Laparoscopic computer-navigated ablation of liver metastases

Objective In order to benefit from the obvious advantages of minimally invasive liver surgery there is a need to develop high precision tools for intraoperative anatomical orientation, navigation and safety control. In a pilot study we adapted a newly developed system for computer-assisted liver surgery (CALS) in terms of accuracy and technical feasibility to the specific requirements of laparoscopy. Here, we present practical aspects related to laparoscopic computer assisted liver surgery (LCALS). Methods Our video relates to a patient presenting with 3 colorectal liver metastases in Seg. II, III and IVa who was selected in an appropriate oncological setting for LCALS using the CAScination system combined with 3D MEVIS reconstruction. After minimal laparoscopic mobilization of the liver, a 4- landmark registration method was applied to enable navigation. Placement of microwave needles was performed using the targeting module of the navigation system and correct needle positioning was confirmed by intraoperative sonography. Ablation of each lesion was carried out by application of microwave energy at 100 Watts for 1 minute. Results To acquire an accurate (less 0.5 cm) registration, 4 registration cycles were necessary. In total, seven minutes were required to accomplish precise registration. Successful ablation with complete response in all treated areas was assessed by intraoperative sonography and confirmed by postoperative CT scan. Conclusions This teaching video demonstrates the theoretical and practical key points of LCALS with a special emphasis on preoperative planning, intraoperative registration and accuracy testing by laparoscopic methodology. In contrast to mere ultrasound-guided ablation of liver lesions, LCALS offers a more dimensional targeting and higher safety control. This is currently also in routine use to treat vanishing lesions and other difficult to target focal lesions within the liver.

Multiprofessional collaboration in teaching practices in all-day-schools in Switzerland

Multiprofessional collaboration in settings of extended education has been an important research topic in the past 40 years and has been discussed as a means to improve educational achievement, foster professional development, and support teachers in their everyday work. Several recent studies in multiprofessional settings found that collaboration practices often remain on a student-centered, time-limited, and superficial level of exchange, whereas higher forms of collaboration are very rare (Dizinger, Fussangel, Kasper, 2011). Furthermore there exists an obvious research gap on collaboration in Swiss all-day schools (Jutzi&Thomann, 2012). In this study we analyzed practices of multiprofessional collaboration in school-based and community-based extracurricular activities of all-day schools in Switzerland. The aim of this qualitative study of 10 all-day schools was to answer the following questions: (a) What forms of collaboration (informal/formal) are used between the different professionals? and (b) Are there different types of all-day schools with regard to distinctive and consistent types of collaboration? We conducted 18 problem-centered interviews (with the principals/heads of the all-day schools) and 10 focus group discussions (teams). In the process of data evaluation, we applied the method of qualitative content analysis. The results show that multiprofessional collabo ration is taking place in all of the all-day schools examined in the study. However, the collaborative practices differ in their level of intensity, design, and purpose.

Vision-based Proximity Detection in Retinal Surgery

In retinal surgery, surgeons face difficulties such as indirect visualization of surgical targets, physiological tremor, and lack of tactile feedback, which increase the risk of retinal damage caused by incorrect surgical gestures. In this context, intraocular proximity sensing has the potential to overcome current technical limitations and increase surgical safety. In this paper, we present a system for detecting unintentional collisions between surgical tools and the retina using the visual feedback provided by the opthalmic stereo microscope. Using stereo images, proximity between surgical tools and the retinal surface can be detected when their relative stereo disparity is small. For this purpose, we developed a system comprised of two modules. The first is a module for tracking the surgical tool position on both stereo images. The second is a disparity tracking module for estimating a stereo disparity map of the retinal surface. Both modules were specially tailored for coping with the challenging visualization conditions in retinal surgery. The potential clinical value of the proposed method is demonstrated by extensive testing using a silicon phantom eye and recorded rabbit in vivo data.

Computer-assisted virtual autopsy using surgical navigation techniques

UNLABELLED OBJECTIVE; Virtual autopsy methods, such as postmortem CT and MRI, are increasingly being used in forensic medicine. Forensic investigators with little to no training in diagnostic radiology and medical laypeople such as state's attorneys often find it difficult to understand the anatomic orientation of axial postmortem CT images. We present a computer-assisted system that permits postmortem CT datasets to be quickly and intuitively resliced in real time at the body to narrow the gap between radiologic imaging and autopsy. CONCLUSION Our system is a potentially valuable tool for planning autopsies, showing findings to medical laypeople, and teaching CT anatomy, thus further closing the gap between radiology and forensic pathology.

Computer Assisted Diagnosis and Treatment Planning of Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a dynamic conflict of the hip defined by a pathological, early abutment of the proximal femur onto the acetabulum or pelvis. In the past two decades, FAI has received increasing focus in both research and clinical practice as a cause of hip pain and prearthrotic deformity. Anatomical abnormalities such as an aspherical femoral head (cam-type FAI), a focal or general overgrowth of the acetabulum (pincer-type FAI), a high riding greater or lesser trochanter (extra-articular FAI), or abnormal torsion of the femur have been identified as underlying pathomorphologies. Open and arthroscopic treatment options are available to correct the deformity and to allow impingement-free range of motion. In routine practice, diagnosis and treatment planning of FAI is based on clinical examination and conventional imaging modalities such as standard radiography, magnetic resonance arthrography (MRA), and computed tomography (CT). Modern software tools allow three-dimensional analysis of the hip joint by extracting pelvic landmarks from two-dimensional antero-posterior pelvic radiographs. An object-oriented cross-platform program (Hip2Norm) has been developed and validated to standardize pelvic rotation and tilt on conventional AP pelvis radiographs. It has been shown that Hip2Norm is an accurate, consistent, reliable and reproducible tool for the correction of selected hip parameters on conventional radiographs. In contrast to conventional imaging modalities, which provide only static visualization, novel computer assisted tools have been developed to allow the dynamic analysis of FAI pathomechanics. In this context, a validated, CT-based software package (HipMotion) has been introduced. HipMotion is based on polygonal three-dimensional models of the patient’s pelvis and femur. The software includes simulation methods for range of motion, collision detection and accurate mapping of impingement areas. A preoperative treatment plan can be created by performing a virtual resection of any mapped impingement zones both on the femoral head-neck junction, as well as the acetabular rim using the same three-dimensional models. The following book chapter provides a summarized description of current computer-assisted tools for the diagnosis and treatment planning of FAI highlighting the possibility for both static and dynamic evaluation, reliability and reproducibility, and its applicability to routine clinical use.

The impact of a computer based adult literacy program on literacy and numeracy : evidence from India

With over 700 million illiterate adults in the world, many governments have implemented adult literacy programs across the world, although typically with low rates of success partly because the quality of teaching is low. One solution may lie in the standardization of teaching provided by computer-aided instruction. We present the first rigorous evidence of the effectiveness of a computer-based adult literacy program. A randomized control trial study of TARA Akshar Plus, an Indian adult literacy program, was implemented in the state of Uttar Pradesh in India. We find large, significant impacts of this computer-aided program on literacy and numeracy outcomes. We compare the improvement in learning to that of other traditional adult literacy programs and conclude that TARA Akshar Plus is effective in increasing literacy and numeracy for illiterate adult women.

Network convergence and QoS for future multimedia services in the VISION project

The emerging use of real-time 3D-based multimedia applications imposes strict quality of service (QoS) requirements on both access and core networks. These requirements and their impact to provide end-to-end 3D videoconferencing services have been studied within the Spanish-funded VISION project, where different scenarios were implemented showing an agile stereoscopic video call that might be offered to the general public in the near future. In view of the requirements, we designed an integrated access and core converged network architecture which provides the requested QoS to end-to-end IP sessions. Novel functional blocks are proposed to control core optical networks, the functionality of the standard ones is redefined, and the signaling improved to better meet the requirements of future multimedia services. An experimental test-bed to assess the feasibility of the solution was also deployed. In such test-bed, set-up and release of end-to-end sessions meeting specific QoS requirements are shown and the impact of QoS degradation in terms of the user perceived quality degradation is quantified. In addition, scalability results show that the proposed signaling architecture is able to cope with large number of requests introducing almost negligible delay.

Interactive Graphic Simulation: An Advanced Methodology to Improve the Teaching-Learning Process in Nuclear Engineering Education and Training

Nowadays, computer simulators are becoming basic tools for education and training in many engineering fields. In the nuclear industry, the role of simulation for training of operators of nuclear power plants is also recognized of the utmost relevance. As an example, the International Atomic Energy Agency sponsors the development of nuclear reactor simulators for education, and arranges the supply of such simulation programs. Aware of this, in 2008 Gas Natural Fenosa, a Spanish gas and electric utility that owns and operate nuclear power plants and promotes university education in the nuclear technology field, provided the Department of Nuclear Engineering of Universidad Politécnica de Madrid with the Interactive Graphic Simulator (IGS) of “José Cabrera” (Zorita) nuclear power plant, an industrial facility whose commercial operation ceased definitively in April 2006. It is a state-of-the-art full-scope real-time simulator that was used for training and qualification of the operators of the plant control room, as well as to understand and analyses the plant dynamics, and to develop, qualify and validate its emergency operating procedures.

Teamwork competence and academic motivation in computer science engineering studies.

The present work is focused on studying two issues: the “teamwork” generic competence and the “academic motivation”. Currently the professional profile of engineers has a strong component of teamwork. On the other hand, motivational profile of students determines their tendencies when they come to work in team, as well as their performance at work. In this context we suggest four hypotheses: (H1) students improve their teamwork capacity by specific training and carrying out a set of activities integrated into an active learning process; (H2) students with higher mastery motivation have better attitude towards team working; (H3) students with higher mastery motivation obtain better results in academic performance; and (H4) students show different motivation profiles in different circumstances: type of courses, teaching methodologies, different times of the learning process. This study was carried out with computer science engineering students from two Spanish universities. The first results point to an improvement in teamwork competence of students if they have previously received specific training in facets of that competence. Other results indicate that there is a correlation between the motivational profiles of students and their perception about teamwork competence. Finally, and contrary to the initial hypothesis, these profiles appear to not influence significantly the academic performance of students.

Teamwork, motivational profiles and academic performance in computer science engineering

The present work is aimed at discussing several issues related to the teamwork generic competence, motivational profiles and academic performance. In particular, we study the improvement of teamwork attitude, the predominant types of motivation in different contexts and some correlations among these three components of the learning process. The above-mentioned aspects are of great importance. Currently, the professional profile of engineers has a strong teamwork component and the motivational profile of students determines both their tendencies when they come to work as part of a team, as well as their performance at work. Taking these issues into consideration, we suggest four hypotheses: (H1) students improve their teamwork capacity through specific training and carrying out of a set of activities integrated into an active learning process; (H2) students with higher mastery motivation have a better attitude towards teamwork; (H3) students with different types of motivations reach different levels of academic performance; and (H4) students show different motivation profiles in different circumstances: type of courses, teaching methodologies, different times of the learning process. This study was carried out with Computer Science Engineering students from two Spanish universities. The first results point to an improvement in teamwork competence of students if they have previously received specific training in facets of that competence. Other results indicate that there is a correlation between the motivational profiles of students and their perception of teamwork competence. Finally, results point to a clear relationship between some kind of motivation and academic performance. In particular, four kinds of motivation are analyzed and students are classified into two groups according to them. After analyzing several marks obtained in compulsory courses, we perceive that those students that show higher motivation for avoiding failure obtain, in general, worse academic performance.

Evaluating new interaction paradigms in SEN teaching: defining the experiment

New devices have made their way into everyday life in recent years, opening the doors to new ways of interacting with computers, providing different, and potentially better, solutions to some problems. But this raises the question of if there is any way of measuring whether or not these new devices are suitable. This paper presents a strategy for evaluating the suitability of new interaction devices in the context of teaching children with special educational needs

Managing daily surgery schedules in a teaching hospital: a mixed-integer optimization approach

Background: This study examined the daily surgical scheduling problem in a teaching hospital. This problem relates to the use of multiple operating rooms and different types of surgeons in a typical surgical day with deterministic operation durations (preincision, incision, and postincision times). Teaching hospitals play a key role in the health-care system; however, existing models assume that the duration of surgery is independent of the surgeon's skills. This problem has not been properly addressed in other studies. We analyze the case of a Spanish public hospital, in which continuous pressures and budgeting reductions entail the more efficient use of resources. Methods: To obtain an optimal solution for this problem, we developed a mixed-integer programming model and user-friendly interface that facilitate the scheduling of planned operations for the following surgical day. We also implemented a simulation model to assist the evaluation of different dispatching policies for surgeries and surgeons. The typical aspects we took into account were the type of surgeon, potential overtime, idling time of surgeons, and the use of operating rooms. Results: It is necessary to consider the expertise of a given surgeon when formulating a schedule: such skill can decrease the probability of delays that could affect subsequent surgeries or cause cancellation of the final surgery. We obtained optimal solutions for a set of given instances, which we obtained through surgical information related to acceptable times collected from a Spanish public hospital. Conclusions: We developed a computer-aided framework with a user-friendly interface for use by a surgical manager that presents a 3-D simulation of the problem. Additionally, we obtained an efficient formulation for this complex problem. However, the spread of this kind of operation research in Spanish public health hospitals will take a long time since there is a lack of knowledge of the beneficial techniques and possibilities that operational research can offer for the health-care system.

Context modelling for natural Human Computer Interaction applications in e-health

The conception of IoT (Internet of Things) is accepted as the future tendency of Internet among academia and industry. It will enable people and things to be connected at anytime and anyplace, with anything and anyone. IoT has been proposed to be applied into many areas such as Healthcare, Transportation，Logistics, and Smart environment etc. However, this thesis emphasizes on the home healthcare area as it is the potential healthcare model to solve many problems such as the limited medical resources, the increasing demands for healthcare from elderly and chronic patients which the traditional model is not capable of. A remarkable change in IoT in semantic oriented vision is that vast sensors or devices are involved which could generate enormous data. Methods to manage the data including acquiring, interpreting, processing and storing data need to be implemented. Apart from this, other abilities that IoT is not capable of are concluded, namely, interoperation, context awareness and security & privacy. Context awareness is an emerging technology to manage and take advantage of context to enable any type of system to provide personalized services. The aim of this thesis is to explore ways to facilitate context awareness in IoT. In order to realize this objective, a preliminary research is carried out in this thesis. The most basic premise to realize context awareness is to collect, model, understand, reason and make use of context. A complete literature review for the existing context modelling and context reasoning techniques is conducted. The conclusion is that the ontology-based context modelling and ontology-based context reasoning are the most promising and efficient techniques to manage context. In order to fuse ontology into IoT, a specific ontology-based context awareness framework is proposed for IoT applications. In general, the framework is composed of eight components which are hardware, UI (User Interface), Context modelling, Context fusion, Context reasoning, Context repository, Security unit and Context dissemination. Moreover, on the basis of TOVE (Toronto Virtual Enterprise), a formal ontology developing methodology is proposed and illustrated which consists of four stages: Specification & Conceptualization, Competency Formulation, Implementation and Validation & Documentation. In addition, a home healthcare scenario is elaborated by listing its well-defined functionalities. Aiming at representing this specific scenario, the proposed ontology developing methodology is applied and the ontology-based model is developed in a free and open-source ontology editor called Protégé. Finally, the accuracy and completeness of the proposed ontology are validated to show that this proposed ontology is able to accurately represent the scenario of interest.

Educational Project for the Teaching of Control of Electric Traction Drives

Electric vehicles constitute a multidisciplinary subject that involves disciplines such as automotive, mechanical, electrical and control engineering. Due to this multidisciplinary technical nature, practical teaching methodologies are of special relevance. Paradoxically, in the past, the training of engineers specializing in this area has lacked the practical component represented by field tests, due to the difficulty of accessing real systems. This paper presents an educational project specifically designed for the teaching and training of engineering students with different backgrounds and experience. The teaching methodology focuses on the topology of electric traction drives and their control. It includes two stages, a simulation computer model and a scaled laboratory workbench that comprises a traction electrical drive coupled to a vehicle emulator. With this equipment, the effectiveness of different traction control strategies can be analyzed from the point of view of energy efficiency, robustness, easiness of implementation and acoustic noise.