I-cobb - An innovative technique in spinal radiographic measurement

The measurement of Cobb angles on radiographs of patients with spinal deformities is routine practice in spinal clinics. The technique relies on the use and availability of specialist equipment such as a goniometer, cobbometer or protractor. The aim of this study was to validate the use of i-Phone (Apple Inc) combined with Tilt Meter Pro software as compared to a protractor in the measurement of Cobb angles. The i-Phone combined with Tilt Meter Pro software offers a faster alternative to the traditional method of Cobb angle measurement. The use of i-Phone offers a more convenient way of measuring Cobb angles in the outpatient setting. The intra-observer repeatability of the iPhone is equivalent to the protractor in the measurement of Cobb angles.

Does chemometrics enhance the performance of electroanalysis?

This review explores the question whether chemometrics methods enhance the performance of electroanalytical methods. Electroanalysis has long benefited from the well-established techniques such as potentiometric titrations, polarography and voltammetry, and the more novel ones such as electronic tongues and noses, which have enlarged the scope of applications. The electroanalytical methods have been improved with the application of chemometrics for simultaneous quantitative prediction of analytes or qualitative resolution of complex overlapping responses. Typical methods include partial least squares (PLS), artificial neural networks (ANNs), and multiple curve resolution methods (MCR-ALS, N-PLS and PARAFAC). This review aims to provide the practising analyst with a broad guide to electroanalytical applications supported by chemometrics. In this context, after a general consideration of the use of a number of electroanalytical techniques with the aid of chemometrics methods, several overviews follow with each one focusing on an important field of application such as food, pharmaceuticals, pesticides and the environment. The growth of chemometrics in conjunction with electronic tongue and nose sensors is highlighted, and this is followed by an overview of the use of chemometrics for the resolution of complicated profiles for qualitative identification of analytes, especially with the use of the MCR-ALS methodology. Finally, the performance of electroanalytical methods is compared with that of some spectrophotometric procedures on the basis of figures-of-merit. This showed that electroanalytical methods can perform as well as the spectrophotometric ones. PLS-1 appears to be the method of practical choice if the %relative prediction error of not, vert, similar±10% is acceptable.

Three-dimensional reconstruction of an ancient Egyptian mummy

A complete series of cross-sectional computed tomography (CT) scans were obtained of a mummy of an Egyptian priestess, Tjenmutengebtiu, (Jeni), who lived in the twenty-second Dynasty (c. 945-715 BC). The purpose of this joint British Museum and St. Thomas’ Hospital project was effectively to ‘unwrap’ a mummy using cross-sectional X-rays. Jeni is encased in a beautifully decorated anthropomorphic cartonnage coffin. The head and neck were scanned with 2mm slices, the teeth with 1mm slices and the rest of the body with 4 mm slices, a 512 x 512 matrix was used. The 2D CT images, and 3D surface reconstruction’s, demonstrate many features of the embalming techniques and funerary customs of the XXII Dynasty. The presence of cloth protruding from the nasal cavities into the otherwise empty cranial cavity indicates that the brain was extracted via the nose. The remains of the heart can be seen as well as four organ packs corresponding to the mummified and repackaged lungs, intestines, stomach and liver. Each of the organ packs encloses a wax figurine representing one of the four sons of Horus. The teeth are in very good condition with little signs of wear, which, considering the gritty diet of the Egyptians, indicates that Jeni must have been very young when she died. A young age of death is also suggested by analysis of the shape of the molar teeth. The body is generally in very good condition demonstrating the consummate skill of the twenty-second Dynasty embalmers.

A novel system for the measurement of body shape and construction of seating supports for patients

Patients with severe back deformities can greatly benefit from customized medical seating. Customized medical seating is made by taking measurements of each individual patient and making the seat as per these measurements. The current measuring systems employed by the industry are limited to use in clinics which are generally located only in major population centres. Patients living in remote areas are severely affected by this as the clinics could be far away and inaccessible for these patients. To provide service of customized medical seating requires a new measurement system which is portable so that the system could be transported to the patients in remote areas. The requirements for a new measurement system are analysed to suite the needs of Equipment Technology Services of the Cerebral Palsy League of Queensland. Design for a new measurement system was conceptualised by reviewing systems and technologies in various scientific disciplines. Design for a new system was finalised by optimizing each individual component. The final approach was validated by measuring difficult models and repeating the process to check for process variances. This system has now been adopted for clinical evaluation by ETS Suggestions have been made for further improvements in this new measurement approach.

Sandstone and rust : designing the qualities of Sydney harbour

Landscape architecture is built from place. What place is depends how one reads a site, which then determines what qualities are engaged with, and how they are engaged with, by design. Sydney Harbour is one of the most celebrated and distinctive harbours in the world. The qualities of the indigenous, pre-European landscape have been referred to regularly in the history of Australian landscape architecture as a source of inspiration for a truly Australian language of landscape design. A range of different models of such an Australian language have been proposed and tested on landscape design sites on Sydney Harbour, models that are in a discourse both with the specific landscape and with local landscape architecture theory and practice, particularly in relation to ideas of ‘appropriateness’ in Australian landscape architecture. This essay examines arguments from the 1970s that proposed a ‘palette’ approach to appropriateness, along with a key project from that period, Long Nose Point Park, that demonstrates this approach. The essay will then discuss three recent projects on the Harbour and demonstrate that these projects transcend the ‘palette’ approach by engaging with specific relationships on their sites (a ‘relationships’ approach) that are tied to the cultural occupation of Sydney Harbour. Along the way, the reader will be introduced to the key figures and history of landscape architecture in Australia, and to the geography of Sydney Harbour with its various ecologies and milieus

Design and evaluation of an MRI compatible axial compression device for 3D assessment of spinal deformity and flexibility in adolescent idiopathic scoliosis

Magnetic Resonance Imaging (MRI) offers a valuable research tool for the assessment of 3D spinal deformity in AIS, however the horizontal patient position imposed by conventional scanners removes the axial compressive loading on the spine. The objective of this study was to design, construct and test an MRI compatible compression device for research into the effect of axial loading on spinal deformity using supine MRI scans. The device was evaluated by performing unloaded and loaded supine MRI scans on a series of 10 AIS patients. The patient group had a mean initial (unloaded) major Cobb angle of 43±7º, which increased to 50±9º on application of the compressive load. The 7° increase in mean Cobb angle is consistent with that reported by a previous study comparing standing versus supine posture in scoliosis patients (Torell et al, 1985. Spine 10:425-7).

Development of patient-specific computer simulation tools for endoscopic scoliosis surgery

Endoscopic approaches for anterior correction of idiopathic scoliosis are a relatively new surgical technique. This paper describes the development of patient-specific finite element modelling techniques to investigate the biomechanics of single rod anterior scoliosis correction. Spinal geometry is obtained from pre-operative CT scans and material properties for osteo-ligamentous spinal tissues are based on existing literature. The techniques being developed will allow pre-surgical prediction of stresses, forces and deformations in spinal tissues, rods and screws under post-operative physiological loads.

Teaching new dogs old tricks. How the move to 24/7 interactive, integrated multimedia, multi-platform news and feature delivery is not really changing the skills employers demand of graduates

The journalism revolution is upon us. In a world where we are constantly being told that everyone can be a publisher and challenges are emerging from bloggers, Twitterers and podcasters, journalism educators are inevitably reassessing what skills we now need to teach to keep our graduates ahead of the game. QUT this year tackled that question head-on as a curriculum review and program restructure resulted in a greater emphasis on online journalism. The author spent a week in the online newsrooms of each of two of the major players – ABC online news and thecouriermail.com to watch, listen and interview some of the key players. This, in addition to interviews with industry leaders from Fairfax and news.com, lead to the conclusion that while there are some new skills involved in new media much of what the industry is demanding is in fact good old fashioned journalism. Themes of good spelling, grammar, accuracy and writing skills and a nose for news recurred when industry players were asked what it was that they would like to see in new graduates. While speed was cited as one of the big attributes needed in online journalism, the conclusion of many of the players was that the skills of a good down-table sub or a journalist working for wire service were not unlike those most used in online newsrooms.

Geometry vs appearance for discriminating between posed and spontaneous emotions

Spontaneous facial expressions differ from posed ones in appearance, timing and accompanying head movements. Still images cannot provide timing or head movement information directly. However, indirectly the distances between key points on a face extracted from a still image using active shape models can capture some movement and pose changes. This information is superposed on information about non-rigid facial movement that is also part of the expression. Does geometric information improve the discrimination between spontaneous and posed facial expressions arising from discrete emotions? We investigate the performance of a machine vision system for discrimination between posed and spontaneous versions of six basic emotions that uses SIFT appearance based features and FAP geometric features. Experimental results on the NVIE database demonstrate that fusion of geometric information leads only to marginal improvement over appearance features. Using fusion features, surprise is the easiest emotion (83.4% accuracy) to be distinguished, while disgust is the most difficult (76.1%). Our results find different important facial regions between discriminating posed versus spontaneous version of one emotion and classifying the same emotion versus other emotions. The distribution of the selected SIFT features shows that mouth is more important for sadness, while nose is more important for surprise, however, both the nose and mouth are important for disgust, fear, and happiness. Eyebrows, eyes, nose and mouth are important for anger.

Applications of medical image processing in the diagnosis and treatment of spinal deformity

In Chapter 10, Adam and Dougherty describe the application of medical image processing to the assessment and treatment of spinal deformity, with a focus on the surgical treatment of idiopathic scoliosis. The natural history of spinal deformity and current approaches to surgical and non-surgical treatment are briefly described, followed by an overview of current clinically used imaging modalities. The key metrics currently used to assess the severity and progression of spinal deformities from medical images are presented, followed by a discussion of the errors and uncertainties involved in manual measurements. This provides the context for an analysis of automated and semi-automated image processing approaches to measure spinal curve shape and severity in two and three dimensions.

Use of the iPhone for Cobb angle measurement in scoliosis

Purpose: The Cobb technique is the universally accepted method for measuring the severity of spinal deformities. Traditionally, Cobb angles have been measured using protractor and pencil on hardcopy radiographic films. The new generation of mobile phones make accurate angle measurement possible using an integrated accelerometer, providing a potentially useful clinical tool for assessing Cobb angles. The purpose of this study was to compare Cobb angle measurements performed using an Apple iPhone and traditional protractor in a series of twenty Adolescent Idiopathic Scoliosis patients. Methods: Seven observers measured major Cobb angles on twenty pre-operative postero-anterior radiographs of Adolescent Idiopathic Scoliosis patients with both a standard protractor and using an Apple iPhone. Five of the observers repeated the measurements at least a week after the original measurements. Results: The mean absolute difference between pairs of iPhone/protractor measurements was 2.1°, with a small (1°) bias toward lower Cobb angles with the iPhone. 95% confidence intervals for intra-observer variability were ±3.3° for the protractor and ±3.9° for the iPhone. 95% confidence intervals for inter-observer variability were ±8.3° for the iPhone and ±7.1° for the protractor. Both of these confidence intervals were within the range of previously published Cobb measurement studies. Conclusions: We conclude that the iPhone is an equivalent Cobb measurement tool to the manual protractor, and measurement times are about 15% less. The widespread availability of inclinometer-equipped mobile phones and the ability to store measurements in later versions of the angle measurement software may make these new technologies attractive for clinical measurement applications.

On the application of the probabilistic linear discriminant analysis to face recognition across expression

Facial expression is one of the main issues of face recognition in uncontrolled environments. In this paper, we apply the probabilistic linear discriminant analysis (PLDA) method to recognize faces across expressions. Several PLDA approaches are tested and cross-evaluated on the Cohn-Kanade and JAFFE databases. With less samples per gallery subject, high recognition rates comparable to previous works have been achieved indicating the robustness of the approaches. Among the approaches, the mixture of PLDAs has demonstrated better performances. The experimental results also indicate that facial regions around the cheeks, eyes, and eyebrows are more discriminative than regions around the mouth, jaw, chin, and nose.

Prevalence of hallux valgus in the general population : a systematic review and meta-analysis

BACKGROUND: Hallux valgus (HV) is a foot deformity commonly seen in medical practice, often accompanied by significant functional disability and foot pain. Despite frequent mention in a diverse body of literature, a precise estimate of the prevalence of HV is difficult to ascertain. The purpose of this systematic review was to investigate prevalence of HV in the overall population and evaluate the influence of age and gender. METHODS: Electronic databases (Medline, Embase, and CINAHL) and reference lists of included papers were searched to June 2009 for papers on HV prevalence without language restriction. MeSH terms and keywords were used relating to HV or bunions, prevalence and various synonyms. Included studies were surveys reporting original data for prevalence of HV or bunions in healthy populations of any age group. Surveys reporting prevalence data grouped with other foot deformities and in specific disease groups (e.g. rheumatoid arthritis, diabetes) were excluded. Two independent investigators quality rated all included papers on the Epidemiological Appraisal Instrument. Data on raw prevalence, population studied and methodology were extracted. Prevalence proportions and the standard error were calculated, and meta-analysis was performed using a random effects model. RESULTS: A total of 78 papers reporting results of 76 surveys (total 496,957 participants) were included and grouped by study population for meta-analysis. Pooled prevalence estimates for HV were 23% in adults aged 18-65 years (CI: 16.3 to 29.6) and 35.7% in elderly people aged over 65 years (CI: 29.5 to 42.0). Prevalence increased with age and was higher in females [30% (CI: 22 to 38)] compared to males [13% (CI: 9 to 17)]. Potential sources of bias were sampling method, study quality and method of HV diagnosis. CONCLUSIONS: Notwithstanding the wide variation in estimates, it is evident that HV is prevalent; more so in females and with increasing age. Methodological quality issues need to be addressed in interpreting reports in the literature and in future research.

Evaluation of the iPhone with an acrylic sleeve versus the Scoliometer for rib hump measurement in scoliosis

Background. Vertebral rotation found in structural scoliosis contributes to trunkal asymmetry which is commonly measured with a simple Scoliometer device on a patient's thorax in the forward flexed position. The new generation of mobile 'smartphones' have an integrated accelerometer, making accurate angle measurement possible, which provides a potentially useful clinical tool for assessing rib hump deformity. This study aimed to compare rib hump angle measurements performed using a Smartphone and traditional Scoliometer on a set of plaster torsos representing the range of torsional deformities seen in clinical practice. Methods. Nine observers measured the rib hump found on eight plaster torsos moulded from scoliosis patients with both a Scoliometer and an Apple iPhone on separate occasions. Each observer repeated the measurements at least a week after the original measurements, and were blinded to previous results. Intra-observer reliability and inter-observer reliability were analysed using the method of Bland and Altman and 95% confidence intervals were calculated. The Intra-Class Correlation Coefficients (ICC) were calculated for repeated measurements of each of the eight plaster torso moulds by the nine observers. Results. Mean absolute difference between pairs of iPhone/Scoliometer measurements was 2.1 degrees, with a small (1 degrees) bias toward higher rib hump angles with the iPhone. 95% confidence intervals for intra-observer variability were +/- 1.8 degrees (Scoliometer) and +/- 3.2 degrees (iPhone). 95% confidence intervals for inter-observer variability were +/- 4.9 degrees (iPhone) and +/- 3.8 degrees (Scoliometer). The measurement errors and confidence intervals found were similar to or better than the range of previously published thoracic rib hump measurement studies. Conclusions. The iPhone is a clinically equivalent rib hump measurement tool to the Scoliometer in spinal deformity patients. The novel use of plaster torsos as rib hump models avoids the variables of patient fatigue and discomfort, inconsistent positioning and deformity progression using human subjects in a single or multiple measurement sessions.

Orthopaedics and Trauma Queensland Annual Report 2011

Orthopaedics and Trauma Queensland, a Centre for Research and Education in Musculoskeletal Disorders, is an internationally recognised research group that is developing into an international leader in research and education. It provides a stimulus for research, education and clinical application within the international orthopaedic and trauma communities. Orthopaedics and Trauma Queensland develops and promotes the innovative use of engineering and technology, in collaboration with surgeons, to provide new techniques, materials, procedures and medical devices. Its integration with clinical practice and strong links with hospitals ensure that the research will be translated into practical outcomes for patients. The group undertakes clinical practice in orthopaedics and trauma and applies core engineering skills to challenges in medicine. The research is built on a strong foundation of knowledge in biomedical engineering, and incorporates expertise in cell biology, mathematical modelling, human anatomy and physiology and clinical medicine in orthopaedics and trauma. New knowledge is being developed and applied to the full range of orthopaedic diseases and injuries, such as knee and hip replacements, fractures and spinal deformities.