PICCOLO White-Light and Narrow-Band Imaging Colonoscopic Dataset: A Performance Comparative of Models and Datasets

Colorectal cancer is one of the world leading death causes. Fortunately, an early diagnosis allows for e_ective treatment, increasing the survival rate. Deep learning techniques have shown their utility for increasing the adenoma detection rate at colonoscopy, but a dataset is usually required so the model can automatically learn features that characterize the polyps. In this work, we present the PICCOLO dataset, that comprises 3433 manually annotated images (2131 white-light images 1302 narrow-band images), originated from 76 lesions from 40 patients, which are distributed into training (2203), validation (897) and test (333) sets assuring patient independence between sets. Furthermore, clinical metadata are also provided for each lesion. Four di_erent models, obtained by combining two backbones and two encoder–decoder architectures, are trained with the PICCOLO dataset and other two publicly available datasets for comparison. Results are provided for the test set of each dataset. Models trained with the PICCOLO dataset have a better generalization capacity, as they perform more uniformly along test sets of all datasets, rather than obtaining the best results for its own test set. This dataset is available at the website of the Basque Biobank, so it is expected that it will contribute to the further development of deep learning methods for polyp detection, localisation and classification, which would eventually result in a better and earlier diagnosis of colorectal cancer, hence improving patient outcomes.This work was partially supported by PICCOLO project. This project has received funding from the European Union’s Horizon2020 research and innovation programme under grant agreement No 732111. Furthermore, this publication has also been partially supported by GR18199 from Consejería de Economía, Ciencia y Agenda Digital of Junta de Extremadura (co-funded by European Regional Development Fund–ERDF. “A way to make Europe”/ “Investing in your future”. This work has been performed by the ICTS “NANBIOSIS” at the Jesús Usón Minimally Invasive Surgery Centre

Construct and face validity of SINERGIA laparoscopic virtual reality simulator

Purpose Laparoscopic techniques have nowadays become a gold standard in many surgical procedures, but they imply a more difficult learning skills process. Simulators have a fundamental role in the formative stage of new surgeons. This paper presents the construct and face validity of SINERGIA laparoscopic virtual reality simulator in order to decide whether it can be considered as an assessment tool. Methods Twenty people participated in this study, 14 were novices and 6 were experts. Five tasks of SINERGIA were included in the study: coordination, navigation, navigation and touch, precise grasping and coordinate traction. For each one of these tasks, a certain number of metrics are automatically recorded. All subjects accomplished each task only once and filled in two questionnaires. A statistical analysis was made and results from both groups were compared with the Mann–Whitney U-test, considering significant differences when P ≤ 0.05. Internal consistency of the system has been analyzed with the Cronbach’s alpha test. Results Novices and experts positively rated SINERGIA characteristics. At least one of the evaluated metrics of each exercise presented significant differences between both groups. Nevertheless, all metrics under study gave a better punctuation to the executions accomplished by experts (lower time, higher efficiency, fewer errors. . .) than to those made by novices. Conclusion SINERGIA laparoscopic virtual reality simulator is able to discriminate subjects according to their level of experience in laparoscopic surgery; therefore, it can be used within a training program as an assessment too

Técnicas de robótica y visión artificial para el entrenamiento quirúrgico de mínima invasión

La cirugía de mínima invasión es una disciplina quirúrgica en auge, debido principalmente a las múltiples ventajas que proporciona a los pacientes y al sistema sanitario. Sin embargo, exige una formación larga y costosa del profesional sanitario que debe mejorarse mediante el diseño y utilización de nuevas tecnologías. En este sentido, se plantea el desarrollo de esta tesis doctoral. Por un lado, la utilización de sistemas de seguimiento para guiar y evaluar el entrenamiento en sus fases más tempranas, complementado con técnicas de visión artificial y diferentes sensores que garanticen una tutorización continua del proceso formativo. Por otro lado, la utilización de estos sistemas como futura herramienta de certificación de la competencia quirúrgica. Finalmente, los resultados obtenidos exponen el enorme potencial futuro de los desarrollos presentados en esta tesis, dentro de un nuevo modelo de formación que integre estos sistemas para complementar las herramientas utilizadas actualmente. En concreto, el sistema ARH ha demostrado capacidad para distinguir niveles de experiencia en ciertos procedimientos laparoscópicos. Además, el dispositivo EDEST ha sido muy valorado por los profesionales como un complemento útil en su proceso formativo. Y finalmente, el software VidLA también ha obtenido resultados aceptables en la evaluación de la destreza quirúrgica. Aunque la tecnología desarrollada en este trabajo ha obtenido buenos resultados en las experiencias realizadas bajo condiciones de entrenamiento reales, para el completo aprovechamiento de estas herramientas se deberían realizar esfuerzos adicionales en nuevos conceptos pedagógicos y didácticos que exploten eficientemente el enorme potencial descubierto por estos desarrollos.Minimally Invasive Surgery is rapidly gaining in importance as a surgical technique, mainly due to all the advantadges provided to both pacients and health system. However, it needs a long and expensive training process of health professionals that must be improved by designing and using new technologies. For this reason, this doctoral thesis has been planned to be performed. On the one hand, early training stages that assures a complete mentoring of the training process using tracking systems, computer vision and sensors to guide and assess trainees. On the other hand, these kinds of systems should be used to certificate surgical competences in the near future. Finally, obtained results show the huge and promising potential of all developments presented in this work. In order to make this, a new training model that integrates all these systems with current training tools should be developed. Specifically, the ARH system has proved its ability to distinguish between different experience levels in some kind of laparoscopic procedures. Furthermore, the EDEST device has been highly rated by surgeons as an useful complementary device during its training process. And finally, the VidLA software has obtained acceptable results for surgical skills' assessment too. All developments performed in this work have obtained good results during real training courses, which were used to validate them. However, additional efforts in new pedagogical and didactical concepts should be performed in order to fully exploit all these new tools

Cardiovascular Circulatory System and Left Carotid Model: A Fractional Approach to Disease Modeling

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, according to recent reports from the World Health Organization (WHO). This fact encourages research into the cardiovascular system (CVS) from multiple and different points of view than those given by the medical perspective, highlighting among them the computational and mathematical models that involve experiments much simpler and less expensive to be performed in comparison with in vivo or in vitro heart experiments. However, the CVS is a complex system that needs multidisciplinary knowledge to describe its dynamic models, which help to predict cardiovascular events in patients with heart failure, myocardial or valvular heart disease, so it remains an active area of research. Firstly, this paper presents a novel electrical model of the CVS that extends the classic Windkessel models to the left common carotid artery motivated by the need to have a more complete model from a medical point of view for validation purposes, as well as to describe other cardiovascular phenomena in this area, such as atherosclerosis, one of the main risk factors for CVDs. The model is validated by clinical indices and experimental data obtained from clinical trials performed on a pig. Secondly, as a first step, the goodness of a fractional-order behavior of this model is discussed to characterize different heart diseases through pressure–volume (PV) loops. Unlike other models, it allows us to modify not only the topology, parameters or number of model elements, but also the dynamic by tuning a single parameter, the characteristic differentiation order; consequently, it is expected to provide a valuable insight into this complex system and to support the development of clinical decision systems for CVDs

Application of fluid mechanics and simulation: Urinary tract and ureteral catheters

The mechanics of urine during its transport from the renal pelvis to the bladder is of great interest for urologists. The knowledge of the different physical variables and their interrelationship, both in physiologic movements and pathologies, will help a better diagnosis and treatment. The objective of this chapter is to show the physics principles and their most relevant basic relations in urine transport, and to bring them over the clinical world. For that, we explain the movement of urine during peristalsis, ureteral obstruction and in a ureter with a stent. This explanation is based in two tools used in bioengineering: the theoretical analysis through the Theory of continuous media and Ffluid mechanics and computational simulation that offers a practical solution for each scenario. Moreover, we review other contributions of bioengineering to the feld of Urology, such as physical simulation or additive and subtractive manufacturing techniques. Finally, we list the current limitations for these tools and the technological development lines with more future projection. CONCLUSIONS: In this chapter we aim to help urologists to understand some important concepts of bioengineering, promoting multidisciplinary cooperation to offer complementary tools that help in diagnosis and treatment of diseases.El comportamiento de la orina durante su transporte, desde la pelvis renal hasta la vejiga, tiene un gran interés para los urólogos. El conocimiento de las diferentes variables físicas y su interrelación, en movimientos fisiológicos y patologías, ayudará a un mejor diagnóstico y tratamiento. El objetivo de este capítulo es exponer y acercar al mundo clínico los conceptos físicos y sus relaciones básicas más relevantes en el transporte de orina. Para ello, se explica el movimiento de la orina durante una peristalsis, una obstrucción ureteral y un uréter tutorizado con un catéter ureteral. Esta explicación se basa en dos herramientas muy utilizadas en bioingeniería: el análisis teórico a través de la Teoría de los Medios Continuos y la Mecánica de Fluidos y la simulación computacional que ofrece una solución práctica de cada uno de los escenarios. Además, se repasan otras aportaciones de la bioingeniería al campo de la Urología, como la simulación física o las técnicas de fabricación aditiva y sustractiva. Finalmente, se enumeran las limitaciones actuales de estas herramientas y las líneas de desarrollo tecnológico con más proyección. CONCLUSIÓN: Se pretende que este capítulo ayude a los urólogos a comprender algunos conceptos importantes de bioingeniería, fomentando la colaboración multidisciplinar para ofrecer herramientas complementarias que les ayuden en el diagnóstico y el tratamiento de enfermedades

Análisis de la presión de la boquilla de varios hidrogeles en la bioimpresión basada en extrusión utilizando dinámica de fluidos computacional

Comunicación presentada a las XXXIX Jornadas de Automática, celebradas en Badajoz del 5 al 7 de Septiembre de 2018 y organizada por la Universidad de Extremadura.Extrusion bioprinting is an additive manufacturing technology with huge possibilities in the creation of engineered tissues. There are many researches about materials, cells and their interrelation. Nevertheless, there are not many researches about how the mechanics affect to cellular viability. In this way, we have done CFD simulations to check how the viscosity of materials can affect the pressure distribution in the tip of a nozzle. These results will be updated, in future works, with simulations of several materials and geometries.La bioimpresión por extrusión es una tecnología de fabricación aditiva con grandes posibilidades en la creación de tejidos de ingeniería. Hay muchas investigaciones sobre los materiales, las células y su interrelación. Sin embargo, no hay muchas investigaciones sobre cómo la mecánica afecta a la viabilidad celular. De esta manera, hemos realizado simulaciones de CFD para verificar cómo la viscosidad de los materiales puede afectar la distribución de la presión en la punta de una boquilla. Estos resultados se actualizarán, en trabajos futuros, con simulaciones de varios materiales y geometrías.Consejería de Economía e Infraestructuras, Junta de Extremadura. Project IB16200 “Optimización y mejora de técnicas de bioimpresión para regeneración de cartílago y prótesis vasculares”peerReviewe

Análisis de la presión de la boquilla de varios hidrogeles en la bioimpresión basada en extrusión utilizando dinámica de fluidos computacional

Comunicación presentada a las XXXIX Jornadas de Automática, celebradas en Badajoz del 5 al 7 de Septiembre de 2018 y organizada por la Universidad de Extremadura.Extrusion bioprinting is an additive manufacturing technology with huge possibilities in the creation of engineered tissues. There are many researches about materials, cells and their interrelation. Nevertheless, there are not many researches about how the mechanics affect to cellular viability. In this way, we have done CFD simulations to check how the viscosity of materials can affect the pressure distribution in the tip of a nozzle. These results will be updated, in future works, with simulations of several materials and geometries.La bioimpresión por extrusión es una tecnología de fabricación aditiva con grandes posibilidades en la creación de tejidos de ingeniería. Hay muchas investigaciones sobre los materiales, las células y su interrelación. Sin embargo, no hay muchas investigaciones sobre cómo la mecánica afecta a la viabilidad celular. De esta manera, hemos realizado simulaciones de CFD para verificar cómo la viscosidad de los materiales puede afectar la distribución de la presión en la punta de una boquilla. Estos resultados se actualizarán, en trabajos futuros, con simulaciones de varios materiales y geometrías.Consejería de Economía e Infraestructuras, Junta de Extremadura. Project IB16200 “Optimización y mejora de técnicas de bioimpresión para regeneración de cartílago y prótesis vasculares”peerReviewe

Nozzle pressure analysis of several hydrogel on extrusion-based bioprinting using computational fluid dynamics

[Abstract] Extrusion bioprinting is an additive manufacturing technology with huge possibilities in the creation of engineered tissues. There are many researches about materials, cells and their interrelation. Nevertheless, there are not many researches about how the mechanics affect to cellular viability. In this way, we have done CFD simulations to check how the viscosity of materials can affect the pressure distribution in the tip of a nozzle. These results will be updated, in future works, with simulations of several materials and geometries.[Resumen] La bioimpresión por extrusión es una tecnología de fabricación aditiva con grandes posibilidades en la creación de tejidos de ingeniería. Hay muchas investigaciones sobre los materiales, las células y su interrelación. Sin embargo, no hay muchas investigaciones sobre cómo la mecánica afecta a la viabilidad celular. De esta manera, hemos realizado simulaciones de CFD para verificar cómo la viscosidad de los materiales puede afectar la distribución de la presión en la punta de una boquilla. Estos resultados se actualizarán, en trabajos futuros, con simulaciones de varios materiales y geometrías.Junta de Extremadura; IB1620

ERGONOMICS EDUCATION IN ORTHOPEDIC SURGERY

The motivation of research was poor quality of working conditions in orthopedic practice which results from lack of use of ergonomics principles by medical staff. Hence, the research objective was to indicate the most important determinants for creating high-quality working conditions in operating room, particularly when performing orthopedic procedures. As methodology, the observations, video-registrations and interviews with orthopedic professionals were conducted. Based on the research material, the ergonomic and workflow assessments were examined. The research outcomes confirmed a problem of low quality working conditions during orthopedic surgeries resulted from insufficient knowledge and awareness of orthopedists regarding ergonomics. There was diagnosed a need for creation of a specialized guide for orthopedists and medical decision makers of how to improve working conditions in operating room on the background of the human and technical perspectives. As a result there was proposed the comprehensive online course on ergonomics for orthopedists and all medical staff who are interested in and are responsible for safety and comfortable conditions at their workplace. Hence the future scope is formulated as the monitoring and evaluation of working conditions after implementing ergonomics course within medical staff.&nbsp