Implementation and validation of an implant-based coordinate system for RSA migration calculation

An in vitro radiostereometric analysis (RSA) phantom study of a total knee replacement was carried out to evaluate the effect of implementing two new modifications to the conventional RSA procedure: (i) adding a landmark of the tibial component as an implant marker and (ii) defining an implant-based coordinate system constructed from implant landmarks for the calculation of migration results. The motivation for these two modifications were (i) to improve the representation of the implant by the markers by including the stem tip marker which increases the marker distribution (ii) to recover clinical RSA study cases with insufficient numbers of markers visible in the implant polyethylene and (iii) to eliminate errors in migration calculations due to misalignment of the anatomical axes with the RSA global coordinate system. The translational and rotational phantom studies showed no loss of accuracy with the two new measurement methods. The RSA system employing these methods has a precision of better than 0.05 mm for translations and 0.03° for rotations, and an accuracy of 0.05 mm for translations and 0.15° for rotations. These results indicate that the new methods to improve the interpretability, relevance, and standardization of the results do not compromise precision and accuracy, and are suitable for application to clinical data.     

The effect of decreasing computed tomography dosage on radiostereometric analysis (RSA) accuracy at the glenohumeral joint

Standard, beaded radiostereometric analysis (RSA) and markerless RSA often use computed tomography (CT) scans to create three-dimensional (3D) bone models. However, ethical concerns exist due to risks associated with CT radiation exposure. Therefore, the aim of this study was to investigate the effect of decreasing CT dosage on RSA accuracy. Four cadaveric shoulder specimens were scanned using a normal-dose CT protocol and two low-dose protocols, where the dosage was decreased by 89% and 98%. 3D computer models of the humerus and scapula were created using each CT protocol. Bi-planar fluoroscopy was used to image five different static glenohumeral positions and two dynamic glenohumeral movements, of which a total of five static and four dynamic poses were selected for analysis. For standard RSA, negligible differences were found in bead (0.21±0.31mm) and bony landmark (2.31±1.90mm) locations when the CT dosage was decreased by 98% (p-values>0.167). For markerless RSA kinematic results, excellent agreement was found between the normal-dose and lowest-dose protocol, with all Spearman rank correlation coefficients greater than 0.95. Average root mean squared errors of 1.04±0.68mm and 2.42±0.81° were also found at this reduced dosage for static positions. In summary, CT dosage can be markedly reduced when performing shoulder RSA to minimize the risks of radiation exposure. Standard RSA accuracy was negligibly affected by the 98% CT dose reduction and for markerless RSA, the benefits of decreasing CT dosage to the subject outweigh the introduced errors.     

Dynamic Time Warping compared to established methods for validation of musculoskeletal models

By means of Multi-Body musculoskeletal simulation, important variables such as internal joint forces and moments can be estimated which cannot be measured directly. Validation can ensued by qualitative or by quantitative methods. Especially when comparing time-dependent signals, many methods do not perform well and validation is often limited to qualitative approaches. The aim of the present study was to investigate the capabilities of the Dynamic Time Warping (DTW) algorithm for comparing time series, which can quantify phase as well as amplitude errors. We contrast the sensitivity of DTW with other established metrics: the Pearson correlation coefficient, cross-correlation, the metric according to Geers, RMSE and normalized RMSE.This study is based on two data sets, where one data set represents direct validation and the other represents indirect validation. Direct validation was performed in the context of clinical gait-analysis on trans-femoral amputees fitted with a 6 component force-moment sensor. Measured forces and moments from amputees' socket-prosthesis are compared to simulated forces and moments. Indirect validation was performed in the context of surface EMG measurements on a cohort of healthy subjects with measurements taken of seven muscles of the leg, which were compared to simulated muscle activations.Regarding direct validation, a positive linear relation between results of RMSE and nRMSE to DTW can be seen. For indirect validation, a negative linear relation exists between Pearson correlation and cross-correlation.We propose the DTW algorithm for use in both direct and indirect quantitative validation as it correlates well with methods that are most suitable for one of the tasks. However, in DV it should be used together with methods resulting in a dimensional error value, in order to be able to interpret results more comprehensible.     

Validation of a behavioral recording automated system in the elevated plus-maze test

The elevated plus-maze test has been widely used for screening of anxiolytic drugs and for exploring neurobiological bases of anxiety. In this study, we validated a new automated system that enables to record exploratory behavior in the elevated plus-maze test. This system, called cyberplus, consisted of ten pairs of photoelectric cells strategically located in several parts of the apparatus, and seemed to be sensitive to the position of the animal's forepaws, so it would yield scores in anxiety measurements and locomotor activity similar to those obtained by following the traditional procedure, that is, by analyzing videotapes by experienced observers. In order to assess this hypothesis, we exposed rats to the elevated plus-maze test and compared the scores obtained by cyberplus with the values recorded by two independent observers, conducting a correlational study with both kinds of recording procedures. The results obtained suggest the utility of cyberplus as a behavioral recording automated system in the elevated plus-maze test, making data collection and data analysis easier in exploring pharmacological and neurobiological bases of anxiety.     

Evaluation of automated hematology analyzer DYMIND DH76 compared to SYSMEX XN 1000 system

BackgroundDYMIND DH76 (DYMIND BIOTECH, China) is a new automated hematology system designed to provide CBC count, including a 5-part WBC differential count, and its analytical performance should be assessed before adoption for clinical use.MethodsThe analyzer was evaluated according to the International Council for Standardization in Haematology guideline. The purposes of this study were to assess its analytical performance in comparison to SYSMEX XN 1000 hematology analyzer currently used in our laboratory, as well as to compare the automated and manual WBC differential.ResultsWithin-run precision in all concentration ranges was very good with coefficients of variation (CVs) between 0.02% and 2.5% except for platelets over 500×109/L (CV 9.5%). Within-batch imprecision showed CVs lower the declared deviation ranges. Accuracy (defined as trueness) was excellent for all CBC and white cell differential parameters, compared with the state of the art%. Linearity was confirmed with excellent regression coefficients (0.999-1.000), even in the lowest values, and carryover was ≤ 1%. Comparison between DYMIND DH76 and SYSMEX XN 1000 was also very good with correlation coefficients (R2) for WBC (1.000), RBC (0.999), hemoglobin (0.999) and PLT over 50×10⁹/L (0.994) and R2 was lower but still acceptable (0.910) for PLT<50×10⁹/L. R2 for neutrophils, lymphocytes, eosinophils, basophils, and monocytes were 0.974, 0.982, 0.957, 0.625, and 0.836, respectively, in the comparison between the manual and DYMIND DH76 automated differential WBC counts.ConclusionsWith excellent analytical performance and acceptable comparative analysis, DYMIND DH76 hematology analyser covered the predefined international standards and requirements and is fully appropriate for clinical application.     

大型医院信息化网络平台的建设

现代化医院需要一个能够承载生命信息的数字化网络平台,面临大量的设备和众多的应用系统,网络架构的先进性、可扩展性、稳定性、可靠性和安全性是必须的。以瑞金医院信息网络平台建设为例,提出了大型现代综合性医院网络建设的难点和要点,认为网络系统建设可采用模块化、层次化的结构,提高网络的可扩展性和可管理性,减少网络广播的危害性,同时对关键节点采用冗余设备进行备份,对关键应用系统采用QoS、负载均衡技术优化网络总体性能,可加强网络运行的稳定性和安全性。     

数字X线摄影系统在新生儿检查中的应用评价

目的评价DR摄影系统在新生儿检查中的应用价值。方法利用CR系统和DR系统（使用剂量为前者的1／4）分别得到新生儿30幅图像。由6位医生来评价以上两者的影像系统对于导尿管末端的显影的清晰程度。结果二者的图像在诊断质量上没有统计学差异。结论DR有较好的分辨率和低噪声特性,高DQE有助于减少新生儿患者的接受剂量,图像传输速度快,使得临床诊断更为及时。     

数字减影血管造影设备的维护与维修

数字减影血管造影设备是大型医学影像仪器,在临床诊断及治疗发挥着重要的作用。因此,及时的维护和规范的保养是降低设备故障,减少维修成本,提高工作效率的关键。本文对我院数字减影血管造影设备的保养工作展开回顾,分析临床工作中常见的设备故障,并总结实用的维护、保养方法,为有效利用设备资源提供参考。     

用于海洋原位浮游生物探测的同轴数字全息显微技术研究

本文将数字全息与显微成像技术相结合,设计搭建了一套数字全息显微系统,用于对浮游生物进行光场获取。基于该系统获取的光场信息,通过在不同景深对图像进行再现,既可以获到单一浮游生物的清晰图像,也可以获得一定水体内浮游生物微粒在海水中的三维分布情况。通过实验测得系统分辨率可以达到7．8微米,景深可以达到10毫米,优于一般光学显微镜的技术指标。研究结果表明优势明显的数字全息显微系统是一种适合海洋原位探测的浮游生物研究的有效方法。基于数字同轴显微系统的水下仪器开发将是下一步工作的努力方向。     

数字化外科技术在颌面部外伤修复重建中的应用与展望

近年来,数字化外科技术在颌面部外伤修复重建临床应用中得到不断发展和完善,极大地提高了手术的精确性和可靠性,节约了手术时间。本文主要从术前手术模拟、快速打印3D头模、术中导航、导板制作、个性化修复体及机器人的临床应用等六个方面来阐述数字化外科技术在颌面部骨折修复重建中的应用,总结了各个技术的原理、优缺点及应用现状,回顾了我们单位应用数字化技术提高颌面部外伤修复手术的精确度和可行性以及恢复了患者良好的面型及功能的临床应用经验。同时,本文对未来数字化外科在颌面部骨折修复重建中的应用提出了新的展望,我们认为,结合术前手术模拟、术中导航及术中机器人技术依据术中具体情况自动调整手术方案进行颌面部骨折修复重建的完全自动化智能机器人的实现将是最终的目标。     

微生物学数字课程的设计与应用

微生物学数字课程是以微生物学知识内容构建、借助高等教育出版社云课程平台传播的课程。作者编著的《微生物学数字课程》已由高等教育出版社出版,本文介绍了微生物学数字课程的设计与教学应用。该课程结构设计包括章节名称、作业、基本问题、小组专题讨论、课程论文、自由讨论区;资源设计包括教学录像、电子资源(教学课件、动画等)、网上自测;交互设计包括讨论、留言、疑难解答等;构建出课前教师在平台发布课程资源和学习任务—学生登录平台观看资源—课中教师进行疑难问题解答及知识总结—学生进行问题讨论、课题成果汇报—课后学生提交作业及网上自测的教学模式。教学实践结果表明,微生物数字课程对提高学生的学习兴趣、合作学习能力、信息技术素养及学习能力具有积极的作用。     

Digital dermatoglyphic patterns in a sample of the Nigerian population

Eight hundred Nigerians (400 males and 400 females) were screened for the analysis of digital dermatoglyphic patterns. The frequency distribution of the patterns are 52.09%, 27.67%, 19.20% and 1.13% for ulnar loops, whorls, arches and radial loops respectively. Except for arches, the males have more of the patterns than females. The pattern intensity indices for males and females are 11.2 and 9.9 respectively. Bilateral symmetry is similar in both sexes and the percent distribution is as high as 81.5% and 84% on digit V in males and females respectively.     

数字化骨科理念辅助椎弓根置钉在寰枢椎不稳中的临床应用

目的:探讨3D打印辅助置钉技术用于寰枢椎不稳椎弓根置钉的安全性及准确性。方法:收集2013年1月到2015年1月西安交通大学第一附属医院收治的寰枢椎不稳病例,术前采用3D打印技术构建个体化3D打印模型,在模型上模拟置钉,获取最佳置钉点、置钉角度等个体化置钉数据,并于术中辅助椎弓根螺钉置入。通过CT扫描评价置钉准确性,测量术前、术后患者寰齿间隙判断寰枢椎复位情况,测量颈延角评价脊髓压迫改善情况,并采用日本骨科学会(JOA)评分判断患者脊髓功能改善情况。术后定期随访观察固定效果、稳定性、神经损伤等手术并发症的发生情况。结果:13例患者均采用3D打印辅助置钉技术进行内固定治疗,手术顺利,术中及术后无血管、神经损伤等并发症,复位及内固定效果满意。共置入椎弓根螺钉31枚,其中29枚完全在椎弓根内,置钉准确率为93.5%。寰枢椎较术前明显复位,术后寰齿间隙、颈延角和JOA评分较术前明显改善,差异具有统计学意义(P0.05)。结论:3D打印技术辅助上颈椎椎弓根置钉的准确性及安全性均较高。     

Assessing ecological risk through automated drainage extraction and watershed delineation

Decision makers are frequently involved in projects requiring ecological risk definition, which are inherent to biological conservation process. It is important to recognize these risks in order to invest wisely in the management and protection of biological resources. In this matter, Geographic Information System tools and remote sensing data have been used frequently as important components in planning and management of conservation units, Rabus et al. (2003), Valeriano et al. (2009) and Valeriano et al. (2010) stressed the advantages of using data that were gathered during the Shuttle Radar Topographic Mission (SRTM) for biological and geomorphologic purposes. For Brazil's national territory, the SRTM data were refined (Valeriano, 2008) and offered as free access on the TOPODATA Project website (http://www.dsr.inpe.br/topodata) where geomorphometric information (including elevation data) at a resolution of 30 m are provided. The aim of this paper is to demonstrate an example of how TOPODATA products have been applied in order to determine the ecological risk of the border of a Conservation Unit, located in the State of São Paulo—Brazil, in the Brazilian Atlantic Forest, using automated drainage network and watershed extraction. A comparison between SRTM, TOPODATA, and ASTER DEM was carried out, showing an advantage of TOPODATA drainage network product. The vectors generated using this data are more similar to the official drainage network vectors than the drainage network extracted using ASTER-DEM or SRTM. The network product generated using ASTER-DEM produced many commission errors and the one generated using SRTM produced a poor network, with generalized vectors, less detailed than the others. The results showed that using the TOPODATA Project‘s Digital Elevation Model (DEM) can provide important data for ecological analysis and significant additional information for decision making, regarding drainage networks and watershed features. The produced map for border ecological risk showed to fit perfectly to the field work analyses, produced in other works. Furthermore, the extracted watershed polygons might furnish important information unrevealing best conservation unit boundaries, which means more efficient management and best biological conservation results.     

数字化表达谱差异分析方法-DGE-P

目的：目前,关于数字化表达谱差异分析的方法及软件极少,且需懂得R语言等,操作繁琐,这给数字表达谱分析带来了不少困难,DGE-P软件针对数字化表达谱开发的差异分析软件。方法：DGE-P软件,利用倍数分析及数字化基因表达谱差异基因检测方法,对通过本软件标准化后的数据进行差异显著性分析。结果：DGE-P软件包含了丰度统计、数据标准化、求倍数分析和p-value值三个模块。可得出倍数分析与数字化基因表达谱差异基因检测方法（p-value）两个值。结论：DGE-P较以前的差异分析软件相比是一款针对数字化表达谱分析的软件,克服了其他软件在无重复实验数据时无法避免误差的缺陷。并且DGE-P较其他的软件相比使用方便,可在windows系统下运行,操作简单。     

数字化远程介入手术示教的实践与思考

目的:探讨介入手术远程演示教学系统的应用及效果。方法:采取多机组、多屏幕实况转播,将导管室的高清血管造影图像、术野图像、全景图像传输到会场。结果:学员对介入手术远程转播满意度为100%,其中最满意的是转播交互环节。本次共进行10台手术远程转播,无一例转播相关并发症发生,患者对治疗评价均及保护隐私情况非常满意。基本实现了导管室与会场的双向音视频互动,学员同术者在手术过程中的直接交流起到了较好的教学效果。结论:介入手术演示已经成为继续医学教育必不可少的手段,数字化介入手术转播是将来介入手术转播的发展方向。     

Digital microfluidic hydrogel microreactors for proteomics

Proteolytic digestion is an essential step in proteomic sample processing. While this step has traditionally been implemented in homogeneous (solution) format, there is a growing trend to use heterogeneous systems in which the enzyme is immobilized on hydrogels or other solid supports. Here, we introduce the use of immobilized enzymes in hydrogels for proteomic sample processing in digital microfluidic (DMF) systems. In this technique, preformed cylindrical agarose discs bearing immobilized trypsin or pepsin were integrated into DMF devices. A fluorogenic assay was used to optimize the covalent modification procedure for enzymatic digestion efficiency, with maximum efficiency observed at 31 μg trypsin in 2-mm diameter agarose gel discs. Gel discs prepared in this manner were used in an integrated method in which proteomic samples were sequentially reduced, alkylated, and digested, with all sample and reagent handling controlled by DMF droplet operation. Mass spectrometry analysis of the products revealed that digestion using the trypsin gel discs resulted in higher sequence coverage in model analytes relative to conventional homogenous processing. Proof-of-principle was demonstrated for a parallel digestion system in which a single sample was simultaneously digested on multiple gel discs bearing different enzymes. We propose that these methods represent a useful new tool for the growing trend toward miniaturization and automation in proteomic sample processing.     

肺癌数字化临床路径管理平台的构建和初步应用

目的:构建肺癌数字化临床路径并研究其在临床中应用优势。方法:收集2013年8月-2016月3月于哈医大四院胸外二科入院的肺癌手术患者,150名患者通过肺癌数字化临床路径管理系诊治(临床路径组),150人通过常规方式诊疗(对照组),比较两组最终的住院天数和住院总费用。结果:临床路径组的住院总天数、住院总费用均小于对照组(P0.05或0.01)。结论:数字化肺癌路径管理平台在临床病人管理中具有一定的优势。     

A modelling approach demonstrating micromechanical changes in the tibial cemented interface due to in vivo service

Post-operative changes in trabecular bone morphology at the cement-bone interface can vary depending on time in service. This study aims to investigate how micromotion and bone strains change at the tibial bone-cement interface before and after cementation. This work discusses whether the morphology of the post-mortem interface can be explained by studying changes in these mechanical quantities. Three post-mortem cement-bone interface specimens showing varying levels of bone resorption (minimal, extensive and intermediate) were selected for this study Using image segmentation techniques, masks of the post-mortem bone were dilated to fill up the mould spaces in the cement to obtain the immediately post-operative situation. Finite element (FE) models of the post-mortem and post-operative situation were created from these segmentation masks. Subsequent removal of the cement layer resulted in the pre-operative situation. FE micromotion and bone strains were analyzed for the interdigitated trabecular bone. For all specimens micromotion increased from the post-operative to the post-mortem models (distally, in specimen 1: 0.1 to 0.5 µm; specimen 2: 0.2 to 0.8 µm; specimen 3: 0.27 to 1.62 µm). Similarly bone strains were shown to increase from post-operative to post-mortem (distally, in specimen 1: −185 to −389 µε; specimen 2: −170 to −824 µε; specimen 3: −216 to −1024 µε). Post-mortem interdigitated bone was found to be strain shielded in comparison with supporting bone indicating that failure of bone would occur distal to the interface. These results indicate that stress shielding of interdigitated trabeculae is a plausible explanation for resorption patterns observed in post-mortem specimens.     

通往风景园林行业的BIM之路——数字化竖向设计教育

随着全球建造业向数字化全面转型,建筑信息模型（BIM)的教学将是未来几年风景园林设计与实施的重要主题。介绍了风景园林专业BIM的教学方法和数字化竖向设计及其应用在BIM场地设计项目中的重要性。数字化竖向设计是实现BIM的途径。风景园林教育必须在其教学中讲解BIM建模方法和过程。