Clustering Methods for Vibro-Acoustic Sensing Features as a Potential Approach to Tissue Characterisation in Robot-Assisted Interventions.

This article provides a comprehensive analysis of the feature extraction methods applied to vibro-acoustic signals (VA signals) in the context of robot-assisted interventions. The primary objective is to extract valuable information from these signals to understand tissue behaviour better and build upon prior research. This study is divided into three key stages: feature extraction using the Cepstrum Transform (CT), Mel-Frequency Cepstral Coefficients (MFCCs), and Fast Chirplet Transform (FCT); dimensionality reduction employing techniques such as Principal Component Analysis (PCA), t-Distributed Stochastic Neighbour Embedding (t-SNE), and Uniform Manifold Approximation and Projection (UMAP); and, finally, classification using a nearest neighbours classifier. The results demonstrate that using feature extraction techniques, especially the combination of CT and MFCC with dimensionality reduction algorithms, yields highly efficient outcomes. The classification metrics (Accuracy, Recall, and F1-score) approach 99%, and the clustering metric is 0.61. The performance of the CT-UMAP combination stands out in the evaluation metrics.

Dataset for polyphonic sound event detection tasks in urban soundscapes: The synthetic polyphonic ambient sound source (SPASS) dataset.

This paper presents the Synthetic Polyphonic Ambient Sound Source (SPASS) dataset, a publicly available synthetic polyphonic audio dataset. SPASS was designed to train deep neural networks effectively for polyphonic sound event detection (PSED) in urban soundscapes. SPASS contains synthetic recordings from five virtual environments: park, square, street, market, and waterfront. The data collection process consisted of the curation of different monophonic sound sources following a hierarchical class taxonomy, the configuration of the virtual environments with the RAVEN software library, the generation of all stimuli, and the processing of this data to create synthetic recordings of polyphonic sound events with their associated metadata. The dataset contains 5000 audio clips per environment, i.e., 25,000 stimuli of 10 s each, virtually recorded at a sampling rate of 44.1 kHz. This effort is part of the project ``Integrated System for the Analysis of Environmental Sound Sources: FuSA System'' in the city of Valdivia, Chile, which aims to develop a system for detecting and classifying environmental sound sources through deep Artificial Neural Network (ANN) models.

Vibro-Acoustic Sensing of Instrument Interactions as a Potential Source of Texture-Related Information in Robotic Palpation.

The direct tactile assessment of surface textures during palpation is an essential component of open surgery that is impeded in minimally invasive and robot-assisted surgery. When indirectly palpating with a surgical instrument, the structural vibrations from this interaction contain tactile information that can be extracted and analysed. This study investigates the influence of the parameters contact angle α and velocity v→ on the vibro-acoustic signals from this indirect palpation. A 7-DOF robotic arm, a standard surgical instrument, and a vibration measurement system were used to palpate three different materials with varying α and v→. The signals were processed based on continuous wavelet transformation. They showed material-specific signatures in the time-frequency domain that retained their general characteristic for varying α and v→. Energy-related and statistical features were extracted, and supervised classification was performed, where the testing data comprised only signals acquired with different palpation parameters than for training data. The classifiers support vector machine and k-nearest neighbours provided 99.67% and 96.00% accuracy for the differentiation of the materials. The results indicate the robustness of the features against variations in the palpation parameters. This is a prerequisite for an application in minimally invasive surgery but needs to be confirmed in realistic experiments with biological tissues.

Aumento de egresos hospitalarios por enfermedad diverticular a nivel nacional en el período 2003-2013 / Increase in hospital discharges due to diverticular disease at the national level in the period 2003-2013

Resumen Introducción: La enfermedad diverticular (ED) es una patología prevalente. Su incidencia ha aumentado, sin embargo, no se cuenta con publicaciones nacionales al respecto. Objetivo: Realizar un análisis de los egresos hospitalarios, edad de presentación, cirugías y letalidad por ED a nivel nacional entre el año 2003 y 2013. Materiales y Método: Se diseñó un estudio en base a datos publicados por la dirección y estadística e información de salud (DEIS) de Chile, entre los años 2003 y 2013. Se calcularon tasas de egreso hospitalarios por año, tasa de ED ajustada por sexo, tasas de intervención quirúrgica y letalidad. Resultados: El total de egresos hospitalarios presentó un alza desde 2.023 hasta 4.172 casos. La tasa de egresos por ED, en el total de la población, presentó un alza de 20 a 33 pacientes por cada 100.000 habitantes. La tasa de egresos hospitalarios presentó un alza de 173 hasta 327 pacientes por cada 100.000 egresos. La edad de presentación disminuyó de 62 a 58 años promedio. En cuanto a las cirugías, disminuyeron de 25% a 17%. La letalidad, es mayor sobre los 60 años y en el subgrupo que requiere cirugía. Discusión: Los resultados concuerdan con la literatura, se presenta un alza de hospitalizaciones, menor edad, menor requerimientos quirúrgicos y mayor letalidad en grupos etarios más avanzados. Conclusión: La enfermedad diverticular es una patología en aumento, desde el punto de vista hospitalario esto se hace evidente ante el crecimiento sostenido de egresos en el período estudiado.

Introduction: Diverticular disease (DD) is a prevalent pathology with multiple clinical manifestations. Its worldwide incidence has increased, however, there are no national publications in this regard. Aim: The objective of this study is to carry out an analysis of hospital discharges, age of presentation, surgeries and fatality due to DD from national data collected between 2003 and 2013. Materials and Method: A study was designed based on data from the management website and statistics and health information (DEIS) for Chile between 2003 and 2013. Hospital discharge rates per year, DD rate adjusted for sex, rates of surgical intervention and fatality were calculated. Results: The total of hospital discharges showed an increase from 2.023 to 4.172 cases. The discharge rate for DD in the total population increased from 20 to 33 patients per 100.000 inhabitants. The hospital discharge rate increased from 173 to 327 patients per 100.000 discharges. The age of presentation decreased from an average 62 to 58 years. Regarding surgeries, they decreased from 25% to 17%. Regarding mortality, it is higher over 60 years and in the surgical versus non-surgical subgroup. Discussion: These results are consistent with the literature; there is an increase in hospitalizations, lower age, lower surgical requirements and higher mortality in more advanced age groups. Conclusión: Diverticular disease is an increasing disease in the inpatient setting over the 10-year period studied.

Síndrome de Hemivagina Obstruida, Útero Didelfo y Agenesia Renal Ipsilateral (OVHIRA), Drenado Parcialmente por Fístula Útero-Uterina Espontánea / Obstructed Hemivagina Syndrome, Uterus didelphys and Ipsilateral Renal Agenesis (OVHIRA), Partially Drained by Spontaneous Uterine-Uterine Fistula

RESUMEN Antecedentes: El síndrome de hemivagina obstruida, útero didlefo y anomalía renal ipsilateral (OVHIRA) es una malformación mülleriana infrecuente. Objetivo: Se presenta un caso con una complicación no antes descrita y se hace una revisión de la literatura hasta la fecha. Caso clínico: Mujer de 12 años de edad con antecedentes de diagnóstico de útero bicorne y agenesia renal derecha en la infancia. Veintidós meses post menarquia consulta por algia pelviana y dismenorrea premenstrual. Ecografía revela hematómetra en cuerpo uterino izquierdo, de 142 x 69 x 61 mm. Resonancia nuclear magnética (RNM) describe además un hematocolpos de 7 x 10 cm y un tabique vaginal transverso de hemivagina izquierda. Se diagnostica OHVIRA y se planifica cirugía para resecar el tabique. Días antes del la cirugía, la paciente tiene episodio de metrorragia. Ecográficamente se constata una disminución considerable del volumen de hematómetra. En la cirugía se pesquisa fístula uterina que comunica útero obstruido izquierdo con útero no obstruido derecho por donde había drenado espontáneamente la hematómetra. Al resecar el tabique vaginal izquierdo se termina de drenar hematómetra y hematocolpos. Al alta, paciente se maneja con dilatación vaginal progresiva por seis meses para evitar la estenosis del tabique. Conclusión: Se presenta una complicación no descrita, fístula útero uterina, de una malformación mülleriana infrecuente (OVHIRA). El proceso diagnóstico meticuloso, la cirugía bien planificada y la dilatación vaginal prolongada permitieron tener éxito en su manejo.

ABSTRACT Background: Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome (OHVIRA) is an uncommon Müllerian anomaly. Objective: A case is described and the main complications related to the syndrome are reviewed. Case report: Female, 12 years old, with a medical history of a bicornuate uterus and right renal agenesis diagnosed at birth. Twenty-two months post menarche she seeks medical attention due to pelvic pain, menometrorrhagia and premenstrual dysmenorrhea. An ultrasound revealed a hematometra, of 142 x 69 x 61 mm, in the left uterus. Magnetic resonance imaging also described a 7 x 10 cm hematocolpos and a transverse vaginal septum of the left hemivagina. OHVIRA is diagnosed and surgery is planned to resect the septum. Two days before the surgery, the patient has an episode of abundant metrorrhagia. Ultrasonographically a considerable decrease in the volume of the hematometra is observed. In surgery, a uterine fistula is discovered which communicates the left obstructed uterus with the right unobstructed uterus, where the hematometra had been partially drained. During the procedure, the left vaginal septum is resected, which completes the drainage of the hematometra and hematocolpos. At discharge, the patient undergoes progressive vaginal dilation for six months to avoid stenosis of the septum. Conclusion: An utero-uterine fistula has not been previously described as a complication of OHVIRA. The meticulous diagnostic process, the well planned surgery and the prolonged vaginal dilation allowed for a successful management.

Planificación Estratégica en Tecnologías de la Información en Sanidad / No disponible

Los desafíos actuales que han de afrontar los Sistemas Sanitarios marcan como objetivos, entre otros, la eficiencia en el uso de los recursos, la eficacia y efectividad en las prestaciones, el análisis de los resultados, el desarrollo profesional, la madurez organizacional, la calidad en la atención y seguridad del paciente. Tales objetivos se apoyan mayoritariamente sobre una base tecnológica para la gestión operativa en los centros e instituciones sanitarias. En este artículo se describe brevemente la importancia de una Planificación Estratégica de las Tecnologías y Sistemas de Información que acompañe a los objetivos macros del sistema sanitario y asegure la mejor inversión en estas tecnologías. Se describen, finalmente las fases de la planificación, la secuencia de las mismas y la importancia de contar con una Oficina de Gestión de Proyectos que garantice la consecución de los objetivos estratégicos y la gestión efectiva de los proyectos emanados del plan (AU)

No disponible