Objectives: initial deep brain stimulation (DBS) programming using a monopolar review is time-consuming, subjective, and burdensome. Incorporating neurophysiology has the potential to expedite, objectify, and automati...
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Objectives: initial deep brain stimulation (DBS) programming using a monopolar review is time-consuming, subjective, and burdensome. Incorporating neurophysiology has the potential to expedite, objectify, and automatize initial DBS programming. We aimed to assess the feasibility and performance of clinically implemented sensing-based initial DBS programming for Parkinson's disease (PD). Materials and Methods: We conducted a single-center retrospective study in 15 patients with PD (25 hemispheres) implanted with a sensing-enabled neurostimulator in whom initial subthalamic nucleus/globus pallidus pars interna DBS programming was guided by beta power in real-time local field potential recordings, instead of a monopolar review. Results: The initial sensing-based programming visit lasted on average 42.2 minutes (SD 18) per hemisphere. During the DBS optimization phase, a conventional monopolar clinical review was not required in any patients. The initial stimulation contact level remained the same at the final follow-up visit in all hemispheres except three. The final amplitude was on average 0.8 mA (SD 0.9) higher than initially set after the original sensing-based programming visit. One year after surgery, off-medication International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) III total score, tremor subscore, MDS-UPDRS IV, and levodopa-equivalent dose improved by 47.0% (p < 0.001), 77.7% (p = 0.001), 51.1% (p = 0.006), and 44.8% (p = 0.011) compared with preoperatively using this approach. Conclusions: This study shows that sensing-based initial DBS programming for PD is feasible and rapid, and selected clinically effective contacts in most patients, including those with tremor. Technologic innovations and practical developments could improve sensing-based programming.
Many initiatives in improving initial learning of programming are based on gut instinct, guesswork, or localised experiences. Gathering real data as a basis for interventions and development work is rare, and doing so...
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ISBN:
(纸本)9781450310987
Many initiatives in improving initial learning of programming are based on gut instinct, guesswork, or localised experiences. Gathering real data as a basis for interventions and development work is rare, and doing so on a large scale is hard. The BlueJ environment is currently being instrumented to allow users to opt in to a large scale research data acquisition project, which is intended to collect data useful to a wide variety of educational programming researchers. The BlueJ project and its development team are ideally placed to collect such data: The development team has working contacts to various educational research groups, and the annual users of BlueJ number in the millions, with users in almost all parts of the world. This scale of deployment of BlueJ, and hence the volume and diversity of the data which can be gathered, are unique in the history of such investigations, and present a significant opportunity for researchers. It is intended to provide open access to this data to any interested research project. We expect that the availability of a large scale, real world data set documenting the behaviour of learners of programming will enable a wide variety of investigations that were previously impractical. This session aims at presenting the ideas so far, and getting input from interested researchers about the design of the data collection details.
Background: Deep brain stimulation (DBS) programming is time intensive. Recent advances in sensing technology of local field potentials (LFPs) may enable improvements. Few studies have compared the use of this technol...
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Background: Deep brain stimulation (DBS) programming is time intensive. Recent advances in sensing technology of local field potentials (LFPs) may enable improvements. Few studies have compared the use of this technology with standard of care. Objective/Hypothesis: Sensing technology of subthalamic nucleus (STN) DBS leads in Parkinson's disease (PD) is reliable and predicts the optimal contacts and settings as predicted by clinical assessment. Materials and Methods: Five subjects with PD (n = 9 hemispheres) with bilateral STN DBS and sensing capable battery replacement were recruited. An LFP sensing review of all bipolar contact pairs was performed three times. Contact with the maximal beta peak power (MBP) was then clinically assessed in a double-blinded fashion, and five conditions were tested: 1) entry settings, 2) off stimulation, 3) MBP at 30 mu s, 4) MBP at 60 mu s, and 5) MBP at 90 mu s. Results: Contact and frequency of the MBP power in all hemispheres did not differ across sessions. The entry settings matched with the contact with the MBP power in 5 of 9 hemispheres. No clinical difference was evident in the stimulation conditions. The clinician and subject preferred settings determined by MBP power in 7 of 9 and 5 of 7 hemispheres, respectively. Conclusions: This study indicates that STN LFPs in PD recorded directly from contacts of the DBS lead provide consistent recordings across the frequency range and a reliably detected beta peak. Furthermore, programming based on the MBP power provides at least clinical equivalence to standard of care programming with STN DBS.
Deep brain stimulation (DBS) has become an integral component of Parkinson disease treatment. programming a DBS device is a time-consuming process and requires a highly trained specialist to obtain optimal results. Du...
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Deep brain stimulation (DBS) has become an integral component of Parkinson disease treatment. programming a DBS device is a time-consuming process and requires a highly trained specialist to obtain optimal results. During the last few years, we have witnessed a rapid technological advance of DBS systems, making the programming process even more complex and emphasizing the need for a structured approach. In this manuscript and the attached videos, we will demonstrate a step-by-step programming approach for DBS targeting the subthalamus and the globus pallidus pars Interna. In doing so we will show the main features and differences of the three main systems available on the market, including the newest ones able to record braingenerated local field potentials for clinical applications.
The acquisition of initial programming skills poses significant challenges for most higher education students. This phenomenon is widely observed globally, although most existing research focuses on populations in Eur...
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ISBN:
(纸本)9798350376623;9798350376616
The acquisition of initial programming skills poses significant challenges for most higher education students. This phenomenon is widely observed globally, although most existing research focuses on populations in Europe and America, leaving notable gaps in understanding these challenges in African Contexts. This study addresses this gap by understanding the faced problems, barriers and adopted strategies by Mozambican lectures and students. The study was based on qualitative study using semi-structured interviews in the data collection process. Six lectures and 16 students from Mozambican universities were interviewed aiming to identify the most common challenges, difficulties, strategies, activities, tools, and assessment methods in an introductory programming course. The content analysis technique were applied for data analyses. The results indicate a series of difficulties related to problems in understanding programming learning aspects, learning and teaching strategies, barriers and use of different assessment methods.
There is a strong movement asserting the importance of quality education all over the world and for students of all ages. Many educators believe that in order to achieve this 21st century skills must be taught and tha...
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ISBN:
(纸本)9781479919086
There is a strong movement asserting the importance of quality education all over the world and for students of all ages. Many educators believe that in order to achieve this 21st century skills must be taught and that digital literacy should be coupled with rigorous Computer Science principles and computational thinking. Accordingly this work will describe a didactic experience in an introductory programming course by describing the context, pedagogical approach, content of the course based on a procedure-first approach, technologies used, research questions addressed, experimental design adopted, data collection and analysis and the main conclusion supported by qualitative and quantitative data. The research questions focus on understanding which is the best medium to design algorithms by comparing flow chart and the Scratch programming language and by evaluating whether using textual language is worth the effort of the syntactic burden imposed by these languages. An analysis of quantitative and qualitative data revealed that both a visual programming and a flow-chart approach are suitable for algorithm design with no statistical difference in terms of number of errors and time taken to write the corresponding code in a textual language. However, the high number of errors suggest that using visual programming allows the student to focus on the problem solving activities.
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