StraightTrack: Towards mixed reality navigation system for percutaneous K-wire insertion.

In percutaneous pelvic trauma surgery, accurate placement of Kirschner wires (K-wires) is crucial to ensure effective fracture fixation and avoid complications due to breaching the cortical bone along an unsuitable trajectory. Surgical navigation via mixed reality (MR) can help achieve precise wire placement in a low-profile form factor. Current approaches in this domain are as yet unsuitable for real-world deployment because they fall short of guaranteeing accurate visual feedback due to uncontrolled bending of the wire.

ChatGPT-4 Knows Its A B C D E but Cannot Cite Its Source.

Introduction: The artificial intelligence language model Chat Generative Pretrained Transformer (ChatGPT) has shown potential as a reliable and accessible educational resource in orthopaedic surgery. Yet, the accuracy of the references behind the provided information remains elusive, which poses a concern for maintaining the integrity of medical content. This study aims to examine the accuracy of the references provided by ChatGPT-4 concerning the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach in trauma surgery.

Poor Outcomes of Girdlestone Resection Arthroplasty in Injection Drug Users: A Retrospective Study.

This retrospective cohort study aims to investigate the clinical outcomes of Girdlestone resection arthroplasty (GRA) in injection drug users with septic hip arthritis. Patients who underwent primary GRA for septic hip arthritis secondary to injection drug use at two academic trauma centers from 2015 to 2023 were retrospectively reviewed. Patient demographics, surgical details, and follow-up outcomes, including patient-reported outcome measures, were collected and analyzed.

Target for lipid-to-carbohydrate intake minimizes cost of growth.

Many theoretical treatments of foraging use energy as currency, with carbohydrates and lipids considered interchangeable as energy sources. However, herbivores must often synthesize lipids from carbohydrates since they are in short supply in plants, theoretically increasing the cost of growth. We tested whether a generalist insect herbivore () can improve its growth efficiency by consuming lipids, and whether these locusts have a preferred caloric intake ratio of carbohydrate to lipid (C : L).

Stand in surgeon's shoes: virtual reality cross-training to enhance teamwork in surgery.

Purpose: Teamwork in surgery depends on a shared mental model of success, i.e., a common understanding of objectives in the operating room.

Take a shot! Natural language control of intelligent robotic X-ray systems in surgery.

Purpose: The expanding capabilities of surgical systems bring with them increasing complexity in the interfaces that humans use to control them. Robotic C-arm X-ray imaging systems, for instance, often require manipulation of independent axes via joysticks, while higher-level control options hide inside device-specific menus. The complexity of these interfaces hinder "ready-to-hand" use of high-level functions.

Pelphix: Surgical Phase Recognition from X-ray Images in Percutaneous Pelvic Fixation.

Surgical phase recognition (SPR) is a crucial element in the digital transformation of the modern operating theater. While SPR based on video sources is well-established, incorporation of interventional X-ray sequences has not yet been explored. This paper presents Pelphix, a first approach to SPR for X-ray-guided percutaneous pelvic fracture fixation, which models the procedure at four levels of granularity - corridor, activity, view, and frame value - simulating the pelvic fracture fixation workflow as a Markov process to provide fully annotated training data.

Failure after operative repair is higher for ballistic femoral neck fractures than for closed, blunt-injury fractures: a multicenter retrospective cohort study.

Introduction: The purpose of this study was to describe the outcomes after operative repair of ballistic femoral neck fractures. To better highlight the devastating nature of these injuries, we compared a cohort of ballistic femoral neck fractures to a cohort of young, closed, blunt-injury femoral neck fractures treated with open reduction and internal fixation (ORIF).

Methods: Retrospective chart review identified all patients presenting with ballistic femoral neck fractures treated at three academic trauma centers between January 2016 and December 2021, as well as patients aged ≤50 with closed, blunt-injury femoral neck fractures who received ORIF.

Quantitative Dual-Energy Imaging of Bone Marrow Edema Using Multisource Cone-Beam CT with Model-Based Decomposition.

Purpose: We investigated the feasibility of dual-energy (DE) detection of bone marrow edema (BME) using a dedicated extremity cone-beam CT (CBCT) with a unique three-source x-ray unit. The sources can be operated at different energies to enable single-scan DE acquisitions. However, they are arranged parallel to the axis of rotation, resulting in incomplete sampling and precluding the application of DE projection-domain decompositions (PDD) for beam-hardening reduction.

Surgical navigation for guidewire placement from intraoperative fluoroscopy in orthopaedic surgery.

. Surgical guidewires are commonly used in placing fixation implants to stabilize fractures. Accurate positioning of these instruments is challenged by difficulties in 3D reckoning from 2D fluoroscopy.

Mixed Reality Interfaces for Achieving Desired Views with Robotic X-ray Systems.

Robotic X-ray C-arm imaging systems can precisely achieve any position and orientation relative to the patient. Informing the system, however, what pose exactly corresponds to a desired view is challenging. Currently these systems are operated by the surgeon using joysticks, but this interaction paradigm is not necessarily effective because users may be unable to efficiently actuate more than a single axis of the system simultaneously.

Psychological treatments for the management of pain after musculoskeletal injury: a systematic review and meta-analysis.

Musculoskeletal injury is a leading cause of pain and disability worldwide; 35% to 75% of people experience persistent pain for months and years after injury. Psychological treatments can reduce pain, functional impairment, and psychological distress but are not widely used after injury. This systematic review and meta-analysis (PROSPERO ID: CRD42021236807) aimed to synthesize the literature testing psychological treatments for pain after musculoskeletal injury.

An autonomous X-ray image acquisition and interpretation system for assisting percutaneous pelvic fracture fixation.

Purpose: Percutaneous fracture fixation involves multiple X-ray acquisitions to determine adequate tool trajectories in bony anatomy. In order to reduce time spent adjusting the X-ray imager's gantry, avoid excess acquisitions, and anticipate inadequate trajectories before penetrating bone, we propose an autonomous system for intra-operative feedback that combines robotic X-ray imaging and machine learning for automated image acquisition and interpretation, respectively.

Methods: Our approach reconstructs an appropriate trajectory in a two-image sequence, where the optimal second viewpoint is determined based on analysis of the first image.

Visualization in 2D/3D registration matters for assuring technology-assisted image-guided surgery.

Purpose: Image-guided navigation and surgical robotics are the next frontiers of minimally invasive surgery. Assuring safety in high-stakes clinical environments is critical for their deployment. 2D/3D registration is an essential, enabling algorithm for most of these systems, as it provides spatial alignment of preoperative data with intraoperative images.

Novel Approach of Femur Shortening With Insertion of Expandable Rod to Achieve End-to-End Repair of Sciatic Nerve Laceration.

Background: Sciatic nerve injuries are challenging for diagnosis and treatment. Particularly in proximally located high-grade injuries, neurorrhaphy often has poor outcomes. Most advocate autologous grafting and some more recently have suggested the value of knee flexion braces to facilitate end-to-end repair.

High carbohydrate consumption increases lipid storage and promotes migratory flight in locusts.

Migration allows animals to track favorable environments and avoid harmful conditions. However, migration is energetically costly, so migrating animals must prepare themselves by increasing their energy stores. Despite the importance of locust migratory swarms, we still understand little about the physiology of locust migration.

Preclinical evaluation of a prototype freehand drill video guidance system for orthopedic surgery.

Internal fixation of pelvic fractures is a challenging task requiring the placement of instrumentation within complex three-dimensional bone corridors, typically guided by fluoroscopy. We report a system for two- and three-dimensional guidance using a drill-mounted video camera and fiducial markers with evaluation in first preclinical studies. The system uses a camera affixed to a surgical drill and multimodality (optical and radio-opaque) markers for real-time trajectory visualization in fluoroscopy and/or CT.

Fat Embolism Syndrome and in-Hospital Mortality Rates According to Patient Age: A Large Nationwide Retrospective Study.

Introduction: Fat embolism syndrome (FES) is a rare life-threatening condition that can develop after traumatic orthopedic injuries. Controversy remains concerning the epidemiology in the elderly population. Therefore, this study aims to report FES related to in-hospital mortality stratified by age.

Different factors limit early- and late-season windows of opportunity for monarch development.

Seasonal windows of opportunity are intervals within a year that provide improved prospects for growth, survival, or reproduction. However, few studies have sufficient temporal resolution to examine how multiple factors combine to constrain the seasonal timing and extent of developmental opportunities. Here, we document seasonal changes in milkweed ()-monarch () interactions with high resolution throughout the last three breeding seasons prior to a precipitous single-year decline in the western monarch population.

Model-based three-material decomposition in dual-energy CT using the volume conservation constraint.

. We develop a model-based optimization algorithm for 'one-step' dual-energy (DE) CT decomposition of three materials directly from projection measurements.Since the three-material problem is inherently undetermined, we incorporate the volume conservation principle (VCP) as a pair of equality and nonnegativity constraints into the objective function of the recently reported model-based material decomposition (MBMD).

A framework for mapping and monitoring human-ocean interactions in near real-time during COVID-19 and beyond.

The human response to the COVID-19 pandemic set in motion an unprecedented shift in human activity with unknown long-term effects. The impacts in marine systems are expected to be highly dynamic at local and global scales. However, in comparison to terrestrial ecosystems, we are not well-prepared to document these changes in marine and coastal environments.

The impact of visualization paradigms on the detectability of spatial misalignment in mixed reality surgical guidance.

Purpose: Mixed reality (MR) for image-guided surgery may enable unobtrusive solutions for precision surgery. To display preoperative treatment plans at the correct physical position, it is essential to spatially align it with the patient intra-operatively. Accurate alignment is safety critical because it will guide treatment, but cannot always be achieved for varied reasons.

Toward Perception-based Anticipation of Cortical Breach During K-wire Fixation of the Pelvis.

Intraoperative imaging using C-arm X-ray systems enables percutaneous management of fractures by providing real-time visualization of tool to tissue relationships. However, estimating appropriate positioning of surgical instruments, such as K-wires, relative to safe bony corridors is challenging due to the projective nature of X-ray images: tool pose in the plane containing the principal ray is difficult to assess, necessitating the acquisition of numerous views onto the anatomy. This task is especially demanding in complex anatomy, such as the superior pubic ramus of the pelvis, and results in high cognitive load and repeat attempts even in experienced trauma surgeons.