A New Coordinate System for Magnetic Resonance Imaging of the Vestibular System

Objectives: To develop and evaluate a new coordinate system for MRI of the vestibular system.Methods: In this study, 53 internal auditory canal MRI and 78 temporal bone CT datasets were analyzed. Mimics Medical software version 21.0 was used to visualize and three-dimensionally reconstruct the image data. We established a new coordinate system, named W–X, based on the center of the bilateral eyeballs and vertex of the bilateral superior semicircular canals. Using the W–X coordinate system and Reid's coordinate system, we measured the orientations of the planes of the anterior semicircular canal (ASCC), the lateral semicircular canal (LSCC), and the posterior semicircular canal (PSCC).Results: No significant differences between the angles measured using CT and MRI were found for any of the semicircular canal planes (p > 0.05). No statistical differences were found between the angles measured using Reid's coordinate system (CT) and the W–X coordinate system (MRI). The mean values of ∠ASCC & LSCC, ∠ASCC & PSCC, and ∠LSCC & PSCC were 84.67 ± 5.76, 94.21 ± 3.81, and 91.79 ± 5.22 degrees, respectively. The angle between the LSCC plane and the horizontal imaging plane was 15.64 ± 3.92 degrees, and the angle between the PSCC plane and the sagittal imaging plane was 48.79 ± 4.46 degrees.Conclusion: A new W–X coordinate system was developed for MRI studies of the vestibular system and can be used to measure the orientations of the semicircular canals.

Current Trends in the Development and Use of Personalized Implants: Engineering Concepts and Regulation Perspectives for the Contemporary Oral and Maxillofacial Surgeon

The recently adopted Medical Device Regulation (MDR) has finally entered into force on 26 May 2021. As innovation and especially the advent of customized prostheses has deeply modified many surgical procedures in our discipline, it is imperative for the contemporary surgeon to become aware of the impact that the MDR will have on many aspects, including the choice of the manufacturer, the evaluation of the devices, point-of-care 3D printing labs, and medical software. In this paper, the authors tried to identify the cultural gaps in clinical practice that the MDR is supposed to fill. To achieve this purpose, a task force of experts was reunited, including CMF surgeons with direct expertise in medical software and 3D printing, mechanical and material engineers, facing the topic of the MDR from a multidimensional perspective. In this article, surgeons and engineers review many crucial aspects concerning the points of the regulation that mostly affect the field of implantable devices for the cranio-maxillo-facial skeleton. The result of interdisciplinary research is a paper aiming to provide surgeons with the knowledge on the fundamental processes of additive manufacturing, increasing the clinician’s awareness on the evaluation of a customized implant before surgery and on the underlying regulatory framework.

EFFICIENCY OF IMPLEMENTATION OF ELECTRONIC DOCUMENT CIRCULATION IN A MULTIDISCIPLINE HOSPITAL AT THE PREHOSPITAL STAGE

Статья посвящена анализу эффективности электронного документооборота в многопрофильном стационаре на догоспитальном этапе (в условиях приемного отделения). Исследование, проводимое в 2020-2021 гг в БУЗ ВО ВОКБ №1, можно считать актуальным, в виду того, что в последние годы в нашей стране в сфере здравоохранения продолжается ряд реформ, направленных на оптимизацию и модернизацию. Этот процесс был бы невозможен без повсеместно проводимой информатизации и цифрофизации. В настоящее время в Воронежской областной клинической больнице №1 происходит внедрение электронного документооборота и специализированных компьютерных программ, изучение эффективности которых и стала целью работы. Объектами исследования послужило 400 пациентов, мужчин и женщин в возрасте от 18 до 79 лет и их истории болезни. Все больные были разделены на 2 группы по 200 человек, в зависимости от того, использовались ли элементы электронного документооборота и специализированные компьютерные программы при их оформлении и при оказании им диагностических мероприятий (не использовались в 1 группе и использовались во 2). В дальнейшем пациенты каждой группы были также подразделены на 2 подгруппы, в зависимости от профиля (хирургия и терапия). В основу исследования лег анализ времени, затраченного на разные этапы догоспитальной помощи - от первичного осмотра и заполнения первичной документации врачами приемного отделения, до выполнения основного спектра лабораторных и инструментальных методов диагностики. Интересной особенностью работы стало выделение в каждой диагностической процедуре нескольких основных этапов, включающих, в том числе и этапы «доставки» пациента к врачу - диагносту, а также временные рамки ознакомления лечащих врачей (терапевта или хирурга приемного отделения или узких специалистов) с результатами исследования. Представленные в статье данные позволяют судить о существенном уменьшении времени, затрачиваемого на оформление и основные диагностические процедуры, благодаря внедрению электронного документооборота. Полученные в работе данные представляют существенный интерес как для практикующих врачей различного профиля и врачей, участвующих в разработке специализированного медицинского программного обеспечения, так и для организаторов здравоохранения The article is devoted to the analysis of the effectiveness of electronic document management in a multidisciplinary hospital at the prehospital stage (in the conditions of the admission department). The research carried out in 2020-2021 at BUZ VO VOKB № 1 can be considered relevant, in view of the fact that in recent years in our country a number of reforms aimed at optimization and modernization have been continuing in our country. This process would not have been possible without the widespread informatization and digitalization. Currently, the Voronezh Regional Clinical Hospital № 1 is introducing electronic document management and specialized computer programs, the study of the effectiveness of which has become the purpose of the work. The objects of the study were 400 patients, men and women, aged 18 to 79 years and their medical history. All patients were divided into 2 groups of 200 people, depending on whether the elements of electronic document management and specialized computer programs were used in their design and in providing them with diagnostic measures (were not used in group 1 and were used in 2). Subsequently, the patients of each group were also subdivided into 2 subgroups, depending on the profile (surgery and therapy). The study was based on the analysis of the time spent on different stages of prehospital care - from the initial examination and filling out the primary documentation by the doctors of the admission department, to the implementation of the main spectrum of laboratory and instrumental diagnostic methods. An interesting feature of the work was the identification of several main stages in each diagnostic procedure, including the stages of "delivery" of the patient to the doctor - diagnostician, as well as the time frame for familiarizing the attending physicians (therapist or surgeon of the admission department or narrow specialists) with the results of the study. The data presented in the article make it possible to judge a significant reduction in the time spent on registration and basic diagnostic procedures due to the introduction of electronic document management. The data obtained in this work are of significant interest both for practicing doctors of various profiles and doctors involved in the development of specialized medical software, and for healthcare organizers

Individualized 3D printing-assisted repair and reconstruction of neoplastic bone defects at irregular bone sites: exploration and practice in the treatment of scapular aneurysmal bone cysts

Background The irregular anatomical shape and complex structures of irregular bones make it more difficult to repair and reconstruct bone defects in irregular bones than in the long bones of the extremities. Three-dimensional (3D) printing technology can help to overcome the technical limitations of irregular bone repair by generating simulations that enable structural integration of the lesion area and bone structure of the donor site in all directions and at multiple angles. Thus, personalized and accurate treatment plans for restoring anatomical structure, muscle attachment points, and maximal function can be made. The present study aimed to investigate the ability of 3D printing technology to assist in the repair and reconstruction of scapular aneurysmal ABC defects. Methods The study included seven patients with ABCs of the scapula. Based on computed tomography (CT) data for the patient, the scapula (including the defect) and pelvis were reconstructed using Mimics Medical software. The reconstructed scapula model was printed using a 3D printer. Before the operation, the model was used to design the surgical approach and simulate the operation process, to determine the length and radius of the plate and the number and direction of screws, and to determine the bone mass of the ilium and develop reasonable strategies for segmentation and distribution. The operation time, amount of bleeding, length and radius of the plate, and direction and number of screws were recorded. Results The average duration of follow-up was 25.6 months, and none of the seven patients experienced recurrence during the follow-up period. The surgical approach, the length and radius of internal fixation, and the number and direction of screws were consistent with the designed operation plan. Patients gradually recovered the anatomical structure of the scapula and function of the shoulder joint. Conclusions In the treatment of bone defects caused by irregular bone tumors, 3D printing technology combined with surgery has the advantages of less trauma, short operation time, less bleeding and reducing the difficulty of operation, which can reduce the waste of bone graft, and more complete reconstruction of the anatomical structure of the defective bone.

Development of a Genetic Method for X-ray Images Analysis based on a Neural Network Model

Background: Modern medicine depends on technical advances in the field of medical instrumentation and the development of medical software. One of the most important tasks for doctors is determination of the exact boundaries of tumors and other abnormal formations in the tissues of the human body. Objective: The paper considers the problems and methods of machine classification and recognition of radiographic images, as well as the improvement of artificial neural networks used to increase the quality and accuracy of detection of abnormal structures on chest radiographs. Methods: A modified genetic method for the optimization of parameters of the model on the basis of a convolutional neural network was developed to solve the problem of recognition of diagnostically significant signs of pneumonia on an X-ray of the lungs. The fundamental difference between the proposed genetic method and existing analogs is in the use of a special mutation operator in the form of an additive convolution of two mutation operators, which reduces neural network training time and also identifies "oneighborhood of solutions" that is most suitable for investigation. Results: A comparative evaluation of the effectiveness of the proposed method and known methods was given. It showed an improvement in accuracy of solving the problem of finding signs of pathology on an X-ray of the lungs. Conclusion: Practical use of the developed method will reduce complexity, increase reliability of search, accelerate the process of diagnosis of diseases and reduce a part of errors and repeated inspections of patients.

Repeatability and reproducibility of deep-learning-based liver volume and Couinaud segment volume measurement tool

Purpose Volumetric and health assessment of the liver is crucial to avoid poor post-operative outcomes following liver resection surgery. No current methods allow for concurrent and accurate measurement of both Couinaud segmental volumes for future liver remnant estimation and liver health using non-invasive imaging. In this study, we demonstrate the accuracy and precision of segmental volume measurements using new medical software, Hepatica™. Methods MRI scans from 48 volunteers from three previous studies were used in this analysis. Measurements obtained from Hepatica™ were compared with OsiriX. Time required per case with each software was also compared. The performance of technicians and experienced radiologists as well as the repeatability and reproducibility were compared using Bland–Altman plots and limits of agreement. Results High levels of agreement and lower inter-operator variability for liver volume measurements were shown between Hepatica™ and existing methods for liver volumetry (mean Dice score 0.947 ± 0.010). A high consistency between technicians and experienced radiologists using the device for volumetry was shown (± 3.5% of total liver volume) as well as low inter-observer and intra-observer variability. Tight limits of agreement were shown between repeated Couinaud segment volume (+ 3.4% of whole liver), segmental liver fibroinflammation and segmental liver fat measurements in the same participant on the same scanner and between different scanners. An underestimation of whole-liver volume was observed between three non-reference scanners. Conclusion Hepatica™ produces accurate and precise whole-liver and Couinaud segment volume and liver tissue characteristic measurements. Measurements are consistent between trained technicians and experienced radiologists. Graphic abstract

Knowledge-Based Systems Manufacturing With Viability Ensuring

With highly increased competition, intelligent product manufacturing based on interpretable knowledge bases has been recognized as an effective method for building applications of explainable Artificial Intelligence that is the hottest topic in the field of Artificial Intelligence. The success of product family directly depends on how effective the viability mechanisms are laid down in its design. In this paper, a systematic cloud-based set of tool family is proposed to develop viable knowledge-based systems. For productive participation of domain and cognitive specialists in manufacturing, the knowledge base should be declarative, testable and integratable with other architectural components. Mechanisms to ensure KBS viability are provided in an ontology-oriented development environment, where each component is formed in terms of domain ontology by using the adaptable instrumental support. Due to the explicit separation of ontology from knowledge, it became possible to divide competencies between specialists creating an ontology and specialists creating a knowledge base. We rely on the fact that the activity of creating an ontology is significantly different from the activity of creating a knowledge base. Creating an ontology is a creative process that requires a systematic analysis of the domain area in order to identify common patterns among its knowledge.The characteristic properties of knowledge-based systems related to viability are described. It is explained, how these properties are provided in development environments implemented on cloud platform. The concept of a specialized manufacturing environment for knowledge-based system is introduced. The necessary set of tools for such ontology-oriented environment construction is determined. The example of tools for creating specialized manufacturing environments is the instruments implemented on the «IACPaaS» platform. The IACPaaS is already used for collective development of thematic cloud knowledge portals with viable knowledge-based systems. This specialized manufacturing environment has enabled the creation of multi-purpose medical software services to support specialist solutions based on knowledge being remotely improved by experts.

Reliability of Cobb’s Angle in a Measurement of Kyphosis – A Meta–Analysis

This study aimed at analyzing the literature systematically on the reliability of Cobb’s angle in measurement of kyphosis. Cobb’s angle is the most widely used measurement to quantify spinal deformity. Kyphosis is the spinal disorder in which an excessive outwards of the spine results in an abnormal rounding of the upper back. Cobb’s angle used as standard measurement to determine and trackthe progression of scoliosis andkyphosis. Hence the purpose of the meta-analysis is to analyze the reliability of Cobb’s angle in a measurement of kyphosis Systematic searches in PubMed, Science direct, Google scholar, Cochrane library, Research Gate for systematic review was done. Research article and review article were selected within the published 1999 – 2020. The study design is Meta-analysis study of Analytical type. Study quality was done by PEDro Scale The study duration is about 4 months. A Meta-analysis was conducted by using Medical software to obtain a summary estimate of the standardized mean difference and 95% confidence limit. 100 articles taken for review in which finally 35 articles were summarized. Almost all the study shows that there was a highly significant difference on measurement of kyphosis using COBB’S angle. Outcome of measurement has excellent reliability with the small range of standard error of measurement. Cobb’s measurement had excellent reliability when used to measure kyphosis. The findings confirm the significance and the ease of using this method.