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The purpose of this paper is to provide a framework for analysing and modelling detailed workflow of image‐guided interventions to facilitate simulation and the re‐engineering process for the development of new procedures in multi‐modal imaging environments.

The methodology presented includes a literature review on workflow simulation in surgery, focussing on radiology environments, an assessment of simulation tools, a data gathering and management framework and research on methods for conceptual modelling of the processes.

The literature review reveals that few authors attempted to analyse the phases within image‐guided interventions, and those that did, only did so partially. The framework developed for this work intends to fill the gap found in the survey. It allows the maintenance and management of large amounts of data, one of the most critical factors when modelling detailed workflow. In addition, selecting the appropriate simulation software plays an important role, saving time in later stages of the project.

The framework presented for endovascular interventions can be extended to other types of image‐guided interventions. Moreover, modelling the workflow processes in a modular way facilitates the re‐engineering process when integrating different imaging modalities during the same procedure.

This paper aims to summarize the radiological interventions that can be used by obstetricians and gynecologists.

E-health systems apply in all hospital sectors in the world; interventional radiology (IR) now includes transcatheter and percutaneous techniques that can be applied to various organ systems, including the female reproductive system and pelvis. Interventional radiologists can now offer many services to obstetricians and gynecologists. With the advent of new procedures and refinement of existing techniques, there are now a number of procedures that can be used to treat both vascular and non-vascular diseases. This review summarizes the radiological interventions that can be used by obstetricians and gynecologists.

This review is intended to help gynecologists and obstetricians understand the role of IR in their specialty. Many valuable vascular and nonvascular interventional services can be provided by radiologists for both obstetric and gynecological indications. Many of these IR procedures are minimally invasive with less risk to the patients.

IR is now being used to treat some conditions encountered in obstetrics and gynecology, in particular, uterine leiomyomas, placenta accreta, postpartum hemorrhage and pelvic congestion syndrome. Moreover, with the help of IR, radiologists can also manage several nonvascular pathologies, including drainage of pelvic abscesses, fallopian tube recanalization, image-guided biopsy and fluid collections involving ovarian lesions. The major challenges faced when performing obstetric IR procedures are reduction of radiation exposure for the patient and fetus and preservation of fertility. This review highlights the role of IR in the treatment of various vascular and nonvascular pathologies encountered in obstetrics and gynecology.

The purpose of this paper is to highlight the relation between radiology and sustainable development with emphasis on the UK and European countries, and to spotlight its possible application in the developing countries.

This is a review paper where data about sustainable development and radiology are collected from selected journals, websites, articles and conferences, e.g. Royal College of Radiology, European Society of Radiology, World Health Organization and other different radiology societies.

Adoption of sustainable diagnostic radiology by many countries in Europe and the UK helps to provide imaging services efficiently and effectively, with simultaneous preservation of the natural resources, patient health and environment much better than before. The developing and underdeveloped countries should follow this knowledge hoping to reach the same goals.

Limiting the use of radiologic examinations, guide the clinicians to use clinical skills before rushing to radiology examinations will save money, preserve equipment and protect patients from possible radiation hazards. The use of teleradiology will indirectly reduce global warming, and will deliver medical services to poor countries.

Improving the health of people of poor countries will improve their socioeconomic level.

This paper focuses on the value of applying sustainable development in radiology not only in general medicine.

The purpose of this paper is to develop the case for studying non-interaction in networks, particularly instances of intentional avoidance of interaction.

The paper is based on the analysis of instances of interaction avoidance across four case studies in medical technology development, food product development, food distribution network change, and regional innovation in construction.

Some answers are provided to the questions of why and how actors may seek to avoid interaction. Five modes of interaction avoidance are identified and outlined. Within these modes, interaction avoidance took place in order to protect knowledge, enforce progress, economise in business networks, avoid wasting resources, and maintain opportunities respectively. This list is not seen to be exhaustive of the theme, and further studies are encouraged.

Few inter-organisational network studies have dealt explicitly with interaction avoidance or non-interaction.

Intelligent pneumatic actuator (IPA) is a new generation of actuator developed for Research and Development (R&D) purposes in the academic and industrial fields. The purpose of this paper is to show the application of optical encoder and pressure sensor in IPA, to develop a real-time model similar to the existing devices, and to assess the position control performance using a proportional-integrative (PI) controller and a bang-bang controller in real-time.

A micro optical encoder chip is used to detect cylinder rod position by reading constructed laser stripes on a guide rod, whereas a pressure sensor is used to detect the chamber pressure reading. To control the cylinder movements by manipulating pulse-width modulation (PWM) cycles, two unit valves of two ports and two positions were used. A PI controller and a bang-bang controller are used with suitable gain value to drive the valve using PWM to achieve the target actuator position.

The results show the experimental results of the closed-loop position tracking performance of the system using a data acquisition (DAQ) card over MATLAB software.

This paper presents a real-time model used to replace the microcontroller-based system from previous IPA design. The paper proposes two control strategies, PI and bang-bang, to control position using encoder and pressure reading.

Cost reduction is a current topic within healthcare. This article aims to show how Lean Six Sigma can be applied to make the orthopedic outpatient clinic within a hospital more cost-effective. The approach can, of course, also be applied to other departments.

We did a pareto analysis to select the project with the greatest potential. The most expensive and time-consuming activity is repeat consultations; these number around 7,500 per year and are all performed by the orthopedic surgeon. This limits the number of appointments available for new patients. Moreover, the hospital gets a fixed amount of money for each new patient. Therefore, reducing the number of repeat consultations is beneficial to both the patient and the hospital.

Based on data analysis, we found that the number of repeat consultations performed by orthopedic surgeons can be reduced by 19.5%. An additional 10.8% can be performed by phone, which will probably save the surgeons considerable time. The freed-up time can be used for new patients. Another result is that hospital visits by patients for repeat consults can be reduced by 20.3%. We believe that these efficiency improvements are also possible for other departments/processes. Finally, in the given case, the freed-up time for new patients could generate 465K euros.

This article shows that 20% of the care provided by the physicians (i.e. repeat consults) is omissible. While most projects focus on doing the same number of activities in a more efficient way, this paper shows that it is also possible to reduce the amount of medical care provided. We believe that it would be beneficial to take such a perspective when looking at other processes and departments within healthcare.

The purposes of this paper are (1) to explore the overall development of AI technologies and applications that have been demonstrated to be fundamentally important in the healthcare industry, and their related commercialized products and (2) to identify technologies with promise as the basis of useful applications and profitable products in the AI-healthcare domain.

This study adopts a technology-driven technology roadmap approach, combined with natural language processing (NLP)-based patents analysis, to identify promising and potentially profitable existing AI technologies and products in the domain of AI healthcare.

Robotics technology exhibits huge potential in surgical and diagnostics applications. Intuitive Surgical Inc., manufacturer of the Da Vinci robotic system and Ion robotic lung-biopsy system, dominates the robotics-assisted surgical and diagnostic fields. Diagnostics and medical imaging are particularly active fields for the application of AI, not only for analysis of CT and MRI scans, but also for image archiving and communications.

This study is a pioneering attempt to clarify the interrelationships of particular promising technologies for application and related products in the AI-healthcare domain. Its findings provide critical information about the patent activities of key incumbent actors, and thus offer important insights into recent and current technological and product developments in the emergent AI-healthcare sector.

This paper aims to provide an insight into recent advancements and developments of robotics for Natural Orifice Transluminal Surgery (NOTES) procedures.

Following an introduction that highlights the evolution from Minimally Invasive Surgery (MIS) to NOTES in the medical field, this paper reviews the main robotics systems that have been designed and implemented for MIS and NOTES, summarising their advantages and limitations and remarking the technological challenges and the requirements that still should be addressed and fulfilled.

The state-of-the-art presented in this paper shows that the majority of the platforms created for NOTES are laboratory prototypes, and their performances are still far from being optimal. New solutions are required to solve the problems confronted by the proposed systems such as the limited number of DOFs, the limited resolution, the optimal fixation and stiffening of the instruments for enabling stable and precise operation, the effective transmission of forces to the tip tools, the improvement of the force feedback feeling and the proper visualization and spatial orientation of the surgical field. Advances in robotics can contribute significantly to the development and future implementation of the NOTES procedure.

This paper highlights the current trends and challenges ahead in robotics applied to NOTES procedure.

The purpose of this study is to develop a magnetic resonance imaging (MRI)-safe iron-free electrical actuator for MR-guided surgical interventions.

The paper deals with the design of an MRI compatible electrical actuator. Three-dimensional electromagnetic and thermal analytical models have been developed to design the actuator. These models have been validated through 3D finite element (FE) computations. The analytical models have been inserted in an optimization procedure that uses genetic algorithms to find the optimal parameters of the actuator.

The analytical models are very fast and precise compared to the FE models. The computation time is 0.1 s for the electromagnetic analytical model and 3 min for the FE one. The optimized actuator does not perturb imaging sequence even if supplied with a current 10 times higher than its rated one. Indeed, the actuator’s magnetic field generated in the imaging area does not exceed 1 ppm of the B₀ field generated by the MRI scanner. The actuator can perform up to 25 biopsy cycles without any risk to the actuator or the patient since he maximum temperature rise of the actuator is about 20°C. The actuator is compact and lightweight compared to its pneumatic counterpart.

The MRI compatible actuator uses the B₀ field generated by scanner as inductor. The design procedure uses magneto-thermal coupled models that can be adapted to the design of a variety actuation systems working in MRI environment.

Quantifying the performance level of surgeons with digital virtual reality (VR) simulators can help ensure that quality requirements in healthcare are met. In order to better understand integration amongst quality principles, practices and technologies in the adoption and diffusion of VR simulators, the authors applied a technological innovation system (TIS) framework. The purpose of this study is to understand how the adoption and diffusion of VR surgical simulators in a Swedish healthcare context is influenced by various system factors.

In this study, single-case holistic design based on innovation system theory was used to analyse the adoption of digital quality technologies related to surgical performance in Swedish hospitals. The case employs a mixed methods approach triangulating data longitudinally from published documents and expert interviews.

Adoption of digital technologies regarding surgical performance is restricted by system factors relating to inconsistent normative and regulatory requirements for quantified performance criteria to judge surgical expertise. Addressing these systems' weaknesses with evidence-based training programmes can have a significant impact on the further development of the innovation system and can ultimately affect healthcare reliability and quality.

This paper explores quality management (QM) challenges in the context of digital transformation in healthcare. The paper attempts to fill the gap for TIS studies in a healthcare context and highlight the role of innovation function strength along the value chain and in relation to technology cycles to increase the understanding of adoption of digital technologies relating to surgical performance.