New functional and biomechanical assessments for the improvement of the surgical navigation systems for joint replacement in the human lower limb

In case of severe osteoarthritis at the knee causing pain, deformity, and loss of stability and mobility, the clinicians consider that the substitution of these surfaces by means of joint prostheses. The objectives to be pursued by this surgery are: complete pain elimination, restoration of the normal physiological mobility and joint stability, correction of all deformities and, thus, of limping. The knee surgical navigation systems have bee developed in computer-aided surgery in order to improve the surgical final outcome in total knee arthroplasty. These systems provide the surgeon with quantitative and real-time information about each surgical action, like bone cut executions and prosthesis component alignment, by mean of tracking tools rigidly fixed onto the femur and the tibia. Nevertheless, there is still a margin of error due to the incorrect surgical procedures and to the still limited number of kinematic information provided by the current systems. Particularly, patello-femoral joint kinematics is not considered in knee surgical navigation. It is also unclear and, thus, a source of misunderstanding, what the most appropriate methodology is to study the patellar motion. In addition, also the knee ligamentous apparatus is superficially considered in navigated total knee arthroplasty, without taking into account how their physiological behavior is altered by this surgery. The aim of the present research work was to provide new functional and biomechanical assessments for the improvement of the surgical navigation systems for joint replacement in the human lower limb. This was mainly realized by means of the identification and development of new techniques that allow a thorough comprehension of the functioning of the knee joint, with particular attention to the patello-femoral joint and to the main knee soft tissues. A knee surgical navigation system with active markers was used in all research activities presented in this research work. Particularly, preliminary test were performed in order to assess the system accuracy and the robustness of a number of navigation procedures. Four studies were performed in-vivo on patients requiring total knee arthroplasty and randomly implanted by means of traditional and navigated procedures in order to check for the real efficacy of the latter with respect to the former. In order to cope with assessment of patello-femoral joint kinematics in the intact and replaced knees, twenty in-vitro tests were performed by using a prototypal tracking tool also for the patella. In addition to standard anatomical and articular recommendations, original proposals for defining the patellar anatomical-based reference frame and for studying the patello-femoral joint kinematics were reported and used in these tests. These definitions were applied to two further in-vitro tests in which, for the first time, also the implant of patellar component insert was fully navigated. In addition, an original technique to analyze the main knee soft tissues by means of anatomical-based fiber mappings was also reported and used in the same tests. The preliminary instrumental tests revealed a system accuracy within the millimeter and a good inter- and intra-observer repeatability in defining all anatomical reference frames. In in-vivo studies, the general alignments of femoral and tibial prosthesis components and of the lower limb mechanical axis, as measured on radiographs, was more satisfactory, i.e. within ±3°, in those patient in which total knee arthroplasty was performed by navigated procedures. As for in-vitro tests, consistent patello-femoral joint kinematic patterns were observed over specimens throughout the knee flexion arc. Generally, the physiological intact knee patellar motion was not restored after the implant. This restoration was successfully achieved in the two further tests where all component implants, included the patellar insert, were fully navigated, i.e. by means of intra-operative assessment of also patellar component positioning and general tibio-femoral and patello-femoral joint assessment. The tests for assessing the behavior of the main knee ligaments revealed the complexity of the latter and the different functional roles played by the several sub-bundles compounding each ligament. Also in this case, total knee arthroplasty altered the physiological behavior of these knee soft tissues. These results reveal in-vitro the relevance and the feasibility of the applications of new techniques for accurate knee soft tissues monitoring, patellar tracking assessment and navigated patellar resurfacing intra-operatively in the contest of the most modern operative techniques. This present research work gives a contribution to the much controversial knowledge on the normal and replaced of knee kinematics by testing the reported new methodologies. The consistence of these results provides fundamental information for the comprehension and improvements of knee orthopedic treatments. In the future, the reported new techniques can be safely applied in-vivo and also adopted in other joint replacements.

Synchronization and Detection Techniques for Navigation and Communication Systems

Synchronization is a key issue in any communication system, but it becomes fundamental in the navigation systems, which are entirely based on the estimation of the time delay of the signals coming from the satellites. Thus, even if synchronization has been a well known topic for many years, the introduction of new modulations and new physical layer techniques in the modern standards makes the traditional synchronization strategies completely ineffective. For this reason, the design of advanced and innovative techniques for synchronization in modern communication systems, like DVB-SH, DVB-T2, DVB-RCS, WiMAX, LTE, and in the modern navigation system, like Galileo, has been the topic of the activity. Recent years have seen the consolidation of two different trends: the introduction of Orthogonal Frequency Division Multiplexing (OFDM) in the communication systems, and of the Binary Offset Carrier (BOC) modulation in the modern Global Navigation Satellite Systems (GNSS). Thus, a particular attention has been given to the investigation of the synchronization algorithms in these areas.

Characterization of inclusions and their distribution in natural and artificial samples by synchrotron cryo-micro-tomography (SCXRT)

Zur geometrischen Vermessung und Beschreibung von Einschlüssen in natürlichen sowie im Labor geschaffenen Eispartikeln wurde ein neuartiger Versuchaufbau an der Tomographie-Endstation der Material Science Beam Line an der Swiss Light Source (SLS, Paul Scherrer Institut, Villigen, Schweiz) entwickelt. Dieser besteht aus einer Plexiglas-Tasse und einem doppelwandigen Kaptonfolien-Käfig, der wiederum auf die Düse eines CryojetXL (Oxford Instruments) montiert wurde. Abgesehen von dem hohen Maß an Flexibilit¨at bez¨uglich der Installation erlaubt es dieser Aufbau, die Temperatur des Experiments mit einer Genauigkeit von ± 1 K über einen Bereich von 271 K bis 220 K zu regeln. In den hier beschriebenen Experimenten wurde eine räumliche Auflösung von 1.4 µm erzielt.

In-vitro synthesis and reconstitution of cytochrome bo 3 ubiquinol oxidase in artificial membranes

Forschung über Membranenproteine stellt strenge Hindernisse, seit ruhigem gerade wenige Beispiele der Membranenproteinsorten sind gekennzeichnet worden in den verwendbaren experimentellen Plattformen gegenüber. Die Hauptherausforderung ist, ihre ausgezeichnete entworfene strukturelle Vollständigkeit zu konservieren, während die Ausdruck-, Lokalisierungs- und Wiederherstellungprozesse auftreten. In-vitro übersetzungssysteme können Vorteile über auf Zellenbasisgenausdruck zum Beispiel haben, wenn das über-ausgedrückte Produkt zur Wirtszelle giftig ist oder wenn fehlende Pfosten-Übersetzungsänderung in den bakteriellen Ausdrucksystemen die Funktionalität der Säugetier- Proteine oder Mangel an vorhandenem Membranenraum verdirbt, Funktionsausdruck verbieten.rn Der Nachahmer von biologische Membranen wie feste gestützte Lipidmembranen sind als Plattform am meisten benutzt, Proteinmembraneninteraktionen nachzuforschen. Wir sind in der Lage, Membranenproteinsorte, da wir eine Plattform für Membranenproteinsynthese vorstellen, nämlich die in-vitrosynthese der Membranenproteine in ein Peptid gestütztes Membranensystem zu adressieren. Die Wiederherstellung der Membranenproteine in den Lipid bilayers resultiert im Allgemeinen mit verschiedenen Proteinanpassungen. Als Alternative erforschen wir dieses System zum ersten Mal, um genaueres Modell zu den zellularen Membranen zu verursachen und ihre Funktion, wie Proteineinfügung, Proteinfunktion und Ligandinteraktionen nachzuahmen.rn In dieser Arbeit ist unser Ziel, komplizierte Transmembraneproteine, wie des Cytochrome bo3-ubiquinol Oxydase (Cyt-bo3) direkt innerhalb der biomimetic vorbildlichen Membrane zu synthetisieren. In unserem System wird festes gestütztes tBLM wie, P19/DMPE/PC als Plattform benutzt. Dieses künstliche Membranensystem mimiks die amphiphile Architektur eines Zelle-abgeleiteten Membranensystems.rn

Resolved stellar populations in milky way and andromeda's new satellites

This thesis concerns the study of the variable stars and resolved stellar populations in four recently discovered dSphs, namely, Hercules and Ursa Major I (UMa I), which are UFD satellites of the MW; Andromeda XIX (And XIX) and Andromeda XXI (And XXI), which are satellites of M31. The main aim is to obtain detailed informations on the properties (age, metallicity, distance, and Oosterhoff type) of the stellar populations in these galaxies, to compare them with those of other satellites around the MW and M31, both ''classical'' dSphs and UFDs. The observables used to achieve these goals are the pulsating variables, especially the RR Lyrae stars, and the color magnitude diagram (CMD) of the resolved stellar populations. In particular, for UMa I, we combined B, V time-series observations from four different ground-based telescopes (Cassini, TLS, TT1 and Subaru) and for Hercules, we used archival data acquired with the Advanced Camera for Surveys (ACS) on board the HST. We used, instead B and V times-series photometry obtained with the Large Binocular Telescope (LBT) for And XIX and And XXI .

In vitro synthesis of the light-harvesting complex into artificial membrane systems

In green plants, the function of collecting solar energy for photosynthesis is fulfilled by a series of light-harvesting complexes (LHC). The light-harvesting chlorophyll a/b protein (LHCP) is synthesized in the cytosol as a precursor (pLHCP), then imported into chloroplasts and assembled into photosynthetic thylakoid membranes. Knowledge about the regulation of the transport processes of LHCP is rather limited. Closely mimicking the in vivo situation, cell-free protein expression system is employed in this dissertation to study the reconstitution of LHCP into artificial membranes. The approach starts merely from the genetic information of the protein, so the difficult and time-consuming procedures of protein expression and purification can be avoided. The LHCP encoding gene from Pisum sativum was cloned into a cell-free compatible vector system and the protein was expressed in wheat germ extracts. Vesicles or pigment-containing vesicles were prepared with either synthetic lipid or purified plant leaf lipid to mimic cell membranes. LHCP was synthesized in wheat germ extract systems with or without supplemented lipids. The addition of either synthetic or purified plant leaf lipid was found to be beneficial to the general productivity of the expression system. The lipid membrane insertion of the LHCP was investigated by radioactive labelling, protease digestion, and centrifugation assays. The LHCP is partially protected against protease digestion; however the protection is independent from the supplemented lipids.

Simulation Guided Navigation in cranio-maxillo-facial surgery: a new approach to improve intraoperative three-dimensional accuracy and reproducibility during surgery.

The aim of this PhD thesis " Simulation Guided Navigation in cranio- maxillo- facial surgery : a new approach to Improve intraoperative three-dimensional accuracy and reproducibility during surgery ." was at the center of its attention the various applications of a method introduced by our School in 2010 and has as its theme the increase of interest of reproducibility of surgical programs through methods that in whole or in part are using intraoperative navigation. It was introduced in Orthognathic Surgery Validation a new method for the interventions carried out according to the method Simulation Guided Navigation in facial deformities ; was then analyzed the method of three-dimensional control of the osteotomies through the use of templates and cutting of plates using the method precontoured CAD -CAM and laser sintering . It was finally proceeded to introduce the method of piezonavigated surgery in the various branches of maxillofacial surgery . These studies have been subjected to validation processes and the results are presented .

Controlled reproduction in Anguilla anguilla (L.): advanced studies on broodstock management, spawning techniques and system design for artificial seed production.

The thesis aims to expose the advances achieved in the practices of captive breeding of the European eel (Anguilla anguilla). Aspects investigated concern both approaches livestock (breeding selection, response to hormonal stimulation, reproductive performance, incubation of eggs) and physiological aspects (endocrine plasma profiles of players), as well as engineering aspects. Studies conducted on various populations of wild eel have shown that the main determining factor in the selection of wild females destined to captive breeding must be the Silver Index which may determine the stage of pubertal development. The hormonal induction protocol adopted, with increasing doses of carp pituitary extract, it has proven useful to ovarian development, with a synchronization effect that is positively reflected on egg production. The studies on the effects of photoperiod show how the condition of total darkness can positively influence practices of reproductions in captivity. The effects of photoperiod were also investigated at the physiological level, observing the plasma levels of steroids ( E2, T) and thyroid hormones (T3 and T4) and the expression in the liver of vitellogenin (vtg1 and vtg2) and estradiol membrane receptor (ESR1). From the comparison between spontaneous deposition and insemination techniques through the stripping is inferred as the first ports to a better qualitative and quantitative yield in the production of eggs capable of being fertilized, also the presence of a percentage of oocytes completely transparent can be used to obtain eggs at a good rate of fertility. Finally, the design and implementation of a system for recirculating aquaculture suited to meet the needs of species-specific eel showed how to improve the reproductive results, it would be preferable to adopt low-flow and low density incubation.

Synthesis and characterization of artificial aggregates and their potential applications in road construction

L’obiettivo del progetto è stato quello di realizzare ed analizzare aggregati artificiali creati attraverso geopolimerizzazione e macro-incapsulazione di paraffina in aggregati leggeri espansi, discutendo i loro possibili impieghi nelle pavimentazioni stradali. Dopo un'accurata calibrazione delle miscele geopolimeriche, sono stati realizzati degli aggregati artificiali, in seguito caratterizzati in accordo con la norma UNI EN 10343, con l'intento di sostituire materiali stradali vergini. Contemporaneamente, sono stati prodotti aggregati leggeri impregnati di paraffina (PCM), in grado di cambiare fase una volta raggiunti all'incirca i 3 °C, e successivamente rivestiti da due strati di resina poliestere e polvere di granito, denominati PLA: sfruttandone le proprietà termiche, si è valutato il loro possibile utilizzo come soluzione anti-icing. L’ultima fase della ricerca è stata incentrata nella realizzazione di aggregati geopolimerici espansi e molto porosi che potessero contenere una elevata quantità di PCM, sostituendo l'argilla espansa utilizzata nella produzione degli PLA.

Radiation dose reduction in computer assisted navigation for functional endoscopic sinus surgery--cadaver head experiments and clinical implementation

Computed tomography based navigation for endoscopic sinus surgery is inflationary used despite of major public concern about iatrogenic radiation induced cancer risk. Studies on dose reduction for CAS-CT are almost nonexistent. We validate the use of radiation dose reduced CAS-CT for clinically applied surface registration.

Comparison of three optical tracking systems in a complex navigation scenario

Three-dimensional rotational X-ray imaging with the SIREMOBIL Iso-C3D (Siemens AG, Medical Solutions, Erlangen, Germany) has become a well-established intra-operative imaging modality. In combination with a tracking system, the Iso-C3D provides inherently registered image volumes ready for direct navigation. This is achieved by means of a pre-calibration procedure. The aim of this study was to investigate the influence of the tracking system used on the overall navigation accuracy of direct Iso-C3D navigation. Three models of tracking system were used in the study: Two Optotrak 3020s, a Polaris P4 and a Polaris Spectra system, with both Polaris systems being in the passive operation mode. The evaluation was carried out at two different sites using two Iso-C3D devices. To measure the navigation accuracy, a number of phantom experiments were conducted using an acrylic phantom equipped with titanium spheres. After scanning, a special pointer was used to pinpoint these markers. The difference between the digitized and navigated positions served as the accuracy measure. Up to 20 phantom scans were performed for each tracking system. The average accuracy measured was 0.86 mm and 0.96 mm for the two Optotrak 3020 systems, 1.15 mm for the Polaris P4, and 1.04 mm for the Polaris Spectra system. For the Polaris systems a higher maximal error was found, but all three systems yielded similar minimal errors. On average, all tracking systems used in this study could deliver similar navigation accuracy. The passive Polaris system showed ? as expected ? higher maximal errors; however, depending on the application constraints, this might be negligible.

Identification of venous variants in the pineal region with three-dimensional preoperative magnetic resonance imaging navigation in patients harbouring tumors in this area: significance for surgical approach to the lesion

The purpose of this study was to identify the anatomy of pineal region venous complex using neuronavigation software when distorted by the presence of a space-occupying lesion and to describe the anatomical relationship between lesion and veins. Moreover we discuss its influence on the choice of the surgical strategy.

Evaluating the Impact of the Number of Access Points in Mobile Robots Localization Using Artificial Neural Networks

Localization is information of fundamental importance to carry out various tasks in the mobile robotic area. The exact degree of precision required in the localization depends on the nature of the task. The GPS provides global position estimation but is restricted to outdoor environments and has an inherent imprecision of a few meters. In indoor spaces, other sensors like lasers and cameras are commonly used for position estimation, but these require landmarks (or maps) in the environment and a fair amount of computation to process complex algorithms. These sensors also have a limited field of vision. Currently, Wireless Networks (WN) are widely available in indoor environments and can allow efficient global localization that requires relatively low computing resources. However, the inherent instability in the wireless signal prevents it from being used for very accurate position estimation. The growth in the number of Access Points (AP) increases the overlap signals areas and this could be a useful means of improving the precision of the localization. In this paper we evaluate the impact of the number of Access Points in mobile nodes localization using Artificial Neural Networks (ANN). We use three to eight APs as a source signal and show how the ANNs learn and generalize the data. Added to this, we evaluate the robustness of the ANNs and evaluate a heuristic to try to decrease the error in the localization. In order to validate our approach several ANNs topologies have been evaluated in experimental tests that were conducted with a mobile node in an indoor space.