Evaluation of lower limb and pelvic marker placement precision among different evaluators and its impact on gait kinematics computed with the Conventional Gait Model

BACKGROUND

Gait analysis relies on the accurate and precise identification of anatomical landmarks to provide reliable and reproducible data. More specifically, the precision of marker placement among repeated measurements is responsible for increased variability in the output gait data.

RESEARCH QUESTION

The objective of this study was to quantify the precision of marker placement on the lower limbs by a test-retest procedure and to investigate its propagation to kinematic data.

METHODS

The protocol was tested on a cohort of eight asymptomatic adults involving four evaluators, with different levels of experience. Each evaluator performed, three repeated marker placements for each participant. The standard deviation was used to calculate the precision of the marker placement, the precision of the orientation of the anatomical (segment) coordinate systems, and the precision of the lower limb kinematics. In addition, one-way ANOVA was used to compare the intra-evaluator marker placement precision and kinematic precisions among the different levels of the evaluator's experience. Finally, a Pearson correlation between marker placement precision and kinematic precision was analyzed.

RESULTS

Results have shown a precision of skin markers within 10 mm and 12 mm for intra-evaluator and inter-evaluator, respectively. Analysis of kinematic data showed good to moderate reliability for all parameters apart from hip and knee rotation that demonstrated poor intra- and inter-evaluator precision. Inter-trial variability was observed reduced than intra- and inter-evaluator variability. Moreover, experience had a positive impact on kinematic reliability since evaluators with higher experience showed a statistically significant increase in precision for most kinematic parameters. However, no correlation was observed between marker placement precision and kinematic precision which indicates that an error in the placement of one specific marker can be compensated or enhanced, in a non-linear way, by an error in the placement of other markers.

Precision of quantitative parameters of 18F-FDG PET/CT in a rabbit VX2 tumor model

Background

The precision reflecting repeated measurement error of quantitative parameters of flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) for evaluating the therapeutic effect of solid tumor can help observe whether a real biologic change in glucose metabolism occurred, or if the change was caused by errors before and after the treatment.

Methods

A total of 18 VX2 tumor-bearing male New Zealand rabbits confirmed by pathology were used, three of which were used for determining the best scanning time point after injection and 15 for a precision experiment by repeating PET/CT scans for three consecutive days. The PET volume computer-assisted reading (PET VCAR) software (GE Healthcare) was used to analyze the standardized uptake value (SUV) and total lesion glycolysis (TLG) parameters. The lean body mass (LBM) to calculate the SUV corrected for lean body mass (SUL) parameters was measured using dual energy X-ray absorptiometry (DXA). The precision was represented as the coefficient of variation of root mean square (RMS-CV) and standard deviation of root mean square (RMS-SD). The least significant change (LSC) was also calculated when considering precision.

Results

The precision of SUV parameters, including SUV_max, SUV_mean and SUV_peak ranged from 18.3% to 18.8%, which was similar to that of the SUL parameters (18.0-18.4%). Using 80% confidence interval (CI), the LSC of SUV_max and SUL_peak were 33.1% and 33.3%, respectively; using 95% CI, the LSC of SUV_max and SUL_peak were 50.1% and 51.0%, respectively.

Conclusions

This research established the method of precision in a rabbit VX2 tumor model, which can be used for monitoring changes to assess the effects of drug treatment on solid tumors in experimental studies with ¹⁸F-FDG PET/CT imaging.

Performance evaluation of mesoscopic photoacoustic imaging

Photoacoustic mesoscopy visualises vascular architecture at high-resolution up to ~3 mm depth. Despite promise in preclinical and clinical imaging studies, with applications in oncology and dermatology, the accuracy and precision of photoacoustic mesoscopy is not well established. Here, we evaluate a commercial photoacoustic mesoscopy system for imaging vascular structures. Typical artefact types are first highlighted and limitations due to non-isotropic illumination and detection are evaluated with respect to rotation, angularity, and depth of the target. Then, using tailored phantoms and mouse models, we investigate system precision, showing coefficients of variation (COV) between repeated scans [short term (1 h): COV= 1.2%; long term (25 days): COV= 9.6%], from target repositioning (without: COV=1.2%, with: COV=4.1%), or from varying in vivo user experience (experienced: COV=15.9%, unexperienced: COV=20.2%). Our findings show robustness of the technique, but also underscore general challenges of limited-view photoacoustic systems in accurately imaging vessel-like structures, thereby guiding users when interpreting biologically-relevant information.

Effect of internal structures on the accuracy of 3D printed full-arch dentition preparation models in different printing systems

PURPOSE

The objective of this study was to investigate how internal structures influence the overall and marginal accuracy of full arch preparations fabricated through additive manufacturing in different printing systems.

MATERIALS AND METHODS

A full-arch preparation digital model was set up with three internal designs, including solid, hollow, and grid. These were printed using three different resin printers with nine models in each group. After scanning, each data was imported into the 3D data processing software together with the master cast, aligned and trimmed, and then put into the 3D data analysis software again to compare the overall and marginal deviation whose results are expressed using root mean square values and color maps. To evaluate the trueness of the resin model, the test data and reference data were compared, and the precision was evaluated by comparing the test data sets. Color maps were observed for qualitative analysis. Data were statistically analyzed by one-way analysis of variance and Bonferroni method was used for post hoc comparison (α = .05).

RESULTS

The influence of different internal structures on the accuracy of 3D printed resin models varied significantly (P < .05). Solid and grid models showed better accuracy, while the hollow model exhibited poor accuracy. The color maps show that the resin models have a tendency to shrink inwards.

CONCLUSION

The internal structure design influences the accuracy of the 3D printing model, and the effect varies in different printing systems. Irrespective of the kind of printing system, the printing accuracy of hollow model was observed to be worse than those of solid and grid models.

Variational inference accelerates accurate DNA mixture deconvolution

We investigate a class of DNA mixture deconvolution algorithms based on variational inference, and we show that this can significantly reduce computational runtimes with little or no effect on the accuracy and precision of the result. In particular, we consider Stein Variational Gradient Descent (SVGD) and Variational Inference (VI) with an evidence lower-bound objective. Both provide alternatives to the commonly used Markov-Chain Monte-Carlo methods for estimating the model posterior in Bayesian probabilistic genotyping. We demonstrate that both SVGD and VI significantly reduce computational costs over the current state of the art. Importantly, VI does so without sacrificing precision or accuracy, presenting an overall improvement over previously published methods.

Assessment of precision in growth inhibition assay (GIA) using human anti-PfRH5 antibodies

BACKGROUND

For blood-stage malaria vaccine development, the in vitro growth inhibition assay (GIA) has been widely used to evaluate functionality of vaccine-induced antibodies (Ab), and Plasmodium falciparum reticulocyte-binding protein homolog 5 (RH5) is a leading blood-stage antigen. However, precision, also called "error of assay (EoA)", in GIA readouts and the source of EoA has not been evaluated systematically.

METHODS

In the Main GIA experiment, 4 different cultures of P. falciparum 3D7 parasites were prepared with red blood cells (RBC) collected from 4 different donors. For each culture, 7 different anti-RH5 Ab (either monoclonal or polyclonal Ab) were tested by GIA at two concentrations on three different days (168 data points). To evaluate sources of EoA in % inhibition in GIA (%GIA), a linear model fit was conducted including donor (source of RBC) and day of GIA as independent variables. In addition, 180 human anti-RH5 polyclonal Ab were tested in a Clinical GIA experiment, where each Ab was tested at multiple concentrations in at least 3 independent GIAs using different RBCs (5,093 data points). The standard deviation (sd) in %GIA and in GIA50 (Ab concentration that gave 50%GIA) readouts, and impact of repeat assays on 95% confidence interval (95%CI) of these readouts was estimated.

RESULTS

The Main GIA experiment revealed that the RBC donor effect was much larger than the day effect, and an obvious donor effect was also observed in the Clinical GIA experiment. Both %GIA and log-transformed GIA50 data reasonably fit a constant sd model, and sd of %GIA and log-transformed GIA50 measurements were calculated as 7.54 and 0.206, respectively. Taking the average of three repeat assays (using three different RBCs) reduces the 95%CI width in %GIA or in GIA50 measurements by ~ half compared to a single assay.

CONCLUSIONS

The RBC donor effect (donor-to-donor variance on the same day) in GIA was much bigger than the day effect (day-to-day variance using the same donor's RBC) at least for the RH5 Ab evaluated in this study; thus, future GIA studies should consider the donor effect. In addition, the 95%CI for %GIA and GIA50 shown here help when comparing GIA results from different samples/groups/studies; therefore, this study supports future malaria blood-stage vaccine development.

Developing a Comprehensive Search Strategy for the Systematic Review of Clinical Decision Support Systems for Nursing Practice

The search strategy of a literature review is of utmost importance as it impacts the validity of its findings. In order to build the best query to guide the literature search on clinical decision support systems applied to nursing clinical practice, we developed an iterative process capitalizing on previous systematic reviews published on similar topics. Three reviews were analyzed relatively to their detection performance. Errors in the choice of keywords and terms used in title and abstract (missing MeSH terms, failure to use common terms), may make relevant articles invisible.

The impact of cell size on morphogen gradient precision

Tissue patterning during embryonic development is remarkably precise. Here, we numerically determine the impact of the cell diameter, gradient length and the morphogen source on the variability of morphogen gradients. We show that the positional error increases with the gradient length relative to the size of the morphogen source, and with the square root of the cell diameter and the readout position. We provide theoretical explanations for these relationships, and show that they enable high patterning precision over developmental time for readouts that scale with expanding tissue domains, as observed in the Drosophila wing disc. Our analysis suggests that epithelial tissues generally achieve higher patterning precision with small cross-sectional cell areas. An extensive survey of measured apical cell areas shows that they are indeed small in developing tissues that are patterned by morphogen gradients. Enhanced precision may thus have led to the emergence of pseudostratification in epithelia, a phenomenon for which the evolutionary benefit had so far remained elusive.

The impact of software updates on accuracy of intraoral scanners

BACKGROUND

Digital workflow is showing an increasing tendency in everyday dentistry. Accuracy is essential during digital dental workflows for all indication areas. The present study aimed to evaluate the effect of software updates on the accuracy of intraoral scanner (IOS) devices.

METHODS

3Shape Trios 3 Pod with software versions 18.1.2. (TRI3_1) and 20.1.2. (TRI3_2); 3Shape Trios 4 Move, version 19.2.2. (TRI4_1); and 3Shape Trios 4 Pod, version 20.1.1. (TRI4_2) were used to take direct optical impressions from a polymethyl methacrylate (PMMA) full arch reference model with prepared teeth (FDI 11,14,17 for crowns and FDI 26 for onlay) and an edentulous region (between FDI 14 and 17). The scanners were used eight times; STL files were imported into Geomagic Control X for accuracy assessment by comparing them to a reference data set created by an industrial high-precision scanner (AICON SmartScan-3D C5). The average deviation of the surface points was calculated in three locations: across a full arch (Parameter 1), the region of a four-unit bridge (Parameter 2), and a single prepared abutment (Parameter 3).

RESULTS

In parameter 1 and 2, the newest model with the latest software (TRI4_2) reached the highest accuracy (31.06 ± 5.24 µm and 21.69 ± 7.50 µm). In parameter 3, an older generation scanner running legacy software produced the highest accuracy: TRI4_1, 11.75 ± 0.35 µm.

CONCLUSION

Appropriate software updates can significantly increase the trueness and precision of intraoral scanner devices. With updated software, the older generation can match the accuracy level of latest equipment.

The precision of two alternative indirect workflows for digital model production: an illusion or a possibility?

OBJECTIVE

Despite the clear drive from both research and clinical dentistry toward digital transformation, there are limitations to implementing intra-oral scanning (IOS) into daily dental practice. This study aimed to compare the precision of digital models obtained from two alternative indirect workflows to direct IOS.

MATERIAL AND METHODS

Two indirect digital workflows were evaluated in this study. In the IOS group (direct), IOS directly obtained digital impressions of participants' upper and lower dental arches, while in the Scan Impression (Scan Imp) group (indirect), a desktop scanner scanned silicone-based impressions of upper and lower whole arches that were taken with plastic trays. In the cone-beam computed tomography impression (CBCT Imp) group (indirect), a CBCT machine scanned the silicone-based impressions. Then, the precision of the entire arch and individual teeth for all digital impressions was virtually quantified. Following superimposition, differences between standard tessellation language (STL) files obtained from both-direct and indirect-methods were evaluated by color-mapping and measuring the surface distance between superimposed STL files. Furthermore, 18 linear measurements were taken from each digital model. ANOVA with repeated measures, Pearson coefficient, and intraclass correlation coefficient were used for intergroup comparisons.

RESULTS

The digital models obtained from the two indirect workflows differed from the IOS in some dental and intra-arch measurements but were considered clinically acceptable. Ranked against IOS, CBCT Imp models had greater precision, followed by Scan Imp.

CONCLUSION

Digital models obtained from two indirect, alternative workflows, desktop, and CBCT scanning of impression, have clinically acceptable accuracy and reliability of tooth size and intra-arch measurements, providing the use of proper methodologies.

CLINICAL RELEVANCE

There are some limitations to implementing IOS in daily clinical practice. However, several alternative digital model production techniques might provide an affordable solution. Although they may insignificantly differ in accuracy, all can be applied clinically.

Impact of Organism Allocations on Potency Estimates from Ceriodaphnia dubia Reproduction Tests

In aquatic toxicology experiments, organisms are randomly assigned to an exposure group that receives a particular concentration level of a toxicant (including a control group with no exposure), and their survival, growth, or reproduction outcomes are recorded. Standard experiments use equal numbers of organisms in each exposure group. In the present study, we explored the potential benefits of modifying the current design of aquatic toxicology experiments when it is of interest to estimate the concentration associated with a specific level of decrease from control reproduction responses. A function of the parameter estimates from fitting a generalized linear regression model used to describe the relationship between individual responses and the toxicant concentration provides an estimate of the potency of the toxicant. After comparing different allocations of organisms to concentration groups, we observed that a reallocation of organisms among these concentration groups could provide more precise estimates of toxicity endpoints than the standard experimental design that uses equal number of organisms in each concentration group; this provides greater precision without the added cost of conducting the experiment. More specifically, assigning more observations to the control zero-concentration condition may result in more precise interval estimates of potency. Environ Toxicol Chem 2023;00:1-10. © 2023 SETAC.

Effect of various printing parameters on the accuracy (trueness and precision) of 3D-printed partial denture framework

OBJECTIVES

To measure and compare the accuracy of 3D-printed materials used for RPD production to improve workflow and eliminate errors in manufacturing.

METHODS

A partially edentulous maxilla (Kennedy Class III, modification 1) was prepared and designed with proximal plates, rest seats and clasps in one first premolar, one canine and two second molars. A total of 540 3D printed RPD frameworks were 3D printed with three different types of resin (DentaCAST (Asiga, Australia), SuperCAST (Asiga, Australia) and NextDent (3D Systems, Netherlands)). To evaluate the trueness of the printing materials, they were printed with three types of layer thickness: 50 μm, 75 μm and 100 μm, using two types of build angles: 0° and 45° and three types of plate locations: side, middle and corner. After production, all specimens were scanned and superimposed with a control sample that was digitally designed. Using the initial alignment and best-fit alignment method, the root mean square error (RMSE) was calculated. To capture region specific discrepancy, 10 points of XYZ internal discrepancy within RPDs were measured and Euclidean error was calculated. Data was statistically analysed using Shapiro-Wilk and Kruskal-Wallis tests, one-way ANOVA and T-test (SPSS Version 29) and MATLAB (R2022b).

RESULTS

Optimal results were found using 45°, middle of the build plate and layer thicknesses of 100 μm (115 ± 19 μm, DentaCAST), 75 μm (143 ± 14 μm, NextDent), 50 μm (98 ± 35 μm, SuperCAST), which were clinically acceptable. Results were statistically significant when comparing layer thickness in each testing group (p < 0.001). Layer thickness was a primary parameter in the determination of print accuracy among all materials (p < 0.001). Higher discrepancies and failures were observed in 0° prints. No statistically significant difference was found in material usage between build angles or layer thickness (p > 0.005).

CONCLUSIONS

All three 3D printing materials exhibited clinically acceptable RMSE results with a build angle of 45° with a printing layer thickness of 50 μm for SuperCAST, 75 μm NextDent and 100 μm for DentaCAST. The highest discrepancies were mostly found in posterior clasps, while the lowest discrepancy was found in palatal straps. Despite unoptimized spacing of prints, frameworks configured to print in the middle of the build plate result in the least printing failures.

Precise display time measurement in JavaScript for web-based experiments

Conducting research via the Internet is a formidable and ever-increasingly popular option for behavioral scientists. However, it is widely acknowledged that web-browsers are not optimized for research: In particular, the timing of display changes (e.g., a stimulus appearing on the screen), still leaves room for improvement. So far, the typically recommended best (or least bad) timing method has been a single (RAF) JavaScript function call within which one would give the display command and obtain the time of that display change. In our Study 1, we assessed two alternatives: Calling the RAF twice consecutively, or calling the RAF during a continually ongoing independent loop of recursive RAF calls. While the former has shown little or no improvement as compared to single RAF calls, with the latter we significantly and substantially improved overall precision, and achieved practically faultless precision in most practical cases. Our two basic methods for effecting display changes, plain text change and color filling, proved equally efficient. In Study 2, we reassessed the "RAF loop" timing method with image elements in combination with three different display methods: We found that the precision remained high when using either or changes - while drawing on a element consistently led to comparatively lower precision. We recommend the "RAF loop" display timing method for improved precision in future studies, and or changes when using image stimuli. We publicly share the easy-to-use code for this method, exactly as employed in our studies.

Precision and reliability study of hospital infusion pumps: a systematic review

BACKGROUND

Infusion Pumps (IP) are medical devices that were developed in the 1960s and generate fluid flow at pressures higher than that of normal blood pressure. Various hospital sectors make use of them, and they have become indispensable in therapies requiring continuity and precision in the administration of medication and/or food. As they are classified Class III (high risk) equipment, their maintenance is crucial for proper performance of the device, as well as patient and operator safety. The principal consideration of the pump is the volume infused, and the device demands great attention to detail when being calibrated. A lack of necessary care with this equipment can lead to uncertainty in volume and precision during the administration of substances. Because of this, it is essential to evaluate its reliability, to prevent possible failures at time of execution. This control aims at the quality of the intended infusion result, becoming an indication of quality.

METHODS

This systematic review summarizes studies done over the last 10 years (2011 to December 2021) that address the reliability and accuracy of hospital infusion pumps, in order to identify planning of maintenance and/or other techniques used in management of the equipment. The Prisma method was applied and the databases utilized were Embase, MEDLINE/Pubmed, Web of Science, Scopus, IEEE Xplore, and Science Direct. In addition, similar reviews were studied in Prospero and the Cochrane Library. For data analysis, softwares such as Mendeley, Excel, RStudio, and VOSviewer were used, and Robvis helped in plotting risk of bias results for studies performed with Cochrane tools.

RESULTS

The six databases selected produced 824 studies. After applying eligibility criteria (inclusion and exclusion), removing duplicates, and applying filters 1 and 2, 15 studies were included in the present review. It was found that the most relevant sources came from the Institute of Electrical and Electronics Engineers (IEEE) and that the most relevant keywords revolved around the terms ("device failure", "infusion pumps", "adverse effects", "complications", etc.). These results made clear that there remains substantial room for improvement as it relates to the study of accuracy and reliability of infusion.

CONCLUSIONS

We verified that the reliability and precision analysis of hospital infusion pumps need to be performed in a more detailed and consistent way. New developments, considering the model and IP specification, are intended, clearly explaining the adopted methodology.

Multivariate analysis of PET pharmacokinetic parameters improves inferential efficiency

PURPOSE

In positron emission tomography quantification, multiple pharmacokinetic parameters are typically estimated from each time activity curve. Conventionally all but the parameter of interest are discarded before performing subsequent statistical analysis. However, we assert that these discarded parameters also contain relevant information which can be exploited to improve the precision and power of statistical analyses on the parameter of interest. Properly taking this into account can thereby draw more informative conclusions without collecting more data.

METHODS

By applying a hierarchical multifactor multivariate Bayesian approach, all estimated parameters from all regions can be analysed at once. We refer to this method as Parameters undergoing Multivariate Bayesian Analysis (PuMBA). We simulated patient-control studies with different radioligands, varying sample sizes and measurement error to explore its performance, comparing the precision, statistical power, false positive rate and bias of estimated group differences relative to univariate analysis methods.

RESULTS

We show that PuMBA improves the statistical power for all examined applications relative to univariate methods without increasing the false positive rate. PuMBA improves the precision of effect size estimation, and reduces the variation of these estimates between simulated samples. Furthermore, we show that PuMBA yields performance improvements even in the presence of substantial measurement error. Remarkably, owing to its ability to leverage information shared between pharmacokinetic parameters, PuMBA even shows greater power than conventional univariate analysis of the true binding values from which the parameters were simulated. Across all applications, PuMBA exhibited a small degree of bias in the estimated outcomes; however, this was small relative to the variation in estimated outcomes between simulated datasets.

CONCLUSION

PuMBA improves the precision and power of statistical analysis of PET data without requiring the collection of additional measurements. This makes it possible to study new research questions in both new and previously collected data. PuMBA therefore holds great promise for the field of PET imaging.

Analytical evaluation and Sigma metrics of 6 next generation chemistry assays on the Abbott Architect system

BACKGROUND

We evaluated analytical and Sigma performance for 6 next generation chemistry assays on the Abbott Architect c8000 system.

METHODS

Albumin with bromocresol purple or green, amylase, cholesterol, total protein, and urea nitrogen were analyzed using photometric technology. Analytical performance goals were defined based on Accreditation Canada Diagnostics (ACD) and Clinical Laboratory Improvement Amendments (CLIA). Precision study consisted of testing 2 quality control concentrations and 3 patient serum sample pools, twice a day in quintuplicate over 5 days. Linearity testing consisted of 5-6 concentrations of commercial linearity materials. We tested a minimum of 120 serum/plasma specimens on the new and current Architect methods for comparison. We assessed accuracy with reference materials for 5 assays, and a calibration standard for cholesterol. Bias from the reference standard target value was used for Sigma metric analysis.

RESULTS

Observed total imprecision of the assays ranged from 0.5 to 4%, meeting pre-defined goals. Linearity was acceptable over the tested range. Measurements on the new and current Architect methods were comparable. Accuracy ranged from 0 to 2.0% absolute mean difference from target value. All 6 next generation clinical chemistry assays demonstrated Six Sigma quality, using CLIA standards.

CONCLUSION

Applying ACD recommendations, 5 assays showed Six Sigma, while cholesterol showed Five Sigma performance.

Diagnostic Strategies for Ruminant Populations

Veterinarians may be asked to assess the presence, absence, or prevalence of a disease in an animal population or to compare the effects of management factors on disease status or production performance. The scope of diagnostic investigations in ruminant populations is often limited by the availability of time, money, and animal handling infrastructure. Selecting the correct number and type of animals to sample maximizes the benefits of the investigation, while minimizing costs. To meet the objectives of the study, the veterinarian must understand the statistical elements that need to be considered to calculate the appropriate sample size.

A rank-based approach to design and analysis of pretest-posttest randomized trials, with application to COVID-19 ordinal scale data

Randomized controlled trials with a pretest-posttest design frequently yield ordered categorical outcome data. Focusing on the estimation of the win probability that a treated participant would have a better score than (or win over) a control participant, we developed methods for analysis and sample size planning for such trials. We exploited the analysis of covariance framework with the dependent variable being individual participants' win fractions at posttest and the covariate being the win fractions at pretest. The win fractions were obtained using the mid-ranks of the ordinal data. Simulation evaluation based on a recent randomized trial on COVID-19 suggests that the methods perform very well. A sample SAS code for data analysis is presented.

Trueness and precision of milled and 3D printed root-analogue implants: A comparative in vitro study

OBJECTIVES

The present study aimed to evaluate the accuracy (trueness and precision) of titanium and zirconia multi-rooted root analogue implants (RAIs) manufactured by milling and 3D-printing.

METHODS

A multi-rooted RAI was designed based on a mandibular second molar segmented from cone-beam computed tomography (CBCT). The manufactured RAIs were divided into four groups: 3D-printed titanium (PT) and 3D-printed zirconia (PZ) (n=10 each), as well as milled titanium (MT) and milled zirconia (MZ) (n=5 each). The specimens were scanned with a high-precision scanner, and the scanned data were imported into 3D-measurement software to evaluate the precision and trueness of each group. Root mean square (RMS) deviations were measured and statistically analysed (One-way ANOVA, Tukey's, p≤0.05).

RESULTS

PZ showed the highest precision with RMS value of 21±6 µm. Nevertheless, there was no statistically significant difference in precision among the other groups. Regarding trueness, MZ showed the highest trueness with RMS value of 66±3 µm, whereas MT showed the lowest trueness result. Inspection sections showed that MT had significantly high RMS deviation in the furcation area (612±64 µm), whereas PZ showed significantly high RMS deviation at the apical area (197±17 µm).

CONCLUSIONS

The manufacturing process significantly influenced the RAI accuracy. PZ exhibited the highest precision, whereas MZ exhibited the highest trueness, followed by PT. Finally, our results suggest that 3D-printing can reproduce concave surfaces and less accessible areas better than milling.

CLINICAL SIGNIFICANCE

Milled and 3D-printed RAIs showed promising results in terms of precision and trueness. However, further clinical research is needed to advocate their use as immediate implants. Additionally, the inherent volumetric changes of the various materials during manufacturing should be considered.

Examining the role of attentional allocation in working memory precision with pupillometry in children and adults

Working memory (WM) precision, or the fidelity with which items can be remembered, is an important aspect of WM capacity that increases over childhood. Why individuals are more or less precise from moment to moment and why WM becomes more stable with age are not yet fully understood. Here, we examined the role of attentional allocation in visual WM precision in children aged 8 to 13 years and young adults aged 18 to 27 years, as measured by fluctuations in pupil dilation during stimulus encoding and maintenance. Using mixed models, we examined intraindividual links between change in pupil diameter and WM precision across trials and the role of developmental differences in these associations. Through probabilistic modeling of error distributions and the inclusion of a visuomotor control task, we isolated mnemonic precision from other cognitive processes. We found an age-related increase in mnemonic precision that was independent of guessing behavior, serial position effects, fatigue or loss of motivation across the experiment, and visuomotor processes. Trial-by-trial analyses showed that trials with smaller changes in pupil diameter during encoding and maintenance predicted more precise responses than trials with larger changes in pupil diameter within individuals. At encoding, this relationship was stronger for older participants. Furthermore, the pupil-performance coupling grew across the delay period-particularly or exclusively for adults. These results suggest a functional link between pupil fluctuations and WM precision that grows over development; visual details may be stored more faithfully when attention is allocated efficiently to a sequence of objects at encoding and throughout a delay period.

[Development of a planned and monitoring robotic assistance and automation for application in orthopedics and trauma surgery]

Robot-assisted surgery offers many advantages with respect to precision and facilitation in medicine, whereby the physician controls the system externally by guiding the movement of the robot during the operation. Despite training and experience, operating errors by the user cannot be excluded. In addition, for the established systems the precise guidance of instruments along complexly shaped surfaces, e.g. for milling or cutting, depends on the skills of the operator. This article presents an expansion of the established robotic assistance for smooth movement along randomly shaped surfaces and introduces a movement automation which goes beyond the assistance systems used so far. Both approaches aim to improve the accuracy in surface-dependent medical procedures and avoid operator errors. Special applications with these requirements are, for example the execution of precise incisions or removal of adhering tissue in cases of spinal stenosis. A segmented computed tomography (CT) or magnetic resonance imaging (MRI) scan serves as the basis for a precise implementation. For robotic assistance externally guided by the operator the commands given to the robot are tested and monitored without delay so that adaptation of the movement exactly corresponding to the surface can be carried out. In contrast, the automation for the established systems differs in that the movement along the desired surface is roughly planned by the surgeon preoperatively by marking prominent points on the CT or MRI scan. From this a suitable track, including the appropriate instrument orientation, is calculated and, after checking the results, the robot finally carries this out autonomously. Based on this procedure, which is planned by humans and carried out by robots, errors are minimized, respective advantages are maximized and costly training on correct steering of robots becomes obsolete. The evaluation is carried out both in simulation and also experimentally on a complexly shaped 3D-printed lumbar vertebra from a CT scan with a Stäubli TX2-60 manipulator (Stäubli Tec-Systems GmbH Robotics, Bayreuth, Germany); however, the procedures are also transferable to and applicable on every other robotic system that covers the necessary working space, such as the da Vinci system.

Influence of additive manufacturing method and build angle on the accuracy of 3D-printed palatal plates

OBJECTIVES

In this in vitro study, the effects of additive manufacturing (AM) methods and build angles on the trueness and precision of 3D-printed palatal plate orthodontic appliances for newborns and infants were examined.

METHODS

Specimens were fabricated by different representative AM methods, including digital light processing (DLP), fused filament fabrication (FFF), and MultiJet printing (MJP). Three build angles (0°, 45°, and 90°) were used. After scanning, all specimens were analyzed using the 3D inspection software. The root mean square values were measured for trueness and precision. Color maps were created to detect deviations in samples. The data were statistically analyzed with a two-way ANOVA.

RESULTS

The trueness and precision were statistically influenced by both AM methods and build angles (p < 0.05). Moreover, the root mean square values of the 45° DLP (0.0221 ± 0.0017 μm) and the 0° MJP (0.0217 ± 0.0014 μm) were significantly lower compared to those in other groups (p < 0.001).

CONCLUSIONS

AM methods (DLP, FFF, and MJP) and build angles (0°, 45°, and 90°) significantly impacted the dimensional accuracy of additively manufactured palatal plate orthodontic appliances. Also, the 45° DLP and the 0° MJP were associated with the highest trueness and precision.

CLINICAL SIGNIFICANCE

All tested AM methods with different build angles yielded clinically acceptable outcomes (within an acceptance range of ±300 μm for trueness), achieving the highest accuracy with a technology-specific suitable build angle.

Accuracy and digital screw path design of TiRobot-assisted pedicle screw placement for lumbar spondylolisthesis

PURPOSE

To investigate lumbar spondylolisthesis screw placement assisted by TiRobot in terms of digital screw path design, accurate implementation, and accuracy evaluation method.

METHODS

In this study, we enrolled 40 patients with lumbar spondylolisthesis between December 2020 and August 2021 who underwent spine surgery at the Affiliated Hospital of PuTian University. Pre-operative computed tomography position and screw path designation, intra-operative pedicle screw placement according to pre-operative planning, and post-operative evaluation of the accuracy of screw placement were performed. 3D coordinates of the entry and exit points before and after the operation were collected. The qualified points at different levels of accuracy were counted. The screw placement accuracy was based on the absolute difference using the Chi-squared test.

RESULTS

In total, 194 screws were successfully implanted with no screws penetrating the cortex. The absolute difference of entry points X, Y, and Z coordinates before and after the operation was 0.425 ± 0.294 mm, 0.417 ± 0.310 mm, and 0.466 ± 0.327 mm, respectively. The corresponding values in terms of exit points were 0.702 ± 0.470 mm, 0.963 ± 0.595mm, and 0.983 ± 0.566 mm, respectively. No obvious differences in coordinates before and after the operation were observed with an entry point degree of accuracy of ≥ 1.2 mm and exit point degree of accuracy of ≥ 2.1 mm. Therefore, the real surgery was consistent with the design.

CONCLUSIONS

TiRobot-assisted lumbar spondylolisthesis surgery achieved optimal path designation and precise surgery.

In vitro comparison of five desktop scanners and an industrial scanner in the evaluation of an intraoral scanner accuracy

OBJECTIVES

The study aimed to compare the precision of ATOS industrial, 3ShapeE4, MeditT710, CeramillMap400, CSNeo, PlanScanLab desktop, and Mediti700 intraoral scanners. The second aim was to compare the trueness of Mediti700 assessed by ATOS and desktop scanners.

METHODS

Four plastic dentate models with 7-12 abutments prepared for complete arch fixed dentures were scanned by all scanners three times. Scans were segmented to retain only the abutments. The precision and trueness were calculated by superimposing scans with the best-fit algorithm. The mean absolute distance was calculated between the scan surfaces. The precision was calculated based on the 12 repeats. Trueness was evaluated by superimposing the desktop and IOS scans to the industrial scans. IOS was also aligned with the two most accurate desktop scanners.

RESULTS

The precision of 3ShapeE4 and MeditT710 (3-4μm) was only slightly lower than that of ATOS (1.7μm, p<0.001) and significantly higher than CeramillMap400, CSNeo, and PlanScanLab (6-10 μm, p<0.001). The trueness was the highest for the 3Shape E4 (12-13 μm) and Medit T710 (13-16 μm) without significant difference. They were significantly better than CeramillMap400, CSNeo, and PlanScanLab (22-31μm, p<0.001). Accordingly, the Mediti700 trueness was evaluated by ATOS, 3ShapeE4, and MeditT710. The three trueness was not significantly different; ATOS (23-26 μm), 3Shape E4 (22-25 μm), and Medit T710 (20-23 μm).

CONCLUSIONS

All desktop scanners had the acceptable accuracy required for a complete arch-fixed prosthesis. The 3Shape E4 and the Medit T710 might be used as reference scanners for studying IOS accuracy.

CLINICAL SIGNIFICANCE

3ShapeE4, MeditT710, CeramillMap400, CSNeo, PlanScanLab laboratory, and Mediti700 intraoral scanners can be used for the prosthetic workflow in a complete arch. 3ShapeE4 and the MeditT710 could be used to test the accuracy of various phases of a laboratory workflow, replacing the industrial scanners.