Notes

Individual-focused occupational health treatments: Any meta-analysis of randomized controlled tests.
Estimating the forces acting between instruments and tissue is a challenging problem for robot-assisted minimally-invasive surgery. Recently, numerous vision-based methods have been proposed to replace electro-mechanical approaches. Moreover, optical coherence tomography (OCT) and deep learning have been used for estimating forces based on deformation observed in volumetric image data. The method demonstrated the advantage of deep learning with 3D volumetric data over 2D depth images for force estimation. In this work, we extend the problem of deep learning-based force estimation to 4D spatio-temporal data with streams of 3D OCT volumes. For this purpose, we design and evaluate several methods extending spatio-temporal deep learning to 4D which is largely unexplored so far. Furthermore, we provide an in-depth analysis of multi-dimensional image data representations for force estimation, comparing our 4D approach to previous, lower-dimensional methods. Also, we analyze the effect of temporal information and we study the prediction of short-term future force values, which could facilitate safety features. For our 4D force estimation architectures, we find that efficient decoupling of spatial and temporal processing is advantageous. We show that using 4D spatio-temporal data outperforms all previously used data representations with a mean absolute error of 10.7 mN. We find that temporal information is valuable for force estimation and we demonstrate the feasibility of force prediction.Unsupervised lesion detection is a challenging problem that requires accurately estimating normative distributions of healthy anatomy and detecting lesions as outliers without training examples. Recently, this problem has received increased attention from the research community following the advances in unsupervised learning with deep learning. Such advances allow the estimation of high-dimensional distributions, such as normative distributions, with higher accuracy than previous methods. The main approach of the recently proposed methods is to learn a latent-variable model parameterized with networks to approximate the normative distribution using example images showing healthy anatomy, perform prior-projection, i.e. reconstruct the image with lesions using the latent-variable model, and determine lesions based on the differences between the reconstructed and original images. While being promising, the prior-projection step often leads to a large number of false positives. In this work, we approach unsupervised lesion detection as an image restoration problem and propose a probabilistic model that uses a network-based prior as the normative distribution and detect lesions pixel-wise using MAP estimation. The probabilistic model punishes large deviations between restored and original images, reducing false positives in pixel-wise detections. Experiments with gliomas and stroke lesions in brain MRI using publicly available datasets show that the proposed approach outperforms the state-of-the-art unsupervised methods by a substantial margin, +0.13 (AUC), for both glioma and stroke detection. Extensive model analysis confirms the effectiveness of MAP-based image restoration.Skin lesion segmentation from dermoscopy images is a fundamental yet challenging task in the computer-aided skin diagnosis system due to the large variations in terms of their views and scales of lesion areas. We propose a novel and effective generative adversarial network (GAN) to meet these challenges. Specifically, this network architecture integrates two modules a skip connection and dense convolution U-Net (UNet-SCDC) based segmentation module and a dual discrimination (DD) module. While the UNet-SCDC module uses dense dilated convolution blocks to generate a deep representation that preserves fine-grained information, the DD module makes use of two discriminators to jointly decide whether the input of the discriminators is real or fake. While one discriminator, with a traditional adversarial loss, focuses on the differences at the boundaries of the generated segmentation masks and the ground truths, the other examines the contextual environment of target object in the original image using a conditional discriminative loss. We integrate these two modules and train the proposed GAN in an end-to-end manner. The proposed GAN is evaluated on the public International Skin Imaging Collaboration (ISIC) Skin Lesion Challenge Datasets of 2017 and 2018. Extensive experimental results demonstrate that the proposed network achieves superior segmentation performance to state-of-the-art methods.Objective Goals of care discussions are crucial in helping parents navigate complex medical decisions and shown to improve quality of care. Little is known about whether physicians elicit or address parents' goals during a child's hospitalization. The purpose of this study was to understand the current practice of goal setting at the beginning of hospitalization by exploring the perspectives of parents of hospitalized children and their hospital physicians. Methods A qualitative study with semi-structured interviews was conducted from 2018 to 2019 at a 361-bed quaternary suburban freestanding children's hospital. Carfilzomib molecular weight Twenty-seven parents of hospitalized children and sixteen pediatric hospital medicine faculty were matched to participate. Data was analyzed using modified grounded theory, with themes identified through constant comparative approach. Results Five themes were identified 1) Majority of hospitalized children's parents want to share their goals with physicians. 2) Parents and physicians share the same underlying goal of getting the child better to go home. 3) Parents of children with chronic diseases identified non-hospital goals that were not addressed. 4) Physicians do not explicitly elicit but rather assume what parents' goals of care are. 5) Factors related to patient, parent, and physician were identified as barriers to goal setting. Conclusions Physicians may not consistently elicit parents' goals of care for their hospitalized children at the start of hospitalization. Parents desire their physicians to explicitly ask about their goals and involve them in goal setting during hospitalization. Strategies were identified by parents and physicians to improve goal setting with parents of hospitalized children.
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