Thoracic wall reconstruction using ultrasound images to model/bend the thoracic prosthesis for correction of pectus excavatum

Pectus excavatum is the most common congenital deformity of the anterior thoracic wall. The surgical correction of such deformity, using Nuss procedure, consists in the placement of a personalized convex prosthesis into sub-sternal position to correct the deformity. The aim of this work is the CT-scan substitution by ultrasound imaging for the pre-operative diagnosis and pre-modeling of the prosthesis, in order to avoid patient radiation exposure. To accomplish this, ultrasound images are acquired along an axial plane, followed by a rigid registration method to obtain the spatial transformation between subsequent images. These images are overlapped to reconstruct an axial plane equivalent to a CT-slice. A phantom was used to conduct preliminary experiments and the achieved results were compared with the corresponding CT-data, showing that the proposed methodology can be capable to create a valid approximation of the anterior thoracic wall, which can be used to model/bend the prosthesis

The use of quantitative performance information by local elected politicians in top managers’ performance evaluation: case studies

This paper studies the use of results oriented performance information (outputs and outcomes) by local elected politicians (aldermen) in top managers’ performance evaluation. The main goal is to understand the top managers’ performance evaluation process conducted by Portuguese aldermen and to identify the dominant evaluation style. In line with Bogt (2001), an exploratory field research was developed in three large municipalities: Porto, Braga and Matosinhos. We intend to answer the following research questions: to what extent are local politicians (aldermen) 1 using results information (about outputs and outcomes) to evaluate top managers’ performance? Do aldermen give any importance to quantitative output information and report them on current planning and control documents? Will the output performance information be used on performance evaluation in a different way concerning policy field (task orientation)? Based on the Hopwood evaluation styles (adapted from the private to the public sector by Bogt, 2001), we have found that the performance evaluation process of top managers is more featured by the ‘operations-conscious styles’ (or ‘implicit style’). Portuguese aldermen recognize the importance to quantify outputs and outcomes, but these days they focus on the information about activities and the realized operations when they evaluate performance. We haven´t found significant differences between different tasks (some exceptions for culture and environment areas). However, the municipality of Matosinhos paid more attention on quantitative performance information. This finding is reinforced by the quality of quantitative data on outputs reported on its management report. Generally speaking, aldermen are aware that more attention should be paid to quantitative information about results and performance, taking into account recent reforms introduced in Portuguese municipalities (PLG) on this field, but the ‘implicit’ style is dominant.

Validation of percutaneous puncture trajectory during renal access using 4D ultrasound reconstruction

Background: An accurate percutaneous puncture is essential for disintegration and removal of renal stones. Although this procedure has proven to be safe, some organs surrounding the renal target might be accidentally perforated. This work describes a new intraoperative framework where tracked surgical tools are superimposed within 4D ultrasound imaging for security assessment of the percutaneous puncture trajectory (PPT). Methods: A PPT is first generated from the skin puncture site towards an anatomical target, using the information retrieved by electromagnetic motion tracking sensors coupled to surgical tools. Then, 2D ultrasound images acquired with a tracked probe are used to reconstruct a 4D ultrasound around the PPT under GPU processing. Volume hole-filling was performed in different processing time intervals by a tri-linear interpolation method. At spaced time intervals, the volume of the anatomical structures was segmented to ascertain if any vital structure is in between PPT and might compromise the surgical success. To enhance the volume visualization of the reconstructed structures, different render transfer functions were used. Results: Real-time US volume reconstruction and rendering with more than 25 frames/s was only possible when rendering only three orthogonal slice views. When using the whole reconstructed volume one achieved 8-15 frames/s. 3 frames/s were reached when one introduce the segmentation and detection if some structure intersected the PPT. Conclusions: The proposed framework creates a virtual and intuitive platform that can be used to identify and validate a PPT to safely and accurately perform the puncture in percutaneous nephrolithotomy.