A Swing-Assist Controller for Enhancing Knee Flexion in a Semi-Powered Transfemoral Prosthesis.

This work proposes a new swing controller for semi-powered low impedance transfemoral prostheses that resolves the issue of potentially competing inputs between artificial assistive power and user-sourced power. Rather than add power as an exogeneous input, the control approach uses power to modify the homogeneous portion of the shank dynamics, and therefore need not construct or curate an input that is coordinated with user input. The implemented controller requires a single control parameter at a given walking speed, where the value of that parameter is a function of walking speed, as determined by an adaptive algorithm, such that peak knee angles are commensurate with walking-speed-dependent behaviors of individuals without any negative gait pathologies.

Recruitment and Retention Strategies for Randomized Clinical Trials Involving Family Members of ICU Patients.

Objectives: To review recruitment and retention strategies of randomized family-centered interventional studies in adult ICUs.

Data Sources: The MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library database from inception to February 2023.

Study Selection: Randomized controlled trials with family-centered interventions in the ICU setting that reported at least one family-centered outcome that were included in our previously published systematic review.

Family-centered interventions and patient outcomes in the adult intensive care unit: A systematic review of randomized controlled trials.

Objective: There is a need to understand how family engagement in the intensive care unit (ICU) impacts patient outcomes. We reviewed the literature for randomized family-centered interventions with patient-related outcomes in the adult ICU.

Data Sources: The MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library databases were searched from inception until July 3, 2023.

Virtual Patient and Family Engagement Strategies in Critical Care: A Scoping Review.

Family engagement in care is increasingly recognized as an essential component of optimal critical care delivery. However, family engagement strategies have traditionally involved in-person family participation. Virtual approaches to family engagement may overcome barriers to family participation in care.

Canadian Cardiovascular Society/Canadian Cardiovascular Critical Care Society/Canadian Association of Interventional Cardiology Clinical Practice Update on Optimal Post Cardiac Arrest and Refractory Cardiac Arrest Patient Care.

Survival to hospital discharge among patients with out-of-hospital cardiac arrest (OHCA) is low and important regional differences in treatment practices and survival have been described. Since the 2017 publication of the Canadian Cardiovascular Society's position statement on OHCA care, multiple randomized controlled trials have helped to better define optimal post cardiac arrest care. This working group provides updated guidance on the timing of cardiac catheterization in patients with ST-elevation and without ST-segment elevation, on a revised temperature control strategy targeting normothermia instead of hypothermia, blood pressure, oxygenation, and ventilation parameters, and on the treatment of rhythmic and periodic electroencephalography patterns in patients with a resuscitated OHCA.

A supervisory controller intended to arrest dynamic falls with a wearable cold-gas thruster.

This article examines the feasibility of employing a cold-gas thruster (CGT), intended as a backpack-wearable device, for purposes of arresting backward falls, and in particular describes a supervisory controller that, for some motion described by an arbitrary combination of center-of-mass angle and angular velocity, both detects an impending fall and determines when to initiate thrust in the CGT in order to arrest the impending fall. The CGT prototype and the supervisory controller are described and experimentally assessed using a rocking block apparatus intended to approximate a backward-falling human. In these experiments, the CGT and supervisory controller restored upright stability to the rocking block in all experiment cases that would have otherwise resulted in a fall without the CGT assistance.

Efficacy of stumble recovery assistance in a knee exoskeleton for individuals with simulated mobility impairment: A pilot study.

Falls due to stumbles are a major cause of injury for many populations, and as such interventions to reduce fall risk have been a key focus of rehabilitation research. However, dedicated stumble recovery assistance in a powered lower-limb exoskeleton has yet to be explored as a fall mitigation intervention. Thus young, healthy adults () were recruited for a stumble recovery experiment to test the efficacy of knee exoskeleton stumble recovery assistance in improving an impaired stumble recovery response (i.

The effects of swing assistance in a microprocessor-controlled transfemoral prosthesis on walking at varying speeds and grades.

This article proposes, describes, and tests a swing-assist walking controller for a stance-controlled, swing-assisted knee prosthesis that aims to combine benefits of passive swing mechanics (e.g., quiet operation, biomimetic function, and low power requirements) with benefits of powered swing assistance (e.

A new approach to a powered knee prosthesis: Layering powered assistance onto strictly passive prosthesis behavior.

This article describes a novel approach to the control of a powered knee prosthesis where the control system provides passive behavior for most activities and then provides powered assistance only for those activities that require them. The control approach presented here is based on the categorization of knee joint function during activities into four behaviors: resistive stance behavior, active stance behavior, ballistic swing, and non-ballistic swing. The approach is further premised on the assumption that healthy non-perturbed swing-phase is characterized by a ballistic swing motion, and therefore, a replacement of that function should be similarly ballistic.

Development and initial validation of a family activation measure for acute care.

Background: Activation of a family member refers to their desire, knowledge, confidence, and skills that can inform engagement in healthcare. Family activation combined with opportunity can lead to engagement in care. No tool currently exists to measure family activation in acute care.

Center-of-Mass Based foot Placement in Stumble Recovery.

Exploring how foot placement relates to center-of-mass kinematics after unexpected disturbances for healthy adults could improve our understanding of human balance as well as inform the design/control of assistive device interventions to reduce fall risk. Therefore, in this work a kinematic dataset of stumble recovery responses from seven healthy adults was analyzed to investigate the effects of stumble perturbations on COM state, and the COM state's relationship to various foot placement metrics. COM velocity excursion after trips was significantly higher than excursion for unperturbed swing phases, increasing linearly as the trip occurred later in swing phase.

Family engagement in care for medical trainees and early career clinicians.

Engaging family members in care improves person- and family-centered outcomes. Many healthcare professionals have limited awareness of the role and potential benefit of family engagement in care. This review describes the rationale for engaging families in care, and opportunities to engage family in various clinical care settings during training and early career practice.

Family Participation in Cardiovascular Intensive Care Unit Rounds: A Pilot Randomized Controlled Trial.

Background: Observational studies have shown an association between family participation in intensive care unit (ICU) rounds and better family-centred outcomes. However, evidence from randomized studies on the impact of family participation in ICU rounds is lacking. The objective of this pilot study was to evaluate the feasibility of a randomized trial for family participation in ICU rounds and obtain preliminary estimates of effect to inform a future effectiveness trial.