Intraoperative imaging in hallux valgus surgery

Background: This prospective study investigates the use of intraoperative fluoroscopy in 28 consecutive cases undergoing hallux valgus surgery. To our knowledge there have been no studies validating the use of intraoperative fluoroscopy in hallux valgus surgery. Methods: We performed a prospective investigation of 28 consecutive cases undergoing hallux valgus surgery. Fluoroscopic images were examined intraoperatively and any significant unforseen findings documented. A comparison was made between the fluoroscopic images and weight bearing films taken 6 weeks postoperatively to examine whether the intraoperative images are an accurate representation of the standard films obtained post-operatively. We excluded those patients that went on to have an Akin osteotomy. Results: There were no unforeseen intraoperative events that were revealed by the use of fluoroscopy and no surgical modifications were made as a result of the intraoperative images. The intraoperative films were found to be a reliable representation of the postoperative weight bearing films but a small increase in the hallux valgus angle was noted at six weeks and this is thought to be due to stretching of the medial soft tissue repair. Conclusions: Intraoperative fluoroscopy is a reliable technique. This study was performed at a centre which performs approximately 100 hallux valgus operations per year and that should be taken into consideration when reviewing our findings. We conclude that there may be a role for fluoroscopy for surgeons in the early stages of the surgical learning curve and for those that infrequently perform hallux valgus surgery. We cannot however recommend that fluoroscopy be used routinely in hallux valgus surgery.

The use of thermal imaging in assessing skin temperature following cryotherapy : a review

Nineteen studies met the inclusion criteria. A skin temperature reduction of 5–15 °C, in accordance with the recent PRICE (Protection, Rest, Ice, Compression and Elevation) guidelines, were achieved using cold air, ice massage, crushed ice, cryotherapy cuffs, ice pack, and cold water immersion. There is evidence supporting the use and effectiveness of thermal imaging in order to access skin temperature following the application of cryotherapy. Thermal imaging is a safe and non-invasive method of collecting skin temperature. Although further research is required, in terms of structuring specific guidelines and protocols, thermal imaging appears to be an accurate and reliable method of collecting skin temperature data following cryotherapy. Currently there is ambiguity regarding the optimal skin temperature reductions in a medical or sporting setting. However, this review highlights the ability of several different modalities of cryotherapy to reduce skin temperature.

Sensors and imaging for wound healing : a review

Wound healing involves a complex series of biochemical events and has traditionally been managed with 'low tech' dressings and bandages. The concept that diagnostic and theranostic sensors can complement wound management is rapidly growing in popularity as there is tremendous potential to apply this technology to both acute and chronic wounds. Benefits in sensing the wound environment include reduction of hospitalization time, prevention of amputations and better understanding of the processes which impair healing. This review discusses the state-of-the-art in detection of markers associated with wound healing and infection, utilizing devices imbedded within dressings or as point-of-care techniques to allow for continual or rapid wound assessment and monitoring. Approaches include using biological or chemical sensors of wound exudates and volatiles to directly or indirectly detect bacteria, monitor pH, temperature, oxygen and enzymes. Spectroscopic and imaging techniques are also reviewed as advanced wound monitoring techniques. The review concludes with a discussion of the limitations of and future directions for this field.

Detection of right-to-left Atrial communication using agitated saline contrast imaging : experience with 1162 patients and recommendations for echocardiography

Background: Right-to-left shunting via a patent foramen ovale (PFO) has a recognized association with embolic events in younger patients. The use of agitated saline contrast imaging (ASCi) for detecting atrial shunting is well documented, however optimal technique is not well described. The purpose of this study is to assess the efficacy and safety of ASCi via TTE for assessment of right-to-left atrial communication in a large cohort of patients. Method: A retrospective review was undertaken of 1162 consecutive transthoracic (TTE) ASCi studies, of which 195 had also undergone clinically indicated transesophageal (TEE) echo. ASCi shunt results were compared with color flow imaging (CFI) and the role of provocative maneuvers (PM) assessed. Results: 403 TTE studies (35%) had paradoxical shunting seen during ASCi. Of these, 48% were positive with PM only. There was strong agreement between TTE ASCi and reported TEE findings (99% sensitivity, 85% specificity), with six false positive and two false negative results. In hindsight, the latter were likely due to suboptimal right atrial opacification, and the former due to transpulmonary shunting. TTE CFI was found to be insensitive (22%) for the detection of a PFO compared with TTE ASCi. Conclusions: TTE ASCi is minimally invasive and highly accurate for the detection of right-to-left atrial communication when PM are used. TTE CFI was found to be insensitive for PFO screening. It is recommended that TTE ASCi should be considered the initial diagnostic tool for the detection of PFO in clinical practice. A dedicated protocol should be followed to ensure adequate agitated saline contrast delivery and performance of provocative maneuvers.

In situ imaging of catalytic etching on silver during methanol oxidation conditions by environmental scanning electron microscopy

Polycrystalline silver is used to catalytically oxidise methanol to formaldehyde. This paper reports the results of extensive investigations involving the use of environmental scanning electron microscopy (ESEM) to monitor structural changes in silver during simulated industrial reaction conditions. The interaction of oxygen, nitrogen, and water, either singly or in combination, with a silver catalyst at temperatures up to 973 K resulted in the appearance of a reconstructed silver surface. More spectacular was the effect an oxygen/methanol mixture had on the silver morphology. At a temperature of ca. 713 K pinholes were created in the vicinity of defects as a consequence of subsurface explosions. These holes gradually increased in size and large platelet features were created. Elevation of the catalyst temperature to 843 K facilitated the wholescale oxygen induced restructuring of the entire silver surface. Methanol reacted with subsurface oxygen to produce subsurface hydroxyl species which ultimately formed water in the subsurface layers of silver. The resultant hydrostatic pressure forced the silver surface to adopt a "hill and valley" conformation in order to minimise the surface free energy. Upon approaching typical industrial operating conditions widespread explosions occurred on the catalyst and it was also apparent that the silver surface was extremely mobile under the applied conditions. The interaction of methanol alone with silver resulted in the initial formation of pinholes primarily in the vicinity of defects, due to reaction with oxygen species incorporated in the catalyst during electrochemical synthesis. However, dramatic reduction in the hole concentration with time occurred as all the available oxygen became consumed. A remarkable correlation between formaldehyde production and hole concentration was found.

The safety profile of perflutren microsphere contrast echocardiography during rest and stress imaging : results from an Australian multicentre cohort

Background Contrast enhanced echocardiography (CEE) is utilised when sub-optimal image quality results in non-diagnostic echocardiograms. However, there have been numerous safety notices issued by regulatory authorities regarding rare but potentially serious adverse reactions (AR). This multi-centre, retrospective analysis was performed to assess the short-term safety of CEE in a broad range of indications. Methods All CEE performed over 58 months at three institutions were assessed for AR within 30 min. Results A total of 5956 CEE were performed in 5576 patients. A total of 4903 were stress CEE and 1053 resting CCE.Bolus administration in 5719, infusion in 237 cases; 89.9% of CCE were outpatients. Commonest CEE indication was functional stress testing (82.3%). There were 16 AR related to CEE (0.27%). All AR were mild, transient and all patients made a full recovery. No cases of serious anaphylaxis or death within 30 min of contrast administration. Comparing those with and without an AR, there were no significant differences in age, gender, BMI, LVEF, patient location, exam type or RVSP. There was a slightly increased likelihood of an AR during infusion versus bolus dosing (p = 0.02). Conclusion CEE is a safe investigation in a broad range of indications and clinical scenarios. AR are very rare, mild and transient.

Revisiting logical imaging for information retrieval

Retrieval with Logical Imaging is derived from belief revision and provides a novel mechanism for estimating the relevance of a document through logical implication (i.e. P(q -> d)). In this poster, we perform the first comprehensive evaluation of Logical Imaging (LI) in Information Retrieval (IR) across several TREC test Collections. When compared against standard baseline models, we show that LI fails to improve performance. This failure can be attributed to a nuance within the model that means non-relevant documents are promoted in the ranking, while relevant documents are demoted. This is an important contribution because it not only contextualizes the effectiveness of LI, but crucially ex- plains why it fails. By addressing this nuance, future LI models could be significantly improved.

Lateralization of temporal lobe epilepsy based on resting-state functional magnetic resonance imaging and machine learning

Lateralization of temporal lobe epilepsy (TLE) is critical for successful outcome of surgery to relieve seizures. TLE affects brain regions beyond the temporal lobes and has been associated with aberrant brain networks, based on evidence from functional magnetic resonance imaging. We present here a machine learning-based method for determining the laterality of TLE, using features extracted from resting-state functional connectivity of the brain. A comprehensive feature space was constructed to include network properties within local brain regions, between brain regions, and across the whole network. Feature selection was performed based on random forest and a support vector machine was employed to train a linear model to predict the laterality of TLE on unseen patients. A leave-one-patient-out cross validation was carried out on 12 patients and a prediction accuracy of 83% was achieved. The importance of selected features was analyzed to demonstrate the contribution of resting-state connectivity attributes at voxel, region, and network levels to TLE lateralization.

Identifying vulnerable carotid plaques in vivo using high resolution magnetic resonance imaging-based finite element analysis

Object. Individuals with carotid atherosclerosis develop symptoms following rupture of vulnerable plaques. Biomechanical stresses within this plaque may increase vulnerability to rupture. In this report the authors describe the use of in vivo carotid plaque imaging and computational mechanics to document the magnitude and distribution of intrinsic plaque stresses. Methods. Ten (five symptomatic and five asymptomatic) individuals underwent plaque characterization magnetic resonance (MR) imaging. Plaque geometry and composition were determined by multisequence review. Intrinsic plaque stress profiles were generated from 3D meshes by using finite element computational analysis. Differences in principal (shear) stress between normal and diseased sections of the carotid artery and between symptomatic and asymptomatic plaques were noted. Results. There was a significant difference in peak principal stress between diseased and nondiseased segments of the artery (mean difference 537.65 kPa, p < 0.05). Symptomatic plaques had higher mean stresses than asymptomatic plaques (627.6 kPa compared with 370.2 kPa, p = 0.05), which were independent of luminal stenosis and plaque composition. Conclusions. Significant differences in plaque stress exist between plaques from symptomatic individuals and those from asymptomatic individuals. The MR imaging-based computational analysis may therefore be a useful aid to identification of vulnerable plaques in vivo.

Evaluation of document binarization using eigen value decomposition

A necessary step for the recognition of scanned documents is binarization, which is essentially the segmentation of the document. In order to binarize a scanned document, we can find several algorithms in the literature. What is the best binarization result for a given document image? To answer this question, a user needs to check different binarization algorithms for suitability, since different algorithms may work better for different type of documents. Manually choosing the best from a set of binarized documents is time consuming. To automate the selection of the best segmented document, either we need to use ground-truth of the document or propose an evaluation metric. If ground-truth is available, then precision and recall can be used to choose the best binarized document. What is the case, when ground-truth is not available? Can we come up with a metric which evaluates these binarized documents? Hence, we propose a metric to evaluate binarized document images using eigen value decomposition. We have evaluated this measure on DIBCO and H-DIBCO datasets. The proposed method chooses the best binarized document that is close to the ground-truth of the document.

Neural Modeling and Imaging of the Cortical Interactions Underlying Syllable Production

This paper describes a neural model of speech acquisition and production that accounts for a wide range of acoustic, kinematic, and neuroimaging data concerning the control of speech movements. The model is a neural network whose components correspond to regions of the cerebral cortex and cerebellum, including premotor, motor, auditory, and somatosensory cortical areas. Computer simulations of the model verify its ability to account for compensation to lip and jaw perturbations during speech. Specific anatomical locations of the model's components are estimated, and these estimates are used to simulate fMRI experiments of simple syllable production with and without jaw perturbations.

Near Field Enhancement and Subwavelength Imaging Using Resonantly Loaded Apertures

It is demonstrated that the electromagnetic (EM) transmission through a subwavelength or non-resonant aperture in a conductive screen can be dramatically enhanced by loading it with folded metallic strips exhibiting resonant properties. When illuminated by an EM plane wave these loaded apertures enable very tight, subwavelength, collimation of the EM power in the near field zone. We propose planar and quasi-planar resonant insertion geometries that should allow, for the first time, two-dimensional dual-polarization subwavelength field confinement along with ability to focus both electric and magnetic fields. The proposed technique for resonance transmission enhancement and near field confinement forms a basis for a new class of microwave near field imaging probe with subwavelength resolution capable of operating over a wide range of imaging distances (0.05–$0.25lambda$). Measurement results demonstrate the possibility of high contrast (more than 3 dB in amplitude and 40 degrees in phase) near field subwavelength imaging of 2D and 3D resonant and non-resonant metallic and dielectric targets in free space and in moderately lossy layered media.

PET/CT imaging for target volume delineation in curative intent radiotherapy of non-small cell lung cancer: IAEA consensus report 2014

This document describes best practice and evidence based recommendations for the use of FDG-PET/CT for the purposes of radiotherapy target volume delineation (TVD) for curative intent treatment of non-small cell lung cancer (NSCLC). These recommendations have been written by an expert advisory group, convened by the International Atomic Energy Agency (IAEA) to facilitate a Coordinated Research Project (CRP) aiming to improve the applications of PET based radiation treatment planning (RTP) in low and middle income countries. These guidelines can be applied in routine clinical practice of radiotherapy TVD, for NSCLC patients treated with concurrent chemoradiation or radiotherapy alone, where FDG is used, and where a calibrated PET camera system equipped for RTP patient positioning is available. Recommendations are provided for PET and CT image visualization and interpretation, and for tumor delineation using planning CT with and without breathing motion compensation.

MPGDs based radiation imaging devices and applications

Este trabalho descreve o desenvolvimento e aplicação de sistemas baseados em detetores gasosos microestruturados, para imagiologia de fluorescência de raios-X por dispersão em energia (EDXRF). A técnica de imagiologia por fluorescência de raios-X assume-se como uma técnica poderosa, não-destrutiva, em análises da distribuição espacial de elementos em materiais. Os sistemas para imagiologia de EDXRF desenvolvidos são constituídos por: um tubo de raios-X, usado para excitar os elementos da amostra; um detetor gasoso microestruturado; e uma lente pinhole que foca a radiação de fluorescência no plano do detetor formando assim a imagem e permitindo a sua ampliação. Por outro lado é estudada a influência do diâmetro da abertura do pinhole bem como do fator de ampliação obtido para a imagem, na resolução em posição do sistema. Foram usados dois conceitos diferentes de detetores gasosos microestruturados. O primeiro, baseado na microestrutura designada por 2D-Micro-Hole & Strip Plate (2D-MHSP) com uma área ativa de 3 3 cm2, enquanto que o segundo, baseado na estrutura 2D-Thick-COBRA (2D-THCOBRA) apresenta uma área ativa de deteção de 10 10 cm2. Estes detetores de raios-X de baixo custo têm a particularidade de funcionar em regime de fotão único permitindo a determinação da energia e posição de interação de cada fotão que chega ao detetor. Deste modo permitem detetar a energia dos fotões X de fluorescência, bem como obter imagens 2D da distribuição desses fotões X para o intervalo de energias desejado. São por isso adequados a aplicações de imagiologia de EDXRF. Os detetores desenvolvidos mostraram resoluções em energia de 17% e 22% para fotões incidentes com uma energia de 5.9 keV, respectivamente para o detetor 2D-MHSP e 2D-THCOBRA e resoluções em posição adequadas para um vasto número de aplicações. Ao longo deste trabalho é detalhado o desenvolvimento, o estudo das características e do desempenho de cada um dos detetores, e sua influência na performance final de cada sistema proposto. Numa fase mais avançada apresentam-se os resultados correspondentes à aplicação dos dois sistemas a diversas amostras, incluindo algumas do nosso património cultural e também uma amostra biológica.