We previously reported our initial experience of subxiphoid single-port robotic-assisted thoracic surgery (SRATS) thymectomy using the single-port robotic surgical system (SPS). However, the potential benefits of this technique remain unknown. Thus, this study examined the multi-institutional experience of SRATS thymectomy and compared perioperative outcomes of this technique with those of subxiphoid single-port video-assisted thoracic surgery (SVATS) thymectomy. Data of patients who underwent subxiphoid SRATS and SVATS thymectomy performed by three thoracic surgeons at three institutions between September 2018 and May 2024 were retrospectively collected. In total, 110 patients were included, with 85 and 25 undergoing SRATS and SVATS thymectomy, respectively. No significant differences were noted in the total operative time (154.46±74.06 vs. 146.76±67.07 min, P=0.674) and conversion rate to median sternotomy (0% vs. 4 %, P=0.227) between the two groups. The SRATS group was associated with a lower conversion rate to multi-port surgery (2% vs. 20%, P=0.006), shorter chest tube drainage duration (1.40±0.94 vs. 2.00±1.29 days, P=0.001), and shorter postoperative hospital stay (2.87±1.26 vs. 5.08±5.20 days, P=0.007). Subxiphoid SRATS thymectomy using the SPS is feasible and can be a good alternative to conventional minimally invasive thymectomy. Further large-scale randomized controlled studies are needed to confirm its benefits.

OBJECTIVE The optimal surgical approach for thymoma resection is still an object of debate. The increasing experience in robotic-assisted thoracic surgery (RATS) has led to the progressive affirmation of this technique as a valid alternative to Video-Assisted Thoracic Surgery (VATS), sternotomy and thoracotomy in this setting. The present study aims to compare the post-operative and short-term results of RATS Thymectomy for thymoma with those of other main surgical approaches (sternotomy, thoracotomy, and VATS) from a high-volume single center. MATERIALS AND METHODS Between May 2021 - September 2023, 40 consecutive patients underwent RATS Thymectomy for I to limited-stage III thymoma in our center. Three homogenous groups of consecutive patients who received thymic surgery by main alternative approaches (sternotomy, thoracotomy, VATS) over the last 5 years, were identified in order to perform a comparative analysis. Data of operative technique, time of surgery, associated resections, conversion rate, overall morbidity, tumor size, radicality, postoperative pain, length of hospital stay, and cosmetic results were recorded and compared between each control group and the RATS group. RESULTS Tumor size was higher in the sternotomy group, but not significantly. The mean operative time of RATS interventions was significantly lower than that of sternotomy and VATS. It was significantly shorter compared to thoracotomy if excluding docking-undocking time. Higher rate of associated adjacent structures resection was reported in the sternotomy group (p=0.005). Conversion rate was significantly higher in VATS group (p= 0.026) compared to RATS. Postoperative pain at 24 and 48 hours was significantly lower in RATS group compared to the others. Improved cosmetics results were reported after RATS compared to sternotomy (p= 0.0001) and thoracotomy (p= 0.001) groups, with a trend towards better results compared to VATS (p=0.05). Length of hospital stay was shorter in the RATS group with a significant difference vs. the sternotomy group (p

Background: In the landscape of thoracic surgery, innovation continually drives progress, offering novel approaches to address complex pathologies while prioritizing patient well-being. Dual-portal robotic-assisted thoracic surgery DRATS represents the next frontier in this evolution. In this report we describe our experience with the DRATS approach for segmentectomy with the indocyanine green intersegmental plane identification. Methods: We presented the case of a patient who underwent a DRATS lingulectomy and lymphadenectomy stations 5, 6, 7, and 10 using the daVinci Surgical System. Results: The patient's postoperative course was uneventful with chest tube was removed in second post operative day. The final pathological analysis confirmed a low-grade malignant potential adenocarcinoma, with main diameter of 1.1 cm, at 3 cm from lung margins. 12 nodes were removed, from station 5,6,7,10,11, all of the free of metastases. Conclusions: Our initial observations suggest that Dual-Portal Robotic-Assisted Tho-racic Surgery (DRATS) demonstrates notable feasibility.

Background Robotic-assisted thoracic surgery (RATS) has become the standard procedure for treating lung malignancy, offering numerous advantages over traditional methods. However, the minimally invasive nature of RATS presents unique challenges, notably a limited field of view and reduced tactile feedback for the surgeon. These limitations can significantly impact the surgeon's ability to navigate complex anatomical structures during surgery. To address these challenges, we recognized the need for enhanced preoperative familiarization with each patient’s specific anatomy. In response, we developed an innovative virtual reality (VR) surgical navigation system, utilizing head-mounted displays (HMDs), designed to provide surgeons with a more comprehensive and interactive understanding of the patient's anatomy before the actual surgery. This VR system aims to extend the surgeon's capabilities in both preoperative sumilation and intraoperative navigation, potentially mitigating the inherent limitations of RATS. Methods Three-dimensional (3D) volumized data, meticulously extracted from preoperative computed tomography (CT) scans, were seamlessly integrated into the Perspectus VR Education software. These data were then displayed on an HMD, facilitating an interactive 3D reconstruction of pulmonary structures. This reconstruction allowed for each structure to be visualized individually, enabling detailed preoperative resection simulations tailored to each patient's unique anatomy. During RATS, these specific 3D reconstructed images were made accessible within the surgeon's console through the TilePro™ multi-display input, providing real-time, intraoperative guidance. Results During the preoperative simulations, the 3D anatomic structure of the pulmonary vessels, as well as the spatial relationship between the lesion and adjacent tissues, were successfully visualized. This enhanced visualization enabled surgeons to thoroughly evaluate a patient's anatomy, significantly improving the safety and accuracy of the subsequent procedure. The integration of VR software with the HMD provided surgeons with a true 3D interaction with real patient data. This setup not only offered a unique perspective through the surgical console but also allowed for easy manipulation of the data on a mobile laptop, thereby enhancing the overall surgical planning process. Conclusions VR simulation using HMDs offers a viewing experience akin to that of a robotic 3D viewer, potentially providing an innovative avenue for surgeons to develop specific robotic surgical skills without the need for practicing on live patients. This technology, when integrated with routine imaging modalities, can significantly enhance preoperative planning. Such integration not only contributes to the safety but also improves the accuracy of anatomical resections. Our findings suggest that VR simulation with HMDs is particularly effective in assisting surgeons to accurately identify lesion locations in RATS, thereby optimizing surgical outcomes.

Background DaVinci Single-Port (SP) robotic surgery offers several benefits compared to traditional multiport laparoscopic or robotic surgeries. One of the main advantages is that it allows for a minimally invasive approach, resulting in a single, smaller incision and reduced trauma to the patient’s body leading to less postoperative pain, faster recovery, and reduced risk of complications. The cosmesis of a single port with minimal visible scarring is also an attractive aspect to the patients; however, many surgeons use an additional port for energy device, stapler use, and drain insertion. Pure single port surgery with one incision is still rare. Here we share our experience of first 10 cases using SP robotic platform in colorectal surgery. Methods From May 2023 to December 2023, colorectal patients who underwent SP-robotic surgery were analyzed. Placement of the incision was umbilicus for 8 patients, and right lower quadrant for 2 patients through which ileostomy maturation was performed. Data including perioperative parameters and postoperative outcomes were analyzed with a median follow-up of 4.6months (range 0.6-7.4months). Results A total number of 10 colorectal patients underwent DaVinci Single-Port robotic colorectal surgery at our institution during this period. Demographics of the patients showed 4 males (40%) and 6 females (60%) with a median age of 63.5years (range 50-75years). Median body mass index (BMI) was 22.89kg/m2 (range 19.92-26.84kg/m2), and 9 patients were diagnosed with colorectal cancer and 1 patient was diagnosed with rectal gastrointestinal tumor. One patient underwent anterior resection and cholecystectomy simultaneously. Mean operation time was 222min (range 142-316min), and mean wound size was 3.25cm (range 2.5-4.5cm). Nine patients underwent surgery with single incision through which single port trocar was inserted, and one patient had one additional port for drain insertion. Mean hospital stay was 6 days (range 4-8 days) with 1 postoperative complication of bleeding requiring transfusion, but there was no re-admission within 30 days. Conclusion Overall, our experience with single-port robotic colorectal surgery has been promising. With only one patient with additional port for drain insertion, all nine patients underwent SP-robotic surgery with single incision for colon as well as rectal surgeries. Compared to an average postoperative length of stay of 6.5-8 days in laparoscopic colorectal surgeries reported in literature, SP-robotic surgery showed faster recovery of 6 days highlighting its benefits in patient recovery and satisfaction.

Background/Objectives: Postoperative intraocular lens (IOL) is a risk associated with IOL scleral fixation. However, the cause of IOL tilt during IOL suturing remains unclear. Therefore, this study aimed to evaluate the surgical outcomes of a modified IOL suturing technique and investigate the factors contributing to postoperative IOL tilt and decentration. Methods: We included 25 eyes of 22 patients who underwent IOL suturing between April 2018 and February 2020. A modified IOL suturing technique that decreased the need for intraocular suture manipulation was used. Factors contributing to IOL tilt and decentration were investigated using an intraoperative optical coherence tomography (iOCT) system. Results: The mean postoperative best-corrected visual acuity improved from 0.15 ± 0.45 to -0.02 ± 0.19 (p = 0.02). The mean IOL tilt angle at the last visit after surgery was 1.84 ± 1.28 degrees. The study revealed that the distance of the scleral puncture site from the corneal limbus had a stronger effect on IOL tilt; while, the suture position of the haptics had a greater effect on IOL decentration. Conclusions: The modified IOL suturing technique, which avoids intraocular suture handling, had favorable surgical outcomes with improved postoperative visual acuity and controlled IOL tilt and decentration. Accurate surgical techniques and careful measurement of distances during surgery are crucial for preventing postoperative IOL tilt and decentration.

Background: Robot-assisted laparoscopic surgery robot-assisted surgical system has gained significant popularity over open and laparoscopic interventions. However, given its high costs, it remains unclear what clinical advantages robot-assisted laparoscopic surgery offers over conventional laparoscopic surgery. Objective: This umbrella review aims to synthesize and compare the clinical outcomes of robot-assisted laparoscopic surgery versus conventional laparoscopic surgery for five surgical procedures. Inclusion criteria: All systematic reviews and meta-analyses published in the past five years that compared the clinical outcomes of conventional laparoscopic surgery and robot-assisted laparoscopic surgery for cholecystectomy, colectomy, hysterectomy, nephrectomy and/or prostatectomy were included. Methods: A systematic literature search was conducted in PubMed and Scopus. The quality of all included reviews was assessed with the AMSTAR 2 quality assessment tool. Each review’s study characteristics (and a list of primary sources) were extracted, along with the quantitative and qualitative data for the following ten clinical outcomes: blood loss, rate of conversion to open surgery, hospitalization costs, incisional hernia rate, intraoperative complication rate, postoperative complication rate, length of hospital stay, operative time, readmission rate and wound infection rate. Results: Fifty-two systematic reviews and (network) meta-analyses were included in this umbrella review, covering more than 1,288,425 patients from 1046 primary sources published between 1996 and 2022. The overall quality of the included reviews was assessed to be low or critically low. Robot-assisted laparoscopic surgery yielded comparable results as conventional laparoscopic surgery in terms of blood loss, conversion to open surgery rate, intraoperative complication rate, postoperative complication rate, readmission rate and wound infection rate for most surgical procedures. While the hospitalization costs of robot-assisted laparoscopic surgery were higher and the operative times of robot-assisted laparoscopic surgery were longer than conventional laparoscopic surgery, robot-assisted laparoscopic surgery reduced the length of hospital stay of patients in nearly all cases. Conclusion: Robot-assisted laparoscopic surgery achieved comparable results with conventional laparoscopic surgery for cholecystectomy, colectomy, hysterectomy, nephrectomy and prostatectomy based on ten clinical outcomes. Further research is needed to prove that robot-assisted laparoscopy is as safe and reliable as conventional laparoscopic surgery.

Objectives: Robotic bilateral axillary breast approach (BABA) thyroid surgery began in 2008 and is now one of the most widely used remote-access thyroid surgeries worldwide. This study aimed to analyze the results of 500 robotic BABA thyroid surgeries performed in a single institution in Korea compared with open thyroid surgery. Methods: From December 2018 to March 2020, 502 robotic BABA thyroidectomies (RTs) and 531 conventional open thyroidectomies (OTs) were performed in our institution by a single endocrine surgeon. We retrospectively reviewed patient medical records and performed a comparative analysis of OT and RT. Results: The RT group was younger (43.41±11.41 versus 54.28±13.41 years, p<0.001) and had a higher proportion of females (84.3% versus 69.3%, p<0.001), a lower BMI (24.66±3.97 versus 25.83±4.07 kg/m2), a higher proportion of lobectomies (52.6% versus 45.2%) and a lower proportion of lateral neck dissections (3.4% versus 10.0%, p<0.001). The RT group had a lnger operation time (145.33±40.80 versus 93.39±43.55 minutes, p<0.001) and higher surgical cost. Although the OT group had a larger tumor size and higher proportion of extrathyroidal extension, the numbers of retrieved lymph nodes were not significantly different between the two groups. Additionally, there was no difference in the stimulated thyroglobulin level before radioactive iodine therapy (7.01±35.73 versus 8.39±58.77, p=0.782). The rates of transient vocal cord palsy and transient hypoparathyroidism were significantly lower in the RT group, and those of scar-related complications were higher in the OT group. Conclusion: Robotic BABA thyroid surgery has advantages not only in better cosmetic outcomes but also in lower rates of vocal cord palsy and hypoparathyroidism, with comparable lymph node retrieval and serum thyroglobulin levels.

As the global population faces an increasing prevalence of physical disabilities, the challenge of motor rehabilitation has become increasingly urgent. Considering that approximately 15% of the global population lives with some form of disability, with a significant number having motor disa-bilities that greatly impact their quality of life, the integration of robotic technologies into rehabili-tation processes offers an opportunity for significant improvement in functional recovery and pa-tient autonomy. This analysis aims to evaluate the progress and challenges encountered in imple-menting robotic technology for the rehabilitation of patients with physical disabilities, highlighting the potential of emerging technologies such as exoskeletons, assisted training devices, and brain-computer interface systems in facilitating motor recovery. By examining relevant clinical studies, the analysis demonstrates the varied effectiveness of robotic therapies compared to traditional re-habilitation methods, while also highlighting the need for ongoing research to optimize care prac-tices and address challenges related to cost, accessibility, and treatment personalization. In con-clusion, robotic technologies represent a promising direction in motor rehabilitation, with the po-tential to revolutionize the care of patients with physical disabilities, significantly improving quali-ty of life and social integration.

The aim of this study was to evaluate the clinical and radiographic outcomes of the All-on-4 technique in fully edentulous maxilla using R2GATE software for flapless, computer-guided surgery and immediate loading. Ten adult patients with fully edentulous maxilla, aged between 35 and 60 years, were included in the study between April 2021 and April 2022. The surgical procedure was performed under local anesthesia and followed the All-on-4 approach with immediate loading of implants using a screw-retained provisional acrylic resin prosthesis on the same day. Final prosthesis was delivered four months after the surgery. Clinical and radiographic outcomes were evaluated at four- and twelve-months post-operation. The study reported a 95% implant survival rate using the All-on-4 technique. The mean marginal bone level was recorded at 0.35 mm and 0.66 mm during the 4 and 12-month follow-up periods, respectively. Fixed provisional prosthesis fracture, abutment, and prosthesis screw loosening were the most frequent mechanical complications reported. Within the limitations of this study, the use of computer-guided surgery in the All-on-4 technique seemed to be a promising treatment option with high implant survival rates that may help reduce post-surgical discomfort and mechanical complications in the rehabilitation of the edentulous maxilla.

(1) Background. Intracavitary hyperthermic chemotherapy (HITHOC) remains a part of the complex mosaic which is the multimodal approach in advanced stage thymomas and pleural malignancies, and its role is still widely debated. In recent years, several studies have demonstrated the feasibility and the efficacy of HITHOC combined with cytoreductive surgery in the treatment of thymoma relapses and malignant pleural mesothelioma (MPM). However, there are currently no studies available on pleurectomy/removal of pleural lesions using the robotic technique, in association with intrathoracic chemotherapy. The aim of this narrative review is to evaluate the feasibility and safety of robotic pleurectomy/removal of relapses and HITHOC in patients with pleural recurrence of thymoma or MPM, after having analyzed the literature concerning this controversial topic, and to report our experience with robotic surgery. (2) Methods: A review of papers published on this topic, from 1980, was conducted. Later, the data of consecutive patients affected by thymoma relapses or MPM who underwent robotic surgery in combination with HITHOC will be collected and analyzed. The surgery performed, prior to intrathoracic infusion of the high-temperature chemotherapy, consisted of the removal of the recurrences or pleurectomy, depending on the pathology. All surgeries were performed with a 4-port-fully robotic technique. (3) Results: Between 2017 and 2022, nine patients underwent robotic cytoreductive surgery in combination with HITHOC. No intraoperative complications occurred. One patient had a grade II Clavien-Dindo postoperative complication. Oncological follow-up showed results in line with the literature. (4) Conclusion: With the limitation of the small number of patients, considering the results, robotic surgery may represent the surgical approach of choice, in combination with HITHOC, in patients with pleural relapses of thymoma and early-stage MPM.

Direct laryngoscope and videolaryngoscope are the dominant endotracheal intubation tools. Styletubation technique (using a video-assisted intubating stylet) has shown its advantages regarding in short intubation time, high success rate, less stimulation, and operator’s satisfaction. The learning curve can be steep but easy to overcome if the technical pitfalls could be avoided. Conditions make styletubation challenging include secretions/blood, short/stiff neck, restricted mouth opening and cervical spine mobility, anatomical abnormalities over head and neck regions, and obesity, etc. In this clinical report, we present the effectiveness and efficiency of routine use of the styletubation for tracheal intubation in a super-super obese patient (BMI 103 kg/m2) undergoing bariatric surgery with laparoscopic sleeve gastrectomy.

Abstract. Leiomyoma is a benign tumour of smooth muscle cells classified into three groups: solid leiomyoma, angioleiomyoma and leiomyoblastoma. Angioleiomyoma arises from the tunica media of veins and arteries of vascular smooth muscle.Nasal cavity, paranasal sinus and oral cavity are the most frequent locations in Head and Neck region. Here we present the case of a tongue base angioleiomyoma with an emphasis on clinical data, pathologic findings and surgical approach. The patient complained about a one-month of globus sensation, dysphagia and hemoptysis without other systemic symptoms. Laryngoscopy revealed the presence of a 2 cm solitary submucosal mass located on the left tongue base covered with normal mucosa. The patient underwent direct laryngoscopy to perform a biopsy for the purpose of achieving the conclusive diagnosis. Treatment options were discussed, included surgical resection. Transoral robot-assisted resection was performed without complications. Clearly the description of our case does not want to have a purpose in terms of indications but wants to describe the possibility of considering TORS in the case of benign tumours of the tongue base, especially in cases like this where a standard technique can difficulty be achieved. Current literature review was provided and discussed.

The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on "Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin" (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results; therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.

Background Bone fracture fixation surgery is one of the most commonly performed surgical procedures in the orthopedic field. However, fracture healing complications occur frequently, and the choice of the most optimal surgical approach often remains challenging. In the last years, computational tools have been developed with the aim to assist preoperative planning procedures of bone fracture fixation surgery. Objectives The aims of this review are (1) to provide a comprehensive overview of the state-of-the-art in computer-assisted preoperative planning of bone fracture fixation surgery, (2) to assess the clinical feasibility of the existing virtual planning approaches, and (3) to assess their clinical efficacy in terms of clinical outcomes as compared to conventional planning methods. Methods A literature search was performed in the MEDLINE-PubMed, Ovid-EMBASE, Ovid-EMCARE, Web of Science, and Cochrane libraries to identify articles reporting on the clinical use of computer-assisted preoperative planning of bone fracture fixation. Results 79 articles were included to provide an overview of the state-of-the art in virtual planning. While patient-specific geometrical model construction, virtual bone fracture reduction, and virtual fixation planning are routinely applied in virtual planning, biomechanical analysis is rarely included in the planning framework. 21 of the included studies were used to assess the feasibility and efficacy of computer-assisted planning methods. The reported total mean planning duration ranged from 22 to 258 minutes in different studies. Computer-assisted planning resulted in reduced operation time (Standardized Mean Difference (SMD): -2.19; 95% Confidence Interval (CI): -2.87, -1.50), less blood loss (SMD: -1.99; 95% CI: -2.75, -1.24), decreased frequency of fluoroscopy (SMD: -2.18; 95% CI: -2.74, -1.61), shortened fracture healing times (SMD:-0.51; 95% CI: -0.97, -0.05) and less postoperative complications (Risk Ratio (RR): 0.64, 95% CI: 0.46, 0.90). No significant differences were found in hospitalization duration. Some studies reported improvements in reduction quality and functional outcomes but these results were not pooled for meta-analysis, since the reported outcome measures were too heterogeneous. Conclusions Current computer-assisted planning approaches are feasible to be used in clinical practice and have been shown to improve clinical outcomes. Including biomechanical analysis into the framework has the potential to further improve clinical outcome.

This paper presents a system developed for the assistance with a collaborative robot in hand-assisted laparoscopic surgery (HALS). The system includes a sensing glove with piezoresistive sensors which capture continuously the flexion degree of the surgeon's fingers. These data are analyzed using an algorithm that detects and recognize the selected movements. This information is sent as commands to the collaborative robot throughout the surgical operation. The bending patterns, speed and execution times of the movements are modelled in a pre-phase in which it will extract all the necessary information for later detection during the motion execution. The results obtained with 10 different volunteers show a high degree of accuracy and a low false discovery rate.

Regional anesthesia in postoperative pain management have developed in recent years, especially with the advent of fascial plane blocks. This study aims to compare the ultrasound-guided bilateral erector spinae plane block (ESPB) versus bilateral transversus abdominis plane block (TAPB) on postoperative analgesia after laparoscopic or robotic urologic surgery. This was a retrospective observational study; 97 patients (ESPB-group) received bilateral ultrasound-guided ESPB with 20 mL of ropivacaine 0.375% plus 0.5 mcg/kg of dexmedetomidine in each side at the level of T7-T9, and 93 patients (TAPB-group) received bilateral ultrasound-guided TAPB with ropivacaine 0.375% or 0.25%. The primary outcome was post-operative numeric rating scale (NRS) pain score, which was significantly lower in the ESPB-group on postoperative days 0, 2, and 3 (p=0.012, p=0.016 and p=0.004). Concerning the secondary outcomes, consumption of ropivacaine was significantly lower in ESPB-group (p<0.001) and the total amount of analgesic rescue doses was significantly lower in the ESPB-group than TAPB-group in postoperative days from 2 to 4 (1 vs 3, p>0.001). Incidence of postoperative nausea and vomiting was higher in the TAPB-group and no block related complications were observed. We conclude that ESPB provide better postoperative pain control with less consumption of local anesthetic and less total rescue analgesic therapies.

This study investigates the trends and patterns of robotic-assisted total knee arthroplasty (RA-TKA) from 2016 to 2019. Using data from the Nationwide Inpatient Sample (NIS), we analyzed demographics, prevalence of comorbidities, total cost, and length of stay (LOS) for 88,415 RA-TKA cases identified during this period. Our analysis revealed a significant increase in RA-TKA procedures, from 5,330 in 2016 to 39,495 in 2019. Patients undergoing RA-TKA were slightly younger, with an average age of 66.2 years. The average hospital stay was 1.89 days, and total charges averaged $65,891. We also examined various comorbidities and demographic factors, including race, median household income, and hospital teaching status. The results show that RA-TKA usage in the US has grown substantially, with specific demographic and clinical patterns. Further studies on the long-term outcomes of RA-TKA are needed to fully understand the benefits of this technology.

Background: Locally advanced rectal cancers (10-20%) can present with infiltration into adjacent viscera. R0 resections remain the key factor for better survival. Traditionally these cases have been managed with open surgery. There are some limitations of laparoscopic surgery in these case, which can potentially be overcome by robotic surgery. Objectives: To determine the feasibility and outcome results of robotic multi-visceral resection of stage T4 rectal carcinoma. Methods: Consecutive patients having locally advanced carcinoma of rectum, who undergone robotic multi-visceral resection as the primary treatment between 2015 -2018 were included, through our database which was maintained prospectively. All perioperative and intraoperative parameters were analyzed. Patient demographics, co-morbidities, preoperative imaging, endoscopic findings, operative data, histopathology results, postoperative hospital course and procedure related postoperative adverse events were noted and analyzed. Results: Twenty-one patients with the diagnosis of nonmetastatic locally advanced rectal cancers were operated with Robotic Si/X platform. The median body mass index was 28.5 kg/m2 (range 21-42). The mean blood loss during operation was 20 ml (range 5-200), and the mean duration of surgery was 280 min (range 240-430). The median hospital stay after operation was 6 days (range 4-25 days). On postoperative histopathology, R0 resection rate was 90.5% (19/21). Conclusions: The robotic multi-visceral en-bloc resection of stage T4 rectal carcinoma is technically feasible and oncologically safe. Advanced technical skills, accurate radiological staging and careful patient selection can allow the extension of minimal access surgery to this challenging group of patients.

The evaluation of robotic hands is a subjectively biased, complex process. The fields pertaining to robotic hands are human-centric in nature, making human hands a good standard for benchmark comparisons of robotic hands. To achieve this, we propose a new evaluation index, where we evaluate robotic hands on three fronts: their form, features and performance. An evaluation on how anthropomorphic robotic hands are in basic mobility, and appearance constitutes the ``Form'', while features that can be read, changed and actuated for effective control of robotic hands constitutes the ``Features''. We derived these key features from an extensive analysis of robotic hands in literature. Finally, the robotic hands carry out a series of tasks that evaluate their ``Performance''. An individual score for each category is drawn and we carry out a three-pronged analysis. We also propose an additional feature in the form of price to provide context when analysing multiple hands.

Abstract: This study aimed to compare the effcacy of robot-assisted and manual cannula insertion in simulated big-bubble deep anterior lamellar keratoplasty (DALK). Novice surgeons with no prior experience in performing DALK were trained to perform the procedure using manual or robot-assisted techniques. The results showed that both methods could generate an airtight tunnel in the porcine cornea, and result in successful generation of a deep stromal demarcation plane representing suffcient depth reached for big-bubble generation in most cases. However, the combination of intraoperative OCT and robotic assistance received a signifcant increase in the depth of achieved detachment in non-perforated cases, comprising a mean of 89% as opposed to 85% of the cornea in manual trials. This research suggests that robot-assisted DALK may offer certain advantages over manual techniques, particularly when used in conjunction with intraoperative OCT.

We introduce a novel hybrid Transformer-CNN architecture for robotic grasp detection, designed to enhance the accuracy of grasping unknown objects. Our proposed architecture has two key designs. Firstly, we develop a hierarchical transformer as the encoder, incorporating the external attention to effectively capture the correlation features across the data. Secondly, the decoder is constructed with cross-layer connections to efficiently fuse multi-scale features. Channel attention is introduced in the decoder to model the correlation between channels and to adaptively recalibrate the channel correlation feature response, thereby increasing the weight of the effective channels. Our method is evaluated on the Cornell and Jacquard public datasets, achieving an image-wise detection accuracy of 98.3% and 95.8% on each dataset, respectively. Additionally, we achieve object-wise detection accuracy of 96.9% and 92.4% on the same datasets. A physical experiment is also performed using the Elite 6Dof robot, with a grasping accuracy rate of 93.3%, demonstrating the proposed method's ability to grasp unknown objects in real-world scenarios. The results of this study show that our proposed method outperforms other state-of-the-art methods.

Cloud robot is becoming popular and security of cloud robot is important. However, the researches of cloud robot safety are a few. This work develops a security policy to defense DDoS attack of cloud robot. In this policy, complex, but accurate calculation models are deployed on the cloud, simple but efficient calculation models are deployed on the robot. In the cloud, there are master server and standby server. The master server transfers parameters of complex but accurate models to the standby server periodically and the master executes the start-stop backup policy. Specifically, this work proposes and proves an algorithm to dynamically adjust the interval of parameter transfer. According to a PDRA feature of Netflow, when DDoS attacks, the master server sends warning signals to the robot and standby server. The robot runs local models to avoid stopping work until it is connected to the standby server. Then, standby server provides service to the robot until the master server recover. Finally, this work implemented a gesture recognition cloud robot based on convolutional neural network, hidden Markov model and PDRA feature of Netflow to verify the policy. Experiment shows that the security policy to defense DDoS attack for cloud robot is effective.

Robotic path planning is a field of research which is gaining traction given the broad domains of interest to which path planning is an important systemic requirement; the aim being to optimise the efficacy of robotic movements in a defined operational environment. For example, robots have been employed in many domains including: cleaning robots (such as vacuum cleaners), automated paint spraying robots, window cleaning robots, forest monitoring robots, agricultural robots (often driven using satellite and geostationary positional satellite data). Additionally, mobile robotic systems have been utilised in disaster areas and locations hazardous to humans (such as war zones in mine clearance). The coverage path planning problem describes an approach which is designed to determine the path that traverses all points in a defined operational environment while avoiding static and dynamic (moving) obstacles. In this paper we present our proposed Smooth-STC model, the aim of the model being to identify an optimal path, avoid all obstacles, prevent (or at least minimise) backtracking, and maximise the coverage in any defined operational environment. The experimental results in a simulation show that, in uncertain environments, our proposed smooth STC method achieves an almost absolute coverage rate and demonstrates improvement when measured against alternative conventional algorithms.

Animal-assisted interventions (AAI) use human-animal interactions to positive effect in various contexts including cancer care. This systematic literature review is the first part of a two-part paper series focusing on the research methods and quantitative results of AAI studies in oncology. We find methodological consistency in the use of canines as therapy animals, in the types of high-risk patients excluded from studies, and in the infection precautions taken with therapy animals throughout cancer wards. The investigated patient endpoints are not significantly affected by AAI, with the exceptions of improvements in oxygen consumption, quality of life, depression, mood, and satisfaction with therapy. The AAI field in oncology has progressed significantly since its inception and has great potential to positively impact future patient outcomes. To advance the field, AAI research in oncology should consistently improve the methodological design of studies, report data more completely, and focus on the therapy animal’s well-being.

Nerve-sparing vs. non nerve sparing surgery (NSS vs. non-NSS) is associated with improved functional outcomes in prostatectomy patients. The aim of the present study is to compare the oncological outcomes of patients with high-risk localized prostate cancer undergoing nerve-sparing and non nerve-sparing robot-assisted radical prostatectomy (RARP). Between November 2002 and December 2018, we prospectively recorded data of patients undergoing RARP for high-risk localized prostate cancer (PCa). NSS (nerve-sparing surgery) was offered based on preoperative clinical characteristics of patients and intraoperative assessment. Patients were stratified into 2 groups according to NSS. The primary outcome was biochemical recurrence (BCR), while positive surgical margin (PSM) and cancer-specific survival (CSS) were secondary outcomes. Logistic regression was used to investigate predictive factors. A total of 779 patients were included in the study, 429 (55.1%) underwent NSS while 350 (44.9%) underwent a non-NSS. After a mean (±SD) follow-up of 192 (±14) months, 328 (42.1%) patients developed BCR, no significant difference was found between NSS and non-NSS group (156 vs. 172; p=0.09). Both univariable and multivariable analysis found that nerve-sparing approach was not a predictor of BCR (p>0.05). NSS vs. non-NSS was not associated with worse oncological outcomes in patients with high-risk PCa

In recent decades, many attempts have been made to automate the entire welding process, how-ever, there remain many non-automated welding operations that present a constant hazard to workers. This article presents an automated welding solution with collaborative robots, with this contribution, we intend to help companies in this sector increase productivity, improve quality, effectively reduce costs, and improve working conditions.

This paper proposes a novel biologically inspired design for an insect-scale flapping robot. The proposed scheme employs two motors to drive four wings, mimicking the flapping motion of nat-ural four-winged insects. The vehicle incorporates two pairs of flapping wings to generate lift force, with a transmission mechanism featuring flexure hinges instead of pivot joints, resulting in reduced weight and volume. The flexure hinges also exhibit nonlinear stiffness to facilitate smooth wing motion. The vehicle is designed to be symmetrical in structure, with the wings of each section generating greater lift through the clap-and-fling mechanism. The final product weighs 6.2g, pos-sesses a wingspan of 17cm, a one-sided flapping wing angle of 103 degrees, and generates lift that exceeds its weight, attesting to its successful design.

Robotic Process Automation (RPA) is a fast growing field inside Business Process Automation (BPA). RPA deals with software robots that use human application interface to do some repetitive tasks like starting programs, filling the forms, clicking on buttons etc. Some RPA software tools like Blue Prism, Rapise and UiPath became popular during last years but there are still some problems with them starting with their high price and difficulties to adapt to the real use cases. On the other hand, Optoklik is a relatively small RPA tool developed to be highly adaptable to the real cases and still easy to use. This paper presents the main functions of Optoklik and discusses its usage in automation of different actions that use human application interface.

People working in the field of Animal-Assisted Interventions (AAI) often state that they perceive animal welfare as a matter of paramount importance, nevertheless most of scientific literature focuses on the effectiveness of interventions from the user's perspective. Before focusing on animals’ management and welfare during the interaction with users, it would be important to ensure animal welfare during their “ordinary lives”. This article reports information and considerations about the management of donkeys involved in AAI in Northern Italy. Six facilities with several years of experience in Donkey-Assisted Interventions were visited for the purpose of an initial data collection regarding the management of donkeys involved in AAI. A general lack of knowledge regarding the nutritional needs of the donkey and a heterogeneity of practices in the field of its preventive medicine have been identified; the study also highlighted a need for efforts to create a more stimulating and enriched environment for animals involved in AAI. Some possible areas for improvement in the management of donkeys involved in AAI have been highlighted. Further studies are necessary to provide a more comprehensive picture of the welfare of donkeys involved in this context.

Animal-assisted interventions (AAI) are a unique class of complementary medical treatments that can improve a patient’s quality of life, both physically and psychologically. Part I of this two-paper systematic literature review series focused on the study methods and quantitative results of researchers in this field. We continue this in-depth review here in Part II by discussing the common theories associated with AAI in the context of cancer. Of all the factors at work in human-animal interactions, researchers explicitly cite compatible animal personality, physical touch, physical movement, distraction/entertainment, and increased human interaction as the mechanisms responsible for the positive clinical outcomes observed in AAI. In various combinations, these mechanisms group under broader theoretical frameworks that attempt to fully explain the AAI context as it relates to cancer care. The social support hypothesis and the conception of a human-animal bond are the most referenced overarching frameworks. The cognitive activation theory of stress, the science of unitary human beings, and the self-object hypothesis are also referenced. We briefly consider other relevant theories commonly noted in the human-animal interactions literature that have the potential to clarify aspects of cancer-related AAI. We also discuss the neurobiological transduction mechanisms needed to connect theoretical frameworks and their mechanisms directly to the observed clinical outcomes. To advance the field, researchers should consider overarching theories with testable hypotheses when designing studies, and use consistent terminology when reporting results. This review lays a foundation for progress towards a unified theoretical framework and for effective treatment of the whole cancer patient.

The Mediterranean Diet, characterized by high intake of plant foods and unsaturated fats, has been suggested to improve assisted reproductive technology (ART) outcomes. This literature review aimed to summarize the evidence from observational studies on the associations between preconception Mediterranean Diet and ART outcomes. PubMed/MEDLINE, Embase, ScienceDirect, and Google Scholar databases were searched to identify relevant studies. Seven observational studies (n=2,321 women on ART) were included. Adherence to the Mediterranean Diet was assessed by food frequency questionnaires with 6-195 items. Three studies found that higher Mediterranean Diet scores improved Clinical Pregnancy or Live Birth rates, while two studies showed a positive effect on ART eggs and embryos. However, two studies reported no significant associations with ultimate ART success, and four studies found no effects on oocyte and embryo number or quality. Evidence for the effects of greater adherence to the Mediterranean Diet on ART outcomes is limited but promising. Additional rigorous research is needed to clarify and weigh the degree of association between the Mediterranean Diet and ART success.

Periacetabular osteotomy (PAO) is an effective approach for surgical treatment of developmental dysplasia of the hip (DDH). However, due to the complex anatomical structure around the hip and limited field of view (FoV) during the surgery, it is challenging for surgeons to perform a PAO surgery. To solve this challenge, we propose a robot-assisted augmented reality (AR)-guided surgical navigation system for PAO. The system mainly consists of a robot arm, an optical tracker, and a Microsoft HoloLens 2 which is a state-of-the-art (SOTA) optical see-through head-mounted display (OST-HMD). For AR guidance, we propose an optical marker-based virtual-physical registration method to estimate a transformation from the optical tracker coordinate system (COS) to the virtual space COS, such that virtual models can be superimposed on the corresponding physical counterparts. Furthermore, to guide the osteotomy, the developed system automatically aligns the bone saw with osteotomy planes planned in preoperative images, and then provides surgeons with not only robot assistance but also AR guidance. Comprehensive experiments were conducted to evaluate both virtual-physical registration accuracy and osteotomy accuracy of the developed navigation system. The proposed virtual-physical registration method achieved an average mean absolute distance error (mADE) of 1.96 ± 0.43 mm. The developed system achieved an average distance deviation of 0.82 ± 0.17 mm and an average angular deviation of 3.77 ± 0.85 . Experimental results demonstrated high virtual-physical registration accuracy. The sub-millimeter distance deviation demonstrated the osteotomy accuracy of the proposed system.

Large datasets play a crucial role in the progression of surgical robotics, facilitating advancements in the fields of surgical task recognition and automation. Moreover, public datasets enable the comparative analysis of various algorithms and methodologies, thereby assessing their effectiveness and performance. The ROSMA (Robotics Surgical Maneuvers) dataset provides 206 trials of common surgical training tasks performed with the da Vinci Research Kit (dVRK). In this work, we extend ROSMA dataset with two annotated subsets: ROSMAT24, which contains bounding box annotations for instrument detection, and ROSMAG40, which contains high and low level gesture annotations. We propose an annotation method that provides independent labels for the right-handed tool and the left-handed tool. For instrument identification, we validate our proposal with a YOLOv4 model in two experimental scenarios. We demonstrate the generalization capabilities of the network to detect instruments in unseen scenarios. For gesture segmentation, we propose two label categories: high-level annotations that describe gestures at a maneuvers level, and low-level annotations that describe gestures at a fine-grain level. To validate this proposal, we have designed a recurrent neural network based on a bidirectional long-short term memory layer. We present results for four cross-validation experimental setups, reaching up to a 77.35% mAP.

About 70% of children and adolescents with cerebral palsy experience gait impairments which affect their autonomy and well-being. Robotic-assisted gait training using the Lokomat is particu-larly promising for rehabilitation as it provides a standardized environment favoring the massive repetition of the movement, in which physical demands are low on the therapist and high training loads can be achieved. As no guidelines exist regarding training protocols and Lokomat settings, the goal of this study was to review the literature on Lokomat-assisted gait therapy and possibly make training recommendations. The twelve studies reviewed reported both positive and null effects of Lokomat training on gait. Half of the studies combined Lokomat with other types of training and only five used a control intervention to assess its benefit. Overall, training was administered 1-5 times per week for 20-60 minutes, over 1-12 weeks. Although Lokomat settings were not always described, progressively decreasing body-weight support and guidance, while increasing treadmill speed appear to be prioritized. The variety of training protocols and settings used did not allow pooling of the studies to assess effects of interventions on gait parameters in children and adoles-cents with cerebral palsy. This review highlights the need for homogenization of interventions so that clear guidelines can emerge and be applied in rehabilitation centers.

We report on an exploratory study conducted at a graduate school in Sweden with a humanoid robot, Baxter. First, we describe a list of potentially useful capabilities for a robot teaching assistant derived from brainstorming and interviews with faculty members, teachers, and students. These selected capabilities consist of reading, greeting, alerting, remote operation, clarification, and motion. Second, we present feedback on how the robot's capabilities, demonstrated in part with the Wizard of Oz approach, were perceived, and iteratively adapted over the course of several lectures, using the \EP tool. Third, we discuss observations and findings regarding the capabilities and the development process. Our findings suggest that using a social robot as a teaching assistant is promising using the chosen capabilities. We find that personalizing the capabilities and the role of embodiment are important topics to be considered in future work.

Service robots operating in indoor environments should recognize dynamic changes from sensors, such as RGB-D camera, and recall the past context. Therefore, we propose a context query-processing framework, comprising spatio-temporal robotic context query language (ST-RCQL) and spatio-temporal robotic context query-processing system (ST-RCQP), for service robots. We designed them based on the spatio-temporal context ontology. ST-RCQL can query not only the current context knowledge but also the past. In addition, ST-RCQL includes a variety of time operators and time constants, and thus queries can be written very efficiently. The ST-RCQP is a query-processing system equipped with a perception handler, working memory, and backward reasoner for real-time query-processing. Moreover, ST-RCQP accelerates query-processing speed by building a spatio-temporal index in the working memory, where percepts are stored. Through various qualitative and quantitative experiments, we demonstrate the high efficiency and performance of the proposed context query-processing framework.

Dog Assisted Therapy is hypothesized to lower stress in children with Autism Spectrum Disorder (ASD) and children with Down Syndrome (DS), which may be visible on a physiological level. In this study, we measured Heart Rate Variability (HRV) and salivary cortisol of 20 children with DS or ASD at the beginning and end of 6 weekly sessions of Dog-Assisted Therapy. We found a decrease of cortisol levels during single sessions, but no overall effect after 6 sessions (6 weeks). The effect of Dog Assisted Therapy on the increase of HRV could not be confirmed. This study is one of the first to use physiological measurements to test the effects of DAT.

Not a lot is known about either death or the dying process. Politicians and many in the medical profession in the UK tend to shy away from interfering with it by not allowing euthanasia as an end of life option for the patient. This is the first paper in a series of two, comparing the situation in human medicine and veterinary medicine, in which euthanasia is well practiced for relieving suffering at the end of an animal’s life. This first part takes the form of a literature review including best practice around end of life care, its deficiencies and the need for assisted dying. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. In countries which have legalized physician assisted suicide for the terminally ill reporting indicates that it works well, without increases in involuntary euthanasia and most importantly without intimidation of the vulnerable. However, there is still an ever increasing tendency to overuse sedation and opioids at the end of life, which merits further investigation. With advances in medical science able to significantly prolong the dying process, patient autonomy demands a review of the law in the UK.

This paper provides a structured and practical roadmap for practitioners to integrate Learning from Demonstration (LfD) into manufacturing tasks, with a specific focus on industrial manipulators. Motivated by the paradigm shift from mass production to mass customization, it is crucial to have an easy-to-follow roadmap for practitioners with moderate expertise, to transform existing robotic processes to customizable LfD-based solutions. To realize this transformation, we devise the key questions of "What to Demonstrate", "How to Demonstrate", "How to Learn", and "How to Refine". To follow through these questions, our comprehensive guide offers a questionnaire-style approach, highlighting key steps from problem definition to solution refinement. The paper equips both researchers and industry professionals with actionable insights to deploy LfD-based solutions effectively. By tailoring the refinement criteria to manufacturing settings, the paper addresses related challenges and strategies for enhancing LfD performance in manufacturing contexts.

Robotic surgery is a rapidly developing and evolving surgical technique. This literature review evaluates the advantages and disadvantages in the context of gallbladder disease comparing robotic Cholecystectomy to the well-established laparoscopic Cholecystectomy. Significant advantages are reduced operative blood loss, hospital stays and post operative pain, alongside increased patient satisfaction and improved visualization and precision compared to the laparoscopic approach. Disadvantages include lack of tactile feedback, significant cost attributed to equipment, training requirements and increased procedural time due to the set-up sequences. The implementation of robotic surgery also poses significant changes for the training of future surgeons. Whilst it can standardize training and increases opportunity for simulation, the concern is the loss of traditional skills. Currently the evidence base remains mixed however the use of robotics in the right setting, with suitably trained operatives and appropriate patients can enable improved outcomes for patients with gallbladder disease. There is a lot of scope for development including the implementation of tactile feedback to aid operative technique and artificial intelligence to aid patient safety. Likely broadening the use and potential benefit of robotic surgery not only for cholecystectomy but many surgical specialties.

Background and Objectives: The aim of this study is to investigate the diagnostic-therapeutic prob-lem of pelvic recurrence of rectum cancer, highlighting current surgical standards and the possi-ble role of the minimally invasive approach. This retrospective analysis of our surgical case study wishes to enter this debate while suggesting a possible line of action, based on the site of recur-rence. Materials and Methods: We examined, retrospectively, all the patients diagnosed, between 2008 and 2018, with cancer of the rectum at the "Pietro Valdoni" Department of Surgery and monitored their follow-up for 5 years. The sample consisted of 368 patients with rectal neoplasm, 136 females and 232 males, with an average age of 65.8 (ranging from 37 to 86). In 103 of the cases, the neo-plasm was located in the upper rectum (28%), in 119 cases in the middle rectum (32.3%), in 102 cases in the lower rectum (27.7%), in 31 cases (8.4%) at the level of the right/sigma junction and in 13 cases it was not possible to define the site with certainty (3.5%). Results: We examined all patients diagnosed with cancer of the rectum between 2008 and 2018 at the "Pietro Valdoni" Department of Surgery retrospectively and monitored their follow-up for 5 years. The sample consists of 368 patients with rectal neoplasm, 136 females and 232 males. Conclusions: The discussion remains open as to which approach is best at surgical level, whether laparoscopic, robotic or open-air. Our experience informs us that the most dangerous site remains on the anastomotic site.

Dairy cattle predicted by genomic breeding values to be heat tolerant are known to have less milk production decline and lower core body temperature increases in response to elevated temperatures. In a study conducted at the University of Melbourne’s Dookie Robotic Dairy Farm during summer, we identified the most 20 heat-susceptible and 20 heat-tolerant cows in a herd of 150 Holstein Friesian lactating cows based on their phenotypic responses (changes in respiration rate, surface body temperature, panting score, and milk production). Hair samples were collected from the tip of the cows' tail following standard genotyping protocols. The results indicated variation in feed saved and HT genomic estimated breeding values (GEBVs) (P≤0.05) across age, indicating a potential for their selection. As expected, the thermotolerant group had higher GEBVs for HT and feed saved but lower for milk production. In general, younger cows had superior GEBVs for Balanced Performance Index (BPI), Type Weighted Index (TWI) and Australian Selection Index (ASI), whilst older cows were superior in fertility, feed saved (FS) and HT. The study demonstrated highly significant (P≤ 0.001) negative correlations (-0.28 to -0.74) between HT and GEBVs for current Australian Dairy cattle selection indices (BPI, TWI, ASI, HWI) and significant (P≤ 0.05) positive correlations between HT and GEBVs for traits like FS (0.45) and fertility (0.25). Genomic selection for HT will help improve cow efficiency and sustainability of dairy production under hot summer conditions. However, a more extensive study involving more lactating cows across multiple farms is recommended to confirm the associations between the phenotypic predictors of HT and GEBVs.

This paper addresses the effects of electric power quality on robotics operation. A general overview is reported to highlight the main characteristics of electric power quality and their effects on a powered system by considering an end-users viewpoint. Then, authors outline the influence of voltage dip effects by focusing at robotic grasping applications. A specific case of study is reported as referring to LARM Hand IV, a three-fingers robotic hand, which has been designed and built at LARM in Cassino. A dedicated test rig has been settled up for generating predefined voltage dips. Experimental tests are carried out for evaluating the effects of different types of voltage dips on the grasping of objects.

Introduction: Novel robotic surgery systems (da Vinci Xi) are superior to classical open and laparoscopic techniques with its clear and three-dimensional view. We aimed to present the first case low anterior resection of rectal cancer and vaginal specimen extraction with Da Vinci Xi.Case: A 75-year-old female patient with rectum adenocarcinoma was undergone robotic-assisted low anterior resection (LAR) of the rectum, vaginal removal of the specimen, colorectal anastomosis and loop ileostomy. The operation time was 190 minutes. There were no postoperative complications. Pathological tumor stage was stage pT1N0 with negative proximal, distal and radial resection margins. The patient was discharged on the third postoperative day.Conclusion: Robot-assisted LAR, total mesorectal excision, vaginal removal of the specimen, colorectal anastomosis, and loop ileostomy can be performed easily and safely with Da Vinci Xi at early stage rectal cancer. And the vaginal extraction of the specimen avoids us from a traditional abdominal incision.

Introduction: Breast ptosis is characterized by the downward nipple-areola complex displacement below the inframammary fold. Breast ptosis is associated with ageing and its concomitant changes in estrogen levels in conjunction with other factors like macromastia, weight loss, pregnancy, and both alcohol and tobacco consumption products affecting breast tissue architecture impacting the well-being and quality of life in the affected women. This study aimed to evaluate the efficacy of a novel mastopexy technique in patients with breast ptosis. Methods: A longitudinal, non-experimental, analytical study was done in a cohort of 231 women diagnosed with breast ptosis treated with a novel low-level multifrequency laser-assisted mastopexy assessing sternal notch-to-nipple distance (SNND) and breast ptosis status according to the Regnault system at the first, second, and third postoperative month. Additionally, the incidence and nature of compli-cations within the first 30 days post-surgery were evaluated according to the Clavien-Dindo system. Results: The breast ptosis proportion significantly changed across the three-month fol-low-up period from 100% to only 10% (all ptosis grade I). 90% of the patients achieved the non-ptosis grade according to the Regnault system (p

The goal of this research is to determine the optimal microwave-assisted sol-gel synthesis pa-rameters of TiO2 nanoparticles with the achievement of the crystalline TiO2 nanoparticles with the highest specific surface area and the lowest energy band gap. Titanium isopropoxide was used as a precursor to prepare the sol (colloidal solution) of TiO2, isopropanol as a solvent, acetylacetone for complexation, and nitric acid as a catalyst. Four samples of titanium dioxide were synthesized from the prepared colloidal solution in a microwave reactor at a temperature of 150 °C for 30 minutes and at a temperature of 200 °C for 10, 20, and 30 minutes. The phase composition of the prepared samples was determined by X-ray diffraction analysis (XRD) and Fourier-transform infrared spectroscopy (FTIR). Nitrogen adsorption/desorption isotherms were used to determine the spe-cific surface area and pore size distributions by Brunauer-Emmett-Teller (BET) method. The band gap energy values of the TiO2 samples were determined by diffuse reflectance spectroscopy (DRS). CrystallineTiO2 nanoparticles with the highest specific surface area and the lowest energy band gap were obtained for the TiO2 sample synthesized at 200 °C for 10 minutes.

: The effect that the microstructure exerts on the TRIP phenomenon and on the mechanical properties in a multiphase steel was studied. Samples of an initially cold-rolled ferrite-pearlite steel underwent different intercritical annealing treatments at 750 °C until an equal fractions of austenite/ferrite was reached; the intercritical treatment was followed by isothermal bainitic treatments before cooling the samples to room temperature. Samples in the first treatment were heated directly to the intercritical temperature, whereas other samples were heated to either 900 or 1100 °C to obtain a fully homogenized, single phase austenitic microstructure prior to the conducting the intercritical treatment. The high temperature homogenization of austenite resulted in the decrease in its stability, so a considerable austenite fraction transformed into martensite by cooling to room temperature after the bainitic heat treatment. Most of the retained austenite transformed during the tensile tests, and as a consequence, the previously homogenized steels showed the highest UTS. In turn, the steel with a ferritic-pearlitic initial microstructure, exhibited higher ductility than the other steels and texture components that favor forming processes.

In order for robots to attain more general-purpose utility, grasping is a necessary skill to master. Such general-purpose robots may use their perception abilities in order to visually identify grasps for a given object. A grasp describes how a robotic end-effector can be arranged on top of an object to securely grab it between the robotic gripper and successfully lift it without slippage. Traditionally, grasp detection requires expert human knowledge to analytically form the task-specific algorithm, but this is an arduous and time-consuming approach. During the last five years, deep learning methods have enabled significant advancements in robotic vision, natural language processing, and automated driving applications. The successful results of these methods have driven robotics researchers to explore the application of deep learning methods in task generalised robotic applications. This paper reviews the current state-of-the-art in regards to the application of deep learning methods to generalised robotic grasping and discusses how each element of the deep learning approach has improved the overall performance of robotic grasp detection. A number of the most promising approaches are evaluated and the most successful for grasp detection is identified as the one-shot detection method. The availability of suitable volumes of appropriate training data is identified as a major obstacle for effective utilisation of the deep learning approaches, and the use of transfer learning techniques is identified as a potential mechanism to address this. Finally, current trends in the field and future potential research directions are discussed.

Electroless etching of semiconductors was elevated to an advanced micromachining process by the addition of a structured metal catalyst. Patterning of the catalyst by lithographic techniques facilitates the patterning of crystalline and polycrystalline wafer substrates. Galvanic deposition of metals on semiconductors has a natural tendency to produce nanoparticles rather than flat uniform films. This characteristic makes possible the etching of not only wafers but also particles with arbitrary shape. While it has been widely recognized that spontaneous deposition of metal nanoparticles can be used in connection with etching to porosify wafers, it is also possible to produced nanostructured powders. MACE can be controlled to produce (1) etch track pores with shapes and sizes closely related to the shape and size of the metal nanoparticle, (2) hierarchically porosified substrates exhibiting combinations of large etch track pores and mesopores, and (3) nanowires with either solid or mesoporous cores. This review discussed the mechanisms of porosification, processing advances and the properties of the etch product with special emphasis on the etching of silicon powders.

This is the second of a series of two papers comparing the end of life issues in human and veterinary medicine. We outline the main differences between human and animal patients such as patient communication, finance and ‘conflicts of interest’ between animal, owner and veterinarian. We discuss striking similarities between human and veterinary issues such as assessing quality of life and the primary role of the attending veterinarian or doctor being the welfare and care of the patient. This paper takes the form of an ethical argument in favour of allowing euthanasia in human medicine, by providing insights into end of life issues for humans from an independent veterinary perspective. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. Doctors in the UK are limited and unwilling to put forward a case for the option of euthanasia for those patients who face a slow and agonizing death. With advances in medical science being able to significantly prolong the dying process, autonomy for the patient demands a review of the law regarding patient choice in the UK.

The integration of Artificial Intelligence (AI) in healthcare has transformed clinical practices by improving the accuracy of diagnosis, optimizing surgical procedures, improving the patient experience, and accelerating drug development. This article provides a comprehensive overview of the many applications of artificial intelligence (AI) across several industries, including fast diagnostics, where ML algorithms greatly enhance the accuracy and velocity of disease diagnosis. State-of-the-art robotic-assisted minimally invasive surgical procedures that shorten patients' hospitalization and improve their chances of recovery, cutting-edge AI applications in healthcare monitoring, and medication development. The article also looks at the primary challenges that AI in healthcare will inevitably encounter, such as differences in product quality, a shortage of skilled workers, privacy and ethical issues, and the need for improved regulatory frameworks. Despite the challenges, AI contributes significant advantages to the healthcare industry, providing novel and remarkable contributions to the efficiency of medical procedures and the progress of medical outcomes. The paper emphasizes the importance of cooperation in overcoming current challenges and enhancing the acceptability of AI technology in clinical settings. This will ensure that AI-driven innovations continue to enhance the standards of patient care.

This paper addresses the approach of fully automated intelligent control systems in production organizations, focusing on intelligent production systems research. The overview highlights a gap in control operations ahead of assembly as single-purpose control machines are frequently employed, which is precisely their drawback. Conversely, there are accurate multipurpose measurement centers that do not provide total quality control over the manufactured parts because of the cost and length of the measuring procedure. The study's primary objective was to create an intelligent modular control system, whose concept enables it to control various components. The purpose of the modular intelligent control system is to keep an eye on each module's quality during the pre-assembly phase. This system ensures exact control over the production process of modules by integrating sophisticated sensors, diagnostic tools, and intelligent control mechanisms. The technology makes it possible to monitor several parameters and important quality features. Integrated sensors and diagnostic technologies identify possible inaccuracies and disparities, guaranteeing prompt diagnosis of issues in specific modules. The system's intelligent control algorithms streamline the production process and guarantee synchronization between individual modules to achieve consistent quality and performance. One advantage of implementing the solution is that, on average, inspection time is reduced by 40 to 60% as compared to the prior manual inspection approach. In addition, full measurement data archiving was made available, and finally, the human element—which introduced a substantial error rate into this process—was removed. This system also helps to increase the project's overall efficiency, predictability, and safety while allowing for quick adjustments by standards and requirements.

Inland waters pose a unique challenge for water quality monitoring by remote sensing techniques due to their complicated spectral features and small-scale variability. At the same time, collecting the high-quality reference data needed to calibrate remote sensing data products is both time consuming and expensive. In this study, we present the further development of a robotic team composed of an uncrewed surface vessel (USV) providing in situ reference measurements and an unmanned aerial vehicle (UAV) equipped with a hyperspectral imager. Together, this team is able to address the limitations of existing approaches by enabling the simultaneous collection of comprehensive in situ data together with high-resolution hyperspectral imagery. We showcase the capabilities of this team using data collected in a north Texas pond during three collections in the fall of 2020. Machine learning models for 13 variables are trained using the data set of paired in situ measurements and coincident reflectance spectra. These models can successfully estimate physical variables, including temperature, conductivity, pH, and turbidity, as well as the concentrations of blue-green algae, colored dissolved organic matter (CDOM), chlorophyll-a, crude oil, optical brighteners and the ions Ca2+, Cl−, and Na+. We extend the training procedure to utilize conformal prediction to estimate 90% confidence intervals for the output of each trained model. The maps generated by applying each trained model to the collected images reveal the small-scale spatial variability within the pond. Additionally, the permutation importance computed for each feature of the trained models highlights the spectral features relevant to each water quality variable.

(1) Background: Mobile health (mHealth) solutions can become means of improving functional recovery and reducing the peri-operative burden and costs associated with arthroplasty procedures. Aim of this study is to explore the objectives, functionalities, and outcomes of a platform designed to provide personalized surgical experiences to qualified patients, along with the associated problems and opportunities. (2) Methods: A survey-based analysis was conducted on patients who were prescribed the use of a specific care management platform and underwent primary Robotic total knee arthroplasty (rTKA) between January 2021 and February 2023. (3) Results: Patients registered on the platform who have undergone primary Robotic TKA (rTKA) were considered. The mean age of registered patients is 68,6 years. The male (M) / female (F) ratio is 45.1% / 54.9%. The patients interviewed were at an average distance of 485 days from the intervention, with a standard deviation of 187.5. The survey highlighted appreciation for the App and its features but limits in its use and in its perception from the patients. All these data were evaluated according to the Wald principles and strategies to improve patient recruitment, enhance adherence, and create a comprehensive patient journey for optimized surgical experiences were analyzed. (4) Conclusions: This patient care platform may have the potential to impact surgical experiences by increasing patient engagement, facilitating remote monitoring, and providing personalized care. There is the need to emphasizes the importance of integrating the recruiting process, improving adherence strategies, and creating a comprehensive patient journey within the platform

The COVID-19 outbreak demonstrated the viability of various remote working solutions, telepresence robots (TPRs) being one of them. High-quality video transmission is one of the cornerstones of using such solutions, as most of the information about the environment is acquired through vision. This study aims to compare the camera capabilities of four models of popular telepresence robots using compact reduced LogMAR and Snellen optometry charts as well as text displayed on the projector screen. The symbols from the images are extracted using OCR (Optical Character Recognition) software and the results of the recognition are compared with the symbols on the charts. Double 3 TPR provides the best quality images of optometric charts, but the OCR results of measurements of the image on the projector do not show the clear advantage of one single model over the others. The results demonstrated by Temi 2 and Double 3 TPRs are generally better than the others, suggesting that these TPRs are more feasible to be used in teaching and learning scenarios.

Background: Mood disorders, especially depression, and emotional difficulties such as anxiety are very common problems among patients with spinal cord injury (SCI). The loss of physical training may deteriorate their mental state, which in turn has a significant impact on the improvement of functioning. The aim of the present study was to examine the influence of innovative rehabilitation approaches involving robotic assisted gait therapy (RAGT) on mood and anxiety symptoms in pa-tients with SCI. Methods: To this single-centre, single-blinded, single-arm, prospective study, 110 participants with subacute SCI were enrolled; patients were divided into experimental (robotic assisted gait therapy -RAGT) and control (conventional gait therapy with dynamic parapodium - DPT) groups. They received five training sessions per week over 7- weeks. The severity of de-pression was assessed by Depression Assessment Questionnaire (KPD) and anxiety symptoms by State - Trait Anxiety Inventory (STAI X-1) on the beginning and end of therapy. Results: SCI patients experienced significantly lower levels of anxiety and depression-related symptoms after completing the seven-week rehabilitation program (KPD: Z=6.35; p<0.001; r=0.43; STAI X-1: Z=-6.20; p<0.001; r=0.42) in both group of patients. In the RAGT group, post-rehabilitation measurements also indicated an improvement in psychological functioning, i.e., a decrease in depression and anxiety, and an increase in self-regulation. Significant results were noted for each variable (STAI X-1: Z = -4.93; KPD: Z = -5.26; SR: Z = -3.21). In the control group, there was also a decrease in the effect on the depression, anxiety-state and an increase in self-regulation ability (STAI X-1: Z=-4.01; KPD: Z=-3.65; SR: Z=-2.83). Rehabilitation modality did not appear to have a statistically significant relationship with the magnitude of improvement in KPD (including SR) and STAI scores. However, there were some significant differences when comparing the groups by extent and depth of injury and type of paralysis. The study also did not find a significant rela-tionship between improvements in physical aspects and changes in psychological factors. Conclusion: Subjects in RAGD and DPT groups experienced a decrease in anxiety and depres-sion after a 7-week rehabilitation program. However, the rehabilitation modality (DPT vs. RAGT) did not differentiate patients with SCI in terms of the magnitude of this change. Our results may suggest that individuals with severe neurological condition and complete spinal cord injury (AIS A) may experience more benefit in terms of change in psychological parameters after rehabilitation with RAGT.

Palpation is a simple but effective method to differentiate tumors from healthy tissues. Development of miniaturized tactile sensors embedded on endoscopic or robotic devices are the key toward precise palpation diagnosis and the subsequent timely treatment. This paper reports on the fabrication and characterization of a novel tactile sensor with mechanical flexibility and optical transparency that can be easily mounted on soft surgical endoscopes and robotics. Utilizing the pneumatic sensing mechanism, the sensor offers a high sensitivity of 1.25 mbar and negligible hysteresis, enabling the detection of phantom tissues with different stiffnesses ranging from 0 to 2.5 MPa. Our configuration combining pneumatic sensing and hydraulic actuating also eliminates electrical wiring from the functional elements located at the robot end-effector, thereby enhancing the system safety. The optical transparency path in the sensors together with its mechanical sensing capability open interesting possibility in early detection of solid tumor as well as in the development of all in-one soft surgical robots that can perform visual/mechanical feedback and optical therapy.

Background: We assess locoregional drug targeting effectiveness of intraoperative (IO) cryoprobe-assisted injection of blue dye (BD) and cytotoxic-tracer mixture (TTM), in VX2 tumor model, and its translational value to cryo-assisted breast tumor surgery with BD alone. Methods: Under computed tomography (CT) guidance, we injected two ml TTM in five aliquots in the margin of 16 frozen or normothermic VX2 tumors. We evaluated the IO and post-operative drug targeting and therapeutic efficacy in tumor-host interface (T-HI) by CT, gross examination, and histopathology. In twenty-six T1 to T4 primary breast cancer (BRCA) we performed ultrasound-guided (US) cryoprobe-assisted tumor freezing, BD guided lymphatic mapping, and surgery. We evaluated, IO and in freshly resected specimen, BD distribution pattern in T-HI, lymph node(s), breast parenchyma, and resection cavity. Results: Fluids-impervious frozen VX2 or breast tumor transported drug(s) an arc-like pattern at T-HI regardless of freeze dose, number of freeze-thaw cycles, drug dose fractionation, tumor characteristics or dimensions. During melting, TTM spread within fifty percent VX2 tumor mirrored that of T-HI; it was massive in normothermia. In VX2 twenty percent focal margin necrosis at pathology coincided with CT gap; in both studies, BD dose-staining spread in T-HI and tumor was linear. Eighty-four patients had one to twelve stained axillary lymph nodes; sixty-nine percent and all respectively, had another quadrant and resection cavity stained. Conclusion: Intraoperative freezing-assisted drug delivery and targeting techniques during cryoablation of VX2 tumor translate successfully to locoregional BD targeting, lymphatic mapping during cryo-assisted surgery of breast cancer.

Background/Objectives: Forceps delivery is a crucial obstetrical technique that has been increasingly underutilized in favor of cesarean delivery, despite numerous complications related to cesarean section. The major concerns in assisted vaginal birth (AVB) are the safety and long-term consequences. Thus, we aimed to investigate the neurodevelopmental outcome of children born with forceps delivery up to the age of seven. Methods: A prospective descriptive study was conducted from January 2011 to December 2016 among 49 women from our department in the Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia. The study included women with term singleton cephalic pregnancies. Descriptive statistics were calculated for the baseline demographic and clinical features, whereas the logistic regression analysis was used to explore the association between various perinatal parameters and neurological status of newborns. The Sarnat and Sarnat classification was used to evaluate neurological status of newborns, while long-term neurodevelopmental outcome was assesed with Griffiths Mental Development Scale and additional questions based on the neurologist's clinical practice and experience. Results: Pathological neurological status of the newborn was found in 16.3%, with pathological ultrasound of CNS in 3%. A statistically significant association was observed with Apgar score, odds ratio of 0.575 (95% CI: 0.407–0.813, p = 0.002) and perinatal asphyxia, odds ratio of 9.882 (95% CI: 1.111–87.902, p = 0.04). However, this was unlikely to be related to the mode of delivery. Long-term adverse neurological outcome was seen in three cases, which accounts for 6.4%. These included mild disorders, such as delayed milestone, speech delay and motor clumsiness. Conclusion: The present study highlights the safety of forceps delivery regarding children's neurological outcomes at 7 years of age. This is an important contribution to the modern management of labor, especially in light of increasing rates of cesarean deliveries worldwide.

Recent technological advances, including capsule endoscopy (CE) and balloon-assisted endoscopy (BAE), have revealed that small intestinal disease is more common than previously thought. CE has advantages including, high diagnostic yield, discom-fort-free, outpatient basis, and physiological images. BAE enabled endoscopic diagnosis and treatment in the deep small bowel. Computed tomography (CT) enterography with negative oral contrast can evaluate masses, wall thickening, and narrowing of the small intestine. In addition, Enhanced CT can detect abnormalities outside the gastrointestinal tract that endoscopy cannot evalu-ate. Each modality has its advantages and disadvantages, and a good combination of multiple modalities leads to an accurate diagnosis. As a first-line modality, three-phase enhanced CT is preferred. If CT shows a mass, stenosis, or wall thickening, a BAE should be selected. If there are no abnormal findings on CT and no obstructive symptoms, CE should be selected. If there are sig-nificant findings in the CE, determine the indication for BAE and its insertion route based on these findings. Early diagnosis of small intestinal tumors is essential for favorable outcomes. For early diagnosis, the possibility of small bowel lesions should be considered in patients with unexplained symptoms and signs after examination of the upper and lower gastro-intestinal tract.

Objectives: Chylothorax is a relatively rare condition of lymphatic fluid accumulation in the thoracic cavity due to a leakage from the thoracic duct or its tributaries. Patients present with dyspnea, malnutrition, and immunosuppression. Treatment can be conservative or surgical, depending on etiology and clinical course. The optimal management algorithm for chylothorax is still controversial. Methods: This is a retrospective study of all patients with chylothorax treated at our Department of Thoracic Surgery during the 10-year period. Results: A total of 14 patients were identified for the study. Nine patients had chylothorax after lung or esophageal cancer surgery. Four patients had chylothorax in advanced lymphoma. One patient had chylothorax after blunt chest trauma. A conservative approach was initiated in most patients (92%), including pleural drainage, nil per mouth, total parenteral nutrition, and somatostatin 0.1 mg bid subcutaneously. Surgical treatment was indicated in patients with thoracic drain production >800 mL per day beyond the fifth day of treatment and those with blunt thoracic trauma. Two patients had thoracic duct ligation via right-sided thoracotomy, and five patients had video-assisted thoracoscopic thoracic duct ligation with the immediate arrest of chylous leakage. Conclusion: Chylothorax should be treated conservatively initially. Surgical treatment should not be delayed in case of failure beyond the fifth day. In our series of patients, a video-assisted thoracoscopic approach for thoracic duct ligation proved to be minimally invasive, highly efficient, and well tolerated by patients and, therefore, should be the preferable route of surgical treatment.

Silicon-based thin-films and nanostructures are of paramount importance in a wide range of applications, including microelectronics, photovoltaics, large area sensors, as well as biomedicine. The wide accessibility of silicon and its relatively low cost have driven a continuous improvement of the technology based on this element. Plasma technology has been widely used for the synthesis of coatings and nanostructures based on silicon. Moreover, it has given a fundamental contribution for continuously improving the control of the physicochemical properties of silicon-based materials, and for allowing the synthesis of nanometric structures with well-defined shape and morphology. In this work, we have reviewed the most interesting developments of plasma-assisted processed for the synthesis of Si-based materials, both inorganic and organic, in the last five years. A special attention has been given to the new techniques, or modifications of already existing ones, that open new possibilities for the synthesis of materials with new properties, as well as nanostructures with novel characteristics.

Conventional phenotyping breeding approaches for vegetable crops like Solanaceae, Bulb, Root crops, have made a significant contribution by developing many varieties. Despite this, conventional phenotyping approaches are not sufficient due to the longer time taken to develop a variety, low genetic gain, environmental factors and some other externalities that affect the phenotype-based selection. To address the challenges of conventional phenotype, a new recent method of high throughput phenotyping (HTP) is considered a promising tool. The development of high-throughput phenotyping technology began in the preceding decade as advancements in sensor, computer vision, automation, and advanced machine learning technologies. HTP platforms are being utilized to undertake non-destructive assessments of the complete plant system in a range of crops. HTP provides the precise measurements and suggests the collection of high-quality and accurate data which is necessary for standardizing phenotyping for the collection of genetic dissection and genomic assisted breeding such as genome-wide association studies (GWAS), linkage mapping, marker-assisted selection (MAS), genomic selection (GS). The remainder of this chapter discusses how high-throughput phenotyping technologies can be used in genomic-assisted breeding for vegetable crops

Objective: The study aimed to explore the experiences of women undergoing Assisted Reproductive Technologies namely; Invitro Fertilization and Intracytoplasmic Sperm Injection at the Finney Hospital and Fertility Centre, New Bortianor, Ghana. Method: A qualitative research design was employed to analyse and describe the experiences of the women seeking Assisted Reproductive Technologies. Fifteen women were invited and interviewed using a semi-structured interview guide. The responses were transcribed verbatim and analysed using content analysis. Results: Three themes emerged from the study: the women’s experiences, challenges and the roles and contributions of significant others. The women were anxious, stressed-up, exhausted and financially burdened. Spouses and health professionals played significant roles by providing social, emotional and financial support for these women. Significant others such as spouses and close relatives were supportive and provided encouragement to the women. Conclusion: The experiences of women undergoing Assisted Reproductive Technologies are multi-dimensional. Thus psychosocial intervention as part of ART services with health insurance cover may be client-centered and more appropriate for these group of women.

Aim: To develop an index for quantitative assessment of the upper limb motor function in children with cerebral palsy before and after robot-assisted therapy. Method: An upper limb motor function index was developed using kinematic, surface electromyography and three-axis inertial measurements unit data collected from 15 children with cerebral palsy (CP) and 15 typically developed children. Children with CP underwent 18 robot-assisted therapy sessions with the REAplan device. All children were evaluated, using kinematic data from the REAplan, electromyography and three-axis inertial measurements unit readings from its accelerometer. A principal component analysis was conducted to produce an evaluation index, which is able to detect the deviation from the upper limb motor function of typically developing children group. Children with CP were evaluated twice before and after the intervention with Box and Blocks test and Finger-To-Nose test. The discriminative and concurrent validity of the upper limb motor function index were investigated. Results: The upper limb motor function index was higher in children with CP post therapy (p<0.001). Finger-To-Nose test values improved after robot-assisted therapy (p<0.03). A weak but positive correlation was observed between upper limb motor function index and clinical tests (r=0.012, p=0.95 and r=0.13, p= 0.54 for Box and Blocks test and Finger-To-Nose test respectively). Interpretation: The upper limb motor function index successfully differentiated between the typically developing children and children with CP and was effective in assessing the improvement of the upper limb motor function after robot-assisted therapy. The upper limb motor function index could be extended to assess and monitor rehabilitation therapies of other populations, such as those with stroke and Parkinson’s disease.

Within environmental perception, automatic navigation and object detection, computer vision is a crucial and demanding field with many applications in modern industries, such as multi-target long-term visual tracking in automated production, defect detection, and driverless robotic vehicles with sensing ability. The performance of computer vision has greatly improved recently thanks to developments in deep learning algorithms and hardware computing capabilities, which has spawned the creation of a large number of related applications. This paper presents the results of a detailed review of over 50 papers published over the course of two decades (1999–2024), with a primary focus on the technical advancement of computer vision. To elucidate the foundational principles, an examination of typical visual algorithms based on traditional correlation filtering was initially conducted. Subsequently, a comprehensive overview of the most recent advancements in deep learning-based computer vision techniques was compiled. Furthermore, a comparative analysis between conventional and novel algorithms was undertaken to discuss the future trends and directions of computer vision. Lastly, the feasibility of employing visual SLAM (Simultaneous Localization and Mapping) algorithms in the context of autonomous vehicles with sensing capability was explored. Furthermore, we explored a thorough and efficient architecture for utilizing these techniques in autonomous robotic vehicles into unmanned green and low-carbon smart factories, underlining novel advances as well as potential prospects for future research.

Robotic systems have been widely used in various industries, so the security of communication between robots and their components has become an issue that needs to be focused on. As a framework for developing robotic systems, the security of ROS2 can directly affect the security of the upper-level robotic systems. Therefore, it is a worthwhile research topic to detect and analyze the security of ROS2. In this paper, we adopt a formal approach to analyze the security of the communication mechanism of ROS2. First, we use a state transition system to model the potential vulnerabilities of ROS2 based on the ROS2 communication mechanism and the basic process of penetration testing. Secondly, we introduce the CIA model on the basis of the established vulnerability model and use LTL to define its security properties. Then, we design and implement a vulnerability detection tool for ROS2 applications based on the vulnerability model and security properties. Finally, we experimentally test some ROS2-based applications, and the results show that ROS2 has vulnerabilities without additional protection safeguards.

This paper proposes a new kind of airship actuator configuration for surveillance and environmental monitoring missions. We present the design and application of a 6-propeller electrical airship (Noamini) with independent tilting propellers, allowing improved and flexible maneuverability. The vehicle has different combinations of differential propulsion and can be used in 2, 4 or 6 motors configuration. We developed a high-fidelity airship simulator for the Noamini airship, which was used to test and validate a control-guidance approach. Incremental Nonlinear Dynamic Inversion (INDI) is used for the velocity/attitude control to follow a high-level L1 guidance reference in a simulated waypoint tracking mission with wind and turbulence. The proposed framework will be soon implemented in the onboard control system of the Noamini, an autonomous airship for environmental monitoring and surveillance applications.

Crack inspection is important to monitor the structural health of pavement structures and to facilitate an easier rehabilitation process. Currently, pavement crack inspection is conducted manually, which is inefficient and costly at the same time. For solving the problem, this work has developed a robotic system for automated data collection and analysis in real-time. The robotic system navigates on the pavement and collects visual images from the surface. A deep learning-based semantic segmentation framework named RCDNet was proposed and implemented on the onboard computer of the robot to identify cracks from the visual images. Simulation results show that the deep learning model obtained 96.29% accuracy for predicting the images. The proposed robotic system was tested on both indoor and outdoor environments and was observed that it can complete inspecting a 3m × 2m grid within 10 minutes and a 2.5m × 1m grid within 6 minutes. This outcome shows that the proposed robotic method can drastically reduce the time of manual inspection. Furthermore, a severity map based on the results from visual images was also generated to provide an idea of which locations should be paid more attention to repair in a test grid.

Bionic robotic hand can perform many movements similar to human hand. But there is still a significant gap in manipulation between robot and human hand. It is necessary to understand the finger kinematics and motion patterns of human hand to improve the performance of robotic hand. This study aimed to comprehensively investigate normal hand motion patterns by evaluating the kinematics of hand grip and release in healthy individuals. The data corresponding to rapid grip and release were collected from the dominant hand of 22 healthy people by sensory glove. The kinematics of 14 finger joints were analyzed, including the dynamic range of motion (ROM), peak velocity, joint sequence and finger sequence. The results show that the proximal interphalangeal (PIP) joint had a largest dynamic ROM than metacarpophalangeal (MCP) and distal interphalangeal (DIP) joints. Besides, the PIP joint had the highest peak velocity, both in flexion and extension. For joint sequence, the PIP joint moved prior to the DIP or MCP joints during flexion, while extension started in DIP or MCP joints, followed by PIP joint. Regarding the finger sequence, the thumb started to move before four fingers, and stopped moving after the fingers during both grip and release. This study explored the normal motion patterns in hand grip and release, which provided kinematic reference for the design of robotic hand and thus contribute to its development.

Vision-based tactile sensors (VBTS) have become the de facto method of giving robots the ability to obtain tactile feedback from their environment. Unlike other solutions to tactile sensing, VBTS offers high spatial resolution feedback without compromising on instrumentation costs or incurring additional maintenance expenses. However, conventional cameras used in VBTS have a fixed update rate and output redundant data, leading to computational overhead downstream. In this work, we present a neuromorphic vision-based tactile sensor (N-VBTS) that employs observations from an event-based camera for contact angle prediction. Particularly, we design and develop a novel graph neural network, dubbed TactiGraph, that asynchronously operates on graphs constructed from raw N-VBTS streams exploiting their spatiotemporal correlations to perform predictions. Although conventional VBTS uses an internal illumination source, TactiGraph is reported to perform efficiently in both scenarios, with and without an internal illumination source. Rigorous experimental results revealed that TactiGraph achieved a mean absolute error of 0.62∘ in predicting the contact angle and was faster and more efficient than both conventional VBTS and other N-VBTS, with lower instrumentation costs. Specifically, N-VBTS requires only 5.5% of the compute-time needed by VBTS when both are tested on the same scenario.

Over the years, Artificial Intelligence (AI) has seen a steady progress in development and evolution that can aid many sectors. Today, AI plays an essential role in the Fourth Industrial Revolution, and it is making its way into the military sector as well. Many countries are actively looking into AI military technology. Some of these innovations include image recognition, text analysis, Self-driving vehicles (SDV), gaming, robotic process automation (RPA) & Robotic and Autonomous Systems (RAS), and Autonomous Weapons Systems (AWS). In this research, we discuss the advantages of each innovation mentioned and analyze the many different cybersecurity threats that awaken due to military artificial intelligence systems. We then discuss the open research areas to better improve the current state of military artificial intelligence applications in terms of ethics, system security, proper strategy plan, accepted responsibility matrix, and introduction of relevant laws.

This paper describes and demonstrates an autonomous robotic team that can rapidly learn the characteristics of environments that it has never seen before. The flexible paradigm is easily scalable to multi-robot, multi-sensor autonomous teams, and is relevant to satellite calibration/validation and the creation of new remote sensing data products. A case study is described for the rapid characterisation of the aquatic environment, over a period of just a few minutes we acquired thousands of training data points. This training data allowed our machine learning algorithms to rapidly learn by example and provide wide area maps of the composition of the environment. Along side these larger autonomous robots two smaller robots that can be deployed by a single individual were also deployed (a walking robot and a robotic hover-board), observing significant small scale spatial variability.

In this work is represented conceptual model of robot-manipulator for capture and holding no-cooperation client spacecraft, which has Payload Adapter interface PAS 1666 S, PAS 1194 C, PAS 1666 MVS, PAS 1184 VS, when there are dynamic errors of linear and angular position of client spacecraft in the interval +/-5 deg. per minute and +/-0.1 meters per minute respectively.

Primary spontaneous pneumothorax (PSP) is a pleural disease that abruptly affects healthy adolescents and young adults, representing a common thoracic disorder in this age group. This study aimed to investigate the necessity of preoperative chest tube insertion in patients with PSP and to re-evaluate current clinical treatment approaches. A retrospective review of medical records was conducted for children and young adults aged 14–30 years, diagnosed with PSP and who underwent Video-assisted thoracoscopic surgery (VATS) between January 2016 and December 2022 at Wonju Severance Christian Hospital. Patients were retrospectively divided into two groups based on their initial treatment: chest tube insertion and non-chest tube insertion. Clinical data including demographics, treatment details, and outcomes were collected and compared. Total 128 cases of PSP were included in the study. The total length of hospital stay was significantly shorter in the non-chest tube group (p=0.000), which was attributed to the omission of pre-operative chest tube insertions. No significant differences were observed between the two groups in terms of postoperative complications or recurrence rates. In cases of young patients with PSP, omitting pre-operative chest tube insertion may be a viable option if the patient is scheduled for VATS.

(1) Background: the popularity of rabbits has increased during the last decades and became the third common companion animals in EU. Their participation in animal assisted interventions (AAI) is growing. It is highly important to ensure the well-being of the animals in AAI. Whereas the needs and the advantages of people involved in AAI are becoming more and more evident, the needs of animals are not clearly determined, it is required not to affect the animals negatively. Those animals who are used for AAI purpose need toneed to be transported regulrarly; (2) Methods: the rabbits stress – caused by transportation – were measured by non-invasive faecaesl cortisol metabolite (FCM) analysis. 18 animals were involved in the study and experienced a 30 minutes transportation every second day duringfor two weeks (total 6 times) while 128 samples were collected; (3) Results: rabbits –could handle the transportation procedure by the first and second time but subsequently the stress hormone metabolites in faeces samples increased significantly regardless of the offered treatments (hay, carrot and apple) during the carriage. (4) Conclusions: those owners who use rabbits for Animal Assisted Intervention purpose need to take into account that transportation itself is a stressful experience for the animals.

Deep sky observation is a fascinating activity, but it requires favourable conditions in order to be fully appreciated. Complex equipment, light pollution around urban areas, lack of contextual information often prevents newcomers from making the most of their observations, restricting the field to a niche expert audience. In this paper, we show how combining the usage of smart telescopes with eXplainable Artificial Intelligence makes the practice of astronomy even more accessible and educative, and how it has been applied during outreach sessions In Luxembourg Greater Region.

Excitation of the acoustic field leading to the Blaha effect affects the plasticity of the material significantly in ultrasonic vibration-assisted forming. In a micro-forming field, the effects are more significant in the deformation in surface of materials [1]-[3], in which reduction of the surface roughness based on the increasing of plastic deformation of surface asperity was effective [4]. On the other hand, the effect on deformation behavior of the bulk region indicted reduction in the yield stress of materials, and not only acoustic effect [5], but also impact effect is found to generate a large amount of dislocation and produce plastic deformation [6][7]. However, the effect on the bulk is more significant as that on the surface. Differences in the effect on the surface and the bulk are not clarified. In this study, the mechanism of the deformation in the surface of the material with ultrasonic vibration assistance is investigated and compared with that in the bulk. Forging tests using a newly developed ultrasonic vibrator were carried out on pure Cu foils with various process conditions. The longitudinal vibration frequency of the ultrasonic transducer is 60∓2kHz, and the vibration amplitude is in an adjustable range of 0~10μm. Forging test was carried out at different initial stress, specimen size and amplitude. The difference in acoustic softening and impact effects on the surface and the bulk was discussed.

The preparation of new materials based on starch for the development of biodegradable packaging is increasing, however, the poor properties of this biopolymer for this application causes an area of opportunities for the improvement of water vapour permeability (WVP), mechanical properties, thermal properties, hydrophilicity, water absorption, among others. Hence, starch has been combined with other polymers such as polyvinyl alcohol, which has shown an improvement in the mechanical properties of starch, also, the use of clays suggests that the properties of response to water can be improved. Therefore, in this work, the preparation and characterization of starch-PVA-nanoclay films prepared by solvent casting is reported. The results obtained suggest that the sonication of nanoclay is necessary to reach a good dispersion, which promotes a strong interaction among starch-PVA-nanoclay. In addition, the properties of WVP and mechanical properties of films improved with incorporation of nanoclay, the concentration of 0.5% w/v of nanoclay showed to be the best concentration due to concentrations of 1.0 and 1.5% w/v were poorer than 0.5% w/v. Accordingly, the successful incorporation of nanoclays into the matrix starch-PVA suggests that this material is a good candidate for use as packaging.

Cannabis is a flowering plant that has long been used for medicinal, therapeutic, and recreational purposes. Cannabis contains more than 500 different compounds, including a unique class of terpeno-phenolic compounds known as cannabinoids; Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most prevalent cannabinoids and have been associated with the therapeutic and medicinal properties of the cannabis plant. In this paper, continuous flow microwave assisted extraction (MAE) is presented and compared with other methods for commercial cannabis extraction. The practical issues of each extraction method are discussed. The main advantages of MAE are: continuous-flow method which allows for higher volumes of biomass to be processed in less time than existing extraction methods, improved extraction efficiency leading to increased final product yields, improved extract consistency and quality because the process does not require stopping and restarting material flows, and ease of scale-up to industrial scale without the use of pressurised batch vessels. Moreover, due to the flexibility of changing the operation conditions, MAE eliminates additional steps required in most extraction methods, such as biomass decarboxylation, winterisation, which typically adds at least a half day to the extraction process. Another factor that sets MAE apart is the ability to achieve high extraction efficiency even at the industrial scale. Whereas the typical recovery of active compounds using supercritical CO¬2 remains around 70-80%, via MAE up to 95% of the active compounds from cannabis biomass can be recovered at the industrial scale.

Rice (Oryza sativa L.) supplies nourishment to about half of the population of the world's inhabitants. Of them, more than 2 billion people suffer from "hidden hunger" in which they are unable to meet the recommended nutrients or micronutrients from their daily dietary intake. Bio-fortification refers to developing micronutrient-rich diet foods using traditional breeding methods and modern biotechnology, a promising approach to nutrition enrichment as part of an integrated strategy for food systems. To improve the profile of rice grain for the biofortification related traits, understanding the genetics of important biofortification traits is required. Moreover, these attributes are quantitative in nature and are influenced by several genes and environmental variables. In the course of past decades, several endeavours such, as finding the important quantitative trait loci (QTLs) for improving the nutrient profile of rice seeds were successfully undertaken. In this review, we have presented the information regarding the QTLs identified for the biofortification traits in the rice.

This research was presented the special designed microfluidic device generated for sperm separation based on assumption of different surface electrical charged of sperms X and Y. However, to avoid ethical problem, the microfluidic chip has been tested with the mimic electrical charged particles, TiO₂-coated Polystyrene beads, (TiO₂-coated Ps-beads), instead of spermatozoa. The work has been separated into three main parts. Firstly, the simply but efficient fabrication of negatively charged TiO₂-coated Ps-beads has been presented. In addition, various characterization techniques such as X-ray diffraction (XRD), Tungsten Scanning Electron Microscopy (W-SEM) with energy-dispersive X-ray spectroscopy (EDS) mode, and X-ray Absorption Spectroscopy (XAS), have been reported in this work to elucidate the reasons behind the persistence of negatively charged on the surface of TiO₂-coated Ps-beads. Results show that the fabricated TiO₂-coated Ps-beads was partly coated in the mixed forms of amorphous Ti⁴⁺ and had caused a negatively charge to appear on the surface after fabrication and had sustained its electrical charged for long. Secondly, process of simulation and fabrication of microfluidic device was presented. Finally the negatively charged TiO₂-coated Ps-beads were tested in this microfluidic devices. For design of microfluidic devices integrated with a couple of microelectrodes, the simulated structures were fabricated by photolithographic technique and tested with the Ps-beads. Percentage of validation for Ps-beads separation indicated that the 100 mm-distance-between-electrodes microfluidic device exhibits to be the highest performance prototype at 86.96%. For further confirmation, another model so called the single path prototype has been established. It is confirmed by 92.59% of validation for the utilization of the device. The successfully designed microfluidic devices can be examined with actual spermatozoa later. Furthermore, process to fabricate the negatively charged TiO₂-coated Ps-beads can be established as testified samples for development of other microfluidic devices.

Complex atypical endometrial hyperplasia (CAH) carries a high probability of cancer. Intraoperative evaluation of endometrial cancer in cases of CAH has not been reliable. The safety and sensitivity of sentinel lymph node (SLN) sampling has been validated. We aim to evaluate the efficacy and safety of SLN sampling in CAH managed by the da Vinci robotic platform. A total of 113 patients with a preoperative diagnosis of CAH were included in this retrospective cohort study. All underwent a robot assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with 69 patients undergoing SLN sampling. Statistical analysis calculated the probability of cancer, SLN map rate, and surgical complications. Predictors of cancer were evaluated. Forty-seven percent of the entire cohort were diagnosed with endometrial cancer. Median age was 63 years in the SLN cohort (N = 69) and 61 in the No SLN cohort (N = 44) (p= 0.363).  Median BMI was 34 Kg/m2 in the SLN cohort and 40 in the No SLN cohort (p= 0.004). Bilateral SLN map was 92.8% and unilateral SLN map rate was 7.2%. There were no grade 3-4 complications in the SLN cohort, and 4 grade 3-4 complications in the No SLN group (p=0.021). A preoperative diagnosis of CAH bordering on or cannot rule out cancer was the only predictor of cancer.

Efficient processing of end-of-life lithium-ion batteries of electric vehicles is important and a pressing challenge for a circular economy. Regardless of whether the processing strategy is recycling, repurposing or remanufacturing, the first processing step would usually involve disassembly. As battery disassembly is a dangerous task, efforts have been made to robotise it. In this paper, a robotic disassembly platform using four industrial robots is proposed to automate the non-destructive disassembly of a plug-in hybrid electric vehicle battery pack into modules. The work was conducted as a case study to demonstrate the concept of autonomous disassembly of an electric vehicle battery pack. A two-step object localisation method based on visual information is used to overcome positional uncertainties from different sources and is validated by experiments. Also, the unscrewing system is highlighted, and its functions, such as handling untightened fasteners, loosening jammed screws, and changing the nutrunner adapters with square drives, are detailed. Furthermore, the time required for each operation is compared with that taken by human operators. Finally, the limitations of the platform are reported and future research directions are suggested.

In the last decade, robotic-mediated rehabilitation has emerged as a potential solution to improve repetitive task training. Each device in this field has a unique development history shaped by engineers’ expertise in specific programming languages or platforms. In this work we adopt an approach that tries to abstract from the final implementation with the aim to make control logic more shareable and understandable. The authors will present the outcomes of the application of a Rapid Control Prototyping strategy to an upper-limb robotic exoskeleton. A model-based design approach implemented on a real-time target machine is presented. This modern design approach was explored with several control strategies and was used to test the exoskeleton’s performances. The proposed method highlights how it is possible to develop the entire control architecture in a single programming environment.

This study introduces a cybernetic control and architectural framework for a robotic fish avatar operated by a human. The behavior of the robot fish is influenced by the electromyographic (EMG) signals of the human operator, triggered by stimuli from the surrounding objects and scenery. An deep artificial neural network (ANN) with perceptrons classifies EMG signals, discerning the type of muscular stimuli generated. The research unveils a fuzzy-based oscillation patterns generator (OPG) designed to emulate functions akin to a neural central pattern generator, producing coordinated fish undulations. The OPG generates swimming behavior as an oscillation function, decoupled into coordinated step signals, right and left, for a dual electromagnetic oscillator in the fish propulsion system. Furthermore, the research presents an underactuated biorobotic mechanism of the subcarangiform type, comprising a two-solenoid electromagnetic oscillator, an antagonistic musculoskeletal elastic system of tendons, and a multi-link caudal spine composed of helical springs. The biomechanics dynamic model and control for swimming, as well as the ballasting system for submersion and buoyancy, are deduced. Experimental results encompass EMG pattern recognition, OPG, and coordinated fish locomotion, with additional topics illustrated through numerical simulations.

This paper presents a new optical, multi-functional, high-resolution 3-axis sensor which serves to navigate and can, for example, replace standard joysticks in medical devices such as electric wheelchairs, surgical robots or medical diagnosis devices. A light source, e.g. a laser diode is affixed to a movable axis and projects a random geometric shape on an image sensor (CMOS or CCD). The software in the downstream microcontroller identifies the geometric shape’s center, distortion and size, then calculates X, Y, and Z coordinates. These coordinates can then be processed in attached devices. The 3-axis sensor is characterized by its very high resolution, precise reproducibility and plausibility of the coordinates produced. In addition, optical processing of the signal provides a high level of safety against electromagnetic and radio frequency interference. The sensor presented here is adaptive and can be adjusted to fit a user’s range of motion (stroke and force). This recommendation aims to optimize sensor systems such as joysticks in medical devices in terms of safety, ease of use, and adaptability.

An early hypothesis in robot-assisted stroke therapy was that sensorimotor stimulation through robotic assistance is beneficial for recovery. Despite 25 years of upper-limb rehabilitation robotics research, this hypothesis remains untested barring a few studies with small sample sizes. This review aims to provide a critical summary of the current state of this hypothesis by collating evidence from rehabilitation robotics and other related therapeutic approaches. The review starts with a causal model to expose the various direct and indirect routes through which robotic assistance can aid sensorimotor recovery. The indirect routes include the influence of robotic assistance on therapy intensity, patient motivation, and active participation. The direct route is through changes in cortical networks through Hebbian(-like) learning and changes in peripheral tissue properties. There is currently mixed evidence for the direct causal effect of robotic assistance on recovery from the upper-limb rehabilitation robotics literature. However, evidence from the neuromuscular electrical stimulation literature provides some support for this causal role. Based on the data at hand, we hypothesize that the enhanced movement-related sensory feedback from robotic assistance has a direct, possibly small, causal role in the sensorimotor recovery of the upper-limb, and this effect might be detectable with high-intensity therapy. Large, high-intensity, controlled studies are warranted to support or refute the role of robotic assistance on recovery, which is both scientifically and practically important.

To validate the accuracy and reliability of onboard sensors for object detection and localization in driver assistance, as well as autonomous driving applications under realistic conditions (indoors and outdoors), a novel tracking system is presented. This tracking system is developed to determine the position and orientation of a slow-moving vehicle (e.g. car during parking maneuvers), independent of the onboard sensors, during test maneuvers within a reference environment. One requirement is a 6 degree of freedom (DoF) pose with a position uncertainty below 5 mm (3σ), an orientation uncertainty below 0.3° (3σ) at a frequency higher than 20 Hz, and a latency smaller than 500 ms. To compare the results from the reference system with the vehicle’s onboard system, a synchronization via Precision Time Protocol (PTP) and a system interoperability to Robot Operating System (ROS) is implemented. The developed system combines motion capture cameras mounted in a 360° panorama view set-up on the vehicle with robotic total stations. A point cloud of the test site serves as a digital twin of the environment, in which the movement of the vehicle is simulated. Results have shown that the fused measurements of these sensors complement each other, so that the accuracy requirements for the 6 DoF pose can be met, while allowing a flexible installation in different environments.

This paper presents the robotic platform, PiBot, that has been developed and that is aimed at improving the teaching of Robotics with vision to secondary students. Its computational core is the Raspberry Pi 3 controller board, and the greatest novelty of this prototype is the support developed for the powerful camera mounted on board, the PiCamera. An open software infrastructure written in Python language was implemented so that the student may use this camera, or even a WebCam, as the main sensor of this robotic platform. Also, higher level commands have been provided to enhance the learning outcome for beginners. In addition, a PiBot 3D printable model and the counterpart for the Gazebo simulator were also developed and fully supported. They are publicly available so that students and educational centers that do not have the physical robot or can not afford the costs of these, can nevertheless practice and learn or teach Robotics using these open platforms: DIY-PiBot and/or simulated-PiBot.

This article presents a new input device for spastic patients and others with similar symptoms. The sensor consists of a disc used to determine positions and can replace standard joysticks in medical devices such as electric-powered wheelchairs. Using a standard joystick while operating a powered wheelchair can result in dangerous situations when spastic movements occur and extremities cramp making them uncontrollable. To avoid this, a disc was developed that can be controlled with any body part. By shifting weight (x- and y-axis) the disc can tilt in any direction creating a proportional output signal and can also be pushed down in the center (z-axis) to open a menu on a screen for example. When spasms occur it is impossible for users to get stuck on the input device because the disc is flat and can be mounted within a control panel. Body parts coming into contact with the disc would merely slide across the disc without triggering unintentional actions. The sensor presented here is also adaptive and can be adjusted to fit a user’s strength and range of motion. This proposal aims to develop an input device that enables spastic patients to operate sensitive systems safely.

This study explores the potential of using a Siamese Network as a biomarker for assessing the effectiveness of Dolphin-Assisted Therapy (DAT) in children with Cerebral Palsy (CP). The problem statement revolves around the need for objective measures to evaluate the impact of DAT on patients with CP, considering the subjective nature of traditional assessment methods. The methodology involves training a Siamese network, a type of neural network designed to compare similarities between inputs, using data collected from CP patients undergoing DAT sessions. The network is trained to learn patterns and similarities between pre- and post-therapy evaluations, in order to identify biomarkers indicative of therapy effectiveness. Notably, the Siamese Network’s architecture ensures that comparisons are made within the same feature space, allowing for more accurate assessments. The results of the study demonstrate promising findings, indicating different patterns in the output of the Siamese Network that correlate with improvements in symptoms of CP post-DAT. These findings suggest the potential utility of the Siamese Network as a biomarker to monitor therapy outcomes in children with CP who undergo DAT, offering a more objective and quantifiable approach to assessing therapeutic interventions. Significant disparities in neuronal voltage perturbations, with a mean of 7.9825 dB in specific samples compared to 6.2838 dB in the data set, indicate a marked difference from resting activity. This suggests that dolphin-assisted therapy selectively activates specific brain regions uniquely during the intervention.

Sperm capacitation involves biochemical and physiological changes that enable sperm to fertilize the oocyte. It can be induced in vitro under controlled conditions that simulate the environment of the oviduct. While extensively studied in mammals, its approach in lizards remains absent. Understanding the mechanisms that facilitate reproduction is essential for advancing the implementation of assisted reproductive technologies in this group. Fifteen males of Sceloporus torquatus were collected during the early stage of the reproductive season. The sperm were isolated from the seminal plasma and then diluted up to a volume of 150 μl using BWW medium to incubate with 5% CO2 at 30 °C for a maximum duration of 3 hours. A fraction was retrieved hourly for ongoing sperm assessment. We found that total motility is maintained up to 2 hours post-incubation, after which it decreased. However, sperm viability remained constant. From that moment on, we observed a transition to a deeper and less symmetrical flagellar bending in many spermatozoa. The chlortetracycline assay indicated a reduction in the percentage of sperm showing the F pattern and an increase in those exhibiting the capacitated (B) and reactive (RA) patterns, accompanied by an elevation in the percentage of damaged acrosomes as revealed by the lectin binding assay. In mammals, these changes are often associated with sperm capacitation. These observations support the notion that this process may also occur in saurian.

Chemical process control relies on a tightly controlled, narrow range of margins for critical variables, ensuring process stability and safeguarding equipment from potential accidents. The availability of historical process data is limited to a specific setpoint of operation. This challenge raises issues for process monitoring in predicting and adjusting to deviations outside of the range of operational parameters. Therefore, this paper proposes simulation-assisted deep transfer learning for predicting and optimizing the final purity and production capacity of the glycerin purification process. The proposed network is trained by the simulation domain to generate a base feature extractor, which is then fine-tuned using few-shot learning techniques on the target learner to extend the working domain of the model beyond the historical practice. The result shows that the proposed model improved prediction performance by 99% in predicting water content and 79.72% in glycerin prediction over the conventional deep learning model. Additionally, the implementation of the proposed model identified the production and product quality improvement for enhancing the glycerin purification process.

Alginate, a biopolymer promising in food, biomedical, pharmaceutical, and electronic materials industries, is characterized by its biodegradability, biocompatibility, low toxicity, and gel-forming properties. It is most abundantly found in brown algae. However, conventional dilute acid and alkali extraction methods face limitations in commercialization due to their long processing time, low throughput, and high solvent requirements. In this study, a microwave-assisted extraction (MAE) process for sodium alginate was designed to improve extraction efficiency. Solid/liquid ratio, extraction temperature, and extraction solvent concentration were major variables affecting sodium alginate extraction from Undaria pinnatifida(sea mustard). They were then statistically optimized using response surface methodology. Under optimal conditions (13.27 g/L, 91.86 ℃, 2.51 %(w/v), and 15 min), the yield was 38.41 %, which was 93.43 % of the theoretical content of sodium alginate in Undaria pinnatifida. Our work has confirmed the productivity and industrial feasibility of efficient extraction of sodium alginate from marine biomass, and we hope that it will serve as an encouraging case for the application of biopolymers as one of the desirable options for alternative petrochemicals to construct a sustainable society.

Catheter-based revascularization procedures developed as an alternative of systemic thrombolysis for patients at intermediate-high and high-risk pulmonary embolism. USAT IH-PE is a retrospective and prospective multicenter registry of such patients treated with ultrasound-facilitated, catheter-directed thrombolysis, whose preliminary results are presented in this study. The primary endpoint was the incidence of pulmonary hypertension (PH) at follow up. Secondary endpoints were short- and mid-term changes in echocardiographic parameters of right ventricle (RV) function, in-hospital and all-cause mortality, and procedure-related bleeding events. Between March 2018 and July 2023, 102 patients were included. The majority were at intermediate-high risk PE (86%), mostly female (57%), median age 66.5 years (IQR 56-74), and 28.4% had active cancer. Echocardiographic follow-up was available for 70 patients, and in only one the diagnosis of PH was confirmed by right heart catheterization, resulting in an incidence of 1.43% (CI 95%, 0.036-7.7). RV echocardiographic parameters improved both at 24 hours and at follow up. In-hospital mortality was 3.9% (CI 95%, 1.08-9.74) while all-cause mortality was 11% (CI 95%, 5.4-19.2). Only 12% had bleeding complications, oh whom 4.9% were BARC 3. Preliminary results from USAT IH-PE registry showed low incidence of PH, improvement in RV function and a safe profile.

Ureteral stricture (US) following ureteroscopic lithotripsy (URSL) has emerged as a serious issue due to the widespread use of laser technology. The management of complex US is challenging. This prospective study evaluated the efficacy of robot-assisted uretero-ureterostomy (RAUU) in addressing US following URSL, and analyzed the pathology of transected ureteral tissues to identify the risk factors for US during URSL. Fourteen patients, with a mean age of 49.8 years, were included in this study. The mean stricture length on radiography was 22.66 ± 7.38 mm. Nine (64.2%) patients had experienced failure with previous interventions, including eight patients who underwent endoscopic incision plus balloon dilation. At an average follow-up of 12.8 months, the overall success rates were 92.9% both clinically and radiographically, without major complications. Pathological findings revealed microcalcifications in 57.1% patients and loss of ureteral mucosa in 28.6% patients. In conclusion, this technique of RAUU via end-to-end anastomosis exhibits promise as a viable option for US following URSL in appropriately selected patients, despite serious pathological changes of the ureter. Migration to the site of ureteral perforation may be the most serious factor contributing to the development of US.

Ion beam-assisted deposition (IBAD) has been proposed as a promising texturing technology that uses film epitaxy method to obtain biaxial texture on a non-textured metal or compound substrate. Magnesium oxide (MgO) is the most well explored texturing material. In order to obtain the optimal biaxial texture, the actual thickness of the IBAD-MgO film must be controlled within 12 nm. Due to the bombardment of ion beams, IBAD-MgO has large lattice deformation, poor texture and many defects in the films. In this work, an additional homogeneous epitaxy MgO (epi-MgO) layer has been deposited on the IBAD-MgO layer by electron-beam evaporation. The biaxial texture can be optimized by the deposition of additional epi-MgO layer. The effects of growth temperature, film thickness, deposition rate and oxygen flux on the texture and morphology of the epi-MgO film were systematically studied. After the research of epi-MgO process, the best full width at half maximum (FWHM) values were 2.2 for the out-of-plane texture and 4.8° for the in-plane texture, respectively. Subsequently, the LaMnO3 cap layer and YBa2Cu3O7-x (YBCO) functional layer was deposited on the epi-MgO layer to test the quality of MgO layer. Finally, the critical current density of YBCO films is 6MA/cm2 (77K, 500nm, self-field), indicating that this research provides a high-quality MgO substrate for the YBCO layer.

Is there any possible synergic effect of fertility outcome between spindle view-assisted intracyto-plasmic sperm injection (SV-ICSI) with or without assisted oocyte activation (AOA) for patients with low fertilization rate history? To explore the answer, a retrospective study was held in our fertility center by reviewing patients receiving SV-ICSI during 2019/03 to 2023/06. Total 47 pa-tients were included, the fertility outcomes of intervention group (AOA-SV-ICSI, 14 patients) and control group (SV-ICSI, 33 patients), such as fertilization rate, blastocyst formation rate and clin-ical pregnancy rate, were analyzed. The blastocyst formation rate between groups was signifi-cantly higher in AOA-SV-ICSI group (p=0.020), but the fertilization rate and clinical pregnancy rate did not reach any statistical significance. This discovery of increased blastocyst formation rate in low fertilization rate patients could possibly help them in getting more usable embryos in fertility treatment.