A 3D computed tomography based tool for orthopedic surgery planning

Series : Lecture notes in computational vision and biomechanics, vol. 19The preparation of a plan is essential for a surgery to take place in the best way possible and also for shortening patient’s recovery times. In the orthopedic case, planning has an accentuated significance due to the close relation between the degree of success of the surgery and the patient recovering time. It is important that surgeons are provided with tools that help them in the planning task, in order to make it more reliable and less time consuming. In this paper, we present a 3D Computed Tomography based solution and its implementation as an OsiriX plugin for orthopedic surgery planning. With the developed plugin, the surgeon is able to manipulate a three-dimensional isosurface rendered from the selected imaging study (a CT scan). It is possible to add digital representations of physical implants (surgical templates), in order to evaluate the feasibility of a plan. These templates are STL files generated from CAD models. There is also the feature to extract new isosurfaces of different voxel values and slice the final 3D model according to a predefined plane, enabling a 2D analysis of the planned solution. Finally, we discuss how the proposed application assists the surgeon in the planning process in an alternative way, where it is possible to three-dimensionally analyze the impact of a surgical intervention on the patient.(undefined

Quantifying the effect of uncertainty in input parameters in a simplified bidomain model of partial thickness ischaemia

Reduced blood flow in the coronary arteries can lead to damaged heart tissue (myocardial ischaemia). Although one method for detecting myocardial ischaemia involves changes in the ST segment of the electrocardiogram, the relationship between these changes and subendocardial ischaemia is not fully understood. In this study, we modelled ST-segment epicardial potentials in a slab model of cardiac ventricular tissue, with a central ischaemic region, using the bidomain model, which considers conduction longitudinal, transverse and normal to the cardiac fibres. We systematically quantified the effect of uncertainty on the input parameters, fibre rotation angle, ischaemic depth, blood conductivity and six bidomain conductivities, on outputs that characterise the epicardial potential distribution. We found that three typical types of epicardial potential distributions (one minimum over the central ischaemic region, a tripole of minima, and two minima flanking a central maximum) could all occur for a wide range of ischaemic depths. In addition, the positions of the minima were affected by both the fibre rotation angle and the ischaemic depth, but not by changes in the conductivity values. We also showed that the magnitude of ST depression is affected only by changes in the longitudinal and normal conductivities, but not by the transverse conductivities

A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

BACKGROUND: Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. METHODS: Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse. RESULTS: Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%). CONCLUSIONS: A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up

The Hubbard model within the equations of motion approach

The Hubbard model has a special role in Condensed Matter Theory as it is considered as the simplest Hamiltonian model one can write in order to describe anomalous physical properties of some class of real materials. Unfortunately, this model is not exactly solved except for some limits and therefore one should resort to analytical methods, like the Equations of Motion Approach, or to numerical techniques in order to attain a description of its relevant features in the whole range of physical parameters (interaction, filling and temperature). In this manuscript, the Composite Operator Method, which exploits the above mentioned analytical technique, is presented and systematically applied in order to get information about the behavior of all relevant properties of the model (local, thermodynamic, single- and two- particle ones) in comparison with many other analytical techniques, the above cited known limits and numerical simulations. Within this approach, the Hubbard model is shown to be also capable to describe some anomalous behaviors of the cuprate superconductors.Comment: 232 pages, more than 300 figures, more than 500 reference

Online dispute resolution: an artificial intelligence perspective

Litigation in court is still the main dispute resolution mode. However, given the amount and characteristics of the new disputes, mostly arising out of electronic contracting, courts are becoming slower and outdated. Online Dispute Resolution (ODR) recently emerged as a set of tools and techniques, supported by technology, aimed at facilitating conflict resolution. In this paper we present a critical evaluation on the use of Artificial Intelligence (AI) based techniques in ODR. In order to fulfill this goal, we analyze a set of commercial providers (in this case twenty four) and some research projects (in this circumstance six). Supported by the results so far achieved, a new approach to deal with the problem of ODR is proposed, in which we take on some of the problems identified in the current state of the art in linking ODR and AI.The work described in this paper is included in TIARAC - Telematics and Artificial Intelligence in Alternative Conflict Resolution Project (PTDC/JUR/71354/2006), which is a research project supported by FCT (Science & Technology Foundation), Portugal. The work of Davide Carneiro is also supported by a doctoral grant by FCT (SFRH/BD/64890/2009).Acknowledgments. The work described in this paper is included in TIARAC - Telematics and Artificial Intelligence in Alternative Conflict Resolution Project (PTDC/JUR/71354/2006), which is a research project supported by FCT (Science & Technology Foundation), Portugal. The work of Davide Carneiro is also supported by a doctoral grant by FCT (SFRH/BD/64890/2009)

Stat3 controls cell death during mammary gland involution by regulating uptake of milk fat globules and lysosomal membrane permeabilization.

We have previously demonstrated that Stat3 regulates lysosomal-mediated programmed cell death (LM-PCD) during mouse mammary gland involution in vivo. However, the mechanism that controls the release of lysosomal cathepsins to initiate cell death in this context has not been elucidated. We show here that Stat3 regulates the formation of large lysosomal vacuoles that contain triglyceride. Furthermore, we demonstrate that milk fat globules (MFGs) are toxic to epithelial cells and that, when applied to purified lysosomes, the MFG hydrolysate oleic acid potently induces lysosomal leakiness. Additionally, uptake of secreted MFGs coated in butyrophilin 1A1 is diminished in Stat3-ablated mammary glands and loss of the phagocytosis bridging molecule MFG-E8 results in reduced leakage of cathepsins in vivo. We propose that Stat3 regulates LM-PCD in mouse mammary gland by switching cellular function from secretion to uptake of MFGs. Thereafter, perturbation of lysosomal vesicle membranes by high levels of free fatty acids results in controlled leakage of cathepsins culminating in cell death.This work was supported by a grant from the Medical Research Council programme grant no. MR/J001023/1 (T.J.S. and B. L-L.) and a Cancer Research UK Cambridge Cancer Centre PhD studentship (H.K.R.).This is the accepted manuscript. The final version is available from Nature Publishing at http://www.nature.com/ncb/journal/vaop/ncurrent/full/ncb3043.html

Estimating stable isotope turnover rates of epidermal mucus and dorsal muscle for an omnivorous fish using a diet-switch experiment

© 2018, The Author(s). Stable isotope (SI) analysis studies rely on knowledge of isotopic turnover rates and trophic-step discrimination factors. Epidermal mucus (‘mucus’) potentially provides an alternative SI ‘tissue’ to dorsal muscle that can be collected non-invasively and non-destructively. Here, a diet-switch experiment using the omnivorous fish Cyprinus carpio and plant- and fish-based formulated feeds compared SI data between mucus and muscle, including their isotopic discrimination factors and turnover rates (as functions of time T and mass G, at isotopic half-life (50) and equilibrium (95)). Mucus isotope data differed significantly and predictively from muscle data. The fastest δ13C turnover rate was for mucus in fish on the plant-based diet (T50: 17 days, T95: 74 days; G50: 1.08(BM), G95: 1.40(BM)). Muscle turnover rates were longer for the same fish (T50: 44 days, T95: 190 days; G50: 1.13(BM), G95: 1.68(BM)). Longer half-lives resulted in both tissues from the fish-based diet. δ13C discrimination factors varied by diet and tissue (plant-based: 3.11–3.28‰; fishmeal: 1.28–2.13‰). Mucus SI data did not differ between live and frozen fish. These results suggest that mucus SI half-lives provide comparable data to muscle, and can be used as a non-destructive alternative tissue in fish-based SI studies

Balancing repair and tolerance of DNA damage caused by alkylating agents

Alkylating agents constitute a major class of frontline chemotherapeutic drugs that inflict cytotoxic DNA damage as their main mode of action, in addition to collateral mutagenic damage. Numerous cellular pathways, including direct DNA damage reversal, base excision repair (BER) and mismatch repair (MMR), respond to alkylation damage to defend against alkylation-induced cell death or mutation. However, maintaining a proper balance of activity both within and between these pathways is crucial for a favourable response of an organism to alkylating agents. Furthermore, the response of an individual to alkylating agents can vary considerably from tissue to tissue and from person to person, pointing to genetic and epigenetic mechanisms that modulate alkylating agent toxicity