Abstract: A method for assisting a user with surgical implementation of a preoperative plan includes generating a physical native tissue model of a native patient tissue. The physical native tissue model includes at least one primary patient tissue area including a surface of interest, at least one secondary patient tissue area including no surfaces of interest, and a base surface for engaging a supporting structure. The physical native tissue model, as generated, includes at least one information feature providing clinically useful information to the user. The information feature is substantially separated from the surface of interest. An apparatus for assisting a user with surgical implementation of a preoperative plan is also provided.

Abstract: A guide for assisting with attachment of a stock prosthetic implant to a patient tissue includes a lower guide surface configured to contact an upper implant surface of the stock prosthetic implant when a lower implant surface of the stock prosthetic implant contacts the patient tissue. An upper guide surface is accessible to a user when the lower guide surface is in contact with the upper implant surface. At least one guiding aperture extends through the guide body between the upper and lower guide surfaces at a predetermined aperture location with respect to the guide body and defines a predetermined target trajectory through the guide body. At least one of the target trajectory and the aperture location of each guiding aperture is preselected responsive to preoperative imaging of the patient tissue. A method of assisting with attachment of a stock prosthetic implant to a patient tissue is also provided.

Abstract: A method of preoperative planning comprises creating a virtual model of a native patient tissue; placing a virtual device into a desired device orientation relative to the virtual model of the native patient tissue; specifying at least one structural change to the native patient tissue to facilitate placement of the virtual device in the desired device orientation; creating a virtual model of an altered patient tissue responsive to the specifying at least one structural change to the native patient tissue; and fabricating a tangible representation of a bone using the virtual model of the altered patient tissue.

Abstract: A method for assisting a user with surgical implementation of a preoperative plan includes generating a physical native tissue model of a native patient tissue. The physical native tissue model includes at least one primary patient tissue area including a surface of interest, at least one secondary patient tissue area including no surfaces of interest, and a base surface for engaging a supporting structure. The physical native tissue model, as generated, includes at least one information feature providing clinically useful information to the user. The information feature is substantially separated from the surface of interest. An apparatus for assisting a user with surgical implementation of a preoperative plan is also provided.

Abstract: A method of preoperative planning and provision of patient-specific surgical aids includes creating a virtual model of a native patient tissue. A virtual device is placed into a predetermined device orientation relative to the virtual model of the native patient tissue. At least one predetermined landmark orientation is specified for placement of at least one virtual landmark relative to the native patient tissue. A virtual patient-specific template containing the predetermined landmark orientation and having a landmark guiding feature is generated. At least one virtual patient-specific placement guide configured to interact simultaneously with at least one previously placed virtual landmark and the virtual device when the virtual device is in the predetermined device orientation is generated. A physical patient-specific template is created as a tangible representation of the virtual patient-specific template.

Abstract: A patient tissue includes a primary patient tissue area and an anatomically differentiated bordering secondary patient tissue area. An apparatus is at least partially customized responsive to preoperative imaging of the patient tissue. Means are provided for mating with the primary patient tissue area in a preselected relative orientation. Means are provided for fixing a first landmark to the primary patient tissue area in at least one of a predetermined marking location and a predetermined marking trajectory. Means are provided for fixing a second landmark to the secondary patient tissue area in at least one of a predetermined marking location and a predetermined marking trajectory. A method of associating a plurality of landmarks with a patient tissue is also provided.

Abstract: In one set of embodiments, methods, systems, and apparatus are provided to attach one or more service policies to resources in an enterprise by receiving a first service policy, receiving a first policy attachment that identifies one or more policy attachment attributes of resources in the enterprise, and generate a first global policy attachment that references the first policy attachment and the first service policy. The method can include receiving a request to access a resource including an attribute that matches one of the policy attachment attributes. The method can include determining that the first service policy is an effective policy for the resource based on the matching resource attribute with the policy attachment attribute. The method can include controlling access to the resource responsive to the request using the effective policy.

Abstract: A patient tissue includes a primary patient tissue area and an anatomically differentiated bordering secondary patient tissue area. An apparatus is at least partially customized responsive to preoperative imaging of the patient tissue. Means are provided for mating with the primary patient tissue area in a preselected relative orientation. Means are provided for fixing a first landmark to the primary patient tissue area in at least one of a predetermined marking location and a predetermined marking trajectory. Means are provided for fixing a second landmark to the secondary patient tissue area in at least one of a predetermined marking location and a predetermined marking trajectory. A method of associating a plurality of landmarks with a patient tissue is also provided.

Abstract: A guide and a stock instrument in combination. The stock instrument includes a guide interacting feature, a lower instrument surface to abut the patient tissue and an upper instrument surface for contacting the guide. The guide includes a guide body including a lower guide surface and an upper guide surface. The lower guide surface mates with the upper instrument surface of the stock instrument when the lower instrument surface is in contact with the patient tissue. The lower guide surface includes an instrument guiding feature to mate with the guide interacting feature. An orienting feature including an arm extends away from the upper guide surface. The arm has a landmark engaging portion to enter a predetermined relationship with a fixed landmark on the patient tissue. The predetermined relationship indicates that the stock instrument has achieved a predetermined instrument relationship with the patient tissue.

Abstract: In one set of embodiments, methods, systems, and apparatus are provided to attach one or more quality of service policies to resources in an enterprise system by receiving a first global policy attachment that references an attachment attribute value and a first service policy, receiving a request to access a policy subject associated with a subject attribute value, identifying an effective policy set referenced by the first global policy attachment, the effective policy set including the first service policy if the attachment attribute value equals the subject attribute value, and granting the request to access based upon the at least one effective policy. The at least one effective policy may further include a first service policy referenced by the first global policy attachment if a first policy attachment scope referenced by the first global policy attachment matches or contains a subject scope associated with the policy subject.

Abstract: One exemplary aspect comprises a method comprising: (a) storing, in a first database, data specific to a client; (b) based on the data, identifying with a processing system comprising one or more processors one or more fields of a record to be updated in a second database managed by the client; (c) obtaining write-only access to one or more fields of the identified one or more fields of the record; and (d) updating, based on the data stored in the first database, one or more fields of the identified one or more fields of the record in the second database.

Abstract: An apparatus for providing a reference indication to a patient tissue includes a primary locating block having a patient-specific primary mating surface contoured for mating contact with a portion of the patient tissue in a predetermined primary mating orientation custom-configured responsive to preoperative imaging of the patient tissue. At least one mounting feature is provided to the primary locating block. At least one secondary item is configured for selective engagement with the primary locating block. The secondary item is at least one of a noncustomized secondary item and a patient-specific secondary item. The secondary item provides a reference indication to at least a portion of the patient tissue. The mounting feature of the primary locating block is configured for engagement with at least one secondary item in a predetermined secondary mounting relationship. The secondary mounting relationship is custom-configured for the patient tissue responsive to preoperative imaging of the patient tissue.

Abstract: An apparatus for providing a reference indication to a patient tissue includes a primary locating block having a patient-specific primary mating surface contoured for mating contact with a portion of the patient tissue in a predetermined primary mating orientation custom-configured responsive to preoperative imaging of the patient tissue. At least one mounting feature is provided to the primary locating block. At least one secondary item is configured for selective engagement with the primary locating block. The secondary item is at least one of a noncustomized secondary item and a patient-specific secondary item. The secondary item provides a reference indication to at least a portion of the patient tissue. The mounting feature of the primary locating block is configured for engagement with at least one secondary item in a predetermined secondary mounting relationship. The secondary mounting relationship is custom-configured for the patient tissue responsive to preoperative imaging of the patient tissue.

Abstract: A stock instrument includes at least one guide interacting feature. A lower instrument surface of the stock instrument is placed into contact with the patient tissue. A guide has a lower guide surface contoured to substantially mate with at least a portion of an upper instrument surface of the stock instrument. A predetermined instrument orientation upon the patient tissue is defined, which is preselected responsive to preoperative imaging of the patient tissue. The guide and instrument are mated in a predetermined relative guide/instrument orientation wherein at least one guide interacting feature of the instrument is placed into engagement with at least one instrument guiding feature of the guide. The guide is moved into a predetermined guide orientation with respect to the patient tissue and concurrently the instrument is moved into a predetermined instrument orientation with respect to the patient tissue.

Abstract: An apparatus for aiding visualization of a prosthetic implant and concurrently landmarking a patient tissue includes a center post having proximal and distal post ends longitudinally separated by a post body. The post body defines a post axis coaxially therewith. An implant emulator embodies a reference feature of a prosthetic implant. The implant emulator is carried on an outer surface of the center post at a predetermined longitudinal spacing from the distal post end. A guiding device is removably attached to the implant emulator. The guiding device includes an attachment structure attached to the implant emulator. A spacing arm is connected to the attachment structure and extends laterally outward from the post axis. A landmark guiding structure is connected to the spacing arm, spaced apart from the center post, and embodies at least one of a location and a trajectory for placement of a landmark.

Abstract: A stock instrument includes at least one guide interacting feature. A lower instrument surface of the stock instrument is placed into contact with the patient tissue. A guide has a lower guide surface contoured to substantially mate with at least a portion of an upper instrument surface of the stock instrument. A predetermined instrument orientation upon the patient tissue is defined, which is preselected responsive to preoperative imaging of the patient tissue. The guide and instrument are mated in a predetermined relative guide/instrument orientation wherein at least one guide interacting feature of the instrument is placed into engagement with at least one instrument guiding feature of the guide. The guide is moved into a predetermined guide orientation with respect to the patient tissue and concurrently the instrument is moved into a predetermined instrument orientation with respect to the patient tissue.

Abstract: An apparatus for transferring location and/or trajectory information from a reference surface to a patient tissue surface for guiding placement of a landmark includes a landmark guiding structure. At least two locating feet are provided, each being laterally spaced from, and indirectly connected to, the landmark guiding structure. A holdaway structure is connected to each locating foot and to the landmark guiding structure. The landmark guiding structure is placed in desired location and/or a desired trajectory with respect to the reference surface. Each locating foot is adjusted into guiding contact with a particular portion of the reference surface. Each locating foot is maintained in the guiding contact position, and the apparatus is placed with each locating foot in guiding contact with a particular portion of the patient tissue surface. A method of transferring location and/or trajectory information from a reference surface to a patient tissue surface is also disclosed.

Abstract: Framework for conditionally attaching web service policies to a policy subject (e.g., a web service client or service endpoint) at subject runtime. In one set of embodiments, a validation process can be performed at a policy subject during an initialization phase to ensure that there are no validation errors with respect to the web service policies that may be conditionally attached to the subject. This validation process can include grouping the policies that have been associated with the policy subject (via policy attachment metadata) by their corresponding constraint expressions, and determining which groups can potentially overlap (i.e., be simultaneously attached to the policy subject) at runtime. Each set of overlapping groups can then be validated using a predefined set of validation rules to identify potential errors pertaining to the policies in the set.

Abstract: Techniques for resolving conflicts between web service policies that are attached (via LPA and/or GPA metadata) to a policy subject (e.g., a WS client/service endpoint). In one set of embodiments, a priority value can be assigned to each policy attached to a policy subject via the policy's corresponding policy attachment metadata file. These priority values can be taken into account when determining whether one policy should be given precedence over another, conflicting policy attached to the same policy subject. In certain embodiments, as part of this determination, the priority value of a policy can be given greater weight than the scope at which the policy is attached.

Abstract: An apparatus for providing a reference indication to a patient tissue includes a primary locating block having a patient-specific primary mating surface contoured for mating contact with a portion of the patient tissue in a predetermined primary mating orientation custom-configured responsive to preoperative imaging of the patient tissue. At least one mounting feature is provided to the primary locating block. At least one secondary item is configured for selective engagement with the primary locating block. The secondary item is at least one of a noncustomized secondary item and a patient-specific secondary item. The secondary item provides a reference indication to at least a portion of the patient tissue. The mounting feature of the primary locating block is configured for engagement with at least one secondary item in a predetermined secondary mounting relationship. The secondary mounting relationship is custom-configured for the patient tissue responsive to preoperative imaging of the patient tissue.