Navigation Assistance Research Articles

The coronal plane alignment of the knee classification does not correlate with the functional knee phenotype classification.

It is now well established that the coronal anatomy of the lower limb is highly variable both in non-arthritic subjects and subjects undergoing total knee arthroplasty (TKA). Two new classifications were recently described independently, but never compared: functional knee phenotypes classification and coronal plane alignment of the knee (CPAK) classification. The hypothesis of this study was that there was a significant difference between the values of the hip-knee-ankle angle (HKA) and the arithmetic hip-knee-ankle angle (aHKA) measures in the same patient at the time of TKA. Five hundred and twenty cases were randomly selected among patients operated on for a TKA with navigation assistance. Anatomical parameters were collected during surgery by a navigation system, and the corresponding data of the CPAK classification were calculated. The numerical values of measured HKA and aHKA in the same patient were compared. The measured HKA had a mean of 3.0° varus (standard deviation of 6.0°). The calculated aHKA had a mean of 1.8° varus (standard deviation 4.8°). There was a significant difference between the values of the two measurements in the same subject (p = 0.005) and a weak negative correlation between the values of the two measurements in the same subject. In addition, there was no relationship between HKA values and joint line obliquity values or CPAK class. A significant difference and a weak correlation between the values of the HKA and aHKA measures in the same subject were observed. The two analysis techniques used provide different information, and their correlation is only partial. These two techniques therefore appear to be complementary rather than exclusive. The clinical relevance of using these techniques during TKA remains unknown. III.

Indoor Signs Detection for Visually Impaired People: Navigation Assistance Based on a Lightweight Anchor-Free Object Detector.

Facilitating the navigation of visually impaired people in indoor environments requires detecting indicating signs and informing them. In this paper, we proposed an indoor sign detection based on a lightweight anchor-free object detection model called FAM-centerNet. The baseline model of this work is the centerNet, which is an anchor-free object detection model with high performance and low computation complexity. A Foreground Attention Module (FAM) was introduced to extract target objects in real scenes with complex backgrounds. This module segments the foreground to extract relevant features of the target object using midground proposal and boxes-induced segmentation. In addition, the foreground module provides scale information to improve the regression performance. Extensive experiments on two datasets prove the efficiency of the proposed model for detecting general objects and custom indoor signs. The Pascal VOC dataset was used to test the performance of the proposed model for detecting general objects, and a custom dataset was used for evaluating the performance in detecting indoor signs. The reported results have proved the efficiency of the proposed FAM in enhancing the performance of the baseline model.

Patients' Willingness to Accept Social Needs Navigation After In-Person versus Remote Screening.

Social needs screening and referral interventions are increasingly common in health care settings. Although remote screening offers a potentially more practical alternative to traditional in-person screening, there is concern that screening patients remotely could adversely affect patient engagement, including interest in accepting social needs navigation. We conducted a cross-sectional study using a multivariable logistic regression analysis and data from the Accountable Health Communities (AHC) model in Oregon. Participants were Medicare and Medicaid beneficiaries in the AHC model from October 2018 through December 2020. The outcome variable was patients' willingness to accept social needs navigation assistance. We included an interaction term (total number of social needs + screening mode) to test whether in-person versus remote screening was an effect modifier. The study included participants who screened positive for ≥1 social need(s); 43% were screened in person and 57% remotely. Overall, 71% of participants were willing to accept help with social needs. Neither screening mode nor interaction term were significantly associated with willingness to accept navigation assistance. Among patients presenting with similar numbers of social needs, results indicate that type of screening mode may not adversely affect patients' willingness to accept health care-based navigation for social needs.

Complications associated with subaxial placement of pedicle screws versus lateral mass screws in the cervical spine (C2-T1): systematic review and meta-analysis comprising 4,165 patients and 16,669 screws.

Lateral mass screw (LMS) and cervical pedicle screw (CPS) fixation are among the most popular techniques for posterior fusion of the cervical spine. Early research prioritized the LMS approach as the trajectory resulted in fewer neurovascular complications; however, with the incorporation of navigation assistance, the CPS approach should be re-evaluated. Our objective was to report the findings of a meta-analysis focused on comparing the LMS and CPS techniques in terms of rate of various complications with inclusion of all levels from C2 to T1. We conducted a systematic review of PubMed and EMBASE databases with final inclusion criteria focused on identifying studies that reported outcomes and complications for either the CPS or LMS technique. These studies were then pooled, and statistical analyses were performed from the cumulative data. A total of 60 studies comprising 4165 participants and 16,669 screws placed within the C2-T1 levels were identified. Within these studies, the LMS group had a significantly increased odds for lateral mass fractures (odds ratio [OR] = 43.2, 95% confidence interval [CI] = 2.62-711.42), additional cervical surgeries (OR = 5.56, 95%CI = 2.95-10.48), and surgical site infections (SSI) (OR = 5.47, 95%CI = 1.65-18.16). No other significant differences between groups in terms of complications were identified. Within the subgroup analysis of navigation versus non-navigation-guided CPS placement, no significant differences were identified for individual complications, although collectively significantly fewer complications occurred with navigation (OR = 5.29, 95%CI = 2.03-13.78). The CPS group had significantly fewer lateral mass fractures, cervical revision surgeries, and SSIs. Furthermore, navigation-assisted CPS placement was associated with a significant reduction in complications overall.

The S-BAN: Insights into the Perception of Shape-Changing Haptic Interfaces via Virtual Pedestrian Navigation

Screen-based pedestrian navigation assistance can be distracting or inaccessible to users. Shape-changing haptic interfaces can overcome these concerns. The S-BAN is a new handheld haptic interface that utilizes a parallel kinematic structure to deliver 2-DOF spatial information over a continuous workspace, with a form factor suited to integration with other travel aids. The ability to pivot, extend and retract its body opens possibilities and questions around spatial data representation. We present a static study to understand user perception of absolute pose and relative motion for two spatial mappings, showing the highest sensitivity to relative motions in the cardinal directions. We then present an embodied navigation experiment in virtual reality (VR). User motion efficiency when guided by the S-BAN was statistically equivalent to using a vision-based tool (a smartphone proxy). Although haptic trials were slower than visual trials, participants’ heads were more elevated with the S-BAN, allowing greater visual focus on the environment.

Scene Recognition for Visually-Impaired People’s Navigation Assistance Based on Vision Transformer with Dual Multiscale Attention

Notable progress was achieved by recent technologies. As the main goal of technology is to make daily life easier, we will investigate the development of an intelligent system for the assistance of impaired people in their navigation. For visually impaired people, navigating is a very complex task that requires assistance. To reduce the complexity of this task, it is preferred to provide information that allows the understanding of surrounding spaces. Particularly, recognizing indoor scenes such as a room, supermarket, or office provides a valuable guide to the visually impaired person to understand the surrounding environment. In this paper, we proposed an indoor scene recognition system based on recent deep learning techniques. Vision transformer (ViT) is a recent deep learning technique that has achieved high performance on image classification. So, it was deployed for indoor scene recognition. To achieve better performance and to reduce the computation complexity, we proposed dual multiscale attention to collect features at different scales for better representation. The main idea was to process small patches and large patches separately and a fusion technique was proposed to combine the features. The proposed fusion technique requires linear time for memory and computation compared to existing techniques that require quadratic time. To prove the efficiency of the proposed technique, extensive experiments were performed on a public dataset which is the MIT67 dataset. The achieved results demonstrated the superiority of the proposed technique compared to the state-of-the-art. Further, the proposed indoor scene recognition system is suitable for implementation on mobile devices with fewer parameters and FLOPs.

Unsung heroes in health education and promotion: How Community Health Workers contribute to hypertension management.

Rural communities are noted as having poor health outcomes. Rural areas experience barriers to care primarily due to a lack of resources, including education, health insurance, transportation, and social support. Additionally, poor health outcomes are a consequence of poor health literacy skills. Community Health Workers (CHWs) are utilized as a resource to combat these issues. This study focused on a CHW led Self-Management Blood Pressure (SMBP) program offered through the University of Texas at Tyler Health Science Center. The goal of the program was to improve management of hypertension through awareness, education, navigation, advocacy, and resource assistance. The SMBP program included structured workshops and regular follow-up with participants including connections to community resources and social support. CHWs worked closely with physicians providing bi-directional feedback on referrals and engagement of communities through outreach events. Furthermore, CHWs aided to bridge cultural or linguistic gaps between service providers and community members. Data is provided indicating this CHW-led intervention played a significant role in improving hypertension through education of how to make lifestyle changes that impact overall health and quality of life. Participants gained knowledge encouraging them to create lifelong healthy habits, coping skills, stress management, self-care, and accountability. Through this innovative approach, participants thrived in the supportive and encouraging environment led by CHWs as well as improved their blood pressure management.

Smart Blind Stick using IOT

Abstract: People suffering from certain permanent Accidental, paralyzing, or aging-related movement abilities frequently require assistance from others. In order to provide navigation assistance. We aim on integrating a smart blind stick with features like voice recognition technology to give voice commands and head- tilting which will control the motion of the blind stick. It also has some additional features such as fire sensors, water sensors, light sensors with buzzer alert and Ultrasonic sensor for obstacle detection. The result of this design will allow the special people to live a life with less dependence on others.

Free Choice Navigation in the Real World: Giving Back Freedom to Wayfinders

In recent years, there has been collected evidence suggesting that increased usage of navigation assistance systems has a harmful effect on spatial cognition, including spatial knowledge acquisition. Previously, we proposed a potential remedy called Free Choice Navigation (simulation study). This novel navigation approach aims to provide the user with more freedom while navigating, and simultaneously give fewer navigation instructions. This approach also aims at increasing engagement with the environment and fostering spatial knowledge acquisition. We conducted a human-subject study with 48 participants comparing Free Choice Navigation with the widespread Turn-by-Turn approach on the outskirts of Vienna, Austria. The study showed the viability of our navigation system in real urban environments, providing fewer navigation instructions compared to the Turn-by-Turn approach (relative to the number of traversed junctions). Fewer instructions and forced engagement with the environment, however, did not result in differences concerning spatial knowledge acquisition, but interestingly, Free Choice Navigation users (without a map) could extract spatial configuration information similarly well as Turn-by-Turn users having a map. Moreover, we provide evidence that people are interested in learning more about their environments and are willing to walk longer routes to achieve it.

Computer-Aided Design and Computer-Aided Modeling (CAD/CAM) for Guiding Dental Implant Surgery: Personal Reflection Based on 10 Years of Real-Life Experience.

Traditional dental implant surgery has been challenged by the phenomenal progression in computer-assisted surgery (CAS) that we have been witnessing in recent years. Among the computer-aided technologies, computer-aided design and computer-aided manufacturing (CAD/CAM) techniques represent by far the most attractive and accepted alternatives over their dynamic counterpart, navigational assistance. Based on many years of experience, we have determined that CAD/CAM technology for guiding dental implant surgery is valuable for rehabilitation of the anterior maxillary region and the management of complete or severe partial edentulism. The technology also guarantees the 3D parallelism of implants. The purpose of the present report is to describe indications for use of CAD/CAM dental implant guided surgery. We analyzed the clinical and radiological data of thirteen consecutive edentulous patients treated using CAD/CAM techniques. All of the patients had stable cosmetic results with a high rate of patient satisfaction at the final follow-up examination. No intra- and/or postoperative complications were encountered during any of the steps of the procedure. The application of CAD/CAM techniques produced successful outcomes in the patients presented in this series.

A Novel Method to Achieve Preferable Bone-to-Implant Contact Area of Zygomatic Implants in Rehabilitation of Severely Atrophied Maxilla.

Purpose: To propose and evaluate a novel method for achieving a favorable bone-to-implant contact (BIC) area for zygomatic implants (ZIs). Materials and Methods: Patients who needed ZIs to restore a severely atrophied maxilla were recruited. In preoperative virtual planning, an algorithm was utilized to find the ZI trajectory that would achieve the largest BIC area with a predefined entry point on the alveolar ridge. The surgery was conducted according to the preoperative plan with the assistance of real-time navigation. Area BIC (A-BIC), linear BIC (L-BIC), distance from implant to infraorbital margin (DIO), distance from implant to infratemporal fossa (DIT), implant exit section, and deviation of the real-time navigated surgery were measured and compared between the preoperative plan and the placed ZIs. The patients were followed up for 6 months. Results: Overall, 11 patients with 21 ZIs were included. The A-BICs and L-BICs were significantly higher in the preoperative plan than in the placed implants (P < .05). Meanwhile, there were no significant differences in DIO or DIT. The planned-placed deviation was 2.31 ± 1.26 mm for the entry, 3.41 ± 1.77 mm for the exit, and 3.06 ± 1.68 degrees for the angle. All ZIs survived to the 6-month follow-up. Conclusion: This novel method can virtually calculate the trajectory of ZIs and transfer the preoperative plan to surgery to acquire a favorable BIC area. The actual positions of placed ZIs were slightly deviated from the ideal due to navigation errors.

Multi-Sensory Visual-Auditory Fusion of Wearable Navigation Assistance for People With Impaired Vision

Multi-Sensory Visual-Auditory Fusion of Wearable Navigation Assistance for People With Impaired Vision

Advancing Accessibility: An Artificial Intelligence Framework for Obstacle Detection and Navigation Assistance for the Visually Impaired

The white cane has long been a fundamental tool for individuals with visual impairments, aiding in surface detection and obstacle identification. However, its limitations in detecting moving objects and distant obstacles pose significant safety risks, particularly in congested areas and busy streets. While service animals offer an alternative, they come with training challenges and high costs. To address these limitations and enhance safety, this paper proposes a comprehensive collision detection and prevention system. The proposed system integrates cutting-edge technologies, including image processing, deep learning, Internet of Things (IoT), cloud computing, and audio production devices. By combining these technologies with the white cane, the system offers a sophisticated navigation option for the visually impaired, effectively detecting and preventing potential collisions. In busy environtment scenarios, the system proves its effectiveness by complementing the white cane's use, overcoming its inherent limitations, and significantly improving navigation capabilities. Through this innovative approach, blind individuals gain enhanced situational awareness, empowering them to navigate diverse environments with increased confidence and safety. By mitigating the drawbacks of the white cane, the proposed system provides a comprehensive and cost-effective solution to enhance the mobility and safety of the visually impaired. This research contributes to the advancement of assistive technologies, offering a valuable resource for researchers, policymakers, and practitioners in the field of accessibility and inclusive design.

Real-Time Passable Area Segmentation With Consumer RGB-D Cameras for the Visually Impaired

Passable area segmentation is an essential component of navigation assistance for the visually impaired people. Pixel-wise semantic segmentation of RGB images can be advanced by exploiting informative features from depth modality. Simple fusion, however, may not lead to satisfactory results as actual depth data are generally noisy, which may worsen the accuracy as the networks go deeper. In this paper, we construct a wearable system with a novel Lightweight Multi-Modality Collaborative Network (LM-MCN), which is performing real-time passable area segmentation to assist people walking alone more safely. Firstly, a normal map estimation (NME) module, which can convert dense depth to a normal map with high accuracy and efficiency, is introduced. Moreover, we propose a multi-modality feature fusion module (M-MFFM), which can recalibrate and fuse the features from both RGB images and the inferred depth information for accurate passable area segmentation. Furthermore, we publish a new passable area segmentation dataset, named SensingAI-Easy-to-Walk (SETW), collected from sidewalk views in urban areas. Extensive experiments demonstrate that depth information is more appealing since it provides a geometric counterpart to the RGB representation. In addition, the experimental results report our method achieves a 96.50% MaxF with real-time inference speed of 50 FPS for KITTI road, which demonstrates the validity and superiority of LM-MCN.

The Swedish policy lab for maritime autonomous surface ships

The Swedish policy lab for maritime autonomous surface ships, or smart ships, explored three use cases for developing policy in practice. The policies regard smart ships on national waters: one short-term written policy identifying the next shared step for two authorities to position remote navigational assistance as a new service, giving the maritime ecosystem one official position to relate to; one informal policy relying on a mutual trust, where information sharing between an operator of small, unmanned ships and the supervisory authority enables critical competence building; and one evolving policy on the process of certifying autonomous or remote operated functions using non-standardized technology. In conclusion, despite shipping being explicitly regulated internationally we found that there is substantial leeway for national policies regarding smart ships on national waters.

Mechanisms to expedite pediatric clinical trial site activation: The DOSE trial experience

BackgroundTimely trial start-up is a key determinant of trial success; however, delays during start-up are common and costly. Moreover, data on start-up metrics in pediatric clinical trials are sparse. To expedite trial start-up, the Trial Innovation Network piloted three novel mechanisms in the trial titled Dexmedetomidine Opioid Sparing Effect in Mechanically Ventilated Children (DOSE), a multi-site, randomized, double-blind, placebo-controlled trial in the pediatric intensive care setting. MethodsThe three novel start-up mechanisms included: 1) competitive activation; 2) use of trial start-up experts, called site navigators; and 3) supplemental funds earned for achieving pre-determined milestones. After sites were activated, they received a web-based survey to report perceptions of the DOSE start-up process. In addition to perceptions, metrics analyzed included milestones met, time to start-up, and subsequent enrollment of subjects. ResultsTwenty sites were selected for participation, with 19 sites being fully activated. Across activated sites, the median (quartile 1, quartile 3) time from receipt of regulatory documents to site activation was 82 days (68, 113). Sites reported that of the three novel mechanisms, the most motivating factor for expeditious activation was additional funding available for achieving start-up milestones, followed by site navigator assistance and then competitive site activation. ConclusionStudy start-up is a critical time for the success of clinical trials, and innovative methods to minimize delays during start-up are needed. Milestone-based funds and site navigators were preferred mechanisms by sites participating in the DOSE study and may have contributed to the expeditious start-up timeline achieved.ClinicalTrials.gov #: NCT03938857

DC Mental Health Access in Pediatrics: Evaluating a Child Psychiatry Access Program in Washington, DC

Child psychiatry access programs (CPAPs) provide primary care providers (PCPs) with assistance in mental health diagnosis, management, and resource navigation. Data collected from DC Mental Health Access in Pediatrics (MAP) included PCPs and patient demographics, clinical encounter information, and provider satisfaction. DC MAP consult volume increased 349.3% over the first 5 years. Services requested included care coordination (85.8%), psychiatric consultation (21.4%), and psychology/social work consultation (9.9%). Of psychiatry-involved consultations, PCPs managed patient medication care with DC MAP support 50.5% of the time. Most (94.1%) PCPs said they would recommend colleagues use DC MAP, and 29.6% reported diverting patients from the emergency departments using DC MAP. DC MAP grew quickly, highlighting program impact and need. Demand for care coordination required flexible staffing and highlighted the need for coordination in pediatrics. Child psychiatry access programs offer an innovative way to enhance PCP management of their patients' mental health needs.

Traffic Organization Service for Maritime Autonomous Surface Ships (MASS) with Different Degrees of Autonomy

Maritime Autonomous Surface Ships (MASS) have been an important direction for the development of intelligent shipping. However, most current international research on MASS focuses on navigation assistance technologies such as perception and decision-making, ignoring MASS’s traffic organization and management. The traffic organization service (TOS) under the e-Navigation strategy also has not researched MASS. In this paper, we propose the notion of on-demand service to MASS with different degrees of autonomy (DoA) and develop a new maritime service (MS) applicable to the MASS with various (DoA) following the e-Navigation technical architecture. We first analyze MASS requirements with different degrees of autonomy in traffic organization to define the service information. Then, based on the traditional TOS, we developed the MASS traffic organization service (MTOS), consisting of an operational architecture, five subsystems, and four services. In particular, we proposed a phased service trigger mechanism to solve the problem of publishing untimely and redundant service information. Tianjin port and Huanghua port were selected as cases study for simulation experiments; the study finding revealed that MTOS could provide standardized, accurate, and efficient traffic organization service for MASS with different degrees of autonomy on demand. The contribution can be applied in the port operation to improve traffic safety.

Addressing Financial Barriers to Health Care Among People Who are Low-Income and Insured in New York City, 2014–2017

While health care-associated financial burdens among uninsured individuals are well described, few studies have systematically characterized the array of financial and logistical complications faced by insured individuals with low household incomes. In this mixed methods paper, we conducted 6 focus groups with a total of 55 residents and analyzed programmatic administrative records to characterize the specific financial and logistic barriers faced by residents living in public housing in East and Central Harlem, New York City (NYC). Participants included individuals who enrolled in a municipal community health worker (CHW) program designed to close equity gaps in health and social outcomes. Dedicated health advocates (HAs) were explicitly paired with CHWs to provide health insurance and health care navigational assistance. We describe the needs of 150 residents with reported financial barriers to care, as well as the navigational and advocacy strategies taken by HAs to address them. Finally, we outline state-level policy recommendations to help ameliorate the problems experienced by participants. The model of paired CHW–HAs may be helpful in addressing financial barriers for insured populations with low household income and reducing health disparities in other communities.

Advanced surgical tool: Progress in clinical application of intelligent surgical robot.

Surgical robot is a revolutionary tool conceived in the progress of clinical medicine, computer science, microelectronics and biomechanics. It provides the surgeon with clearer views and more comfortable surgical postures. With the assistance of computer navigation during delicate operations, it can further shorten the patient recovery time via reducing intraoperative bleeding, the risk of infection and the amount of anesthesia needed. As a comprehensive surgical revolution, surgical robot technique has a wide range of applications in related fields. This paper reviews the development status and operation principles of these surgical robots. At the same time, we also describe their up-to-date applications in different specialties and discusses the prospects and challenges of surgical robots in the medical area.