approach to the topic. In total 9 clusters could be identified at the different levels. It can be seen that three clusters form well. For the others, a rather diffuse picture can be observed. In order to find out which topics are hidden behind the individual clusters, 6 publications from each cluster were subjected to a more detailed examination. With these steps, a number of 54 publications were identified for de- tailed consideration. The modeling approaches that are currently being applied in research can be classified into domain-specific tools (e. g. global water models, crop models or global climate models) and into more general tools to perform for example a life cycle analysis, spatial analysis using geographic information system, or system dynamics for a general understanding of the links between the domains. With the domain-specific tools, detailed research questions can be addressed to answer questions for a specific domain. However, these tools have the disadvantage that especially the links between the sectors food, energy, and water are not fully considered. Many implementations that are made today are at lowest level (micro) relate to bounded spatial areas and are derived from macro and meso level goals.
Literature reviews are essential for any scientific work, both as part of a dissertation or as a stand-alone work. Scientists benefit from the fact that more and more literature is available in electronic form, and finding and accessing relevant literature has become more accessible through scientific databases. However, a traditional literature review method is characterized by a highly manual process, while technologies and methods in big data, machine learning, and text mining have advanced. Especially in areas where research streams are rapidly evolving, and topics are becoming more comprehensive, complex, and heterogeneous, it is challenging to provide a holistic overview and identify research gaps manually. Therefore, we have developed a framework that supports the traditional approach of conducting a literature review using machine learning and text mining methods. The framework is particularly suitable in cases where a large amount of literature is available, and a holistic understanding of the research area is needed. The framework consists of several steps in which the critical mind of the scientist is supported by machine learning. The unstructured text data is transformed into a structured form through data preparation realized with text mining, making it applicable for various machine learning techniques. A concrete example in the field of smart cities makes the framework tangible.
Home health applications have evolved over the last few decades. Assistive systems such as a data platform in connection with health devices can allow for health-related data to be automatically transmitted to a database. However, there remain significant challenges concerning intermodular communication. Central among them is the challenge of achieving interoperability, the ability of devices to communicate and share data with each other. A major goal of this project was to extend an existing data platform (COMES®) and establish working interoperability by connecting assistive devices with differing approaches. We describe this process for a sleep monitoring and a physical exercise device. Furthermore, we aimed to test this setup and the implementation with a data platform in both a laboratory and an in-home setting with 11 elderly participants. The platform modification was realized, and the relevant changes were made so that the incoming data could be processed by the data platform, as well as visually displayed in real-time. Data was recorded by the respective device and transmitted into the data server with minor disruptions. Our observations affirmed that difficulties and data loss are far more likely to occur with increasing technical complexity, in the event of instable internet connection, or when the device setup requires (elderly) subjects to take specific steps for proper functioning. We emphasize the importance for tests and evaluations of home health technologies in real-life circumstances.
The citizen-centered health platform project is intended to provide a platform that can be used in EU cross-border regions, where social and economic exchange occurs across national borders. The overriding challenges are: (a) social: improving citizen-centered health and care provision; (b) technical: providing a digital platform for networking citizens, service providers, and municipal actors; (c) economic: developing long-term successful (sustainable) business models/value chains. The platform should strengthen and expand existing networks and establish new regional networks. Each network addresses particular challenges and apply them in a region-specific manner. Here, the national boundary conditions and the interregional needs play an essential role. These objectives require sufficient participation of civil society representatives. Furthermore, the platform will establish an overarching, sustainable, and knowledge-based network of health experts. The platform is to be jointly developed and implemented in the regions and follow an open-access approach. Therefore, synergies will be shared more quickly, strengthening competencies and competitiveness. In addition to practice partners, scientific and municipal institutions and SMEs are involved. The actors thus contribute to scientific performance, innovative strength, and resilience.
This paper reviews suggestions for changes to database technology coming from the work of many researchers, particularly those working with evolving big data. We discuss new approaches to remote data access and standards that better provide for durability and auditability in settings including business and scientific computing. We propose ways in which the language standards could evolve, with proof-of-concept implementations on Github.
Intraoperative imaging can assist neurosurgeons to define brain tumours and other surrounding brain structures. Interventional ultrasound (iUS) is a convenient modality with fast scan times. However, iUS data may suffer from noise and artefacts which limit their interpretation during brain surgery. In this work, we use two deep learning networks, namely UNet and TransUNet, to make automatic and accurate segmentation of the brain tumour in iUS data. Experiments were conducted on a dataset of 27 iUS volumes. The outcomes show that using a transformer with UNet is advantageous providing an efficient segmentation modelling long-range dependencies between each iUS image. In particular, the enhanced TransUNet was able to predict cavity segmentation in iUS data with an inference rate of more than 125 FPS. These promising results suggest that deep learning networks can be successfully deployed to assist neurosurgeons in the operating room.
Hintergrund: Endoskopische Operationsverfahren haben sich als Goldstandard in der Nasennebenhöhlen-(NNH-)Chirurgie etabliert. Den sich daraus ergebenden Herausforderungen für die chirurgische Ausbildung kann durch den Einsatz von Virtuelle-Realität-(VR-)Trainingssimulatoren begegnet werden. Bislang wurde eine Reihe von Simulatoren für NNH-Operationen entwickelt. Frühere Studien im Hinblick auf den Trainingseffekt wurden jedoch nur mit medizinisch vorgebildeten Probanden durchgeführt oder es wurde nicht über dessen zeitlichen Verlauf berichtet.
Methoden: Ein NNH-CT-Datensatz wurde nach der Segmentierung in ein 3-dimensionales, polygonales Oberflächenmodell überführt und mithilfe von originalem Fotomaterial texturiert. Die Interaktion mit der virtuellen Umgebung erfolgte über ein haptisches Eingabegerät. Während der Simulation wurden die Parameter Eingriffsdauer und Fehleranzahl erfasst. Zehn Probanden absolvierten jeweils eine Trainingseinheit bestehend aus je 5 Übungsdurchläufen an 10 aufeinanderfolgenden Tagen.
Ergebnisse: Vier Probanden verringerten die benötigte Zeit um mehr als 60% im Verlauf des Übungszeitraums. Vier der Probanden verringerten ihre Fehleranzahl um mehr als 60%. Acht von 10 Probanden zeigten eine Verbesserung bezüglich beider Parameter. Im Median wurde im gesamten gemessenen Zeitraum die Dauer des Eingriffs um 46 Sekunden und die Fehleranzahl um 191 reduziert. Die Überprüfung eines Zusammenhangs zwischen den 2 Parametern ergab eine positive Korrelation.
Schlussfolgerung: Zusammenfassend lässt sich feststellen, dass das Training am NNH-Simulator auch bei unerfahrenen Personen die Performance beträchtlich verbessert, sowohl in Bezug auf die Dauer als auch auf die Genauigkeit des Eingriffs.
The scoring of sleep stages is an essential part of sleep studies. The main objective of this research is to provide an algorithm for the automatic classification of sleep stages using signals that may be obtained in a non-obtrusive way. After reviewing the relevant research, the authors selected a multinomial logistic regression as the basis for their approach. Several parameters were derived from movement and breathing signals, and their combinations were investigated to develop an accurate and stable algorithm. The algorithm was implemented to produce successful results: the accuracy of the recognition of Wake/NREM/REM stages is equal to 73%, with Cohen's kappa of 0.44 for the analyzed 19324 sleep epochs of 30 seconds each. This approach has the advantage of using the only movement and breathing signals, which can be recorded with less effort than heart or brainwave signals, and requiring only four derived parameters for the calculations. Therefore, the new system is a significant improvement for non-obtrusive sleep stage identification compared to existing approaches.
Nowadays, the importance of early active patient mobilization in the recovery and rehabilitation phase has increased significantly. One way to involve patients in the treatment is a gamification-like approach, which is one of the methods of motivation in various life processes. This article shows a system prototype for patients who require physical activity because of active early mobilization after medical interventions or during illness. Bedridden patients and people with a sedentary lifestyle (predominantly lying in bed) are also potential users. The main idea for the concept was non-contact system implementation for the patients making them feel effortless during its usage. The system consists of three related parts: hardware, software, and game application. To test the relevance and coherence of the system, it was used by 35 people. The participants were asked to play a video game requiring them to make body movements while lying down. Then they were asked to take part in a small survey to evaluate the system's usability. As a result, we offer a prototype consisting of hardware and software parts that can increase and diversify physical activity during active early mobilization of patients and prevent the occurrence of possible health problems due to predominantly low activity. The proposed design can be possibly implemented in hospitals, rehabilitation centers, and even at home.