The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Dov Dori - One of the best experts on this subject based on the ideXlab platform.
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model based system specification with tesperanto readable text from formal graphics
Systems Man and Cybernetics, 2015Co-Authors: Alex Blekhman, Juan P Wachs, Dov DoriAbstract:Technical reports and papers may be represented by a fundamental model, which can take the form of a block diagram, a state-machine, a flow diagram, or alternatively some ad hoc chart. This basic scheme can convey better the true value of otherwise verbose and potentially encumbered narrative-based specifications. We present a model-based methodology for authoring technical documents. The underlying idea is to first formalize the system to be specified using a conceptual model, and then automatically generate from the tested and verified model a humanly-readable text in a subset of English we call Tesperanto. This technical documents’ authoring methodology is carried out in an integrated bimodal text-graphics document authoring environment. The methodology was evaluated with the International Organization for Standardization standards and a medical robotics case study. The evaluation resulted in tangible improvements in the quality and consistency of international standards. Further, it can serve to document complex dynamics among agents, such as interaction between an Operation Room technician robot and the surgeon, suggesting that it could be applied to represent and bring value to other types of technical documents.
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Operation Room tool handling and miscommunication scenarios an object process methodology conceptual model
Artificial Intelligence in Medicine, 2014Co-Authors: Juan P Wachs, Boaz Frenkel, Dov DoriAbstract:Abstract Objective Errors in the delivery of medical care are the principal cause of inpatient mortality and morbidity, accounting for around 98,000 deaths in the United States of America (USA) annually. Ineffective team communication, especially in the Operation Room (OR), is a major root of these errors. This miscommunication can be reduced by analyzing and constructing a conceptual model of communication and miscommunication in the OR. We introduce the principles underlying Object-Process Methodology (OPM)-based modeling of the intricate interactions between the surgeon and the surgical technician while handling surgical instruments in the OR. This model is a software- and hardware-independent description of the agents engaged in communication events, their physical activities, and their interactions. The model enables assessing whether the task-related objectives of the surgical procedure were achieved and completed successfully and what errors can occur during the communication. Methods and material The facts used to construct the model were gathered from observations of various types of Operations miscommunications in the operating Room and its outcomes. The model takes advantage of the compact ontology of OPM, which is comprised of stateful objects – things that exist physically or informatically, and processes – things that transform objects by creating them, consuming them or changing their state. The modeled communication modalities are verbal and non-verbal, and errors are modeled as processes that deviate from the “sunny day” scenario. Using OPM refinement mechanism of in-zooming, key processes are drilled into and elaborated, along with the objects that are required as agents or instruments, or objects that these processes transform. The model was developed through an iterative process of observation, modeling, group discussions, and simplification. Results The model faithfully represents the processes related to tool handling that take place in an OR during an Operation. The specification is at various levels of detail, each level is depicted in a separate diagram, and all the diagrams are “aware” of each other as part of the whole model. Providing ontology of verbal and non-verbal modalities of communication in the OR, the resulting conceptual model is a solid basis for analyzing and understanding the source of the large variety of errors occurring in the course of an Operation, providing an opportunity to decrease the quantity and severity of mistakes related to the use and misuse of surgical instrumentations. Since the model is event driven, rather than person driven, the focus is on the factors causing the errors, rather than the specific person. This approach advocates searching for technological solutions to alleviate tool-related errors rather than finger-pointing. Concretely, the model was validated through a structured questionnaire and it was found that surgeons agreed that the conceptual model was flexible (3.8 of 5, std = 0.69), accurate, and it generalizable (3.7 of 5, std = 0.37 and 3.7 of 5, std = 0.85, respectively). Conclusion The detailed conceptual model of the tools handling subsystem of the Operation performed in an OR focuses on the details of the communication and the interactions taking place between the surgeon and the surgical technician during an Operation, with the objective of pinpointing the exact circumstances in which errors can happen. Exact and concise specification of the communication events in general and the surgical instrument requests in particular is a prerequisite for a methodical analysis of the various modes of errors and the circumstances under which they occur. This has significant potential value in both reduction in tool-handling-related errors during an Operation and providing a solid formal basis for designing a cybernetic agent which can replace a surgical technician in routine tool handling activities during an Operation, freeing the technician to focus on quality assurance, monitoring and control of the cybernetic agent activities. This is a critical step in designing the next generation of cybernetic OR assistants.
Juan P Wachs - One of the best experts on this subject based on the ideXlab platform.
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model based system specification with tesperanto readable text from formal graphics
Systems Man and Cybernetics, 2015Co-Authors: Alex Blekhman, Juan P Wachs, Dov DoriAbstract:Technical reports and papers may be represented by a fundamental model, which can take the form of a block diagram, a state-machine, a flow diagram, or alternatively some ad hoc chart. This basic scheme can convey better the true value of otherwise verbose and potentially encumbered narrative-based specifications. We present a model-based methodology for authoring technical documents. The underlying idea is to first formalize the system to be specified using a conceptual model, and then automatically generate from the tested and verified model a humanly-readable text in a subset of English we call Tesperanto. This technical documents’ authoring methodology is carried out in an integrated bimodal text-graphics document authoring environment. The methodology was evaluated with the International Organization for Standardization standards and a medical robotics case study. The evaluation resulted in tangible improvements in the quality and consistency of international standards. Further, it can serve to document complex dynamics among agents, such as interaction between an Operation Room technician robot and the surgeon, suggesting that it could be applied to represent and bring value to other types of technical documents.
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Operation Room tool handling and miscommunication scenarios an object process methodology conceptual model
Artificial Intelligence in Medicine, 2014Co-Authors: Juan P Wachs, Boaz Frenkel, Dov DoriAbstract:Abstract Objective Errors in the delivery of medical care are the principal cause of inpatient mortality and morbidity, accounting for around 98,000 deaths in the United States of America (USA) annually. Ineffective team communication, especially in the Operation Room (OR), is a major root of these errors. This miscommunication can be reduced by analyzing and constructing a conceptual model of communication and miscommunication in the OR. We introduce the principles underlying Object-Process Methodology (OPM)-based modeling of the intricate interactions between the surgeon and the surgical technician while handling surgical instruments in the OR. This model is a software- and hardware-independent description of the agents engaged in communication events, their physical activities, and their interactions. The model enables assessing whether the task-related objectives of the surgical procedure were achieved and completed successfully and what errors can occur during the communication. Methods and material The facts used to construct the model were gathered from observations of various types of Operations miscommunications in the operating Room and its outcomes. The model takes advantage of the compact ontology of OPM, which is comprised of stateful objects – things that exist physically or informatically, and processes – things that transform objects by creating them, consuming them or changing their state. The modeled communication modalities are verbal and non-verbal, and errors are modeled as processes that deviate from the “sunny day” scenario. Using OPM refinement mechanism of in-zooming, key processes are drilled into and elaborated, along with the objects that are required as agents or instruments, or objects that these processes transform. The model was developed through an iterative process of observation, modeling, group discussions, and simplification. Results The model faithfully represents the processes related to tool handling that take place in an OR during an Operation. The specification is at various levels of detail, each level is depicted in a separate diagram, and all the diagrams are “aware” of each other as part of the whole model. Providing ontology of verbal and non-verbal modalities of communication in the OR, the resulting conceptual model is a solid basis for analyzing and understanding the source of the large variety of errors occurring in the course of an Operation, providing an opportunity to decrease the quantity and severity of mistakes related to the use and misuse of surgical instrumentations. Since the model is event driven, rather than person driven, the focus is on the factors causing the errors, rather than the specific person. This approach advocates searching for technological solutions to alleviate tool-related errors rather than finger-pointing. Concretely, the model was validated through a structured questionnaire and it was found that surgeons agreed that the conceptual model was flexible (3.8 of 5, std = 0.69), accurate, and it generalizable (3.7 of 5, std = 0.37 and 3.7 of 5, std = 0.85, respectively). Conclusion The detailed conceptual model of the tools handling subsystem of the Operation performed in an OR focuses on the details of the communication and the interactions taking place between the surgeon and the surgical technician during an Operation, with the objective of pinpointing the exact circumstances in which errors can happen. Exact and concise specification of the communication events in general and the surgical instrument requests in particular is a prerequisite for a methodical analysis of the various modes of errors and the circumstances under which they occur. This has significant potential value in both reduction in tool-handling-related errors during an Operation and providing a solid formal basis for designing a cybernetic agent which can replace a surgical technician in routine tool handling activities during an Operation, freeing the technician to focus on quality assurance, monitoring and control of the cybernetic agent activities. This is a critical step in designing the next generation of cybernetic OR assistants.
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a gesture based tool for sterile browsing of radiology images
Journal of the American Medical Informatics Association, 2008Co-Authors: Juan P Wachs, Helman Stern, Yael Edan, Michael Gillam, Jonathan A Handler, Craig Feied, Mark S SmithAbstract:The use of doctor-computer interaction devices in the Operation Room (OR) requires new modalities that support medical imaging manipulation while allowing doctors' hands to remain sterile, supporting their focus of attention, and providing fast response times. This paper presents "Gestix," a vision-based hand gesture capture and recognition system that interprets in real-time the user's gestures for navigation and manipulation of images in an electronic medical record (EMR) database. Navigation and other gestures are translated to commands based on their temporal trajectories, through video capture. "Gestix" was tested during a brain biopsy procedure. In the in vivo experiment, this interface prevented the surgeon's focus shift and change of location while achieving a rapid intuitive reaction and easy interaction. Data from two usability tests provide insights and implications regarding human-computer interaction based on nonverbal conversational modalities.
Hugo Sax - One of the best experts on this subject based on the ideXlab platform.
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operating Room technician trainees teach medical students an inter professional peer teaching approach for infection prevention strategies in the Operation Room
Antimicrobial Resistance and Infection Control, 2019Co-Authors: Jan Breckwoldt, Monika Knecht, Ralph Massee, Barbara Flach, Caroline Hofmannhuber, Sylvia Kaapfrohlich, Claudia M Witt, Ruth Aeberhard, Hugo SaxAbstract:Education is a cornerstone strategy to prevent health-associated infections. Trainings benefit from being interactive, simulation-based, team-orientated, and early in professional socialization. We conceived an innovative inter-professional peer-teaching module with operating Room technician trainees (ORTT) teaching infection prevention behavior in the operating Room (OR) to medical students (MDS). ORTT delivered a 2-h teaching module to small groups of MDS in a simulated OR setting with 4 posts: ‘entering OR’; ‘surgical hand disinfection’; ‘dressing up for surgery and preparing a surgical field’, ‘debriefing’. MDS and ORTT evaluated module features and teaching quality through 2 specific questionnaires. Structured field notes by education specialist observers were analyzed thematically. On Likert scales from − 2 to + 2, mean overall satisfaction was + 1.91 (±0.3) for MDS and + 1.66 (±0.6 SD) for ORTT while teaching quality was rated + 1.89 (±0.3) by MDS and self-rated with + 1.34 (±0.5) by ORTT. Students and observers highlighted that the training fostered mutual understanding and provided insight into the corresponding profession. Undergraduate inter-professional teaching among ORTT and MDS in infection prevention and control proved feasible with high educational quality. Inducing early mutual understanding between professional groups might improve professional collaboration and patient safety.
Jan Breckwoldt - One of the best experts on this subject based on the ideXlab platform.
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operating Room technician trainees teach medical students an inter professional peer teaching approach for infection prevention strategies in the Operation Room
Antimicrobial Resistance and Infection Control, 2019Co-Authors: Jan Breckwoldt, Monika Knecht, Ralph Massee, Barbara Flach, Caroline Hofmannhuber, Sylvia Kaapfrohlich, Claudia M Witt, Ruth Aeberhard, Hugo SaxAbstract:Education is a cornerstone strategy to prevent health-associated infections. Trainings benefit from being interactive, simulation-based, team-orientated, and early in professional socialization. We conceived an innovative inter-professional peer-teaching module with operating Room technician trainees (ORTT) teaching infection prevention behavior in the operating Room (OR) to medical students (MDS). ORTT delivered a 2-h teaching module to small groups of MDS in a simulated OR setting with 4 posts: ‘entering OR’; ‘surgical hand disinfection’; ‘dressing up for surgery and preparing a surgical field’, ‘debriefing’. MDS and ORTT evaluated module features and teaching quality through 2 specific questionnaires. Structured field notes by education specialist observers were analyzed thematically. On Likert scales from − 2 to + 2, mean overall satisfaction was + 1.91 (±0.3) for MDS and + 1.66 (±0.6 SD) for ORTT while teaching quality was rated + 1.89 (±0.3) by MDS and self-rated with + 1.34 (±0.5) by ORTT. Students and observers highlighted that the training fostered mutual understanding and provided insight into the corresponding profession. Undergraduate inter-professional teaching among ORTT and MDS in infection prevention and control proved feasible with high educational quality. Inducing early mutual understanding between professional groups might improve professional collaboration and patient safety.
H Feussner - One of the best experts on this subject based on the ideXlab platform.
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real time monitoring for detection of retained surgical sponges and team motion in the surgical Operation Room using radio frequency identification rfid technology a preclinical evaluation
Journal of Surgical Research, 2012Co-Authors: Michael Kranzfelder, Dorit Zywitza, Thomas Jell, Armin Schneider, Sonja Gillen, Helmut Friess, H FeussnerAbstract:Background Technical progress in the surgical operating Room (OR) increases constantly, facilitating the development of intelligent OR systems functioning as “safety backup” in the background of surgery. Precondition is comprehensive data retrieval to identify imminent risky situations and inaugurate adequate security mechanisms. Radio-frequency-identification (RFID) technology may have the potential to meet these demands. Methods We set up a pilot study investigating feasibility and appliance reliability of a stationary RFID system for real-time surgical sponge monitoring (passive tagged sponges, position monitoring: mayo-stand/abdominal situs/waste bucket) and OR team tracking (active transponders, position monitoring: right/left side of OR table). Results In vitro : 20/20 sponges (100%) were detected on the mayo-stand and within the OR-phantom, however, real-time detection accuracy declined to 7/20 (33%) when the tags were moved simultaneously. All retained sponges were detected correctly. In vivo (animal): 7–10/10 sterilized sponges (70%–100%) were detected correctly within the abdominal cavity. OR-team: detection accuracy within the OR (surveillance antenna) and on both sides of the OR table (sector antenna) was 100%. Mean detection time for position change (left to right side and contrariwise) was 30–60 s. No transponder failure was noted. Conclusion This is the first combined RFID system that has been developed for stationary use in the surgical OR. Preclinical evaluation revealed a reliable sponge tracking and correct detection of retained textiles (passive RFID) but also demonstrated feasibility of comprehensive data acquisition of team motion (active RFID). However, detection accuracy needs to be further improved before implementation into the surgical OR.