bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel method for defining ligament characteristics in subject specific dynamic surgical planning
Authors: Theodore Willy , Little Joseph , Liu David , Bare Jonathan , Dickison David , Taylor Mark , Miles Brad
Published: February 2018

Despite of the high success of TKA, 20% of recipients remain dissatisfied with their surgery. There is an increasing discordance in the literature on what is an optimal goal for component alignment. Furthermore, the unique patient specific anatomical characteristics will also play a role. The dynamic characteristics of a TKR is a product of the complex interaction between a patient’s individual anatomical characteristics and the specific alignment of the components in that patient knee joint. These interactions can be better understood with computational models. Our objective was to characterise ligament characteristics by measuring knee joint laxity with functional radiograph and with the aid of a computational model and an optimisation study to estimate the subject specific free length of the ligaments.

Pre-operative CT and functional radiographs, varus and valgus stressed X-rays assessing the collateral ligaments, were captured for 10 patients. CT scan was segmented and 3D-2D pose estimation was performed against the radiographs. Patient specific tibio-femoral joint computational model was created. The model was virtually positioned to the functional radiograph positions to simulate the boundary conditions when the knee is stressed. The model was simulated to achieve static equilibrium. Optimisation was done on ligament free length and a scaling coefficient, flexion factor, to consider the ligaments wrapping behaviour.

Our findings show the generic values for reference strain differ significantly from reference strains calculated from the optimised ligament parameters, up to 35% as percentage strain. There was also a wide variation in the reference strain values between subjects and ligaments, with a range of 37% strain between subjects. Additionally, the knee laxity recorded clinically shows a large variation between patients and it appears to be divorced from coronal alignment measured in CT. This suggest the ligaments characteristics vary widely between subjects and non-functional imaging is insufficient to determine its characteristics. These large variations necessitates a subject-specific approach when creating knee computational models and functional radiographs may be a viable method to characterise patient specific ligaments.
Medial Unicompartmental Knee Arthroplasty Using Patient-Specific Instrumentation – Accuracy of Preoperative Planning, Time Saving and Cost Effectiveness
Authors: Seeber Gesine , Kolbow Kristina , Maus Uwe , Kluge Alexander , Lazovic Djordje
Published: February 2018

Since the past few years, patient-specific instrumentation (PSI) has been greatly publicized in knee endoprosthetics. Manufacturers propose advantages such as better accuracy of fit and reduction of both surgical time and operation costs due to pre- operative prosthesis planning. Whether these proposed advantages are achieved in medial unicompartmental knee arthroplasty (UKA) remains unclear. This paper presents results from a retrospective analysis of 22 patients (24 knees) who were electively provided with a medial unicompartmental knee arthroplasty using patient- specific instrumentation.
Pedicle screw insertion in spine: a randomized controlled study for robot-assisted spinal surgery
Authors: Tian Wei , Fan Mingxing , Liu Yajun
Published: February 2018

To introduce a new robot-assisted surgical system for spinal posterior fixation which called TiRobot, based on intraoperative three-dimensional images. TiRobot has three components: the planning and navigation system, optical tracking system and robotic arm system. By combining navigation and robot techniques, TiRobot can guide the screw trajectories for orthopedic surgeries.

In this randomized controlled study approved by the Ethics Committee, 40 patients were involved and all has been fully informed and sign the informed consent. 17 patients were treated by free-hand fluoroscopy-guided surgery, and 23 patients were treated by robot-assisted spinal surgery.

A total of 190 pedicle screws was implanted. The overall operation time were not different for both groups. None of the screws necessitated re-surgery for revised placement. In the robot-assisted group, assessment of pedicle screw accuracy showed that 102 of 102 screws (100%) were safely placed (<2 mm, category A+B). And mean deviation in entry point was 1.70 +/- 0.83mm, mean deviation in end point was 1.84 +/- 1.04mm. In the conventional freehand group, assessment of pedicle screw accuracy showed that 87 of 88 (98.9%) were safely placed (<2 mm, category A+B), 1 screw fall in category C, mean deviation in entry point was 3.73 +/- 2.28mm, mean deviation in end point was 4.11 +/- 2.31mm.

This randomized controlled study verified that robot-assisted pedicle screw placement with real-time navigation is a more accuracy and safer method, also revealed great clinical potential of robot-assisted surgery in the future.
Margin quality and local recurrence with Patient specific instruments for bone tumor resection
Authors: Paul Laurent , Schubert Thomas , Evrard Robin , Docquier Pierre-Louis
Published: February 2018

Bone tumor resection and subsequent reconstruction remains challenging for the surgeon. Obtaining adequate margins is mandatory to decrease the risk of local recurrence. Improving surgical margins quality without excessive resection, reducing surgical time and increasing the quality of the reconstruction are the main goals of today’s research in bone tumor surgical management. With the outstanding improvements in imaging and computerized planning, it is now a standard. However, surgical accuracy is essential in orthopaedic oncologic surgery (Grimmer 2005).

Patient specific instruments (PSI) may greatly improve the surgeon's ability to achieve the targeted resection. Thanks to its physical support, PSI can physically guide the blade yielding to a better control over the cutting process (Wong, 2014). Surgical time might significantly be reduced as well when compared to conventional method or navigated procedure. Finally, reconstruction may gain in rapidity and quality especially when allograft is the preferred solution as PSI can be designed as well for allograft cutting (Bellanova, 2013).

Since 2011, PSI have systematically been used in our institution for bone tumor resection and when applicable allograft reconstruction. This paper reports the mid- to long-term medical outcomes on a large series.
Computer-Assisted TKA : Long-Term Outcomes at a Minimum Follow-Up of 10 Years of 129 E-Motion FP Mobile Bearing Prostheses.
Authors: Saragaglia Dominique , Seurat Olivier , Pailhé Régis , Rubens-Duval Brice
Published: February 2018

The hypothesis was that long-term outcomes were satisfactory or superior to the other implants design reported outcomes. This study confirms our initial hypothesis, that the outcomes of the TKA e-Motion FP with ultra-congruent mobile-bearing were satisfactory at more than 10 years of follow-up. Navigation, whose accuracy is well established, probably contributed to the quality of the results.
Handheld Robot for Bone Drilling Assistance
Authors: Yen Ping-Lang , Hung Shuo-Suei
Published: February 2018

Computer navigation systems has provided useful visual guidance for the surgeon to deliberately locate the tools to the anatomy. However, the tool positioning process is still manually performed. Sometimes the tool positioning may cause fatigue, stress and might be of risk to patient too. In this paper we designed a special purpose handheld robot for bone drilling. Meanwhile the coordinated controller assists the surgeon to precisely and safely drill the bone safely. Two force sensors are embedded at the handle and the cutter to measure the human exerted force and bone drilling force, respectively. The velocity command was then computed by the admittance controller for the robot controller. The motion of the control handle is positioned by the surgeon, while the surgical tool driven by the robot end-effector. The coordination between the human operator and the robot was designed so that the bone drilling can be performed more effectively than only imagenavigation scenario. The drill was able to be maintained on the target trajectory with reasonable accuracy within 2 mm although the human operator has deviated the surgical tool up to 5 cm. The compensation function to guide the drill back to the planned path was very useful to prevent the drill’s breakage when penetrating through the holes on the bone plate in bone drilling procedure.
Patient-Specific Templates for Corrective Osteotomy
Authors: Hafez Mahmoud
Published: February 2018

Correction osteotomy using conventional techniques may lead to under and over correction. The advantage of using patient specific templates for osteotomy is to predetermine the exact direction and degree of deformity before surgery and to estimate postoperative limb alignment which must mimic the physiologic loading to secure favorable clinical outcome.
Patient Specific Instruments Can Achieve a Better Surgical Accuracy Than Navigation Assistance in Joint-Preserving Surgery of the Knee Joint: a Cadaveric Comparative Study
Authors: Bosma Sarah , Jutte Paul , Wong Kwok-Chuen , Paul Laurent , Gerbers Jasper
Published: February 2018

Orthopaedic oncologic surgery requires resection with a safe margin as inadequate surgical margin leads to unfavorable results with an increased rate of local tumor re- currence [1]. Computer Navigation Assisted Surgery (CAS) and Patient Specific In- strumentation (PSI) have been reported to increase accuracy and predictability of tumor resections [2-6]. The technically demanding joint-preserving surgery that re- tains the native joint with the better function may be benefited from the new tech- niques [7]. CAS has the advantages of real-time intraoperative guidance of the bone resections but requires bulky and costly facilities [5]. PSI is a simple option of repli- cating surgical plan but lacks intraoperative image feedback on the surgery [5,6]. As primary bone sarcoma is uncommon, clinical studies for meaningful comparison of the two techniques may not be feasible. The cadaver study was to investigate the surgical accuracy of CAS and PSI in joint-preserving tumor surgery of knee joint.
Orbital Views - defying gravity
Authors: Solignac Amaury , Rieuf Vincent
Published: February 2018

The Orbital Views program brings virtual reality in true weightless and partial weight environments, in preparation for real space missions in orbit and on the surface of other planets. It opens opportunities for the training of astronauts on critical tasks that can only be trained in reduced-weight environments such as parabolic flights. With appropriate installations, Orbital Views also allows modern space tourists to experience the sights, sounds, and proprioceptive feelings of space without actually going there.
Individual Cooling and Compression System for Accelerated Swelling Reduction on Fractures
Authors: Paessler Annekathrin , Fielitz Markus , Rathmann Heiko , Andrusch Konstantin , Nagel Thomas , Lienig Jens
Published: February 2018

After a fracture injury a swelling of the skin soft tissue results which prevents an early operation. In order to shorten the waiting time until the decrease of the swelling, the metabolism-reducing effect of mild local hypothermia and the swelling-reducing effect of compression therapy should be used in a device anatomically adjusted to the patient. For the best possible treatment, a regulation of the cooling and compression parameters should be carried out by means of sensor technology in order to allow an adaptation to the individual patient.

After a fracture injury a swelling of the skin soft tissue results which prevents an early operation. In order to shorten the waiting time until the decrease of the swelling, the metabolism-reducing effect of mild local hypothermia and the swelling-reducing effect of compression therapy should be used in a device anatomically adjusted to the patient. For the best possible treatment, a regulation of the cooling and compression parameters should be carried out by means of sensor technology in order to allow an adaptation to the individual patient.

Based on medical studies, parameter areas relevant to patients could be determined. These were implemented in first functional models for a cooling system and a compression system. Anatomically adapted cooling and pressure chambers allow a good physical coupling of the system to humans. The first test results, considering the heat emission and the skin elasticity properties of the human body, show that both rapid cooling can be achieved in a range of between 17 and 20°C of skin temperature within 4 min, and that under a pressure effect of between 10 and 20 kPa in the pressure chambers a pressure on the human tissue can be produced up to 15 kPa. The cooling system based on Peltier elements is capable of transporting a heat flow up to 10 W. The quiet, maintenance-free Peltier elements also increase the patient's acceptance. In the pressure chambers, a temporally overlapping generation of pressure pulses can imitate the process of natural walking by the effect of muscle pumps and contribute to a technical lymphatic drainage. By detecting the inflammation area with the aid of netlike-arranged temperature sensors and measuring the internal pressure of the pressure chambers in the case of a swelling tissue, cooling can be carried out at a determined point and the occurrence of, for example, a compartment syndrome can be prevented by regulating the pressure.

At present still ongoing, promising developments of models for the consideration of the temperature distribution and pressure differences in the cardiovascular system should enable a determination of optimized cooling and pressure curves adapted to the individual human. In this way, the best possible control circuits should be identified using medical expert knowledge.
Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy to Plan Compared to Manual Technique
Authors: Hampp Emily , Scholl Laura , Prieto Michael , Chang Ta-Cheng , Abbasi Abdullah , Bhowmik-Stoker Manoshi , Jacofsky David , Mont Michael , Otto Jason
Published: February 2018

While total knee arthroplasty has demonstrated clinical success, final bone cut and final component alignment can be critical for achieving a desired overall limb alignment. This cadaver study investigated whether robotic-arm assisted total knee arthroplasty (RATKA) allows for accurate bone cuts and component position to plan, compared to manual technique. Six cadaveric specimens (12 knees) were prepared by an experienced user of manual total knee arthroplasty (MTKA), who was inexperienced in RATKA. For each cadaveric pair, a RATKA was prepared on the right leg and a MTKA was prepared on the left leg. Final bone cuts and final component position to plan were measured relative to fiducials, and mean and standard deviations were compared.

Measurements of final bone cut error for each cut show that RATKA had greater accuracy and precision to plan for femoral anterior internal/external (0.8±0.5° vs. 2.7±1.9°) and flexion/extension* (0.5±0.4° vs. 4.3±2.3°), anterior chamfer varus/valgus* (0.5±0.1° vs. 4.1±2.2°) and flexion/extension (0.3±0.2° vs. 1.9±1.0°), distal varus/valgus (0.5±0.3° vs. 2.5±1.6°) and flexion/extension (0.8±0.5° vs. 1.1±1.1°), posterior chamfer varus/valgus* (1.3±0.4° vs. 2.8±2.0°) and flexion/extension (0.8±0.5° vs. 1.4±1.6°), posterior internal/external* (1.1±0.6° vs. 2.8±1.6°) and flexion/extension (0.7±0.6° vs. 3.7±4.0°), and tibial varus/valgus* (0.6±0.3° vs. 1.3±0.7°) rotations, compared to MTKA, respectively (where * indicates a significant difference between the two operative methods based on 2-Variances testing, with α at 0.05). Measurements of final component position error show that RATKA had greater accuracy and precision to plan for femoral varus/valgus* (0.6±0.3° vs. 3.0±1.4°), flexion/extension* (0.6±0.5° vs. 3.0±2.1°), internal/external (0.8±0.5° vs. 2.6±1.6°), and tibial varus/valgus (0.7±0.4° vs. 1.1±0.8°) than the MTKA control, respectively.

In general, RATKA demonstrated greater accuracy and precision of bone cuts and component placement to plan, compared to MTKA in this cadaveric study. For further confirmation, RATKA accuracy of component placement should be investigated in a clinical setting.
Evaluation of the Use of Artificial X-Rays for Educational and Intraoperative Guidance During C-Arm Positioning
Authors: Touchette Michele , Anglin Carolyn , Guy Pierre , Amlani Meena , Hodgson Antony J.
Published: February 2018

Fluoroscopic C-arms are operated by medical radiography technologists (RTs) in the Canadian operating room (OR). While they do receive formal, accredited training, most of this training is theoretical, rather than hands-on. During their first encounters in the OR, new RTs can experience difficulty achieving the radiographic views required by surgeons, often needing several scout X-rays during C-arm positioning before achieving the correct anatomical view. Furthermore, ambiguous language by surgeons often inadequately conveys their request (Pally 2013). The result is often frustration, unnecessary radiation exposure, and added OR time (Booij 2007).

Several groups have tried to address this problem by overlaying artificial X-ray images on a live video feed (Chen 2013, Reaungamornat 2012, Müller 2011). Others have used artificial X-rays for simulation training (Bott 2008, Gong 2014, Cleary 2004). Though the intent is to improve C-arm positioning accuracy and efficiency during orthopaedic procedures, these systems have primarily been evaluated on system accuracy and not on their potential to decrease radiation exposure inside the OR or C-arm positioning time.

The purpose of this study was therefore to evaluate the value of artificial X-rays in enhancing C-arm positioning performance using inexperienced users.
Intraoperative Workflow Optimization by Using a Universal Foot Switch for Open Integrated OR Systems in Orthopaedic Surgery
Authors: Janss Armin , Vitting Anna , Strathen Benjamin , Strake Melanie , Radermacher Klaus
Published: February 2018

Nowadays, foot switches are used in almost every operating theatre to support the interaction with medical devices. Foot switches are especially used to release risk- sensitive functions of e.g. the drilling device, the high-frequency device or the X-ray C- arm. In general, the use of foot switches facilitates the work, since they enable the surgeon to use both hands exclusively for the manipulation within the operation procedures. Due to the increasing number of (complex) devices controlled by foot switches, the surgeons face a variety of challenges regarding usability and safety of these human-machine-interfaces.

In the future, the approach of integrated medical devices in the OR on the basis of the open communication standard IEEE 11073 gives the opportunity to provide a central surgical cockpit with a universal foot switch for the surgeon, enabling the interaction with various devices different manufacturers. In the framework of the ongoing OR.NET initiative founded on the basis of the OR.NET research project (2012- 2016) a novel concept for a universal foot switch (within the framework of a surgical workstation) has been developed in order to optimize the intraoperative workflow for the OR-personnel.

Here, we developed three wireless functional models of a universal foot switch together with a standardised modular interface for visual feedback via a central surgical cockpit display. Within the development of our latest foot switch, the requirements have been inter alia to provide adequate functionalities to cover the needs for the interventions in the medical disciplines orthopaedic surgery, neurosurgery and ENT.

The evaluation has been conducted within an interaction-centered usability analysis with surgeons from orthopaedics, neurosurgery and ENT. By using the Thinking Aloud technique in a Wizard-of-Oz experiment the usability criteria effectiveness, learnability and user satisfaction have been analysed.

Regarding learnability 83.25% of the subjects stated that the usage of the universal foot switch is easy to learn. An average of 77,2% of users rated the usability of the universal foot switch between good and excellent on the SUS scale. The intuitiveness of the graphical user interface has been approved with 91.75% and the controllability with 83.25%. Finally, 86% of the subjects stated a high user satisfaction.
Patient Specific Simulated Dynamics Following TKA Correlate With Patient Reported Outcomes
Authors: Twiggs Joshua Guy , Theodore Willy , Ruys Andrew , Fritsch Brett , Roe Justin , Dickison David , Miles Brad
Published: February 2018

Component alignment cannot fully explain TKA performance with regards to patient reported outcomes and pain. Patient specific variations in musculoskeletal anatomy are one explanation for this. Computational simulations allow for the impact of component alignment and variable patient specific musculoskeletal anatomy on dynamics to be studied across populations. This study aims to determine if simulated dynamics correlate with Patient Reported Outcomes.

Landmarking of key anatomical points and 3D registration of implants was performed on 96 segmented post-operative CT scans of TKAs. A cadaver rig validated platform for generating patient specific rigid body musculoskeletal models was used to assess the resultant motions. Resultant dynamics were segmented and tested for differentiation with and correlation to a 6 month postoperative Knee injury and Osteoarthritis Outcome Score (KOOS).

Significant negative correlations were found between the postoperative KOOS symptoms score and the rollback occurring in midflexion (p<0.001), quadriceps force in mid flexion (p=0.025) and patella tilt throughout flexion (p=0.009, p=0.005, p=0.010 at 10°, 45° and 90° of flexion). A significant positive correlation was found between lateral shit of the patella through flexion and the symptoms score. (p=0.012) Combining a varus/valgus angular change from extension to full flexion between 0° and 4° (long leg axis) and measured rollback of no more than 6mm without roll forward forms a ‘kinematic safe zone’ of outcomes in which the postoperative KOOS score is 11.5 points higher (p=0.013).

The study showed statistically significant correlations between kinematic factors in a simulation of postoperative TKR and post-operative KOOS scores. The presence of a ‘kinematic safe zone’ in the data suggests a patient specific optimisation target for any given individual patient and the opportunity to preoperatively determine a patient specific alignment target.
Medical optical localizer based on Apple iPhone smartphone
Authors: Daniol Mateusz , Martin Tobias , Alk Andreas , Kozak Josef
Published: February 2018

Medical navigation providing intraoperative localization of medical instruments plays a crucial role in computer assisted surgery (CAS). Several different multiple- camera standalone optical localizers are available on the market nowadays. Our aim was to develop, easy-to-use, low-cost and portable medical localizer based on iPhone 6S camera. We decided to develop a specialized smartphone app which is able to detect two rigid bodies (RB) on the camera screen and estimate their position both in devices and global coordinate system using sensor fusion with smartphones accelerometer and gyroscope. In the procedure one RB serve as reference and the other is attached to the tool. The prototype was preliminary calibrated using 2D and 3D VDI/VDE 2634 standard. Validation procedure involved measurements of the position and distance of two RBs placed 500 mm from each other in a distance of 1 meter to the smartphones camera. The measurements were taken from three different angles: -30°, 0°, 30° regarding RBs plane. The standard deviation of the measured distance was 0.62 mm with average measured distance of 498.0 mm. The other tests were made in a test-setup where the virtual offset of ultrasound probe was added to one of the RBs so the distance between probe and reference was 195 mm. The tests showed that the position of ultrasound probe is estimated with standard deviation of 0.70 mm and the average measured distance is 195.18 mm. Due to the promising results of those evaluations, we plan to perform more specific tests in clinical setup in near future.
Analysis of Gender-Specific Aspects of the Morphology of the Distal Femur
Authors: Asseln Malte , Hänisch Christoph , Schick Fabian , Radermacher Klaus
Published: February 2018

In total knee arthroplasty (TKA) the implant design is one key factor for a proper functional restoration of the diseased knee. Therefore, detailed knowledge on the shape (morphology) is essential to guide the design process. In literature, the morphology has been extensively studied revealing differences, e.g. between ethnicity and gender. However, it is still unclear in which way gender-specific morphological differences are sexual dimorphism or explained by differences in size.

The aim of this study was to investigate the morphology of the distal femur under gender-specific aspects for a large group of patients. Statistical analysis was used to reveal significant differences and subsequent correlation analysis to normalize the morphology.

A dataset of n=363 segmented distal femoral bone surface reconstructions (229 female, 134 male) were randomly collected from a database of patients which underwent TKA. In total, 34 morphological features (distances, angles), quantifying the distal femoral geometry, were determined full automatically. Subsequently, graphs and descriptive statistics were used to check normality and gender-specific differences were analyzed by calculating the 95% confidence intervals for women and men separately. Finally, significant differences were normalized by dividing each feature by appropriate distance measurements and confidence intervals were recalculated.

Looking at the confidence 95% intervals, 6 of 34 features did not show any significant differences between genders. Remarkably, this primarily involves angular (relative) features whereas distance (absolute) measurements were mostly gender dependent. Then, we normalized all distance measurements and radii according to their direction of measurement: Features defined in medial/lateral (ML) direction were divided by the overall ML width and those following the anterior/posterior direction were normalized based on the overall AP length. The results demonstrated that gender- specific differences mostly disappear by using an adequate normalization term.

In conclusion, implant sizes (femoral components) should not be linearly scaled according to one dimension. Instead, ML and AP directions should be regarded separately (non-isotropic scaling). Taking this into consideration, gender-specific differences might be neglected.
A Machine Learning Framework for Intraoperative Segmentation and Quality Assessment of Pedicle Screw X-Rays
Authors: Esfandiari Hooman , Anglin Carolyn , Street John , Guy Pierre , Hodgson Antony J.
Published: February 2018

Pedicle screw fixation is a technically demanding procedure with potential difficulties and reoperation rates are currently on the order of 11%. The most common intraoperative practice for position assessment of pedicle screws is biplanar fluoroscopic imaging that is limited to two-dimensions and is associated to low accuracies. We have previously introduced a full-dimensional position assessment framework based on registering intraoperative X-rays to preoperative volumetric images with sufficient accuracies. However, the framework requires a semi-manual process of pedicle screw segmentation and the intraoperative X-rays have to be taken from defined positions in space in order to avoid pedicle screws’ head occlusion. This motivated us to develop advancements to the system to achieve higher levels of automation in the hope of higher clinical feasibility.

In this study, we developed an automatic segmentation and X-ray adequacy assessment protocol. An artificial neural network was trained on a dataset that included a number of digitally reconstructed radiographs representing pedicle screw projections from different points of view. This model was able to segment the projection of any pedicle screw given an X-ray as its input with accuracy of 93% of the pixels. Once the pedicle screw was segmented, a number of descriptive geometric features were extracted from the isolated blob. These segmented images were manually labels as ‘adequate’ or ‘not adequate’ depending on the visibility of the screw axis. The extracted features along with their corresponding labels were used to train a decision tree model that could classify each X-ray based on its adequacy with accuracies on the order of 95%.

In conclusion, we presented here a robust, fast and automated pedicle screw segmentation process, combined with an accurate and automatic algorithm for classifying views of pedicle screws as adequate or not. These tools represent a useful step towards full automation of our pedicle screw positioning assessment system.
Wire Placement in the Lisfranc Joint Using a 2D Projection-Based Software Application for Mobile C-Arms: an Experimental Study in 20 Cadaver Specimens
Authors: Swartman Benedict , Schnetzke Marc , Beisemann Nils , Keil Holger , Franke Jochen , Grützne Paul Alfred , Vetter Sven
Published: February 2018

In the surgical treatment of Lisfranc injuries, percutaneous wire transfixation of the

tarsometatarsal complex can be challenging due to it’s small corridors and complex anatomy. A novel 2D projection-based software application detects Kirschner wires (K- wires) and automatically indicates their intended direction as a colored trajectory. The aim was to investigate whether the software facilitates K-wire placement in the Lisfranc joint for the inexperienced and the experienced surgeon.

In 20 cadaver foot specimens, 5 K-wires were retrogradely placed into the tarsometatarsal complex from D1-D5 by an experienced and an inexperienced surgeon, with and without using the application. The specimens were presented in pairs; surgeons and software use were equally randomized. Number of placement attempts, duration of procedure, fluoroscopy time, and number of individual fluoroscopy images were recorded.

Use of the software by the inexperienced surgeon significantly reduced the number of placement attempts from 14.2 to 8.8 (p=0.008). The application also reduced the number of fluoroscopy images from 44.8 to 40.8 (p=0.230). Duration of procedure and fluoroscopy time were not affected significantly. The experienced surgeon needed more placement attempts using the software (8.2 vs. 9.2; p=0.351). Duration of procedure, fluoroscopy time and number of fluoroscopy images increased while using the software, yet not significantly.

During percutaneous K-wire transfixation of the Lisfranc joint, the novel software is a useful tool for the inexperienced surgeon. In our chosen study setting, the experienced surgeon did not benefit from the software.

Due to its independency on fixed reference markers or registration processes, the software contributes to the procedures in orthopedic surgery.
Quantifying Dynamic Assessment of Developmental Dysplasia of the Hip
Authors: Paserin Olivia , Quader Niamul , Mulpuri Kishore , Cooper Anthony , Schaeffer Emily , Hodgson Antony J. , Abugharbieh Rafeef
Published: February 2018

Although physical and ultrasound (US)-based screening for congenital deformities of the hip (developmental dysplasia of the hip, or DDH) is routinely performed in most countries, one of the most commonly performed maneuvers done under ultrasound observation - dynamic assessment - has been shown to be relatively unreliable and is associated with significant misdiagnosis rates, on the order of 29%.

Our overall research objective is to develop a quantitative method of assessing hip instability, which we hope will standardize diagnosis across different raters and health-centers, and may perhaps improve reliability of diagnosis. To quantify dynamic assessment, we propose to use the variability in femoral head coverage (FHC) measurements within multiple US scans collected during a dynamic assessment. In every US scan, we use our recently-developed automatic FHC measuring tool which leverages phase symmetry features to approximate vertical cortex of ilium and a random forest classifier to identify approximate location of the femoral head. Having estimated FHC in each scan, we estimate the change in FHC across all the US scans during a dynamic assessment and compare this change with variability of FHC found in previous studies.

Our findings - in a dynamic assessment on an infant done by an orthopaedic surgeon, the femoral centre moved by up to 19% of its diameter during distraction, from 55% FHC to 74% FHC. This change in FHC is slightly greater than its variability in static US scans reported in previous studies, suggesting that the distraction force likely produced a real lateral displacement. Our clinician’s qualitative assessment concluded the hip to be normal as this degree of distraction was not indicative of instability. This suggests that our technique likely has sufficient resolution and repeatability to quantify differences in laxity between stable and unstable hips, although this presumption will have to be confirmed in a subsequent study with additional subjects. The long-term significance of this approach to evaluating dynamic assessments may lie in increasing early diagnostic sensitivity in order to prevent dysplasia remaining undetected prior to manifesting itself in early adulthood joint disease.
BİLİŞİM TEKNOLOJİLERİ REHBER ÖĞRETMENLERİ TEKNOLOJİ KOÇLUK ÖLÇEĞİNİN GELİŞTİRİLMESİ
Authors: GÖKBULUT Bayram
Published: February 2018

Eğitim
kurumlarında teknoloji kullanımına yön veren, okulda teknoloji kullanım kültürü
oluşturmayı amaçlayan bireyler teknoloji koçu olarak ifade edilmektedir. Eski
adı ile formatör yeni adı ile bilişim teknoloji öğretmenleri bu yönü ile bir
teknoloji koçu olarak görev yapmakta olup, bilişim teknolojileri
öğretmenlerinden bu yönü ile ayrışmaktadır. Bu araştırmanın amacı 2011 yılında
ISTE (International Society for Technology in Education - Uluslararası Eğitimde
Teknolojiler Topluluğu) tarafından teknoloji koçları için yayınlanan ISTE-C
standartları temel alınarak Bilişim Teknolojileri Rehber Öğretmenlerinin (BTRÖ)
teknoloji koçluk düzeylerini belirleyecek bir ölçme aracının geliştirilmesidir.
Bu kapsamda Türkiye genelinde görev yapan 404 BTRÖ’nün katılımı ile ölçek
geliştirme çalışması yapılmıştır. Araştırma sonucunda üç faktörlü (Vizyoner
Liderlik- α1=.938, Mesleki Gelişim - α2=.936 ve Dijital Vatandaşlık - α3=.905)
ve 20 maddeden oluşan bir ölçme aracı geliştirilmiştir. Ölçeğin güvenirliğini
belirlemek için ölçeğin iç tutarlılık katsayısı α=.958 olarak hesaplanmıştır.
Ayrıca madde ayırt edicilik puanlarına da bakılmıştır. Geliştirilen ölçme
aracının BTRÖ’lerin teknoloji koçluk düzeylerini belirleyecek geçerli ve
güvenilir bir ölçme aracı olduğu ifade edilebilir.
PERBANDINGAN ESTIMASI ANGGARAN BIAYA DENGAN METODE SNI DAN BOW
Authors: Putra Mahardika Rahmawan , Affandy Nur Azizah
Published: February 2018

The  concept  of  drafting  the  Budget  Plan  (RAB)  project  is  done  based  on  an  analysis  of each constituent component  for every  work items on the entire project. This calculation analysis use two methods, SNI method and BOW method. This calculation uses the analysis of unit price in 2016.  From  the  calculation,  the  analysis  of  unit  prices  in  the  construction  of  religious  ministry office  in  Lamongan  Regencyshows  that  the  budget  estimation  using  SNI  method  is  more economical.  SNI  method  has  more  economical  budget  in  the  amount  of  Rp.  709,743,313.65 compared to BOW method, amountedRp 1,759,104,217.65. The difference of those two methods is Rp.  1,049,360,904.  This  result  occurs  because  the  coefficient  for  SNI  method  is  lower  than  the BOW method.
EVALUASI DAERAH IRIGASI BENGAWAN JERO KABUPATEN LAMONGAN
Authors: Setiawan Aris , Affandy Nur Azizah
Published: February 2018

Bengawan  Jero  Irrigation  Area  is  located  in  the  District  Administration  of  Work  Areas Karangbinangun, Lamongan.Objective of the research that for determine the level of damage that occurred  in  Bengawan  Jero  Irrigation  Area  and  determine  the  priority  scale  rehabilitation  of irrigation  area  of  Bengawan  Jero  damage.  Based  on  the  analysis  and  discussion,  analysis  of priority  rehabilitation  of  irrigation  area  of  Bengawan  Jero  using  Analytical  Hierarchy  Process (AHP) give first priority to sub-system 05 = 0.68. The next priority is a sub-system 07 = 0.44, subsystem 01 = 0.23, sub-system 09 = 0.70, sub-system 03 = 0.25, sub-system 10 = 0.42, sub-system 11 = 0.65 , sub-system 06 = 0.52, sub-system 08 = 0.54, sub-system 04 = 0.50 and last priority is the sub system  02 = 0.23. Selection of rehabilitation alternatives tailored to the available funds. If the available funds are insufficient for the rehabilitation of irrigation area Bengawan overall Jerothen rehabilitation can put emphasis on the primary channel only
PENGARUH MOTIVASI DAN LINGKUNGAN KERJA TERHADAP KINERJA TENAGA KERJA PROYEK PEMBANGUNAN GEDUNG MTsN II BOJONEGORO
Authors: Ratna Sari Ayu Kurnia
Published: February 2018

The purpose of the study were 1) to describe  motivation ,and work environment on performance of building construction project personnel MTsN II Bojonegoro., 2) to determine and analyze the simultaneous effect of simultaneous motivation and working environment significantly against performance of building construction project personnel MTsN II Bojonegoro , 3) to determine and analyze the partial effect  motivation and working environment significantly to the performance of building construction project personnel MTsN II Bojonegoro, 4) to determine and analyze between , motivation, and working environment has dominant influence towards performance of building construction project personnel MTsN II Bojonegoro.This research was conducted with a population of as many as 27 respondents. Data were collected using a questionnaire in the form of a statement list. Data analysis technique used is the multiple linear regression analysis using SPSS 17.0. Based on the results obtained regression analysis test F value of 11.128 with a signification level of 0.000, which means that simultaneous motivate and work environment has a significant influence on the performance of.The value of building construction project personnel MTsN II Bojonegoro coefficient of determinant of  = 0.481 means that 48.1% of medical personnel’s performance can be explained by the motivation and the environment and the rest 51.9% influence by other variables beyond the motivation and work environment.t value variable motivation () of 3.239 with a significance level of 0.003. t value variable environment () amounted to 2.516 with significance level of 0.003
PENGARUH AIR PDAM, LAUT, COMBERAN PADA PROSES CURING TERHADAP KUAT TEKAN BETON Fc 14,53 Mpa
Authors: Saputra Richo Dwi , Hepiyanto Rasio
Published: February 2018

Concrete is a mixture of concrete forming materials, namely: fine aggregate, coarse aggregate, cement, and water. Each concrete construction always be able to show its function, ie strength and endurance during the planned life. Therefore, in this research concrete treatment is known to increase the concrete but also need to know how long the concrete treatment is good Only requires water from the loss of water experienced. Thus the research is conducted to find out how much the influence of curing process uses sea water, PDAM sewage toward to the strength of concrete press. This research was conducted with the use of 3 types of water that is water PDAM, sea water, sewage. Cylindrical tests specimen with diameter 15 cm and height 30 cm. Each sample is made of 3 specimens by the age of 7 days. The value of compressive strength in PDAM water, seawater, sewage successively at the age of 7 days is 13,522 MPa, 8,759 MPa, 10,296 MPa. The value of compressive strength of Water PDAM at 7 days has increased compared to the compressive strength value of seawater and sewage, while the value of compressive strength of seawater has decreased compared to the rising sewage. So it can be concluded that the value of the highest compressive strength is water PDAM at the age of 7 days.
Rancang Bangun Alat Pengusir Burung Pemakan Padi Berbasis Mikrokontroller Atmega328 Dengan Sel Surya
Authors: Laksono Arief Budi , Zahidi A Rifqi Zulfahmi
Published: February 2018

Penelitian ini bertujuan untuk merencanakan dengan mendesain alat pengusir burung pemakan padi berbasis mikrokontroller dengan sel surya sebagai . Dimana selama ini pengusiran burung oleh petani masih menggunakan cara-cara manual atau dengan bantuan kerja manusia. Program pada mikrokontroller Atmega328 menggunakan asembler atau C, sensor PIR digunakan untuk menangkap pergerakan burung. Untuk mengusik kehadiran burung menggunakan sirine yang mampu mengeluarkan suara dengan keras. Hasil yang diperoleh dari penelitian ini adalah desain Alat Pengusir Burung Pemakan Padi Berbasis Mikrokontroller Atmega 328 Dengan Sel Surya dengan sensor pir sebagai pendeteksi kehadiran burung.
Simulasi Alat Pengendali Otomasi Pintu Gerbang dan Garasi Menggunakan Pemancar Radio RF dan Sensor IR
Authors: Raharjo Nahdia , Putra M Titon Jaya
Published: February 2018

Berkembangnya ilmu pengetahuan dan teknologi yang terbaru pada zaman sekarang ini semakin banyak memberikan kemudahan dalam kehidupan sehari-hari. Dimana segala hal yang banyak diterapkan ilmu pengetahuan dan teknologi dengan mesin ataupun elektronika, sehingga pekerjaan manusia dapat dikerjakan dengan mudah tanpa harus membuang tenaga dan menghemat waktu. Berbagai alat rumah tangga hingga alat-alat pekerjaan banyak yang sudah menggunakan alat elektronik tersebut, sehingga pekerjaan manusia jauh lebih ringan dan mudah. Sebagai salah satu contoh pemanfaatan frekuensi radio yang bukan hanya dimanfaatkan sebagai sarana komunikasi juga dapat sebagai pengendali jarak jauh. Yang juga di padukan dengan sensor infrared sebagai pengaman system, serta di lengkapi dengan SCR sebagai saklar aktif.

Salah satu sistem kemudahan yang dimiliki pintu gerbang ini adalah sistem kendali buka pintu gerbang dengan remote. Dengan menekan saklar pada remote control pintu gerbang atau garasi dapat kita kendalikan membuka atau menutup tanpa menarik atau mendorongnya, dan juga di tambahkan satu fitur sebagai saklar reset, yang berguna untuk menghentikan putaran motor-motor DC.

System kerja alat ini menggunakan pemancar dan penerima radio RF yang berfrekuensi 40 MHz ,dengan mengirimkan pulsa-pulsa dengan menggunakan IC TX-2 T1143 sebagai pengirim sinyal pulsa dan IC RX-2 30905286 yang berjarak kurang dari 10 m.
Rancang Bangun Alat Otomatis Pengisian Tangki Air WSLIC Menggunakan Radio Frekuensi di Desa Sukobendu Kecamatan Mantup Kabupaten Lamongan
Authors: Abidin Zainal , Rizqi Moh Andi Bahtiyar
Published: February 2018

Perkembangan teknologi elektronika semakin luas dipergunakan dalam peralatan, mulai dari peralatan yang sangat canggih sampai dengan peralatan yang sederhana, bahkan sampai dengan pekerjaan sehari-hari yang biasa dilakukan di rumah. Air merupakan kebutuhan hidup sehari-hari, ketika air yang di pompa dan ditampung dalam tangki air, manusia hanya menghidupkan pompa ketika tandon air kosong dan mematikan pompa ketika tangki air penuh. Pada umumnya alat otomatis yang digunakan pada tangki air hanya menggunakan saklar yang diberi pelampung yang sistem kerjanya jika air melewati batas atas pengisian maka secara otomatis saklar yang diberi pelampung secara otomatis akan memutus arus. alat yang dibuat menggunakan Radio Frekuensi (RF). Alat ini bekerja menghasilkan sinyal yang dikirim oleh sensor elektroda yang dapat mematikan dan menyalakan pompa secara otomatis sehingga mencegah air tumpah. Alat ini terdiri dari transmitter dan receiver. Bagian trasmitter diletakkan pada tangki air sedangkan bagian receiver pada pompa air. Pengatur nyala atau mati pompa air dapat diatur dengan menggunakan gelombang radio sebagai media pengiriman sinyal perintah. Hal ini lebih efisien untuk jangkauan yang cukup jauh antara tansmitter dengan receiver. Alat ini bisa diterapkan pada WSLIC(Water and Sanitation for Low Income Community). Pada penelitian ini diperoleh hasil jarak alat ini dapat bekerja dengan baik secara optimal adalah 0 sampai 30 meter dan pada jarak 35 sampai 50 meter alat ini tidak dapat mengatur pompa air secara optimal dan diatas 50 alat ini tidak dapat mengatur pompa air
Rancang Bangun Otomatisasi Intensitas Cahaya, Suhu dan Kelembaban Untuk Budidaya Jamur Tiram Berbasis Mikrokontroler di Desa Kendal, Sekaran, Lamongan
Authors: Suharjianto Suharjianto
Published: February 2018

Budidaya jamur tiram dilakukan di daerah dataran tinggi yang memiliki temperatur yang rendah sedangkan pada daerah dataran rendah dibudidayakan pada kumbung-kumbung jamur. Agar pertumbuhan jamur dalam kumbung dapat optimal maka suhu dan kelembaban dari kumbung harus dijaga sesuai dengan kondisi alaminya. Di dataran rendah, pengaturan suhu dan kelembaban kumbung jamur masih dilakukan secara manual, sehingga kontrol otomatis diperlukan untuk mengatur suhu dan kelembaban kumbung jamur agar meringankan kerja petani jamur. Untuk menjaga kondisi kumbung yang ideal yaitu ruang budidaya yang memiliki suhu dan kelembaban ±30°C dan 70% – 90% RH, diperlukan alat berupa mist maker dan blower serta sensor DHT 11 untuk men-sensing dari suhu dan kelembaban ruang. Alat ini akan mengatur suhu dan kelambaban pada miniatur kumbung jamur secara otomatis, jika sensor DHT11 mendeteksi suhu >30˚C dan kelembaban 300 lux maka lampu LED secara otomatis akan menyala.
Efek Hujan Asam terhadap Pertum buhan Tanaman
Authors: Nasihah Mimatun
Published: February 2018

Pencemaran Udara  adalah peristiwa masuknya, atau tercampurnya, polutan (unsur-unsur berbahaya)  ke  dalam  lapisan  udara  (atmosfer)  yang  dapat  mengakibatkan  menurunnya  kualitas  udara  (lingkungan).  (Hogan, 1973).  Hujan asam  diartikan sebagai berbagai macam hujan dengan pH di bawah 5,6. Hujan secara  alami bersifat asam (pH sedikit di bawah 6) karena karbondioksida (CO2) di udara yang larut dengan air hujan  memiliki  bentuk sebagai asam  lemah. Tanaman dipengaruhi oleh  hujan asam dalam  berbagai  macam  cara.  Lapisan lilin pada daun rusak sehingga nutrisi menghilang sehingga tanaman tidak tahan terhadap keadaan  dingin, jamur dan serangga. Pertumbuhan akar menjadi lambat sehingga lebih sedikit nutrisi yang bisa diambil,  dan  mineral-mineral  penting  menjadi  hilang.  Metode  penelitian  ini  eksperimen  yakni  Penelitian  ini  menggunakan  metode  eksperimental  yaitu  suatu  penelitian  yang  dengan  sengaja  peneliti  melakukan  manipulasi terhadap satu atau lebih variabel dengan suatu cara tertentu sehingga berpengaruh pada satu atau  lebih variabel lain yang diukur.  Hasil penelitian ini menunjukan bahwa terdapat pengaruh hujan asam terhadap  pertumbuhan  tanaman.  Semakin  banyak  hujan  asam/semakin  rendah  pH  air  maka  pertumbuhan  tanaman  semakin tidak  normal, tidak  hanya pertumbuhan yang tidak normal tetapi banya k tanaman  yang tidak bisa tumbuh.