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1.
Front Neurorobot ; 15: 749024, 2021.
Article in English | MEDLINE | ID: covidwho-1477842

ABSTRACT

Spinal cord stimulation (SCS) is an established treatment for refractory pain syndromes and has recently been applied to improve locomotion. Several technical challenges are faced by surgeons during SCS lead implantation, particularly in the confined dorsal epidural spaces in patients with spinal degenerative disease, scarring and while targeting challenging structures such as the dorsal root ganglion. Magnetic navigation systems (MNS) represent a novel technology that uses externally placed magnets to precisely steer tethered and untethered devices. This innovation offers several benefits for SCS electrode placement, including enhanced navigation control during tip placement, and the ability to position and reposition the lead in an outpatient setting. Here, we describe the challenges of SCS implant surgery and how MNS can be used to overcome these hurdles. In addition to tethered electrode steering, we discuss the navigation of untethered micro- and nanorobots for wireless and remote neuromodulation. The use of these small-scale devices can potentially change the current standard of practice by omitting the need for electrode and pulse generator implantation or replacement. Open questions include whether small-scale robots can generate an electrical field sufficient to activate neuronal tissue, as well as testing precise navigation, placement, anchoring, and biodegradation of micro- and nanorobots in the in vivo environment.

2.
Front Robot AI ; 8: 652685, 2021.
Article in English | MEDLINE | ID: covidwho-1266693

ABSTRACT

The Coronavirus disease 2019 (Covid-19) pandemic has brought the world to a standstill. Healthcare systems are critical to maintain during pandemics, however, providing service to sick patients has posed a hazard to frontline healthcare workers (HCW) and particularly those caring for elderly patients. Various approaches are investigated to improve safety for HCW and patients. One promising avenue is the use of robots. Here, we model infectious spread based on real spatio-temporal precise personal interactions from a geriatric unit and test different scenarios of robotic integration. We find a significant mitigation of contamination rates when robots specifically replace a moderate fraction of high-risk healthcare workers, who have a high number of contacts with patients and other HCW. While the impact of robotic integration is significant across a range of reproductive number R0, the largest effect is seen when R0 is slightly above its critical value. Our analysis suggests that a moderate-sized robotic integration can represent an effective measure to significantly reduce the spread of pathogens with Covid-19 transmission characteristics in a small hospital unit.

3.
Interdiscip Neurosurg ; 22: 100878, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-709592

ABSTRACT

COVID-19 patients are increasingly understood to develop multisystem manifestations, including neurologic involvement. We report the case of a 42-year old COVID-19 positive patient with a fatal intracerebral hemorrhage (ICH). The patient presented with fever and dyspnea, requiring intubation due to medical complications. After prolonged sedation and anticoagulation, the patient suddenly developed bilaterally fixed and dilated pupils, caused by a right-sided intracranial hemorrhage with uncal herniation. The course of this case illustrates the delicate balance between hypercoagulability and coagulation factor depletion; especially in the intubated and sedated patient, in whom regular neurological assessments are impeded. As we expand our understanding of the neurological ramifications of COVID-19, clinicians need to be increasingly aware of the precarious coagulation balance.

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