A gaze-contingent framework for perceptually-enabled applications in healthcare

Patient safety and quality of care remain the focus of the smart operating room of the future. Some of the most influential factors with a detrimental effect are related to suboptimal communication among the staff, poor flow of information, staff workload and fatigue, ergonomics and sterility in the operating room. While technological developments constantly transform the operating room layout and the interaction between surgical staff and machinery, a vast array of opportunities arise for the design of systems and approaches, that can enhance patient safety and improve workflow and efficiency. The aim of this research is to develop a real-time gaze-contingent framework towards a "smart" operating suite, that will enhance operator's ergonomics by allowing perceptually-enabled, touchless and natural interaction with the environment. The main feature of the proposed framework is the ability to acquire and utilise the plethora of information provided by the human visual system to allow touchless interaction with medical devices in the operating room. In this thesis, a gaze-guided robotic scrub nurse, a gaze-controlled robotised flexible endoscope and a gaze-guided assistive robotic system are proposed. Firstly, the gaze-guided robotic scrub nurse is presented; surgical teams performed a simulated surgical task with the assistance of a robot scrub nurse, which complements the human scrub nurse in delivery of surgical instruments, following gaze selection by the surgeon. Then, the gaze-controlled robotised flexible endoscope is introduced; experienced endoscopists and novice users performed a simulated examination of the upper gastrointestinal tract using predominately their natural gaze. Finally, a gaze-guided assistive robotic system is presented, which aims to facilitate activities of daily living. The results of this work provide valuable insights into the feasibility of integrating the developed gaze-contingent framework into clinical practice without significant workflow disruptions.Open Acces

Hierarchical, informed and robust machine learning for surgical tool management

This thesis focuses on the development of a computer vision and deep learning based system for the intelligent management of surgical tools. The work accomplished included the development of a new dataset, creation of state of the art techniques to cope with volume, variety and vision problems, and designing or adapting algorithms to address specific surgical tool recognition issues. The system was trained to cope with a wide variety of tools, with very subtle differences in shapes, and was designed to work with high volumes, as well as varying illuminations and backgrounds. Methodology that was adopted in this thesis included the creation of a surgical tool image dataset and development of a surgical tool attribute matrix or knowledge-base. This was significant because there are no large scale publicly available surgical tool datasets, nor are there established annotations or datasets of textual descriptions of surgical tools that can be used for machine learning. The work resulted in the development of a new hierarchical architecture for multi-level predictions at surgical speciality, pack, set and tool level. Additional work evaluated the use of synthetic data to improve robustness of the CNN, and the infusion of knowledge to improve predictive performance

Body sensor networks: smart monitoring solutions after reconstructive surgery

Advances in reconstructive surgery are providing treatment options in the face of major trauma and cancer. Body Sensor Networks (BSN) have the potential to offer smart solutions to a range of clinical challenges. The aim of this thesis was to review the current state of the art devices, then develop and apply bespoke technologies developed by the Hamlyn Centre BSN engineering team supported by the EPSRC ESPRIT programme to deliver post-operative monitoring options for patients undergoing reconstructive surgery. A wireless optical sensor was developed to provide a continuous monitoring solution for free tissue transplants (free flaps). By recording backscattered light from 2 different source wavelengths, we were able to estimate the oxygenation of the superficial microvasculature. In a custom-made upper limb pressure cuff model, forearm deoxygenation measured by our sensor and gold standard equipment showed strong correlations, with incremental reductions in response to increased cuff inflation durations. Such a device might allow early detection of flap failure, optimising the likelihood of flap salvage. An ear-worn activity recognition sensor was utilised to provide a platform capable of facilitating objective assessment of functional mobility. This work evolved from an initial feasibility study in a knee replacement cohort, to a larger clinical trial designed to establish a novel mobility score in patients recovering from open tibial fractures (OTF). The Hamlyn Mobility Score (HMS) assesses mobility over 3 activities of daily living: walking, stair climbing, and standing from a chair. Sensor-derived parameters including variation in both temporal and force aspects of gait were validated to measure differences in performance in line with fracture severity, which also matched questionnaire-based assessments. Monitoring the OTF cohort over 12 months with the HMS allowed functional recovery to be profiled in great detail. Further, a novel finding of continued improvements in walking quality after a plateau in walking quantity was demonstrated objectively. The methods described in this thesis provide an opportunity to revamp the recovery paradigm through continuous, objective patient monitoring along with self-directed, personalised rehabilitation strategies, which has the potential to improve both the quality and cost-effectiveness of reconstructive surgery services.Open Acces

Kontextsensitivität für den Operationssaal der Zukunft

The operating room of the future is a topic of high interest. In this thesis, which is among the first in the recently defined field of Surgical Data Science, three major topics for automated context awareness in the OR of the future will be examined: improved surgical workflow analysis, the newly developed event impact factors, and as application combining these and other concepts the unified surgical display.Der Operationssaal der Zukunft ist ein Forschungsfeld von großer Bedeutung. In dieser Dissertation, die eine der ersten im kürzlich definierten Bereich „Surgical Data Science“ ist, werden drei Themen für die automatisierte Kontextsensitivität im OP der Zukunft untersucht: verbesserte chirurgische Worflowanalyse, die neuentwickelten „Event Impact Factors“ und als Anwendungsfall, der diese Konzepte mit anderen kombiniert, das vereinheitlichte chirurgische Display

Kontextsensitivität für den Operationssaal der Zukunft

The operating room of the future is a topic of high interest. In this thesis, which is among the first in the recently defined field of Surgical Data Science, three major topics for automated context awareness in the OR of the future will be examined: improved surgical workflow analysis, the newly developed event impact factors, and as application combining these and other concepts the unified surgical display.Der Operationssaal der Zukunft ist ein Forschungsfeld von großer Bedeutung. In dieser Dissertation, die eine der ersten im kürzlich definierten Bereich „Surgical Data Science“ ist, werden drei Themen für die automatisierte Kontextsensitivität im OP der Zukunft untersucht: verbesserte chirurgische Worflowanalyse, die neuentwickelten „Event Impact Factors“ und als Anwendungsfall, der diese Konzepte mit anderen kombiniert, das vereinheitlichte chirurgische Display

Spectral LADAR: Active Range-Resolved Imaging Spectroscopy

Imaging spectroscopy using ambient or thermally generated optical sources is a well developed technique for capturing two dimensional images with high per-pixel spectral resolution. The per-pixel spectral data is often a sufficient sampling of a material's backscatter spectrum to infer chemical properties of the constituent material to aid in substance identification. Separately, conventional LADAR sensors use quasi-monochromatic laser radiation to create three dimensional images of objects at high angular resolution, compared to RADAR. Advances in dispersion engineered photonic crystal fibers in recent years have made high spectral radiance optical supercontinuum sources practical, enabling this study of Spectral LADAR, a continuous polychromatic spectrum augmentation of conventional LADAR. This imaging concept, which combines multi-spectral and 3D sensing at a physical level, is demonstrated with 25 independent and parallel LADAR channels and generates point cloud images with three spatial dimensions and one spectral dimension. The independence of spectral bands is a key characteristic of Spectral LADAR. Each spectral band maintains a separate time waveform record, from which target parameters are estimated. Accordingly, the spectrum computed for each backscatter reflection is independently and unambiguously range unmixed from multiple target reflections that may arise from transmission of a single panchromatic pulse. This dissertation presents the theoretical background of Spectral LADAR, a shortwave infrared laboratory demonstrator system constructed as a proof-of-concept prototype, and the experimental results obtained by the prototype when imaging scenes at stand off ranges of 45 meters. The resultant point cloud voxels are spectrally classified into a number of material categories which enhances object and feature recognition. Experimental results demonstrate the physical level combination of active backscatter spectroscopy and range resolved sensing to produce images with a level of complexity, detail, and accuracy that is not obtainable with data-level registration and fusion of conventional imaging spectroscopy and LADAR. The capabilities of Spectral LADAR are expected to be useful in a range of applications, such as biomedical imaging and agriculture, but particularly when applied as a sensor in unmanned ground vehicle navigation. Applications to autonomous mobile robotics are the principal motivators of this study, and are specifically addressed

Trademarks and Textual Data: A Broader Perspective on Innovation = Marques et données textuelles : Une perspective élargie sur l’innovation

Patente messen häufig technische Innovationen, während Handelsmarken Low-Tech und Dienstleistungen abdecken. In dieser Arbeit werden Textdaten von Marken untersucht, um verschiedene Rechte des geistigen Eigentums zu kombinieren. Textdaten ermöglichen zum Beispiel die Analyse großer Datenmengen, die Kombination verschiedener Quellen und datengestützte Erkenntnisse. Die Kombination von Handelsmarken und Patenten in den Bereichen Robotik (Hightech) und Schuhe (Lowtech) bietet eine breitere Abdeckung und Details zu Innovationen, die je nach Sektor variieren. Im Musikinstrumentensektor verdeutlichen Textdaten zu Marken, Patenten und Designs den laufenden technologischen Wandel. Patente beziehen sich auf Daten und Digitalisierungsthemen und werden von High-Tech-Firmen genutzt, während Handelsmarken die Signalverarbeitung und Videospiele von Spielfirmen abdecken. Designs fungieren als verbindendes Element. Eine Differenzierung zwischen Unternehmen und Tätigkeitsbereichen ist möglich. Zusammenfassend zeigt die These, dass die Integration von textuellen Markendaten die Innovationsabdeckung erweitert

The Development and Evaluation of Non-invasive Methods to Characterise the Disease States of Patients Utilising Selective Discrimination, Gas Chromatography-Mass Spectrometry and Chemometrics

The ‘smell’ of illness, disease or age has been known for many centuries, mainly created by volatile organic compounds (VOCs). Dogs were first reported to detect cancer in 2004. Increasingly, the profiles of VOCs are being utilised as non-invasive diagnostic methods. The aim of the thesis was to develop and evaluate the performance of analytical methods to characterise the disease states of patients utilising selective discrimination, gas chromatography-mass spectrometry (GC-MS) and chemometrics. The primary analytical technique investigated was GC-Time-of-Flight-MS coupled with headspace solid-phase microextraction (HS-SPME-GC-ToFMS). A robust and sensitive method was developed by optimisation of all sample analysis parameters and was applied to clinical samples from bladder and prostate cancer patients and those with hepatic disorders. This evidence was obtained by quantifying an internal standard, present in every sample and blank throughout the studies. Based on these findings, large numbers of clinical samples were analysed with confidence. Statistically significant mathematical models were developed in partnership with Cranfield University to classify the diseased state of samples and clinically relevant controls. PLS-DA was determined as the best classifier. The results from the HS-SPME-GC-ToFMS studies were highly promising. Bladder cancer gave a mean accuracy of >80 % and even low-grade tumours gave a sensitivity of 73 %, superior to urine cytology. Higher clinical performance was obtained in the prostate cancer study, with BPH distinguishable from cancer. Hepatic disorders were better again (>86 %). Preliminary studies on sepsis detection also showed promise. Several recommendations were made to enable significant clinical results in the future based on analytical rigour

Models and mechanisms for tangible user interfaces

Thesis (M.S.)--Massachusetts Institute of Technology, Program in Media Arts & Sciences, 1997.Includes bibliographical references (leaves 79-82).Brygg Anders Ullmer.M.S