Systemic response of the GH/IGF-I axis in timely versus delayed fracture healing

The GH-IGF axis has profound effects on the local and systemic regulation of bone metabolism and may be important for quality of fracture healing. To test the hypothesis that deficiency of the GH/IGF axis may play a role in the pathogenesis of fracture non-union we investigated whether alterations of serum concentrations of the GH-IGF axis could be related to failed fracture healing compared to timely fracture healing in trauma patients. Serum probes were prospectively collected from 186 patients with surgical treatment of long bone fractures up to 6 months after surgery. Samples from 14 patients with atrophic type of non-union have been compared to 14 matched patients with normal bone healing. Postoperative time courses of serum concentrations have been analyzed using commercially available chemiluminescence sandwich assays (GH), fully automated assay systems (IGF-I, IGFBP-3) or sandwich immunometric assays (ALS). Comparison between both collectives revealed significantly lower serum concentrations of GH dependent ALS during early (1st week after surgery) and of both IGFBP-3 and ALS during late stages of fracture healing (6 and 8 weeks after surgery) in non-union patients, coinciding clinically with failed fracture healing. Tendentially lower serum levels of IGF-I in the non-union group over the entire investigation period were statistically not significant. We have been able to show time courses of serum concentrations of the GH/IGF-I axis during normal and failed fracture healing in humans. An impairment of the GH/IGF-I axis might be involved in the biochemical mechanisms determining delayed or failed fracture healing.

Validation of a new method for determination of cup orientation in THA

Our goal was to validate accuracy, consistency, and reproducibility/reliability of a new method for determining cup orientation in total hip arthroplasty (THA). This method allows matching the 3D-model from CT images or slices with the projected pelvis on an anteroposterior pelvic radiograph using a fully automated registration procedure. Cup orientation (inclination and anteversion) is calculated relative to the anterior pelvic plane, corrected for individual malposition of the pelvis during radiograph acquisition. Measurements on blinded and randomized radiographs of 80 cadaver and 327 patient hips were investigated. The method showed a mean accuracy of 0.7 +/- 1.7 degrees (-3.7 degrees to 4.0 degrees) for inclination and 1.2 +/- 2.4 degrees (-5.3 degrees to 5.6 degrees) for anteversion in the cadaver trials and 1.7 +/- 1.7 degrees (-4.6 degrees to 5.5 degrees) for inclination and 0.9 +/- 2.8 degrees (-5.2 degrees to 5.7 degrees) for anteversion in the clinical data when compared to CT-based measurements. No systematic errors in accuracy were detected with the Bland-Altman analysis. The software consistency and the reproducibility/reliability were very good. This software is an accurate, consistent, reliable, and reproducible method to measure cup orientation in THA using a sophisticated 2D/3D-matching technique. Its robust and accurate matching algorithm can be expanded to statistical models.

A communication and information technology infrastructure for real time monitoring and management of type 1 diabetes patients

This paper is focused on the integration of state-of-the-art technologies in the fields of telecommunications, simulation algorithms, and data mining in order to develop a Type 1 diabetes patient's semi to fully-automated monitoring and management system. The main components of the system are a glucose measurement device, an insulin delivery system (insulin injection or insulin pumps), a mobile phone for the GPRS network, and a PDA or laptop for the Internet. In the medical environment, appropriate infrastructure for storage, analysis and visualizing of patients' data has been implemented to facilitate treatment design by health care experts.

Beitrag zur Dimensionierung von automatischen Sortiersystemen (Sorter)

Automatischen Sortiersysteme (Sorter) besitzen in der Intralogistik eine große Bedeutung. Sorter erreichen eine ausdauernd hohe Sortierleistung bei gleichzeitig geringer Fehlsortierrate und bilden deshalb oft den zentralen Baustein in Materialflusssystemen mit hoher Umschlagsrate. Distributionszentren mit Lager und Kommissionierfunktion sind typische Vertreter solcher Materialflusssysteme. Ein Sorter besteht aus den Subsystemen Einschleusung, Verteilförderer und Endstellen. Die folgenden Betrachtungen fokussieren auf ein Sortermodell mit einem Verteilförderer in Ringstruktur und einer Einzelplatzbelegung. Auf jedem Platz kann genau ein Gut transportiert werden. Der Verteilförderer besitzt somit eine feste Transportkapazität. Derartige Förderer werden in der Regel als Kippschalen- oder Quergurt-Sorter ausgeführt. Die theoretische Sortierleistung für diesen Sortertyp kann aus Fahrgeschwindigkeit und Transportplatzabstand bestimmt werden. Diese Systemleistung wird im praktischen Betrieb kaum erreicht. Verschiedene Faktoren im Einschleusbereich und im Ausschleusbereich führen zu einer Leistungsminderung. Betrachtungen zur Bestimmung der mittleren Warteschlangenlänge im Einschleusbereich sowie zur Ermittlung des Rundläuferanteils auf dem Verteilförderer werden im folgenden Beitrag vorgestellt. Diesem Beitrag liegt ein Forschungsvorhaben zugrunde, das aus Mitteln des Bundesministeriums für Wirtschaft und Technologie (BMWi) über die Arbeitsgemeinschaft industrieller Forschungsvereinigungen "Otto von Guericke" (AiF) gefördert und im Auftrage der Bundesvereinigung Logistik e.V. (BVL) ausgeführt wurde.

Comparison of 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT within patients with gastroenteropancreatic neuroendocrine tumors

Somatostatin receptor PET tracers such as [68Ga-DOTA,1-Nal3]-octreotide (68Ga-DOTANOC) and [68Ga-DOTA,Tyr3]-octreotate (68Ga-DOTATATE) have shown promising results in patients with neuroendocrine tumors, with a higher lesion detection rate than is achieved with 18F-fluorodihydroxyphenyl-l-alanine PET, somatostatin receptor SPECT, CT, or MR imaging. 68Ga-DOTANOC has high affinity for somatostatin receptor subtypes 2, 3, and 5 (sst2,3,5). It has a wider receptor binding profile than 68Ga-DOTATATE, which is sst2-selective. The wider receptor binding profile might be advantageous for imaging because neuroendocrine tumors express different subtypes of somatostatin receptors. The goal of this study was to prospectively compare 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT in the same patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and to evaluate the clinical impact of 68Ga-DOTANOC PET/CT. Methods: Eighteen patients with biopsy-proven GEP-NETs were evaluated with 68Ga-DOTANOC and 68Ga-DOTATATE using a randomized crossover design. Labeling of DOTANOC and DOTATATE with 68Ga was standardized using a fully automated synthesis device. PET/CT findings were compared with 3-phase CT scans and in some patients with MR imaging, 18F-FDG PET/CT, and histology. Uptake in organs and tumor lesions was quantified and compared by calculation of maximum standardized uptake values (SUVmax) using volume computer-assisted reading. Results: Histology revealed low-grade GEP-NETs (G1) in 4 patients, intermediate grade (G2) in 7, and high grade (G3) in 7. 68Ga-DOTANOC and 68Ga-DOTATATE were false-negative in only 1 of 18 patients. In total, 248 lesions were confirmed by cross-sectional and PET imaging. The lesion-based sensitivity of 68Ga-DOTANOC PET was 93.5%, compared with 85.5% for 68Ga-DOTATATE PET (P = 0.005). The better performance of 68Ga-DOTANOC PET is attributed mainly to the significantly higher detection rate of liver metastases rather than tumor differentiation grade. Multivariate analysis revealed significantly higher SUVmax in G1 tumors than in G3 tumors (P = 0.009). This finding was less pronounced with 68Ga-DOTANOC (P > 0.001). Altogether, 68Ga-DOTANOC changed treatment in 3 of 18 patients (17%). Conclusion: The sst2,3,5-specific radiotracer 68Ga-DOTANOC detected significantly more lesions than the sst2-specific radiotracer 68Ga-DOTATATE in our patients with GEP-NETs. The clinical relevance of this finding has to be proven in larger studies.

Monitoring of alcohol markers by capillary electrophoresis.

Work dealing with the monitoring of alcohol markers by CE performed during the past two decades led to the development of assays for carbohydrate-deficient transferrin (CDT), ethyl sulfate, ethyl glucuronide, and phosphatidylethanol in body fluids and first attempts for the detection of the urinary 5-hydroxytryptophol/5-hydroxyindoleacetic acid ratio and stable hemoglobin acetaldehyde adducts. Most notably are assays for CDT that have been commercialized and are being used in many laboratories under routine conditions. This paper provides insight into the development, specifications, and use of the currently known CE-based assays suitable to detect alcohol markers. The achievements reached so far indicate that CE is an attractive technology for monitoring alcohol markers. This is particularly seen with the CDT assays that do not require an elaborate sample pretreatment and thus could be fully automated for high-throughput analyses on multicapillary instruments.

Multi-modal glioblastoma segmentation: man versus machine

BACKGROUND AND PURPOSE Reproducible segmentation of brain tumors on magnetic resonance images is an important clinical need. This study was designed to evaluate the reliability of a novel fully automated segmentation tool for brain tumor image analysis in comparison to manually defined tumor segmentations. METHODS We prospectively evaluated preoperative MR Images from 25 glioblastoma patients. Two independent expert raters performed manual segmentations. Automatic segmentations were performed using the Brain Tumor Image Analysis software (BraTumIA). In order to study the different tumor compartments, the complete tumor volume TV (enhancing part plus non-enhancing part plus necrotic core of the tumor), the TV+ (TV plus edema) and the contrast enhancing tumor volume CETV were identified. We quantified the overlap between manual and automated segmentation by calculation of diameter measurements as well as the Dice coefficients, the positive predictive values, sensitivity, relative volume error and absolute volume error. RESULTS Comparison of automated versus manual extraction of 2-dimensional diameter measurements showed no significant difference (p = 0.29). Comparison of automated versus manual segmentation of volumetric segmentations showed significant differences for TV+ and TV (p<0.05) but no significant differences for CETV (p>0.05) with regard to the Dice overlap coefficients. Spearman's rank correlation coefficients (ρ) of TV+, TV and CETV showed highly significant correlations between automatic and manual segmentations. Tumor localization did not influence the accuracy of segmentation. CONCLUSIONS In summary, we demonstrated that BraTumIA supports radiologists and clinicians by providing accurate measures of cross-sectional diameter-based tumor extensions. The automated volume measurements were comparable to manual tumor delineation for CETV tumor volumes, and outperformed inter-rater variability for overlap and sensitivity.

Computer assisted planning and navigation of periacetabular osteotomy with range of motion optimization

Femoroacetabular impingement (FAI) before or after Periacetabular Osteotomy (PAO) is surprisingly frequent and surgeons need to be aware of the risk preoperatively and be able to avoid it intraoperatively. In this paper we present a novel computer assisted planning and navigation system for PAO with impingement analysis and range of motion (ROM) optimization. Our system starts with a fully automatic detection of the acetabular rim, which allows for quantifying the acetabular morphology with parameters such as acetabular version, inclination and femoral head coverage ratio for a computer assisted diagnosis and planning. The planned situation was optimized with impingement simulation by balancing acetabuar coverage with ROM. Intra-operatively navigation was conducted until the optimized planning situation was achieved. Our experimental results demonstrated: 1) The fully automated acetabular rim detection was validated with accuracy 1.1 ± 0.7mm; 2) The optimized PAO planning improved ROM significantly compared to that without ROM optimization; 3) By comparing the pre-operatively planned situation and the intra-operatively achieved situation, sub-degree accuracy was achieved for all directions.

A unified approach to architecture conformance checking

Architectural decisions can be interpreted as structural and behavioral constraints that must be enforced in order to guarantee overarching qualities in a system. Enforcing those constraints in a fully automated way is often challenging and not well supported by current tools. Current approaches for checking architecture conformance either lack in usability or offer poor options for adaptation. To overcome this problem we analyze the current state of practice and propose an approach based on an extensible, declarative and empirically-grounded specification language. This solution aims at reducing the overall cost of setting up and maintaining an architectural conformance monitoring environment by decoupling the conceptual representation of a user-defined rule from its technical specification prescribed by the underlying analysis tools. By using a declarative language, we are able to write tool-agnostic rules that are simple enough to be understood by untrained stakeholders and, at the same time, can be can be automatically processed by a conformance checking validator. Besides addressing the issue of cost, we also investigate opportunities for increasing the value of conformance checking results by assisting the user towards the full alignment of the implementation with respect to its architecture. In particular, we show the benefits of providing actionable results by introducing a technique which automatically selects the optimal repairing solutions by means of simulation and profit-based quantification. We perform various case studies to show how our approach can be successfully adopted to support truly diverse industrial projects. We also investigate the dynamics involved in choosing and adopting a new automated conformance checking solution within an industrial context. Our approach reduces the cost of conformance checking by avoiding the need for an explicit management of the involved validation tools. The user can define rules using a convenient high-level DSL which automatically adapts to emerging analysis requirements. Increased usability and modular customization ensure lower costs and a shorter feedback loop.

Ultrasonic sensors in urban traffic driving-aid systems

Currently, vehicles are often equipped with active safety systems to reduce the risk of accidents, most of which occur in urban environments. The most prominent include Antilock Braking Systems (ABS), Traction Control and Stability Control. All these systems use different kinds of sensors to constantly monitor the conditions of the vehicle, and act in an emergency. In this paper the use of ultrasonic sensors in active safety systems for urban traffic is proposed, and the advantages and disadvantages when compared to other sensors are discussed. Adaptive Cruise Control (ACC) for urban traffic based on ultrasounds is presented as an application example. The proposed system has been implemented in a fully-automated prototype vehicle and has been tested under real traffic conditions. The results confirm the good performance of ultrasonic sensors in these systems. ©2011 by the authors.

User-definable resource usage bounds analysis for java bytecode

Automatic cost analysis of programs has been traditionally concentrated on a reduced number of resources such as execution steps, time, or memory. However, the increasing relevance of analysis applications such as static debugging and/or certiflcation of user-level properties (including for mobile code) makes it interesting to develop analyses for resource notions that are actually application-dependent. This may include, for example, bytes sent or received by an application, number of files left open, number of SMSs sent or received, number of accesses to a datábase, money spent, energy consumption, etc. We present a fully automated analysis for inferring upper bounds on the usage that a Java bytecode program makes of a set of application programmer-deflnable resources. In our context, a resource is defined by programmer-provided annotations which state the basic consumption that certain program elements make of that resource. From these deflnitions our analysis derives functions which return an upper bound on the usage that the whole program (and individual blocks) make of that resource for any given set of input data sizes. The analysis proposed is independent of the particular resource. We also present some experimental results from a prototype implementation of the approach covering a signiflcant set of interesting resources.

Customizable resource usage analysis for java bytecode

Automatic cost analysis of programs has been traditionally studied in terms of a number of concrete, predefined resources such as execution steps, time, or memory. However, the increasing relevance of analysis applications such as static debugging and/or certification of user-level properties (including for mobile code) makes it interesting to develop analyses for resource notions that are actually applicationdependent. This may include, for example, bytes sent or received by an application, number of files left open, number of SMSs sent or received, number of accesses to a database, money spent, energy consumption, etc. We present a fully automated analysis for inferring upper bounds on the usage that a Java bytecode program makes of a set of application programmer-definable resources. In our context, a resource is defined by programmer-provided annotations which state the basic consumption that certain program elements make of that resource. From these definitions our analysis derives functions which return an upper bound on the usage that the whole program (and individual blocks) make of that resource for any given set of input data sizes. The analysis proposed is independent of the particular resource. We also present some experimental results from a prototype implementation of the approach covering an ample set of interesting resources.

Automatic-dependent surveillance-broadcast experimental deployment using system wide information management

This paper describes an automatic-dependent surveillance-broadcast (ADS-B) implementation for air-to-air and ground-based experimental surveillance within a prototype of a fully automated air traffic management (ATM) system, under a trajectory-based-operations paradigm. The system is built using an air-inclusive implementation of system wide information management (SWIM). This work describes the relations between airborne and ground surveillance (SURGND), the prototype surveillance systems, and their algorithms. System's performance is analyzed with simulated and real data. Results show that the proposed ADS-B implementation can fulfill the most demanding surveillance accuracy requirements.

Nondestructive quantification of chemical and physical properties of fruits by time-resolved reflectance spectroscopy in the wavelength range 650-1000 nm

Time-resolved reflectance spectroscopy can be used to assess nondestructively the bulk (rather than the superficial) optical properties of highly diffusive media. A fully automated system for time-resolved reflectance spectroscopy was used to evaluate the absorption and the transport scattering spectra of fruits in the red and the near-infrared regions. In particular, data were collected in the range 650-1000 nm from three varieties of apples and from peaches, kiwifruits, and tomatoes. The absorption spectra were usually dominated by the water peak near 970 nm, whereas chlorophyll was detected at 675 nm. For ail species the scattering decreased progressively with increasing wavelength. A best fit to water and chlorophyll absorption line shapes and to Mie theory permitted the estimation of water and chlorophyll content and the average size of scattering centers in the bulls; of intact fruits.

Estudio de la viabilidad técnica y económica del establecimiento de una terminal de contenedores automatizada en el Mediterráneo español

Esta Tesis analiza, en primer lugar, las posibilidades y condiciones de los puertos españoles de Algeciras, Valencia y Barcelona para acoger en el futuro una terminal totalmente automatizada (robotizada) de contenedores con una capacidad aproximada de 1,3-1,4 millones de contenedores/año o 2 millones de TEU/año. Entre las posibles amenazas y oportunidades que pueden afectar al actual tráfico de esos puertos, la Tesis se centra en el desvío del tráfico de contenedores de transbordo, la sustitución de los tráficos marinos por tráficos ferroviarios, la posibilidad de convertir al Mediterráneo español en la puerta de entrada de productos asiáticos, el cambio de la ruta Asia-Europa a través del Canal de Suez por la ruta Asia-Europa a través del Ártico, la posibilidad de circunvalar África para evitar el Canal de Suez y la próxima apertura de nuevo Canal de Panamá ampliado. La Tesis describe el Estado del Arte de la tecnología para las terminales de contenedores automatizadas que pudiera ser aplicada en nuestro país y desarrolla una terminal automatizada con la capacidad ya mencionada de 2 millones de TEU/año. El tema del ferrocarril en las terminales de contenedores, como futura lanzadera para la proyección de la influencia de los puertos, está desarrollado como una parte esencial de una terminal de contenedores. Se investiga, también, la automatización total o parcial en la transferencia de mercancía buque-ferrocarril La Tesis también desarrolla una metodología para desglosar los costes e ingresos de una terminal automatizada. A través de esos costes e ingresos se va desarrollando, mediante la utilización de hojas Excel relacionadas, el método para mostrar la estructuración de los hitos económicos fundamentales hasta llegar al VAN, TIR y Periodo de Retorno de la Inversión como elementos clave para la calificación de la terminal como proyecto de inversión. La Tesis realiza la misma metodología para la terminal convencional de contenedores más habitual en el Mediterráneo español: la terminal que utiliza sistemas de grúas sobre ruedas (RTG) en el patio de contenedores. Por último, la Tesis establece la comparativa entre los dos tipos de terminales analizadas: la convencional y la automatizada, basándose en el coste de la mano de obra portuaria como elemento clave para dicha comparativa. Se establece la frontera que determina en qué niveles de coste del personal portuario la terminal automatizada es mejor proyecto de inversión que la terminal convencional con RTG. Mediante la creación de la metodología descrita, la Tesis permite: - La comparativa entre diferentes tipos de terminales - La posibilidad de analizar un modelo de terminal variando sus parámetros fundamentales: costes de los estibadores, nuevas tecnologías de manipulación, diferentes rendimientos, variación de los ingresos, etc. - Descubrir el modelo más rentable de una futura terminal mediante la comparación de las diferentes tecnologías que se puedan emplear para la construcción de dicha terminal ABSTRACT This Thesis examines, first, the possibilities and conditions of the Spanish ports of Algeciras, Valencia and Barcelona to host in the future a fully automated container terminal (robotized) with a capacity of approximately 1.3-1.4 million containers/year or 2 million TEU/year. Among the potential threats and opportunities that may affect the current traffic of these ports, the thesis focuses on the diversion of container transhipment traffic, the replacing of marine traffic by rail traffic, the possibility of converting the Spanish Mediterranean in the door input of Asian products, the changing of the Asia-Europe route through the Suez Canal by the Asia-Europe route through the Arctic, the possibility of circumnavigating Africa to avoid the Suez Canal and the upcoming opening of the new expanded Canal of Panama. The Thesis describes the state-of-the-art technology for automated container terminals that could be applied in our country and develops an automated terminal with the listed capacity of 2 million TEUs / year. The use of the railway system in container terminals to be used as future shuttle to the projection of the influence of the ports is developed as an essential part of a container terminal. We also investigate the total or partial automation in transferring goods from ship to rail. The Thesis also develops a methodology to break down the costs and revenues of an automated terminal. Through these costs and revenues is developed, using linked Excel sheets, the method to show the formation of structured key economic milestones until the NPV, IRR and Period of Return of Investment as key to determining the terminal as an investment project. The Thesis takes the same methodology for the conventional container terminal more common in the Spanish Mediterranean: the terminal using rubber tyred cranes (RTG) in the container yard. Finally, the Thesis provides a comparison between the two types of analyzed terminals: conventional and automated, based on the cost of stevedores labor as a key point for that comparison. It establishes the boundary that determines what levels of stevedore costs make automated terminal to be better investment project than a conventional terminal using RTG. By creating the above methodology, the Thesis allows: - The comparison between different types of terminals - The possibility of analyzing a model of terminal varying its key parameters: stevedores costs, new technologies of container handling, different loading/unloading rates, changes in incomes and so on - Unveil the most profitable model for a future terminal by comparing the different technologies that can be employed for the construction of that terminal