Performance and Usability Evaluation of an Extended Reality Platform to Monitor Patient’s Health during Surgical Procedures

An extended-reality (XR) platform for real-time monitoring of patients' health during surgical procedures is proposed. The proposed system provides real-time access to a comprehensive set of patients' information, which are made promptly available to the surgical team in the operating room (OR). In particular, the XR platform supports the medical staff by automatically acquiring the patient's vitals from the operating room instrumentation and displaying them in real-time directly on an XR headset. Furthermore, information regarding the patient clinical record is also shown upon request. Finally, the XR-based monitoring platform also allows displaying in XR the video stream coming directly from the endoscope. The innovative aspect of the proposed XR-based monitoring platform lies in the comprehensiveness of the available information, in its modularity and flexibility (in terms of adaption to different sources of data), ease of use, and most importantly, in a reliable communication, which are critical requirements for the healthcare field. To validate the proposed system, experimental tests were conducted using instrumentation typically available in the operating room (i.e., a respiratory ventilator, a patient monitor for intensive care, and an endoscope). The overall results showed (i) an accuracy of the data communication greater than 99 %, along with (ii) an average time response below ms, and (iii) satisfying feedback from the SUS questionnaires filled out by the physicians after intensive use

Septic skin lesions: an uncommon manifestation of peripheral prosthetic vascular graft infection

Peripheral prosthetic vascular graft infection following lower limb surgical revascularization is a relatively rare but serious condition. A case of early infection and occlusion of a above-knee femoro-popliteal artery prosthetic bypass is here reported. It was accompanied by acute lower limb ischemia, fever and distally by embolic septic skin lesions

Soft Transducer for Patient’s Vitals Telemonitoring with Deep Learning-Based Personalized Anomaly Detection

This work addresses the design, development and implementation of a 4.0-based wearable soft transducer for patient-centered vitals telemonitoring. In particular, first, the soft transducer measures hypertension-related vitals (heart rate, oxygen saturation and systolic/diastolic pressure) and sends the data to a remote database (which can be easily consulted both by the patient and the physician). In addition to this, a dedicated deep learning algorithm, based on a Long-Short-Term-Memory Autoencoder, was designed, implemented and tested for providing an alert when the patient’s vitals exceed certain thresholds, which are automatically personalized for the specific patient. Furthermore, a mobile application (EcO2u) was developed to manage the entire data flow and facilitate the data fruition; this application also implements an innovative face-detection algorithm that ensures the identity of the patient. The robustness of the proposed soft transducer was validated experimentally on five individuals, who used the system for 30 days. The experimental results demonstrated an accuracy in anomaly detection greater than 93%, with a true positive rate of more than 94

Role of MRI Features as a Prognostic Index in Cervical Spondilogenetic Myelopathy

Introduction The importance of a correct preoperative radiological diagnosis in patients with cervical myelopathy has been widely demonstrated. Indeed, few studies still exist about the correlation between postoperative radiographic and clinical modifications. Materials and Methods The authors present a prospective study of 54 patients with cervical spondilogenetic myelopathy, who underwent surgery for corpectomy and anterior fusion with mesh in a period between January 2005 and August 2013. Images of cervical RMN were studied pre-and postoperatively and attention has been focused on alterations of intramedullary signal on T1- and T2-weighted sequences. Pre-and postoperative changes were correlated with clinical data (obtained by means of a Nurick scales and JOA classification—modified by Benzel). In relation to cervical RM-based studies, patients were divided into 3 groups: (A) no intramedullary signal alteration; (B) alterations in T2-weighted sequences; (C) alterations of the signal in both T1- and T2-weighted sequences. Results In all patients, decompression of the cervical spinal cord has been demonstrated by extension of the anteroposterior diameter of the spinal canal and by increase in the thickness of the subarachnoid space. In group A patients, no intramedullary signal changes were highlighted postoperatively. Patients in group B showed improvement on the base of hyperintensity disappearance on T2-weighted MRI, correlating with an improvement in the clinical quadro. Patients of group C have not been showing changes in the intramedullary MRI signal despite spinal cord decompression. Conclusions Signal alterations in T1 are an unfavorable prognostic index and proved to be irreversible. They correlate with a lack of clinical improvement of the patient. Patients in group B are those with the greatest clinical benefit after surgery and in whom clinical improvement correlates clearly with the radiological outcome

Design and Optimization of Polarization Splitting and Rotating Devices in Silicon-on-Insulator Technology

We review polarization splitting and rotating photonic devices based on silicon-on-insulator technology platform, focusing on their performance and design criteria. In addition, we present a theoretical investigation and optimization of some rotator and splitter architectures to be employed for polarization diversity circuits. In this context, fabrication tolerances and their influences on device performance are theoretically estimated by rigorous simulations too

Co-Expression of Podoplanin and CD44 in Proliferative Vitreoretinopathy Epiretinal Membranes

Epiretinal membranes (ERMs) are sheets of tissue that pathologically develop in the vitreoretinal interface leading to progressive vision loss. They are formed by different cell types and by an exuberant deposition of extracellular matrix proteins. Recently, we reviewed ERMs’ extracellular matrix components to better understand molecular dysfunctions that trigger and fuel the onset and development of this disease. The bioinformatics approach we applied delineated a comprehensive overview on this fibrocellular tissue and on critical proteins that could really impact ERM physiopathology. Our interactomic analysis proposed the hyaluronic-acid-receptor cluster of differentiation 44 (CD44) as a central regulator of ERM aberrant dynamics and progression. Interestingly, the interaction between CD44 and podoplanin (PDPN) was shown to promote directional migration in epithelial cells. PDPN is a glycoprotein overexpressed in various cancers and a growing body of evidence indicates its relevant function in several fibrotic and inflammatory pathologies. The binding of PDPN to partner proteins and/or its ligand results in the modulation of signaling pathways regulating proliferation, contractility, migration, epithelial–mesenchymal transition, and extracellular matrix remodeling, all processes that are vital in ERM formation. In this context, the understanding of the PDPN role can help to modulate signaling during fibrosis, hence opening a new line of therap