Search results for: maxillofacial reconstruction

Authors: L. Sun, O. Bloom, K. Anderson

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The medial and lateral sural artery perforator flaps (MSAP and LSAP, respectively) are two recently described flaps that are less commonly used in lower limb trauma reconstructive surgeries compared to flaps such as the anterolateral thigh (ALT) flap or the gastrocnemius flap. The LSAP flap has several theoretical benefits over the MSAP, including the ability to be sensate and being more easily manoeuvred into position as a local flap for coverage of lateral knee or leg defects. It is less commonly used in part due to a lack of documented studies of the anatomical reliability of the perforator, and an unquantified average length of the pedicle used for microsurgical anastomosis (if used as a free flap) or flap rotation (if used as a pedicled flap). It has been shown to have significantly lower donor site morbidity compared to other flaps such as the ALT, due to the decreased need for intramuscular dissection and resulting in less muscle loss at the donor site. 11 cadaveric lower limbs were dissected, with a mean of 1.6 perforators per leg, with an average pedicle length of 45mm to the sural artery and 70mm to the popliteal artery. While the majority of perforating arteries lay close to the midline (average of 19mm lateral to the midline), there were patients whose artery was significantly lateral and would have been likely injured by the initial incision during an operation. Adding to the literature base of documented LSAP dissections provides a greater understanding of the anatomical basis of these perforator flaps, and the authors hope this will establish them as a more commonly used and discussed option when managing complicated lower limb trauma requiring soft tissue reconstruction.

Keywords: cadaveric, dissection, lateral, perforator flap, sural artery, surface anatomy

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Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

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This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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Authors: Fabio Rodriguez Sanchez, Josef Bruers, Iciar Arteagoitia, Carlos Rodriguez Andres

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Background: Oral implants are a routine treatment to replace lost teeth. Although they have a high rate of success, implant failures do occur. Perioperative antibiotics have been suggested to prevent postoperative infections and dental implant failures, but they remain a controversial treatment among healthy patients. The objective of this study was to determine whether antibiotic prophylaxis is a common treatment in the Netherlands among general dentists, maxillofacial-surgeons, periodontists and implantologists in conjunction with oral implant surgery among healthy patients and to assess the nature of antibiotics prescriptions in order to evaluate whether any consensus has been reached and the current recommendations are being followed. Methodology: Observational cross-sectional study based on a web-survey reported according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A validated questionnaire, developed by Deeb et al. (2015), was translated and slightly adjusted to circumstances in the Netherlands. It was used with the explicit permission of the authors. This questionnaire contained both close-ended and some open-ended questions in relation to the following topics: demographics, qualification, antibiotic type, prescription-duration and dosage. An email was sent February 2018 to a sample of 600 general dentists and all 302 oral implantologists, periodontists and maxillofacial surgeons who were recognized by the Dutch Association of Oral Implantology (NVOI) as oral health care providers placing oral implants. The email included a brief introduction about the study objectives and a link to the web questionnaire, which could be filled in anonymously. Overall, 902 questionnaires were sent. However, 29 questionnaires were not correctly received due to an incorrect email address. So a total number of 873 professionals were reached. Collected data were analyzed using SPSS (IBM Corp., released 2012, Armonk, NY). Results: The questionnaire was sent back by a total number of 218 participants (response rate=24.2%), 45 female (20.8%) and 171 male (79.2%). Two respondents were excluded from the study group because they were not currently working as oral health providers. Overall 151 (69.9%) placed oral implants on regular basis. Approximately 79 (52.7%) of these participants prescribed antibiotics only in determined situations, 66 (44.0%) prescribed antibiotics always and 5 dentists (3.3%) did not prescribe antibiotics at all when placing oral implants. Overall, 83 participants who prescribed antibiotics, did so both pre- and postoperatively (58.5%), 12 exclusively postoperative (8.5%), and 47 followed an exclusive preoperative regime (33.1%). A single dose of 2,000 mg amoxicillin orally 1-hour prior treatment was the most prescribed preoperative regimen. The most frequent prescribed postoperative regimen was 500 mg amoxicillin three times daily for 7 days after surgery. On average, oral health professionals prescribed 6,923 mg antibiotics in conjunction with oral implant surgery, varying from 500 to 14,600 mg. Conclusions: Antibiotic prophylaxis in conjunction with oral implant surgery is prescribed in the Netherlands on a rather large scale. Dutch professionals might prescribe antibiotics more cautiously than in other countries and there seems to be a lower range on the different antibiotic types and regimens being prescribed. Anyway, recommendations based on last-published evidence are frequently not being followed.

Keywords: clinical decision making, infection control, antibiotic prophylaxis, dental implants

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Authors: Jeong-Hyun Hong, Wonsuk Choi, Hyungdal Park, Jinseok Kim, Junesun Kim

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Identifying the chronic functions of an implanted neural electrode is an important factor in acquiring neural signals through the electrode or restoring the nerve functions after peripheral nerve injury. The purpose of this study was to investigate the biocompatibility of the chronic implanted neural electrode into the sciatic nerve. To do this, a sieve-type neural electrode was implanted at proximal and distal ends of a transected sciatic nerve as an experimental group (Sieve group, n=6), and the end-to-end epineural repair was operated with the cut sciatic nerve as a control group (reconstruction group, n=6). All surgeries were performed on the sciatic nerve of the right leg in Sprague Dawley rats. Behavioral tests were performed before and 1, 4, 7, 10, 14, and weekly days until 5 months following surgery. Changes in sensory function were assessed by measuring paw withdrawal responses to mechanical and cold stimuli. Motor function was assessed by motion analysis using a Qualisys program, which showed a range of motion (ROM) related to the joints. Neurofilament-heavy chain and fibronectin expression were detected 5 months after surgery. In both groups, the paw withdrawal response to mechanical stimuli was slightly decreased from 3 weeks after surgery and then significantly decreased at 6 weeks after surgery. The paw withdrawal response to cold stimuli was increased from 4 days following surgery in both groups and began to decrease from 6 weeks after surgery. The ROM of the ankle joint was showed a similar pattern in both groups. There was significantly increased from 1 day after surgery and then decreased from 4 days after surgery. Neurofilament-heavy chain expression was observed throughout the entire sciatic nerve tissues in both groups. Especially, the sieve group was showed several neurofilaments that passed through the channels of the sieve-type neural electrode. In the reconstruction group, however, a suture line was seen through neurofilament-heavy chain expression up to 5 months following surgery. In the reconstruction group, fibronectin was detected throughout the sciatic nerve. However, in the sieve group, the fibronectin was observed only in the surrounding nervous tissues of an implanted neural electrode. The present results demonstrated that the implanted sieve-type neural electrode induced a focal inflammatory response. However, the chronic implanted sieve-type neural electrodes did not cause any further inflammatory response following peripheral nerve injury, suggesting the possibility of the chronic application of the sieve-type neural electrodes. This work was supported by the Basic Science Research Program funded by the Ministry of Science (2016R1D1A1B03933986), and by the convergence technology development program for bionic arm (2017M3C1B2085303).

Keywords: biocompatibility, motor functions, neural electrodes, peripheral nerve injury, sensory functions

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Authors: Mohammad Alobaidy, David Nicoll, Tracey Wilkinson

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Background: Many patients suffer postoperative knee stability after total knee arthroplasty (joint replacement) involving posterior cruciate ligament (PCL) sacrificing or retaining, but is not clear whether the meniscofemoral ligaments (MFLs) are retained during these procedures; their function in terms of knee stability is not well established in the literature. Purpose: Macroscopic, detailed, morphometric investigation of the anterior and posterior MFLs of the knee joint was undertaken to assist understanding of knee stability after total knee arthroplasty and ligament reconstruction. Methods: Dissection of eighty Thiel embalmed knees from 19 male and 21 female cadavers was conducted, mean age 77 (range 47-99 years). The origin and insertion of the anterior and posterior MFLs were measured using high accuracy, calibrated, digital Vernier calipers at 0.01mm. Results: The means were: anterior meniscofemoral ligament (aMFL) length 28.4 ± 2.7mm; posterior meniscofemoral ligament (pMFL) length 29 ± 3.7mm; aMFL femoral width 6.4 ± 1.7mm, mid-distance ligament width 4 ± 1.1mm, meniscal ligament width 3.9 ± 1.2mm; pMFL femoral width 5.6 ± 1.5mm, mid-distance ligament width 4.1 ± 1.1mm, meniscal ligament width 4.1 ± 1.3mm. Some of the male measurements were larger than female, with significant differences in the length of the aMFL femoral length p<0.01 and pMFL femoral length p<0.007, and width of the pMFL mid-distance p<0.04. Conclusion: This study may help explore the role of the meniscofemoral ligaments in knee stability after total knee arthroplasty with a posterior cruciate ligament retaining prosthesis. Anatomical information for Thiel embalmed knees may aid orthopaedic surgeons in ligament reconstruction.

Keywords: anterior and posterior meniscofemoral ligaments, morphometric analysis, Thiel embalmed knees, knee arthroplasty

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Authors: Lim Chen Kim, Tan Kian Lam, Chan Yi Chee

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This research presents a multi-modal simulation in the reconstruction of the past and the construction of present in digital cultural heritage on mobile platform. In bringing the present life, the virtual environment is generated through a presented scheme for rapid and efficient construction of 360° panoramic view. Then, acoustical heritage model and crowd model are presented and improvised into the 360° panoramic view. For the reconstruction of past life, the crowd is simulated and rendered in an old trading port. However, the keystone of this research is in a virtual walkthrough that shows the virtual present life in 2D and virtual past life in 3D, both in an environment of virtual heritage sites in George Town through mobile device. Firstly, the 2D crowd is modelled and simulated using OpenGL ES 1.1 on mobile platform. The 2D crowd is used to portray the present life in 360° panoramic view of a virtual heritage environment based on the extension of Newtonian Laws. Secondly, the 2D crowd is animated and rendered into 3D with improved variety and incorporated into the virtual past life using Unity3D Game Engine. The behaviours of the 3D models are then simulated based on the enhancement of the classical model of Boid algorithm. Finally, a demonstration system is developed and integrated with the models, techniques and algorithms of this research. The virtual walkthrough is demonstrated to a group of respondents and is evaluated through the user-centred evaluation by navigating around the demonstration system. The results of the evaluation based on the questionnaires have shown that the presented virtual walkthrough has been successfully deployed through a multi-modal simulation and such a virtual walkthrough would be particularly useful in a virtual tour and virtual museum applications.

Keywords: Boid Algorithm, Crowd Simulation, Mobile Platform, Newtonian Laws, Virtual Heritage

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Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

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Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector

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Authors: P. Moskal, T. Bednarski, P. Bialas, E. Czerwinski, A. Gajos, A. Gruntowski, D. Kaminska, L. Kaplon, G. Korcyl, P. Kowalski, T. Kozik, W. Krzemien, E. Kubicz, Sz. Niedzwiecki, M. Palka, L. Raczynski, Z. Rudy, P. Salabura, N. G. Sharma, M. Silarski, A. Slomski, J. Smyrski, A. Strzelecki, A. Wieczorek, W. Wislicki, M. Zielinski, N. Zon

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A new concept and results of the performance tests of the TOF-PET detection system developed at the Jagiellonian University will be presented. The novelty of the concept lies in employing long strips of polymer scintillators instead of crystals as detectors of annihilation quanta, and in using predominantly the timing of signals instead of their amplitudes for the reconstruction of Lines-of-Response. The diagnostic chamber consists of plastic scintillator strips readout by pairs of photo multipliers arranged axially around a cylindrical surface. To take advantage of the superior timing properties of plastic scintillators the signals are probed in the voltage domain with the accuracy of 20 ps by a newly developed electronics, and the data are collected by the novel trigger-less and reconfigurable data acquisition system. The hit-position and hit-time are reconstructed by the dedicated reconstruction methods based on the compressing sensing theory and the library of synchronized model signals. The solutions are subject to twelve patent applications. So far a time-of-flight resolution of ~120 ps (sigma) was achieved for a double-strip prototype with 30 cm field-of-view (FOV). It is by more than a factor of two better than TOF resolution achievable in current TOF-PET modalities and at the same time the FOV of 30 cm long prototype is significantly larger with respect to typical commercial PET devices. The Jagiellonian PET (J-PET) detector with plastic scintillators arranged axially possesses also another advantage. Its diagnostic chamber is free of any electronic devices and magnetic materials thus giving unique possibilities of combining J-PET with CT and J-PET with MRI for scanning the same part of a patient at the same time with both methods.

Keywords: PET-CT, PET-MRI, TOF-PET, scintillator

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Authors: Ilja Käch, Abdul R. Jandali, Nadja Zechmann-Müller

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Introduction: We discuss the treatment of two young male patients suffering from scaphoid non-union after a traumatic scaphoid fracture. The currently propagated techniques for treating a scaphoid non-union in children are either the operative reconstruction of the scaphoid or the conservative treatment with splinting in a scaphoid cast. Cases: In the first case, we operated on a 13 years old male patient with a posttraumatic scaphoid non-union in the middle third with a humpback deformity. We resected the middle third of the scaphoid and grafted the defect with an iliac crest bone, and the DISI-Deformity was reduced. Fixation was performed with K-Wires and immobilisation in a scaphoid cast. In the second case a 13 years old male patient also with a posttraumatic scaphoid non-union in the middle third and humpback deformity, DISI-deformity, was treated conservatively. Immobilisation in a scaphoid cast for four months was performed. Results: Operative: One year postoperatively the patient achieved a painless free arc of motion. Flexion/Extension 70/0/60°, Radial-/Ulnarduction 30/0/30° and Pro-/Supination 90/0/90°. The computer tomogram showed complete consolidation and bony fusion of the iliac crest bone. Conservative: Six to eight months after conservative treatment the patient demonstrated painless motion and AROM Flexion/Extension 80/0/80°, Radial-/Ulnarduction and Pro-/Supination in maximum range. Complete consolidation in the computer tomogram with persistent humpback- and DISI deformity. Conclusion: In the literature, both techniques are described, either the operative scaphoid reconstruction or the conservative treatment with splinting. In our cases, both the operative and conservative treatments showed comparable good results. However, the humpback- and DISI deformity can only be addressed with a surgical approach.

Keywords: scaphoid, non-union, trauma, operative vs. non operative

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Authors: Chun-Liang Wu, Kai-Ping Shaw, Cheng-Ping Yu, Wu-Chien Chien, Hsiao-Ting Chen, Shao-Huang Wu

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Objective: This study analyzed three criminal judicial cases. We applied the patterned injuries of the rider to demonstrate the facts of each accident, reconstruct the scenes, and pursue the truth. Methods: Case analysis, a method that collects evidence and reasons the results in judicial procedures, then the importance of the pattern of injury as evidence will be compared and evaluated. The patterned injuries analysis method is to compare the collision situation between an object and human body injuries to determine whether the characteristics can reproduce the unique pattern of injury. Result: Case 1: Two motorcycles, A and B, head-on collided; rider A dead, and rider B was accused. During the prosecutor’s investigation, the defendant learned that rider A had an 80 mm open wound on his neck. During the court trial, the defendant requested copies of the case file and found out that rider A had a large contusion on his chest wall, and the cause of death was traumatic hemothorax and abdominal wall contusion. The defendant compared all the evidence at the scene and determined that the injury was obviously not caused by the collision of the body or the motorcycle of rider B but that rider was out of control and injured himself when he crossed the double yellow line. In this case, the defendant was innocent in the High Court judgment in April 2022. Case 2: Motorcycles C and D head-on crashed, and rider C died of massive abdominal bleeding. The prosecutor decided that rider C was driving under the influence (DUI), but rider D was negligent and sued rider D. The defendant requested the copies’ file and found the special phenomenon that the front wheel of motorcycle C was turned left. The defendant’s injuries were a left facial bone fracture, a left femur fracture, and other injuries on the left side. The injuries were of human-vehicle separation and human-vehicle collision, which proved that rider C suddenly turned left when the two motorcycles approached, knocked down motorcycle D, and the defendant flew forward. Case 3: Motorcycle E and F’s rear end collided, the front rider E was sentenced to 3 months, and the rear rider F sued rider E for more than 7 million N.T. The defendant found in the copies’ file that the injury of rider F was the left tibial platform fracture, etc., and then proved that rider F made the collision with his left knee, causing motorcycle E to fall out of control. This evidence was accepted by the court and is still on trial. Conclusion: The application of patterned injuries in the reconstruction of a motorcycle accident could discover the truth and provide the basis for judicial justice. The cases and methods could be the reference for the policy of preventing traffic accident casualties.

Keywords: judicial evidence, patterned injuries analysis, accident reconstruction, fatal motorcycle injuries

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Authors: Mounir Azzam, Valerie Graw, Andreas Rienow

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The Syrian war, which commenced in 2011, has resulted in significant changes in the real estate market in the Damascus metropolitan area, with rising levels of insecurity and disputes over tenure rights. The quest for spatial justice is, therefore, imperative, and this study performs a spatiotemporal analysis to investigate the impact of the war on real estate differentiation. Using the hedonic price models including 2,411 housing transactions over the period 2010-2022, this study aims to understand the spatial dynamics of the real estate market in wartime. Our findings indicate that war variables have had a significant impact on the differentiation and depreciation of property prices. Notably, property attributes have a more substantial impact on real estate values than district location, with severely damaged buildings in Damascus city resulting in an 89% decline in prices, while prices in Rural Damascus districts have decreased by 50%. Additionally, this study examines the urban texture of Damascus using correlation and homogeneity statistics derived from the gray-level co-occurrence matrix obtained from Google Earth Engine. We monitored 250 samples from hedonic datasets within three different years of the Syrian war (2015, 2019, and 2022). Our findings show that correlation values were highly differentiated, particularly among Rural Damascus districts, with a total decline of 87.2%. While homogeneity values decreased overall between 2015 and 2019, they improved slightly after 2019. The findings have valuable implications, not only for investment prospects in setting up a successful reconstruction strategy but also for spatial justice of property rights in strongly encouraging sustainable real estate development.

Keywords: hedonic price, real estate differentiation, reconstruction strategy, spatial justice, urban texture analysis

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Authors: L. Della Ragione, G. Meccariello

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In recent years the progress of the automobile industry in Italy in the field of reduction of emissions values is very remarkable. Nevertheless, their evaluation and reduction is a key problem, especially in the cities, which account for more than 50% of world population. In this paper we dealt with the problem of describing a quantitative approach for the reconstruction of GPS coordinates and altitude, in the context of correlation study between driving cycles / emission / geographical location, during an experimental campaign realized with some instrumented cars.

Keywords: air pollution, driving cycles, GPS signal, vehicle location

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Authors: Wei Yao

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A steerable and flexible drill is needed in orthopaedic surgery. For example, osteoarthritis is a common condition affecting millions of people for which joint replacement is an effective treatment which improves the quality and duration of life in elderly sufferers. Conventional surgery is not very accurate. Computer navigation and robotics can help increase the accuracy. For example, In Total Hip Arthroplasty (THA), robotic surgery is currently practiced mainly on acetabular side helping cup positioning and orientation. However, femoral stem positioning mostly uses hand-rasping method rather than robots for accurate positioning. The other case for using a flexible drill in surgery is Anterior Cruciate Ligament (ACL) Reconstruction. The majority of ACL Reconstruction failures are primarily caused by technical mistakes and surgical errors resulting from drilling the anatomical bone tunnels required to accommodate the ligament graft. The proposed new steerable drill system will perform orthopedic surgery through curved tunneling leading to better accuracy and patient outcomes. It may reduce intra-operative fractures, dislocations, early failure and leg length discrepancy by making possible a new level of precision. This technology is based on a robotically assisted, steerable, hand-held flexible drill, with a drill-tip tracking device and a multi-modality navigation system. The critical differentiator is that this robotically assisted surgical technology now allows the surgeon to prepare 'patient specific' and more anatomically correct 'curved' bone tunnels during orthopedic surgery rather than drilling straight holes as occurs currently with existing surgical tools. The flexible and steerable drill and its navigation system for femoral milling in total hip arthroplasty had been tested on sawbones to evaluate the accuracy of the positioning and orientation of femoral stem relative to the pre-operative plan. The data show the accuracy of the navigation system is better than traditional hand-rasping method.

Keywords: navigation, robotic orthopedic surgery, steerable drill, tracking

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Authors: Livia Eisler, Cristiane C. B. Alves, Cristina L. F. Ortolani, Kurt Faltin Jr.

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Purpose: This paper proposes a technically simple diagnosis method among orthodontists and maxillofacial surgeons in order to evaluate discrete bone alterations. The methodology consists of a protocol to optimize the diagnosis and minimize the possibility for orthodontic and ortho-surgical retreatment. Materials and Methods: A protocol of image processing and analysis, through ImageJ software and its plugins, was applied to 20 pairs of lateral cephalometric images obtained from cone beam computerized tomographies, before and 1 year after undergoing orthognathic surgery. The optical density of the images was analyzed in the condylar region to determine possible bone alteration after surgical correction. Results: Image density was shown to be altered in all image pairs, especially regarding the condyle contours. According to measures, condyle had a gender-related density reduction for p=0.05 and condylar contours had their alterations registered in mm. Conclusion: A simple, viable and cost-effective technique can be applied to achieve the more detailed image-based diagnosis, not depending on the human eye and therefore, offering more reliable, quantitative results.

Keywords: bone resorption, computer-assisted image processing, orthodontics, orthognathic surgery

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Authors: Massimo Miccoli, Luca Marangoni, Alberto Aniello Scaringi, Alessandro Marceddu, Alessandro Amicone

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The susceptibility of deep neural networks (DNNs) to adversarial manipulations is a recognized challenge within the computer vision domain. Adversarial examples, crafted by adding subtle yet malicious alterations to benign images, exploit this vulnerability. Various defense strategies have been proposed to safeguard DNNs against such attacks, stemming from diverse research hypotheses. Building upon prior work, our approach involves the utilization of autoencoder models. Autoencoders, a type of neural network, are trained to learn representations of training data and reconstruct inputs from these representations, typically minimizing reconstruction errors like mean squared error (MSE). Our autoencoder was trained on a dataset of benign examples; learning features specific to them. Consequently, when presented with significantly perturbed adversarial examples, the autoencoder exhibited high reconstruction errors. The architecture of the autoencoder was tailored to the dimensions of the images under evaluation. We considered various image sizes, constructing models differently for 256x256 and 512x512 images. Moreover, the choice of the computer vision model is crucial, as most adversarial attacks are designed with specific AI structures in mind. To mitigate this, we proposed a method to replace image-specific dimensions with a structure independent of both dimensions and neural network models, thereby enhancing robustness. Our multi-modal autoencoder reconstructs the spectral representation of images across the red-green-blue (RGB) color channels. To validate our approach, we conducted experiments using diverse datasets and subjected them to adversarial attacks using models such as ResNet50 and ViT_L_16 from the torch vision library. The autoencoder extracted features used in a classification model, resulting in an MSE (RGB) of 0.014, a classification accuracy of 97.33%, and a precision of 99%.

Keywords: adversarial attacks, malicious images detector, binary classifier, multimodal transformer autoencoder

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Authors: Milad Pirali, Sohrab Keyhani, Mohhamad Ali Sanjari, Ali Ashraf Jamshidi

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Purpose: The effect of hamstring antagonist activity on the knee extensors torque of the Anterior Cruciate Ligament reconstruction (ACLR) is not clear and persistent muscle weakness is common after ACLR. Hamstring activation when acting as antagonist is considered very important for knee strengths. Therefore the purpose of this study was to examine hamstring antagonist coactivation during maximal effort of the isokinetic knee extension in ACLR athletes with hamstring autograft. Materials and Methods: We enrolled 20 professional athletes who underwent primary ACLR (hamstring tendon autograft)with 6-24 months postoperative and 20 healthy subjects as control group. Each subjects performed maximal effort isokinetic knee extension and flexion in 60/˚ s and 180/˚ s velocities for the involved and uninvolved limb. Synchronously, surface electromyography (EMG) was recorded of vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF) and biceps femoris (BF). The antagonist integrated EMG (IEMG) values were normalized to the IEMG of the same muscle during maximal isokinetic eccentric effort at the same velocities and ROM. Results: A one-way analysis of variance designs shows significantly greater IEMG coactivation of hamstring and decreased activation of Vm in ACLR when compared to uninvolved and control group leg in 60/˚ s and 180/˚ s velocities. Likewise peak torque to body weight was decreased in ACLR compared to uninvolved and control group during knee extension in both velocities (p < 0.05). Conclusions: Decreased extensors moment caused by decreased quadriceps inhibition and increased hamstring coactivation. In addition, these result indicated to decrease of motor unit recruitment in the VM (as a kinesiologicmonitore of the knee). It is appearing that strengthening of the quadriceps to be an important for rehabilitation program after ACLR for preparation in athletes endeavors. Therefore, we suggest that having more emphasis and focus on quadriceps strength and less emphasis on hamstring following ACLR.

Keywords: ACLR-coactivation, dynamometry, electromyography, isokinetic

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Authors: Divyesh Patel, Tanuja Srivastava

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This paper considers the NP-hard problem of reconstructing binary matrices satisfying exactly-1-4-adjacency constraint from its row and column projections. This problem is formulated into a maximization problem. The objective function gives a measure of adjacency constraint for the binary matrices. The maximization problem is solved by the simulated annealing algorithm and experimental results are presented.

Keywords: discrete tomography, exactly-1-4-adjacency, simulated annealing, binary matrices

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Authors: Manish Khanna

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Higher education seeks to preserve, transmit and advance knowledge. It is one of the most important instruments of change and progress. The observation of Kothari Commission (1964-66) is true even today; The destiny of India is now being shaped in her classrooms. This, we believe, is no more rhetoric. In the world based on science and technology it is education that determines the level of prosperity, welfare, and security of the people. On the quality and number of persons coming out of our schools and colleges will depend our success in the great enterprise of national reconstruction.

Keywords: higher education, quality in academics, Kothari commission, privatising higher education

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Authors: Thomas Louis, Irina Primac, Florent Morfoisse, Tania Durre, Silvia Blacher, Agnes Noel

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In vitro and in vivo lymphangiogenesis assays are essential for the identification of potential lymphangiogenic agents and the screening of pharmacological inhibitors. In the present study, we analyse three biological models: in vitro lymphatic endothelial cell spheroids, in vivo ear sponge assay, and in vivo lymph node colonisation by tumour cells. These assays provide suitable 3D models to test pro- and anti-lymphangiogenic factors or drugs. 3D images were acquired by confocal laser scanning and light sheet fluorescence microscopy. Virtual scan microscopy followed by 3D reconstruction by image aligning methods was also used to obtain 3D images of whole large sponge and ganglion samples. 3D reconstruction, image segmentation, skeletonisation, and other image processing algorithms are described. Fixed and time-lapse imaging techniques are used to analyse lymphatic endothelial cell spheroids behaviour. The study of cell spatial distribution in spheroid models enables to detect interactions between cells and to identify invasion hierarchy and guidance patterns. Global measurements such as volume, length, and density of lymphatic vessels are measured in both in vivo models. Branching density and tortuosity evaluation are also proposed to determine structure complexity. Those properties combined with vessel spatial distribution are evaluated in order to determine lymphangiogenesis extent. Lymphatic endothelial cell invasion and lymphangiogenesis were evaluated under various experimental conditions. The comparison of these conditions enables to identify lymphangiogenic agents and to better comprehend their roles in the lymphangiogenesis process. The proposed methodology is validated by its application on the three presented models.

Keywords: 3D image segmentation, 3D image skeletonisation, cell invasion, confocal microscopy, ear sponges, light sheet microscopy, lymph nodes, lymphangiogenesis, spheroids

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Authors: Margareta Simina Stanc, Aurel Mototolea, Tiberiu Potarniche

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Sacidava archeological site is located in Dobrudja region, Romania, on a hill on the right bank of the Danube - the Musait point, located at about 5 km north-east from Dunareni village. The place-name documents the fact that, prior to the Roman conquest, in the area, there was a Getic settlement. The location of the Sacidava was made possible by corroborating the data provided by the ancient sources with the epigraphic documents (the milial pillar during the time of Emperor Decius). The tegular findings attest that an infantry unit, cohors I Cilicum milliaria equitata, as well as detachments from Legio V Macedonica and Legio XI Claudia, were confined to Sacidava. During the period of the Dominion, the garrison of the fortification is the host of a cavalry unit: cuneus equitum scutariorum. In the immediate vicinity to the Roman fortress, to the east, were identified two other fortifications: a Getic settlement (4th-1st century B.C.) and an Early Medieval settlement (9th-10th century A.C.). The archaeological material recovered during the research is represented by ceramic forms such as amphoras, jugs, pots, cups, plates, to which are added oil lamps, some of them typologically new at the time of discovery. Local ceramic shapes were also founded, worked by hand or by wheel, considered un-Romanized or in the course of Romanization. During the time of the Principality, Sacidava it represented an important military outpost serving mainly the city of Tropaeum Traiani, controlling also the supply and transport on the Danube limes in the Moesic sector. This role will determine the development of the fortress and the appearance of extramuros civil structures, thus becoming an important landmark during the 5th-6th centuries A.C., becoming a representation of power of the Roman empire in an area of continuous conflict. During recent archaeological researches, faunal remains were recovered, and their analysis allowed to estimate the animal resources and subsistence practices (animal husbandry, hunting, fishing) in the settlement. The methodology was specific to archaeozoology, mainly consisting of anatomical, taxonomical, and taphonomical identifications, recording, and quantification of the data. The remains of domestic mammals have the highest proportion indicating the importance of animal husbandry; the predominant species are Bos taurus, Ovis aries/Capra hircus, and Sus domesticus. Fishing and hunting were of secondary importance in the subsistence economy of the community. Wild boar and the red deer were the most frequently hunted species. Just a few fish bones were recovered. Thus, the ancient city of Sacidava is proving to be an important element of cultural heritage of the south-eastern part of Romania, for whose conservation and enhancement efforts must be made, especially by landscape reconstruction.

Keywords: archaeozoology, landscape reconstruction, limes, military outpost

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Authors: Marinelle El-Khoury, Lina Bouhaya, Nivine Abbas, Hassan Sleiman

Abstract:

The road network in the north of Lebanon is a prime example of the lack of pavement design and execution in Lebanon.  These roads show major distresses and hence, should be tested and evaluated. The aim of this research is to investigate and determine the deficiencies in road surface design in Lebanon, and to propose an environmentally friendly asphalt mix design. This paper consists of several parts: (i) evaluating pavement performance and structural behavior, (ii) identifying the distresses using visual examination followed by laboratory tests, (iii) deciding the optimal solution where rehabilitation or reconstruction is required and finally, (iv) identifying a sustainable method, which uses recycled material in the proposed mix. The asphalt formula contains Reclaimed Asphalt Pavement (RAP) in the base course layer and in the asphalt layer. Visual inspection of the roads in Tripoli shows that these roads face a high level of distress severity. Consequently, the pavement should be reconstructed rather than simply rehabilitated. Coring was done to determine the pavement layer thickness. The results were compared to the American Association of State Highway and Transportation Officials (AASHTO) design methodology and showed that the existing asphalt thickness is lower than the required asphalt thickness. Prior to the pavement reconstruction, the road materials were tested according to the American Society for Testing and Materials (ASTM) specification to identify whether the materials are suitable. Accordingly, the ASTM tests that were performed on the base course are Sieve analysis, Atterberg limits, modified proctor, Los Angeles, and California Bearing Ratio (CBR) tests. Results show a CBR value higher than 70%. Hence, these aggregates could be used as a base course layer. The asphalt layer was also tested and the results of the Marshall flow and stability tests meet the ASTM specifications. In the last section, an environmentally friendly mix was proposed. An optimal RAP percentage of 30%, which produced a well graded base course and asphalt mix, was determined through a series of trials.

Keywords: asphalt mix, reclaimed asphalt pavement, California bearing ratio, sustainability

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Authors: Kevin Syam, Devendra K. Chauhan, Mandeep Singh Dhillon

Abstract:

Background: The posterior horn of medial meniscus (PHMM) is a secondary stabilizer against anterior translation of tibia. Cadaveric studies have revealed increased strain on the ACL graft and greater instrumented laxity in Posterior horn deficient knees. Clinical studies have shown higher prevalence of radiological OA after ACL reconstruction combined with menisectomy. However, functional outcomes in ACL reconstructed knee in the absence of Posterior horn is less discussed, and specific role of posterior horn is ill-documented. This study evaluated functional and radiological outcomes in posterior horn preserved and posterior horn sacrificed ACL reconstructed knees. Materials: Of the 457 patients who had ACL reconstruction done over a 6 year period, 77 cases with minimum follow up of 18 months were included in the study after strict exclusion criteria (associated lateral meniscus injury, other ligamentous injuries, significant cartilage degeneration, repeat injury and contralateral knee injuries were excluded). 41 patients with intact menisci were compared with 36 patients with absent posterior horn of medial meniscus. Radiological and clinical tests for instability were conducted, and knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and the Orthopadische Arbeitsgruppe Knie score (OAK). Results: We found a trend towards significantly better overall outcome (OAK) in cases with intact PHMM at average follow-up of 43.03 months (p value 0.082). Cases with intact PHMM had significantly better objective stability (p value 0.004). No significant differences were noted in the subjective IKDC score (p value 0.526) and the functional OAK outcome (category D) (p value 0.363). More cases with absent posterior horn had evidence of radiological OA (p value 0.022) even at mid-term follow-up. Conclusion: Even though the overall OAK and subjective IKDC scores did not show significant difference between the two subsets, the poorer outcomes in terms of objective stability and radiological OA noted in the absence of PHMM, indicates the importance of preserving this important part of the meniscus.

Keywords: ACL, functional outcome, knee, posterior of medial meniscus

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Authors: Ilham Aji Dermawan, M. Sapari Dwi Hadian, R. Irvan Sophian, Iyan Haryanto

Abstract:

The study of the geological structure in the surrounding area of Cidaun, Cianjur Regency, West Java Province, Indonesia was conducted around the southern coast of Java Island. This study aims to determine the potentially structural trap deposits of freshwater resources in the study area, according to that the study area is an area directly adjacent to the beach, where the water around it did not seem fresh and brackish due to the exposure of sea water intrusion. This study uses the method of geomorphological analysis and geological mapping by taking the data directly in the field within 10x10 km of the research area. Geomorphological analysis was done by calculating the watershed drainage density value and roundness of watershed value ratio. The goal is to determine the permeability of the sub-soil conditions, rock constituent, and the flow of surface water. While the field geological mapping aims to take the geological structure data and then will do the reconstruction to determine the geological conditions of research area. The result, from geomorphology aspects, that the considered area of potential groundwater consisted of permeable surface material, permeable sub-soil, and low of water run-off flow. It is very good for groundwater recharge area. While the results of geological reconstruction after conducted of geological mapping is joints that present were initiated for the Cipandak Fault that cuts Cipandak River. That fault across until the Cibako Syncline fold through the Cibako River. This syncline is expected to place of influent groundwater aquifer. The tip of Cibako River then united with Cipandak River, where the Cipandak River extends through Cipandak Syncline fold axis in the southern regions close to its estuary. This syncline is expected to place of influent groundwater aquifer too.

Keywords: geological structure, groundwater, hydrogeology, influent aquifer, structural trap

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Authors: Lukas Vierus, Thomas Schuster

Abstract:

A general framework is examined for dynamic tensor field tomography within an inhomogeneous medium characterized by refraction and absorption, treated as an inverse source problem concerning the associated transport equation. Guided by Fermat’s principle, the Riemannian metric within the specified domain is determined by the medium's refractive index. While considerable literature exists on the inverse problem of reconstructing a tensor field from its longitudinal ray transform within a static Euclidean environment, limited inversion formulas and algorithms are available for general Riemannian metrics and time-varying tensor fields. It is established that tensor field tomography, akin to an inverse source problem for a transport equation, persists in dynamic scenarios. Framing dynamic tensor tomography as an inverse source problem embodies a comprehensive perspective within this domain. Ensuring well-defined forward mappings necessitates establishing existence and uniqueness for the underlying transport equations. However, the bilinear forms of the associated weak formulations fail to meet the coercivity condition. Consequently, recourse to viscosity solutions is taken, demonstrating their unique existence within suitable Sobolev spaces (in the static case) and Sobolev-Bochner spaces (in the dynamic case), under a specific assumption restricting variations in the refractive index. Notably, the adjoint problem can also be reformulated as a transport equation, with analogous results regarding uniqueness. Analytical solutions are expressed as integrals over geodesics, facilitating more efficient evaluation of forward and adjoint operators compared to solving partial differential equations. Certainly, here's the revised sentence in English: Numerical experiments are conducted using a Nesterov-accelerated Landweber method, encompassing various fields, absorption coefficients, and refractive indices, thereby illustrating the enhanced reconstruction achieved through this holistic modeling approach.

Keywords: attenuated refractive dynamic ray transform of tensor fields, geodesics, transport equation, viscosity solutions

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Authors: M. Kowalski, M. Życzkowski, M. Karol

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Current quantum key distribution systems (QKD) offer low bit rate of up to single MHz. Compared to conventional optical fiber links with multiple GHz bitrates, parameters of recent QKD systems are significantly lower. In the article we present the conception of application of the Compressed Sensing method for compression of quantum information. The compression methodology as well as the signal reconstruction method and initial results of improving the throughput of quantum information link are presented.

Keywords: quantum key distribution systems, fiber optic system, compressed sensing

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Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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Authors: Altayeb Abdalla Ahmed

Abstract:

Skeletal phenotype is a product of a balanced interaction between genetics and environmental factors throughout different life stages. Therefore, interlimb proportions are variable between populations. Although interlimb proportion indices have been used in anthropology in assessing the influence of various environmental factors on limbs, an extensive literature review revealed that there is a paucity of published research assessing interlimb part correlations and possibility of reconstruction. Hence, this study aims to assess the relationships between upper and lower limb parts and develop regression formulae to reconstruct the parts from one another. The left upper arm length, ulnar length, wrist breadth, hand length, hand breadth, tibial length, bimalleolar breadth, foot length, and foot breadth of 376 right-handed subjects, comprising 187 males and 189 females (aged 25-35 years), were measured. Initially, the data were analyzed using basic univariate analysis and independent t-tests; then sex-specific simple and multiple linear regression models were used to estimate upper limb parts from lower limb parts and vice-versa. The results of this study indicated significant sexual dimorphism for all variables. The results indicated a significant correlation between the upper and lower limbs parts (p < 0.01). Linear and multiple (stepwise) regression equations were developed to reconstruct the limb parts in the presence of a single or multiple dimension(s) from the other limb. Multiple stepwise regression equations generated better reconstructions than simple equations. These results are significant in forensics as it can aid in identification of multiple isolated limb parts particularly during mass disasters and criminal dismemberment. Although a DNA analysis is the most reliable tool for identification, its usage has multiple limitations in undeveloped countries, e.g., cost, facility availability, and trained personnel. Furthermore, it has important implication in plastic and orthopedic reconstructive surgeries. This study is the only reported study assessing the correlation and prediction capabilities between many of the upper and lower dimensions. The present study demonstrates a significant correlation between the interlimb parts in both sexes, which indicates a possibility to reconstruction using regression equations.

Keywords: anthropometry, correlation, limb, Sudanese

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Authors: El Mahdi Barrah, Said Safi, Abdessamad Malaoui

Abstract:

In this paper, we present an algorithm for reconstruction from incomplete 2D scans for tifinagh characters. This algorithm is based on using correlation between the lost block and its neighbors. This system proposed contains three main parts: pre-processing, features extraction and recognition. In the first step, we construct a database of tifinagh characters. In the second step, we will apply “shape analysis algorithm”. In classification part, we will use Neural Network. The simulation results demonstrate that the proposed method give good results.

Keywords: Tifinagh character recognition, neural networks, local cost computation, ANN

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Authors: Hatice Boyacioglu, Nursel Akkaya, Humeyra Ozge Yilanci, Hilmi Kansu, Nihal Avcu

Abstract:

The strong relationship between the reduction in the size of the pulp cavity and increasing age has been reported in the literature. This relationship can be utilized to estimate the age of an individual by measuring the pulp cavity size using dental radiographs as a non-destructive method. The purpose of this study is to develop a population specific regression model for age estimation in a sample of Turkish adults by applying Cameriere’s method on panoramic radiographs. The sample consisted of 100 panoramic radiographs of Turkish patients (40 men, 60 women) aged between 20 and 70 years. Pulp and tooth area ratios (AR) of the maxilla¬¬ry canines were measured by two maxillofacial radiologists and then the results were subjected to regression analysis. There were no statistically significant intra-observer and inter-observer differences. The correlation coefficient between age and the AR of the maxillary canines was -0.71 and the following regression equation was derived: Estimated Age = 77,365 – ( 351,193 × AR ). The mean prediction error was 4 years which is within acceptable errors limits for age estimation. This shows that the pulp/tooth area ratio is a useful variable for assessing age with reasonable accuracy. Based on the results of this research, it was concluded that Cameriere’s method is suitable for dental age estimation and it can be used for forensic procedures in Turkish adults. These instructions give you guidelines for preparing papers for conferences or journals.

Keywords: age estimation by teeth, forensic dentistry, panoramic radiograph, Cameriere's method

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Authors: J. Chamorro-Servent, S. Tassani, M. A. Gonzalez-Ballester, L. J. Roca, J. Romeu, O. Camara

Abstract:

Electromagnetic and microwave imaging (MWI) have been used in medical imaging in the last years, being the most common applications of breast cancer and stroke detection or monitoring. In those applications, the subject or zone to observe is surrounded by a number of antennas, and the Nyquist criterium can be satisfied. Additionally, the space between the antennas (transmitting and receiving the electromagnetic fields) and the zone to study can be prepared in a homogeneous scenario. However, this may differ in other cases as could be intracardiac catheters, stomach monitoring devices, pelvic organ systems, liver ablation monitoring devices, or uterine fibroids’ ablation systems. In this work, we analyzed different MWI algorithms to find the most suitable method for dealing with an intrabody scenario. Due to the space limitations usually confronted on those applications, the device would have a cylindrical configuration of a maximum of eight transmitters and eight receiver antennas. This together with the positioning of the supposed device inside a body tract impose additional constraints in order to choose a reconstruction method; for instance, it inhabitants the use of well-known algorithms such as filtered backpropagation for diffraction tomography (due to the unusual configuration with probes enclosed by the imaging region). Finally, the difficulty of simulating a realistic non-homogeneous background inside the body (due to the incomplete knowledge of the dielectric properties of other tissues between the antennas’ position and the zone to observe), also prevents the use of Born and Rytov algorithms due to their limitations with a heterogeneous background. Instead, we decided to use a time-reversed algorithm (mostly used in geophysics) due to its characteristics of ignoring heterogeneities in the background medium, and of focusing its generated field onto the scatters. Therefore, a 2D time-reversed finite difference time domain was developed based on the time-reversed approach for microwave breast cancer detection. Simultaneously an in-silico testbed was also developed to compare ground-truth dielectric properties with corresponding microwave imaging reconstruction. Forward and inverse problems were computed varying: the frequency used related to a small zone to observe (7, 7.5 and 8 GHz); a small polyp diameter (5, 7 and 10 mm); two polyp positions with respect to the closest antenna (aligned or disaligned); and the (transmitters-to-receivers) antenna combination used for the reconstruction (1-1, 8-1, 8-8 or 8-3). Results indicate that when using the existent time-reversed method for breast cancer here for the different combinations of transmitters and receivers, we found false positives due to the high degrees of freedom and unusual configuration (and the possible violation of Nyquist criterium). Those false positives founded in 8-1 and 8-8 combinations, highly reduced with the 1-1 and 8-3 combination, being the 8-3 configuration de most suitable (three neighboring receivers at each time). The 8-3 configuration creates a region-of-interest reduced problem, decreasing the ill-posedness of the inverse problem. To conclude, the proposed algorithm solves the main limitations of the described intrabody application, successfully detecting the angular position of targets inside the body tract.

Keywords: FDTD, time-reversed, medical imaging, microwave imaging

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