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In the field of computer- and robot-assisted minimally invasive surgery, enormous progress has been made in recent years based on the recognition of surgical instruments in endoscopic images and videos. In particular, the determination of the position and type of instruments is of great interest. Current work involves both spatial and temporal information, with the idea that predicting the movement of surgical tools over time may improve the quality of the final segmentations. The provision of publicly available datasets has recently encouraged the development of new methods, mainly based on deep learning. In this review, we identify and characterize datasets used for method development and evaluation and quantify their frequency of use in the literature. We further present an overview of the current state of research regarding the segmentation and tracking of minimally invasive surgical instruments in endoscopic images and videos. The paper focuses on methods that work purely visually, without markers of any kind attached to the instruments, considering both single-frame semantic and instance segmentation approaches, as well as those that incorporate temporal information. The publications analyzed were identified through the platforms Google Scholar, Web of Science, and PubMed. The search terms used were “instrument segmentation”, “instrument tracking”, “surgical tool segmentation”, and “surgical tool tracking”, resulting in a total of 741 articles published between 01/2015 and 07/2023, of which 123 were included using systematic selection criteria. A discussion of the reviewed literature is provided, highlighting existing shortcomings and emphasizing the available potential for future developments.
Although adopting Low Code Development Platforms (LCDPs) promises significant efficiency and effectiveness improvements for application development, its adoption still needs further empirical research. This paper uses a combinatorial approach to research LCDP adoption and presents the results of a multiple mini case study with 36 cases on LCDP adoption. A combination of the Socio-Technical Systems theory and the Technology-Organisational-Environment model is used as a theoretical lens. In this paper, we show that LCDP adoption is a multifaceted phenomenon and identify three archetypes for LCDP adoption (i.e., IT Resource Shortage Mitigators, Application Development Democratisers, and Synergy Realisers) and one archetype for LCDP non-adoption (i.e., Intricacy Adversaries). Each archetype can be interpreted as an individual path towards LCDP (non-)adoption. Based on these archetypes, we derive seven starting points for practitioners to adopt LCDPs in work systems. Moreover, by using the theoretical lenses, the paper shows that for an LCDP adoption to occur, an optimisation of the social and technical sub-systems is required.
Ziel der Studie:
Ziel der Studie ist die Messung des Stands der Digitalisierung und die mit einer Anbindung an die Telematikinfrastruktur verbundenen Chancen und Herausforderungen für Rehabilitationseinrichtungen.
Methodik:
Teilstandardisierte Online-Befragung bei Trägern von Rehabilitationseinrichtungen in Bayern (n=33). Der Fragebogen mit 36 Fragen beinhaltet eine leicht veränderte Skala auf Basis des „Electronic Medical Record Adoption Model (EMRAM)“.
Ergebnisse:
Der Digitalisierungsgrad wurde in 70 Prozent der Rehabilitationseinrichtungen mit Stufe 0 angegeben (Stufenmodell bis 7). Die Übermittlung patientenbezogener Daten (Eingang und Ausgang) erfolgt häufig analog, wohingegen die Verarbeitung innerhalb der Einrichtung in vielen Fällen bereits überwiegend digital ist. Beim Anschluss an die Telematikinfrastruktur wird hoher Aufwand bei der Installation, aber auch der Schulung des Personals und der Anpassung der Arbeitsorganisation gesehen.
Schlussfolgerung:
Durch Änderung der gesetzlich-finanziellen Lage in Deutschland eröffnen sich für Rehabilitationseinrichtungen neue Möglichkeiten einer verstärkten Digitalisierung. Hürden hängen mit Anforderungen an IT-Sicherheit, Schulung des Personals und sowie dem ebenfalls geringen Digitalisierungsstand bei Krankenhäusern und Ärzt*innen sowie Patient*innen zusammen, die eine digitale Datenübermittlung erschweren.
Organizations are under increasing pressure to develop applications within budget and time at high quality. Therefore, multiple organizations adopt Low Code Development Platforms (LCDP) to develop applications faster and cheaper compared to traditional application development. However, current research on LCDP adoption lacks empirical grounding as well as a deeper understanding of the importance of adoption drivers and inhibitors. We conducted semi-structured interviews and a Delphi study with seventeen experts to address these gaps. As a result, we identified twelve drivers and nineteen inhibitors for adopting LCDPs. We show that the experts have a consensus on the most and the least important drivers and inhibitors for LCDP adoption. Yet, the ranking of the drivers and inhibitors between the most and least important is highly context dependent. For some drivers and inhibitors, the experts’ ranking is similar to academic literature, whereas, for others, it differs. In conclusion, the study at hand empirically validates drivers and inhibitors for LCDP adoption, adds six new drivers and six new inhibitors to the body of knowledge, and analyses the importance of these factors.
The prospect of achieving computational speedups by exploiting quantum phenomena makes the use of quantum processing units (QPUs) attractive for many algorithmic database problems. Query optimisation, which concerns problems that typically need to explore large search spaces, seems like an ideal match for the known quantum algorithms. We present the first quantum implementation of join ordering, which is one of the most investigated and fundamental query optimisation problems, based on a reformulation to quadratic binary unconstrained optimisation problems. We empirically characterise our method on two state-of-the-art approaches (gate-based quantum computing and quantum annealing), and identify speed-ups compared to the best know classical join ordering approaches for input sizes that can be processed with current quantum annealers. However, we also confirm that limits of early-stage technology are quickly reached.
Current QPUs are classified as noisy, intermediate scale quantum computers (NISQ), and are restricted by a variety of limitations that reduce their capabilities as compared to ideal future quantum computers, which prevents us from scaling up problem dimensions and reaching practical utility. To overcome these challenges, our formulation accounts for specific QPU properties and limitations, and allows us to trade between achievable solution quality and possible problem size.
In contrast to all prior work on quantum computing for query optimisation and database-related challenges, we go beyond currently available QPUs, and explicitly target the scalability limitations: Using insights gained from numerical simulations and our experimental analysis, we identify key criteria for co-designing QPUs to improve their usefulness for join ordering, and show how even relatively minor physical architectural improvements can result in substantial enhancements. Finally, we outline a path towards practical utility of custom-designed QPUs.
On analytic properties of the standard zeta function attached to a vector-valued modular form
(2022)
We proof a Garrett–Böcherer decomposition of a vector-valued Siegel Eisenstein series E2l,0 of genus 2 transforming with the Weil representation of Sp2(Z) on the group ring C[(L′/L)2]. We show that the standard zeta function associated to a vector-valued common eigenform f for the Weil representation can be meromorphically continued to the whole s-plane and that it satisfies a functional equation. The proof is based on an integral representation of this zeta function in terms of f and E2l,0.
Die vorliegende Studie untersucht Schlüsselfaktoren erfolgrei-
cher CIOs in deutschen Großunternehmen. Mit einer mittleren Verweildauer (Median) von 4,0 Jahren weisen deutsche CIOs, die mit 43 % noch überwiegend an den CFO berichten, im Vergleich zu anderen C-Level-Positionen eine deutlich kürzere Verweildauer im Amt auf. Die Ergebnisse aus 60 Interviews mit erfolgreichen deutschsprachigen CIOs, die primär über eine überdurchschnittlich lange Verweildauer verfügen, lassen verschiedene Schlüsselfaktoren für den Erfolg erkennen: Grundvoraussetzung ist stets die Gewährleistung eines sicheren und effizienten IT-Betriebs. Über effektive und innovative Change-Projekte machen die interviewten CIOs den IT-Mehrwert transparent und agieren als Brückenbauer zwischen IT und Fachbereichen. Dadurch wirken sie positiv auf die Firmenkultur ein und etablieren die IT nachhaltig in den Fachbereichen als Erfolgsfaktor. Erfolgreiche CIOs selbst sind keine „Techies“, sondern zeichnen sich durch hohe Führungskompetenz und ein hohes Geschäftsverständnis, gepaart mit visionärem Denken aus. Dadurch gelingt es ihnen, die IT zukunftsorientiert auszurichten und Anforderungen und Potenziale für und aus den Fachbereichen frühzeitig zu antizipieren. Die zukünftige Entwicklung der CIO-Organisation und der Paradigmen in der IT wird durch die Studienteilnehmer hingegen teilweise kontrovers diskutiert – so gibt es beispielsweise bei der Beurteilung der Sinnhaftigkeit und Relevanz der CDO-Position noch kein einheitliches Meinungsbild.
Final assembly at Krones AG must make the best possible use of its production space and meeting the specified customer due dates is critical. Via a self developed simulation tool, the present scheduling procedure is compared with the one by priority rule shortest slack. As a consequence slack should have a higher importance in the planning
Deep Reinforcement Learning (RL) has considerably advanced over the past decade. At the same time, state-of-the-art RL algorithms require a large computational budget in terms of training time to converge. Recent work has started to approach this problem through the lens of quantum computing, which promises theoretical speed-ups for several traditionally hard tasks. In this work, we examine a class of hybrid quantumclassical RL algorithms that we collectively refer to as variational quantum deep Q-networks (VQ-DQN). We show that VQ-DQN approaches are subject to instabilities that cause the learned policy to diverge, study the extent to which this afflicts reproduciblity of established results based on classical simulation, and perform systematic experiments to identify potential explanations for the observed instabilities. Additionally, and in contrast to most existing work on quantum reinforcement learning, we execute RL algorithms on an actual quantum processing unit (an IBM Quantum Device) and investigate differences in behaviour between simulated and physical quantum systems that suffer from implementation deficiencies. Our experiments show that, contrary to opposite claims in the literature, it cannot be conclusively decided if known quantum approaches, even if simulated without physical imperfections, can provide an advantage as compared to classical approaches. Finally, we provide a robust, universal and well-tested implementation of VQ-DQN as a reproducible testbed for future experiments.
Introduction: Improving energy efficiency and reducing energy wastage is an important topic of our time. But it is quite difficult to figure out how much of our total electricity bill can be mapped to which device or at what time the device used it. We believe energy efficiency of normal households can be improved, if this kind of transparency would be available. In this article, we present a system for energy measurement at mains sockets to gain a transparent view of energy consumption for each device in a household. It consists of several smart energy measuring devices (SEMDs) that use a low-power radio protocol to dynamically build and connect to a radio network to transfer power usage date to a server. At the server, the data is stored and can be accessed via web interface.
Results: Our primary goal was to build a back-end system for an energy metering platform with very low energy consumption. This platform can provide data for a variety of services that enables users (the consumers) to understand and improve their energy consumption behavior and increase overall energy efficiency of their households.
In this paper, we consider the reconstruction problem of photoacoustic tomography (PAT) with a flat observation surface. We develop a direct reconstruction method that employs regularization with wavelet sparsity constraints. To that end, we derive a wavelet-vaguelette decomposition (WVD) for the PAT forward operator and a corresponding explicit reconstruction formula in the case of exact data. In the case of noisy data, we combine the WVD reconstruction formula with soft-thresholding, which yields a spatially adaptive estimation method. We demonstrate that our method is statistically optimal for white random noise if the unknown function is assumed to lie in any Besov-ball. We present generalizations of this approach and, in particular, we discuss the combination of PAT-vaguelette soft-thresholding with a total variation (TV) prior. We also provide an efficient implementation of the PAT-vaguelette transform that leads to fast image reconstruction algorithms supported by numerical results.
We present the Regensburg Breast Shape Model (RBSM)—a 3D statistical shape model of the female breast built from 110 breast scans acquired in a standing position, and the first publicly available. Together with the model, a fully automated, pairwise surface registration pipeline used to establish dense correspondence among 3D breast scans is introduced. Our method is computationally efficient and requires only four landmarks to guide the registration process. A major challenge when modeling female breasts from surface-only 3D breast scans is the non-separability of breast and thorax. In order to weaken the strong coupling between breast and surrounding areas, we propose to minimize the variance outside the breast region as much as possible. To achieve this goal, a novel concept called breast probability masks (BPMs) is introduced. A BPM assigns probabilities to each point of a 3D breast scan, telling how likely it is that a particular point belongs to the breast area. During registration, we use BPMs to align the template to the target as accurately as possible inside the breast region and only roughly outside. This simple yet effective strategy significantly reduces the unwanted variance outside the breast region, leading to better statistical shape models in which breast shapes are quite well decoupled from the thorax. The RBSM is thus able to produce a variety of different breast shapes as independently as possible from the shape of the thorax. Our systematic experimental evaluation reveals a generalization ability of 0.17 mm and a specificity of 2.8 mm. To underline the expressiveness of the proposed model, we finally demonstrate in two showcase applications how the RBSM can be used for surgical outcome simulation and the prediction of a missing breast from the remaining one. Our model is available at https://www.rbsm.re-mic.de/.
Mit PowerPoint oder LaTeX Beamer erstellte Vorlesungsfolien sind meist statisch und dienen hauptsächlich der Präsentation von Lehrinhalten. Als Alternative dazu werden drei Erweiterungen für das HTML- und JavaScript-basierte Präsentationsframework reveal.js vorgestellt, die für mehr Interaktion in der Datenbankenlehre sorgen sollen: (1) Eine Live-Ausführung von SQL-Anfragen und eine Darstellung des Anfrageergebnisses direkt auf der Folie; mit Möglichkeit zur Anpassung der Anfrage im Präsentationsbetrieb, (2) eine JSON-basierte Beschreibung von ER-Diagrammen, welche graphisch auf den Folien dargestellt werden sollen und (3) eingebettete Smartphone-Umfragen, um zwischendurch – ohne einen Kontextwechsel – Quiz-Fragen zu stellen.
Metadata management constitutes a key prerequisite for enterprises as they engage in data analytics and governance. Today, however, the context of data is often only manually documented by subject matter experts, and lacks completeness and reliability due to the complex nature of data pipelines. Thus, collecting data lineage—describing the origin, structure, and dependencies of data—in an automated fashion increases quality of provided metadata and reduces manual effort, making it critical for the development and operation of data pipelines. In our practice report, we propose an end-to-end solution that digests lineage via (Py‑)Spark execution plans. We build upon the open-source component Spline, allowing us to reliably consume lineage metadata and identify interdependencies. We map the digested data into an expandable data model, enabling us to extract graph structures for both coarse- and fine-grained data lineage. Lastly, our solution visualizes the extracted data lineage via a modern web app, and integrates with BMW Group’s soon-to-be open-sourced Cloud Data Hub.
This paper describes a large-scale empirical study investigating the relevance of socio-technical congruence over key basic software quality metrics, namely, bugs and churn. That is, we explore whether alignment or misalignment of social communication structures and technical dependencies in large software projects influences software quality. To this end, we have defined a quantitative and operational notion of socio-technical congruence, which we call /socio-technical motif congruence/ (STMC). STMC is a measure of the degree to which developers working on the same file or on two related files, need to communicate. As socio-technical congruence is a complex and multi-faceted phenomenon, the interpretability of the results is one of our main concerns, so we have employed a careful mixed-methods statistical analysis. In particular, we provide analyses with similar techniques as employed by seminal work in the field to ensure comparability of our results with the existing body of work. The major result of our study, based on an analysis of 25 large open-source projects, is that STMC is /not/ related to project quality measures---software bugs and churn---in any temporal scenario. That is, we find no statistical relationship between the alignment of developer tasks and developer communications on one hand, and project outcomes on the other hand. We conclude that, wherefore congruence does matter as literature shows, then its measurable effect lies elsewhere.
Hintergrund
Impfungen stellen eine bedeutende Präventionsmaßnahme dar. Grundlegend für die Eindämmung der Coronapandemie mittels Durchimpfung der Gesellschaft ist eine ausgeprägte Impfbereitschaft.
Ziel der Arbeit
Die Impfbereitschaft mit einem COVID‑19-Vakzin (Impfstoff gegen das Coronavirus) und deren Einflussfaktoren werden anhand einer Zufallsstichprobe der Gesamtbevölkerung in Deutschland untersucht.
Material und Methoden
Die Studie basiert auf einer telefonischen Zufallsstichprobe und berücksichtigt ältere und vorerkrankte Personen ihrem Bevölkerungsanteil entsprechend. Die Ein-Themen-Bevölkerungsbefragung zur Impfbereitschaft (n = 2014) wurde im November/Dezember 2020 durchgeführt.
Ergebnisse
Die Impfbereitschaft in der Stichprobe liegt bei rund 67 %. Vorerfahrungen mit Impfungen moderieren die Impfbereitschaft. Sie steigt bei Zugehörigkeit zu einer Risikogruppe. Der Glaube an die Wirksamkeit alternativer Heilmethoden und Befürwortung alternativer Behandlungsverfahren geht mit geringerer Impfbereitschaft einher. Ältere Menschen sind impfbereiter, kovariierend mit ihrer Einschätzung höherer Gefährdung bei Erkrankung. Ebenso ist die Ablehnung einer Impfung mit der Überschätzung von Nebenwirkungen assoziiert.
Schlussfolgerung
Die Impfbereitschaft hängt mit Impferfahrungen und Einstellungen zu Gesundheitsbehandlungsverfahren allgemein zusammen. Die Überschätzung der Häufigkeit ernsthafter Nebenwirkungen bei Impfungen weist auf weit verbreitete Fehlinformationen hin.
Hintergrund:
Eltern stehen im Rahmen der eigenen Impfung und der Kinderimpfung mit einem COVID-19-Vakzin vor einer Impfentscheidung. Zum aktuellen Zeitpunkt gibt es keine (vollständige) Impfempfehlung.
Fragestellung:
Die Studie untersucht die Impfbereitschaft von Eltern minderjähriger Kinder und Personen ohne minderjährige Kinder, wobei insbesondere Geschlechtsunterschiede überprüft werden.
Methoden:
Die Studie basiert auf einer Zufallsstichprobe (Telefon-Survey, n = 2014, Erhebung zwischen 12.11.2020 und 10.12.2020). Die Auswertung stützt sich insbesondere auf die Teilstichprobe von Personen mit minderjährigen Kindern im Haushalt (n = 461).
Ergebnisse:
Eltern weisen durchgängig eine geringere Impfbereitschaft mit einem COVID-19-Vakzin auf als Befragte ohne minderjährige Kinder (54,1 % vs. 71,1 %). Väter weisen eine stärker ausgeprägte eigene Impfbereitschaft auf als Mütter. Darüber hinaus sind Männer eher als Frauen bereit, das eigene Kind mit einem COVID-19-Vakzin impfen zu lassen.
Schlussfolgerungen:
Bei Eltern und insbesondere Müttern ist eine erhebliche Fehleinschätzung von Impfrisiken und häufiger Glaube an Impfverschwörungstheorien zu beobachten. Empfohlen werden anschauliche und leicht verständliche Informationen über die Wirkung und Nebenwirkungen der Impfung mit einem COVID-19-Vakzin durch zuständige Institutionen und Ärzte.
Although the average tenure of CIOs has increased over the last years, the majority of CIOs have been in their positions for only three years or less. Nevertheless, some CIOs have been successful in their position for a long time. In this study, we use tenure as a proxy for success as a CIO. The goal of this paper is to examine factors that are critical to the success of long-term CIOs. For this purpose, we created and analyzed resumes of 384 CIOs. Out of these 384, we conducted 19 interviews with CIOs from top-tier companies and collected and analyzed both qualitative and quantitative data. In the process, we were able to identify nine factors that are critical for the success (CSF) of CIOs. These factors fall into three categories. Category “Personality” includes “Accepting and embracing change” (CSF #1), “Being perseverant to pursue long-term goals” (CSF #2), “Anticipating the future through visionary thinking” (CSF #3), and “Being empathetic to deal with uncertainty felt by co-workers” (CSF #4). The “Role Fulfilment” category includes “Cross-functional involvement and integration of the IT organization” (CSF #5), “Positioning and restructuring of the IT organization” (CSF #6), and “Well-connected and communicative leadership” (CSF #7). The “Organizational Environment” category consists of “Availability of skilled workforce” (CSF #8) and “Reporting line to the CEO” (CSF #9). CSFs 1, 2, and 3 were perceived as most important by the participating CIOs. The results may be of particular interest both to aspiring CIOs and equally their employing organizations, as they reflect what long-term CIOs value during their time in office.
Nach einer Fraktur ist Mobilisierung Behandlungsziel und Therapiesäule. Das Festlegen von Outcomes basiert jedoch auf vielen Unsicherheiten, da Assessments nicht für alle Patient/-innen geeignet sind. Sie können agesabhängig beeinflusst und subjektiv geprägt sein. Sensorbasiertes Bewegungsmonitoring bietet eine Ergänzung zur Operationalisierung der Gehfähigkeit. Für Längsschnittuntersuchungen, die auch im häuslichen Umfeld durchgeführt werden, eignet sich die tägliche Schrittzahl als Variable. Sie kann durch einen handelsüblichen Fitnesstracker beobachtet
werden.
Background: For surgical fixation of bone fractures of the human hand, so-called Kirschner-wires (K-wires) are drilled through bone fragments. Due to the minimally invasive drilling procedures without a view of risk structures like vessels and nerves, a thorough training of young surgeons is necessary. For the development of a virtual reality (VR) based training system, a three-dimensional (3D) printed phantom hand is required. To ensure an intuitive operation, this phantom hand has to be realistic in both, its position relative to the driller as well as in its haptic features. The softest 3D printing material available on the market, however, is too hard to imitate human soft tissue. Therefore, a support-material (SUP) filled metamaterial is used to soften the raw material. Realistic haptic features are important to palpate protrusions of the bone to determine the drilling starting point and angle. An optical real-time tracking is used to transfer position and rotation to the training system.
Methods: A metamaterial already developed in previous work is further improved by use of a new unit cell. Thus, the amount of SUP within the volume can be increased and the tissue is softened further. In addition, the human anatomy is transferred to the entire hand model. A subcutaneous fat layer and penetration of air through pores into the volume simulate shiftability of skin layers. For optical tracking, a rotationally symmetrical marker attached to the phantom hand with corresponding reference marker is developed. In order to ensure trouble-free position transmission, various types of marker point applications are tested.
Results: Several cuboid and forearm sample prints lead to a final 30 centimeter long hand model. The whole haptic phantom could be printed faultless within about 17 hours. The metamaterial consisting of the new unit cell results in an increased SUP share of 4.32%. Validated by an expert surgeon study, this allows in combination with a displacement of the uppermost skin layer a good palpability of the bones. Tracking of the hand marker in dodecahedron design works trouble-free in conjunction with a reference marker attached to the worktop of the training system.
Conclusions: In this work, an optically tracked and haptically correct phantom hand was developed using dual-material 3D printing, which can be easily integrated into a surgical training system.
Purpose
Age-related macular degeneration (AMD) is a common threat to vision. While classification of disease stages is critical to understanding disease risk and progression, several systems based on color fundus photographs are known. Most of these require in-depth and time-consuming analysis of fundus images. Herein, we present an automated computer-based classification algorithm.
Design Algorithm development for AMD classification based on a large collection of color fundus images. Validation is performed on a cross-sectional, population-based study.
Participants.
We included 120 656 manually graded color fundus images from 3654 Age-Related Eye Disease Study (AREDS) participants. AREDS participants were >55 years of age, and non-AMD sight-threatening diseases were excluded at recruitment. In addition, performance of our algorithm was evaluated in 5555 fundus images from the population-based Kooperative Gesundheitsforschung in der Region Augsburg (KORA; Cooperative Health Research in the Region of Augsburg) study.
Methods.
We defined 13 classes (9 AREDS steps, 3 late AMD stages, and 1 for ungradable images) and trained several convolution deep learning architectures. An ensemble of network architectures improved prediction accuracy. An independent dataset was used to evaluate the performance of our algorithm in a population-based study.
Main Outcome Measures.
κ Statistics and accuracy to evaluate the concordance between predicted and expert human grader classification.
Results.
A network ensemble of 6 different neural net architectures predicted the 13 classes in the AREDS test set with a quadratic weighted κ of 92% (95% confidence interval, 89%–92%) and an overall accuracy of 63.3%. In the independent KORA dataset, images wrongly classified as AMD were mainly the result of a macular reflex observed in young individuals. By restricting the KORA analysis to individuals >55 years of age and prior exclusion of other retinopathies, the weighted and unweighted κ increased to 50% and 63%, respectively. Importantly, the algorithm detected 84.2% of all fundus images with definite signs of early or late AMD. Overall, 94.3% of healthy fundus images were classified correctly.
Conclusions
Our deep learning algoritm revealed a weighted κ outperforming human graders in the AREDS study and is suitable to classify AMD fundus images in other datasets using individuals >55 years of age.
Background: Currently, it is common practice to use three-dimensional (3D) printers not only for rapid prototyping in the industry, but also in the medical area to create medical applications for training inexperienced surgeons. In a clinical training simulator for minimally invasive bone drilling to fix hand fractures with Kirschner-wires (K-wires), a 3D-printed hand phantom must not only be geometrically but also haptically correct. Due to a limited view during an operation, surgeons need to perfectly localize underlying risk structures only by feeling of specific bony protrusions of the human hand.
Methods: The goal of this experiment is to imitate human soft tissue with its haptic and elasticity for a realistic hand phantom fabrication, using only a dual-material 3D printer and support-material-filled metamaterial between skin and bone. We present our workflow to generate lattice structures between hard bone and soft skin with iterative cube edge (CE) or cube face (CF) unit cells. Cuboid and finger shaped sample prints with and without inner hard bone in different lattice thickness are constructed and 3D printed.
Results: The most elastic available rubber-like material is too firm to imitate soft tissue. By reducing the amount of rubber in the inner volume through support material (SUP), objects become significantly softer. Without metamaterial, after disintegration, the SUP can be shifted through the volume and thus the body loses its original shape. Although the CE design increases the elasticity, it cannot restore the fabric form. In contrast to CE, the CF design increases not only the elasticity but also guarantees a local limitation of the SUP. Therefore, the body retains its shape and internal bones remain in its intended place. Various unit cell sizes, lattice thickening and skin thickness regulate the rubber material and SUP ratio. Test prints with higher SUP and lower rubber material percentage appear softer and vice versa. This was confirmed by an expert surgeon evaluation. Subjects adjudged pure rubber-like material as too firm and samples only filled with SUP or lattice structure in CE design as not suitable for imitating tissue. 3D-printed finger samples in CF design were rated as realistic compared to the haptic of human tissue with a good palpable bone structure.
Conclusions: We developed a new dual-material 3D print technique to imitate soft tissue of the human hand with its haptic properties. Blowy SUP is trapped within a lattice structure to soften rubber-like 3D print material, which makes it possible to reproduce a realistic replica of human hand soft tissue.
One common method to fix fractures of the human hand after an accident is an osteosynthesis with Kirschner wires (K-wires) to stabilize the bone fragments. The insertion of K-wires is a delicate minimally invasive surgery, because surgeons operate almost without a sight. Since realistic training methods are time consuming, costly and insufficient, a virtual-reality (VR) based training system for the placement of K-wires was developed. As part of this, the current work deals with the real-time bone drilling simulation using a haptic force-feedback device.
To simulate the drilling, we introduce a virtual fixture based force-feedback drilling approach. By decomposition of the drilling task into individual phases, each phase can be handled individually to perfectly control the drilling procedure. We report about the related finite state machine (FSM), describe the haptic feedback of each state and explain, how to avoid jerking of the haptic force-feedback during state transition.
The usage of the virtual fixture approach results in a good haptic performance and a stable drilling behavior. This was confirmed by 26 expert surgeons, who evaluated the virtual drilling on the simulator and rated it as very realistic. To make the system even more convincing, we determined real drilling feed rates through experimental pig bone drilling and transferred them to our system. Due to a constant simulation thread we can guarantee a precise drilling motion.
Virtual fixtures based force-feedback calculation is able to simulate force-feedback assisted bone drilling with high quality and, thus, will have a great potential in developing medical applications.
Computer-aided diagnosis using deep learning in the evaluation of early oesophageal adenocarcinoma
(2019)
Computer-aided diagnosis using deep learning (CAD-DL) may be an instrument to improve endoscopic assessment of Barrett’s oesophagus
(BE) and early oesophageal adenocarcinoma (EAC). Based on still images from two databases, the diagnosis of EAC by CAD-DL reached sensitivities/specificities of 97%/88% (Augsburg data) and 92%/100% (Medical Image Computing and Computer-Assisted Intervention [MICCAI]
data) for white light (WL) images and 94%/80% for narrow band images (NBI) (Augsburg data), respectively. Tumour margins delineated by
experts into images were detected satisfactorily with a Dice coefficient (D) of 0.72. This could be a first step towards CAD-DL for BE assessment. If developed further, it could become a useful
adjunctive tool for patient management.