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Fay A, Synott E, McDaid E, Barrett E. A comparison of the immediate effects of the Andago over ground body weight support trainer versus over ground walking on selected gait parameters in a post-acute rehabilitation population. Physiother Theory Pract 2024; 40:767-777. [PMID: 36593733 DOI: 10.1080/09593985.2022.2162834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The Andago is an electromechanical gait trainer providing dynamic body weight support while simultaneously enabling over ground walking. The aim of this study was to compare the effects of the Andago with over ground walking on selected gait parameters, during a single gait reeducation session in a post-acute rehabilitation population. METHODS Twenty-seven participants (mean age 78 yrs. (SD = 9.2), female 55.6% (n = 15)) undergoing rehabilitation for neurological (51.8%, n = 14), orthopedic (33.3%, n = 9), and medical conditions (14.8%, n = 4) completed the study. This was a single group, cross sectional, repeated measures study. Participants completed a 10-meter walk test (10MWT) and a 20-minute gait reeducation session under two conditions: i) harnessed in the Andago with body weight support or ii) using their normal walking pattern. Walking speed, steps taken, distance walked, rest breaks, Borg ratings of perceived exertion, and fear of falling were compared over both conditions. RESULTS Walking speed was significantly slower with the Andago (10MWT mean difference 0.12 (95% CI 0.03-0.20), eta squared 0.24, p = .008; 20-min gait mean difference 0.04 (95% CI 0.00-0.09), eta squared 0.15, p = .049). During the 20-minute gait reeducation session, step count, distance walked, and duration of walking was similar over both conditions, however participants recorded less rest breaks and fear of falling at minutes 10 and 20 in favor of the Andago. CONCLUSION Gait parameters measured during a single gait reeducation session in the Andago, in a mixed cohort of predominately older rehabilitation patients, appear comparable to conventional over ground training, other than walking speed which was reduced.
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Affiliation(s)
- Amy Fay
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, College Green, Dublin, Ireland
| | - Eoin Synott
- Physiotherapy Department, Royal Hospital Donnybrook, Morehampton Road, Dublin, Ireland
| | - Edel McDaid
- Physiotherapy Department, Royal Hospital Donnybrook, Morehampton Road, Dublin, Ireland
| | - Emer Barrett
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, College Green, Dublin, Ireland
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Garcia A, Shave S, Cheng YS, Santos F, Quesnel A, Cohen MS, Lee DJ. Initial Experience With Robotic-Assisted Otologic and Lateral Skull Base Surgery. Otolaryngol Head Neck Surg 2024; 170:1190-1194. [PMID: 38230445 DOI: 10.1002/ohn.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/23/2023] [Indexed: 01/18/2024]
Abstract
Robotic-assisted surgery has gained popularity for otolaryngology procedures. It provides high-definition images and surgical precision to perform diverse procedures. It is an alternative to the operating microscope, endoscope, or exoscope when reaching hidden anatomical structures in the ear. In this proof-of-concept study, we aim to demonstrate the possibility of using a robotic-assisted device to perform ear surgery in conjunction with the microscope or the endoscope. In total, there were 9 ear and lateral skull base procedures performed with the use of robotic-assisted surgery. All surgeons underwent surveys to assess the performance and workload of the device compared to the microscope or endoscope. There were no postoperative complications. Robotic-assisted surgery was optimal for providing high image quality, ergonomics, and maintaining surgical performance. The size of the device and mental demand were higher compared to the microscope or endoscope. Robotic-assisted surgery can be an adjuvant to perform otologic and neurotologic surgery.
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Affiliation(s)
- Alejandro Garcia
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary (MEEI), Harvard Medical School, Boston, Massachusetts, USA
| | - Samantha Shave
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary (MEEI), Harvard Medical School, Boston, Massachusetts, USA
| | - Yew S Cheng
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary (MEEI), Harvard Medical School, Boston, Massachusetts, USA
| | - Felipe Santos
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary (MEEI), Harvard Medical School, Boston, Massachusetts, USA
| | - Alicia Quesnel
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary (MEEI), Harvard Medical School, Boston, Massachusetts, USA
| | - Michael S Cohen
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary (MEEI), Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel J Lee
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary (MEEI), Harvard Medical School, Boston, Massachusetts, USA
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Langensiepen S, Nielsen S, Madi M, Siebert M, Körner D, Elissen M, Meyer G, Stephan A. [User-oriented needs assessment of the potential use of assistive robots in direct nursing care: A mixed methods study]. Pflege 2024; 37:69-78. [PMID: 36468879 DOI: 10.1024/1012-5302/a000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
User-oriented needs assessment of the potential use of assistive robots in direct nursing care: A mixed methods study Abstract. Background: So far, hardly any robots have been used in nursing that take over patient-related activities and thereby reduce the physical strain on the caregivers. Using user-centered design approaches, the interdisciplinary project "PfleKoRo" was therefore developing a robotic assistance system that can be used in the direct care of bedridden patients requiring intensive or very intensive care. Aim: The aim of this study was to identify nursing activities with the greatest support potential for an assistant robot for the direct care of bedridden patients. Method: Focus groups (n = 3) with nursing professionals (n = 14) from acute and long-term care were conducted first in an explorative mixed method design and then evaluated by means of content analysis. A selection of nursing activities was then prioritized by the participants of the focus groups (n = 10) with regard to their potential for support from an assistant robot in a standardized survey. Results: The highest priority was given to turning and holding patients in a lateral position as well as holding their legs in order to perform nursing tasks. Further support was needed, among other things, for repositioning the patient to the head of the bed and for tasks such as the transfer of patients. Conclusion: Turning patients and holding them in a lateral position as well as holding the leg are seen as target activities with the greatest support potential for "PfleKoRo", presenting the starting point for further development.
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Affiliation(s)
- Sina Langensiepen
- Pflegedirektion, Stabsstelle Pflegewissenschaft, Uniklinik RWTH Aachen, Deutschland
| | - Svenja Nielsen
- Pflegedirektion, Stabsstelle Pflegewissenschaft, Uniklinik RWTH Aachen, Deutschland
| | - Murielle Madi
- Pflegedirektion, Stabsstelle Pflegewissenschaft, Uniklinik RWTH Aachen, Deutschland
| | | | - Daniel Körner
- Institut für Angewandte Medizintechnik, RWTH Aachen, Deutschland
| | - Maurice Elissen
- Klinik für Operative Intensivmedizin und Intermediate Care, Uniklinik RWTH Aachen, Deutschland
| | - Gabriele Meyer
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Deutschland
| | - Astrid Stephan
- Pflegedirektion, Stabsstelle Pflegewissenschaft, Uniklinik RWTH Aachen, Deutschland
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Escobar MC, White TJ. Fast and Slow-Twitch Actuation via Twisted Liquid Crystal Elastomer Fibers. Adv Mater 2024:e2401140. [PMID: 38520204 DOI: 10.1002/adma.202401140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/29/2024] [Indexed: 03/25/2024]
Abstract
The performance of robotic systems could benefit from low-density material actuators that emulate muscle typology (e.g., fast and slow twitch) of natural systems. Recent reports detail the thermomechanical, chemical, electrical, and pneumatic response of twisted and coiled fibers. The geometrical constraints imparted on typically commodity materials realize distinguished stimuli-induced actuation including low density, high force, and moderate stroke. Here, we prepare actuators by twisting fibers composed of liquid crystal elastomers (LCEs). The actuators combine the inherent stimuli-response of LCEs with the geometrical constraints of twisted fiber actuators to dramatically increase the deformation rate, specific work, and achievable force output. In some geometries, the thermomechanical response of the LCE exhibits a pseudo-first-order transition. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Melvin Colorado Escobar
- Materials Science and Engineering Program, University of Colorado, Boulder, Boulder, CO, 80309, USA
| | - Timothy J White
- Materials Science and Engineering Program, University of Colorado, Boulder, Boulder, CO, 80309, USA
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Boulder, CO, 80309, USA
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Fritschen A, Lindner N, Scholpp S, Richthof P, Dietz J, Linke P, Guttenberg Z, Blaeser A. High-Scale 3D-Bioprinting Platform for the Automated Production of Vascularized Organs-on-a-Chip. Adv Healthc Mater 2024:e2304028. [PMID: 38511587 DOI: 10.1002/adhm.202304028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/18/2024] [Indexed: 03/22/2024]
Abstract
3D bioprinting possesses the potential to revolutionize contemporary methodologies for fabricating tissue models employed in pharmaceutical research and experimental investigations. This is enhanced by combining bioprinting with advanced Organs-on-a-Chip (OOCs), which includes a complex arrangement of multiple cell types representing organ-specific cells, connective tissue and vasculature. However, both OOCs and bioprinting so far demand a high degree of manual intervention, thereby impeding efficiency and inhibiting scalability to meet technological requirements. Through the combination of drop-on-demand bioprinting with robotic handling of microfluidic chips, a print procedure is achieved that is proficient in managing three distinct tissue models on a chip within only a minute, as well as capable of consecutively processing numerous OOCs without manual intervention. This process rests upon the development of a post-printing sealable microfluidic chip, that is compatible with different types of 3D-bioprinters and easily connected a perfusion system. The capabilities of the automized bioprint process are showcased through the creation of a multicellular and vascularized liver carcinoma model on chip. The process achieves full vascularization and stable microvascular network formation over 14 days of culture time, with pronounced spheroidal cell growth and albumin secretion of HepG2 serving as a representative cell model. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anna Fritschen
- BioMedical Printing Technology, Department of Mechanical Engineering, Technical University of Darmstadt, 64289, Darmstadt, Germany
| | - Nils Lindner
- BioMedical Printing Technology, Department of Mechanical Engineering, Technical University of Darmstadt, 64289, Darmstadt, Germany
| | - Sebastian Scholpp
- BioMedical Printing Technology, Department of Mechanical Engineering, Technical University of Darmstadt, 64289, Darmstadt, Germany
| | - Philipp Richthof
- BioMedical Printing Technology, Department of Mechanical Engineering, Technical University of Darmstadt, 64289, Darmstadt, Germany
| | - Jonas Dietz
- BioMedical Printing Technology, Department of Mechanical Engineering, Technical University of Darmstadt, 64289, Darmstadt, Germany
| | - Philipp Linke
- ibidi GmbH, Lochhamer Schlag 11, 82166, Gräfelfing, Germany
| | | | - Andreas Blaeser
- BioMedical Printing Technology, Department of Mechanical Engineering, Technical University of Darmstadt, 64289, Darmstadt, Germany
- Centre for Synthetic Biology, Technical University of Darmstadt, 64289, Darmstadt, Germany
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Abu Al-Haija Q. Editorial: Artificial intelligence solutions for decision making in robotics. Front Robot AI 2024; 11:1389191. [PMID: 38533526 PMCID: PMC10964767 DOI: 10.3389/frobt.2024.1389191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Affiliation(s)
- Qasem Abu Al-Haija
- Department of Cybersecurity, Faculty of Computer and Information Technology, Jordan University of Science and Technology, Irbid, Jordan
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Mansfield D, Montazeri A. A survey on autonomous environmental monitoring approaches: towards unifying active sensing and reinforcement learning. Front Robot AI 2024; 11:1336612. [PMID: 38533524 PMCID: PMC10964253 DOI: 10.3389/frobt.2024.1336612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/22/2024] [Indexed: 03/28/2024] Open
Abstract
The environmental pollution caused by various sources has escalated the climate crisis making the need to establish reliable, intelligent, and persistent environmental monitoring solutions more crucial than ever. Mobile sensing systems are a popular platform due to their cost-effectiveness and adaptability. However, in practice, operation environments demand highly intelligent and robust systems that can cope with an environment's changing dynamics. To achieve this reinforcement learning has become a popular tool as it facilitates the training of intelligent and robust sensing agents that can handle unknown and extreme conditions. In this paper, a framework that formulates active sensing as a reinforcement learning problem is proposed. This framework allows unification with multiple essential environmental monitoring tasks and algorithms such as coverage, patrolling, source seeking, exploration and search and rescue. The unified framework represents a step towards bridging the divide between theoretical advancements in reinforcement learning and real-world applications in environmental monitoring. A critical review of the literature in this field is carried out and it is found that despite the potential of reinforcement learning for environmental active sensing applications there is still a lack of practical implementation and most work remains in the simulation phase. It is also noted that despite the consensus that, multi-agent systems are crucial to fully realize the potential of active sensing there is a lack of research in this area.
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Udayagiri R, Yin J, Cai X, Townsend W, Trivedi V, Shende R, Sowande OF, Prosser LA, Pikul JH, Johnson MJ. Towards an AI-driven soft toy for automatically detecting and classifying infant-toy interactions using optical force sensors. Front Robot AI 2024; 11:1325296. [PMID: 38533525 PMCID: PMC10963494 DOI: 10.3389/frobt.2024.1325296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/29/2024] [Indexed: 03/28/2024] Open
Abstract
Introduction: It is crucial to identify neurodevelopmental disorders in infants early on for timely intervention to improve their long-term outcomes. Combining natural play with quantitative measurements of developmental milestones can be an effective way to swiftly and efficiently detect infants who are at risk of neurodevelopmental delays. Clinical studies have established differences in toy interaction behaviors between full-term infants and pre-term infants who are at risk for cerebral palsy and other developmental disorders. Methods: The proposed toy aims to improve the quantitative assessment of infant-toy interactions and fully automate the process of detecting those infants at risk of developing motor delays. This paper describes the design and development of a toy that uniquely utilizes a collection of soft lossy force sensors which are developed using optical fibers to gather play interaction data from infants laying supine in a gym. An example interaction database was created by having 15 adults complete a total of 2480 interactions with the toy consisting of 620 touches, 620 punches-"kick substitute," 620 weak grasps and 620 strong grasps. Results: The data is analyzed for patterns of interaction with the toy face using a machine learning model developed to classify the four interactions present in the database. Results indicate that the configuration of 6 soft force sensors on the face created unique activation patterns. Discussion: The machine learning algorithm was able to identify the distinct action types from the data, suggesting the potential usability of the toy. Next steps involve sensorizing the entire toy and testing with infants.
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Affiliation(s)
- Rithwik Udayagiri
- Rehabilitation Robotics Lab (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
- Pikul Research Group (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
| | - Jessica Yin
- Pikul Research Group (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
- Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA, United States
| | - Xinyao Cai
- Pikul Research Group (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
| | - William Townsend
- Pikul Research Group (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
| | - Varun Trivedi
- Rehabilitation Robotics Lab (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Rohan Shende
- Rehabilitation Robotics Lab (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
- Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA, United States
| | - O. Francis Sowande
- Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA, United States
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Laura A. Prosser
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, United States
| | - James H. Pikul
- Pikul Research Group (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
- Department of Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA, United States
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, United States
| | - Michelle J. Johnson
- Rehabilitation Robotics Lab (A GRASP Lab), University of Pennsylvania, Philadelphia, PA, United States
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA, United States
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Pavan A, Fasano A, Cortellini L, Lattanzi S, Papadopoulou D, Insalaco S, Germanotta M, Aprile I. Implementation of a robot-mediated upper limb rehabilitation protocol for a customized treatment after stroke: A retrospective analysis. NeuroRehabilitation 2024:NRE230367. [PMID: 38457161 DOI: 10.3233/nre-230367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Many authors have emphasized the need for individualized treatments in rehabilitation, but no tailored robotic rehabilitation protocol for stroke patients has been established yet. OBJECTIVE To evaluate the effectiveness of a robot-mediated upper limb rehabilitation protocol based on clinical assessment for customized treatment of stroke patients. METHODS Clinical data from 81 patients with subacute stroke, undergoing an upper limb robot-mediated rehabilitation, were analyzed retrospectively. 49 patients were treated using a customized robotic protocol (experimental group, EG) based on a clinically guided flowchart, while 32 were treated without it (control group, CG). Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Motricity Index (MI), modified Barthel Index (mBI) and Numerical Rating Scale (NRS) measured before (T0) and after (T1) rehabilitation intervention were used as clinical outcomes. RESULTS There was statistically significant improvement in both groups in terms of FMA-UE, MI, and mBI, while no change in NRS. Intergroup analysis showed significantly greater improvement of the FMA-UE (P = 0.002) and MI (P < 0.001) in the EG, compared with the CG. CONCLUSION The implementation of our robotic protocol for customized treatment of stroke patients yielded greater recovery in upper limb motor function and strength over robotic treatment without a defined protocol.
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Affiliation(s)
- Arianna Pavan
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence, Italy
| | - Alessio Fasano
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence, Italy
| | | | | | | | | | | | - Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence, Italy
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Ollivier B, Wakelin E, Plaskos C, Vandenneucker H, Luyckx T. Widening of tibial resection boundaries increases the rate of femoral component valgus and internal rotation in functionally aligned TKA. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38444096 DOI: 10.1002/ksa.12118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE The purpose of this study was to investigate the influence of increasing the tibial boundaries in functional alignment on femoral component orientation in total knee arthroplasty (TKA). METHODS A retrospective review of a database of robotic-assisted TKAs using a digital joint tensioning device was performed (BalanceBot®; Corin). A total of 692 TKAs with correctable deformity were included. Functional alignment with a tibia-first balancing technique was simulated by performing an anatomic tibial resection to recreate the native medial proximal tibial angle within certain boundaries (A, 87-90°; B, 86-90°; C, 84-92°), while accounting for wear. After balancing the knee, the resulting amount of femoral component outliers in the coronal and axial plane was calculated for each group and correlated to the coronal plane alignment of the knee (CPAK) classification. RESULTS The proportion of knees with high femoral component varus (>96°) or valgus (<87°) alignment increased from 24.5% (n = 170) in group A to 26.5% (n = 183) in group B and 34.2% (n = 237) in group C (p < 0.05). Similarly, more knees with high femoral component external rotation (>6°) or internal rotation (>3°) were identified in group C (33.4%, n = 231) than in group B (23.7%, n = 164) and A (18.4%, n = 127) (p < 0.05). There was a statistically significant (p < 0.01) overall increase in knees with both femoral component valgus <87° and internal rotation >3° from group A (4.0%, n = 28) to B (7.7%, n = 53) and C (15.8%, n = 109), with CPAK type I and II showing a 12.9- and 2.9-fold increase, respectively. CONCLUSION Extending the tibial boundaries when using functional alignment with a tibia-first balancing technique in TKA leads to a statistically significant higher percentage of knees with a valgus lateral distal femoral angle < 87° and >3° internal rotation of the femoral component, especially in CPAK type I and II. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Britt Ollivier
- Department of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Hilde Vandenneucker
- Department of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium
| | - Thomas Luyckx
- Department of Orthopaedic Surgery, AZ Delta, Roeselare, Belgium
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Overgaard BS, Christensen ABH, Terslev L, Savarimuthu TR, Just SA. Artificial intelligence model for segmentation and severity scoring of osteophytes in hand osteoarthritis on ultrasound images. Front Med (Lausanne) 2024; 11:1297088. [PMID: 38500949 PMCID: PMC10944993 DOI: 10.3389/fmed.2024.1297088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024] Open
Abstract
Objective To develop an artificial intelligence (AI) model able to perform both segmentation of hand joint ultrasound images for osteophytes, bone, and synovium and perform osteophyte severity scoring following the EULAR-OMERACT grading system (EOGS) for hand osteoarthritis (OA). Methods One hundred sixty patients with pain or reduced function of the hands were included. Ultrasound images of the metacarpophalangeal (MCP), proximal interphalangeal (PIP), distal interphalangeal (DIP), and first carpometacarpal (CMC1) joints were then manually segmented for bone, synovium and osteophytes and scored from 0 to 3 according to the EOGS for OA. Data was divided into a training, validation, and test set. The AI model was trained on the training data to perform bone, synovium, and osteophyte identification on the images. Based on the manually performed image segmentation, an AI was trained to classify the severity of osteophytes according to EOGS from 0 to 3. Percent Exact Agreement (PEA) and Percent Close Agreement (PCA) were assessed on individual joints and overall. PCA allows a difference of one EOGS grade between doctor assessment and AI. Results A total of 4615 ultrasound images were used for AI development and testing. The developed AI model scored on the test set for the MCP joints a PEA of 76% and PCA of 97%; for PIP, a PEA of 70% and PCA of 97%; for DIP, a PEA of 59% and PCA of 94%, and CMC a PEA of 50% and PCA of 82%. Combining all joints, we found a PEA between AI and doctor assessments of 68% and a PCA of 95%. Conclusion The developed AI model can perform joint ultrasound image segmentation and severity scoring of osteophytes, according to the EOGS. As proof of concept, this first version of the AI model is successful, as the agreement performance is slightly higher than previously found agreements between experts when assessing osteophytes on hand OA ultrasound images. The segmentation of the image makes the AI explainable to the doctor, who can immediately see why the AI applies a given score. Future validation in hand OA cohorts is necessary though.
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Affiliation(s)
- Benjamin Schultz Overgaard
- Section of Rheumatology, Department of Medicine, Svendborg Hospital – Odense University Hospital, Svendborg, Denmark
| | | | - Lene Terslev
- Center for Rheumatology and Spine Disease, Rigshospitalet, Glostrup, Denmark
| | | | - Søren Andreas Just
- Section of Rheumatology, Department of Medicine, Svendborg Hospital – Odense University Hospital, Svendborg, Denmark
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Xi J, Yang H, Li X, Wei R, Zhang T, Dong L, Yang Z, Yuan Z, Sun J, Hua Q. Recent Advances in Tactile Sensory Systems: Mechanisms, Fabrication, and Applications. Nanomaterials (Basel) 2024; 14:465. [PMID: 38470794 DOI: 10.3390/nano14050465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/07/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024]
Abstract
Flexible electronics is a cutting-edge field that has paved the way for artificial tactile systems that mimic biological functions of sensing mechanical stimuli. These systems have an immense potential to enhance human-machine interactions (HMIs). However, tactile sensing still faces formidable challenges in delivering precise and nuanced feedback, such as achieving a high sensitivity to emulate human touch, coping with environmental variability, and devising algorithms that can effectively interpret tactile data for meaningful interactions in diverse contexts. In this review, we summarize the recent advances of tactile sensory systems, such as piezoresistive, capacitive, piezoelectric, and triboelectric tactile sensors. We also review the state-of-the-art fabrication techniques for artificial tactile sensors. Next, we focus on the potential applications of HMIs, such as intelligent robotics, wearable devices, prosthetics, and medical healthcare. Finally, we conclude with the challenges and future development trends of tactile sensors.
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Affiliation(s)
- Jianguo Xi
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Huaiwen Yang
- School of Integrated Circuit Science and Engineering, Beihang University, Beijing 100191, China
| | - Xinyu Li
- School of Integrated Circuit Science and Engineering, Beihang University, Beijing 100191, China
| | - Ruilai Wei
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Institute of Flexible Electronics, Beijing Institute of Technology, Beijing 102488, China
| | - Taiping Zhang
- Tianfu Xinglong Lake Laboratory, Chengdu 610299, China
| | - Lin Dong
- Henan Key Laboratory of Diamond Optoelectronic Materials and Devices, Key Laboratory of Materials Physics, Ministry of Education, School of Physics and Microelectronics, Zhengzhou University, Zhengzhou 450001, China
| | - Zhenjun Yang
- Hefei Hospital Affiliated to Anhui Medical University (The Second People's Hospital of Hefei), Hefei 230011, China
| | - Zuqing Yuan
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Institute of Flexible Electronics, Beijing Institute of Technology, Beijing 102488, China
| | - Junlu Sun
- Henan Key Laboratory of Diamond Optoelectronic Materials and Devices, Key Laboratory of Materials Physics, Ministry of Education, School of Physics and Microelectronics, Zhengzhou University, Zhengzhou 450001, China
| | - Qilin Hua
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Institute of Flexible Electronics, Beijing Institute of Technology, Beijing 102488, China
- Guangxi Key Laboratory of Brain-Inspired Computing and Intelligent Chips, Guangxi Normal University, Guilin 541004, China
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13
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Varas-Diaz G, Bhatt T, Oken B, Roth E, Hayes J, Cordo P. Concurrent ankle-assisted movement, biofeedback, and proprioceptive stimulation reduces lower limb motor impairment and improves gait in persons with stroke. Physiother Theory Pract 2024; 40:477-486. [PMID: 36102364 DOI: 10.1080/09593985.2022.2122763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 07/20/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Persons with stroke live with residual sensorimotor impairments in their lower limbs (LL), which affects their gait. PURPOSE We investigated whether these residual impairments and resulting gait deficits can be reduced through concurrently applied assisted movement, biofeedback, and proprioceptive stimulation. METHODS A robotic device provided impairment-oriented training to the affected LL of 24 persons with stroke (PwS) with moderate-to-severe LL impairment. Participants were given 22-30 training sessions over 2-3 months. During training, the interventional device cyclically dorsiflexed and plantarflexed the ankle at 5 deg/s through ±15 deg for 30 min while the participant assisted with the imposed movement. Concurrently, participants received visual biofeedback of assistive joint torque or agonist EMG while mechanical vibration was applied to the currently lengthening (i.e. antagonist) tendon. RESULTS Sensorimotor impairment significantly decreased over the training period, which was sustained over 3 months, based on the Fugl-Meyer Assessment (FMA-LL) (p < .001), modified Ashworth scale in dorsiflexors (p < .05), and an ankle strength test (dorsiflexors and plantarflexors) (p < .05). Balance and gait also improved, based on the Tinetti Performance Oriented Mobility Assessment (POMA) (p < .05). CONCLUSION Impairment-oriented training using a robotic device capable of applying assisted movement, biofeedback, and proprioceptive stimulation significantly reduces LL impairment and improves gait in moderately-to-severely impaired PwS.
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Affiliation(s)
- Gonzalo Varas-Diaz
- School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
- Department of Physical Therapy, University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL, USA
| | - Tanvi Bhatt
- Department of Physical Therapy, University of Illinois at Chicago, College of Applied Health Sciences, Chicago, IL, USA
| | - Barry Oken
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Elliot Roth
- Department of Physical Medicine and Rehabilitation, Northwestern University, Evanston, IL, USA
| | - John Hayes
- College of Optometry, Pacific University, Forest Grove, OR, USA
| | - Paul Cordo
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- AMES Technology Inc, Portland, OR, USA
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Abstract
OBJECTIVE Using the example of robotic-assisted surgery (RAS), we explore the methodological and practical challenges of technology integration in surgery, provide examples of evidence-based improvements, and discuss the importance of systems engineering and clinical human factors research and practice. BACKGROUND New operating room technologies offer potential benefits for patients and staff, yet also present challenges for physical, procedural, team, and organizational integration. Historically, RAS implementation has focused on establishing the technical skills of the surgeon on the console, and has not systematically addressed the new skills required for other team members, the use of the workspace, or the organizational changes. RESULTS Human factors studies of robotic surgery have demonstrated not just the effects of these hidden complexities on people, teams, processes, and proximal outcomes, but also have been able to analyze and explain in detail why they happen and offer methods to address them. We review studies on workload, communication, workflow, workspace, and coordination in robotic surgery, and then discuss the potential for improvement that these studies suggest within the wider healthcare system. CONCLUSION There is a growing need to understand and develop approaches to safety and quality improvement through human-systems integration at the frontline of care.Precis: The introduction of robotic surgery has exposed under-acknowledged complexities of introducing complex technology into operating rooms. We explore the methodological and practical challenges, provide examples of evidence-based improvements, and discuss the implications for systems engineering and clinical human factors research and practice.
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Affiliation(s)
- Ken Catchpole
- Medical University of South Carolina, Charleston, USA
| | - Tara Cohen
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Sam Lawton
- Medical University of South Carolina, Charleston, USA
| | | | | | - Lynne Nemeth
- Medical University of South Carolina, Charleston, USA
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15
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Faschingbauer M, Freisem K, Khury F, Martin RJ, Bieger R, Reichel H. Tourniquet does not affect intraoperative kinematics during total knee arthroplasty: Results of a prospective study using a robotic assistance system. Knee Surg Sports Traumatol Arthrosc 2024; 32:678-684. [PMID: 38410061 DOI: 10.1002/ksa.12086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/02/2024] [Accepted: 02/04/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE Tourniquet use during total knee arthroplasty (TKA) remains controversial. There are limited data demonstrating the effect of tourniquet use on flexion and extension gaps. The use of a tourniquet can theoretically affect the kinematics of the knee joint, specifically the extension and flexion gaps and the laxity, by mechanically compressing the soft tissues including the muscles above the knee joint. Therefore, this study was designed to prospectively evaluate changes in flexion and extension gaps with and without the use of a tourniquet. METHODS The following prospective study included 50 consecutive patients who underwent TKA using a surgical robot. The inclusion criteria were advanced osteoarthritis (OA) and varus-alignment or valgus-alignment <3° (hip-knee-ankle angle, standing long-leg X-ray), and the exclusion criteria were BMI >35 kg/m2 and mechanical axis in >3° valgus. A CR-TKA was performed, and the medial and lateral gaps (in mm) throughout the full range of motion in 10° increments were recorded. The procedure was conducted both with and without an applied tourniquet (350 mmHg). RESULTS No significant differences were observed in the medial joint space. By contrast, the lateral gap showed significant differences in 10-20° of flexion (with a tourniquet 1.9 mm vs. without a tourniquet 2.1 mm, p = 0.018), 20-30° (1.6 vs. 1.8 mm, p = 0.02), 100-110° (0.9 vs. 1.1 mm, p = 0.021), and 110-120° (0.8 vs. 1 mm, p = 0.038). Thus, at the above degrees of flexion on the lateral side, there was a decrease in the mean of 0.2 mm with the use of a tourniquet. CONCLUSION Although the use of a tourniquet showed a detectable change in the lateral gap in four 10° segments of flexion, clinical relevance with an average difference of 0.2 mm is not achieved. Thus, the use of a tourniquet in TKA can still be advocated based on the presented data. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
| | - Kay Freisem
- Department of Orthopaedic Surgery, University of Ulm, Ulm, Germany
| | - Farouk Khury
- Department of Orthopaedic Surgery, University of Ulm, Ulm, Germany
- Rambam Medical Center, Division of Orthopaedic Surgery, The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Ryan J Martin
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ralf Bieger
- Schoen Clinic München Harlaching, Center for Knee, Hip and Shoulder Surgery, Munich, Germany
| | - Heiko Reichel
- Department of Orthopaedic Surgery, University of Ulm, Ulm, Germany
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16
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Tou S, Au S, Clancy C, Clarke S, Collins D, Dixon F, Dreher E, Fleming C, Gallagher AG, Gomez-Ruiz M, Kleijnen J, Maeda Y, Rollins K, Matzel KE. European Society of Coloproctology guideline on training in robotic colorectal surgery (2024). Colorectal Dis 2024. [PMID: 38429251 DOI: 10.1111/codi.16904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 03/03/2024]
Affiliation(s)
- Samson Tou
- Department of Colorectal Surgery, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
- School of Medicine, University of Nottingham, Derby, UK
| | | | - Cillian Clancy
- Department of Colorectal Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Steven Clarke
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Danielle Collins
- Department of Colorectal Surgery, Western General Hospital, NHS Lothian, Edinburgh, Scotland
| | - Frances Dixon
- Department of Colorectal Surgery, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Elizabeth Dreher
- Department of Urology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Christina Fleming
- Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland
| | | | - Marcos Gomez-Ruiz
- Colorectal Surgery Unit, General Surgery Department, Marqués de Valdecilla University Hospital, Santander, Spain
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | - Jos Kleijnen
- Kleijnen Systematic Reviews Ltd, York, UK
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Yasuko Maeda
- Department of Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Katie Rollins
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
| | - Klaus E Matzel
- Section of Coloproctology, Department of Surgery, University of Erlangen-Nürnberg, FAU, Erlangen, Germany
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17
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Diquattro E, Prill R, Salzmann M, Traina F, Becker R. High three-dimensional accuracy of component placement and lower limb alignment using a robotic arm-assisted system and gap-balancing instrument in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2024; 32:685-692. [PMID: 38415872 DOI: 10.1002/ksa.12088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE It was hypothesized that robotic arm-assisted total knee arthroplasty (RA-TKA) using additionally a gap-balancing instrumentation will show high accuracy in executing the planning in femoral and tibial component placement throughout the range of knee motion (ROM) during TKA surgery. METHODS Prospectively collected data were analysed for patients undergoing RA-TKA. A cruciate retaining cemented design was implanted using the MAKO® robotic system. Lower limb alignment at 0°, 30°, 45°, 60° and 90° of flexion was recorded at the beginning of surgery and finally after implantation of the components. A ligament tensioner was inserted after tibial precut to measure the extension and flexion gap, and final component placement was planned based on 3D CT images. Femoral and tibial component placement was measured in all three planes. RESULTS A total of 104 patients were included (mean age 69.4 ± 9 years; 44 male, 60 female). The difference in component placement after planning and final implantation showed less valgus of 0.7° ± 1.4° (p < 0.001), less external rotation of 0.6° ± 1.9° (p = 0.001) and less flexion of 0.9° ± 1.8° (p < 0.001) for the femoral component. The tibial component was placed in more varus of 0.2° ± 0.9° (p = 0.056) and more posterior slope of 0.5° ± 0.9° (p < 0.001). The lower limb alignment in extension was 4.4° ± 5.2° of varus of the native knee and changed to 1.2° ± 1.9° of varus after TKA (p < 0.01). CONCLUSION Robotic-assisted TKA helps to achieve the target of alignment and component placement very close to the planning. It allows optimal component placement of off-the-shelf implants respecting patient's specific anatomy. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Emanuele Diquattro
- Orthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee Implants, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Robert Prill
- Department of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
- Faculty of Health Sciences, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Mikhail Salzmann
- Department of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Francesco Traina
- Orthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee Implants, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Roland Becker
- Department of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
- Faculty of Health Sciences, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
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18
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Tsintotas KA, Kansizoglou I, Pastra K, Aloimonos Y, Gasteratos A, Sirakoulis GC, Sandini G. Editorial: Enhanced human modeling in robotics for socially-aware place navigation. Front Robot AI 2024; 11:1348022. [PMID: 38495301 PMCID: PMC10940522 DOI: 10.3389/frobt.2024.1348022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Affiliation(s)
| | | | | | | | | | | | - Giulio Sandini
- Italian Institute of Technology (IIT), Genova, Liguria, Italy
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19
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Murgante Testa N, Mongelli F, Sabbatini F, Iaquinandi F, Prouse G, Pini R, La Regina D. Safety and feasibility of emergency robot-assisted transabdominal preperitoneal repair for the treatment of incarcerated inguinal hernia: A retrospective study. World J Surg 2024; 48:622-628. [PMID: 38501558 DOI: 10.1002/wjs.12063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/27/2023] [Indexed: 03/20/2024]
Abstract
BACKGROUND Few studies assessed robotic in emergency setting and no solid evidence was demonstrated. The aim of this study was to evaluate the feasibility and safety of robot-assisted transabdominal preperitoneal (R-TAPP) repair for the treatment of incarcerated inguinal hernia. METHODS We retrospectively searched from a prospectively maintained database patients who underwent R-TAPP or open surgery for incarcerated inguinal hernias from January 2018 to March 2023. The primary endpoint was to assess safety and feasibility of the R-TAPP compared to the standard approach. For eligible patients, data was extracted and analyzed using a propensity score-matching (PSM). RESULTS Thirty-four patients were retrieved from our database, 15 underwent R-TAPP, while 19 underwent open surgery. Mean age was 73.1 ± 14.6 years, 30 patients (88.2%) were male and mean BMI was 23.5 ± 3.2 kg/m2. No intraoperative complication occurred. Three cases requiring small bowel resection were all in the open surgery group (p = 0.112). The operative time was 108 ± 31 min versus 112 ± 31 min in the R-TAPP and open surgery groups (p = 0.716). Seven postoperative complications occurred, only one classified as severe was in the open surgery group. The length of hospital stay was 2.9 ± 1.8 in the R-TAPP versus 4.2 ± 2.3 min in the open surgery group (p = 0.077). PSM analysis showed similar postoperative outcomes and costs in both groups. CONCLUSIONS Despite its limitations, our study appears to endorse the safety and feasibility of the robotic-assisted treatment for incarcerated inguinal hernia. This approach yielded comparable results to open surgery, albeit in a limited number of patients, suggesting it might be a viable alternative.
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Affiliation(s)
- Nicole Murgante Testa
- Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland
| | - Francesco Mongelli
- Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Flaminia Sabbatini
- Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland
| | - Fabiano Iaquinandi
- Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland
| | - Giorgio Prouse
- Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland
| | - Ramon Pini
- Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland
| | - Davide La Regina
- Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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20
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Chao LM, Jia L, Wang S, Liberzon A, Ravi S, Couzin ID, Li L. Tailbeat perturbations improve swimming efficiency by reducing the phase lag between body motion and the resulting fluid response. PNAS Nexus 2024; 3:pgae073. [PMID: 38487161 PMCID: PMC10939483 DOI: 10.1093/pnasnexus/pgae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/02/2024] [Indexed: 03/17/2024]
Abstract
Understanding how animals swim efficiently and generate high thrust in complex fluid environments is of considerable interest to researchers in various fields, including biology, physics, and engineering. However, the influence of often-overlooked perturbations on swimming fish remains largely unexplored. Here, we investigate the propulsion generated by oscillating tailbeats with superimposed rhythmic perturbations of high frequency and low amplitude. We reveal, using a combination of experiments in a biomimetic fish-like robotic platform, computational fluid dynamics simulations, and theoretical analysis, that rhythmic perturbations can significantly increase both swimming efficiency and thrust production. The introduction of perturbations increases pressure-induced thrust, while reduced phase lag between body motion and the subsequent fluid dynamics response improves swimming efficiency. Moreover, our findings suggest that beneficial perturbations are sensitive to kinematic parameters, resolving previous conflicts regarding the effects of such perturbations. Our results highlight the potential benefits of introducing perturbations in propulsion generators, providing potential hypotheses for living systems and inspiring the design of artificial flapping-based propulsion systems.
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Affiliation(s)
- Li-Ming Chao
- Department of Collective Behaviour, Max Planck Institute of Animal Behavior, Konstanz 78464, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz 78464, Germany
- Department of Biology, University of Konstanz, Konstanz 78464, Germany
| | - Laibing Jia
- Department of Naval Architecture, Ocean and Marine Engineering, University of Strathclyde, Glasgow G4 0LZ, UK
| | - Siyuan Wang
- Department of Collective Behaviour, Max Planck Institute of Animal Behavior, Konstanz 78464, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz 78464, Germany
- Department of Biology, University of Konstanz, Konstanz 78464, Germany
| | - Alexander Liberzon
- School of Mechanical Engineering, Tel Aviv University, Tel Aviv 69978, Israel
| | - Sridhar Ravi
- School of Engineering and Information Technology, University of New South Wales, Canberra, ACT 2610, Australia
| | - Iain D Couzin
- Department of Collective Behaviour, Max Planck Institute of Animal Behavior, Konstanz 78464, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz 78464, Germany
- Department of Biology, University of Konstanz, Konstanz 78464, Germany
| | - Liang Li
- Department of Collective Behaviour, Max Planck Institute of Animal Behavior, Konstanz 78464, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Konstanz 78464, Germany
- Department of Biology, University of Konstanz, Konstanz 78464, Germany
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21
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Watanabe K, Miwa H, Wakui T, Kajitani I. Adopting the service system view toward successful implementation of assistive technologies. Geriatr Gerontol Int 2024; 24 Suppl 1:74-80. [PMID: 38221515 DOI: 10.1111/ggi.14797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/26/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
This study aims to provide an overview of the service system view (SSV), and the current status of its adoption for the development and implementation of assistive technology (AT). The role of ATs in the global aging scenario is anticipated; however, their diffusion is cumbersome. The SSV captures stakeholders, technologies, and their interactions as integrated systems. Based on this perspective, several approaches for designing long-term care services have been proposed that would be helpful for the successful implementation of ATs. However, the existing geriatrics and gerontology literature seldom addresses these topics. Based on a literature review, this study first illustrates the challenges of using ATs in the real world. The existing literature highlights the sociotechnical challenges of utilizing ATs, such as the changes required in care work and resistance to them. To overcome the challenges, three approaches associated with the SSV have been introduced: service design, service engineering and living labs. This paper also introduces recent national projects in Japan that have adopted these approaches. As the importance of the SSV is growing for the successful implementation of ATs, the ability to adopt the SSV and its approaches is anticipated. In relation to geriatrics and gerontology studies, the impact on older adults' quality of life, as well as the economic effect, needs to be analyzed in future research. Geriatr Gerontol Int 2024; 24: 74-80.
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Affiliation(s)
- Kentaro Watanabe
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Kashiwa, Japan
| | - Hiroyasu Miwa
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Kashiwa, Japan
| | - Tomoko Wakui
- Human Care Research Team, Tokyo Metropolitan Institute of Geriatrics and Gerontology, Itabashi-ku, Japan
- Research & Development Center for Health Services, University of Tsukuba, Tsukuba, Japan
| | - Isamu Kajitani
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Kashiwa, Japan
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Höhler C, Trigili E, Astarita D, Hermsdörfer J, Jahn K, Krewer C. The efficacy of hybrid neuroprostheses in the rehabilitation of upper limb impairment after stroke, a narrative and systematic review with a meta-analysis. Artif Organs 2024; 48:232-253. [PMID: 37548237 DOI: 10.1111/aor.14618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/30/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Paresis of the upper limb (UL) is the most frequent impairment after a stroke. Hybrid neuroprostheses, i.e., the combination of robots and electrical stimulation, have emerged as an option to treat these impairments. METHODS To give an overview of existing devices, their features, and how they are linked to clinical metrics, four different databases were systematically searched for studies on hybrid neuroprostheses for UL rehabilitation after stroke. The evidence on the efficacy of hybrid therapies was synthesized. RESULTS Seventy-three studies were identified, introducing 32 hybrid systems. Among the most recent devices (n = 20), most actively reinforce movement (3 passively) and are typical exoskeletons (3 end-effectors). If classified according to the International Classification of Functioning, Disability and Health, systems for proximal support are expected to affect body structures and functions, while the activity and participation level are targeted when applying Functional Electrical Stimulation distally plus the robotic component proximally. The meta-analysis reveals a significant positive effect on UL functions (p < 0.001), evident in a 7.8-point Mdiff between groups in the Fugl-Meyer assessment. This positive effect remains at the 3-month follow-up (Mdiff = 8.4, p < 0.001). CONCLUSIONS Hybrid neuroprostheses have a positive effect on UL recovery after stroke, with effects persisting at least three months after the intervention. Non-significant studies were those with the shortest intervention periods and the oldest patients. Improvements in UL functions are not only present in the subacute phase after stroke but also in long-term chronic stages. In addition to further technical development, more RCTs are needed to make assumptions about the determinants of successful therapy.
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Affiliation(s)
- Chiara Höhler
- Research Department, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- Chair of Human Movement Science, Faculty of Sport and Health Science, Technical University Munich, Munich, Germany
| | - Emilio Trigili
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Davide Astarita
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Joachim Hermsdörfer
- Chair of Human Movement Science, Faculty of Sport and Health Science, Technical University Munich, Munich, Germany
| | - Klaus Jahn
- Research Department, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), Munich, Germany
| | - Carmen Krewer
- Research Department, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- Chair of Human Movement Science, Faculty of Sport and Health Science, Technical University Munich, Munich, Germany
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23
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Song A, Lusk JB, Roh KM, Hsu ST, Valikodath NG, Lad EM, Muir KW, Engelhard MM, Limkakeng AT, Izatt JA, McNabb RP, Kuo AN. RobOCTNet: Robotics and Deep Learning for Referable Posterior Segment Pathology Detection in an Emergency Department Population. Transl Vis Sci Technol 2024; 13:12. [PMID: 38488431 PMCID: PMC10946693 DOI: 10.1167/tvst.13.3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/31/2024] [Indexed: 03/19/2024] Open
Abstract
Purpose To evaluate the diagnostic performance of a robotically aligned optical coherence tomography (RAOCT) system coupled with a deep learning model in detecting referable posterior segment pathology in OCT images of emergency department patients. Methods A deep learning model, RobOCTNet, was trained and internally tested to classify OCT images as referable versus non-referable for ophthalmology consultation. For external testing, emergency department patients with signs or symptoms warranting evaluation of the posterior segment were imaged with RAOCT. RobOCTNet was used to classify the images. Model performance was evaluated against a reference standard based on clinical diagnosis and retina specialist OCT review. Results We included 90,250 OCT images for training and 1489 images for internal testing. RobOCTNet achieved an area under the curve (AUC) of 1.00 (95% confidence interval [CI], 0.99-1.00) for detection of referable posterior segment pathology in the internal test set. For external testing, RAOCT was used to image 72 eyes of 38 emergency department patients. In this set, RobOCTNet had an AUC of 0.91 (95% CI, 0.82-0.97), a sensitivity of 95% (95% CI, 87%-100%), and a specificity of 76% (95% CI, 62%-91%). The model's performance was comparable to two human experts' performance. Conclusions A robotically aligned OCT coupled with a deep learning model demonstrated high diagnostic performance in detecting referable posterior segment pathology in a cohort of emergency department patients. Translational Relevance Robotically aligned OCT coupled with a deep learning model may have the potential to improve emergency department patient triage for ophthalmology referral.
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Affiliation(s)
- Ailin Song
- Duke University School of Medicine, Durham, NC, USA
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | - Jay B. Lusk
- Duke University School of Medicine, Durham, NC, USA
| | - Kyung-Min Roh
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | - S. Tammy Hsu
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | | | - Eleonora M. Lad
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | - Kelly W. Muir
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | - Matthew M. Engelhard
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | | | - Joseph A. Izatt
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Ryan P. McNabb
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | - Anthony N. Kuo
- Department of Ophthalmology, Duke University, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
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Neugarten JM. Accuracy and Precision of Haptic Robotic-Guided Implant Surgery in a Large Consecutive Series. Int J Oral Maxillofac Implants 2024; 39:99-106. [PMID: 37939239 DOI: 10.11607/jomi.10468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Abstract
PURPOSE To determine the accuracy of dental implant placement using haptic robotic guidance in a large clinical series. MATERIALS AND METHODS In a prospective single-arm clinical study, 108 patients received 273 individual endosteal implants. A virtual preoperative restorative and surgical plan was created from a CBCT scan and matched to the surgical workspace on the day of surgery via either a tooth-based or bone-based fiducial splint. Intraoperatively, the surgeon manipulated a handpiece attached to a haptic robotic guidance arm. A variety of drills and implants were used. Both the osteotomy and the implant placement were guided by 3D haptic constraints according to the virtual plan. Postoperative CBCT scans permitted the calculation of the actual implant placement deviations compared to the plan for accuracy. Precision was calculated by comparing SDs from published literature. RESULTS The implants were evenly distributed by arch, with 47% placed in the maxilla and 53% in the mandible. The mean ± SD signed depth deviation was 0.14 ± 0.87 mm proud. The global angular deviation averaged 1.42 ± 1.53 degrees, with 95% confidence limits of 1.24 and 1.60 degrees. The crown of the actual placed implant showed an average deviation from the plan of 1.10 ± 0.69 mm and the apex of the placed implant showed a deviation of 1.12 ± 0.69 mm. Haptic robotic guidance showed greater precision than freehand, static computerguided, and dynamic computer-guided implant placement. CONCLUSIONS This large clinical series of 273 implants shows a high accuracy of implant placement compared to the published accuracy for angular deviations for any technology, as well as demonstrating statistically greater precision. Long-term clinical studies are necessary to establish the true effect of increased accuracy on clinical outcomes. Using haptic robotic guidance provides accurate implant placement while allowing additional benefits compared to computer-guided surgery, namely full visualization of the surgical field and the ability to change the plan intraoperatively.
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Salomons N, Scassellati B. Time-dependant Bayesian knowledge tracing-Robots that model user skills over time. Front Robot AI 2024; 10:1249241. [PMID: 38469397 PMCID: PMC10925631 DOI: 10.3389/frobt.2023.1249241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/12/2023] [Indexed: 03/13/2024] Open
Abstract
Creating an accurate model of a user's skills is an essential task for Intelligent Tutoring Systems (ITS) and robotic tutoring systems. This allows the system to provide personalized help based on the user's knowledge state. Most user skill modeling systems have focused on simpler tasks such as arithmetic or multiple-choice questions, where the user's model is only updated upon task completion. These tasks have a single correct answer and they generate an unambiguous observation of the user's answer. This is not the case for more complex tasks such as programming or engineering tasks, where the user completing the task creates a succession of noisy user observations as they work on different parts of the task. We create an algorithm called Time-Dependant Bayesian Knowledge Tracing (TD-BKT) that tracks users' skills throughout these more complex tasks. We show in simulation that it has a more accurate model of the user's skills and, therefore, can select better teaching actions than previous algorithms. Lastly, we show that a robot can use TD-BKT to model a user and teach electronic circuit tasks to participants during a user study. Our results show that participants significantly improved their skills when modeled using TD-BKT.
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Affiliation(s)
- Nicole Salomons
- Department of Computer Science, Yale University, New Haven, CT, United States
- I-X and the Department of Computing, Imperial College London, London, United Kingdom
| | - Brian Scassellati
- Department of Computer Science, Yale University, New Haven, CT, United States
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Javadi Y, Mills B, MacLeod C, Lines D, Abad F, Lotfian S, Mehmanparast A, Pierce G, Brennan F, Gachagan A, Mineo C. Phased Array Ultrasonic Method for Robotic Preload Measurement in Offshore Wind Turbine Bolted Connections. Sensors (Basel) 2024; 24:1421. [PMID: 38474957 DOI: 10.3390/s24051421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/13/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024]
Abstract
This paper presents a novel approach for preload measurement of bolted connections, specifically tailored for offshore wind applications. The proposed method combines robotics, Phased Array Ultrasonic Testing (PAUT), nonlinear acoustoelasticity, and Finite Element Analysis (FEA). Acceptable defects, below a pre-defined size, are shown to have an impact on preload measurement, and therefore conducting simultaneous defect detection and preload measurement is discussed in this paper. The study demonstrates that even slight changes in the orientation of the ultrasonic transducer, the non-automated approach, can introduce a significant error of up to 140 MPa in bolt stress measurement and therefore a robotic approach is employed to achieve consistent and accurate measurements. Additionally, the study emphasises the significance of considering average preload for comparison with ultrasonic data, which is achieved through FEA simulations. The advantages of the proposed robotic PAUT method over single-element approaches are discussed, including the incorporation of nonlinearity, simultaneous defect detection and stress measurement, hardware and software adaptability, and notably, a substantial improvement in measurement accuracy. Based on the findings, the paper strongly recommends the adoption of the robotic PAUT approach for preload measurement, whilst acknowledging the required investment in hardware, software, and skilled personnel.
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Affiliation(s)
- Yashar Javadi
- Centre for Ultrasonic Engineering (CUE), Department of Electronic & Electrical Engineering (EEE), University of Strathclyde, Glasgow G1 1XQ, UK
- Department of Design, Manufacturing & Engineering Management (DMEM), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Brandon Mills
- Centre for Ultrasonic Engineering (CUE), Department of Electronic & Electrical Engineering (EEE), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Charles MacLeod
- Centre for Ultrasonic Engineering (CUE), Department of Electronic & Electrical Engineering (EEE), University of Strathclyde, Glasgow G1 1XQ, UK
| | - David Lines
- Centre for Ultrasonic Engineering (CUE), Department of Electronic & Electrical Engineering (EEE), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Farhad Abad
- Department of Naval Architecture, Ocean & Marine Engineering (NAOME), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Saeid Lotfian
- Department of Naval Architecture, Ocean & Marine Engineering (NAOME), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Ali Mehmanparast
- Department of Naval Architecture, Ocean & Marine Engineering (NAOME), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Gareth Pierce
- Centre for Ultrasonic Engineering (CUE), Department of Electronic & Electrical Engineering (EEE), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Feargal Brennan
- Department of Naval Architecture, Ocean & Marine Engineering (NAOME), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Anthony Gachagan
- Centre for Ultrasonic Engineering (CUE), Department of Electronic & Electrical Engineering (EEE), University of Strathclyde, Glasgow G1 1XQ, UK
| | - Carmelo Mineo
- Institute for High Performance Computing and Networking, National Research Council, Via Ugo La Malfa 153, 90146 Palermo, Italy
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Adiuku N, Avdelidis NP, Tang G, Plastropoulos A. Advancements in Learning-Based Navigation Systems for Robotic Applications in MRO Hangar: Review. Sensors (Basel) 2024; 24:1377. [PMID: 38474913 DOI: 10.3390/s24051377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024]
Abstract
The field of learning-based navigation for mobile robots is experiencing a surge of interest from research and industry sectors. The application of this technology for visual aircraft inspection tasks within a maintenance, repair, and overhaul (MRO) hangar necessitates efficient perception and obstacle avoidance capabilities to ensure a reliable navigation experience. The present reliance on manual labour, static processes, and outdated technologies limits operation efficiency in the inherently dynamic and increasingly complex nature of the real-world hangar environment. The challenging environment limits the practical application of conventional methods and real-time adaptability to changes. In response to these challenges, recent years research efforts have witnessed advancement with machine learning integration aimed at enhancing navigational capability in both static and dynamic scenarios. However, most of these studies have not been specific to the MRO hangar environment, but related challenges have been addressed, and applicable solutions have been developed. This paper provides a comprehensive review of learning-based strategies with an emphasis on advancements in deep learning, object detection, and the integration of multiple approaches to create hybrid systems. The review delineates the application of learning-based methodologies to real-time navigational tasks, encompassing environment perception, obstacle detection, avoidance, and path planning through the use of vision-based sensors. The concluding section addresses the prevailing challenges and prospective development directions in this domain.
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Affiliation(s)
- Ndidiamaka Adiuku
- Integrated Vehicle Health Management Centre (IVHM), School of Aerospace, Transport and Manufacturing, Cranfield University, Bedfordshire MK43 0AL, UK
| | - Nicolas P Avdelidis
- Integrated Vehicle Health Management Centre (IVHM), School of Aerospace, Transport and Manufacturing, Cranfield University, Bedfordshire MK43 0AL, UK
| | - Gilbert Tang
- Centre for Robotics and Assembly, School of Aerospace, Transport and Manufacturing (SATM), Cranfield University, Bedfordshire MK43 0AL, UK
| | - Angelos Plastropoulos
- Integrated Vehicle Health Management Centre (IVHM), School of Aerospace, Transport and Manufacturing, Cranfield University, Bedfordshire MK43 0AL, UK
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Su J, Zhang H, Li H, He K, Tu J, Zhang F, Liu Z, Lv Z, Cui Z, Li Y, Li J, Tang LZ, Chen X. Skin-Inspired Multi-Modal Mechanoreceptors for Dynamic Haptic Exploration. Adv Mater 2024:e2311549. [PMID: 38363810 DOI: 10.1002/adma.202311549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/02/2024] [Indexed: 02/18/2024]
Abstract
Active sensing is a fundamental aspect of human and animal interactions with the environment, providing essential information about the hardness, texture, and tackiness of objects. This ability stems from the presence of diverse mechanoreceptors in the skin, capable of detecting a wide range of stimuli and from the sensorimotor control of biological mechanisms. In contrast, existing tactile sensors for robotic applications typically excel in identifying only limited types of information, lacking the versatility of biological mechanoreceptors and the requisite sensing strategies to extract tactile information proactively. Here, inspired by human haptic perception, a skin-inspired artificial 3D mechanoreceptor (SENS) capable of detecting multiple mechanical stimuli is developed to bridge sensing and action in a closed-loop sensorimotor system for dynamic haptic exploration. A tensor-based non-linear theoretical model is established to characterize the 3D deformation (e.g., tensile, compressive, and shear deformation) of SENS, providing guidance for the design and optimization of multimode sensing properties with high fidelity. Based on SENS, a closed-loop robotic system capable of recognizing objects with improved accuracy (≈96%) is further demonstrated. This dynamic haptic exploration approach shows promise for a wide range of applications such as autonomous learning, healthcare, and space and deep-sea exploration.
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Affiliation(s)
- Jiangtao Su
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Hang Zhang
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
- Singapore-HUJ Alliance for Research and Enterprise (SHARE), The Smart Grippers for Soft Robotics (SGSR) Programme, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, 138602, Singapore
| | - Haicheng Li
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Ke He
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
- Singapore-HUJ Alliance for Research and Enterprise (SHARE), The Smart Grippers for Soft Robotics (SGSR) Programme, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, 138602, Singapore
| | - Jiaqi Tu
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Feilong Zhang
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Zhihua Liu
- Institute of Materials Research and Engineering, the Agency for Science, Technology and Research, Singapore, 138634, Singapore
| | - Zhisheng Lv
- Institute of Materials Research and Engineering, the Agency for Science, Technology and Research, Singapore, 138634, Singapore
| | - Zequn Cui
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Yanzhen Li
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Jiaofu Li
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Leng Ze Tang
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - Xiaodong Chen
- Innovative Centre for Flexible Devices (iFLEX), Max Planck-NTU Joint Lab for Artificial Senses, School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
- Institute for Digital Molecular Analytics and Science (IDMxS), Nanyang Technological University, 59 Nanyang Drive, Singapore, 636921, Singapore
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Kanoulas D, Khattak S, Loianno G. Editorial: Rising stars in field robotics: 2022. Front Robot AI 2024; 11:1379661. [PMID: 38419614 PMCID: PMC10900065 DOI: 10.3389/frobt.2024.1379661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 03/02/2024] Open
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Cochrane NH, Kim BI, Stauffer TP, Hallows RK, Urish KL, Carvajal Alba JA, Seyler TM. Revision Total Knee Arthroplasty With an Imageless, Second-Generation Robotic System. J Arthroplasty 2024:S0883-5403(24)00118-9. [PMID: 38355066 DOI: 10.1016/j.arth.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Robotic-assisted total knee arthroplasty is increasingly used in revision total knee arthroplasty (rTKA), with imageless systems recently receiving Food and Drug Administration (FDA) approval. However, there remains a paucity of literature on the use of robotic assistance in revision total knee arthroplasty (TKA). This paper describes the imageless surgical technique for robotic revision TKA using a second-generation robotic system and details both intraoperative and 90-day outcomes. METHODS This was a retrospective review of 115 robotic revision TKAs from March 2021 to May 2023 at 3 tertiary academic centers. Patient demographics, perioperative surgical data, and 90-day outcomes were collected. Pain and Patient-Reported Outcomes Measurement Information System scores preoperatively and postoperatively were recorded. All-cause reoperations at the final follow-up were detailed. The mean patient age was 65 years (range, 43 to 88), and 58% were women. The mean follow-up time was 13 months (range, 3 to 51). RESULTS The most common indications for rTKA were instability (n = 37, 32%) and aseptic loosening (n = 42, 37%). There were 83 rTKAs to a posterior-stabilized liner, 22 to a varus-valgus constrained liner, and 5 to a hinged construct. The median polyethylene size was 11 (interquartile range, 10 to 13), and 93% of patients had their joint line restored within 5 millimeters of the native contralateral knee. Within the 90-day postoperative window, there were 8 emergency department visits and 2 readmissions. At the final follow-up, there were 5 reoperations and 2 manipulations under anesthesia. There were 4 patients who required irrigation and debridement after superficial wound dehiscence, and one had an arthrotomy disruption after a fall. CONCLUSIONS This review demonstrates favorable intraoperative and 90-day outcomes and suggests that imageless robotic surgery is a promising modality in rTKA. Further studies comparing the longitudinal outcomes after robotic and conventional rTKA are warranted.
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Affiliation(s)
- Niall H Cochrane
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Billy I Kim
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Taylor P Stauffer
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Rhett K Hallows
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Kenneth L Urish
- Arthritis and Arthroplasty Design Group, The Bone and Joint Center, Magee Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Bioengineering, and Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jaime A Carvajal Alba
- Department of Orthopaedic Surgery, University of Miami Health System, Miami, Florida
| | - Thorsten M Seyler
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina
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Sands T. Bio-Inspired Space Robotic Control Compared to Alternatives. Biomimetics (Basel) 2024; 9:108. [PMID: 38392155 DOI: 10.3390/biomimetics9020108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
Controlling robots in space with necessarily low material and structural stiffness is quite challenging at least in part due to the resulting very low structural resonant frequencies or natural vibration. The frequencies are sometimes so low that the very act of controlling the robot with medium or high bandwidth controllers leads to excitation of resonant vibrations in the robot appendages. Biomimetics or biomimicry emulates models, systems, and elements of nature for solving such complex problems. Recent seminal publications have re-introduced the viability of optimal command shaping, and one recent instantiation mimics baseball pitching to propose control of highly flexible space robots. The readership will find a perhaps dizzying array of thirteen decently performing alternatives in the literature but could be left bereft selecting a method(s) deemed to be best suited for a particular application. Bio-inspired control of space robotics is presented in a quite substantial (perhaps not comprehensive) comparison, and the conclusions of this study indicate the three top performing methods based on minimizing control effort (i.e., fuel) usage, tracking error mean, and tracking error deviation, where 96%, 119%, and 80% performance improvement, respectively, are achieved.
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Affiliation(s)
- Timothy Sands
- Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14853, USA
- Department of Mechanical and Aerospace Engineering, Naval Postgraduate School, Monterey, CA 93943, USA
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Kann MR, Ruiz-Cardozo MA, Brehm S, Bui T, Joseph K, Barot K, Trevino G, Carey-Ewend A, Singh SP, De La Paz M, Hanafy A, Olufawo M, Patel RP, Yahanda AT, Perdomo-Pantoja A, Jauregui JJ, Cadieux M, Pennicooke B, Molina CA. Utilization of Augmented Reality Head-Mounted Display for the Surgical Management of Thoracolumbar Spinal Trauma. Medicina (Kaunas) 2024; 60:281. [PMID: 38399568 PMCID: PMC10890598 DOI: 10.3390/medicina60020281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Augmented reality head-mounted display (AR-HMD) is a novel technology that provides surgeons with a real-time CT-guided 3-dimensional recapitulation of a patient's spinal anatomy. In this case series, we explore the use of AR-HMD alongside more traditional robotic assistance in surgical spine trauma cases to determine their effect on operative costs and perioperative outcomes. Materials and Methods: We retrospectively reviewed trauma patients who underwent pedicle screw placement surgery guided by AR-HMD or robotic-assisted platforms at an academic tertiary care center between 1 January 2021 and 31 December 2022. Outcome distributions were compared using the Mann-Whitney U test. Results: The AR cohort (n = 9) had a mean age of 66 years, BMI of 29.4 kg/m2, Charlson Comorbidity Index (CCI) of 4.1, and Surgical Invasiveness Index (SII) of 8.8. In total, 77 pedicle screws were placed in this cohort. Intra-operatively, there was a mean blood loss of 378 mL, 0.78 units transfused, 398 min spent in the operating room, and a 20-day LOS. The robotic cohort (n = 13) had a mean age of 56 years, BMI of 27.1 kg/m2, CCI of 3.8, and SII of 14.2. In total, 128 pedicle screws were placed in this cohort. Intra-operatively, there was a mean blood loss of 432 mL, 0.46 units transfused units used, 331 min spent in the operating room, and a 10.4-day LOS. No significant difference was found between the two cohorts in any outcome metrics. Conclusions: Although the need to address urgent spinal conditions poses a significant challenge to the implementation of innovative technologies in spine surgery, this study represents an initial effort to show that AR-HMD can yield comparable outcomes to traditional robotic surgical techniques. Moreover, it highlights the potential for AR-HMD to be readily integrated into Level 1 trauma centers without requiring extensive modifications or adjustments.
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Affiliation(s)
- Michael Ryan Kann
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Miguel A. Ruiz-Cardozo
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Samuel Brehm
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Tim Bui
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Karan Joseph
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Karma Barot
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Gabriel Trevino
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Abigail Carey-Ewend
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Som P. Singh
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Matthew De La Paz
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Ahmed Hanafy
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Michael Olufawo
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Rujvee P. Patel
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Alexander T. Yahanda
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Alexander Perdomo-Pantoja
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Julio J. Jauregui
- Department of Orthopedic Surgery, University of Maryland Medical System, Baltimore, MD 21201, USA
| | - Magalie Cadieux
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Brenton Pennicooke
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Camilo A. Molina
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
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Sabbagh H, Haas E, Baumert U, Seidel CL, Hötzel L, Wichelhaus A. Biomechanical Simulation of Orthodontic En-Bloc Retraction Comparing Compound Technique and Sliding Mechanics Using a HOSEA Robotic Device. Bioengineering (Basel) 2024; 11:153. [PMID: 38391639 PMCID: PMC10886252 DOI: 10.3390/bioengineering11020153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
En-bloc retraction is a common procedure in orthodontic therapy. The application of palatal root torque moments is required to control incisor inclination during retraction, yet studies comparing forces and moments with respect to different mechanics are lacking. This study aimed to investigate the forces and moments during orthodontic en-bloc retraction using a robotic biomechanical simulation system, comparing two distinct approaches: (I) compound technique [stainless steel (SS) combined with nickel-titanium (NiTi)] using industrially pretorqued retraction-torque-archwires (RTA) in combination with NiTi closed coil springs; (II) conventional sliding mechanics using SS archwires with manually applied anterior twist bends in combination with elastic chains. Two dimensions (0.017" × 0.025" and 0.018" × 0.025") and ten archwires per group were investigated using 0.022" slot self-ligating brackets. Kruskal-Wallis tests with a significance level of α = 0.05 were conducted. The biomechanical simulation showed that en-bloc retraction was characterized by a series of tipping and uprighting movements, differing significantly regarding the examined mechanics. Collateral forces and moments occurred in all groups. Notably, RTA exhibited fewer extrusive forces. The most bodily movement was achieved with the compound technique and the 0.018" × 0.025" RTA. Sliding mechanics exhibited maximum palatal root torque moments of more than 20 Nmm, exceeding recommended values.
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Affiliation(s)
- Hisham Sabbagh
- Department of Orthodontics and Dentofacial Orthopedics, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Ellen Haas
- Department of Orthodontics and Dentofacial Orthopedics, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Uwe Baumert
- Department of Orthodontics and Dentofacial Orthopedics, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Corinna Lesley Seidel
- Department of Orthodontics and Dentofacial Orthopedics, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Linus Hötzel
- Department of Orthodontics and Dentofacial Orthopedics, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
| | - Andrea Wichelhaus
- Department of Orthodontics and Dentofacial Orthopedics, LMU University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany
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Herrin KR, Kwak ST, Rock CG, Chang YH. Gait quality in prosthesis users is reflected by force-based metrics when learning to walk on a new research-grade powered prosthesis. Front Rehabil Sci 2024; 5:1339856. [PMID: 38370855 PMCID: PMC10869520 DOI: 10.3389/fresc.2024.1339856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/12/2024] [Indexed: 02/20/2024]
Abstract
Introduction Powered prosthetic feet require customized tuning to ensure comfort and long-term success for the user, but tuning in both clinical and research settings is subjective, time intensive, and the standard for tuning can vary depending on the patient's and the prosthetist's experience levels. Methods Therefore, we studied eight different metrics of gait quality associated with use of a research-grade powered prosthetic foot in seven individuals with transtibial amputation during treadmill walking. We compared clinically tuned and untuned conditions with the goal of identifying performance-based metrics capable of distinguishing between good (as determined by a clinician) from poor gait quality. Results Differences between the tuned and untuned conditions were reflected in ankle power, both the vertical and anterior-posterior impulse symmetry indices, limb-force alignment, and positive ankle work, with improvements seen in all metrics during use of the tuned prosthesis. Discussion Notably, all of these metrics relate to the timing of force generation during walking which is information not directly accessible to a prosthetist during a typical tuning process. This work indicates that relevant, real-time biomechanical data provided to the prosthetist through the future provision of wearable sensors may enhance and improve future clinical tuning procedures associated with powered prostheses as well as their long-term outcomes.
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Affiliation(s)
- Kinsey R. Herrin
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, United States
| | - Samuel T. Kwak
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Chase G. Rock
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Young-Hui Chang
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, United States
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
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Khalifeh K, Brown NJ, Pennington Z, Pham M. Spinal Robotics in Adult Spinal Deformity Surgery: A Systematic Review. Neurospine 2024:ns.2347138.569. [PMID: 38317548 DOI: 10.14245/ns.2347138.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/31/2023] [Indexed: 02/07/2024] Open
Abstract
Spinal robotics have the potential to improve the consistency of outcomes in adult spinal deformity (ASD) surgery. The objective of this paper is to assess the accuracy of pedicle and S2AI screws placed with robotic guidance in ASD patients. PubMed Central, Google Scholar, and an institutional library database were queried until May 2023. Articles were included if they described ASD correction via robotic guidance and pedicle and/or S2AI screw accuracy. Articles were excluded if they described pediatric/adolescent spinal deformity or included outcomes for both ASD and non-ASD patients without separating the data. Methodological quality was assessed using the Newcastle-Ottawa scale. Primary endpoints were pedicle screw accuracy based on the Gertzbein-Robbins Scale and self-reported accuracy percentages for S2AI screws. Data were extracted for patient demographics, operative details, and perioperative outcomes and assessed using descriptive statistics. Five studies comprising 138 patients were included (mean age 66.0yr; 85 female). A total of 1,508 screws were inserted using robotic assistance (51 S2AI screws). Two studies assessing pedicle screws reported clinically acceptable trajectory rates of 98.7% and 96.0%, respectively. Another study reported a pedicle screw accuracy rate of 95.5%. Three studies reported 100% accuracy across 51 total S2AI screws. Eight total complications and four reoperations were reported. Current evidence supports the application of robotics in ASD surgery as safe and effective for placement of both screw types. However, due to the paucity of data, a comprehensive assessment of its incremental benefit over other techniques cannot be made. Further work using expanded cohorts is merited.
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Affiliation(s)
- Kareem Khalifeh
- Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California
| | - Nolan J Brown
- Department of Neurosurgery, University of California Irvine, Orange, California
| | - Zach Pennington
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota 200 1st Street SW, Rochester, MN 55905
| | - Martin Pham
- Department of Neurosurgery, University of California San Diego School of Medicine, San Diego, California
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Gioè A, Monterossi G, Gueli Alletti S, Panico G, Campagna G, Costantini B, Naldini A, Pedone Anchora L, Oliva R, Mastrovito S, Fagotti A, Fanfani F, Scambia G. The new robotic system HUGO RAS for gynecologic surgery: First European experience from Gemelli Hospital. Int J Gynaecol Obstet 2024. [PMID: 38299809 DOI: 10.1002/ijgo.15396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To evaluate the safety and feasibility of the new surgical robot HUGO robotic assisted surgery (RAS) in a series of gynecologic surgical procedures. METHODS Between March and October 2022, 138 patients treated at Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy were enrolled in the study. All patients suitable for a minimally-invasive approach were prospectively included and divided into two groups: Group 1 (78 patients) made up of patients operated on for uterine and/or adnexal pathologies, and Group 2 (60 patients) made up of patients treated for pelvic organ prolapse. RESULTS In Group 1, median docking time (DT) was 5 min and median console time (CT) was 90 min. In two patients (2.6%) redocking was necessary. In two patients (2.6%), the surgeon continued the surgery laparoscopically. Intraoperative complications occurred in two surgeries (2.6%). In Group 2, median DT was 4 min and median CT was 134.5 min. In three patients (5%), redocking was necessary. In all patients, the surgery was successfully completed robotically without intraoperative complications. CONCLUSIONS The present study demonstrates that the new HUGO RAS system for gynecologic surgery is safe with good results in terms of surgical efficacy and perioperative outcomes. Further studies are needed to investigate its use in other technical and surgical aspects.
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Affiliation(s)
- Alessandro Gioè
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giorgia Monterossi
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Salvatore Gueli Alletti
- UOC Ginecologica e Ostetricia, Dipartimento Materno-Infantile, Ospedale Buccheri La Ferla Fatebenefratelli, Palermo, Italy
| | - Giovanni Panico
- UOC Chirurgia Ginecologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giuseppe Campagna
- UOC Chirurgia Ginecologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Barbara Costantini
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Angelica Naldini
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Luigi Pedone Anchora
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | | | - Anna Fagotti
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Fanfani
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Pata F, Tutino R, Picciariello A, Cantarella F. Editorial: Colorectal surgery and proctology: past, present, and future. Front Surg 2024; 11:1373867. [PMID: 38371881 PMCID: PMC10870640 DOI: 10.3389/fsurg.2024.1373867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 02/20/2024] Open
Affiliation(s)
- Francesco Pata
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
- Department of Surgery, AO Annunziata, Cosenza, Italy
| | - Roberta Tutino
- Department of General and Emergency Surgery, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | | | - Francesco Cantarella
- CPEP (Centre for Proctology and Perineology), Ospedali Privati Forlì, Forlì, Italy
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Prigozin A, Degani A. Interacting with Obstacles Using a Bio-Inspired, Flexible, Underactuated Multilink Manipulator. Biomimetics (Basel) 2024; 9:86. [PMID: 38392133 PMCID: PMC10886640 DOI: 10.3390/biomimetics9020086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 02/24/2024] Open
Abstract
With the increasing demand for robotic manipulators to operate in complex environments, it is important to develop designs that work in obstacle-rich environments and can navigate around obstacles. This paper aims to demonstrate the capabilities of a bio-inspired, underactuated multilink manipulator in environments with fixed and/or movable obstacles. To simplify the system design, a single rotational actuator is used at the base of the manipulator. We present a modeling method for flexible, multilink underactuated manipulators, including their interaction with obstacles. We also demonstrate how to plan a trajectory for the manipulator in environments with fixed obstacles. The robustness of the manipulator is examined by analyzing the effects of uncertainty in its initial state and the position of obstacles. Next, we demonstrate the performance of the manipulator in environments with movable obstacles and show the advantages of controlling the obstacles' radii and positions. Lastly, we showcase the process of picking up an object in workspaces with obstacles. All the findings are supported by simulations as well as hardware experiments.
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Affiliation(s)
- Amit Prigozin
- Faculty of Civil and Environmental Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Amir Degani
- Faculty of Civil and Environmental Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
- Technion Autonomous Systems Program (TASP), Technion-Israel Institute of Technology, Haifa 3200003, Israel
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Palese MA, Chin CP, Garden EB, Eilender B, Levy M, Ravivarapu KT, Wang D, Freid H, Al-Alao O, Araya JS, LaPointe-Rudow D, Herron D, Chin E, Arvelakis A, Shapiro R, Larenas F, Florman SS. Comparison of Single-Port Robotic Donor Nephrectomy and Laparoscopic Donor Nephrectomy. J Endourol 2024; 38:136-141. [PMID: 38185847 DOI: 10.1089/end.2023.0364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Purpose: To compare the intra- and postoperative outcomes of single-port robotic donor nephrectomies (SP RDNs) and laparoscopic donor nephrectomies (LDNs). Materials and Methods: We retrospectively reviewed our institutional database for patients who received LDN or SP RDN between September 2020 and December 2022. Donor baseline characteristics, intraoperative outcomes, postoperative outcomes, and recipient renal function were extracted and compared between LDN and SP RDN. SP RDN learning curve analysis based on operative time and graft extraction time was performed using cumulative sum analysis. Results: One hundred forty-four patients underwent LDN and 32 patients underwent SP RDN. LDN and SP RDN had similar operative times (LDN: 190.3 ± 28.0 minutes, SP RDN: 194.5 ± 35.1 minutes, p = 0.3253). SP RDN patients had significantly greater extraction times (LDN: 83.2 ± 40.3 seconds, SP RDN: 204.1 ± 52.2 seconds, p < 0.0001) and warm ischemia times (LDN: 145.1 ± 61.7 seconds, SP RDN: 275.4 ± 65.6 seconds, p < 0.0001). There were no differences in patient subjective pain scores, inpatient opioid usage, or Clavien-Dindo II+ complications. Short- and medium-term postoperative donor and recipient renal function were also similar between the groups. SP RDN graft extraction time and total operative time learning curves were achieved at case 27 and 13, respectively. Conclusion: SP RDN is a safe and feasible alternative to LDN that minimizes postoperative abdominal incisional scars and has a short learning curve. Future randomized prospective clinical trials are needed to confirm the findings of this study and to identify other potential benefits and drawbacks of SP RDNs.
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Affiliation(s)
- Michael A Palese
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Chih Peng Chin
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Evan B Garden
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin Eilender
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Micah Levy
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Krishna T Ravivarapu
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel Wang
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Hannah Freid
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Osama Al-Alao
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joseph Sewell Araya
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dianne LaPointe-Rudow
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel Herron
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Edward Chin
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Antonios Arvelakis
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ron Shapiro
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Francisca Larenas
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sander S Florman
- Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Rafferty H, Cretaro C, Arfanis N, Moore A, Pong D, Tulk Jesso S. Towards human-centered AI and robotics to reduce hospital falls: finding opportunities to enhance patient-nurse interactions during toileting. Front Robot AI 2024; 11:1295679. [PMID: 38357295 PMCID: PMC10865095 DOI: 10.3389/frobt.2024.1295679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction: Patients who are hospitalized may be at a higher risk for falling, which can result in additional injuries, longer hospitalizations, and extra cost for healthcare organizations. A frequent context for these falls is when a hospitalized patient needs to use the bathroom. While it is possible that "high-tech" tools like robots and AI applications can help, adopting a human-centered approach and engaging users and other affected stakeholders in the design process can help to maximize benefits and avoid unintended consequences. Methods: Here, we detail our findings from a human-centered design research effort to investigate how the process of toileting a patient can be ameliorated through the application of advanced tools like robots and AI. We engaged healthcare professionals in interviews, focus groups, and a co-creation session in order to recognize common barriers in the toileting process and find opportunities for improvement. Results: In our conversations with participants, who were primarily nurses, we learned that toileting is more than a nuisance for technology to remove through automation. Nurses seem keenly aware and responsive to the physical and emotional pains experienced by patients during the toileting process, and did not see technology as a feasible or welcomed substitute. Instead, nurses wanted tools which supported them in providing this care to their patients. Participants envisioned tools which helped them anticipate and understand patient toileting assistance needs so they could plan to assist at convenient times during their existing workflows. Participants also expressed favorability towards mechanical assistive features which were incorporated into existing equipment to ensure ubiquitous availability when needed without adding additional mass to an already cramped and awkward environment. Discussion: We discovered that the act of toileting served more than one function, and can be viewed as a valuable touchpoint in which nurses can assess, support, and encourage their patients to engage in their own recovery process as they perform a necessary and normal function of life. While we found opportunities for technology to make the process safer and less burdensome for patients and clinical staff alike, we believe that designers should preserve and enhance the therapeutic elements of the nurse-patient interaction rather than eliminate it through automation.
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Affiliation(s)
- Hannah Rafferty
- Systems Science and Industrial Engineering, SUNY Binghamton, Vestal, NY, United States
| | - Cameron Cretaro
- Systems Science and Industrial Engineering, SUNY Binghamton, Vestal, NY, United States
| | - Nicholas Arfanis
- Systems Science and Industrial Engineering, SUNY Binghamton, Vestal, NY, United States
| | - Andrew Moore
- Systems Science and Industrial Engineering, SUNY Binghamton, Vestal, NY, United States
| | - Douglas Pong
- Systems Science and Industrial Engineering, SUNY Binghamton, Vestal, NY, United States
| | - Stephanie Tulk Jesso
- Systems Science and Industrial Engineering, SUNY Binghamton, Vestal, NY, United States
- Human-Centered Mindful Technologies Lab, Systems Science and Industrial Engineering, SUNY Binghamton, Vestal, NY, United States
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Kiper P, Guzik A, Petrarca M, Oliva-Pascual-Vaca A, Luque-Moreno C. Editorial: New approaches for central nervous system rehabilitation. Front Neurol 2024; 15:1367519. [PMID: 38356885 PMCID: PMC10864656 DOI: 10.3389/fneur.2024.1367519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Affiliation(s)
- Pawel Kiper
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, Venice, Italy
| | - Agnieszka Guzik
- Department of Physiotherapy, College of Medical Sciences, Institute of Health Sciences, University of Rzeszów, Rzeszów, Poland
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory (MARlab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Angel Oliva-Pascual-Vaca
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - Carlos Luque-Moreno
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
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Zhao X, Yao H, Lv Y, Chen Z, Dong L, Huang J, Mi S. Reprogrammable Magnetic Soft Actuators with Microfluidic Functional Modules via Pixel-Assembly. Small 2024:e2310009. [PMID: 38295155 DOI: 10.1002/smll.202310009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/31/2023] [Indexed: 02/02/2024]
Abstract
Magnetic soft actuators and robots have attracted considerable attention in biomedical applications due to their speedy response, programmability, and biocompatibility. Despite recent advancements, the fabrication process of magnetic actuators and the reprogramming approach of their magnetization profiles continue to pose challenges. Here, a facile fabrication strategy is reported based on arrangements and distributions of reusable magnetic pixels on silicone substrates, allowing for various magnetic actuators with customizable architectures, arbitrary magnetization profiles, and integration of microfluidic technology. This approach enables intricate configurations with decent deformability and programmability, as well as biomimetic movements involving grasping, swimming, and wriggling in response to magnetic actuation. Moreover, microfluidic functional modules are integrated for various purposes, such as on/off valve control, curvature adjustment, fluid mixing, dynamic microfluidic architecture, and liquid delivery robot. The proposed method fulfills the requirements of low-cost, rapid, and simplified preparation of magnetic actuators, since it eliminates the need to sustain pre-defined deformations during the magnetization process or to employ laser heating or other stimulation for reprogramming the magnetization profile. Consequently, it is envisioned that magnetic actuators fabricated via pixel-assembly will have broad prospects in microfluidics and biomedical applications.
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Affiliation(s)
- Xiaoyu Zhao
- Bio-manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, 518000, China
| | - Hongyi Yao
- Bio-manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, 518000, China
| | - Yaoyi Lv
- Bio-manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, 518000, China
| | - Zhixian Chen
- Bio-manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, 518000, China
| | - Lina Dong
- Bio-manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, 518000, China
| | - Jiajun Huang
- Bio-manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, 518000, China
- Optometry Advanced Medical Equipment R&D Center, Research Institute of Tsinghua University in Shenzhen, Shenzhen, Guangdong, 518000, China
| | - Shengli Mi
- Bio-manufacturing Engineering Laboratory, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, 518000, China
- Optometry Advanced Medical Equipment R&D Center, Research Institute of Tsinghua University in Shenzhen, Shenzhen, Guangdong, 518000, China
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Zhang K, Pakrashi V, Murphy J, Hao G. Inspection of Floating Offshore Wind Turbines Using Multi-Rotor Unmanned Aerial Vehicles: Literature Review and Trends. Sensors (Basel) 2024; 24:911. [PMID: 38339628 PMCID: PMC10857435 DOI: 10.3390/s24030911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Operations and maintenance (O&M) of floating offshore wind turbines (FOWTs) require regular inspection activities to predict, detect, and troubleshoot faults at high altitudes and in harsh environments such as strong winds, waves, and tides. Their costs typically account for more than 30% of the lifetime cost due to high labor costs and long downtime. Different inspection methods, including manual inspection, permanent sensors, climbing robots, remotely operated vehicles (ROVs), and unmanned aerial vehicles (UAVs), can be employed to fulfill O&M missions. The UAVs, as an enabling technology, can deal with time and space constraints easily and complete tasks in a cost-effective and efficient manner, which have been widely used in different industries in recent years. This study provides valuable insights into the existing applications of UAVs in FOWT inspection, highlighting their potential to reduce the inspection cost and thereby reduce the cost of energy production. The article introduces the rationale for applying UAVs to FOWT inspection and examines the current technical status, research gaps, and future directions in this field by conducting a comprehensive literature review over the past 10 years. This paper will also include a review of UAVs' applications in other infrastructure inspections, such as onshore wind turbines, bridges, power lines, solar power plants, and offshore oil and gas fields, since FOWTs are still in the early stages of development. Finally, the trends of UAV technology and its application in FOWTs inspection are discussed, leading to our future research direction.
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Affiliation(s)
- Kong Zhang
- School of Engineering and Architecture, University College Cork, T12 K8AF Cork, Ireland; (K.Z.); (J.M.)
- Marine and Renewable Energy Ireland, Environmental Research Institute, University College Cork, P43 C573 Cork, Ireland
| | - Vikram Pakrashi
- UCD Centre for Mechanics, Dynamical Systems and Risk Laboratory, School of Mechanical and Materials Engineering, University College Dublin, D04 V1W8 Dublin, Ireland;
| | - Jimmy Murphy
- School of Engineering and Architecture, University College Cork, T12 K8AF Cork, Ireland; (K.Z.); (J.M.)
- Marine and Renewable Energy Ireland, Environmental Research Institute, University College Cork, P43 C573 Cork, Ireland
| | - Guangbo Hao
- School of Engineering and Architecture, University College Cork, T12 K8AF Cork, Ireland; (K.Z.); (J.M.)
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Ma R, Kiyasseh D, Laca JA, Kocielnik R, Wong EY, Chu TN, Cen S, Yang CH, Dalieh IS, Haque TF, Goldenberg MG, Huang X, Anandkumar A, Hung AJ. Artificial Intelligence-Based Video Feedback to Improve Novice Performance on Robotic Suturing Skills: A Pilot Study. J Endourol 2024. [PMID: 37905524 DOI: 10.1089/end.2023.0328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Introduction: Automated skills assessment can provide surgical trainees with objective, personalized feedback during training. Here, we measure the efficacy of artificial intelligence (AI)-based feedback on a robotic suturing task. Materials and Methods: Forty-two participants with no robotic surgical experience were randomized to a control or feedback group and video-recorded while completing two rounds (R1 and R2) of suturing tasks on a da Vinci surgical robot. Participants were assessed on needle handling and needle driving, and feedback was provided via a visual interface after R1. For feedback group, participants were informed of their AI-based skill assessment and presented with specific video clips from R1. For control group, participants were presented with randomly selected video clips from R1 as a placebo. Participants from each group were further labeled as underperformers or innate-performers based on a median split of their technical skill scores from R1. Results: Demographic features were similar between the control (n = 20) and feedback group (n = 22) (p > 0.05). Observing the improvement from R1 to R2, the feedback group had a significantly larger improvement in needle handling score (0.30 vs -0.02, p = 0.018) when compared with the control group, although the improvement of needle driving score was not significant when compared with the control group (0.17 vs -0.40, p = 0.074). All innate-performers exhibited similar improvements across rounds, regardless of feedback (p > 0.05). In contrast, underperformers in the feedback group improved more than the control group in needle handling (p = 0.02). Conclusion: AI-based feedback facilitates surgical trainees' acquisition of robotic technical skills, especially underperformers. Future research will extend AI-based feedback to additional suturing skills, surgical tasks, and experience groups.
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Affiliation(s)
- Runzhuo Ma
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Dani Kiyasseh
- Department of Computing and Mathematical Sciences, California Institute of Technology, Pasadena, California, USA
| | - Jasper A Laca
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Rafal Kocielnik
- Department of Computing and Mathematical Sciences, California Institute of Technology, Pasadena, California, USA
| | - Elyssa Y Wong
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Timothy N Chu
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Steven Cen
- Radiology Department, University of Southern California, Los Angeles, California, USA
| | - Cherine H Yang
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Istabraq S Dalieh
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Taseen F Haque
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Mitch G Goldenberg
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Xiuzhen Huang
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
- Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Anima Anandkumar
- Department of Computing and Mathematical Sciences, California Institute of Technology, Pasadena, California, USA
| | - Andrew J Hung
- Catherine & Joseph Aresty Department of Urology, Center for Robotic Simulation and Education, USC Institute of Urology, University of Southern California, Los Angeles, California, USA
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Lippi G, Mattiuzzi C, Favaloro EJ. Artificial intelligence in the pre-analytical phase: State-of-the art and future perspectives. J Med Biochem 2024; 43:1-10. [PMID: 38496022 PMCID: PMC10943465 DOI: 10.5937/jomb0-45936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 03/19/2024] Open
Abstract
The use of artificial intelligence (AI) has become widespread in many areas of science and medicine, including laboratory medicine. Although it seems obvious that the analytical and post-analytical phases could be the most important fields of application in laboratory medicine, a kaleidoscope of new opportunities has emerged to extend the benefits of AI to many manual labor-intensive activities belonging to the pre-analytical phase, which are inherently characterized by enhanced vulnerability and higher risk of errors. These potential applications involve increasing the appropriateness of test prescription (with computerized physician order entry or demand management tools), improved specimen collection (using active patient recognition, automated specimen labeling, vein recognition and blood collection assistance, along with automated blood drawing), more efficient sample transportation (facilitated by the use of pneumatic transport systems or drones, and monitored with smart blood tubes or data loggers), systematic evaluation of sample quality (by measuring serum indices, fill volume or for detecting sample clotting), as well as error detection and analysis. Therefore, this opinion paper aims to discuss the state-of-the-art and some future possibilities of AI in the preanalytical phase.
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Affiliation(s)
- Giuseppe Lippi
- University of Verona, Section of Clinical Biochemistry and School of Medicine, Verona, Italy
| | - Camilla Mattiuzzi
- Hospital of Rovereto, Provincial Agency for Social and Sanitary Services (APSS), Medical Direction, Trento, Italy
| | - Emmanuel J. Favaloro
- Institute of Clinical Pathology and Medical Research (ICPMR), Sydney Centres for Thrombosis and Haemostasis, Department of Haematology, NSW Health Pathology, Westmead Hospital, Westmead, NSW Australia
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Lynch C, Sakamuru S, Ooka M, Huang R, Klumpp-Thomas C, Shinn P, Gerhold D, Rossoshek A, Michael S, Casey W, Santillo MF, Fitzpatrick S, Thomas RS, Simeonov A, Xia M. High-Throughput Screening to Advance In Vitro Toxicology: Accomplishments, Challenges, and Future Directions. Annu Rev Pharmacol Toxicol 2024; 64:191-209. [PMID: 37506331 PMCID: PMC10822017 DOI: 10.1146/annurev-pharmtox-112122-104310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Traditionally, chemical toxicity is determined by in vivo animal studies, which are low throughput, expensive, and sometimes fail to predict compound toxicity in humans. Due to the increasing number of chemicals in use and the high rate of drug candidate failure due to toxicity, it is imperative to develop in vitro, high-throughput screening methods to determine toxicity. The Tox21 program, a unique research consortium of federal public health agencies, was established to address and identify toxicity concerns in a high-throughput, concentration-responsive manner using a battery of in vitro assays. In this article, we review the advancements in high-throughput robotic screening methodology and informatics processes to enable the generation of toxicological data, and their impact on the field; further, we discuss the future of assessing environmental toxicity utilizing efficient and scalable methods that better represent the corresponding biological and toxicodynamic processes in humans.
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Affiliation(s)
- Caitlin Lynch
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Srilatha Sakamuru
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Masato Ooka
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Ruili Huang
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Carleen Klumpp-Thomas
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Paul Shinn
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - David Gerhold
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Anna Rossoshek
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Sam Michael
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Warren Casey
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Michael F Santillo
- Division of Toxicology, Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, Laurel, Maryland, USA
| | - Suzanne Fitzpatrick
- Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Russell S Thomas
- Center for Computational Toxicology and Exposure, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Anton Simeonov
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
| | - Menghang Xia
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA; ,
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Youssef Y, De Wet D, Back DA, Scherer J. Digitalization in orthopaedics: a narrative review. Front Surg 2024; 10:1325423. [PMID: 38274350 PMCID: PMC10808497 DOI: 10.3389/fsurg.2023.1325423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Advances in technology and digital tools like the Internet of Things (IoT), artificial intelligence (AI), and sensors are shaping the field of orthopaedic surgery on all levels, from patient care to research and facilitation of logistic processes. Especially the COVID-19 pandemic, with the associated contact restrictions was an accelerator for the development and introduction of telemedical applications and digital alternatives to classical in-person patient care. Digital applications already used in orthopaedic surgery include telemedical support, online video consultations, monitoring of patients using wearables, smart devices, surgical navigation, robotic-assisted surgery, and applications of artificial intelligence in forms of medical image processing, three-dimensional (3D)-modelling, and simulations. In addition to that immersive technologies like virtual, augmented, and mixed reality are increasingly used in training but also rehabilitative and surgical settings. Digital advances can therefore increase the accessibility, efficiency and capabilities of orthopaedic services and facilitate more data-driven, personalized patient care, strengthening the self-responsibility of patients and supporting interdisciplinary healthcare providers to offer for the optimal care for their patients.
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Affiliation(s)
- Yasmin Youssef
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Deana De Wet
- Orthopaedic Research Unit, University of Cape Town, Cape Town, South Africa
| | - David A. Back
- Center for Musculoskeletal Surgery, Charité University Medicine Berlin, Berlin, Germany
| | - Julian Scherer
- Orthopaedic Research Unit, University of Cape Town, Cape Town, South Africa
- Department of Traumatology, University Hospital of Zurich, Zurich, Switzerland
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Leszczak J, Wolan-Nieroda A, Drużbicki M, Poświata A, Mikulski M, Roksela A, Guzik A. Evaluation of Reliability of the Luna EMG Rehabilitation Robot to Assess Proprioception in the Upper Limbs in 102 Healthy Young Adults. Med Sci Monit 2024; 30:e942439. [PMID: 38178559 PMCID: PMC10775584 DOI: 10.12659/msm.942439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/31/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Proprioception, the body's ability to perceive its own position and movement, is fundamental for motor control and coordination. Reliable assessment tools are essential, particularly for conditions affecting proprioceptive function. This study aimed to evaluate the external and internal compliance of the Luna EMG -multifunction robotic device in assessing proprioception. MATERIAL AND METHODS The study involved 102 healthy students (31 men and 71 women; mean age 22.2±1.46 years), assessing proprioception using the Luna EMG for the upper limbs. Two investigators conducted measurements, which were repeated after 2 weeks under identical conditions. RESULTS Based on the identified values of the interclass correlation coefficient (ICC) (ICC=0.969-0.997), which is a key measure of agreement between 2 assessments, the study shows a high agreement of measurements both between investigators (for right hand: P=0.3484 [Exam 1]; P=1.0000 [Exam 2]; for left hand: P=0.1092 [Exam 1]; P=0.7706 [Exam 2]) and between the examinations (for right hand: 0.1127 [Investigator 1]; 0.2113 [Investigator 2]; for left hand: P=0.0087 [Investigator 1]; P=0.1466 [Investigator 2]). The Bland-Altman analysis showed very small inter-rater deviations, approximately 0.05° in the first examination for the left side and 0.04° for the right side. The highest deviation between the examinations, amounting to 0.08°, was identified for the left side. CONCLUSIONS The study shows that the Luna EMG multifunction robotic device enables a reliable evaluation of upper limb proprioception. Measurements performed using this device show high internal and external consistency in the assessment of the proprioceptive senses of the upper limb in 102 healthy young adults.
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Affiliation(s)
- Justyna Leszczak
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | | | - Mariusz Drużbicki
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | | | | | - Anna Roksela
- EGZOTech, Sp. z o.o., Gliwice, Poland
- Faculty of Automatic Control, Electronics, and Computer Science, PhD School, Silesian University of Technology, Gliwice, Poland
| | - Agnieszka Guzik
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
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Rossetto F, Mestanza Mattos FG, Gervasoni E, Germanotta M, Pavan A, Cattaneo D, Aprile I, Baglio F. Efficacy of telerehabilitation with digital and robotic tools for the continuity of care of people with chronic neurological disorders: The TELENEURO@REHAB protocol for a randomized controlled trial. Digit Health 2024; 10:20552076241228928. [PMID: 38465294 PMCID: PMC10924562 DOI: 10.1177/20552076241228928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/09/2024] [Indexed: 03/12/2024] Open
Abstract
Context Chronic Neurological Disorders (CNDs) are among the leading causes of disability worldwide, and their contribution to the overall need for rehabilitation is increasing. Therefore, the identification of new digital solutions to ensure early and continuous care is mandatory. Objective This protocol proposes to test the usability, acceptability, safety, and efficacy of Telerehabilitation (TR) protocols with digital and robotic tools in reducing the perceived level of disability in CNDs including Parkinson's Disease (PD), Multiple Sclerosis (MS), and post-stroke patients. Design Setting and Subjects This single-blinded, multi-site, randomized, two-treatment arms controlled clinical trial will involve PD (N = 30), MS (N = 30), and post-stroke (N = 30). Each participant will be randomized (1:1) to the experimental group (20 sessions of motor telerehabilitation with digital and robotic tools) or the active control group (20 home-based motor rehabilitation sessions according to the usual care treatment). Primary and secondary outcome measures will be obtained at the baseline (T0), post-intervention (T1, 5 weeks after baseline), and at follow-up (T2, 2 months after treatment). Main Outcome Measures a multifaceted evaluation including quality of life, motor, and clinical/functional measures will be conducted at each time-point of assessment. The primary outcome measures will be the change in the perceived level of disability as measured by the World Health Organization Disability Assessment Schedule 2.0. Conclusion The implementation of TR protocols will enable a more targeted and effective response to the growing need for rehabilitation linked to CNDs, ensuring accessibility to rehabilitation services from the initial stages of the disease.
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Affiliation(s)
| | | | - Elisa Gervasoni
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
| | | | - Arianna Pavan
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
| | - Davide Cattaneo
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
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Pijls BG. Technology assistance in primary total knee replacement: hype or hope? Expert Rev Med Devices 2024; 21:11-14. [PMID: 37992036 DOI: 10.1080/17434440.2023.2287576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Total knee replacement (TKR) reduces pain, it increases quality of life and it generally lasts a long time with revision rates of less than 5% at 10 years. Some authors have suggested that outcomes may be further improved by technology assistance. AREAS COVERED Technology assistance in primary TKR includes technologies such as navigated TKR, patient specific instrumentation TKR and robotic TKR. EXPERT OPINION In general, technology assistance results in higher accuracy of component positioning and alignment, but this is likely not clinically relevant as no clinically important difference in clinical outcomes, quality of life and complications such as revisions has been demonstrated in meta-analyses of randomized controlled trials. As technology assistance in primary TKR is increasingly used to capture patient and surgeon data, surgeons have an increasingly important role in protecting their patients' data and their own data. Real world evidence of implant registries has shown that TKR without technologically assistance can achieve perfectly acceptable outcomes. Although there is a genuine hope that technology-assisted TKR may further improve these outcomes, this hope is based on promises rather than solid evidence. At the same time, technology assisted TKR is heavily promoted including direct patient marketing, which are aspects of a hype.
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Affiliation(s)
- Bart G Pijls
- Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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