Exploiting Temporal Image Information in Minimally Invasive Surgery

Minimally invasive procedures rely on medical imaging instead of the surgeons direct vision. While preoperative images can be used for surgical planning and navigation, once the surgeon arrives at the target site real-time intraoperative imaging is needed. However, acquiring and interpreting these images can be challenging and much of the rich temporal information present in these images is not visible. The goal of this thesis is to improve image guidance for minimally invasive surgery in two main areas. First, by showing how high-quality ultrasound video can be obtained by integrating an ultrasound transducer directly into delivery devices for beating heart valve surgery. Secondly, by extracting hidden temporal information through video processing methods to help the surgeon localize important anatomical structures. Prototypes of delivery tools, with integrated ultrasound imaging, were developed for both transcatheter aortic valve implantation and mitral valve repair. These tools provided an on-site view that shows the tool-tissue interactions during valve repair. Additionally, augmented reality environments were used to add more anatomical context that aids in navigation and in interpreting the on-site video. Other procedures can be improved by extracting hidden temporal information from the intraoperative video. In ultrasound guided epidural injections, dural pulsation provides a cue in finding a clear trajectory to the epidural space. By processing the video using extended Kalman filtering, subtle pulsations were automatically detected and visualized in real-time. A statistical framework for analyzing periodicity was developed based on dynamic linear modelling. In addition to detecting dural pulsation in lumbar spine ultrasound, this approach was used to image tissue perfusion in natural video and generate ventilation maps from free-breathing magnetic resonance imaging. A second statistical method, based on spectral analysis of pixel intensity values, allowed blood flow to be detected directly from high-frequency B-mode ultrasound video. Finally, pulsatile cues in endoscopic video were enhanced through Eulerian video magnification to help localize critical vasculature. This approach shows particular promise in identifying the basilar artery in endoscopic third ventriculostomy and the prostatic artery in nerve-sparing prostatectomy. A real-time implementation was developed which processed full-resolution stereoscopic video on the da Vinci Surgical System

New Zealand Public Television, Public Service and Everything in Between: The Success and Struggles of New Zealand on Air and Public Television

This thesis explores the contemporary situation of 'public television' in New Zealand. As this country’s longest-standing, most significant facilitator of the diverse range of locally-produced programmes that pursue the 'cultural identity' objectives that are regarded as centrally important to 'public television', the focus of this thesis will be on the role and contributions of public broadcast funding agency, New Zealand on Air. This focus has three main functions in this thesis, allowing it to: first, investigate the necessity of facilitating and producing 'public television'; second, to explore the successful ways in which this element of television has been delivered to viewers; and third, to examine the limitations posed by a highly commercial broadcast television environment on the pursuit of 'public television' objectives. This undertaking is important because 'public television' faces a number of significant challenges in New Zealand, the most significant of which is inadequate public investment. Other challenges can be sourced to the intense competition and inadequate regulation of New Zealand television, which is a consequence of the deregulation and restructuring that it was subjected to in 1988-89. In the decades since, the broader environmental conditions encouraged by these changes have never been redressed. Presently, despite 'public television' fulfilling vital cultural functions, its situation has reached a crisis point, emphatically in regard to provisions for 'mainstream' broadcast audiences. For this reason, there needs to be an in-depth exploration of the issues and potentials in 'public television', to which this thesis aims to contribute. The exploration that this thesis offers is structured in three chapters. The first examines the establishment and role of New Zealand on Air. The second addresses the ways in which 'public television' programmes are successfully facilitated through the considerations and funding allocations of NZoA. The third considers the limitations of New Zealand’s television environment on the pursuit of 'public television' and argues the necessity for enhanced resources to be provided in order to improve the current situation

Temporal Segmentation of Surgical Sub-tasks through Deep Learning with Multiple Data Sources

Many tasks in robot-assisted surgeries (RAS) can be represented by finite-state machines (FSMs), where each state represents either an action (such as picking up a needle) or an observation (such as bleeding). A crucial step towards the automation of such surgical tasks is the temporal perception of the current surgical scene, which requires a real-time estimation of the states in the FSMs. The objective of this work is to estimate the current state of the surgical task based on the actions performed or events occurred as the task progresses. We propose Fusion-KVE, a unified surgical state estimation model that incorporates multiple data sources including the Kinematics, Vision, and system Events. Additionally, we examine the strengths and weaknesses of different state estimation models in segmenting states with different representative features or levels of granularity. We evaluate our model on the JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS), as well as a more complex dataset involving robotic intra-operative ultrasound (RIOUS) imaging, created using the da Vinci® Xi surgical system. Our model achieves a superior frame-wise state estimation accuracy up to 89.4%, which improves the state-of-the-art surgical state estimation models in both JIGSAWS suturing dataset and our RIOUS dataset

From principles to action: Applying the National Research Council's principles for effective decision support to the Federal Emergency Management Agency's watch office

AbstractThe National Research Council (NRC) proposed six principles for effective decision support in its 2009 report Informing Decisions in a Changing Climate. We structured a collaborative project between the Federal Emergency Management Agency Region R9 (FEMA R9), the Western Region Headquarters of the National Weather Service (WR-NWS), and the Climate Assessment of the Southwest (CLIMAS) at the University of Arizona around the application of the NRC principles. The goal of the project was to provide FEMA R9's Watch Office with climate information scaled to their temporal and spatial interests to aid them in assessing the potential risk of flood disasters. We found that we needed specific strategies and activities in order to apply the principles effectively. By using a set of established collaborative research approaches we were better able to assess FEMA R9's information needs and WR-NWS's capacity to meet those needs. Despite our diligent planning of engagement strategies, we still encountered some barriers to transitioning our decision support tool from research to operations. This paper describes our methods for planning and executing a three-party collaborative effort to provide climate services, the decision support tool developed through this process, and the lessons we will take from this deliberate collaborative process to our future work and implications of the NRC principles for the broader field of climate services

The Far-infrared Continuum of Quasars

ISO provides a key new far-infrared window through which to observe the multi-wavelength spectral energy distributions (SEDs) of quasars and active galactic nuclei (AGN). It allows us, for the first time, to observe a substantial fraction of the quasar population in the far-IR, and to obtain simultaneous, multi-wavelength observations from 5--200 microns. With these data we can study the behavior of the IR continuum in comparison with expectations from competing thermal and non-thermal models. A key to determining which mechanism dominates, is the measurement of the peak wavelength of the emission and the shape of the far-IR--mm turnover. Turnovers which are steeper than frequency^2.5 indicate thermal dust emission in the far-IR. Preliminary results from our ISO data show broad, fairly smooth, IR continuum emission with far-IR turnovers generally too steep to be explained by non-thermal synchrotron emission. Assuming thermal emission throughout leads to a wide inferred temperature range of 50-1000 K. The hotter material, often called the AGN component, probably originates in dust close to and heated by the central source, e.g. the ubiquitous molecular torus. The cooler emission is too strong to be due purely to cool, host galaxy dust, and so indicates either the presence of a starburst in addition to the AGN or AGN-heated dust covering a wider range of temperatures than present in the standard, optically thick torus models.Comment: 4 pages, to be published in the proceedings of "The Universe as Seen by ISO," ed. M. Kessler. This and related papers can be found at http://hea-www.harvard.edu/~ehooper/ISOkp/ISOkp.htm

Familiarity with radiation exposure dose from diagnostic imaging for acute pulmonary embolism and current patterns of practice

Objective: To assess the current level of knowledge and practice patterns of emergency physicians regarding radiation exposure from diagnostic imaging modalities for investigating acute pulmonary embolism (PE)

Directed Acyclic Graph Continuous Max-Flow Image Segmentation for Unconstrained Label Orderings

Label ordering, the specification of subset–superset relationships for segmentation labels, has been of increasing interest in image segmentation as they allow for complex regions to be represented as a collection of simple parts. Recent advances in continuous max-flow segmentation have widely expanded the possible label orderings from binary background/foreground problems to extendable frameworks in which the label ordering can be specified. This article presents Directed Acyclic Graph Max-Flow image segmentation which is flexible enough to incorporate any label ordering without constraints. This framework uses augmented Lagrangian multipliers and primal–dual optimization to develop a highly parallelized solver implemented using GPGPU. This framework is validated on synthetic, natural, and medical images illustrating its general applicability

Arterial Anatomy of the Anterior Abdominal Wall:Evidence-Based Safe Sites for Instrumentation based on Radiological Analysis of 100 Patients

Introduction: Multiple medical interventions require percutaneous instrumentation of the anterior abdominal wall, all of which carry a potential for vascular trauma. We assessed the presence, position and size of the anterior abdominal wall superior and inferior (deep) epigastric arteries to determine the safest site with respect to vascular anatomy of the rectus sheath. Materials & Methods: In a review of 100 arterial phase, contrast-enhanced abdominal computed tomography scans, anterior abdominal wall arteries were assessed bilaterally at three axial planes: transpyloric, umbilicus and anterior superior iliac spine (ASIS). Results: The mean age of patients was 69.2 years (SD ± 15), with 62 male and 38 female. An artery was visible least frequently at the transpyloric plane (5%), compared to the umbilicus (72-79%) and ASIS (93-96%), on the left (χ (4) = 207.272; p < 0.001) and right (χ (4) = 198.553; p < 0.001), with a moderate strength association (Cramer's V = 0.588 (left) and 0.575 (right)). The arteries were most commonly observed within the rectus abdominis muscle at the level of the umbilicus and ASIS on both sides (62-68%). The inferior epigastric artery was observed to be larger in diameter, start more laterally, and move medially as it travelled superiorly. Discussion: These data suggest that the safest site to instrument the rectus sheath, with respect to vascular anatomy, is at the transpyloric plane. This information on anatomical variation of the anterior abdominal wall vasculature may be of particular interest to anesthetists performing rectus sheath block and surgeons during laparoscopic port insertion. This article is protected by copyright. All rights reserved