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Neuropsychological interventions following traumatic brain injury
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
Jason W. Krellman, Theodore Tsaousides, Wayne A. Gordon
Although the use of technology in TBI rehabilitation is expected to increase in the next few years, technological aids should not be intended to replace a therapist but rather to enhance the effectiveness of treatment. Findings from studies showing no advantage of computer-assisted interventions over traditional interventions141,144 illustrate the importance of the clinician as an active participant in the treatment. Therapists set and maintain the structure of treatment, determine treatment needs and readiness, provide feedback and guidance, and teach and reinforce the use of compensatory methods. Therapists also help the patient process emotional reactions that might otherwise impede daily functioning or progress in rehabilitation, and they facilitate the inclusion of family or other collaterals in the treatment, which is often helpful in reinforcing the use of rehabilitation strategies in daily life and maximizing functional gains.73,78–81 Most importantly, a positive working alliance between therapist and client facilitates treatment and contributes to successful treatment outcome.6,150,151
Role of Computer-Assisted Programs in Optimizing the Use of Antimicrobial Agents
Published in Robert C. Owens, Paul G. Ambrose, Charles H. Nightingale, Antibiotic Optimization, 2004
John P. Burke, Rajesh R. Mehta
Implemented over the past decade, the use of the Automated Antibiotic Assistant for surgical prophylaxis and definitive treatment has led to significant improvements in overall antibiotic use at the LDS Hospital. Between 1988 and 1998, the period during which computer-based decision support was first introduced, optimal timing of antibiotic prophylaxis for surgical patients improved from 40% to over 99% while rates of surgical site infection were also reduced (38). Computer-assisted interventions accompanied these improvements and achieved significantly shorter durations of prophylaxis, a reduction in the proportion of patients receiving prophylaxis for more than 24 hours (from 30% in 1988 to less than 6% in 1998) and a 50% reduction in the mean number of antibiotic doses over the 10-year period.
Aging in Place
Published in Goh Cheng Soon, Gerard Bodeker, Kishan Kariippanon, Healthy Ageing in Asia, 2022
There are some examples of promoting and building smart homes for aging in place in Hong Kong. The Hong Kong Science and Technology Park runs a demo showcase on smart living–aging in place that has a thematic focus on the role of technology on health monitoring, home safety, daily living, and rehabilitation [https://www.hkstp.org/en]. The Housing Society provides the first private senior housing in Hong Kong with monitoring and sensing equipment at the Tanner Hill development [http://www.thetannerhill.hkhs.com]. Some countries such as the United Kingdom have websites managed by nongovernment organizations listing aids and equipment for different aspects of home living that are available and may be purchased online for home delivery. Computer programs used for ongoing rehabilitation may also be installed at home to allow earlier return home from hospitals, such as the upper limb movement-based computer training program using “able X” (Lam et al., 2018). Computer-assisted interventions using touch screen video game technology have also been used in older Chinese adults with mild-to-moderate dementia to improve cognitive function and behavioral symptoms (Yu et al., 2015). The development of robots to aid in home tasks as well as providing social interaction has been spearheaded by Japan, particularly for use in eldercare. The use of the baby-seal PARO is well known and used in many countries including Denmark, Canada, Italy, and the United States since 2003, particularly for dementia care. In 2009, it was certified by the Food and Drug Administration as a therapeutic device. Efficacy has been documented in various clinical trials in eliciting positive responses, improved moods, reduced depressive symptoms, and caregiver burden (Robinson et al., 2016; Mervin et al., 2018).
Real-time tracking of surgical instruments based on spatio-temporal context and deep learning
Published in Computer Assisted Surgery, 2019
Zijian Zhao, Zhaorui Chen, Sandrine Voros, Xiaolin Cheng
Detection and tracking of surgical instruments are crucial to computer-assisted interventions (CAIs) for minimally-invasive surgery (MIS) [1]. Recently, CAIs for MIS have attracted increasing attention, since they offer several advantages over traditional MIS. They can improve the accuracy of the location of surgical tools, enhance the control capabilities of the surgeons performing the procedures, and reduce the cost of human assistants; collectively, these advantages make surgery more efficient. CAI techniques can be divided into two categories: hardware-based and image-based solutions. Hardware-based solutions require modification to instrument design, which poses ergonomic challenges and additionally suffers from robustness issues due to line-of-sight requirements [2]. Therefore more and more CAI techniques are using image-based solutions. Most image-based solutions employ visual tracking algorithms, since CAI systems are endoscopically controlled to automatically track the instruments.
An automated optimization pipeline for clinical-grade computer-assisted planning of high tibial osteotomies under consideration of weight-bearing
Published in Computer Assisted Surgery, 2023
Tabitha Roth, Bastian Sigrist, Matthias Wieczorek, Nathanael Schilling, Sandro Hodel, Jonas Walker, Mario Somm, Wolfgang Wein, Reto Sutter, Lazaros Vlachopoulos, Jess G. Snedeker, Sandro F. Fucentese, Philipp Fürnstahl, Fabio Carrillo
Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure which aims to realign the lower limb to shift the load from the damaged medial compartment of the knee to the healthy lateral compartment in patients with symptomatic osteoarthritis (OA) associated with a genu varum deformity [1]. However, a precise anatomical correction is crucial since over- and undercorrection are known to be the main reasons for clinical failure [2,3]. For instance, unintended changes of the tibial slope (TS) [4] or tibial tuberosity can result in anteroposterior instability and increased strain on the cruciate ligaments [5–7] or alteration of patellofemoral tracking [8]. Strategic preoperative planning is thus a crucial element of clinical success. Traditionally, 2D long-leg standing radiographs are used, taking the mechanical axis (MA) as the most important parameter. For the past decades, the principles published by Paley et al. [9] have been widely used as the general guideline in this regard. With the emergence of modern computer-assisted techniques, 2D preoperative planning based on radiographs has gradually been replaced by methods using Computer Tomography (CT)-reconstructed 3D bone models. The latter not only provides the surgeon with the detailed patient anatomy, but also allows for preoperative 3D measurements [10] and treatment planning [11], biomechanical simulations [12] and the use of patient-specific instruments (PSI) [13]. Furthermore, 3D approaches enable computer-assisted interventions (CAI) based on navigation [14] or robotics [15]. However, state-of-the-art 3D preoperative planning has its shortcomings: although automatic planning approaches have been proposed [16], these still requires the manual generation of preoperative planning solutions by trained interdisciplinary teams [17,18], which makes the entire process expensive and time-consuming. Due to additional degrees of freedom (DoF) and added complexity in 3D, the planning process is not only tedious but also technically demanding. Therefore, the close collaboration of surgeons and engineers is required throughout the planning process to combine technical with clinical and surgical knowledge. The integration of the combined knowledge into computer algorithms is the main obstacle to overcome during the development of automated computer methods for preoperative planning; a compromise between automation and adaptability has to be found.