Artificial intelligence and automation in endoscopy and surgery

Modern endoscopy relies on digital technology, from high-resolution imaging sensors and displays to electronics connecting configurable illumination and actuation systems for robotic articulation. In addition to enabling more effective diagnostic and therapeutic interventions, the digitization of the procedural toolset enables video data capture of the internal human anatomy at unprecedented levels. Interventional video data encapsulate functional and structural information about a patient’s anatomy as well as events, activity and action logs about the surgical process. This detailed but difficult-to-interpret record from endoscopic procedures can be linked to preoperative and postoperative records or patient imaging information. Rapid advances in artificial intelligence, especially in supervised deep learning, can utilize data from endoscopic procedures to develop systems for assisting procedures leading to computer-assisted interventions that can enable better navigation during procedures, automation of image interpretation and robotically assisted tool manipulation. In this Perspective, we summarize state-of-the-art artificial intelligence for computer-assisted interventions in gastroenterology and surgery

Networking Architecture and Key Technologies for Human Digital Twin in Personalized Healthcare: A Comprehensive Survey

Digital twin (DT), refers to a promising technique to digitally and accurately represent actual physical entities. One typical advantage of DT is that it can be used to not only virtually replicate a system's detailed operations but also analyze the current condition, predict future behaviour, and refine the control optimization. Although DT has been widely implemented in various fields, such as smart manufacturing and transportation, its conventional paradigm is limited to embody non-living entities, e.g., robots and vehicles. When adopted in human-centric systems, a novel concept, called human digital twin (HDT) has thus been proposed. Particularly, HDT allows in silico representation of individual human body with the ability to dynamically reflect molecular status, physiological status, emotional and psychological status, as well as lifestyle evolutions. These prompt the expected application of HDT in personalized healthcare (PH), which can facilitate remote monitoring, diagnosis, prescription, surgery and rehabilitation. However, despite the large potential, HDT faces substantial research challenges in different aspects, and becomes an increasingly popular topic recently. In this survey, with a specific focus on the networking architecture and key technologies for HDT in PH applications, we first discuss the differences between HDT and conventional DTs, followed by the universal framework and essential functions of HDT. We then analyze its design requirements and challenges in PH applications. After that, we provide an overview of the networking architecture of HDT, including data acquisition layer, data communication layer, computation layer, data management layer and data analysis and decision making layer. Besides reviewing the key technologies for implementing such networking architecture in detail, we conclude this survey by presenting future research directions of HDT

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Artificial Intelligence: Development and Applications in Neurosurgery

The last decade has witnessed a significant increase in the relevance of artificial intelligence (AI) in neuroscience. Gaining notoriety from its potential to revolutionize medical decision making, data analytics, and clinical workflows, AI is poised to be increasingly implemented into neurosurgical practice. However, certain considerations pose significant challenges to its immediate and widespread implementation. Hence, this chapter will explore current developments in AI as it pertains to the field of clinical neuroscience, with a primary focus on neurosurgery. Additionally included is a brief discussion of important economic and ethical considerations related to the feasibility and implementation of AI-based technologies in neurosciences, including future horizons such as the operational integrations of human and non-human capabilities

European governance challenges in bio-engineering : making perfect life : bio-engineering (in) the 21st century : final report

In the STOA project Making Perfect Life four fields were studied of 21st century bio-engineering: engineering of living artefacts, engineering of the body, engineering of the brain, and engineering of intelligent artefacts. This report describes the main results of the project. It shows how developments in the four fields of bio-engineering are shaped by two megatrends: "biology becoming technology" and "technology becoming biology". These developments result in a broadening of the bio-engineering debate in our society. The report addresses the long term views that are inspiring this debate and discusses a multitude of ethical, legal and social issues that arise from bio-engineering developments in the fields described. Against this background four specific developments are studied in more detail: the rise of human genome sequencing, the market introduction of neurodevices, the capturing by information technology of the psychological and physiological states of users, and the pursuit of standardisation in synthetic biology. These developments are taken in this report as a starting point for an analysis of some of the main European governance challenges in 21st century bio-engineering

European governance challenges in bio-engineering : making perfect life : bio-engineering (in) the 21st century : final report

In the STOA project Making Perfect Life four fields were studied of 21st century bio-engineering: engineering of living artefacts, engineering of the body, engineering of the brain, and engineering of intelligent artefacts. This report describes the main results of the project. It shows how developments in the four fields of bio-engineering are shaped by two megatrends: "biology becoming technology" and "technology becoming biology". These developments result in a broadening of the bio-engineering debate in our society. The report addresses the long term views that are inspiring this debate and discusses a multitude of ethical, legal and social issues that arise from bio-engineering developments in the fields described. Against this background four specific developments are studied in more detail: the rise of human genome sequencing, the market introduction of neurodevices, the capturing by information technology of the psychological and physiological states of users, and the pursuit of standardisation in synthetic biology. These developments are taken in this report as a starting point for an analysis of some of the main European governance challenges in 21st century bio-engineering

A Comprehensive Survey of the Tactile Internet: State of the art and Research Directions

The Internet has made several giant leaps over the years, from a fixed to a mobile Internet, then to the Internet of Things, and now to a Tactile Internet. The Tactile Internet goes far beyond data, audio and video delivery over fixed and mobile networks, and even beyond allowing communication and collaboration among things. It is expected to enable haptic communication and allow skill set delivery over networks. Some examples of potential applications are tele-surgery, vehicle fleets, augmented reality and industrial process automation. Several papers already cover many of the Tactile Internet-related concepts and technologies, such as haptic codecs, applications, and supporting technologies. However, none of them offers a comprehensive survey of the Tactile Internet, including its architectures and algorithms. Furthermore, none of them provides a systematic and critical review of the existing solutions. To address these lacunae, we provide a comprehensive survey of the architectures and algorithms proposed to date for the Tactile Internet. In addition, we critically review them using a well-defined set of requirements and discuss some of the lessons learned as well as the most promising research directions

Development and evaluation of a haptic framework supporting telerehabilitation robotics and group interaction

Telerehabilitation robotics has grown remarkably in the past few years. It can provide intensive training to people with special needs remotely while facilitating therapists to observe the whole process. Telerehabilitation robotics is a promising solution supporting routine care which can help to transform face-to-face and one-on-one treatment sessions that require not only intensive human resource but are also restricted to some specialised care centres to treatments that are technology-based (less human involvement) and easy to access remotely from anywhere. However, there are some limitations such as network latency, jitter, and delay of the internet that can affect negatively user experience and quality of the treatment session. Moreover, the lack of social interaction since all treatments are performed over the internet can reduce motivation of the patients. As a result, these limitations are making it very difficult to deliver an efficient recovery plan. This thesis developed and evaluated a new framework designed to facilitate telerehabilitation robotics. The framework integrates multiple cutting-edge technologies to generate playful activities that involve group interaction with binaural audio, visual, and haptic feedback with robot interaction in a variety of environments. The research questions asked were: 1) Can activity mediated by technology motivate and influence the behaviour of users, so that they engage in the activity and sustain a good level of motivation? 2) Will working as a group enhance users’ motivation and interaction? 3) Can we transfer real life activity involving group interaction to virtual domain and deliver it reliably via the internet? There were three goals in this work: first was to compare people’s behaviours and motivations while doing the task in a group and on their own; second was to determine whether group interaction in virtual and reala environments was different from each other in terms of performance, engagement and strategy to complete the task; finally was to test out the effectiveness of the framework based on the benchmarks generated from socially assistive robotics literature. Three studies have been conducted to achieve the first goal, two with healthy participants and one with seven autistic children. The first study observed how people react in a challenging group task while the other two studies compared group and individual interactions. The results obtained from these studies showed that the group interactions were more enjoyable than individual interactions and most likely had more positive effects in terms of user behaviours. This suggests that the group interaction approach has the potential to motivate individuals to make more movements and be more active and could be applied in the future for more serious therapy. Another study has been conducted to measure group interaction’s performance in virtual and real environments and pointed out which aspect influences users’ strategy for dealing with the task. The results from this study helped to form a better understanding to predict a user’s behaviour in a collaborative task. A simulation has been run to compare the results generated from the predictor and the real data. It has shown that, with an appropriate training method, the predictor can perform very well. This thesis has demonstrated the feasibility of group interaction via the internet using robotic technology which could be beneficial for people who require social interaction (e.g. stroke patients and autistic children) in their treatments without regular visits to the clinical centres