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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.
Purpose
Artificial intelligence (AI), in particular deep neural networks, has achieved remarkable results for medical image analysis in several applications. Yet the lack of explainability of deep neural models is considered the principal restriction before applying these methods in clinical practice.
Methods
In this study, we propose a NeuroXAI framework for explainable AI of deep learning networks to increase the trust of medical experts. NeuroXAI implements seven state-of-the-art explanation methods providing visualization maps to help make deep learning models transparent.
Results
NeuroXAI has been applied to two applications of the most widely investigated problems in brain imaging analysis, i.e., image classification and segmentation using magnetic resonance (MR) modality. Visual attention maps of multiple XAI methods have been generated and compared for both applications. Another experiment demonstrated that NeuroXAI can provide information flow visualization on internal layers of a segmentation CNN.
Conclusion
Due to its open architecture, ease of implementation, and scalability to new XAI methods, NeuroXAI could be utilized to assist radiologists and medical professionals in the detection and diagnosis of brain tumors in the clinical routine of cancer patients. The code of NeuroXAI is publicly accessible at https://github.com/razeineldin/NeuroXAI.
Adoption of artificial intelligence (AI) has risen sharply in recent years but many firms are not successful in realising the expected benefits or even terminate projects before completion. While there are a number of previous studies that highlight challenges in AI projects, critical factors that lead to project failure are mostly unknown. The aim of this study is therefore to identify distinct factors that are critical for failure of AI projects. To address this, interviews with experts in the field of AI from different industries are conducted and the results are analyzed using qualitative analysis methods. The results show that both, organizational and technological issues can cause project failure. Our study contributes to knowledge by reviewing previously identified challenges in terms of their criticality for project failure based on new empirical data, as well as, by identifying previously unknown factors.
Geometry of music perception
(2022)
Prevalent neuroscientific theories are combined with acoustic observations from various studies to create a consistent geometric model for music perception in order to rationalize, explain and predict psycho-acoustic phenomena. The space of all chords is shown to be a Whitney stratified space. Each stratum is a Riemannian manifold which naturally yields a geodesic distance across strata. The resulting metric is compatible with voice-leading satisfying the triangle inequality. The geometric model allows for rigorous studies of psychoacoustic quantities such as roughness and harmonicity as height functions. In order to show how to use the geometric framework in psychoacoustic studies, concepts for the perception of chord resolutions are introduced and analyzed.
Handling complexity in modern software engineering : editorial introduction to issue 32 of CSIMQ
(2022)
The potential of the Internet and related digital technologies, such as the Internet of Things (IoT), cognition and artificial intelligence, data analytics, services computing, cloud computing, mobile systems, collaboration networks, and cyber-physical systems, are both strategic drivers and enablers of modern digital platforms with fast-evolving ecosystems of intelligent services for digital products. This issue of CSIMQ presents three recent articles on modern software engineering. First, we focus on continuous software development and place it in the context of software architectures and digital transformation. The first contribution is followed by the description of the basis of specific security requirements and adequate digital monitoring mechanisms. Finally, we present a practical example of the digital management of livestock farming.
Hybrid project management is an approach that combines traditional and agile project management techniques. The goal is to benefit from the strengths of each approach, and, at the same time avoid the weaknesses. However, due to the variety of hybrid methodologies that have been presented in the meantime, it is not easy to understand the differences or similarities of the methodologies, as well as, the advantages or disadvantages of the hybrid approach in general. Additionally, there is only fragmented knowledge about prerequisites and success factors for successfully implementing hybrid project management in organizations. Hence, the aim of this study is to provide a structured overview of the current state of research regarding the topic. To address this aim, we have conducted a systematic literature review focusing on a set of specific research questions. As a result, four different hybrid methodologies are discussed, as well as, the definition, benefits, challenges, suitability and prerequisites of hybrid project management. Our study contributes to knowledge by synthesizing and structuring prior work in this growing area of research, which serves as a basis for purposeful and targeted research in the future.
Healthy sleep is required for sufficient restoration of the human body and brain. Therefore, in the case of sleep disorders, appropriate therapy should be applied timely, which requires a prompt diagnosis. Traditionally, a sleep diary is a part of diagnosis and therapy monitoring for some sleep disorders, such as cognitive behaviour therapy for insomnia. To automatise sleep monitoring and make it more comfortable for users, substituting a sleep diary with a smartwatch measurement could be considered. With the aim of providing accurate results, a study with a total of 30 night recordings was conducted. Objective sleep measurement with a Samsung Galaxy Watch 4 was compared with a subjective approach (sleep diary), evaluating the four relevant sleep characteristics: time of getting asleep, wake up time, sleep efficiency (SE), and total sleep time (TST). The performed analysis has demonstrated that the median difference between both measurement approaches was equal to 7 and 3 minutes for a time of getting asleep and wake up time correspondingly, which allows substituting a subjective measurement with a smartwatch. The SE was determined with a median difference between the two measurement methods of 5.22%. This result also implicates a possibility of substitution. Some single recordings have indicated a higher variance between the two approaches. Therefore, the conclusion can be made that a substitution provides reliable results primarily in the case of long-term monitoring. The results of the evaluation of the TST measurement do not allow to recommend substitution of the measurement method.
The paper describes how eye-tracking can be used to explore electronic patient records (EPR) in a sterile environment. As an information display, we used a system that we developed for the presentation of patient data and for supporting surgical hand disinfection. The eye-tracking was performed using the Tobii Eye Tracker 4C, and the connection between the eye-tracker and the HTML website was realized using the Tobii EyeX Chrome Extension. Interactions with the EPR are triggered by fixations of icons. The interaction was working as intended, but test persons reported a high mental load while using the system.
The use of deep learning models with medical data is becoming more widespread. However, although numerous models have shown high accuracy in medical-related tasks, such as medical image recognition (e.g. radiographs), there are still many problems with seeing these models operating in a real healthcare environment. This article presents a series of basic requirements that must be taken into account when developing deep learning models for biomedical time series classification tasks, with the aim of facilitating the subsequent production of the models in healthcare. These requirements range from the correct collection of data, to the existing techniques for a correct explanation of the results obtained by the models. This is due to the fact that one of the main reasons why the use of deep learning models is not more widespread in healthcare settings is their lack of clarity when it comes to explaining decision making.
Near-data processing in database systems on native computational storage under HTAP workloads
(2022)
Today’s Hybrid Transactional and Analytical Processing (HTAP) systems, tackle the ever-growing data in combination with a mixture of transactional and analytical workloads. While optimizing for aspects such as data freshness and performance isolation, they build on the traditional data-to-code principle and may trigger massive cold data transfers that impair the overall performance and scalability. Firstly, in this paper we show that Near-Data Processing (NDP) naturally fits in the HTAP design space. Secondly, we propose an NDP database architecture, allowing transactionally consistent in-situ executions of analytical operations in HTAP settings. We evaluate the proposed architecture in state-of-the-art key/value-stores and multi-versioned DBMS. In contrast to traditional setups, our approach yields robust, resource- and cost-effcient performance.
Uncontrolled movement of instruments in laparoscopic surgery can lead to inadvertent tissue damage, particularly when the dissecting or electrosurgical instrument is located outside the field of view of the laparoscopic camera. The incidence and relevance of such events are currently unknown. The present work aims to identify and quantify potentially dangerous situations using the example of laparoscopic cholecystectomy (LC). Twenty-four final year medical students were prompted to each perform four consecutive LC attempts on a well-established box trainer in a surgical training environment following a standardized protocol in a porcine model. The following situation was defined as a critical event (CE): the dissecting instrument was inadvertently located outside the laparoscopic camera’s field of view. Simultaneous activation of the electrosurgical unit was defined as a highly critical event (hCE). Primary endpoint was the incidence of CEs. While performing 96 LCs, 2895 CEs were observed. Of these, 1059 (36.6%) were hCEs. The median number of CEs per LC was 20.5 (range: 1–125; IQR: 33) and the median number of hCEs per LC was 8.0 (range: 0–54, IQR: 10). Mean total operation time was 34.7 min (range: 15.6–62.5 min, IQR: 14.3 min). Our study demonstrates the significance of CEs as a potential risk factor for collateral damage during LC. Further studies are needed to investigate the occurrence of CE in clinical practice, not just for laparoscopic cholecystectomy but also for other procedures. Systematic training of future surgeons as well as technical solutions address this safety issue.