Force Sensing in Arthroscopic Instruments using Fiber Bragg Gratings

Minimally-invasive surgery has revolutionized many medical procedures; however, it also impedes the ability to feel the interaction between the surgical tool and the anatomical part being operated on. In order to address this problem, it is necessary to obtain accurate measurements of the interaction forces exerted on the surgical tools during surgery. These forces can then be manifested to the surgeon via a haptic device or presented visually (visual-force feedback). This thesis describes the use of a fiber optic device to measure and display to the surgeon interaction forces acting on an arthroscopic tool. The sensorization of the tool involves a simple, highly efficient and robust design and is ideally suited for use in a surgical training environment aimed at narrowing the gap between trainees and expert surgeons before the trainees proceed to their first surgery in vivo. The major advantages of using fiber optics include their small size, their local simplicity, their ease of sterilization, and their high sensitivity. In this thesis, a complete low-cost sensing solution is described, including 1) the use of fiber Bragg grating and long period grating sensors, 2) design of a low-cost optical interrogator, 3) high resolution electronic signal processing, and 4) fabrication of the tool using wire EDM, CNC, and 3D metal sintering technologies. The full design of an arthroscopic grasper is presented, along with the preliminary design and manufacturing of an arthroscopic probe and shaver. The designed low-cost system was compared with a commercially-available optical interrogator. The calibration and experimental results for this system are presented and discussed for accuracy and performance of the sensorized tool before and after an axial element was added for increased sensitivity. Sources of error and methods of improvement for the optical system, arthroscopic tool, and testing procedures are discussed to inform the design of future generations of these instruments

Solving the challenges of concept drift in data stream classification.

The rise of network connected devices and applications leads to a significant increase in the volume of data that are continuously generated overtime time, called data streams. In real world applications, storing the entirety of a data stream for analyzing later is often not practical, due to the data stream’s potentially infinite volume. Data stream mining techniques and frameworks are therefore created to analyze streaming data as they arrive. However, compared to traditional data mining techniques, challenges unique to data stream mining also emerge, due to the high arrival rate of data streams and their dynamic nature. In this dissertation, an array of techniques and frameworks are presented to improve the solutions on some of the challenges. First, this dissertation acknowledges that a “no free lunch” theorem exists for data stream mining, where no silver bullet solution can solve all problems of data stream mining. The dissertation focuses on detection of changes of data distribution in data stream mining. These changes are called concept drift. Concept drift can be categorized into many types. A detection algorithm often works only on some types of drift, but not all of them. Because of this, the dissertation finds specific techniques to solve specific challenges, instead of looking for a general solution. Then, this dissertation considers improving solutions for the challenges of high arrival rate of data streams. Data stream mining frameworks often need to process vast among of data samples in limited time. Some data mining activities, notably data sample labeling for classification, are too costly or too slow in such large scale. This dissertation presents two techniques that reduce the amount of labeling needed for data stream classification. The first technique presents a grid-based label selection process that apply to highly imbalanced data streams. Such data streams have one class of data samples vastly outnumber another class. Many majority class samples need to be labeled before a minority class sample can be found due to the imbalance. The presented technique divides the data samples into groups, called grids, and actively search for minority class samples that are close by within a grid. Experiment results show the technique can reduce the total number of data samples needed to be labeled. The second technique presents a smart preprocessing technique that reduce the number of times a new learning model needs to be trained due to concept drift. Less model training means less data labels required, and thus costs less. Experiment results show that in some cases the reduced performance of learning models is the result of improper preprocessing of the data, not due to concept drift. By adapting preprocessing to the changes in data streams, models can retain high performance without retraining. Acknowledging the high cost of labeling, the dissertation then considers the scenario where labels are unavailable when needed. The framework Sliding Reservoir Approach for Delayed Labeling (SRADL) is presented to explore solutions to such problem. SRADL tries to solve the delayed labeling problem where concept drift occurs, and no labels are immediately available. SRADL uses semi-supervised learning by employing a sliding windowed approach to store historical data, which is combined with newly unlabeled data to train new models. Experiments show that SRADL perform well in some cases of delayed labeling. Next, the dissertation considers improving solutions for the challenge of dynamism within data streams, most notably concept drift. The complex nature of concept drift means that most existing detection algorithms can only detect limited types of concept drift. To detect more types of concept drift, an ensemble approach that employs various algorithms, called Heuristic Ensemble Framework for Concept Drift Detection (HEFDD), is presented. The occurrence of each type of concept drift is voted on by the detection results of each algorithm in the ensemble. Types of concept drift with votes past majority are then declared detected. Experiment results show that HEFDD is able to improve detection accuracy significantly while reducing false positives. With the ability to detect various types of concept drift provided by HEFDD, the dissertation tries to improve the delayed labeling framework SRADL. A new combined framework, SRADL-HEFDD is presented, which produces synthetic labels to handle the unavailability of labels by human expert. SRADL-HEFDD employs different synthetic labeling techniques based on different types of drift detected by HEFDD. Experimental results show that comparing to the default SRADL, the combined framework improves prediction performance when small amount of labeled samples is available. Finally, as machine learning applications are increasingly used in critical domains such as medical diagnostics, accountability, explainability and interpretability of machine learning algorithms needs to be considered. Explainable machine learning aims to use a white box approach for data analytics, which enables learning models to be explained and interpreted by human users. However, few studies have been done on explaining what has changed in a dynamic data stream environment. This dissertation thus presents Data Stream Explainability (DSE) framework. DSE visualizes changes in data distribution and model classification boundaries between chunks of streaming data. The visualizations can then be used by a data mining researcher to generate explanations of what has changed within the data stream. To show that DSE can help average users understand data stream mining better, a survey was conducted with an expert group and a non-expert group of users. Results show DSE can reduce the gap of understanding what changed in data stream mining between the two groups

From Wearable Sensors to Smart Implants – Towards Pervasive and Personalised Healthcare

<p>Objective: This article discusses the evolution of pervasive healthcare from its inception for activity recognition using wearable sensors to the future of sensing implant deployment and data processing. Methods: We provide an overview of some of the past milestones and recent developments, categorised into different generations of pervasive sensing applications for health monitoring. This is followed by a review on recent technological advances that have allowed unobtrusive continuous sensing combined with diverse technologies to reshape the clinical workflow for both acute and chronic disease management. We discuss the opportunities of pervasive health monitoring through data linkages with other health informatics systems including the mining of health records, clinical trial databases, multi-omics data integration and social media. Conclusion: Technical advances have supported the evolution of the pervasive health paradigm towards preventative, predictive, personalised and participatory medicine. Significance: The sensing technologies discussed in this paper and their future evolution will play a key role in realising the goal of sustainable healthcare systems.</p> <p> </p

Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery

One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions

Combined supervised and unsupervised learning to identify subclasses of disease for better prediction

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonDisease subtyping, which aids in the development of personalised treatments, remains a challenge in data analysis because of the many different ways to group patients based upon their data. However, if I can identify subclasses of disease, this will help to develop better models that are more specific to individuals and should therefore improve prediction and understanding of the underlying characteristics of the disease in question. In addition, patients might suffer from multiple disease complications. Models that are tailored to individuals could improve both prediction of multiple complications and understanding of underlying disease characteristics. However, AI models can become outdated over time due to either sudden changes in the underlying data, such as those caused by new measurement methods, or incremental changes, such as the ageing of the study population. This thesis proposes a new algorithm that integrates consensus clustering methods with classification in order to overcome issues with sample bias. The method was tested on a freely available dataset of real-world breast cancer cases and data from a London hospital on systemic sclerosis, a rare and potentially fatal condition. The results show that nearest consensus clustering classification improves accuracy and prediction significantly when this algorithm is compared with competitive similar methods. In addition, this thesis proposes a new algorithm that integrates latent class models with classification. The new algorithm uses latent class models to cluster patients within groups; this results in improved classification and aids in the understanding of the underlying differences of the discovered groups. The method was tested on data from patients with systemic sclerosis (SSc), a rare and potentially fatal condition, and coronary heart disease. Results show that the latent class multi-label classification (MLC) model improves accuracy when compared with competitive similar methods. Finally, this thesis implemented the updated concept drift method (DDM) to monitor AI models over time and detect drifts when they occur. The method was tested on data from patients with SSc and patients with coronavirus disease (COVID)

Diagnostics and correction of batch effects in large-scale proteomic studies: a tutorial.

Advancements in mass spectrometry-based proteomics have enabled experiments encompassing hundreds of samples. While these large sample sets deliver much-needed statistical power, handling them introduces technical variability known as batch effects. Here, we present a step-by-step protocol for the assessment, normalization, and batch correction of proteomic data. We review established methodologies from related fields and describe solutions specific to proteomic challenges, such as ion intensity drift and missing values in quantitative feature matrices. Finally, we compile a set of techniques that enable control of batch effect adjustment quality. We provide an R package, proBatch , containing functions required for each step of the protocol. We demonstrate the utility of this methodology on five proteomic datasets each encompassing hundreds of samples and consisting of multiple experimental designs. In conclusion, we provide guidelines and tools to make the extraction of true biological signal from large proteomic studies more robust and transparent, ultimately facilitating reliable and reproducible research in clinical proteomics and systems biology