RESUMO
The performance of deep learning-based detection methods has made them an attractive option for robotic perception. However, their training typically requires large volumes of data containing all the various situations the robots may potentially encounter during their routine operation. Thus, the workforce required for data collection and annotation is a significant bottleneck when deploying robots in the real world. This applies especially to outdoor deployments, where robots have to face various adverse weather conditions. We present a method that allows an independent car tansporter to train its neural networks for vehicle detection without human supervision or annotation. We provide the robot with a hand-coded algorithm for detecting cars in LiDAR scans in favourable weather conditions and complement this algorithm with a tracking method and a weather simulator. As the robot traverses its environment, it can collect data samples, which can be subsequently processed into training samples for the neural networks. As the tracking method is applied offline, it can exploit the detections made both before the currently processed scan and any subsequent future detections of the current scene, meaning the quality of annotations is in excess of those of the raw detections. Along with the acquisition of the labels, the weather simulator is able to alter the raw sensory data, which are then fed into the neural network together with the labels. We show how this pipeline, being run in an offline fashion, can exploit off-the-shelf weather simulation for the auto-labelling training scheme in a simulator-in-the-loop manner. We show how such a framework produces an effective detector and how the weather simulator-in-the-loop is beneficial for the robustness of the detector. Thus, our automatic data annotation pipeline significantly reduces not only the data annotation but also the data collection effort. This allows the integration of deep learning algorithms into existing robotic systems without the need for tedious data annotation and collection in all possible situations. Moreover, the method provides annotated datasets that can be used to develop other methods. To promote the reproducibility of our research, we provide our datasets, codes and models online.
Assuntos
Algoritmos , Redes Neurais de Computação , Humanos , Reprodutibilidade dos Testes , Simulação por Computador , Tempo (Meteorologia)RESUMO
Despite the advances in mobile robotics, the introduction of autonomous robots in human-populated environments is rather slow. One of the fundamental reasons is the acceptance of robots by people directly affected by a robot's presence. Understanding human behavior and dynamics is essential for planning when and how robots should traverse busy environments without disrupting people's natural motion and causing irritation. Research has exploited various techniques to build spatio-temporal representations of people's presence and flows and compared their applicability to plan optimal paths in the future. Many comparisons of how dynamic map-building techniques show how one method compares on a dataset versus another, but without consistent datasets and high-quality comparison metrics, it is difficult to assess how these various methods compare as a whole and in specific tasks. This article proposes a methodology for creating high-quality criteria with interpretable results for comparing long-term spatio-temporal representations for human-aware path planning and human-aware navigation scheduling. Two criteria derived from the methodology are then applied to compare the representations built by the techniques found in the literature. The approaches are compared on a real-world, long-term dataset, and the conception is validated in a field experiment on a robotic platform deployed in a human-populated environment. Our results indicate that continuous spatio-temporal methods independently modeling spatial and temporal phenomena outperformed other modeling approaches. Our results provide a baseline for future work to compare a wide range of methods employed for long-term navigation and provide researchers with an understanding of how these various methods compare in various scenarios.
RESUMO
The performance of deep neural networks and the low costs of computational hardware has made computer vision a popular choice in many robotic systems. An attractive feature of deep-learned methods is their ability to cope with appearance changes caused by day-night cycles and seasonal variations. However, deep learning of neural networks typically relies on large numbers of hand-annotated images, which requires significant effort for data collection and annotation. We present a method that allows autonomous, self-supervised training of a neural network in visual teach-and-repeat (VT&R) tasks, where a mobile robot has to traverse a previously taught path repeatedly. Our method is based on a fusion of two image registration schemes: one based on a Siamese neural network and another on point-feature matching. As the robot traverses the taught paths, it uses the results of feature-based matching to train the neural network, which, in turn, provides coarse registration estimates to the feature matcher. We show that as the neural network gets trained, the accuracy and robustness of the navigation increases, making the robot capable of dealing with significant changes in the environment. This method can significantly reduce the data annotation efforts when designing new robotic systems or introducing robots into new environments. Moreover, the method provides annotated datasets that can be deployed in other navigation systems. To promote the reproducibility of the research presented herein, we provide our datasets, codes and trained models online.
Assuntos
Mãos , Redes Neurais de Computação , Curadoria de Dados , Reprodutibilidade dos Testes , Projetos de PesquisaRESUMO
Visual teach and repeat navigation (VT&R) is popular in robotics thanks to its simplicity and versatility. It enables mobile robots equipped with a camera to traverse learned paths without the need to create globally consistent metric maps. Although teach and repeat frameworks have been reported to be relatively robust to changing environments, they still struggle with day-to-night and seasonal changes. This paper aims to find the horizontal displacement between prerecorded and currently perceived images required to steer a robot towards the previously traversed path. We employ a fully convolutional neural network to obtain dense representations of the images that are robust to changes in the environment and variations in illumination. The proposed model achieves state-of-the-art performance on multiple datasets with seasonal and day/night variations. In addition, our experiments show that it is possible to use the model to generate additional training examples that can be used to further improve the original model's robustness. We also conducted a real-world experiment on a mobile robot to demonstrate the suitability of our method for VT&R.
Assuntos
Redes Neurais de Computação , Robótica , Robótica/métodosRESUMO
Requests for plastic surgery procedures that alter one's body image are on the rise. To ensure the best possible outcome, patients who request a combined procedure (eg, abdominoplasty and liposuction) must meet certain criteria to be eligible for surgery. It is critically important for patients to understand that these surgeries are not weight-reduction procedures, and they must be prepared to make lifestyle changes to ensure long-lasting results. These procedures are performed in a variety of facilities (eg, surgeons' offices, surgery centers, hospitals). Perioperative nurses must have a basic knowledge and understanding of abdominoplasty and liposuction and the special requirements and potential complications involved with these procedures.
Assuntos
Abdome/cirurgia , Lipectomia/métodos , Obesidade/cirurgia , Enfermagem de Centro Cirúrgico/métodos , Imagem Corporal , Humanos , Estilo de Vida , Lipectomia/efeitos adversos , Lipectomia/enfermagem , Avaliação em Enfermagem , Registros de Enfermagem , Obesidade/enfermagem , Obesidade/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Educação de Pacientes como Assunto , Seleção de Pacientes , Assistência Perioperatória/métodos , Assistência Perioperatória/enfermagem , Pré-Medicação/métodos , Pré-Medicação/enfermagem , Terapia por Ultrassom/métodos , Terapia por Ultrassom/enfermagem , Agentes Molhantes/uso terapêuticoRESUMO
BACKGROUND: Safety in office-based surgery remains of paramount importance. Accordingly, many consider Advanced Cardiac Life Support training a critical component of safety preparation for office-based surgery. A survey was recently designed and distributed to assess the experience and attitudes of board-certified plastic surgeons toward Advanced Cardiac Life Support training. METHODS: A two-page, 14-question survey was mailed to the 4581 members of the American Society of Plastic Surgeons. The anonymous survey consisted of multiple choice questions eliciting status of Advanced Cardiac Life Support certification, use of office-based surgery, experience with adverse cardiac and respiratory events, and opinions on mandating Advanced Cardiac Life Support training. RESULTS: The total number of surveys returned was 1461 (32 percent). Current Basic Life Support and Advanced Cardiac Life Support certification was 65.6 percent and 44.9 percent, respectively. Over the past 10 years, 29 percent of plastic surgeons participated in a cardiac or respiratory arrest, and 43.9 percent of these surgeons acted as the code leader; 60.2 percent of plastic surgeons felt Advanced Cardiac Life Support certification should be required, but only 26 percent of these felt it should be mandated to maintain board certification. CONCLUSIONS: Historically, Advanced Cardiac Life Support and facility accreditation were strongly recommended but often not required for office-based surgery. The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery have taken steps to increase patient safety, mandating that outpatient plastic surgery only be performed at accredited facilities. Many credentialing organizations are now escalating the requirements for Advanced Cardiac Life Support/Basic Life Support certification.
Assuntos
Suporte Vital Cardíaco Avançado/educação , Suporte Vital Cardíaco Avançado/normas , Procedimentos Cirúrgicos Ambulatórios/normas , Certificação/normas , Cirurgia Plástica/normas , Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Certificação/estatística & dados numéricos , Pesquisas sobre Atenção à Saúde , Humanos , Segurança , Cirurgia Plástica/efeitos adversos , Estados UnidosRESUMO
The legal system depends on the medical expert for evidence. Doctors readily complain about frivolous cases that go to trial, yet a lawyer cannot bring a frivolous claim to trial without a physician expert witness stating that the claim is not frivolous. An insurance company cannot raise premiums without medical expert witnesses servicing the increasing litigation against the insured. Physicians must look to themselves as a major contributor to rising malpractice insurance costs. For without the physician expert witness, no medical malpractice lawsuit can take place. It is the expert physician, not the attorneys or insurance companies, who defines "meritless" and "frivolous" and who ultimately controls the courts' medical malpractice caseload.
Assuntos
Prova Pericial/tendências , Imperícia , Papel do Médico , Prova Pericial/economia , Prova Pericial/legislação & jurisprudência , Prova Pericial/normas , Honorários e Preços , Humanos , Seguro de Responsabilidade Civil/economia , Licenciamento em Medicina/normas , Imperícia/economia , Imperícia/legislação & jurisprudência , Imperícia/tendências , Motivação , Assistência ao Paciente/economia , Governo Estadual , Estados UnidosRESUMO
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Explain what governmental regulations control the labeling and distribution of herbal supplements. 2. List the more commonly used supplements and their reported benefits. 3. List the possible postoperative complications from consumption of the more commonly used herbal supplements. 4. Explain the preoperative management of patients using herbal supplements. 5. Know additional resources to consult when unanswered questions arise. BACKGROUND: The American public spends over $5 billion per year on herbal supplements, and approximately 20 percent of all Americans use prescription medications concurrently with herbal supplements. As the number of people who take alternative medicines rises, there is growing awareness among health care providers of the need to become educated and to educate their patients on the effects that such supplementation may have on their health. As plastic surgeons, we have an added responsibility to become informed because of potential adverse interactions with other medications and anesthesia in the elective surgical patient. METHODS: Literature regarding commonly encountered herbal supplements and vitamins was reviewed and summarized to include reported indications for use and potential adverse effects and interactions specific to the perioperative patient. RESULTS: Abundant literature exists regarding herbal supplementation, but very little scientific evidence exists to advocate the use of the majority of supplements available on the market. In addition, little is known about the positive and negative interactions that these supplements are capable of producing, and those interactions that are known are based on case reports. CONCLUSIONS: With the lack of quality scientific studies to support the efficacy of most herbal products available and the limited regulation of these products by the government, health care providers are faced with a significant public health dilemma. This article provides a brief overview of information published on commonly encountered herbal supplements and vitamins taken by plastic surgery patients.
Assuntos
Suplementos Nutricionais , Fitoterapia , Preparações de Plantas , Complicações Pós-Operatórias/induzido quimicamente , Cirurgia Plástica , Vitaminas , Suplementos Nutricionais/efeitos adversos , Interações Ervas-Drogas , Humanos , Fitoterapia/efeitos adversos , Preparações de Plantas/efeitos adversos , Vitaminas/efeitos adversosRESUMO
BACKGROUND: Deep vein thrombosis is a known serious complication of surgical procedures and a significant cause of morbidity and mortality. Plastic surgeons' management of the risk of deep vein thrombosis and current information regarding deep vein thrombosis incidence rates are limited. A survey was designed and mailed to plastic surgeons to collect data on the patterns of practice with regard to deep vein thrombosis in patients undergoing plastic surgery procedures. METHODS: A comprehensive self-administered, anonymous survey was mailed to 1557 plastic surgeons in March of 2003. RESULTS: A total of 334 completed responses were available for analysis. Subsets of surgeons do not use any deep vein thrombosis prophylaxis: 16.4 percent who perform face lifts; 21.3 percent who perform liposuction; and 8.7 percent who perform a combined abdominoplasty-liposuction procedure. Only 48.7 percent of surgeons performing face lifts, 43.7 percent of surgeons performing liposuction, and 60.8 percent performing a combined procedure use deep vein thrombosis prophylaxis all the time. CONCLUSIONS: These results demonstrate a need for educational efforts and guidelines to direct clinical practice in line with evidence-based data concerning plastic surgery procedures and deep vein thrombosis. Plastic surgeons should be aware of the potential and real risks of deep vein thrombosis and procedures for prevention and treatment to reduce morbidity and mortality associated with deep vein thrombosis in all plastic surgery patients.
Assuntos
Fibrinolíticos/uso terapêutico , Padrões de Prática Médica , Cirurgia Plástica , Trombose Venosa/prevenção & controle , Humanos , Inquéritos e Questionários , Trombose Venosa/epidemiologiaRESUMO
Since the caveman, man has been tending to his wounds. Wound care evolved from magical incantations, potions, and ointments, to a systematic text of wound care and surgery from Hippocrates and Celsus. These advances were lost after the fall of the Roman Empire. In Europe, the Middle Ages were a regression of wound care back to potions and charms. It was'nt until the time of large armies using muskets and cannons that surgical wound care emerged again. This article will briefly highlight major milestones in wound care.
Assuntos
Infecção da Ferida Cirúrgica/história , Cicatrização/fisiologia , Ferimentos e Lesões/história , Animais , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História Antiga , História Medieval , Humanos , Medicina Militar/história , Infecção da Ferida Cirúrgica/terapia , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões/fisiopatologia , Ferimentos e Lesões/terapiaRESUMO
Understanding wound healing today involves much more than simply stating that there are three phases: "inflammation, proliferation, and maturation." Wound healing is a complex series of reactions and interactions among cells and "mediators." Each year, new mediators are discovered and our understanding of inflammatory mediators and cellular interactions grows. This article will attempt to provide a concise report of the current literature on wound healing by first reviewing the phases of wound healing followed by "the players" of wound healing: inflammatory mediators (cytokines, growth factors, proteases, eicosanoids, kinins, and more), nitric oxide, and the cellular elements. The discussion will end with a pictorial essay summarizing the wound-healing process.
Assuntos
Hemostasia/imunologia , Mediadores da Inflamação/imunologia , Inflamação/imunologia , Neovascularização Fisiológica/imunologia , Cicatrização/imunologia , Proliferação de Células , Células/imunologia , Quimiotaxia/imunologia , Colágeno/fisiologia , Citocinas/imunologia , Eicosanoides/imunologia , Proteínas da Matriz Extracelular/imunologia , Humanos , Óxido Nítrico/imunologia , Fatores de Tempo , Cicatrização/fisiologiaRESUMO
Understanding wound healing today involves much more than simply stating that there are three phases: inflammation, proliferation, and maturation. Wound healing is a complex series of reactions and interactions among cells and "mediators." Each year, new mediators are discovered and our understanding of inflammatory mediators and cellular interactions grows. This article will attempt to provide a concise overview on wound healing and wound management.
Assuntos
Cicatrização/fisiologia , Ferimentos e Lesões/terapia , Divisão Celular , Cicatriz/prevenção & controle , Humanos , Inflamação , Ferimentos e Lesões/patologia , Ferimentos e Lesões/fisiopatologiaRESUMO
BACKGROUND: Liposuction is the most common cosmetic operation performed. To the authors' knowledge, no report has examined patients' attitudes and postoperative opinions, lifestyle changes, weight gain changes, and satisfaction with their liposuction procedure in general and by specific site. The authors report on data from a survey provided to patients by two plastic surgeons at the University of Texas Southwestern Medical Center at Dallas. METHODS: Six hundred questionnaires were mailed to all patients who had liposuction surgery performed between 1999 and 2003. There were 108 undeliverable surveys; 209 completed surveys were returned (34.8 percent of 600 and 42.5 percent of 492 surveys). Data were analyzed using the chi-square test. A p value of less than 0.05 was considered significant. RESULTS: The majority of patients (80 percent) were satisfied with their results. Fifty-three percent thought that their appearance was either "excellent" or "very good." With regard to satisfaction by site treated, 60 percent or more of the responders were "very satisfied" or "satisfied" with their results. Weight gain was reported in 43 percent of the responders, with 56 percent of them gaining between 5 and 10 pounds 6 months after their surgery. Fat return was reported in 65 percent of the responders. The abdomen was the most common location for fat return. As a group, 79.7 percent would have the procedure again and 86 percent would recommend the procedure to family or friends. Approximately 75 percent of responders described their postoperative discomfort as mild to moderate, with 60 percent indicating that their discomfort lasted less than 7 days (39.8 percent indicated their pain lasted longer than 7 days); 83 percent indicated that they only needed to use narcotics for 7 days of less. When responders were divided into groups, the great majority of patients were satisfied with the surgery and their results. CONCLUSIONS: Despite postoperative pain, fat return, and weight gain, patients were willing to have the procedure again and recommend it to others. Those patients who were unsatisfied and were less likely to refer patients were those who had the lowest opinion of their appearance.
Assuntos
Estilo de Vida , Lipectomia/psicologia , Satisfação do Paciente , Abdome , Analgésicos Opioides/uso terapêutico , Imagem Corporal , Feminino , Seguimentos , Humanos , Lipectomia/estatística & dados numéricos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/epidemiologia , Satisfação do Paciente/estatística & dados numéricos , Recidiva , Inquéritos e Questionários , Texas , Fatores de Tempo , Resultado do Tratamento , Aumento de PesoRESUMO
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Discern the importance of the physician's office administrative capacity. 2. Recognize the necessity of a system for quality assessment. 3. Assess which procedures are safe in the office-based setting. 4. Know the basic steps to properly evaluate patients for office-based plastic surgery. BACKGROUND: At least 44,000 Americans die annually as a result of preventable medical errors. Medical mistakes are the eighth leading cause of death in the United States, costing between $54.6 billion and $79 billion, or 6 percent of total annual national health care expenditures. Office-based procedures comprise a 10-fold increase in risk for serious injury or death as compared with an ambulatory surgical facility. METHODS: This article reviews the literature on office-based patient safety issues. It places special emphasis on the statements and advisories published by the American Society of Plastic Surgeons' convened Task Force on Patient Safety in Office-Based Settings. This article stresses areas of increased patient safety concern, such as deep vein thrombosis prophylaxis and liposuction surgery. RESULTS: The article divides patient safety in health care delivery into three broad categories. First, patient safety starts with emphasis at the administrative level. The physician or independent governing body must develop a system of quality assessment that functions to minimize preventable errors and report outcomes and errors. Second, the clinical aspects of patient safety require that the physician evaluate whether the procedure(s) and the patient are proper for the office setting. Finally, this article gives special attention to liposuction, the most frequently performed office-based plastic surgery procedure. CONCLUSIONS: Patient safety must be every physician's highest priority, as reflected in the Hippocratic Oath: primum non nocere ("first, do no harm"). In the office setting, this priority requires both administrative and clinical emphasis. The physician who gives the healing touch of quality care must always have patient safety as the foremost priority.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Lipectomia , Procedimentos de Cirurgia Plástica , Garantia da Qualidade dos Cuidados de Saúde , Gestão da Segurança , Procedimentos Cirúrgicos Ambulatórios/normas , Anestesia/normas , Sedação Consciente , Serviços Médicos de Emergência , Jejum , Humanos , Consentimento Livre e Esclarecido , Lipectomia/efeitos adversos , Lipectomia/normas , Prontuários Médicos , Alta do Paciente , Guias de Prática Clínica como Assunto , Cuidados Pré-Operatórios , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/normas , Fatores de Risco , Trombose Venosa/prevenção & controleRESUMO
Patients need to have realistic expectations for a long-term successful body contour result. There are four key elements for long-term successful improvement in body contour, and the patient is responsible for the first three: exercise, a proper diet, and other positive lifestyle changes; and successful body contouring. An extensive survey requesting information about the procedures, areas of liposuction, lifestyle habits, and satisfaction was mailed to 600 patients who had liposuction surgery performed between 1999 and 2003. One hundred and eight surveys were undeliverable and 209 completed surveys were returned (34.8 percent of 600 mailed surveys and 42.5 percent of 492 delivered surveys). Data were analyzed by a binary logistic regression with backward elimination. Weight gain (versus no weight gain) was used as the dependent variable. The results showed that regardless of whether the patient did or did not gain weight, both groups reported being very satisfied (30 percent and 48 percent, respectively) or satisfied (43 percent and 34 percent, respectively) with their procedure. Among the weight gain patients, 72 percent would still have the procedure again, compared with 82 percent of responders who did not gain weight. When asked if they would recommend the procedure to family or friends, 90 percent of responders who did not gain weight would recommend the procedure whereas only 74 percent of responders who did gain weight would recommend the procedure (p < 0.001). Among those patients who gained weight, only 29 percent thought their appearance was excellent or good (compared with 79 percent of those who did not gain weight). Among the 57 percent of patients who did not gain weight, 35 percent report exercising more postoperatively (compared with only 10 percent in the weight gain group, p = 0.002) and 50 percent report eating a healthier diet (22 percent in the weight gain group report eating a healthier diet, p = 0.002). In the weight gain group, 67 percent report no change in their diet regimen and only 17 percent thought their productivity increased (compared with 25 percent among the no weight gain group, p = 0.002). Successful body contouring surgery requires a patient to embrace positive lifestyle habits. The results of this survey have been used to create a quantitative decision-making framework or a "road map" for patients and plastic surgeons to use for navigating toward successful long-term results.