scholarly journals Advanced intraoperative imaging

2017 ◽  
Vol 1 (1) ◽  
pp. 2514183X1771831 ◽  
Author(s):  
Andreas Raabe ◽  
Jens Fichtner ◽  
Jan Gralla
Keyword(s):  
Image Guidance ◽  
New Technologies ◽  
Intraoperative Imaging ◽  
Pedicle Screws ◽  
Image Intensifier ◽  
Standard Of Care ◽  
Extent Of Resection ◽  
Broad Term ◽  
Magnet Resonance ◽  
First Time

There are several unique features of the concept of advanced intraoperative imaging modalities with CT (computed tomography), MRI (magnet resonance imaging) and DSA (digital substraction angiography) inaugurated in one operating tract. For the first time, there is the opportunity to switch from postoperative to intraoperative imaging – when the surgeon can not only check the result of surgery but improve it – but in general, that is, for all specialties, at least theoretically. Intraoperative imaging is a broad term with many technologies already in routine use today, such as image intensifier, ultrasound, fluorescence technologies, and soon. Using intra-operative CT, MRI, and DSA is not indisputable. Does the benefit justify such immense costs, both in building and in maintenance? To evaluate the clinical benefit and possible drawbacks of these technologies and if there's a substantial benefit for the patients. Also, this is a review of literature to evaluate the evidence and clinical impact of advanced intraoperative imaging in neurosurgery. There is one prospective randomized trial showing that intraoperative MRI increases the extent of resection. In spine surgery, there are several randomized trials showing that pedicle screws are inserted more accurately when image guidance is used. However, there is no RCT comparing navigation with intraoperative CT-updated navigation. Several prospective studies are showing that intraoperative DSA is able to identify vascular remnants or vessel occlusions in case of aneurysm-, arteriovenous malformation-and arteriovenous fistula-surgery. A fair comparison of the benefit of these new technologies must take into consideration that other methods of intraoperative imaging or image guidance already exist. Hence, there are some patients in whom the use of the more advanced technologies makes a personal, individual difference that may affect quality of life and survival. We have to differentiate between (1) the best diagnostic procedure and (2) the term “standard of care.” Advanced intraoperative imaging is a gold standard in terms of imaging but not a standard of care.

scholarly journals The Neurosurgeon’s Armamentarium for Gliomas: An Update on Intraoperative Technologies to Improve Extent of Resection

2021 ◽  
Vol 10 (2) ◽  
pp. 236
Author(s):  
Alexander J. Schupper ◽  
Raymund L. Yong ◽  
Constantinos G. Hadjipanayis
Keyword(s):  
Tumor Tissue ◽  
Imaging Techniques ◽  
Intraoperative Imaging ◽  
Standard Of Care ◽  
Extent Of Resection ◽  
Guided Surgery ◽  
Current State ◽  
Fluorescence Guided Surgery ◽  
Neurosurgical Treatment ◽  
Intraoperative Visualization

Maximal safe resection is the standard of care in the neurosurgical treatment of high-grade gliomas. To aid surgeons in the operating room, adjuvant techniques and technologies centered around improving intraoperative visualization of tumor tissue have been developed. In this review, we will discuss the most advanced technologies, specifically fluorescence-guided surgery, intraoperative imaging, neuromonitoring modalities, and microscopic imaging techniques. The goal of these technologies is to improve detection of tumor tissue beyond what conventional microsurgery has permitted. We describe the various advances, the current state of the literature that have tested the utility of the different adjuvants in clinical practice, and future directions for improving intraoperative technologies.

Image-Guided Spinal Surgery and Robotics in MIS: Where Are We Now?

2018 ◽  
Vol 1 (2) ◽  
pp. 2
Author(s):  
Chiung Chyi Shen
Keyword(s):  
Pedicle Screw ◽  
Spinal Surgery ◽  
Surgical Navigation ◽  
Improve Patient Safety ◽  
Intraoperative Imaging ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Image Guided

Use of pedicle screws is widespread in spinal surgery for degenerative, traumatic, and oncological diseases. The conventional technique is based on the recognition of anatomic landmarks, preparation and palpation of cortices of the pedicle under control of an intraoperative C-arm (iC-arm) fluoroscopy. With these conventional methods, the median pedicle screw accuracy ranges from 86.7% to 93.8%, even if perforation rates range from 21.1% to 39.8%.The development of novel intraoperative navigational techniques, commonly referred to as image-guided surgery (IGS), provide simultaneous and multiplanar views of spinal anatomy. IGS technology can increase the accuracy of spinal instrumentation procedures and improve patient safety. These systems, such as fluoroscopy-based image guidance ("virtual fluoroscopy") and computed tomography (CT)-based computer-guidance systems, have sensibly minimized risk of pedicle screw misplacement, with overall perforation rates ranging from between 14.3% and 9.3%, respectively."Virtual fluoroscopy" allows simultaneous two-dimensional (2D) guidance in multiple planes, but does not provide any axial images; quality of images is directly dependent on the resolution of the acquired fluoroscopic projections. Furthermore, computer-assisted surgical navigation systems decrease the reliance on intraoperative imaging, thus reducing the use of intraprocedure ionizing radiation. The major limitation of this technique is related to the variation of the position of the patient from the preoperative CT scan, usually obtained before surgery in a supine position, and the operative position (prone). The next technological evolution is the use of an intraoperative CT (iCT) scan, which would allow us to solve the position-dependent changes, granting a higher accuracy in the navigation system. 

Conference report: innovation, interaction … and a lot of data: first time reflections on Internet Librarian International, UK 2018

2019 ◽  
Vol 36 (2) ◽  
pp. 21-22
Author(s):  
Ray Harper
Keyword(s):  
Best Practice ◽  
New Technologies ◽  
Conference Report ◽  
Library Services ◽  
New Techniques ◽  
Content Type ◽  
Making A Difference ◽  
Analyse Data ◽  
Physical Spaces ◽  
First Time

Purpose The purpose of this paper is to summarise a number of presentations at Day 1 of the Internet Librarian International conference, London, UK (16 October 2018). This was the 20th conference in the series, and the three key themes included were the next-gen library and librarian; understanding users, usage and user experience; and inclusion and inspiration: libraries making a difference. Design/methodology/approach This paper reports from the viewpoint of a first-time attendee of the conference. This summarises the main issues raised by each presentation and draws out the key learning points for practical situations. Findings The conference covered a variety of practical ways in which libraries can use technology to support users and make decisions about services. These include developing interactive physical spaces which include augmented reality; introducing “chat-bots” to support users; using new techniques to analyse data; and piloting new ways to engage users (such as coding clubs). A key theme was how we use and harness data in a way that is ethical, effective and relevant to library services. Originality/value This conference focussed on practical examples of how library and information services across sectors and countries are innovating in a period of huge change. The conference gave delegates numerous useful ideas and examples of best practice and demonstrated the strength of the profession in adapting to new technologies and developments.

scholarly journals Innovating on Inhaled Bioequivalence: A Critical Analysis of the Current Limitations, Potential Solutions and Stakeholders of the Process

Pharmaceutics ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1051
Author(s):  
Jonattan Gallegos-Catalán ◽  
Zachary Warnken ◽  
Tania F. Bahamondez-Canas ◽  
Daniel Moraga-Espinoza
Keyword(s):  
New Technologies ◽  
Innovation Process ◽  
Cost Effective ◽  
Regulatory Agencies ◽  
Drug Products ◽  
Effective Strategies ◽  
Rate Analysis ◽  
Orally Inhaled Drug Products ◽  
Next Generation Impactor ◽  
First Time

Orally inhaled drug products (OIDPs) are an important group of medicines traditionally used to treat pulmonary diseases. Over the past decade, this trend has broadened, increasing their use in other conditions such as diabetes, expanding the interest in this administration route. Thus, the bioequivalence of OIDPs is more important than ever, aiming to increase access to affordable, safe and effective medicines, which translates into better public health policies. However, regulatory agencies leading the bioequivalence process are still deciding the best approach for ensuring a proposed inhalable product is bioequivalent. This lack of agreement translates into less cost-effective strategies to determine bioequivalence, discouraging innovation in this field. The Next-Generation Impactor (NGI) is an example of the slow pace at which the inhalation field evolves. The NGI was officially implemented in 2003, being the last equipment innovation for OIDP characterization. Even though it was a breakthrough in the field, it did not solve other deficiencies of the BE process such as dissolution rate analysis on physiologically relevant conditions, being the last attempt of transferring technology into the field. This review aims to reveal the steps required for innovation in the regulations defining the bioequivalence of OIDPs, elucidating the pitfalls of implementing new technologies in the current standards. To do so, we collected the opinion of experts from the literature to explain these trends, showing, for the first time, the stakeholders of the OIDP market. This review analyzes the stakeholders involved in the development, improvement and implementation of methodologies that can help assess bioequivalence between OIDPs. Additionally, it presents a list of methods potentially useful to overcome some of the current limitations of the bioequivalence standard methodologies. Finally, we review one of the most revolutionary approaches, the inhaled Biopharmaceutical Classification System (IBCs), which can help establish priorities and order in both the innovation process and in regulations for OIDPs.

scholarly journals Intraoperative imaging technology to maximise extent of resection for glioma: a network meta-analysis

2020 ◽  
Author(s):  
Daniel M Fountain ◽  
Andrew Bryant ◽  
Damiano Giuseppe Barone ◽  
Mueez Waqar ◽  
Michael G Hart ◽  
...  
Keyword(s):  
Intraoperative Imaging ◽  
Meta Analysis ◽  
Extent Of Resection ◽  
Imaging Technology

Business model of garment enterprises: a scientometric review

2021 ◽  
Vol 91 (13-14) ◽  
pp. 1609-1626
Author(s):  
Yuran Jin ◽  
Xiangye Song ◽  
Jinhuan Tang ◽  
Xiaodong Dong ◽  
Huisheng Ji
Keyword(s):  
Conference Proceedings ◽  
Social Science ◽  
Business Model ◽  
Western Europe ◽  
Business Models ◽  
New Technologies ◽  
Citation Index ◽  
The United States ◽  
Fast Fashion ◽  
First Time

The research on the business model of garment enterprises (BMGE) has expanded rapidly in the last decade. However, there is still a lack of comprehensive reviews of it, let alone visual research. Based on scientometrics, in this paper 118 papers and their 4803 references from Science Citation Index Expanded, Social Sciences Citation Index, Conference Proceedings Citation Index—Science, and Conference Proceedings Citation Index—Social Science & Humanities for the period 2010–2020 about the BMGE were analyzed by visualizing the co-cited references, co-occurrence keywords, burst references, dual-map overlays, and more with CiteSpace, Google Maps, and VOSviewer. The research revealed the intellectual landscapes of the BMGE for the first time and mapped the landmark papers, hotspots and trends, national or regional distributions and their cooperation networks, highly cited authors, and prestigious journals and disciplines related to the BMGE. The results show that the biggest hotspot is the fast fashion business model; social responsibility, smart fashion, Internet of Things, and sharing fashion are the main emerging hotspots; and the research focuses has evolved from traditional business models to business models driven by new technologies, then to new issues such as circular economy models. The institutions are mainly distributed in China, the United States, and Western Europe, and there is cooperation between more than 11 countries. The most popular disciplines are economics and politics, while psychology, education, and social science are the essential basic disciplines. The Journal of Cleaner Production and Journal of Fashion Marketing and Management, among others, actively promoted the research.

scholarly journals Endonasal endoscopic reoperation for residual or recurrent craniopharyngiomas

2017 ◽  
Vol 126 (2) ◽  
pp. 418-430 ◽  
Author(s):  
Sivashanmugam Dhandapani ◽  
Harminder Singh ◽  
Hazem M. Negm ◽  
Salomon Cohen ◽  
Mark M. Souweidane ◽  
...  
Keyword(s):  
Tumor Volume ◽  
Visual Outcome ◽  
Extent Of Resection ◽  
Endocrine Function ◽  
Subtotal Resection ◽  
Total Resection ◽  
Medical College ◽  
The Impact ◽  
First Time

OBJECTIVE Craniopharyngiomas can be difficult to remove completely based on their intimate relationship with surrounding visual and endocrine structures. Reoperations are not uncommon but have been associated with higher rates of complications and lower extents of resection. So radiation is often offered as an alternative to reoperation. The endonasal endoscopic transsphenoidal approach has been used in recent years for craniopharyngiomas previously removed with craniotomy. The impact of this approach on reoperations has not been widely investigated. METHODS The authors reviewed a prospectively acquired database of endonasal endoscopic resections of craniopharyngiomas over 11 years at Weill Cornell Medical College, NewYork-Presbyterian Hospital, performed by the senior authors. Reoperations were separated from first operations. Pre- and postoperative visual and endocrine function, tumor size, body mass index (BMI), quality of life (QOL), extent of resection (EOR), impact of prior radiation, and complications were compared between groups. EOR was divided into gross-total resection (GTR, 100%), near-total resection (NTR, > 95%), and subtotal resection (STR, < 95%). Univariate and multivariate analyses were performed. RESULTS Of the total 57 endonasal surgical procedures, 22 (39%) were reoperations. First-time operations and reoperations did not differ in tumor volume, radiological configuration, or patients' BMI. Hypopituitarism and diabetes insipidus (DI) were more common before reoperations (82% and 55%, respectively) compared with first operations (60% and 8.6%, respectively; p < 0.001). For the 46 patients in whom GTR was intended, rates of GTR and GTR+NTR were not significantly different between first operations (90% and 97%, respectively) and reoperations (80% and 100%, respectively). For reoperations, prior radiation and larger tumor volume had lower rates of GTR. Vision improved equally in first operations (80%) compared with reoperations (73%). New anterior pituitary deficits were more common in first operations compared with reoperations (51% vs 23%, respectively; p = 0.08), while new DI was more common in reoperations compared with first-time operations (80% vs 47%, respectively; p = 0.08). Nonendocrine complications occurred in 2 (3.6%) first-time operations and no reoperations. Tumor regrowth occurred in 6 patients (11%) over a median follow-up of 46 months and was not different between first versus reoperations, but was associated with STR (33%) compared with GTR+NTR (4%; p = 0.02) and with not receiving radiation after STR (67% vs 22%; p = 0.08). The overall BMI increased significantly from 28.7 to 34.8 kg/m2 over 10 years. Six months after surgery, there was a significant improvement in QOL, which was similar between first-time operations and reoperations, and negatively correlated with STR. CONCLUSIONS Endonasal endoscopic transsphenoidal reoperation results in similar EOR, visual outcome, and improvement in QOL as first-time operations, with no significant increase in complications. EOR is more impacted by tumor volume and prior radiation. Reoperations should be offered to patients with recurrent craniopharyngiomas and may be preferable to radiation in patients in whom GTR or NTR can be achieved.

The accuracy of pedicle screw placement using intraoperative image guidance systems

2014 ◽  
Vol 20 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Alexander Mason ◽  
Renee Paulsen ◽  
Jason M. Babuska ◽  
Sharad Rajpal ◽  
Sigita Burneikiene ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Image Guidance ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Data Sets ◽  
Pedicle Screw Placement ◽  
Fluoroscopic Image ◽  
Fluoroscopic Navigation ◽  
Guidance Systems ◽  
Accuracy Rates

Object Several retrospective studies have demonstrated higher accuracy rates and increased safety for navigated pedicle screw placement than for free-hand techniques; however, the accuracy differences between navigation systems has not been extensively studied. In some instances, 3D fluoroscopic navigation methods have been reported to not be more accurate than 2D navigation methods for pedicle screw placement. The authors of this study endeavored to identify if 3D fluoroscopic navigation methods resulted in a higher placement accuracy of pedicle screws. Methods A systematic analysis was conducted to examine pedicle screw insertion accuracy based on the use of 2D, 3D, and conventional fluoroscopic image guidance systems. A PubMed and MEDLINE database search was conducted to review the published literature that focused on the accuracy of pedicle screw placement using intraoperative, real-time fluoroscopic image guidance in spine fusion surgeries. The pedicle screw accuracy rates were segregated according to spinal level because each spinal region has individual anatomical and morphological variations. Descriptive statistics were used to compare the pedicle screw insertion accuracy rate differences among the navigation methods. Results A total of 30 studies were included in the analysis. The data were abstracted and analyzed for the following groups: 12 data sets that used conventional fluoroscopy, 8 data sets that used 2D fluoroscopic navigation, and 20 data sets that used 3D fluoroscopic navigation. These studies included 1973 patients in whom 9310 pedicle screws were inserted. With conventional fluoroscopy, 2532 of 3719 screws were inserted accurately (68.1% accuracy); with 2D fluoroscopic navigation, 1031 of 1223 screws were inserted accurately (84.3% accuracy); and with 3D fluoroscopic navigation, 4170 of 4368 screws were inserted accurately (95.5% accuracy). The accuracy rates when 3D was compared with 2D fluoroscopic navigation were also consistently higher throughout all individual spinal levels. Conclusions Three-dimensional fluoroscopic image guidance systems demonstrated a significantly higher pedicle screw placement accuracy than conventional fluoroscopy or 2D fluoroscopic image guidance methods.

Research on the Key Technologies for New Large Dual-Platen High-Precision Clamping System

2010 ◽  
Vol 97-101 ◽  
pp. 64-68
Author(s):  
Jian Chen ◽  
Jin Wang ◽  
Guo Dong Lu ◽  
Zheng Qi Ling
Keyword(s):  
High Precision ◽  
Large Scale ◽  
New Technologies ◽  
Impact Factors ◽  
Adaptive Correction ◽  
Hydraulic Servo ◽  
New Type ◽  
Clamping System ◽  
Plastic Parts ◽  
First Time

High- precision and large scale are the developing trend for injection molding machine clamping system .This paper compared the characteristics of three-platen toggle and dual-platen hydraulic clamping system. The key impact factors that effecting plastic parts` precision from clamping system were discussed systematically first time. Based on these analyses, a new clamping system has been proposed and manufactured to improve the plastics parts` precision, including three new technologies: new type dual-platen structure, parallelism adaptive correction technology and numerical controlled hydraulic servo system technology. It has been applied in practical machine successfully, and experiment result proves that it is effective enough to satisfying the high-precision molding of large plastics parts.

Upgrade of Plate Heat Exchanger at Optimal Cost Through Core Pack Plate Welding Modification

2021 ◽  
Author(s):  
Khaled M. Mazen Al Khoujah ◽  
Antonio - Medina ◽  
Juma Rashid Al Qaydi ◽  
Jawwad Kaleem ◽  
Fatima Hassan Al Mansoori ◽  
...  
Keyword(s):  
Heat Exchanger ◽  
New Technologies ◽  
Plate Heat Exchanger ◽  
Innovative Design ◽  
Plate Heat ◽  
Optimal Cost ◽  
Operating Modes ◽  
Gas Processing ◽  
Maximum Benefit ◽  
First Time

Abstract An innovative design was implemented as a solution for the repetitive failure of a plate heat exchanger installed at Gas Processing Facilitates due to weld cracking, the new design was introduced for the first time in the facility, demonstrating the novelty of utilizing new technologies and enhanced designs in Heat Exchangers used for gas processing. The main challenges were in accommodating various operating modes and ensure the prevention of reoccurrence of the failures. The success was achieved through the collaboration between the operating company and Industry experts in heat transfer equipment to replace the existing design at the gas processing Facilitates with no change in piping layouts, hence, performing the replacement at optimal cost and maximum benefit.

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