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Implant placement necessitates an interdisciplinary approach in which a team of dental implant specialists, including an oral surgeon, prosthodontist, periodontist, and oral radiologist, collaborate on the design, execution, and maintenance of the implants to provide the best possible result. According to the data, the vast majority of the participating dentists provide implant-supported restorations to their patients on a regular basis. Surprisingly, the percentage of dentists who plan implant placement and employ backward planning methods was significantly lower. This finding implies that dentists do not always follow the current scientific consensus that the placement of an implant should be based on prosthetic principles.

This report describes a prosthetically-driven implant planning method, guided by the alignment procedures between the cone beam computed tomography, intraoral digital scans, and digitized maxillary and mandibular interim complete dentures using intraoral composite resin markers as a common reference. The markers were attached to the keratinized oral mucosa of the edentulous ridges using cyanoacrylate and kept in place during the digitizing procedures. The technique provides a simpler and more economical alternative to conventional prosthetically-driven static implant planning methods.

Nowadays, the daily forecast for employee losses becomes a major issue. Staff participation is an important issue for the organization, especially when professional technical staff and key people in the organization come from good positions. This leads to a loss of finances to replace skilled labor. Therefore, we use data from current and former employees to analyze common causes of employee access or influence. To avoid employment, we use several planning methods, namely: Decision Tree, Log-log of Backlog, SVM, KNN, Random Forest, Bayes Naive. To do this, we use the method to select employment information and analyze the results to avoid employee income. Companies need to anticipate employee incentives and contribute to economic growth by reducing manpower.

One cycle of chemotherapy does not eliminate all cancer cells, therefore it takes a repeated cycle (Williams, et al, 2016), so the guarantee the availability of chemotherapy drugs is needed. An effective drug requirement planning is required to ensure the availability of chemotherapy drug. This study was intended to determine the effectiveness of planning the need for chemotherapy drugs using the morbidity method on the availability of chemotherapy drugs in Dr. Ramelan Navy Hospital. This study was an observational study with a cross sectional study design. The instrument used in this study was the data collection sheet with data sources prescription sheets and sheets of chemotherapy drug reconstitution during 2015-2017. Descriptive data analysis and to determine effective planning methods using indicators of drug availability. The results showed that the planning of drug needs with the morbidity method can better guarantee the availability of chemotherapy drugs and can minimize drug shortages compared to the consumption method that has been done so far in Dr. Ramelan Navy Hosptal. So it can be concluded that in this study, the morbidity method is effective in meeting the needs of chemotherapy drugs.

Background The aim of the study was to develop and assess a technique for the optimization of breast electronic tissue compensation (ECOMP) treatment plans based on the breast radius and separation. Materials and methods Ten ECOMP plans for 10 breast cancer patients delivered at our institute were collected for this work. Pre-treatment CT-simulation images were anonymized and input to a framework for estimation of the breast radius and separation for each axial slice. Optimal treatment fluence was estimated based on the breast radius and separation, and a total beam fluence map for both medial and lateral fields was generated. These maps were then imported into the Eclipse Treatment Planning System and used to calculate a dose distribution. The distribution was compared to the original treatment hand-optimized by a medical dosimetrist. An additional comparison was performed by generating plans assuming a single tissue penetration depth determined by averaging the breast radius and separation over the entire treatment volume. Comparisons between treatment plans used the dose homogeneity index (HI; lower number is better). Results HI was non-inferior between our algorithm (HI = 12.6) and the dosimetrist plans (HI = 9.9) (p-value > 0.05), and was superior than plans obtained using a single penetration depth (HI = 17.0) (p-value < 0.05) averaged over the 10 collected plans. Our semi-supervised algorithm takes approximately 20 seconds for treatment plan generation and runs with minimal user input, which compares favorably with the dosimetrist plans that can take up to 30 minutes of attention for full optimization. Conclusions This work indicates the potential clinical utility of a technique for the optimization of ECOMP breast treatments.

The field of musculoskeletal diagnostics and personalized medicine has undergone a revolutionary transformation due to a deeper understanding of skeletal biomechanics and due to technological advancements. Analogous to this transformation, our understanding of spinopelvic conditions has experienced a paradigm shift in terms of both static and dynamic changes in spinopelvic pathologies and enabled a more accurate delineation of the drivers of disability. The purpose of this review is to describe the standard and state of the art of preoperative diagnostic and planning methods for common spinopelvic pathologies and to discuss both the added clinical value and limitations. The rationale is to accelerate the accurate and timely diagnosis and as well as the efficient and safe preoperative workflow.

Purpose To propose a method of optimizing intensity modulated proton therapy (IMPT) plans robust against dosimetric degradation caused by random anatomic variations during treatment. Methods and Materials Fifteen patients with prostate cancer treated with IMPT to the pelvic targets were nonrandomly selected. On the repeated quality assurance computed tomography (QACTs) for some patients, bowel density changes were observed and caused dose degradation because the treated plans were not robustly optimized (non-RO). To mitigate this effect, we developed a robust planning method based on 3 CT images, including the native planning CT and its 2 copies, with the bowel structures being assigned to air and tissue, respectively. The RO settings included 5 mm setup uncertainty and 3.5% range uncertainty on 3 CTs. This method is called pseudomultiple-CT RO (pMCT-RO). Plans were also generated using RO on the native CT only, with the same setup and range uncertainties. This method is referred to as single-CT RO (SCT-RO). Doses on the QACTs and the nominal planning CT were compared for the 3 planning methods. Results All 3 plan methods provided sufficient clinical target volumes D95% and V95% on the QACTs. For pMCT-RO plans, the normal tissue Dmax on QACTs of all patients was at maximum 109.1%, compared with 144.4% and 116.9% for non-RO and SCT-RO plans, respectively. On the nominal plans, the rectum and bladder doses were similar among all 3 plans; however, the volume of normal tissue (excluding the rectum and bladder) receiving the prescription dose or higher is substantially reduced in either pMCT-RO plans or SCT-RO plans, compared with the non-RO plans. Conclusions We developed a robust optimization method to further mitigate undesired dose heterogeneity caused by random anatomic changes in pelvic IMPT treatment. This method does not require additional patient CT scans. The pMCT-RO planning method has been implemented clinically since 2017 in our center.

Objective To research and assess automatic volumetric modulated arc therapy (VMAT) planning methods for patients with intraocular cancer. Methods The mdaccAutoPlan system was added to the Pinnacle3 treatment planning system as a plug‐in. Automatic VMAT plans were generated for 10 patients diagnosed with intraocular cancer, and evaluated according to standard dose‐volume histogram parameters. Results The planning target volume of enrolled patients ranges from 14.24 to 50.69 cm3. Both planning methods lead to acceptable planning target volume target coverage with a V95 of 97.9 ± 1.4% and 96.4 ± 1.5% for manual and automatic plans (P = 0.03), respectively. Automatic planning lowered the dose delivered to the ipsilateral lens and optical nerves, but increased the dose to the brainstem compared with manual planning. Automatic planning significantly prolonged VMAT planning time (3.25 ± 0.53 h vs. 1.02 ± 0.69 h, P

Surgical resection is the main clinical method for the treatment of bone tumors. A critical procedure for bone tumor resection is to plan a set of cut planes that enable resecting the bone tumor with a safe margin while preserving the maximum amount of healthy bone. Currently, the surgeons rely on manual methods to plan the cut planes, which highly depend on the surgeons’ experiences and have been demonstrated to be error-prone, and in turn, increase the recurrence rate or resect much healthy bone. This study targets on improving the precision of cut plane planning for the image guided pelvis tumor resection surgeries. A semi-automatic approach to cut plane planning was proposed via a coarse-to-fine strategy. It can efficiently identify a dangerous region in the 3D space, which contains the bone tumor and its surrounding normal tissue with a safe margin. By projecting the dangerous region into an appropriate 2D space, a segmented boundary-constrained linear regression method was leveraged to plan a set of 3D cut planes that ensure the minimum area of the resected specimen in the 2D space while having the dangerous region cleared. Further, a coarse-to-fine 3D cut plane planning method was developed by incorporating a 3D cut plane refinement scheme with our 2D planning method. Extensive experiments, on the surgical data from nine previous pelvis tumor resection surgeries, demonstrated that our proposed approach substantially improved the localization precision of cut planes ( ${p} ) and decreased the amount of resected specimen ( ${p} ), as compared to the manual method.

The paper presents the results of theoretical and experimental studies aimed at optimizing the decortication process of industrial hemp stems. In order to achieve this goal, physical and mechanical properties of industrial hemp straw stems were investigated, with the choice of the main quality indicator - diameter, which directly influences the bast output. Also, with the help of mathematical planning of the experiment, the optimal treatment mode for the stems of industrial hemp with clearing of wood of 5-6% was calculated.

Objective The purpose of this study was to evaluate the use of a modified template system and double computed tomography scan procedure to maintain mandibular width in cases of mandibular reconstruction. Study design Ten patients who underwent mandibular reconstruction with a fibular flap were enrolled. The surgeries were planned with a computer-aided surgical simulation (CASS) planning method. Following double computed tomography scan procedure, the template system was designed in a computer and was fabricated using a three-dimensional printing technique. The cutting guides were designed with the holes of the conventional reconstruction plate on the remnant mandibular segments. After surgery, the outcome evaluation was compared by first superimposing the post-operative computed tomography model onto the planned model and then measuring the differences between the planned and actual outcomes. Results All surgeries were completed successfully using the template system. With the use of the templates, the largest linear root-mean-square deviation (RMSD) between the planned and post-operative remnant segments was 1.01 mm, and the largest angular RMSD was 4.05°. Conclusions The authors conclude that this template system and double computed tomography scan procedure provides a reliable method to maintain mandibular width in mandibular reconstruction using a fibular flap.

The aim of this retrospective study was to determine if the split x-jaw planning technique could be used with Varian linear accelerators to improve plan conformity and limit dose to organs at risk (OAR) for planning target volumes that require field sizes larger than the 15 cm extent of the multileaf collimator in the x-jaw position. Traditional planning techniques include limited and open x-jaw methods. The study population included 20 randomly selected patients with endometrial carcinoma. Treatment plans for each patient were designed using split, limited, and open x-jaw volumetric modulated arc radiotherapy for comparison purposes. Dose statistics including the PTV conformity index and dose to OAR were used to evaluate plan performance. The split x-jaw planning method had the most consistent conformity index (0.98 ± 0.02), followed by the open (01 ± 0.03), and the limited (1.04 ± 0.05) techniques. On average, the split method better spared the OAR. In comparison to the limited and open techniques, the split method reduced the dose to the bowel by 3.8%, rectum by 3.2%, sigmoid by 2.1%, right femoral head by 3.5%, and left femoral head by 3.9%. The split and open techniques showed comparable bladder results and were superior over the limited method. The monitor units were highest with the split method leading to increased treatment times. The split x-jaw planning technique should be used with Varian linear accelerators to produce superior volumetric modulated arc radiotherapy plans for planning target volumes larger than the maximum extent of the multileaf collimator in the x-jaw direction.

Introduction There are several methods for correcting distal femoral valgus deformity in skeletally mature patients including fixator-assisted plating (FAP), fixator-assisted nailing (FAN) and nailing using the reverse planning method. The fixator-assisted techniques have been previously compared in the literature and found to be similarly accurate. This study is the first to compare all three procedures in a single series. Materials and methods A retrospective review of patients who had undergone distal femoral valgus correction at a single institution between March 2017 and February 2020 was undertaken. Three different patient groups were identified based on the surgical technique used: the FAP, the FAN and the reverse planning method. The mechanical lateral distal fimoral angle (mLDFA) was recorded and compared preoperatively and postoperatively. The body mass index (BMI), duration of surgery, postoperative range of motion (ROM) and complication profile for each patient were also recorded and compared. Results A total of 27 limbs in 24 patients were included in this study. There were 8 male and 16 female patients. There were 10 limbs from 9 patients in the reverse planning group, 11 limbs from 11 patients in the FAN group and 6 limbs from 4 patients in the FAP group. There was a statistically significant difference in the mean preoperative and postoperative mLDFA for each of the individual groups (p < 0.0001 for each group). All patients had restoration of the mLDFA to within normal limits except one patient in the reverse planning group. This was purposefully performed to compensate for an ipsilateral proximal tibial deformity. There was no statistically significant difference in the mean preoperative and postoperative mLDFA across the groups (p = 0.2897 and 0.3440, respectively). The operative time of the reverse planning method and the FAP were significantly shorter than FAN (p = 0.0016 and p = 0.0035, respectively). The mean final knee ROM amongst the groups was similar (p = 0.8190). We recorded no infections or union complications in any group. There was one case of hardware irritation causing lateral knee pain that did not require treatment in the reverse planning group and one fracture through a temporary half-pin site in the FAN group. All six plates in the FAP group had to be removed following union on account of localised discomfort from the hardware. Conclusion The reverse planning method, the FAN and the FAP are comparable in terms of accuracy in achieving correction of distal femur valgus deformity in skeletally mature patients. The reverse planning method had the best combination of outcomes in this study since it was just as accurate as the FAN and the FAP techniques and did not require any additional surgeries. While both the reverse planning and the FAP were faster than the FAN technique, the reverse planning method allows the ability to perform both deformity correction and lengthening. Ultimately, the decision of which technique to use depends on a combination of the patient's preference and the surgeon's level of comfort with the technique. How to cite this article Iobst C, Waseemuddin M, Bafor A. Accuracy and Safety of Distal Femoral Valgus Correction: A Comparison of Three Techniques. Strategies Trauma Limb Reconstr 2020;15(1):41–46.

Polyphenolic vegetable complexes are active antioxidants and play an important role in the processes of free radicals quenching in the human body. The aim of the work was to develop an immobilization method as a way for improving the stability of polyphenols in dried cowberry squeezing extract (DCSE) and to develop semi-finished minced meat products with antioxidant effect without changing their nutritional value. Experiments were carried out to study the nutritional value of DCSE. The presence of a large number of polyphenolic compounds in DCSE and a high radical-binding ability of the extract were revealed. Based on the mathematical planning method, an offal paste composition was obtained, which was used to obtain pellets, and the formulation of semi-finished minced meat products with pellets was optimized. It was established that preliminary immobilization of DCSE on offal pellets components allows to increase the level of total antioxidant content in the minced meat. Subsequent heat treatment of semi-finished minced meat products produced from such minced meat showed an increase in stability and, thus, bioavailability of antioxidants and the possibility of obtaining a finished product with antioxidant effect. The antioxidant effect of cowberry squeezing extract in the meat system is proved: accumulation of lipid oxidative decomposition products in the meat system during storage of frozen semi-finished minced meat products was inhibited to a greater extent when using offal pellets with immobilized compounds of cowberry squeezing extract. This work was carried out as part of the State Assignment of the Ministry of Education and Science of the Russian Federation No. 19.5486.2017/BCh and the «Young Scientists of ESSTU‑2019» grant.

Purpose This study aims to compare stereotactic radiosurgery (SRS) planning of epilepsy that complies with Radiosurgery or Open Surgery for Epilepsy (ROSE) guidelines in GammaKnife, non‐coplanar conformal (NCC) plan in Eclipse, dynamic conformal arc (DCA) plan in Brainlab, and a volumetric modulated arc therapy (VMAT) plan in Eclipse. Methods Twenty plans targeting Mesial temporal lobe epilepsy (MTLE) was generated using GammaKnife, Eclipse with 20 NCC beams, Brainlab with 5 DCA, and Eclipse VMAT with 4 arcs observing ROSE trial guidelines. Multivariate analysis of variance and Wilcoxon signed‐rank test were used to compare dosimetric data of the plans and perform pairwise comparison, respectively. Results The plans obeyed the recommended prescription isodose volume (PIV) within 5.5–7.5 cc and maximum doses to brainstem, optic apparatus (OA) of 10 and 8 Gy, respectively, for a prescription dose of 24 Gy. The volumes of the target were in the range 4.0–7.4 cc. Mean PIV, maximum dose to brainstem, OA were 6.5 cc, 10 Gy, 7.9 Gy in GammaKnife; 7.2 cc, 6.1 Gy, 4.5 Gy in Eclipse NCC; 7.2 cc, 6.4 Gy, 5.7 Gy in Brainlab DCA; and 5.2 cc, 8.4 Gy, 6.1 Gy in Eclipse VMAT plans, respectively. Multivariate analysis of variance showed significant differences among the 4 SRS planning techniques (P‐values

To investigate if the conventional localizer radiograph (LR) can be replaced by a synthetic LR (SLR), generated from a low-dose spiral CT scan, for CT scan planning with minimal changes to current clinical workflows.A dosimetric comparison of SLRs and LRs was made using Monte Carlo methods. Water equivalent diameters (WEDs) of a centered and mis-centered phantom were estimated from low-dose spiral CT scans and LRs acquired at different angles. Body sizes, in the form of two lengths and two diameters obtained from SLRs and LRs, were compared for 10 patients (4 men and 6 women with a mean age of 74.8 and 76.2 years respectively) undergoing CT of thorax and abdomen. The image quality of SLRs for CT scan planning relative to LRs was rated using a 5-grade scale by four radiologists and two CT radiographers.An SLR can be obtained at a comparable effective dose to that of traditionally acquired LRs: 0.14 mSv. WEDs from LRs were more affected by mis-centering than WEDs calculated from low-dose spiral scans. One significant discrepancy of estimated body sizes was observed, the broadest part of the patient that on lateral localizers showed a mean deviation of 17.7 mm (range: 7.3-28.7 mm, p 0.001). The anteroposterior/posteroanterior SLR image quality was assessed as better compared to an LR while the same could not be shown for lateral localizers.SLRs based on low-dose spiral scans can replace LRs for CT planning.

The purpose of this study was to compare the planning methods of Dugdale and Miniaci for high tibial osteotomies (HTO) and to assess how their use could influence on the degree of correction and thus the postoperative weight bearing line (WBL). Pre- and postoperative standing hip-knee-ankle (HKA) radiographs were obtained from 70 patients that underwent HTO. The correction angles were determined using Dugdale’s and Miniaci’s methods, and for the latter, both for an opening wedge as well for a closing wedge osteotomy. In a subset of 50 patients, the calculations were performed twice by two observers to calculate inter- and intra-rater reliability. Regression analysis and Bland–Altman plots were used to compare the methods. Whereas the Dugdale method had been used in the planning of the real operations, a regression model was used to predict how the obtained correction would have been if the Miniaci method had been used instead. Intra- and inter-rater reliability was excellent for the correction angle for both Dugdale’s (0.992 and 0.991) and Miniaci’s methods (0.988 and 0.987). When planning for an opening wedge osteotomy (OW) and a closing wedge osteotomy (CW), using the Miniaci method and comparing the correction angle with the angle obtained by the Dugdale method, the Miniaci OW and CW angles were larger by a factor of 1.07 (95% CI 1.06–1.08) and 1.10 (95% CI 1.09–1.11). Postoperatively, a mean undercorrection of 2.9° (SD = 2.3) was found. Predicting the correction with use of the calculated Miniaci angles resulted in an undercorrection of 2.5°, indicating that use of the Dugdale method accounted for 14% of the undercorrection. It is more likely to underestimate the correction angle when using the Dugdale method compared to the Miniaci method. This could lead to poorer correction accuracy. As the inter-rater reliability is excellent for both methods, choosing to use the Dugdale method on basis of simplicity is not justified. III, Diagnostic study.

CONTEXT The Public Health Accreditation Board requires accredited local health departments (LHDs) to complete community health improvement plans (CHIPs). Evidence suggests that participatory planning frameworks, cross-sector collaboration, social determinants of health (SDOHs), and steering organizations are integral to effective public health planning. However, little is known about the degree to which LHDs incorporate these aspects during the CHIP process. OBJECTIVES To describe the use of planning methods, SDOHs, cross-sector partnerships, and steering organizations during the CHIP development process among nationally accredited LHDs and to identify whether LHD jurisdictional size or region is associated with differences in use. DESIGN The most recent CHIPs from 93% of all nationally accredited LHDs (n = 195) were qualitatively reviewed and numerically coded for each of the planning components to calculate frequency and degree of use. Differences in use of each component by LHDs' jurisdictional size and region were tested using the chi-square test. MAIN OUTCOME MEASURE Use of CHIP planning frameworks, SDOH inclusion, cross-sector partnerships, and steering organizations. RESULTS One-half of LHDs (53%) reported use of Mobilizing for Action through Planning and Partnerships, but nearly one-fourth of LHDs did not use any planning framework. LHDs with a large jurisdictional size (>500 000) were significantly more likely to include SDOHs to a high degree than LHDs with mid- (100 000-499 999) to small- (

Purpose/Objective(s) Head and neck cancer (HNC) RT typically results in high doses to organs-at-risk (OARs), contributing to decreased quality-of-life (QOL) seen in patient reported outcomes (PRO). Current RT planning methods are driven by singular dosimetric trade-offs that may be inconsistent with improving a patient's overall predicted total toxicity burden (TTB). We developed an aggregate toxicity assessment over time including PROs that represents a paradigm shift over informal summary of individual toxicity. Here we introduce a treatment planning approach to directly optimize and reduce the predicted TTB-PRO of a patient's RT plan. Materials/Methods We implemented a prioritized approach to TTB optimization using an in-house optimization plugin linked to a commercial treatment planning system. Prioritized TTB (P-TTB) plans were optimized using a two-stage hierarchal method for inverse IMRT planning. In the first stage, TTB, defined as the weighted-sum of NTCPs, is minimized subject to high-priority OAR dose limits, target prescription, and target coverage requirements. Weights for the toxicities directly represent the relative undesirability of toxicities. In the second stage, a weighted-sum dose-metric objective is minimized, similar to current clinical practice. This stage is subject to the same constraints as the first stage, but an additional constraint for TTB is incorporated based on the optimal solution of the first stage. Using this approach, we retrospectively generated plans for 5 HNC patients and compared the resulting plans to IMRT plans generated without the added TTB constraint. Both plans consisted of 9 equally spaced beams with the same OAR dose limits and dose-metric objective. Target dose requirements were based on simultaneous integrated boost prescriptions of 70 and 56 Gy delivered in 35 fractions. TTB was calculated using previously published NTCP models for dysphagia and xerostomia. Dysphagia was based on increase in aspiration or HNQOL score > 81 as a function of pharyngeal constrictor (PC) mean dose. Xerostomia was based on parotid flow ratio 73 as a function of parotid gland (PG) mean dose. Results Our optimization engine successfully generated P-TTB plans for all five patients while maintaining similar target coverage to the standard dosimetrically optimized plans. P-TTB plans resulted in average absolute NTCP reductions of 15.5% (range: 0.2 - 53.4) for dysphagia and 20.5% (1.9 - 68.5) for xerostomia. These changes correlate to average mean dose decreases of 6.9 Gy (0.2 - 22.7) for PC and 10.2 Gy (1.2 - 33.5) for PGs. P-TTB planning resulted in greater fluence modulation and higher doses to OARs not included in the calculation of TTB. Conclusion The P-TTB planning method offers an intuitive optimization approach to balancing trade-offs between various treatment outcomes and has the ability to directly reduce and redistribute predicted toxicity which may aid in improving QOL for HNC patients receiving RT.

Introduction We developed a national survey to capture how respiratory departments in England adapted during the first wave of the COVID-19 pandemic and to develop lessons which can be applied to subsequent planning Methods A link to the online survey, hosted on a secure platform in an NHS England and Improvement account, was sent by email to all NHS trusts in England with known respiratory departments The survey was open for 43 days during August and September 2020 The survey included sections on COVID patient numbers, bed capacity, workforce, delivery of respiratory support, equipment, diagnostic and interventional services, and follow-up for patients discharged Results 58 (43 9%) responses were received Workforce-42 sites (72 4%) changed their respiratory consultant rota, for example, by changing to 12 hours shifts and overnight resident on calls 24 sites (41 4%) stated that respiratory consultants had been removed from the general medical rota Respiratory Support-CPAP was used in a variety of clinical environments including closed bays (in 36 sites) and closed wards (19 sites), and was primarily used as a bridge to ventilation (46 sites), to prevent intubation (48 sites) and as a ceiling of care (47 sites) Equipment-28 (48 3%) of units reported a shortage of at least one respiratory medical consumable (most commonly non-vented NIV masks (16 units) and CPAP machines (12 units)) Diagnostic and interventional services-Bronchoscopy and EBUS services were suspended in 16 (27 6%) and 10 (17 2%) sites respectively and continued for cancer patients only in 24 (41 4%) and 27 (46 6%) sites respectively Follow up-12 units (20 7%) did not offer follow up to patients with COVID related pneumonia at 6 weeks Conclusion This national survey shows the significant changes made, and challenges faced, by respiratory departments during the first wave of the COVID-19 pandemic We identified some areas where there were deviations from best practice and some positive changes that should be continued The lessons drawn from the survey results can assist in future COVID-19 planning

Background Hippocampal‐avoidance prophylactic cranial irradiation (HA‐PCI) offers potential neurocognitive benefits but raises technical challenges to treatment planning. This study aims to improve the conventional planning method using volumetric modulated arc therapy (VMAT) technique and investigate a better patient’s head positioning to achieve a high quality of HA‐PCI treatment plans. Methods The improved planning method set a wide expansion of hippocampus as a special region for dose decline. The whole brain target was divided into two parts according to whether the slice included hippocampus and their optimization objectives were set separately. Four coplanar full arcs with partial field sizes were employed to deliver radiation dose to different parts of the target. The collimator angle for all arcs was 90°. Tilting patient’s head was achieved by rotating CT images. The improved planning method and tilted head positioning were verified using datasets from 16 patients previously treated with HA‐PCI using helical tomotherapy (HT). Results For the improved VMAT plans, the max and mean doses to hippocampus were 7.88 Gy and 6.32 Gy, respectively, significantly lower than those for the conventional VMAT plans (P 0.1) but lower max dose (P

The purpose of this study was to evaluate the dosimetric advantage of inverse planning optimization (IPO) in locally advanced cervical cancer using high-dose-rate (HDR) brachytherapy (BT). IPO was compared with point A plan and geometric optimization (GO). The three planning methods were evaluated using doses to the virtual organ-at-risk (OAR) and D90 (the minimum dose covering of 90% of the volume) to the virtual high-risk clinical target volume (HR-CTV) based on quantitative analysis. HR-CTV structures measuring 38.5 cm3 and 59.5 cm3 were created based on the outcomes of a European Group cohort study. The HR-CTVs were located either at the center of the cervix (cervical center model) or shifted toward the left (extensive disease model). The distances from the HR-CTVs to the rectum were set at 0 mm, 3 mm, 5 mm, 8 mm, 10 mm, and 15 mm. We analyzed 336 conditions in this study. All doses were evaluated by conversion to doses in 2-Gy fractions of conventional radiotherapy. The D90 of the HR-CTV using GO and IPO could achieve the desired dose in all conditions, providing better results than that of point A plan. IPO makes it possible to deliver a sufficient dose for the D90 of the HR-CTV while reducing OAR doses with smaller HR-CTV values (

Deformities of the midfoot are often treated with midfoot osteotomies. The goal of the midfoot osteotomy is to create a plantigrade forefoot to hindfoot relationship. Many different techniques are described for performing midfoot osteotomies. Our goal is to present an objective pre-operative planning method and an intra-operative technique for accurate multiplanar realignment and discuss our short-term results. We retrospectively reviewed 18 patients, 10 female (56%) and 8 male (44%), that underwent realignment midfoot osteotomies. The mean follow-up was 25 months (range, 4-120). The mean age at the time of surgery was 53 years (range, 21-76). Statistically significant improvement in radiographic alignment was found in the anteroposterior talo-first metatarsal angle (p = .002) and the mechanical axis deviation of the foot (p = .02). This study proved that our pre-operative and intra-operative planning technique provides accurate multiplanar radiographic realignment with good clinical results.

In this article, the advantages, disadvantages and pitfalls of three-dimensional virtual surgical planning (3D-VSP) compared to traditional two-dimensional (2D) planning methods in orthognathic surgery are discussed, alongside a standardised protocol that can be utilised. A skeletal Class II, skeletal Class III and an anterior open bite clinical case along with their 3D-VSP management are presented, highlighting modifications that can be made to computer-aided design/computer-aided manufacture (CAD/CAM) cutting guide and plate designs.

In machining process for a workpiece with low rigidity such as a blade shape, it is required to consider elastic deformation of the workpiece shape itself due to cutting force. Conventionally, reduction of the cutting force in machining process is achieved by optimization of feed rate value in NC program. On the other hand, since a decrease in the feed rate causes an increase in machining time. So, other optimization algorithm is required. In this paper, a new method to suppress the elastic deformation of the workpiece by changing tool posture in multi-axis controlled machining is proposed. The proposed method is intended for finish machining process for blade shape with a ball end mill. In the proposed method, first, the cutting force loaded on the workpiece surface in a certain posture candidate is predicted, and an instantaneous cutting force at the moment when the machining surface is generated is estimated by model-based computer simulation. Based on this results, the amount of elastic deformation on the machined surface is estimated by FEM. This process is repeated at each cutter location and tool posture candidate, and the new tool posture that can minimize machining error caused by the elastic deformation is determined at each cutter location.

Purpose To compare preplanning and intraoperative planning methods of lung tumor brachytherapy based on postimplant CT images and dosimetric outcomes. Methods and Materials Detailed postimplant evaluations of iodine-125 seed implants were performed in 15 patients using a preplanning technique and in 15 patients treated with an intraoperative planning technique. The implant details, dosimetric parameters, and implant quality indices were compared. Furthermore, the dose to the lung and the incidence of complications were compared. Results The planning target volume was similar in both groups (p = 0.496). The median V100%, V150%, and V200% values (the percent of the planning target volume receiving 100%, 150%, and 200% of the prescription dose) for the intraoperative planning technique were 95.65%, 76.47%, and 59.80%, respectively. The median V100%, V150%, and V200% values for the preplanning methodology were 88.86%, 69.23%, and 28.30%, respectively (p Conclusion These data showed that the intraoperative planning method was superior to the preplanning method for the treatment of lung tumors.

Background Home care providers struggle to manage their day-to-day work, which is increasing in volume and complexity. In general, they are expected to achieve more with the same planning methods, resources, and capacity. To meet emerging needs and use the available resources more effectively and efficiently, evidence and strategies are needed to inform planning methods for home care services. However, limited data are available to inform this change. This paper investigated the amount of time used to carry out direct activities and six indirect activities across three rural Norwegian municipalities (M1, M2 and M3). Methods Home care staff recorded data over 8 weeks in 2016; the majority of the staff used a smartphone application and some staff used a manual form to report the durations of the activities. Results The median time spent on direct activities was 11–13 min, and this work constituted less than 50% of the total work in the three municipalities. The median driving time was 5–7 min, which accounted for 43–54% of the total indirect work. Administration, particularly reporting and documentation, displayed greater differences across the municipalities, together accounting for 38–50% of the total indirect time. M2 and M3 used substantially more time for documentation, including 20 min in M2 and M3, in contrast to only 1 min in M1. Similarly, the median reporting times were 30 min (M2) and 28 min (M3), compared with only 17 min in M1. Conclusions Home care staff spent less time on direct activities than on indirect activities, of which several activities have the potential for change. These results may help managers utilize resources effectively and plan appropriately, and they may also serve as a basis for future research to identify areas with improvement opportunities and, in turn, make more time available for direct patient care.

Seasonal influenza is a serious public health concern, against which vaccination is one of the most effective ways to protect people. However, the effect of vaccination on containing influenza spread critically depends on the immunization programme adopted. Therefore, the problem of finding the optimal combination of vaccination strategies, with a view to decreasing the programme cost, enhancing vaccination efficiency, and improving societal benefits, is of great theoretical and practical importance. We develop a multiple criteria mathematical programming model to address the problem, analyze the model, and derive the structural properties of the optimal solution. Conducting extensive numerical studies to assess the merit of the model, we find that an integrated strategy embracing early-stage indiscriminate mass vaccination with late-stage targeted vaccination outperforms other strategies in cost and efficacy.

The quality of radiotherapy has greatly improved due to the high precision achieved by intensity-modulated radiation therapy (IMRT). Studies have been conducted to increase the quality of planning and reduce the costs associated with planning through automated planning method; however, few studies have used the deep learning method for optimization of planning. The purpose of this study was to propose an automated method based on a convolutional neural network (CNN) for predicting the dosimetric eligibility of patients with prostate cancer undergoing IMRT. Sixty patients with prostate cancer who underwent IMRT were included in the study. Treatment strategy involved division of the patients into two groups, namely, meeting all dose constraints and not meeting all dose constraints, by experienced medical physicists. We used AlexNet (i.e., one of common CNN architectures) for CNN-based methods to predict the two groups. An AlexNet CNN pre-trained on ImageNet was fine-tuned. Two dataset formats were used as input data: planning computed tomography (CT) images and structure labels. Five-fold cross-validation was used, and performance metrics included sensitivity, specificity, and prediction accuracy. Class activation mapping was used to visualize the internal representation learned by the CNN. Prediction accuracies of the model with the planning CT image dataset and that with the structure label dataset were 56.7 ± 9.7% and 70.0 ± 11.3%, respectively. Moreover, the model with structure labels focused on areas associated with dose constraints. These results revealed the potential applicability of deep learning to the treatment planning of patients with prostate cancer undergoing IMRT.

Even though the relevance of solid waste management goals for our societies becomes more and more acknowledged around the globe, one of the major challenges is to get the level of attention needed from those who are responsible for making the decisions. Waste management is one issue among others of the issues policy-makers do have to take care of, but many times other issues seem to have a higher priority. This prioritization often is also based on the aim of achieving short term effects and does not take into account infrastructural synergies that may be realized when tackling waste management issues as well as middle and long-term effects of addressing or neglecting waste management challenges, even though when basic waste management needs are addressed there are interfaces between the waste sector and the producing sectors that need to be handled in a reasonable way in order to allow for securing that pollutants and harmful substances are being concentrated in the waste management sphere and a portion of secondary materials as high as possible is being recycled. This paper shows examples of the challenges addressed and proposes how these could be handled in the future for the sake of the implementation of a circular economy.

Radiotherapy to the breast after surgery sometimes requires adjoining nodes to be included in the treatment volume. In these cases, the traditional approach has been a complex 3‐Dimensional Conformal Radiotherapy (3DCRT) beam arrangement which can result in significant dose heterogeneity at the beam junctions. A Volumetric Modulated Arc Therapy (VMAT) beam arrangement has previously been proposed for breast cases, where the chest wall/breast is treated with a limited angle (partial arc) tangential VMAT technique (Virén et al. [2015] Radiat Oncol. 10:79). In our study, this approach is extended to breast and chest wall cases with adjoining nodes by adding a separate conventional VMAT arc field specifically limited to the superior nodes. This VMAT method was implemented using a semiautomated approach on 27 patients, and the resultant plan compared to a monoisocentric 3DCRT plan. Plan statistics, Dose‐Volume Histogram (DVH) analysis and Radiation Oncologist (RO) preference were assessed. When compared to the 3DCRT technique, the VMAT planning method was found to result in better target volume coverage, high doses to organs at risk (OAR) were reduced but greater OAR volumes received low doses. Having said that, the volume receiving low doses with this tangential VMAT technique was less than that of other VMAT planning methods described in the literature, and the integral dose was less than the 3DCRT method. The VMAT technique also resulted in more robust junction doses that the 3DCRT method. RO review found that the VMAT technique was preferred in 81% of cases. Specifically, the VMAT plans were preferred in all categories of patients except left chest wall cases where the intermammary nodes were also treated. The VMAT technique described here is a useful addition to the treatment options available for breast/chest wall and nodal patients.

Purpose Intermediate- and low-dose falloff in stereotactic body radiotherapy (SBRT) of lung tumor is known to relate to normal tissue toxicity. The purpose is twofold to analyze the relation between RTOG parameters (namely, R50%, D2cm) in lung SBRT plans and to explore planning methods that correlate with higher than acceptable dose to normal tissue. Methods RTOG recommended target dose coverage, conformity index, homogeneity index, R50%, and D2cm were evaluated retrospectively in 105 lung tumor SBRT plans. Deviations in R50% and D2cm were correlated with parameters including prescription dose, tumor location, number of beams or arcs, beam configuration (coplanar or noncoplanar), type of treatment plan (3D-CRT, IMRT or volumetric arc therapy), and shortest distance to the chest wall. Result All plans met the target coverage, conformity index, homogeneity index, and critical organ dose tolerance objectives. Dose falloff product (DFP) of R50% and D2cm has a small variance and small dependence on PTV. Low correlation between DFP and PTV suggests that R50% and D2cm are not independent. Coplanar beam placement was found to be prevalent among plans with large deviations in R50%, D2cm. Conclusion This study questions the independence of the two RTOG recommended metrics, R50% and D2cm in lung SBRT plans, and suggests that noncoplanar beams may provide better normal tissue sparing by reducing the intermediate dose falloff.

The analysis and planning methods for competing risks model have been described in the literatures in recent decades, and non-inferiority clinical trials are helpful in current pharmaceutical practice. Analytical methods for non-inferiority clinical trials in the presence of competing risks were investigated by Parpia et al., who indicated that the proportional sub-distribution hazard model is appropriate in the context of biological studies. However, the analytical methods of competing risks model differ from those appropriate for analyzing non-inferiority clinical trials with a single outcome; thus, a corresponding method for planning such trials is necessary. A sample size formula for non-inferiority clinical trials in the presence of competing risks based on the proportional sub-distribution hazard model is presented in this paper. The primary endpoint relies on the sub-distribution hazard ratio. A total of 120 simulations and an example based on a randomized controlled trial verified the empirical performance of the presented formula. The results demonstrate that the empirical power of sample size formulas based on the Weibull distribution for non-inferiority clinical trials with competing risks can reach the targeted power., 24 pages, 1 figure

// Ki Mun Kang 1, 2 , Hoon Sik Choi 2, 3 , Bae Kwon Jeong 1, 2 , Jin Ho Song 2, 3 , In-Bong Ha 1, 2 , Yun Hee Lee 1, 2 , Chul Hang Kim 3 and Hojin Jeong 1, 2 1 Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea 2 Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea 3 Department of Radiation Oncology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea Correspondence to: Hojin Jeong, email: jeong3023@gmail.com Keywords: MRI-based radiotherapy, rigid image registration, brain tumor, radiotherapy planning Received: March 24, 2017 Accepted: April 24, 2017 Published: May 07, 2017 ABSTRACT An alternative pseudo CT generation method for magnetic resonance image (MRI)-based radiotherapy planning was investigated in the work. A pseudo CT was initially generated using the rigid image registration between the planning MRI and previously acquired diagnostic CT scan. The pseudo CT generated was then refined to have the same morphology with that of the referenced planning image scan by applying the outer body correction scheme. This method was applied to some sample of brain image data and the feasibility of the method was assessed by comparing dosimetry results with those from the current gold standard CT-based calculations. Validation showed that nearly the entire pixel doses calculated from pseudo CT were agreed well with those from actual planning CT within 2% in dosimetric and 1mm in geometric uncertainty ranges. The results demonstrated that the method suggested in the study was sufficiently accurate, and thus could be applicable to MRI-based brain radiotherapy planning.

In laparoscopic gastrectomy, as well as other laparoscopic surgery, the surgeon operates on target organs using a laparoscope and forceps inserted into the abdominal cavity through ports placed in the abdominal wall. Therefore, port placement is of vital significance in laparoscopic surgery. In this paper, we present a method for achieving optimal port placement in laparoscopic gastrectomy based on relationships between the locations of the ports and anatomical structures. We utilize three angle conditions to determine the optimal port placement. Proper angles for the angle conditions are calculated from measurements obtained during laparoscopic gastrectomy. The port positions determined by surgeons experienced in laparoscopic gastrectomy are measured using a three-dimensional positional tracker. The locations of the blood vessels, as well as other vital anatomical structures that are also critical in laparoscopic gastrectomy, are identified from computed tomography images. The angle relationships between the port and blood vessel locations are analyzed using the obtained positional information. Optimal port placement is determined based on the angle conditions. We evaluated the proposed method using the positional information obtained during 26 laparoscopic gastrectomies. Our evaluation determined that the proposed method generates optimal port placement with average errors of 22.2 and 21.2 mm in the left- and the right-hand side ports for a lead surgeon. Experienced surgeons confirmed that the optimal port placement generated by the proposed method was sufficient for clinical use. The proposed method provides optimal port placement in laparoscopic gastrectomy and enables a novice surgeon to determine port placement much like an experienced surgeon.

Radiotherapy is one of the main treatment modalities in modern day’s oncology practice and is used to treat tumours in up to 50% of all cancer patients. The key to successful delivery of a high radiation dose to the tumour without causing unacceptable toxicity of normal tissues is the use of treatment fractionation. During fractionated radiotherapy, it is of importance to reduce inter- and intra-fraction geometrical uncertainties in order to ensure adequate dose delivery to the tumour and preventing unnecessary irradiation of normal tissues. Geometrical uncertainties can be the result of many different factors, including patient set-up, mechanical errors, patient or organ motion, and anatomical changes during the course of treatment. Of these factors, respiratory induced organ motion significantly contributes to geometrical uncertainties during radiotherapy. Therefore, adequate management of moving targets during radiotherapy contributes to the reduction of geometrical uncertainties in radiotherapy planning and improves accuracy of dose delivery. Many technological solutions have been developed for management of respiratory motion during radiotherapy. These include the use of different planning methods in combination with conventional radiotherapy techniques, respiratory gated radiotherapy, and real-time tumour tracking approaches. This chapter will provide an overview of the most important radiotherapy strategies to account for organ motion due to patient respiration. Different technical considerations and solutions regarding respiratory motion management during all the steps of radiotherapy workflow will be discussed.

Background and purpose\ud \ud Current automated planning methods do not allow for the intuitive exploration of clinical trade-offs during calibration. Recently a novel automated planning solution, which is calibrated using Pareto navigation principles, has been developed to address this issue. The purpose of this work was to clinically validate the solution for prostate cancer patients with and without elective nodal irradiation.\ud \ud \ud Materials and methods\ud \ud For 40 randomly selected patients (20 prostate and seminal vesicles (PSV) and 20 prostate and pelvic nodes (PPN)) automatically generated volumetric modulated arc therapy plans (VMATAuto) were compared against plans created by expert dosimetrists under clinical conditions (VMATClinical) and no time pressures (VMATIdeal). Plans were compared through quantitative comparison of dosimetric parameters and blind review by an oncologist.\ud \ud \ud Results\ud \ud Upon blind review 39/40 and 33/40 VMATAuto plans were considered preferable or equal to VMATClinical and VMATIdeal respectively, with all deemed clinically acceptable. Dosimetrically, VMATAuto, VMATClinical and VMATIdeal were similar, with observed differences generally of low clinical significance. Compared to VMATClinical, VMATAuto reduced hands-on planning time by 94% and 79% for PSV and PPN respectively. Total planning time was significantly reduced from 22.2 mins to 14.0 mins for PSV, with no significant reduction observed for PPN.\ud \ud \ud Conclusions\ud \ud A novel automated planning solution has been evaluated, whose Pareto navigation based calibration enabled clinical decision-making on trade-off balancing to be intuitively incorporated into automated protocols. It was successfully applied to two sites of differing complexity and robustly generated high quality plans in an efficient manner.

Due to ignore the impact and the supply requirements of the high-speed traction load at the planning stage, many engineering projects have to increase investment for power quality mitigation. This paper proposes a preliminary planning method for better integration of high-speed traction load. Considering the uncertainty of high-speed traction load, the probabilistic flow analysis model is built to establish the procedure for prediction of system status. Combined with power quality constraints, a chance-constrained model whose objective function is the minimum of investment and loss is established and solved by LDIW-PSO algorithmic. A practical high-speed railway construction project in southwest China is introduced to testify the validity and applicability of the method. According to the simulation results, different toll collection in line with varied supply requirement can be taken into consideration.

Background The superficial circumflex iliac artery perforator flap (SCIP) is a thin, pliable, and versatile flap used mainly for extremities and head and neck reconstruction. Different planning methods have been described, but these are not yet standardized like in other flaps. The aim of this study is to present a fast, effective, and reliable method for SCIP flap planning using computed tomography angiography (CTA). Patients and Methods Between October 2017 and September 2018, CTA was performed on 40 patients. Preoperative planning of SCIP flaps based on the medial branch was performed analyzing CTA images. The perforating sites of the medial branch on the deep (point D) and superficial fascia (point S) were identified. Distances to those points, from the center of the umbilicus in the “y-axis” and the midline perpendicularly in the “x-axis,” were measured. These measurements were transferred to the patient's skin as a guide for dissection. Results Eighty areas were studied identifying points D and S in CTA. Forty-three SCIP flaps were performed using this planning method. In 100% of the flaps, points D and S matched perfectly with handheld Doppler and surgical findings. Conclusion Points D and S method for medial branch based SCIP planning with CTA is an easy to learn, efficient, fast, and reliable technique for preoperative planning, allowing a safe and predictable elevation of the flap.

Background Different planning methods of IMRT planning techniques (IMRT (DMLC) and RapidArc) vs. stander techniques (three-dimensional radiation therapy (3DCRT)) will be evaluated for prostate cancer patients’ planning and verification. Three groups of localized prostate cancer patients are planned and evaluated regarding DVHs and practical radiation dosimetry, and ten 3DCRT plans are assessed statistically for each patient. Results Plan (7) with parameters of five equally weighted fields with angles of 0°, 45°, 90°, 270°, and 315° and energy of 15MV is the most suitable plan both for PTV coverage and for OAR sparing with a fewer number of fields and fewer number of gantry angles. IMRT complexity involves the requirement of long treatment times and additional effort for planning, safety checks, and quality control before the patient start the treatment and proceed. Conclusions The selected plan also is more safe on patients up to 7400 cGy than other plans and is easier to be applied compared to IMRT and RapidArc plans, depending on patient geometry. IMRT radiation doses are more effective and can safely be delivered to PTV with little side effects compared with 3D conformal and conventional techniques. RapidArc has the advantage of re-optimizing and small arcs of variable parameters in dose delivery, taking into account the maximum speed of gantry and MLCs.

Background: Maternal, fetal and neonatal mortality are 10 to 100 fold higher in many low-income compared to high-income countries. Reasons for these discrepancies include limited antenatal care and delivery outside health facilities. Objectives: The study aimed at conducting a baseline survey to assess the current levels of maternal health indicators in six counties in Western Kenya. Methods: This was a cross sectional study conducted targeting women residing in Uasin-Gishu, ElgeyoMarakwet, TransNzoia, Bungoma, Busia and Kakamega counties who had given birth five years prior to the interview. Socio-demographic and maternal indicators were collected using forms adopted from KDHS 2009. Interviews were conducted in the homesteads between December 2015 and June 2016. Results: A total of 6257 women participated in the study, median age 27 years IQR 23-32. Majority of the women had post-primary level of education, were married and 40% were members of an income-generating activity. 56.8% were using modern family planning method, 49% attended WHO recommended four plus antenatal clinic visits and only 20% attended in the first trimester. Majority, 85% had their most recent delivery in a health facility. Conclusion: Findings suggest that women are not attending recommended four plus antenatal clinic visits and even those that attend are few are during the first trimester. Keywords: System approach, maternal and child health care, Kenyan communities.

Objective This study aims to investigate a hybrid automated treatment planning (HAP) solution that combines knowledge-based planning (KBP) and script-based planning for esophageal cancer. Methods In order to fully investigate the advantages of HAP, three planning strategies were implemented in the present study: HAP, KBP, and full manual planning. Each method was applied to 20 patients. For HAP and KBP, the objective functions for plan optimization were generated from a dose–volume histogram (DVH) estimation model, which was based on 70 esophageal patients. Script-based automated planning was used for HAP, while the regular IMRT inverse planning method was used for KBP. For full manual planning, clinical standards were applied to create the plans. Paired t-tests were performed to compare the differences in dose-volume indices among the three planning methods. Results Among the three planning strategies, HAP exhibited the best performance in all dose-volume indices, except for PTV dose homogeneity and lung V5. PTV conformity and spinal cord sparing were significantly improved in HAP (P Conclusion HAP is an effective planning strategy for obtaining a high quality treatment plan for esophageal cancer.

The purpose of this study was to investigate the potential advantages of the fixed‐jaw technique (FJT) over the conventional split‐field technique (SFT) for cervical and upper thoracic esophageal cancer (EC) patients treated with intensity‐modulated radiotherapy. The SFT and FJT plans were generated for 15 patients with cervical and upper thoracic EC. Dosimetric parameters and delivery efficiency were compared. An area ratio (AR) of the jaw opening to multileaf collimator (MLC) aperture weighted by the number of monitor units (MUs) was defined to evaluate the impact of the transmission through the MLC on the dose gradient outside the PTV50.4, and the correlation between the gradient index (GI) and AR was analyzed. The FJT plans achieved a better GI and AR (P

BACKGROUND: Preoperative planning is an integral part of total hip arthroplasty and has a significant impact on surgical technique and clinical outcome. The variety of types and sizes of endoprosthesis components makes the procedure more demanding and generates a need for accurate preoperative planning. The objective of this study was to analyze an analog method of preoperative planning of primary total hip arthroplasty based on templates overlaying on preoperative radiograms and compare its accuracy for predicting the size, both the stem and cup, with computer planning methods. METHODS: A retrospective cohort study based on 360 X-ray images of hip joints in 348 patients qualified for total hip arthroplasty between 2018 and 2019. The study group consisted of 136 men and 212 women, with an average age of 65 years (56 to 85 years). Material included both cementless and cemented endoprostheses. RESULTS: In the analyzed material, the accuracy of cup planning using the analog method was 85% (P

This paper proposes a hybrid vision-based reach-to-grasp task planning method for trans-humeral prostheses exploiting both vision and electromyography (EMG) signals. The hybrid method mainly consists of 2-1/2D visual servoing module and EMG-based module. The visual servoing intends to align the object on to the center of the palm while correcting its orientation. EMG signals extracted from the remaining muscles of the disabled arm due to amputation are used to control the elbow flexion/extension (FE). While using the 2-1/2D visual servoing module, the object reaching algorithm changes the elbow FE angle to reach the palm toward the object of interest. Initially, the EMG-based module controls the elbow FE. Once an object is detected, the EMG signals emanating from the arm muscles generate a reach request. This process then activates the visual servoing module to bring the palm toward the object. Since both EMG-based module and the visual servoing module are producing elbow FE angles while reaching toward an object, these two modules are integrated to obtain a resultant angle for elbow FE. Experiments are conducted using a simulation environment and a prosthesis to validate the proposed task planning method. The EMG-based module is capable of following the natural elbow FE motion. Moreover, the task planning method is capable of driving the prosthesis toward the object with proper orientation.

This paper proposes a preoperative planning method for magnetically induced hyperthermia (MIH) using ferromagnetic thermoseeds based on clinical computed tomography images. Combined with external alternating magnetic field excitation, the heating model of millimeter-sized cylindrical thermoseeds and the three-dimensional (3D) tissue bio-heat conduction model are established. The Arrhenius model is employed to evaluate the thermal injury degree of tumors and surrounding normal tissues. Based on these methods, MIH treatment planning system software is developed, where the 3D real-time model of patient anatomy is reconstructed with graphics processing unit-accelerated visualization techniques, organs and tumors are segmented, and thermoseeds are conformal-implanted to establish the temperature field distribution and the necrosis zone. This paper can provide guidance on establishment of a rational MIH preoperative planning to prediction and control of the effective therapeutic region.