bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a retrospective process for analyzing results of a HMM based posture recognition system in a functionalized nursing bed
Authors: Demmer Julia , Kitzig Andreas , Naroska Edwin
Published: September 2017

In the area of care in general but especially in the care of elderly, there is a great interest in deriving patient parameters preparation free. For this purpose, a load cell functionalized nursing bed has been developed at Niederrhein University of Applied Science. The system allows analysis and recognition of the persons’ positions and actions in the bed. The Hidden Markov Toolkit (HTK) based posture recognition system was initially presented at the BMT 2015 by our research group. The initial system shows good results but to draw conclusions about the patient's condition, a minimum possible error rate should be achieved. For this purpose, a two-step retrospective analysis of the initial results was developed as an extension to improve the accuracy of the system.

In a first step, the results of the initial recognition are analysed and classified into correct or incorrect results. This is done by means of probability based distance measure. The distances are calculated by the Viterbi algorithm. Based on these distance measures, errors and so called ‘secure support points’ are determined in the recognition result and the associated parameters are extracted.

The second part of the extension deals with a retrospective recognition method to improve the error rate of the initial recognition step. Based on the determined support points, the errors are analysed again applying syntactic relation. To this end, a special parameter set to control the recognition system, the so-called ‘syntax’, is generated individually for each erroneous recognition result based on the preceding secure support point. The new parameterized recognition system is then used to improve the initial erroneous results by re-classification. Finally, the corrected recognition results are combined with the preliminary recognition result.
Inflow mapping method for numerical flow simulations of OCT-based patient-specific vessels using CFD
Authors: Wüstenhagen Carolin , Borowski Finja , Haude Michael , Neumann Franz-Josef , Grabow Niels , Schmitz Klaus-Peter , Stiehm Michael
Published: September 2017

Alteration of the flow characteristics in coronary vessels is correlated with coronary heart disease (CHD). In particular, wall shear stress (WSS) appears to be a hemody-namic key factor in the genesis of CHD. Since computational fluid dynamics (CFD) is a well-known method for the inves-tigation of WSS, it may be a valuable tool for the prediction of CHD. Latest imaging techniques, such as optical coher-ence tomography (OCT) in conjunction with angiography deliver precise 2D data sets of patient-specific vessel geome-try, which can be used for CFD analysis. Current CFD stud-ies utilize patient-specific geometries, but are lacking well defined physiologic inflow conditions.

In this study, we present an inflow mapping method for patient-specific arterial vessels, which is capable of consider-ing the influence of bifurcations located proximal of the OCT-data set. At first, the patient-specific vessel was recon-structed. For this purpose the OCT-based vessel cross sec-tions were arranged along an angiographic based vessel pathway. Secondly, we simulated the flow field in a generic bifurcation model by means of CFD. Thereafter the flow field of a side branch was extracted and transferred (mapped) to the inlet of the patient-specific vessel.

To evaluate the influence of the physiological inlet the WSS distribution of the same patient-specific vessel was calculated using an axial-symmetric inflow condition. Analy-sis of the simulation data yielded deviations of the WSS distribution in the proximal vessel segment. A bifurcation, located upstream of the relevant vessel segment strongly affects the flow in the OCT-based vessel reconstruction and has a strong influence on the results of the numerical analy-sis. Therefore, it is important to implement not only the pa-tient-specific geometry, but also an inlet boundary condition adapted to the upstream velocity distribution reflecting the actual proximal flow situation of the vessel.
Numerical design studies on a novel electrostimulative osteosynthesis system for the mandible
Authors: Raben Hendrikje , Schmidt Christian , Sridhar Karthik , Kämmerer Peer W. , van Rienen Ursula
Published: September 2017

Fractures or other major bone defects in the mandible are commonly treated by mounting a reconstruction plate at the fracture site. To avoid complications due to loosening of the implant or the fixation screws, electrical stimulation presents a possibility to accelerate bone healing. The aim of this study was to investigate different combinations of activated electrodes and plate designs regarding their feasibility for electrostimulation of the mandibular bone. The electric field distribution for multiple implant designs was computed using the finite element method. The results suggest that the electrode insulation renders a crucial parameter, which influences substantially the stimulation impact and its power consumption.
Numerical flow simulation methods and additive manufacturing methods for the development of a flow optimised design of a novel point-of-care diagnostic device
Authors: Dethloff Manuel , Seitz Hermann , Dangers Marc
Published: September 2017

For the development of a novel, user-friendly and low cost point-of-care diagnostic device for the detection of disease specific biomarker a flow optimised design of the test system has to be investigated. The resulting test system is characterised by a reduced execution period, a reduction of execution steps and an integrated waste management. Based on previous results, the current study focused on the design implementation of the fluidic requirements, e. g. tightness, inside the test device. With the help of fluid flow simulations (CFD – computational fluid dynamics) the flow behaviour inside the test device was analysed for different designs and arrangements. Prototypes generated from additive manufacturing technologies (PolyJet modeling) are used for validating the simulation results and further experimental tests.
Investigation of Bauschinger effect in thermo-plastic polymers for biodegradable stents
Authors: Schümann Kerstin , Sahmel Olga , Martin Heiner , Schmitz Klaus-Peter , Grabow Niels
Published: September 2017

The Bauschinger effect is a phenomenon metals show as a result of plastic deformation. After a primary plastic deformation the yield strength in the opposite loading direction decreases. The aim of this study is to investigate if there is a phenomenon similar to Bauschinger effect in thermoplastic polymers for stent application that would influence the mechanical properties of these biodegradable implants. Combined uniaxial tensile with subsequent compression tests as well as conventional compression tests without prior tensile loading were performed using biodegradable polymers for stent application (PLLA and a PLLA based blend). Comparing the results of compression tests with prior tensile loading to the compression-only tests a decrease in compressive strength can be observed for both of the tested materials. The conclusion of the performed experiments is that there is a phenomenon similar to Bauschinger effect not only in metallic materials but also in the examined thermoplastic polymers. The observed reduction of compressive strength as a consequence of prior tensile loading can influence the mechanical behaviour, e.g. the radial strength, of polymeric stents after sustaining a complex load history due to crimping and expansion.
Patient-related QA for helical TomoTherapy with Delta4: analysis of the results
Authors: Salz Henning , Howitz Simon , Brachwitz Tim , Wiezorek Tilo
Published: September 2017

The biplanar diode arrays Delta4PT and Delta4+ has been used in our hospital since the introduction of the TomoTherapy in 2013 to ensure a good agreement between the calculated and the measured dose distributions in patient-related QA with helical TomoTherapy. The aim of this presentation is to evaluate the quality of the measurement procedure with the Delta4 phantoms Delta4PT and (since January 2016) Delta4+. This includes the influence of a cross calibration with a treatment plan with low modulation.

Two analyses were performed: (i) All treatment plans in a period of three months (n=86) were not only calculated and measured with Delta4PT or Delta4+ but also with an ionization chamber (Exradin A1SL) in the homogeneous “cheese phantom”. (ii) All data measured from January 2016 to April 2017 (Delta4+, n=132) were analyzed regarding median dose deviation, Gamma analysis and others.

The comparison with chamber measurements shows that all measurements with Delta4 and almost all with the ionization chambers (79 of 86) yield a deviation of measured vs. planned dose in the PTV of less than 2.5%, but with a lower variation of the Delta4 measurements. However, a strong correlation between both was not observed.

The separate analysis of the measurements with the newer Delta4+ (since January 2016) shows a mean dose deviation in the PTVs of only 0.14% with a standard deviation (S.D.) of 0.69%. Before every measurement a cross calibration has been performed. Without this cross calibration, the deviation would be 0.96% with an increased standard deviation of 0.93%.

It is concluded that the Delta4 systems are well suited for patient-related QA for helical TomoTherapy treatment plans. The comparison with chamber measurements shows a plausible accordance between both systems whereas the variation of single measurements is quite different.

With the help of a daily cross calibration the variability of the Delta4 results is further decreased and the results show higher accuracy and reliability. According to our experience, a daily cross calibration is mandatory for a reliable patient-related QA.
Analysis of resolution properties for three generations of MV imagers in radiation therapy using the modulation transfer function
Authors: Loot Katharina , Waletzko Oliver , Rohn Ralf , Spaan Bernhard , Block Andreas
Published: September 2017

Imaging in radiation therapy has become an important part of clinical routine. In order to evaluate and compare the image quality of verification images from different imaging modalities, one needs objective criteria like the modulation transfer function (MTF). The aim of our study was to compare the resolution properties of three generations of electronic portal imaging devices (EPIDs), namely one fluoroscopic-optical system and two different flat-panel imaging systems.
Impact of 4D CT for treatment planning of moving targets: a computer-based biological evaluation
Authors: Helf Eike , Waletzko Oliver , Mehrens Christian , Rohn Ralf , Block Andreas
Published: September 2017

This study deals with comparison of conventional and 4D CT (GE Lightspeed) planning on the tumour control probability (TCP), using the TCP model of the AAPM-Report Task Group 166. In the first step a VMAT treatment plan was calculated (Varian Eclipse 13.7) on basis of conventional CT data. This treatment plan was transferred to the complete 4D CT, which represents the tumour volume in motion. Due to the increased volume and the resulting decrease of tumour coverage the TCP went down from 97,6% to 91,2%. After adding an internal target volume (ITV, ICRU 62) to the conventional CT according to our clinical protocols (1,0 cm cc and 0,3 cm axial plane) the TCP increased to 98,0% when applying the conventional plan to the 4D CT. This finding demonstrates the need of 4D CT for moving tumours in chest and abdomen region.

Average IPs with increasing width have been created to evaluate the impact on the TCP and the non-malignant tissue. Our observations had shown that heart, lung and spinal cord radiation exposure did not correlate to chosen respiration segment. This could be explained by the extremely slight ratio of the planning target volume and the irradiated normal tissue.

This procedure enables us to evaluate the efficacy of treatment plans. Furthermore, optimizing trials like the influence of respiration-gated RT, setting individual margins and fitting planning objectives and parameters are still under investigation.
Development of sonosensitive Poly-(L)-lactic acid nanoparticles
Authors: Hiltl Pia-Theresa , Fink Michael , Rupitsch Stefan J. , Lee Geoffrey , Ermert Helmut
Published: September 2017

Due to serious side effects of traditional chemotherapeutic treatment, novel treatment techniques like targeted drug delivery, which allows a reduction of the overall dosage of drugs, are investigated. It is worth mentioning that at the same time, precise drug delivery offers an increased dosage of chemotherapeutic drugs in the tumorous area employing the EPR effect. Therefore, vehicles smaller than 400 nm can be used to pass the poorly aligned endothelial cells of tumour vessels passively through their fenestrations. In a subsequent step, the chemotherapeutic drugs need to be released. One possibility is an ultrasound-based release via inertial cavitation. Thereby, it is desirable to restrict the drug release to a narrow range. Thus, the cavitation inducing ultrasound wave has to be focused to that region of interest. Ultrasound frequencies of more than 500 kHz enable sufficient focusing, however, inertial cavitation occurs primarily at much lower frequencies. In order to afford inertial cavitation at 500 kHz, either bigger particles in the range of micrometres are needed as cavitation nucleus, which is not possible due to the EPR effect or high acoustic pressure is needed to generate inertial cavitation. Nevertheless, this high pressure is inappropriate for clinical applications due to thermal and mechanical effects on biological tissue.

We have produced Poly-(L)-lactic acid (PLLA) nanoparticles by a solvent evaporation technique that serve as nucleus for inertial cavitation at moderate acoustic pressure of 800 kPa and at high frequencies of 800 kHz after the particles have been freeze-dried. In this contribution, we characterize the designed particles and present the production process. Moreover, we show that these particles enable inertial cavitation at an acoustic pressure and at acoustic frequencies which are commonly used in clinical ultrasound units. We also show that other particles with the same size at the same acoustic parameters do not induce cavitation activity.
Distance-dependent adhesion of vascular cells on biofunctionalized nanostructures
Authors: Biela Sarah , Striegl Britta , Frey Kerstin , Spatz Joachim P. , Kemkemer Ralf
Published: September 2017

Cell-cell and cell-extracellular matrix (ECM) adhesion regulates fundamental cellular functions and is crucial for cell-material contact. Adhesion is influenced by many factors like affinity and specificity of the receptor-ligand interaction or overall ligand concentration and density. To investigate molecular details of cell-ECM and cadherins (cell-cell) interaction in vascular cells functional nanostructured surfaces were used Ligand-functionalized gold nanoparticles (AuNPs) with 6-8 nm diameter, are precisely immobilized on a surface and separated by non-adhesive regions so that individual integrins or cadherins can specifically interact with the ligands on the AuNPs. Using 40 nm and 90 nm distances between the AuNPs and functionalized either with peptide motifs of the extracellular matrix (RGD or REDV) or vascular endothelial-cadherins (VEC), the influence of distance and ligand specificity on spreading and adhesion of endothelial cells (ECs) and smooth muscle cells (SMCs) was investigated. We demonstrate that RGD-dependent adhesion of vascular cells is similar to other cell types and that the distance dependence for integrin binding to ECM-peptides is also valid for the REDV motif. VEC-ligands decrease adhesion significantly on the tested ligand distances. These results may be helpful for future improvements in vascular tissue engineering and for development of implant surfaces.
Rheological analysis of hybrid hydrogels during polymerization processes
Authors: Illner Sabine , Sahmel Olga , Siewert Stefan , Eickner Thomas , Grabow Niels
Published: September 2017

Development of new implant coatings with temperature-controlled drug release to treat infections after device implantation can be triggered by highly elastic hydrogels with adequate stability and adhesive strength in the swollen state. By using an ionic liquid (IL [ViPrIm]+[Br]−) as additive to N-isopropylacrylamide (NIPAAm) unique effects on volumetric changes and mechanical properties as well as thermoresponsive drug release of the obtained hybrid hydrogels were observed. In this context, rheological measurements allow the monitoring of gelation processes as well as chemical, mechanical, and thermal treatments and effects of additives. Hybrid hydrogels of pNIPAAm and poly (ionic liquid) (PIL) were prepared by radical emulsion polymerization with N,N′-methylenebis(acrylamide) as 3D crosslinking agent. By varying monomer, initiator and crosslinker amounts the multi-compound system during polymerization was monitored by oscillatory time sweep experiments. The time dependence of the storage modulus (G′) and the loss modulus (G″) was measured, whereby the intersection of G′ and G″ indicates the sol-gel transition. Viscoelastic behavior and complex viscosity of crosslinked and non-crosslinked hydrogels were obtained. Within material characterization rheology can be used to determine process capability and optimal working conditions. For biomedical applications complete hydrogelation inter-connecting all compounds can be received providing the possibility to process mechanically stable, swellable implant coatings or wound closures.
Marker for the pre-clinical development of bone substitute materials
Authors: de Wild Michael , Zimmermann Simon , Obrecht Marcel , Dard Michel
Published: September 2017

Thin mechanically stable Ti-cages have been developed for the in-vivo application as X-ray and histology markers for the optimized evaluation of pre-clinical performance of bone graft materials. A metallic frame defines the region of interest during histological investigations and supports the identification of the defect site. This standardization of the procedure enhances the quality of pre-clinical experiments. Different models of thin metallic frameworks were designed and produced out of titanium by additive manufacturing (Selective Laser Melting). The productibility, the mechanical stability, the handling and suitability of several frame geometries were tested during surgery in artificial and in ex-vivo bone before a series of cages was preclinically investigated in the female Göttingen minipigs model. With our novel approach, a flexible process was established that can be adapted to the requirements of any specific animal model and bone graft testing.
Signal and energy transmission for implanted systems
Authors: Müller Carsten , Audí Josep M. Cardona , Ruff Roman , Hoffmann Klaus-Peter
Published: September 2017

Aspects and approaches for the design of systems for simultaneous signal and energy transmission for medical implants are presented. The main focus is on the consideration of the mutual influence on both transmission lines. To minimize the influence of capacitive as well as inductive paths, that affect the transmission, reducing the number of components is discussed. In order to increase the degree of miniaturization and reliability, the realization of certain functionalities is based on the so-called parasitics of electrical components. An implementation example is presented.
An evaluation study of vital parameter determination with RGB cameras in the field of ambient assisted living
Authors: Wiede Christian , Richter Julia , Hirtz Gangolf
Published: September 2017

The remote determination of vital parameters can contribute to the field of ambient assisted living (AAL) to face the challenges of a steadily ageing society. In this study, we examined the possibility to remotely measure the four vital parameters heart rate, respiration rate, oxygen saturation and blood pressure in AAL environments. For this, we evaluated the state of the art, implementations and concepts. While, the determination of heart and respiration rate is ready for usage, further attention has to be paid to the determination of oxygen saturation and blood pressure.
Data-driven analysis of interactions between people with dementia and a tablet device
Authors: Doneit Wolfgang , Lohse Jana , Glesing Kristina , Simon Clarissa , Fischer Monika , Depner Anamaria , Kruse Andreas , Franz Ingo , Schultz Tanja , Putze Felix , Schulze Timo , Engels Marc Aurel , Gaerte Philipp , Bothe Dietmar , Ziegler Christof , Maucher Irene , Ricken Michael , Dimitrov Todor , Herzig Joachim , Bernardin Keni , Gehrig Tobias , Mikut Ralf
Published: September 2017

In the project I-CARE a technical system for tablet devices is developed that captures the personal needs and skills of people with dementia. The system provides activation content such as music videos, biographical photographs and quizzes on various topics of interest to people with dementia, their families and professional caregivers. To adapt the system, the activation content is adjusted to the daily condition of individual users. For this purpose, emotions are automatically detected through facial expressions, motion, and voice. The daily interactions of the users with the tablet devices are documented in log files which can be merged into an event list. In this paper, we propose an advanced format for event lists and a data analysis strategy. A transformation scheme is developed in order to obtain datasets with features and time series for popular methods of data mining. The proposed methods are applied to analysing the interactions of people with dementia with the I-CARE tablet device. We show how the new format of event lists and the innovative transformation scheme can be used to compress the stored data, to identify groups of users, and to model changes of user behaviour. As the I-CARE user studies are still ongoing, simulated benchmark log files are applied to illustrate the data mining strategy. We discuss possible solutions to challenges that appear in the context of I-CARE and that are relevant to a broad range of applications.
Fast care – real-time sensor data analysis framework for intelligent assistance systems
Authors: Hein Albert , Grützmacher Florian , Haubelt Christian , Kirste Thomas
Published: September 2017

Main target of fast care is the development of a real-time capable sensor data analysis framework for intelligent assistive systems in the field of Ambient Assisted Living, eHealth, Tele Rehabilitation, and Tele Care. The aim is to provide a medically valid integrated situation model based on a distributed, ad-hoc connected, energy-efficient sensor infrastructure suitable for daily use. The integrated situation model combining physiological, cognitive, and kinematic information about the patient is grounded on the intelligent fusion of heterogeneous sensor data on different levels. The model can serve as a tool for quickly identifying risk and hazards as well as enable medical assistance systems to autonomously intervene in real-time and actively give telemedical feedback.
Correlation of arterial blood pressure to synchronous piezo, impedance and photoplethysmographic signal features
Authors: Pielmuş Alexandru-Gabriel , Osterland Dennis , Klum Michael , Tigges Timo , Feldheiser Aarne , Hunsicker Oliver , Orglmeister Reinhold
Published: September 2017

In this paper we investigate which pulse wave pick-up technologies are well suited for blood pressure trend estimation. We use custom built hardware to acquire electrocardiographic, applanation-tonometric, photo- and impedance-plethysmographic signals during low intensity workouts. Beat-to-beat features and pulse wave runtimes are correlated to the reference arterial blood pressure. Temporal lag adjustment is performed to determine the latency of feature response. Best results are obtained for systolic arterial blood pressure. These suggest that every subject has a range of well-performing features, but it is not consistent among all. Spearman Rho values reach in excess of 0.8, with their significance being validated by p-values lower than 0.01.
Improvement of a multi-stage model for the modeling of a functionalized nursing bed as support for the sensor-assisted function-alization of furniture in the hospital and care sector
Authors: Kitzig Andreas , Schröter Stefan , Naroska Edwin , Stockmanns Gudrun , Viga Reinhard , Grabmaier Anton
Published: September 2017

Development of preparation-free functionalized furniture based patient monitoring systems for use in the area of home- or stationary- care is often empirically driven. In particular, functionalization of furniture by means of different sensors is strongly affected by this development methodology. As a result, the systems are often not extensive-ly extendable or cannot be optimized because basic mechanisms are not comprehensible. In order to support development or optimization, a modelling approach is often useful. Thus, using a more comprehensive approach the required sensitivity of the sensors as well as their position in the system can be derived from a simulation model. In order to solve this problem, a multi-stage model was introduced at the BMT conference in 2014 by the authors, which allows the designer to model the entire system. The model has been extended and improved in the meantime and the achieved progress is presented in this work. The presented modelling approach can be divided into three main components. These are the person under supervision, the furniture (in our case a nursing bed) and the sensors (force measuring cells) which are modelled separately. In this work the main focus will be on improving the modelling of the human movement process and its implementation. Furthermore, the modelling of the sensor behavior in the nursing bed is described in detail with regard to their oscillation behavior and the influence on the model.
Toward steerable electrodes. An overview of concepts and current research.
Authors: Rau Thomas S. , Hügl Silke , Lenarz Thomas , Majdani Omid
Published: September 2017

Restoration of hearing is a demanding surgical task which requires the insertion of a cochlear implant electrode array into the inner ear while preserving the delicate basilar membrane inside the cochlea for an atraumatic insertion. Already shortly after the first clinical success with early versions of cochlear implants the desire for a controlled insertion of the electrode array arose. Such a steerable electrode should be in its shape adaptable to the individual path of the helical inner ear in order to avoid any contact between the implant and the surrounding tissue. This article provides a short overview of concepts and actuator mechanisms investigated in the past and present with the objective of developing a steerable electrode array for an individualized insertion process. Although none of these concepts has reached clinical implementation, there are promising experimental results indicating that insertion forces can be reduced up to 60% compared to straight and not steerable electrodes. Finally, related research topics are listed which require considerable further improvements until steerable electrodes will reach clinical applicability.
Reconstruction of biological functions: novel implant concepts for cardiovascular, ophthal-mologic and otolaryngologic applications
Authors: Grabow Niels , Schmitz Klaus-Peter
Published: September 2017

Biomedical engineering innovations towards the reconstruction of biological functions seek to improve the quality of patients’ lives. The coordinated research project “RESPONSE – Partnership for Innovation in Implant Technology” (BMBF program Twenty20 – Partnership for Innovation, 2014 - 2021) is focusing on the development of novel concepts for (i) cardiovascular scaffolds, glaucoma and ENT stents, (ii) transcatheter heart valves and venous valves, (iii) polymeric implants and polymer/drug formulations. Current clinical paradigm shifts, fostered by the progress in implant technology and a growing global demand, frame the background for the joint research efforts of academia and industry in the RESPONSE consortium.
Effects of replacing the nasal cavity with a simple pipe like structure in CFD simulations of the airflow within the upper airways of OSA patients with patient individual flow rates
Authors: Hagen Christina , Gurumurthy Pragathi , Buzug Thorsten M.
Published: September 2017

OSA is characterized by repetitive collapses of the upper airways during sleep. Computational fluid dynamics can be used to investigate the abnormal pressure distribution in the patient’s airways. The computational costs and model reconstruction effort can be reduced by focusing the simulations on the pharynx and replacing the nasal cavity by a simple pipe structure. In this work, the effects of the mentioned replacement on the simulated flow are evaluated. Airflow simulations using the k-ω turbulence model are performed in the anatomically correct airway of a patient having a high difference in the inspiratory volume flow rates of both nostrils, as well as in a model with replaced nasal cavity by a simple pipe structure. The simulated pressure distributions of both models are in very good agreement indicating the acceptability of replacing the nasal cavity by simple pipe structures in in-silico airflow analyses of OSA patients.
Deep bilinear features for Her2 scoring in digital pathology
Authors: Rodner Erik , Simon Marcel , Denzler Joachim
Published: September 2017

We present an automated approach for rating HER2 over-expressions in given whole-slide images of breast cancer histology slides. The slides have a very high resolution and only a small part of it is relevant for the rating.

Our approach is based on Convolutional Neural Networks (CNN), which are directly modelling the whole computer vision pipeline, from feature extraction to classification, with a single parameterized model. CNN models have led to a significant breakthrough in a lot of vision applications and showed promising results for medical tasks. However, the required size of training data is still an issue. Our CNN models are pre-trained on a large set of datasets of non-medical images, which prevents over-fitting to the small annotated dataset available in our case. We assume the selection of the probe in the data with just a single mouse click defining a point of interest. This is reasonable especially for slices acquired together with another sample. We sample image patches around the point of interest and obtain bilinear features by passing them through a CNN and encoding the output of the last convolutional layer with its second-order statistics.

Our approach ranked second in the Her2 contest held by the University of Warwick achieving 345 points compared to 348 points of the winning team. In addition to pure classification, our approach would also allow for localization of parts of the slice relevant for visual detection of Her2 over-expression.
Functional modeling of the craniospinal system for in-vitro parameter studies on the pathogenesis of NPH
Authors: Benninghaus Anne , Goffin Christine , Leonhardt Steffen , Radermacher Klaus
Published: September 2017

Normal Pressure Hydrocephalus (NPH) has become a common disease in the elderly coming along with typical symptoms of dementia, gait ataxia and urinary incontinence, which make the differential diagnosis with other forms of dementia difficult. Furthermore the pathogenesis of NPH is still not understood. About 10% of all demented patients might be suffering from NPH [1]. Many hypotheses suggest that modified biomechanical boundary conditions affect the craniospinal dynamics inducing the pathogenesis of NPH. We present a novel approach for an in-vitro model of the craniospinal system to investigate important hydrodynamic influences on the system such as (dynamic) compliance of the vascular system and especially the spinal subarachnoid space (SAS) as well as reabsorption and hydrostatics. The experimental set-up enables the individual adjustment of relevant parameters for sensitivity analyses regarding the impact of resulting CSF dynamics on the pathogenesis of NPH.
3D detection of the central sleep apnoea syndrome
Authors: Garn Heinrich , Kohn Bernhard , Wiesmeyr Christoph , Dittrich Klaus , Wimmer Markus , Mandl Magdalena , Kloesch Gerhard , Boeck Marion , Stefanic Andrijana , Seidel Stefan
Published: September 2017

In polysomnography, an oronasal thermal airflow sensor and respiratory inductance plethysmography (RIP) belts at thorax and abdomen are used to detect central sleep apnoea. These sensors are uncomfortable to wear, can disturb the patient’s sleep, and data quality can be significantly di-minished if a sensor slips off the patient. Contactless meas-urements would be a desirable alternative. We utilized a 3D time-of-flight sensor to monitor respiratory-related chest movements to decipher epochs of normal breathing and ap-noea in ten adult patients with a total of 467 apnoea events. Time-synchronized comparisons of 3D measurements of chest movements due to respiration to polysomnography signals from rip belts and nasal airflow proved that the 3D sensor provided largely equivalent results. This new tech-nique could support the diagnosis of central sleep apnoea and Cheyne-Stokes respiration.
Assessment of local high-density mapping for the analysis of radiofrequency ablation lesions in the left atrium
Authors: Stritt Michael , Oesterlein Tobias , Pollnow Stefan , Luik Armin , Schmitt Claus , Dössel Olaf
Published: September 2017

Recent studies about the development of endocardial radiofrequency (RF) ablation lesions (ALs) tried to identify reliable electrogram (EGM) markers for assessment of lesion transmurality. Additional clinically relevant information for physicians can be provided by examining endocardial EGM parameters like signal morphology, amplitude or time points in the signal. We investigated EGM features of the pulmonary vein ostia before and after RF ablation for three point-shaped lesions. Using high-density (HD) mapping, local activation time (LAT) and voltage maps were created, which provided information about the RF ALs regarding the lesion size and showed activation time delay as well as low-voltage areas with bipolar peak-to-peak voltages smaller than 2mV. The time delay of the depolarization front comparing the activation times anterior and posterior to the RF AL was up to 51.5 ms. In a circular area with 5mm radius around an RF AL the mean peak-to-peak voltage decreased by 62-94% to about 0.12-0.44mV and the mean maximal absolute EGM derivative was reduced by 65-96 %. Comparing the results of this study with EGMs of similar clinical settings confirmed our expectations regarding the low-voltage areas caused by the ablation procedure. An improved understanding of the electrophysiological changes is of fundamental importance to provide more information for enhanced RF ablation assessment.
Implementation and evaluation of segmentation algorithms according to multimodal imaging in personalized medicine
Authors: Stich Manuel , Vogt Jeannine , Lindner Michaela , Ringler Ralf
Published: September 2017

Multimodal imaging is gaining in importance in the field of personalized medicine and can be described as a current trend in medical imaging diagnostics. The segmentation, classification and analysis of tissue structures is essential. The goal of this study is the evaluation of established segmentation methods on different medical image data sets acquired with different diagnostic procedures. Established segmentation methods were implemented using the latest state of the art and applied to medical image data sets. In order to benchmark the segmentation performance quantitatively, medical image data sets were superimposed with artificial Gaussian noise, and the mis-segmentation as a function of the image SNR or CNR was compared to a gold standard. The evaluation of the image segmentation showed that the best results of pixel-based segmentation (< 3%) can be achieved with methods of machine learning, multithreshold and advanced level-set method - even at high artificial noise (SNR< 18). Finally, the complexity of the object geometry and the contrast of the ROI to the surrounding tissue must also be considered to select the best segmentation algorithm.
Determination of the excitation origin in the ventricles from the ECG using support vector regression
Authors: Pilia Nicolas , Ritter Christian , Potyagaylo Danila , Schulze Walther H. W. , Dössel Olaf , Lenis Gustavo
Published: September 2017

A common treatment of focal ventricular tachycardia is the catheter ablation of triggering sites. They have to be found manually by the physician during an intervention in a catheter lab. Thus, a method for determining the position of the focus automatically is desired. The inverse problem of electrocardiography addresses this problem by reconstructing the source of the ectopic beats using the surface ECG. This problem is ill-posed and therefore needs specific methods for solving it. We propose a machine learning approach for localisation of the ectopic foci in the heart to assist cardiologists with their therapy planning.We simulated 600 120-lead ECGs with different known excitation origins in the heart using a cellular automaton followed by a forward calculation. Features from the ECGs were used as input for a support vector regression (SVR). We assumed a functional relation between features from the ECG and the excitation origin. To benchmark SVR, we also used the well-known Tikhonov 0th order regularisation to reconstruct the transmembrane potentials in the heart and detect the location of the ectopic foci. Parameters for SVR and regularisation were chosen using a grid search minimising the error between estimated and true excitation origin. Compared to the Tikhonov regularisation method, SVR achieved a smaller deviation between estimated and real excitation origin evaluated with 6-fold cross validation. Future work could investigate on the behaviour on data from simulations with other torso and electrophysiological models, the influence of other methods for feature extraction and finally the evaluation with clinical data.
Estimating refractory periods during atrial fibrillation based on electrogram cycle lengths in a heterogeneous simulation setup
Authors: Unger Laura , Oesterlein Tobias , Seemann Gunnar , Dössel Olaf , Spector Peter , Loewe Axel
Published: September 2017

Acquiring adequate mapping data in patients with atrial fibrillation is still one of the main obstacles in the treatment of this atrial arrhythmia. Due to the lack of catheters with both a panoramic field of view and sufficient electrode density for simultaneous mapping, electrophysiologists are forced to fall back on sequential mapping techniques. But, because activation patterns change rapidly during atrial fibrillation, they cannot be mapped sequentially. We propose that mapping tissue properties which are time independent, in contrast, allows a sequential approach. Here, we use the shortest measured electrogram cycle length to estimate the effective refractory period of the underlying tissue in a simulation study. Atrial fibrillation was simulated in a spherical model of the left atrium comprised of regions with varied refractory period. We found that the minimal measured electrogram cycle length correlates with the effective refractory period of the underlying tissue if the regions with distinct refractory properties are large enough and if the absolute difference in effective refractory periods is sufficient. This approach is capable of identifying regions of lowered effective refractory period without the need for cardioversion. Those regions are likely to harbor drivers of atrial fibrillation, which emphasizes the necessity of their localization.
Relation between pulse pressure and the pulsation strength in camera-based photoplethysmograms
Authors: Trumpp Alexander , Rasche Stefan , Wedekind Daniel , Rudolf Matthias , Malberg Hagen , Matschke Klaus , Zaunseder Sebastian
Published: September 2017

Camera-based photoplethysmography (cbPPG) is an innovative measuring technique that enables the remote extraction of vital signs using video cameras. Most studies in the field focus on heart rate detection while other physiological quantities are often ignored. In this work, we analyzed the relation between the pulse pressure and the pulsation strengths of cbPPG signals for 70 patients after surgery. Our results show a high correlation between the two measures (r = 0.54). Furthermore, the influence of technical and medical factors was tested. The controlled impact of these factors proved to enhance the correlation by between 9 and 27 %.
Design of an experimental four-camera setup for enhanced 3D surface reconstruction in microsurgery
Authors: Marzi Christian , Wachter Andreas , Nahm Werner
Published: September 2017

Future fully digital surgical visualization systems enable a wide range of new options. Caused by optomechanical limitations a main disadvantage of today’s surgical microscopes is their incapability of providing arbitrary perspectives to more than two observers. In a fully digital microscopic system, multiple arbitrary views can be generated from a 3D reconstruction. Modern surgical microscopes allow replacing the eyepieces by cameras in order to record stereoscopic videos. A reconstruction from these videos can only contain the amount of detail the recording camera system gathers from the scene. Therefore, covered surfaces can result in a faulty reconstruction for deviating stereoscopic perspectives. By adding cameras recording the object from different angles, additional information of the scene is acquired, allowing to improve the reconstruction. Our approach is to use a fixed four-camera setup as a front-end system to capture enhanced 3D topography of a pseudo-surgical scene. This experimental setup would provide images for the reconstruction algorithms and generation of multiple observing stereo perspectives. The concept of the designed setup is based on the common main objective (CMO) principle of current surgical microscopes. These systems are well established and optically mature. Furthermore, the CMO principle allows a more compact design and a lowered effort in calibration than cameras with separate optics. Behind the CMO four pupils separate the four channels which are recorded by one camera each. The designed system captures an area of approximately 28mm × 28mm with four cameras. Thus, allowing to process images of 6 different stereo perspectives. In order to verify the setup, it is modelled in silico. It can be used in further studies to test algorithms for 3D reconstruction from up to four perspectives and provide information about the impact of additionally recorded perspectives on the enhancement of a reconstruction.
Automatic lung segmentation in the presence of alveolar collapse
Authors: Noshadi Areg , Kircher Michael , Pollnow Stefan , Elke Gunnar , Frerichs Inéz , Dössel Olaf
Published: September 2017

Lung ventilation and perfusion analyses using chest imaging methods require a correct segmentation of the lung to offer anatomical landmarks for the physiological data. An automatic segmentation approach simplifies and accelerates the analysis. However, the segmentation of the lungs has shown to be difficult if collapsed areas are present that tend to share similar gray values with surrounding non-pulmonary tissue. Our goal was to develop an automatic segmentation algorithm that is able to approximate dorsal lung boundaries even if alveolar collapse is present in the dependent lung areas adjacent to the pleura. Computed tomography data acquired in five supine pigs with injured lungs were used for this purpose. First, healthy lung tissue was segmented using a standard 3D region growing algorithm. Further, the bones in the chest wall surrounding the lungs were segmented to find the contact points of ribs and pleura. Artificial boundaries of the dorsal lung were set by spline interpolation through these contact points. Segmentation masks of the entire lung including the collapsed regions were created by combining the splines with the segmentation masks of the healthy lung tissue through multiple morphological operations. The automatically segmented images were then evaluated by comparing them to manual segmentations and determining the Dice similarity coefficients (DSC) as a similarity measure. The developed method was able to accurately segment the lungs including the collapsed regions (DSCs over 0.96).
Portable XRF: A Tool for the Study of Corundum Gems
Authors: Barone Germana , Mazzoleni Paolo , Bersani Danilo , Raneri Simona
Published: September 2017

Origin of gemstones is a key aspect not only in gemological field but also in Cultural Heritage studies, for the correct evaluation of precious artifacts. The studies on gems require the application of non-invasive and non-destructive methods; among them, portable spectroscopic techniques has been demonstrated as powerful tools, providing a fingerprint of gems for origin and provenance determination. In this study, portable XRF spectroscopy has been applied to test the potential of the technique for the origin determination of corundum gems. The obtained results allowed distinguishing natural and synthetic rubies and sapphires.
Land Developers and Archaeological Information
Authors: Huvila Isto
Published: September 2017

Land developers are significant stakeholders of archaeological work in the developed world. A better understanding of their information practices is crucial for the preservation and management of archaeological heritage. This study investigates land developers’ use, needs and conceptions of the usefulness- value of archaeological information and their views of development-led archaeological process. The findings are based on a survey of Finnish and Swedish land developers (N=34) that have contracted and financed archaeological fieldwork. The results show that the most useful information for land developers is data on the spatial location of archaeological sites but that the situation is much more nuanced than often suggested. Even if the most of the respondents were rather satisfied with the current situation, the lack of information can have major consequences and there are several obstacles to obtain relevant information. Extensive reliance on people sources can be seen both a symptom of the current problems and an indication of the importance of closer collaboration between archaeologists and land developers. Further, the study shows that the different levels of the perceived usefulness of specific types of archaeological information can be explained by the different regimes determining their worth in the two communities.
Recognition of the role of nature in the formation of fractal architecture
Authors: Mirmoradi Seyedeh Somayeh
Published: September 2017

After a long period of one-way consumerist attitude toward nature, there have been some alternate perspectives on the systemic relationship between humans and nature, which have been again brought up during the past few decades. Since the late twentieth century, fractal architecture has been one of the most important themes discussed in architecture and it is based on the chaos and complexity theories. Critics often criticize this architecture due to its lack of architectural values, practicality, and attention to economy, culture, and history. The current study aims to clarify the scientific theories that are the theoretical foundations of this approach in contemporary architecture. By categorizing the practical examples of this architectural approach, they are analyzed in terms of their relationship with nature using the logical reasoning method to achieve a favorable architecture. In fact, the gap between this architecture and nature’s behavior is shown.