The detection of amplitude modulation (AM) of a carrier can be impaired by additional (masker) AM applied to the same carrier (within-carrier modulation masking, MM) or to a different carrier (across-carrier MM). These two types of MM were compared for young normal-hearing and older hearing-impaired subjects. The signal was 4- or 16-Hz sinusoidal AM of a 4000-Hz carrier. Masker AM with depth 0.4 was applied either to the same carrier or to a carrier at 3179 or 2518 Hz. The masker AM rate was 0.25, 0.5, 1, 2, or 4 times the signal rate. The signal AM depth was varied adaptively to determine the threshold. Both within-carrier and across-carrier MM patterns were similar for the two groups, suggesting that the hypothetical modulation filters are not affected by hearing loss or age. The signal AM detection thresholds were also similar for the two groups. Thresholds in the absence of masker AM were lower (better) for the older hearing-impaired than for the young normal-hearing subjects. Since the masked modulation thresholds were similar for the two groups, it seems unlikely that abnormal MM contributes to the difficulties experienced by older hearing-impaired people in understanding speech in background sounds.
BackgroundRobotically performed neurointerventional surgery has the potential to reduce occupational hazards to staff, perform intervention with greater precision, and could be a viable solution for teleoperated neurointerventional procedures.ObjectiveTo determine the indication, robotic systems used, efficacy, safety, and the degree of manual assistance required for robotically performed neurointervention.MethodsWe conducted a systematic review of the literature up to, and including, articles published on April 12, 2021. Medline, PubMed, Embase, and Cochrane register databases were searched using medical subject heading terms to identify reports of robotically performed neurointervention, including diagnostic cerebral angiography and carotid artery intervention.ResultsA total of 8 articles treating 81 patients were included. Only one case report used a robotic system for intracranial intervention, the remaining indications being cerebral angiography and carotid artery intervention. Only one study performed a comparison of robotic and manual procedures. Across all studies, the technical success rate was 96% and the clinical success rate was 100%. All cases required a degree of manual assistance. No studies had clearly defined patient selection criteria, reference standards, or index tests, preventing meaningful statistical analysis.ConclusionsGiven the clinical success, it is plausible that robotically performed neurointerventional procedures will eventually benefit patients and reduce occupational hazards for staff; however, there is no high-level efficacy and safety evidence to support this assertion. Limitations of current robotic systems and the challenges that must be overcome to realize the potential for remote teleoperated neurointervention require further investigation.
The Woven Endobridge (WEB; Microvention, Aliso Viejo, California, USA) is a relatively new device which has been shown to be safe and effective for the treatment of wide necked bifurcation aneurysms in multiple prospective Good Clinical Practice studies. However, the vast majority of aneurysms included in these studies have been unruptured. The aim of this review is to summarise the current evidence available on the treatment of ruptured aneurysms with the WEB.
Purpose The use of robotics is emerging for performing interventional radiology procedures. Robots in interventional radiology are typically controlled using button presses and joystick movements. This study identified how different human–robot interfaces affect endovascular surgical performance using interventional radiology simulations. Methods Nine participants performed a navigation task on an interventional radiology simulator with three different human–computer interfaces. Using Simulation Open Framework Architecture we developed a simulation profile of vessels, catheters and guidewires. We designed and manufactured a bespoke haptic interventional radiology controller for robotic systems to control the simulation. Metrics including time taken for navigation, number of incorrect catheterisations, number of catheter and guidewire prolapses and forces applied to vessel walls were measured and used to characterise the interfaces. Finally, participants responded to a questionnaire to evaluate the perception of the controllers. Results Time taken for navigation, number of incorrect catheterisations and the number of catheter and guidewire prolapses, showed that the device-mimicking controller is better suited for controlling interventional neuroradiology procedures over joystick control approaches. Qualitative metrics also showed that interventional radiologists prefer a device-mimicking controller approach over a joystick approach. Conclusion Of the four metrics used to compare and contrast the human–robot interfaces, three conclusively showed that a device-mimicking controller was better suited for controlling interventional neuroradiology robotics.
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