1,721,001 research outputs found
Evaluation of dysplasia of the hip (children with DDH, adolescents, and adults)
No full textDevelopmental dysplasia of the hip (DDH) is a congenital anomaly, characterized by insufficient development of coxofemoral joints and concomi- tant laxity of the capsule-binding system, which may result in partial or total loss of coxofemoral joint relationships [1, 2].
It is the most common osteoarticular defor- mity, presents a predilection for female sex with a female/male ratio of 61. The incidence varies between 0.7% and 2.5%, and it is very common in the north Italy, France, Spain, and the Balkans where the incidence stands at 2–4%. Incidence is significantly lower in African and Asian patients [3, 4]. In 45% of cases, it is bilateral and associ- ated with other congenital malformations such as clubfoot. DDH often leads to early degenerative hip arthritis if not treated [5]
Hierarchical fracture classification of proximal femur X-Ray images using a multistage Deep Learning approach
Get PDFPurpose - Suspected fractures are among the most common reasons for patients to visit emergency departments and often can be difficult to detect and analyze them on film scans. Therefore, we aimed to design a Deep Learning-based tool able to help doctors in diagnosis of bone fractures, following the hierarchical classification proposed by the Arbeitsgemeinschaft für Osteosynthesefragen (AO) Foundation and the Orthopaedic Trauma Association (OTA).
Methods - 2453 manually annotated images of proximal femur were used for the classification in different fracture types (1133 Unbroken femur, 570 type A, 750 type B). Secondly, the A type fractures were further classified into the types A1, A2, A3. Two approaches were implemented: the first is a fine-tuned InceptionV3 convolutional neural network (CNN), used as a baseline for our own proposed approach; the second is a multistage architecture composed by successive CNNs in cascade, perfectly suited to the hierarchical structure of the AO/OTA classification. Gradient Class Activation Maps (Grad-CAM) where used to visualize the most relevant areas of the images for classification. The averaged ability of the CNN was measured with accuracy, area under receiver operating characteristics curve (AUC), recall, precision and F1-score. The averaged ability of the orthopedists with and without the help of the CNN was measured with accuracy and Cohen’s Kappa coefficient.
Results: We obtained an averaged accuracy of 0.86 (CI 0.84-0.88) for three classes classification and 0.81 (CI 0.79-0.82) for five classes classification. The average accuracy improvement of specialists was 14% with and without the CAD (Computer Assisted Diagnosis) system.
Conclusion: We showed the potential of using a CAD system based on CNN for improving diagnosis accuracy and for helping students with a lower level of expertise. We started our work with proximal femur fractures and we aim to extend it to all bone segments further in the future, in order to implement a tool that could be used in every-day hospital routine
A mixed reality framework for interpretable and explainable joint replacement assessment
No full textVision Transformer for femur fracture classification
No full textIntroduction: In recent years, the scientific community focused on developing Computer-Aided Diagnosis (CAD) tools that could improve clinicians’ bone fractures diagnosis, primarily based on Convolutional Neural Networks (CNNs). However, the discerning accuracy of fractures’ subtypes was far from optimal. The aim of the study was 1) to evaluate a new CAD system based on Vision Transformers (ViT), a very recent and powerful deep learning technique, and 2) to assess whether clinicians’ diagnostic accuracy could be improved using this system. Materials and methods: 4207 manually annotated images were used and distributed, by following the AO/OTA classification, in different fracture types. The ViT architecture was used and compared with a classic CNN and a multistage architecture composed of successive CNNs. To demonstrate the reliability of this approach, (1) the attention maps were used to visualize the most relevant areas of the images, (2) the performance of a generic CNN and ViT was compared through unsupervised learning techniques, and (3) 11 clinicians were asked to evaluate and classify 150 proximal femur fractures’ images with and without the help of the ViT, then results were compared for potential improvement. Results: The ViT was able to predict 83% of the test images correctly. Precision, recall and F1-score were 0.77 (CI 0.64–0.90), 0.76 (CI 0.62–0.91) and 0.77 (CI 0.64–0.89), respectively. The clinicians’ diagnostic improvement was 29% (accuracy 97%; p 0.003) when supported by ViT's predictions, outperforming the algorithm alone. Conclusions: This paper showed the potential of Vision Transformers in bone fracture classification. For the first time, good results were obtained in sub-fractures classification, outperforming the state of the art. Accordingly, the assisted diagnosis yielded the best results, proving the effectiveness of collaborative work between neural networks and clinicia
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Experimental assessment of pelvis slipping during postless traction for orthopaedic applications
Get PDFPelvic manipulator for fractures reduction
No full textThe surgical treatment of pelvic fractures has been proved to be technically challenging; 3D imaging and navigation can give a substantial benefit; a further step is here introduced with robotized fracture reduction. A specific device to be interfaced with existing surgical tables has been designed; its main specifications are allowing 3D fluoroscopy of wide areas, and housing a hexapod robot for fracture reduction. This robot can be remotely controlled by a joystick; therefore it can accurately reproduce reduction trajectories established in the pre-operative planning and it can maintain the reduced position while synthesis devices are applied. A prototype has been built and tested in order to assess its range of movement, its accuracy, and its learnability. Further efforts will address the implementation of navigated surgery and to the development of a haptic interface in order to let the surgeon sense soft tissue resistance
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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