Suivi automatique d'instruments dans les séquences d'images thoracoscopiques

Anatomie de la structure thoracique -- Chirurgie minimalement invasive -- Contexte clinique -- Système de navigation pour le rachis -- Approches au suivi d'instruments chirurgicaux -- Techniques de suivi d'objets à travers une séquence d'images -- Objectifs spécifiques du projet -- Méthodologie -- Extraction des caractéristiques de l'instrument -- Suivi temporel par filtrage particulaire -- Méthode d'évaluation et de validation -- Interface graphique et mise en contexte -- Extraction des caractéristiques de l'instrument -- Suivi automatique des instruments -- Précision de la procédure de suivi -- Temps de calcul -- Limites de la méthode proposée

Système d'endoscopie basé sur la tomographie par cohérence optique dédié à l'étude des cordes vocales pédiatriques et des pathologies associées

RÉSUMÉ Le larynx est responsable de la phonation, et son bon fonctionnement est essentiel pour assurer une respiration et une déglutition adéquates. Le développement de cette structure anatomique engendre une série de changement physiologique et morphologique. Au courant de sa vie, de 1 à 9% de la population sera affectée par une pathologie laryngée, dont un grand nombre affecte spécifiquement la population pédiatrique. Les enfants affectés par ces pathologies laryngées sont particulièrement susceptibles de développer des problèmes additionnels de nature médicale, académique et psychosociale. Bien que plusieurs recherches aient été effectuées pour comprendre le développement des cordes vocales et les pathologies laryngées, plusieurs questions restent encore sans réponse. Le cycle de développement de cette microstructure anatomique est incompris, principalement à cause des méthodes actuelles de dépistage qui demeurent invasives. Par conséquent, les traitements thérapeutiques ou chirurgicaux sont peu adaptés à la clientèle pédiatrique et certains résultats sont sous-optimaux. Cette problématique illustre un besoin urgent pour un système d’imagerie non invasif dédié à l’observation des cordes vocales en pédiatrie. La conception et la validation d’un outil clinique pour l’imagerie intraopératoire des cordes vocales comportent de nombreux défis. L’hypothèse principale de cette thèse repose sur la possibilité de caractériser les cordes vocales pédiatriques de façon minimalement invasive. L’innovation est en grande partie attribuée à la conception et à la réalisation d’un système d’imagerie ainsi que d’une méthode permettant l’étude systématique des zones du larynx d’où émergent les pathologies. Cette thèse vise à développer un outil et une méthode menant à une compréhension plus approfondie de la maturation de cette microstructure La tomographie par cohérence optique (ou OCT, de l’anglais « Optical Coherence Tomography») est une technologie d’imagerie laser utilisée depuis quelques années en ophtalmologie,et récemment en cardiologie. Elle permet d’obtenir des coupes transversales (en profondeur) avec une résolution de l’ordre de quelques microns. Cette technique permettrait donc d’imager les structures anatomiques des cordes vocales pédiatriques, jusqu’ici inaccessibles étant donné la nature invasive de la biopsie. Ayant identifié l’OCT comme une modalité d’imagerie optique potentielle pour l’analyse des cordes vocales et des structures avoisinantes du larynx, l’objectif est de définir et de caractériser de façon optique la microstructure des cordes vocales.----------ABSTRACT The larynx is responsible for phonation, and its proper functioning is essential to breathing and swallowing. The development of this anatomical structure creates a series of physiological and morphological changes. In one’s lifetime, 1 to 9 % of the population will be affected by a laryngeal pathology, many of which specifically affecting the pediatric population. Children afflicted by laryngeal pathologies are particularly likely to develop additional medical, academic and psycho-social issues. Although several research studies have been conducted to understand the development of the vocal folds and laryngeal lesions, several questions remain unanswered. The development cycle of this anatomical microstructure is poorly understood, which is mainly due of current lack of noninvasive evaluation tools. This results in therapeutic or surgical treatments not being perfectly adapted to the pediatric clientele and some results are thus suboptimal. This issue illustrates the urgent need for non-invasive Imaging system dedicated to the observation of the vocal folds in the pediatric population. The design and validation of a clinical tool for intraoperative imaging of the vocal folds have many challenges. The main hypothesis of this thesis related to the noninvasive characterization of pediatric vocal folds. The innovation is largely attributed to the design and implementation of an imaging system and a method for the systematic study of the larynx, especially in areas from where diseases originate. This thesis aims at developing a tool and a method leading to a deeper understanding of the maturation of this icrostructure. Optical coherence tomography (OCT) is an optical imaging technology adopted in ophthalmology and recently in cardiology. It provides cross sectional (in depth) images with a resolution of a few microns. This technique allows imaging of anatomical structures of the pediatric vocal folds, without the negative consequences associated with biopsy. Having identified OCT as a potential optical imaging method for the analysis of the vocal folds and surrounding structures of the larynx, the objective is to define and characterize the microstructure of vocal folds. A validation is initially performed using an ex vivo study of different cadaveric specimens, animals and humans. These specimens were analyzed using OCT to identify elements associated with stages of maturation of the vocal folds. A systematic comparison of optical coherence tomography with histology was carried out to identify specific characteristics of each population. These encouraging results have enabled the development of an OCT system coupled to a handheld probe adapted for intraoperative imaging of the pediatric vocal fold

Toward an automated method for optical coherence tomography characterization

With the increasing use of optical coherence tomography (OCT) in biomedical applications, robust yet simple methods for calibrating and benchmarking a system are needed. We present here a procedure based on a calibration object complemented with an algorithm that analyzes three-dimensional OCT datasets to retrieve key characteristics of an OCT system. The calibration object combines state-of-the-art tissue phantom material with a diamond-turned aluminum multisegment mirror. This method is capable of determining rapidly volumetric field-of-view, axial resolution, and image curvature. Moreover, as the phantom material mimics biological tissue, the system's signal and noise levels can be evaluated in conditions close to biological experiments. We believe this method could improve OCT quantitative data analysis and help OCT data comparison for longitudinal or multicenter studies

Overcoming language barriers in pediatric care: a multilingual, AI-driven curriculum for global healthcare education

BackgroundOnline medical education often faces challenges related to communication and comprehension barriers, particularly when the instructional language differs from the healthcare providers' and caregivers' native languages. Our study addresses these challenges within pediatric healthcare by employing generative language models to produce a linguistically tailored, multilingual curriculum that covers the topics of team training, surgical procedures, perioperative care, patient journeys, and educational resources for healthcare providers and caregivers.MethodsAn interdisciplinary group formulated a video curriculum in English, addressing the nuanced challenges of pediatric healthcare. Subsequently, it was translated into Spanish, primarily emphasizing Latin American demographics, utilizing OpenAI's GPT-4. Videos were enriched with synthetic voice profiles of native speakers to uphold the consistency of the narrative.ResultsWe created a collection of 45 multilingual video modules, each ranging from 3 to 8 min in length and covering essential topics such as teamwork, how to improve interpersonal communication, “How I Do It” surgical procedures, as well as focused topics in anesthesia, intensive care unit care, ward nursing, and transitions from hospital to home. Through AI-driven translation, this comprehensive collection ensures global accessibility and offers healthcare professionals and caregivers a linguistically inclusive resource for elevating standards of pediatric care worldwide.ConclusionThis development of multilingual educational content marks a progressive step toward global standardization of pediatric care. By utilizing advanced language models for translation, we ensure that the curriculum is inclusive and accessible. This initiative aligns well with the World Health Organization's Digital Health Guidelines, advocating for digitally enabled healthcare education

Video_1_Overcoming language barriers in pediatric care: a multilingual, AI-driven curriculum for global healthcare education.MP4

BackgroundOnline medical education often faces challenges related to communication and comprehension barriers, particularly when the instructional language differs from the healthcare providers' and caregivers' native languages. Our study addresses these challenges within pediatric healthcare by employing generative language models to produce a linguistically tailored, multilingual curriculum that covers the topics of team training, surgical procedures, perioperative care, patient journeys, and educational resources for healthcare providers and caregivers.MethodsAn interdisciplinary group formulated a video curriculum in English, addressing the nuanced challenges of pediatric healthcare. Subsequently, it was translated into Spanish, primarily emphasizing Latin American demographics, utilizing OpenAI's GPT-4. Videos were enriched with synthetic voice profiles of native speakers to uphold the consistency of the narrative.ResultsWe created a collection of 45 multilingual video modules, each ranging from 3 to 8 min in length and covering essential topics such as teamwork, how to improve interpersonal communication, “How I Do It” surgical procedures, as well as focused topics in anesthesia, intensive care unit care, ward nursing, and transitions from hospital to home. Through AI-driven translation, this comprehensive collection ensures global accessibility and offers healthcare professionals and caregivers a linguistically inclusive resource for elevating standards of pediatric care worldwide.ConclusionThis development of multilingual educational content marks a progressive step toward global standardization of pediatric care. By utilizing advanced language models for translation, we ensure that the curriculum is inclusive and accessible. This initiative aligns well with the World Health Organization's Digital Health Guidelines, advocating for digitally enabled healthcare education.</p

Image_1_Overcoming language barriers in pediatric care: a multilingual, AI-driven curriculum for global healthcare education.TIFF

BackgroundOnline medical education often faces challenges related to communication and comprehension barriers, particularly when the instructional language differs from the healthcare providers' and caregivers' native languages. Our study addresses these challenges within pediatric healthcare by employing generative language models to produce a linguistically tailored, multilingual curriculum that covers the topics of team training, surgical procedures, perioperative care, patient journeys, and educational resources for healthcare providers and caregivers.MethodsAn interdisciplinary group formulated a video curriculum in English, addressing the nuanced challenges of pediatric healthcare. Subsequently, it was translated into Spanish, primarily emphasizing Latin American demographics, utilizing OpenAI's GPT-4. Videos were enriched with synthetic voice profiles of native speakers to uphold the consistency of the narrative.ResultsWe created a collection of 45 multilingual video modules, each ranging from 3 to 8 min in length and covering essential topics such as teamwork, how to improve interpersonal communication, “How I Do It” surgical procedures, as well as focused topics in anesthesia, intensive care unit care, ward nursing, and transitions from hospital to home. Through AI-driven translation, this comprehensive collection ensures global accessibility and offers healthcare professionals and caregivers a linguistically inclusive resource for elevating standards of pediatric care worldwide.ConclusionThis development of multilingual educational content marks a progressive step toward global standardization of pediatric care. By utilizing advanced language models for translation, we ensure that the curriculum is inclusive and accessible. This initiative aligns well with the World Health Organization's Digital Health Guidelines, advocating for digitally enabled healthcare education.</p