Validating a minipig model of reversible cerebral demyelination using human diagnostic modalities and electron microscopy.

Background: Inflammatory demyelinating diseases of the central nervous system, such as multiple sclerosis, are significant sources of morbidity in young adults despite therapeutic advances. Current murine models of remyelination have limited applicability due to the low white matter content of their brains, which restricts the spatial resolution of diagnostic imaging. Large animal models might be more suitable but pose significant technological, ethical and logistical challenges.

Automated Opportunistic Trabecular Volumetric Bone Mineral Density Extraction Outperforms Manual Measurements for the Prediction of Vertebral Fractures in Routine CT.

Opportunistic osteoporosis screening using multidetector CT-scans (MDCT) and convolutional neural network (CNN)-derived segmentations of the spine to generate volumetric bone mineral density (vBMD) bears the potential to improve incidental osteoporotic vertebral fracture (VF) prediction. However, the performance compared to the established manual opportunistic vBMD measures remains unclear. Hence, we investigated patients with a routine MDCT of the spine who had developed a new osteoporotic incidental VF and frequency matched to patients without incidental VFs as assessed on follow-up MDCT images after 1.

Design of topology optimized compliant legs for bio-inspired quadruped robots.

Robotic legs are an important component of the quadruped robot for achieving different motion gaits. Although the conventional rigid-link-based legs can generally perform robust motions, they still have the issues with poor sealing when operating in complex and liquid terrains. To cope with this problem, fully compliant legs with monolithic structure have been introduced in recent years to improve the system compactness and structural compliance of quadruped robots.

PLAFOKON: a new concept for a patient-individual and intervention-specific flexible surgical platform.

Background: Research in the field of surgery is mainly driven by aiming for trauma reduction as well as for personalized treatment concepts. Beyond laparoscopy, other proposed approaches for further reduction of the therapeutic trauma have failed to achieve clinical translation, with few notable exceptions. We believe that this is mainly due to a lack of flexibility and high associated costs.

Influence of Salt Support Structures on Material Jetted Aluminum Parts.

Like most additive manufacturing processes for metals, material jetting processes require support structures in order to attain full 3D capability. The support structures have to be removed in subsequent operations, which increases costs and slows down the manufacturing process. One approach to this issue is the use of water-soluble support structures made from salts that allow a fast and economic support removal.

Design of a novel tendon-driven manipulator structure based on monolithic compliant rolling-contact joint for minimally invasive surgery.

Purpose: Compliant mechanisms are commonly used in the design of manipulator and surgical robotic tools for minimally invasive surgery (MIS) thanks to their compactness, ability of miniaturization and lower part count. However, conventional compliant joint has higher internal stiffness, which limits the bending radius. To overcome this problem, a novel tendon-driven manipulator structure based on monolithic compliant rolling-contact joint (CRCJ) is proposed.

Evaluation of improved bi-manual endoscopic resection using a customizable 3D-printed manipulator system designed for use with standard endoscopes: a feasibility study using a porcine ex-vivo model.

A major drawback of endoscopic en-bloc resection technique is its inability to perform bimanual tasks. Although endoscopic platforms that enable bimanual tasks are commercially available, they are neither approved for various locations nor adaptable to specific patients and indications. Based on evolution of an adaptive 3D-printable platform concept, system variants with different characteristic properties were evaluated for ESD scenarios, ex-vivo in two locations in the stomach and colorectum.

3-dimensional printing for the diagnosis of left ventricular outflow tract obstruction after mitral valve replacement.

The objective of this study was to evaluate the use of the generation of 3D models and 3D prints of complex cases for physicians at the example of an intricate left ventricular outflow tract obstruction (LVOTO). LVOTO is a known complication of mitral valve surgery. A 38-year-old female patient with increasing dyspnoea after mitral valve replacement was referred to our centre.

Evaluation of long-term stability of monolithic 3D-printed robotic manipulator structures for minimally invasive surgery.

Purpose: In the era of patient-centered medicine, clinical procedures, tools and instruments should be individually adapted to the patient. In this context, the presented 3D-printed Single-Port Overtube Manipulator System follows the aims to provide patient- and task-specific disposable manipulators for minimally invasive surgery. In a first experiment, the robustness of the monolithic flexure hinge structures in use as robotic manipulators will be investigated.

A handheld flexible manipulator system for frontal sinus surgery.

Purpose: Draf drainage is the standard treatment procedure for frontal sinus diseases. In this procedure, rigid angled endoscopes and rigid curved instruments are used. However, laterally located pathologies in the frontal sinus cannot be reached with rigid instrumentation.

Patient-specific catheter shaping for the minimally invasive closure of the left atrial appendage.

Purpose: The minimally invasive closure of the left atrial appendage is a promising alternative to anticoagulation for stroke prevention in patients suffering from atrial fibrillation. One of the challenges of this procedure is the correct positioning and the coaxial alignment of the tip of the catheter sheath to the implant landing zone.

Method: In this paper, a novel preoperative planning system is proposed that allows patient-individual shaping of catheters to facilitate the correct positioning of the catheter sheath by offering a patient-specific catheter shape.

From SOMDA to application - integration strategies in the OR.NET demonstration sites.

The effective development and dissemination of the open integration for the next generation of operating rooms require a comprehensive testing environment. In this paper, we present the various challenges to be addressed in demonstration applications, and we discuss the implementation approach, the foci of the demonstration sites and the evaluation efforts. Overall, the demonstrator setups have proven the feasibility of the service-oriented medical device architecture (SOMDA) and real-time approaches with a large variety of example applications.

OR.NET RT: how service-oriented medical device architecture meets real-time communication.

Today's landscape of medical devices is dominated by stand-alone systems and proprietary interfaces lacking cross-vendor interoperability. This complicates or even impedes the innovation of novel, intelligent assistance systems relying on the collaboration of medical devices. Emerging approaches use the service-oriented architecture (SOA) paradigm based on Internet protocol (IP) to enable communication between medical devices.

A new 3D-printed overtube system for endoscopic submucosal dissection: first results of a randomized study in a porcine model.

Background And Study Aim: Endoscopic therapy of early malignant alterations can be difficult and cumbersome. Our research study group took advantage of new methods for rapid prototyping (i. e.

A 3D-printed functioning anatomical human middle ear model.

The middle ear is a sophisticated and complex structure with a variety of functions, yet a delicate organ prone to injuries due to various reasons. Both, understanding and reconstructing its functions has always been an important topic for researchers from medical and technical background. Currently, human temporal bones are generally used as model for tests, experiments and validation of the numerical results.

Quantitative Assessment of Parkinsonian Tremor Based on an Inertial Measurement Unit.

Quantitative assessment of parkinsonian tremor based on inertial sensors can provide reliable feedback on the effect of medication. In this regard, the features of parkinsonian tremor and its unique properties such as motor fluctuations and dyskinesia are taken into account. Least-square-estimation models are used to assess the severities of rest, postural, and action tremors.

Quantitative assessment of parkinsonian bradykinesia based on an inertial measurement unit.

Background: As the most characteristic feature of Parkinson's disease (PD), bradykinesia (slowness of movement) affects all patients with Parkinson's disease and interferes with their daily activities. This study introduces a wearable bradykinesia assessment system whose core component is composed of an inertial measurement unit.

Methods: The system diagram and assessment task were defined in accordance with clinical requirements from neurologists.

First application of behavoir recognition through the recording of ADL by radio modules in a home.

In this contribution the behavior of an elderly couple, recorded by a radio module system in their own home is analyzed. There is an increasing interest in giving elderly people the possibility to live at their own homes as long as possible. Since diseases like dementia are diagnosed through the change of behavior, especially the activities of daily living (ADL), there is a growing need of an objective instrument for measuring behavioral changes.

Force sensing micro-forceps for robot assisted retinal surgery.

Membrane peeling is a standard vitreoretinal procedure, where the surgeon delaminates a very thin membrane from retina surface using surgical picks and forceps. This requires extremely delicate manipulation of the retinal tissue. Applying excessive forces during the surgery can cause serious complications leading to vision loss.

A new evaluation and training system for micro-telemanipulation at the middle ear.

In this article, a new surgical model for evaluating telemanipulators used in middle ear surgery is presented. The purpose of this work was to develop an evaluation and training system which imitates a typical surgical task of middle ear surgery and which can easily be repeated in order to get significant result. The abstract task can be performed manually or by means of a microsurgical telemanipulator and guaranties stable experimental conditions between different subjects at any time.

A new instrument for endoscopic submucosal dissection (with videos).

Background: Although it is effective for treatment of early neoplasms, endoscopic submucosal dissection (ESD) can be technically demanding and time consuming. Furthermore, use of multiple instruments is often mandatory for performing various steps associated with the procedure.

Objective: To design, create, and evaluate a new instrument for ESD.

Concept and modular telemedicine platform for measuring of vital signs, ADL and behavioral patterns of elderly in home settings.

In this contribution a new centralized platform for telemedicine is presented. It combines functions for measuring of vital signs, ADL and behavioral patterns and is especially designed for home care scenarios and the use by elderly people who are not familiar with the use of a PC. Unlike many other approaches we did not use a modified standard PC but developed a new dedicated hardware platform.

Evaluation of a radio based ADL interaction recognition system in a day hospital for old age psychiatry with healthy probands.

In this contribution the evaluation of a system called "Eventlogger" is presented, which is installed in a day hospital for old age psychiatry. The Eventlogger is a radio based module with an adjustable communication range, able to recognize interaction of the user with objects or with other people. It is intended to function as a monitoring tool for the users' activities.

A sensor network to iPhone interface separating continuous and sporadic processes in mobile telemedicine.

In this contribution, a new concept for interfacing sensor network nodes (motes) and smartphones is presented for the first time. In the last years, a variety of telemedicine applications on smartphones for data reception, display and transmission have been developed. However, it is not always practical or possible to have a smartphone application running continuously to accomplish these tasks.