A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures

Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well as highlighting the differences between bone and soft tissue punctures. An overall average error of 4.23 mm and 3.07 mm for bone and soft tissue punctures, respectively, demonstrated the feasibility of using this system for such interventions. The proposed system workflow was shown to be effective in separating the preparation from the sterile phase, as well as in keeping the system manageable by a single operator. Among the distinct sources of error, the user error based on the system accuracy (defined as the distance from the planned target to the actual needle tip) appeared to be the most significant. Bone punctures showed higher user error, whereas soft tissue punctures showed higher tissue deformation error.

Developing a model of library user education for freshman science students

Discusses the cooperative effort between librarians and science faculty at Bucknell University in developing an effective library use education course for incoming undergraduate science and engineering students. Describes course structure and activities, and includes a library instruction bibliography. (five references) (EA)

Surgical planning tool for robotically assisted hearing aid implantation

PURPOSE : For the facilitation of minimally invasive robotically performed direct cochlea access (DCA) procedure, a surgical planning tool which enables the surgeon to define landmarks for patient-to-image registration, identify the necessary anatomical structures and define a safe DCA trajectory using patient image data (typically computed tomography (CT) or cone beam CT) is required. To this end, a dedicated end-to-end software planning system for the planning of DCA procedures that addresses current deficiencies has been developed. METHODS :    Efficient and robust anatomical segmentation is achieved through the implementation of semiautomatic algorithms; high-accuracy patient-to-image registration is achieved via an automated model-based fiducial detection algorithm and functionality for the interactive definition of a safe drilling trajectory based on case-specific drill positioning uncertainty calculations was developed. RESULTS :    The accuracy and safety of the presented software tool were validated during the conduction of eight DCA procedures performed on cadaver heads. The plan for each ear was completed in less than 20 min, and no damage to vital structures occurred during the procedures. The integrated fiducial detection functionality enabled final positioning accuracies of [Formula: see text] mm. CONCLUSIONS :    Results of this study demonstrated that the proposed software system could aid in the safe planning of a DCA tunnel within an acceptable time.

Computer technology applications in surgical implant dentistry: a systematic review

PURPOSE: To assess the literature on accuracy and clinical performance of computer technology applications in surgical implant dentistry. MATERIALS AND METHODS: Electronic and manual literature searches were conducted to collect information about (1) the accuracy and (2) clinical performance of computer-assisted implant systems. Meta-regression analysis was performed for summarizing the accuracy studies. Failure/complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates of 12-month proportions. RESULTS: Twenty-nine different image guidance systems were included. From 2,827 articles, 13 clinical and 19 accuracy studies were included in this systematic review. The meta-analysis of the accuracy (19 clinical and preclinical studies) revealed a total mean error of 0.74 mm (maximum of 4.5 mm) at the entry point in the bone and 0.85 mm at the apex (maximum of 7.1 mm). For the 5 included clinical studies (total of 506 implants) using computer-assisted implant dentistry, the mean failure rate was 3.36% (0% to 8.45%) after an observation period of at least 12 months. In 4.6% of the treated cases, intraoperative complications were reported; these included limited interocclusal distances to perform guided implant placement, limited primary implant stability, or need for additional grafting procedures. CONCLUSION: Differing levels and quantity of evidence were available for computer-assisted implant placement, revealing high implant survival rates after only 12 months of observation in different indications and a reasonable level of accuracy. However, future long-term clinical data are necessary to identify clinical indications and to justify additional radiation doses, effort, and costs associated with computer-assisted implant surgery.

Prosthetically driven, computer-guided implant planning for the edentulous maxilla: a model study

OBJECTIVES: To analyze computer-assisted diagnostics and virtual implant planning and to evaluate the indication for template-guided flapless surgery and immediate loading in the rehabilitation of the edentulous maxilla. MATERIALS AND METHODS: Forty patients with an edentulous maxilla were selected for this study. The three-dimensional analysis and virtual implant planning was performed with the NobelGuide software program (Nobel Biocare, Göteborg, Sweden). Prior to the computer tomography aesthetics and functional aspects were checked clinically. Either a well-fitting denture or an optimized prosthetic setup was used and then converted to a radiographic template. This allowed for a computer-guided analysis of the jaw together with the prosthesis. Accordingly, the best implant position was determined in relation to the bone structure and prospective tooth position. For all jaws, the hypothetical indication for (1) four implants with a bar overdenture and (2) six implants with a simple fixed prosthesis were planned. The planning of the optimized implant position was then analyzed as follows: the number of implants was calculated that could be placed in sufficient quantity of bone. Additional surgical procedures (guided bone regeneration, sinus floor elevation) that would be necessary due the reduced bone quality and quantity were identified. The indication of template-guided, flapless surgery or an immediate loaded protocol was evaluated. RESULTS: Model (a) - bar overdentures: for 28 patients (70%), all four implants could be placed in sufficient bone (total 112 implants). Thus, a full, flapless procedure could be suggested. For six patients (15%), sufficient bone was not available for any of their planned implants. The remaining six patients had exhibited a combination of sufficient or insufficient bone. Model (b) - simple fixed prosthesis: for 12 patients (30%), all six implants could be placed in sufficient bone (total 72 implants). Thus, a full, flapless procedure could be suggested. For seven patients (17%), sufficient bone was not available for any of their planned implants. The remaining 21 patients had exhibited a combination of sufficient or insufficient bone. DISCUSSION: In the maxilla, advanced atrophy is often observed, and implant placement becomes difficult or impossible. Thus, flapless surgery or an immediate loading protocol can be performed just in a selected number of patients. Nevertheless, the use of a computer program for prosthetically driven implant planning is highly efficient and safe. The three-dimensional view of the maxilla allows the determination of the best implant position, the optimization of the implant axis, and the definition of the best surgical and prosthetic solution for the patient. Thus, a protocol that combines a computer-guided technique with conventional surgical procedures becomes a promising option, which needs to be further evaluated and improved.

Landmark-based augmented reality system for paranasal and transnasal endoscopic surgeries

BACKGROUND: In this paper we present a landmark-based augmented reality (AR) endoscope system for endoscopic paranasal and transnasal surgeries along with fast and automatic calibration and registration procedures for the endoscope. METHODS: Preoperatively the surgeon selects natural landmarks or can define new landmarks in CT volume. These landmarks are overlaid, after proper registration of preoperative CT to the patient, on the endoscopic video stream. The specified name of the landmark, along with selected colour and its distance from the endoscope tip, is also augmented. The endoscope optics are calibrated and registered by fast and automatic methods. Accuracy of the system is evaluated in a metallic grid and cadaver set-up. RESULTS: Root mean square (RMS) error of the system is 0.8 mm in a controlled laboratory set-up (metallic grid) and was 2.25 mm during cadaver studies. CONCLUSIONS: A novel landmark-based AR endoscope system is implemented and its accuracy is evaluated. Augmented landmarks will help the surgeon to orientate and navigate the surgical field. Studies prove the capability of the system for the proposed application. Further clinical studies are planned in near future.

The impact of new technologies on distance learning students

This is a European Commission Leonardo da Vinci Reference Material project on the impact of new technology on distance learning students. It is known that all the Ministries of Education of the 27 European Union countries pay millions of Euros annually in the provision of educational technology for their schools, colleges and universities. A review of the literature of the impact of technology, however, showed that the research in this field was unacceptably fragile. What research there was focused on the impact of technology on children in American schools. The project set out, therefore, to measure the impact of technology on adult education, lifelong learning and distance education, with a particular focus on adult distance learning.

Matching form with content

Successful computer-supported distance education requires that its enabling technologies are accessible and usable anywhere. They should work seamlessly inside and outside the information superhighway, wherever the target learners are located, without obtruding on the learning activity. It has long been recognised that the usability of interactive computer systems is inversely related to the visibility of the implementing technologies. Reducing the visibility of technology is especially challenging in the area of online language learning systems, which require high levels of interactivity and communication along multiple dimensions such as speaking, listening, reading and writing. In this article, the authors review the concept of invisibility as it applies to the design of interactive technologies and appliances. They describe a specialised appliance matched to the requirements for distance second language learning, and report on a successful multi-phase evaluation process, including initial field testing at a Thai open university.

Matching form with content

Successful computer-supported distance education requires that its enabling technologies are accessible and usable anywhere. They should work seamlessly inside and outside the information superhighway, wherever the target learners are located, without obtruding on the learning activity. It has long been recognised that the usability of interactive computer systems is inversely related to the visibility of the implementing technologies. Reducing the visibility of technology is especially challenging in the area of online language learning systems, which require high levels of interactivity and communication along multiple dimensions such as speaking, listening, reading and writing. In this article, the authors review the concept of invisibility as it applies to the design of interactive technologies and appliances. They describe a specialised appliance matched to the requirements for distance second language learning, and report on a successful multi-phase evaluation process, including initial field testing at a Thai open university.

E-Portfolios als Instrument zur Professionalisierung in der Lehrer- und Lehrerinnenausbildung

E-Portfolios haben in den letzten Jahren große Aufmerksamkeit in der aktuellen pädagogischen Fachdiskussion erfahren und können als einer der wesentlichen Trends bezeichnet werden. Mit der Bologna-konformen Überarbeitung der Lehrpläne an Hochschulen und Universitäten und der Ausrichtung de Studien an Kompetenzen (Outcome- statt Input-Orientierung) bzw. Lernerzentrierung haben immer mehr E-Portfolios den Eingang in die Curricula verschiendenster Aus- und Weiterbildungsstudien gefunden. Dieses Buch beschreibt die Arbeit mit E-Portfolios in der schulpraktischen Hochschulausbildung von Lehrerinnen und Lehrern mit dem Ziel, motivationale und technologische Faktoren der Nutzung von E-Portfolios durch Studierende zu bewerten und E-Portfolios sowohl als Werkzeug als auch als Methode in der Pädagogen- und Pädagoginnenbildung weiterzuentwickeln.

Constructing a user experience user experience-based mobile learning environment

Mobile learning, in the past defined as learning with mobile devices, now refers to any type of learning-on-the-go or learning that takes advantage of mobile technologies. This new definition shifted its focus from the mobility of technology to the mobility of the learner (O'Malley and Stanton 2002; Sharples, Arnedillo-Sanchez et al. 2009). Placing emphasis on the mobile learner’s perspective requires studying “how the mobility of learners augmented by personal and public technology can contribute to the process of gaining new knowledge, skills, and experience” (Sharples, Arnedillo-Sanchez et al. 2009). The demands of an increasingly knowledge based society and the advances in mobile phone technology are combining to spur the growth of mobile learning. Around the world, mobile learning is predicted to be the future of online learning, and is slowly entering the mainstream education. However, for mobile learning to attain its full potential, it is essential to develop more advanced technologies that are tailored to the needs of this new learning environment. A research field that allows putting the development of such technologies onto a solid basis is user experience design, which addresses how to improve usability and therefore user acceptance of a system. Although there is no consensus definition of user experience, simply stated it focuses on how a person feels about using a product, system or service. It is generally agreed that user experience adds subjective attributes and social aspects to a space that has previously concerned itself mainly with ease-of-use. In addition, it can include users’ perceptions of usability and system efficiency. Recent advances in mobile and ubiquitous computing technologies further underline the importance of human-computer interaction and user experience (feelings, motivations, and values) with a system. Today, there are plenty of reports on the limitations of mobile technologies for learning (e.g., small screen size, slow connection), but there is a lack of research on user experience with mobile technologies. This dissertation will fill in this gap by a new approach in building a user experience-based mobile learning environment. The optimized user experience we suggest integrates three priorities, namely a) content, by improving the quality of delivered learning materials, b) the teaching and learning process, by enabling live and synchronous learning, and c) the learners themselves, by enabling a timely detection of their emotional state during mobile learning. In detail, the contributions of this thesis are as follows: • A video codec optimized for screencast videos which achieves an unprecedented compression rate while maintaining a very high video quality, and a novel UI layout for video lectures, which together enable truly mobile access to live lectures. • A new approach in HTTP-based multimedia delivery that exploits the characteristics of live lectures in a mobile context and enables a significantly improved user experience for mobile live lectures. • A non-invasive affective learning model based on multi-modal emotion detection with very high recognition rates, which enables real-time emotion detection and subsequent adaption of the learning environment on mobile devices. The technology resulting from the research presented in this thesis is in daily use at the School of Continuing Education of Shanghai Jiaotong University (SOCE), a blended-learning institution with 35.000 students.

Against the Tide

In his most recent publication, Against the Tide: Critics of Digitalisation, Otto Peters brings together some of the most formidable and critical voices and compelling perspectives on the potential hazards of digitalization. The viewpoints presented range from personal, anthropological, and pedagogical to more scientific and technical, and arise from multiple disciplines. Peters has long been a respected scholar in the field of distance education, and while Peters’ earlier work has advocated the affordances of digitalization, this latest book is an abrupt shift to the darker side of digitalization. The assembly of critics Peters has gathered come from around the world and different walks of life: journalists, educators, scientists, philosophers, lawyers, mathematicians, and computer scientists, to name a few. Their one shared bond is a deep-seated belief that digitalization will have a profound and lasting impact on humankind – and not only in positive ways. ...