Real-Time Detection and Tracking using Wireless Sensor Networks (Information Sheet)

To develop and deploy a detection and tracking system based on wireless sensor networks. Real-Time detection and tracking is achieved using Wireless Sensor Networks Hardware. The system is envisioned to be able to effectively handle multiple arbitrarily moving targets

On the detection of myocardial scar based on ECG/VCG analysis

In this paper, we address the problem of detecting the presence of myocardial scar from standard ECG/VCG recordings, giving effort to develop a screening system for the early detection of scar in the point-of-care. Based on the pathophysiological implications of scarred myocardium, which results in disordered electrical conduction, we have implemented four distinct ECG signal processing methodologies in order to obtain a set of features that can capture the presence of myocardial scar. Two of these methodologies: a.) the use of a template ECG heartbeat, from records with scar absence coupled with Wavelet coherence analysis and b.) the utilization of the VCG are novel approaches for detecting scar presence. Following, the pool of extracted features is utilized to formulate an SVM classification model through supervised learning. Feature selection is also employed to remove redundant features and maximize the classifier's performance. Classification experiments using 260 records from three different databases reveal that the proposed system achieves 89.22% accuracy when applying 10- fold cross validation, and 82.07% success rate when testing it on databases with different inherent characteristics with similar levels of sensitivity (76%) and specificity (87.5%)

Post-Operative Medium- and Long-Term Endocrine Outcomes in Patients with Non-Functioning Pituitary Adenomas—Machine Learning Analysis

Post-operative endocrine outcomes in patients with non-functioning pituitary adenoma (NFPA) are variable. The aim of this study was to use machine learning (ML) models to better predict medium- and long-term post-operative hypopituitarism in patients with NFPAs. We included data from 383 patients who underwent surgery with or without radiotherapy for NFPAs, with a follow-up period between 6 months and 15 years. ML models, including k-nearest neighbour (KNN), support vector machine (SVM), and decision tree models, showed a superior ability to predict panhypopituitarism compared with non-parametric statistical modelling (mean accuracy: 0.89; mean AUC-ROC: 0.79), with SVM achieving the highest performance (mean accuracy: 0.94; mean AUC-ROC: 0.88). Pre-operative endocrine function was the strongest feature for predicting panhypopituitarism within 1 year post-operatively, while endocrine outcomes at 1 year post-operatively supported strong predictions of panhypopituitarism at 5 and 10 years post-operatively. Other features found to contribute to panhypopituitarism prediction were age, volume of tumour, and the use of radiotherapy. In conclusion, our study demonstrates that ML models show potential in predicting post-operative panhypopituitarism in the medium and long term in patients with NFPM. Future work will include incorporating additional, more granular data, including imaging and operative video data, across multiple centres

Shifted-windows transformers for the detection of cerebral aneurysms in microsurgery

Purpose: Microsurgical Aneurysm Clipping Surgery (MACS) carries a high risk for intraoperative aneurysm rupture. Automated recognition of instances when the aneurysm is exposed in the surgical video would be a valuable reference point for neuronavigation, indicating phase transitioning and more importantly designating moments of high risk for rupture. This article introduces the MACS dataset containing 16 surgical videos with frame-level expert annotations and proposes a learning methodology for surgical scene understanding identifying video frames with the aneurysm present in the operating microscope’s field-of-view./ Methods: Despite the dataset imbalance (80% no presence, 20% presence) and developed without explicit annotations, we demonstrate the applicability of Transformer-based deep learning architectures (MACSSwin-T, vidMACSSwin-T) to detect the aneurysm and classify MACS frames accordingly. We evaluate the proposed models in multiple-fold cross-validation experiments with independent sets and in an unseen set of 15 images against 10 human experts (neurosurgeons)./ Results: Average (across folds) accuracy of 80.8% (range 78.5–82.4%) and 87.1% (range 85.1–91.3%) is obtained for the image- and video-level approach, respectively, demonstrating that the models effectively learn the classification task. Qualitative evaluation of the models’ class activation maps shows these to be localized on the aneurysm’s actual location. Depending on the decision threshold, MACSWin-T achieves 66.7–86.7% accuracy in the unseen images, compared to 82% of human raters, with moderate to strong correlation./ Conclusions: Proposed architectures show robust performance and with an adjusted threshold promoting detection of the underrepresented (aneurysm presence) class, comparable to human expert accuracy. Our work represents the first step towards landmark detection in MACS with the aim to inform surgical teams to attend to high-risk moments, taking precautionary measures to avoid rupturing

Artificial intelligence in orthopaedic surgery

The use of artificial intelligence (AI) is rapidly growing across many domains, of which the medical field is no exception. AI is an umbrella term defining the practical application of algorithms to generate useful output, without the need of human cognition. Owing to the expanding volume of patient information collected, known as ‘big data’, AI is showing promise as a useful tool in healthcare research and across all aspects of patient care pathways. Practical applications in orthopaedic surgery include: diagnostics, such as fracture recognition and tumour detection; predictive models of clinical and patient-reported outcome measures, such as calculating mortality rates and length of hospital stay; and real-time rehabilitation monitoring and surgical training. However, clinicians should remain cognizant of AI’s limitations, as the development of robust reporting and validation frameworks is of paramount importance to prevent avoidable errors and biases. The aim of this review article is to provide a comprehensive understanding of AI and its subfields, as well as to delineate its existing clinical applications in trauma and orthopaedic surgery. Furthermore, this narrative review expands upon the limitations of AI and future direction

A Deep Learning Approach to Classify Surgical Skill in Microsurgery Using Force Data from a Novel Sensorised Surgical Glove

Microsurgery serves as the foundation for numerous operative procedures. Given its highly technical nature, the assessment of surgical skill becomes an essential component of clinical practice and microsurgery education. The interaction forces between surgical tools and tissues play a pivotal role in surgical success, making them a valuable indicator of surgical skill. In this study, we employ six distinct deep learning architectures (LSTM, GRU, Bi-LSTM, CLDNN, TCN, Transformer) specifically designed for the classification of surgical skill levels. We use force data obtained from a novel sensorized surgical glove utilized during a microsurgical task. To enhance the performance of our models, we propose six data augmentation techniques. The proposed frameworks are accompanied by a comprehensive analysis, both quantitative and qualitative, including experiments conducted with two cross-validation schemes and interpretable visualizations of the network’s decision-making process. Our experimental results show that CLDNN and TCN are the top-performing models, achieving impressive accuracy rates of 96.16% and 97.45%, respectively. This not only underscores the effectiveness of our proposed architectures, but also serves as compelling evidence that the force data obtained through the sensorzsed surgical glove contains valuable information regarding surgical skill

Identifying key mechanisms leading to visual recognition errors for missed colorectal polyps using eye-tracking technology

BACKGROUND AND AIMS: Lack of visual recognition of colorectal polyps may lead to interval cancers. The mechanisms contributing to perceptual variation, particularly for subtle and advanced colorectal neoplasia, has scarcely been investigated. We aimed to evaluate visual recognition errors and provide novel mechanistic insights. METHODS: Eleven participants (7 trainees, 4 medical students) evaluated images from the UCL polyp perception dataset, containing 25 polyps, using eye tracking equipment. Gaze errors were defined as those where the lesion was not observed according to eye tracking technology. Cognitive errors occurred when lesions were observed but not recognised as polyps by participants. A video study was also performed including 39 subtle polyps, where polyp recognition performance was compared with a convolutional neural network (CNN). RESULTS: Cognitive errors occurred more frequently than gaze errors overall (65.6%) , with a significantly higher proportion in trainees (P=0.0264). In the video validation, the CNN detected significantly more polyps than trainees and medical students, with per polyp sensitivities of 79.5%, 30.0% and 15.4% respectively. CONCLUSIONS: Cognitive errors were the most common reason for visual recognition errors. The impact of interventions such as artificial intelligence, particularly on different types of perceptual errors, needs further investigation including potential effects on learning curves. To facilitate future research, a publicly accessible visual perception colonoscopy polyp database was created

Catheter manipulation analysis for objective performance and technical skills assessment in transcatheter aortic valve implantation

Purpose Transcatheter aortic valve implantation (TAVI) demands precise and efficient handling of surgical instruments within the confines of the aortic anatomy. Operational performance and dexterous skills are critical for patient safety, and objective methods are assessed with a number of manipulation features, derived from the kinematic analysis of the catheter/guidewire in fluoroscopy video sequences. Methods A silicon phantom model of a type I aortic arch was used for this study. Twelve endovascular surgeons, divided into two experience groups, experts (n=6) and novices (n=6), performed cannulation of the aorta, representative of valve placement in TAVI. Each participant completed two TAVI experiments, one with conventional catheters and one with the Magellan robotic platform. Video sequences of the fluoroscopic monitor were recorded for procedural processing. A semi-automated tracking software provided the 2D coordinates of the catheter/guidewire tip. In addition, the aorta phantom was segmented in the videos and the shape of the entire catheter was manually annotated in a subset of the available video frames using crowdsourcing. The TAVI procedure was divided into two stages, and various metrics, representative of the catheter’s overall navigation as well as its relative movement to the vessel wall, were developed. Results Experts consistently exhibited lower values of procedure time and dimensionless jerk, and higher average speed and acceleration than novices. Robotic navigation resulted in increased average distance to the vessel wall in both groups, a surrogate measure of safety and reduced risk of embolisation. Discrimination of experience level and types of equipment was achieved with the generated motion features and established clustering algorithms. Conclusions Evaluation of surgical skills is possible through the analysis of the catheter/guidewire motion pattern. The use of robotic endovascular platforms seems to enable more precise and controlled catheter navigation

An accurate range-only tracking system using wireless sensor networks

This paper discusses the design of a real-time tracking system targeted for deployment in wireless sensor networks. The system, utilizes accumulated range data from a number of anchor sensor nodes to infer the position and other kinematic of a mobile target. To track manoeuvring targets three dynamic models are used. A particle filter inspired algorithm o the range measurements in real-time to produce an estimate of the target’s position and two-axis velocity. The evaluated through simulations that reveal its ability to accurately (RMSE <10m) track manoeuvring targets

On the trade-off of accuracy and computational complexity for classifying normal and abnormal ECG in remote CVD monitoring systems

Remote cardiovascular disease monitoring systems are characterised from a limited number of available leads and limited processing capabilities. In this paper, we investigate the trade-off between accuracy and computational complexity in order to derive the best strategy for classifying the ECG signal into normal or abnormal in such systems, with the spectral energy contained in the constituent waves of the ECG signal, as the primary feature for classification. Five established classifiers are considered and through exhaustive simulations the maximum accuracy is derived for each classifier. Based on 104 ECG records, we present a systematic analysis of the tradeoff between computational complexity and accuracy, which allow us to deduce the best classification strategy considering only a small number of available leads