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One of the key challenges for automatic assistance is the support of actors in the operating room depending on the status of the procedure. Therefore, context information collected in the operating room is used to gain knowledge about the current situation. In literature, solutions already exist for specific use cases, but it is doubtful to what extent these approaches can be transferred to other conditions. We conducted a comprehensive literature research on existing situation recognition systems for the intraoperative area, covering 274 articles and 95 cross-references published between 2010 and 2019. We contrasted and compared 58 identified approaches based on defined aspects such as used sensor data or application area. In addition, we discussed applicability and transferability. Most of the papers focus on video data for recognizing situations within laparoscopic and cataract surgeries. Not all of the approaches can be used online for real-time recognition. Using different methods, good results with recognition accuracies above 90% could be achieved. Overall, transferability is less addressed. The applicability of approaches to other circumstances seems to be possible to a limited extent. Future research should place a stronger focus on adaptability. The literature review shows differences within existing approaches for situation recognition and outlines research trends. Applicability and transferability to other conditions are less addressed in current work.
Stent graft visualization and planning tool for endovascular surgery using finite element analysis
(2014)
Purpose: A new approach to optimize stent graft selection for endovascular aortic repair is the use of finite element analysis. Once the finite element model is created and solved, a software module is needed to view the simulation results in the clinical work environment. A new tool for Interpretation of simulation results, named Medical Postprocessor, that enables comparison of different stent graft configurations and products was designed, implemented and tested. Methods Aortic endovascular stent graft ring forces and sealing states in the vessel landing zone of three different configurations were provided in a surgical planning software using the Medical Imaging Interaction Tool Kit (MITK) Software system. For data interpretation, software modules for 2D and 3D presentations were implemented. Ten surgeons evaluated the software features of the Medical Postprocessor. These surgeons performed usability tests and answered questionnaires based on their experience with the system.
Results: The Medical Postprocessor visualization system enabled vascular surgeons to determine the configuration with the highest overall fixation force in 16 ± 6 s, best proximal sealing in 56±24 s and highest proximal fixation force in 38 ± 12 s. The majority considered the multiformat data provided helpful and found the Medical Postprocessor to be an efficient decision support system for stent graft selection. The evaluation of the user interface results in an ISONORMconform user interface (113.5 points).
Conclusion: The Medical Postprocessor visualization Software tool for analyzing stent graft properties was evaluated by vascular surgeons. The results show that the software can assist the interpretation of simulation results to optimize stent graft configuration and sizing.
Database management systems and K/V-Stores operate on updatable datasets – massively exceeding the size of available main memory. Tree-based K/V storage management structures became particularly popular in storage engines. B+ -Trees [1, 4] allow constant search performance, however write-heavy workloads yield in inefficient write patterns to secondary storage devices and poor performance characteristics. LSM-Trees [16, 23] overcome this issue by horizontal partitioning fractions of data – small enough to fully reside in main memory, but require frequent maintenance to sustain search performance.
Firstly, we propose Multi-Version Partitioned BTrees (MV-PBT) as sole storage and index management structure in key-sorted storage engines like K/V-Stores. Secondly, we compare MV-PBT against LSM-Trees. The logical horizontal partitioning in MV-PBT allows leveraging recent advances in modern B+ -Tree techniques in a small transparent and memory resident portion of the structure. Structural properties sustain steady read performance, yielding efficient write patterns and reducing write amplification.
We integrated MV-PBT in the WiredTiger [15] KV storage engine. MV-PBT offers an up to 2× increased steady throughput in comparison to LSM-Trees and several orders of magnitude in comparison to B+ -Trees in a YCSB [5] workload.
Stress is recognized as a predominant disease with raising costs for rehabilitation and treatment. Currently there are several different approaches that can be used for determining and calculating the stress levels. Usually the methods for determining stress are divided in two categories. The first category do not require any special equipment for measuring the stress. This category useless the variation in the behaviour patterns that occur while stress. The core disadvantage for the category is their limitation to specific use case. The second category uses laboratories instruments and biological sensors. This category allow to measure stress precisely and proficiently but on the same time they are not mobile and transportable and do not support real-time feedback. This work presents a mobile system that provides the calculation of stress. For achieving this, the of a mobile ECG sensor is analysed, processed and visualised over a mobile system like a smartphone. This work also explains the used stress measurement algorithm. The result of this work is a portable system that can be used with a mobile system like a smartphone as visual interface for reporting the current stress level.
Stress is becoming an important topic in modern life. The influence of stress results in a higher rate of health disorders such as burnout, heart problems, obesity, asthma, diabetes, depressions and many others. Furthermore individual’s behavior and capabilities could be directly affected leading to altered cognition, inappropriate decision making and problem solving skills. In a dynamic and unpredictable environment, such as automotive, this can result in a higher risk for accidents. Different papers faced the estimation as well as prediction of drivers’ stress level during driving. Another important question is not only the stress level of the driver himself, but also the influence on and of a group of other drivers in the near area. This paper proposes a system, which determines a group of drivers in a near area as clusters and it derives the individual stress level. This information will be analyzed to generate a stress map, which represents a graphical view about road section with a higher stress influence. Aggregated data can be used to generate navigation routes with a lower stress influence to decrease stress influenced driving as well as improve road safety.
Besides the optimisation of the car, energy-efficiency and safety can also be increased by optimising the driving behaviour. Based on this fact, a driving system is in development whose goal is to educate the driver in energy efficient and safe driving. It monitors the driver, the car and the environment and gives energy-efficiency and safety relevant recommendations. However, the driving system tries not to distract or bother the driver by giving recommendations for example during stressful driving situations or when the driver is not interested in that recommendation. Therefore, the driving system monitors the stress level of the driver as well as the reaction of the driver to a given recommendation and decideswhether to give a recommendation or not. This allows to suppress recommendations when needed and, thus, to increase the road safety and the user acceptance of
the driving system.
Background
Personalized medicine requires the integration and analysis of vast amounts of patient data to realize individualized care. With Surgomics, we aim to facilitate personalized therapy recommendations in surgery by integration of intraoperative surgical data and their analysis with machine learning methods to leverage the potential of this data in analogy to Radiomics and Genomics.
Methods
We defined Surgomics as the entirety of surgomic features that are process characteristics of a surgical procedure automatically derived from multimodal intraoperative data to quantify processes in the operating room. In a multidisciplinary team we discussed potential data sources like endoscopic videos, vital sign monitoring, medical devices and instruments and respective surgomic features. Subsequently, an online questionnaire was sent to experts from surgery and (computer) science at multiple centers for rating the features’ clinical relevance and technical feasibility.
Results
In total, 52 surgomic features were identified and assigned to eight feature categories. Based on the expert survey (n = 66 participants) the feature category with the highest clinical relevance as rated by surgeons was “surgical skill and quality of performance” for morbidity and mortality (9.0 ± 1.3 on a numerical rating scale from 1 to 10) as well as for long-term (oncological) outcome (8.2 ± 1.8). The feature category with the highest feasibility to be automatically extracted as rated by (computer) scientists was “Instrument” (8.5 ± 1.7). Among the surgomic features ranked as most relevant in their respective category were “intraoperative adverse events”, “action performed with instruments”, “vital sign monitoring”, and “difficulty of surgery”.
Conclusion
Surgomics is a promising concept for the analysis of intraoperative data. Surgomics may be used together with preoperative features from clinical data and Radiomics to predict postoperative morbidity, mortality and long-term outcome, as well as to provide tailored feedback for surgeons.
Context: Agile practices as well as UX methods are nowadays well-known and often adopted to develop complex software and products more efficiently and effectively. However, in the so called VUCA environment, which many companies are confronted with, the sole use of UX research is not sufficient to find the best solutions for customers. The implementation of Design Thinking can support this process. But many companies and their product owners don’t know how much resources they should spend for conducting Design Thinking.
Objective: This paper aims at suggesting a supportive tool, the “Discovery Effort Worthiness (DEW) Index”, for product owners and agile teams to determine a suitable amount of effort that should be spent for Design Thinking activities.
Method: A case study was conducted for the development of the DEW index. Design Thinking was introduced into the regular development cycle of an industry Scrum team. With the support of UX and Design Thinking experts, a formula was developed to determine the appropriate effort for Design Thinking.
Results: The developed “Discovery Effort Worthiness Index” provides an easy-to-use tool for companies and their product owners to determine how much effort they should spend on Design Thinking methods to discover and validate requirements. A company can map the corresponding Design Thinking methods to the results of the DEW Index calculation, and product owners can select the appropriate measures from this mapping. Therefore, they can optimize the effort spent for discovery and validation.
Der Kundenservice bietet für das Marketing umfangreiche Ansätze zur Differenzierung. Dabei zahlen positive Serviceerlebnisse der Kunden auf unterschiedliche Marketingziele ein. Durch Social Media stehen darüber hinaus neue Möglichkeiten für den Servicedialog zur Verfügung. Der vorliegende Beitrag beschreibt die Umsetzung dieser Möglichkeiten bei der Telekom Deutschland GmbH.