Control techniques for mechatronic assisted surgery

The treatment response for traumatic head injured patients can be improved by using an autonomous robotic system to perform basic, time-critical emergency neurosurgery, reducing costs and saving lives. In this thesis, a concept for a neurosurgical robotic system is proposed to perform three specific emergency neurosurgical procedures; they are the placement of an intracranial pressure monitor, external ventricular drainage, and the evacuation of chronic subdural haematoma. The control methods for this system are investigated following a curiosity led approach. Individual problems are interpreted in the widest sense and solutions posed that are general in nature. Three main contributions result from this approach: 1) a clinical evidence based review of surgical robotics and a methodology to assist in their evaluation, 2) a new controller for soft-grasping of objects, and 3) new propositions and theorems for chatter suppression sliding mode controllers. These contributions directly assist in the design of the control system of the neurosurgical robot and, more broadly, impact other areas outside the narrow con nes of the target application. A methodology for applied research in surgical robotics is proposed. The methodology sets out a hierarchy of criteria consisting of three tiers, with the most important being the bottom tier and the least being the top tier. It is argued that a robotic system must adhere to these criteria in order to achieve acceptability. Recent commercial systems are reviewed against these criteria, and are found to conform up to at least the bottom and intermediate tiers. However, the lack of conformity to the criteria in the top tier, combined with the inability to conclusively prove increased clinical benefit, particularly symptomatic benefit, is shown to be hampering the potential of surgical robotics in gaining wide establishment. A control scheme for soft-grasping objects is presented. Grasping a soft or fragile object requires the use of minimum contact force to prevent damage or deformation. Without precise knowledge of object parameters, real-time feedback control must be used to regulate the contact force and prevent slip. Moreover, the controller must be designed to have good performance characteristics to rapidly modulate the fingertip contact force in response to a slip event. A fuzzy sliding mode controller combined with a disturbance observer is proposed for contact force control and slip prevention. The robustness of the controller is evaluated through both simulation and experiment. The control scheme was found to be effective and robust to parameter uncertainty. When tested on a real system, however, chattering phenomena, well known to sliding mode research, was induced by the unmodelled suboptimal components of the system (filtering, backlash, and time delays). This reduced the controller performance. The problem of chattering and potential solutions are explored. Real systems using sliding mode controllers, such as the control scheme for soft-grasping, have a tendency to chatter at high frequencies. This is caused by the sliding mode controller interacting with un-modelled parasitic dynamics at the actuator-input and sensor-output of the plant. As a result, new chatter-suppression sliding mode controllers have been developed, which introduce new parameters into the system. However, the effect any particular choice of parameters has on system performance is unclear, and this can make tuning the parameters to meet a set of performance criteria di cult. In this thesis, common chatter-suppression sliding mode control strategies are surveyed and simple design and estimation methods are proposed. The estimation methods predict convergence, chattering amplitude, settling time, and maximum output bounds (overshoot) using harmonic linearizations and invariant ellipsoid sets

Mathematical modelling of immune condition dynamics : a clinical perspective

This thesis describes the use of mathematical modelling to analyse the treatment of patients with immune disorders; namely, Multiple Myeloma, a cancer of plasma cells that create excess monoclonal antibody; and kidney transplants, where the immune system produces polygonal antibodies against the implanted organ. Linear and nonlinear compartmental models play an important role in the analysis of biomedical systems; in this thesis several models are developed to describe the in vivo kinetics of the antibodies that are prevalent for the two disorders studied. These models are validated against patient data supplied by clinical collaborators. Through this validation process important information regarding the dynamic properties of the clinical treatment can be gathered. In order to treat patients with excess immune antibodies the clinical staff wish to reduce these high levels in the patient to near healthy concentrations. To achieve this they have two possible treatment modalities: either using artificial methods to clear the material, a process known as apheresis, or drug therapy to reduce the production of the antibody in question. Apheresis techniques differ in their ability to clear different immune complexes; the effectiveness of a range of apheresis techniques is categorised for several antibody types and antibody fragments. The models developed are then used to predict the patient response to alternative treatment methods, and schedules, to find optimal combinations. In addition, improved measurement techniques that may offer an improved diagnosis are suggested. Whilst the overall effect of drug therapy is known, through measuring the concentration of antibodies in the patient’s blood, the short-term relationship between drug application and reduction in antibody synthesis is still not well defined; therefore, methods to estimate the generation rate of the immune complex, without the need for invasive procedures, are also presented

What is Mizzou Advantage?

This booklet provides detailed information about the Mizzou Advantage and the projects awarded grants in rounds 1 and 2 of the program

NASA SBIR abstracts of 1991 phase 1 projects

The objectives of 301 projects placed under contract by the Small Business Innovation Research (SBIR) program of the National Aeronautics and Space Administration (NASA) are described. These projects were selected competitively from among proposals submitted to NASA in response to the 1991 SBIR Program Solicitation. The basic document consists of edited, non-proprietary abstracts of the winning proposals submitted by small businesses. The abstracts are presented under the 15 technical topics within which Phase 1 proposals were solicited. Each project was assigned a sequential identifying number from 001 to 301, in order of its appearance in the body of the report. Appendixes to provide additional information about the SBIR program and permit cross-reference of the 1991 Phase 1 projects by company name, location by state, principal investigator, NASA Field Center responsible for management of each project, and NASA contract number are included

Advanced Strategies for Robot Manipulators

Amongst the robotic systems, robot manipulators have proven themselves to be of increasing importance and are widely adopted to substitute for human in repetitive and/or hazardous tasks. Modern manipulators are designed complicatedly and need to do more precise, crucial and critical tasks. So, the simple traditional control methods cannot be efficient, and advanced control strategies with considering special constraints are needed to establish. In spite of the fact that groundbreaking researches have been carried out in this realm until now, there are still many novel aspects which have to be explored

Ballard v. Kerr Clerk\u27s Record Dckt. 42611

https://digitalcommons.law.uidaho.edu/idaho_supreme_court_record_briefs/6640/thumbnail.jp

An investigation into the effects of commencing haemodialysis in the critically ill

<b>Introduction:</b> We have aimed to describe haemodynamic changes when haemodialysis is instituted in the critically ill. 3 hypotheses are tested: 1)The initial session is associated with cardiovascular instability, 2)The initial session is associated with more cardiovascular instability compared to subsequent sessions, and 3)Looking at unstable sessions alone, there will be a greater proportion of potentially harmful changes in the initial sessions compared to subsequent ones. <b>Methods:</b> Data was collected for 209 patients, identifying 1605 dialysis sessions. Analysis was performed on hourly records, classifying sessions as stable/unstable by a cutoff of >+/-20% change in baseline physiology (HR/MAP). Data from 3 hours prior, and 4 hours after dialysis was included, and average and minimum values derived. 3 time comparisons were made (pre-HD:during, during HD:post, pre-HD:post). Initial sessions were analysed separately from subsequent sessions to derive 2 groups. If a session was identified as being unstable, then the nature of instability was examined by recording whether changes crossed defined physiological ranges. The changes seen in unstable sessions could be described as to their effects: being harmful/potentially harmful, or beneficial/potentially beneficial. <b>Results:</b> Discarding incomplete data, 181 initial and 1382 subsequent sessions were analysed. A session was deemed to be stable if there was no significant change (>+/-20%) in the time-averaged or minimum MAP/HR across time comparisons. By this definition 85/181 initial sessions were unstable (47%, 95% CI SEM 39.8-54.2). Therefore Hypothesis 1 is accepted. This compares to 44% of subsequent sessions (95% CI 41.1-46.3). Comparing these proportions and their respective CI gives a 95% CI for the standard error of the difference of -4% to 10%. Therefore Hypothesis 2 is rejected. In initial sessions there were 92/1020 harmful changes. This gives a proportion of 9.0% (95% CI SEM 7.4-10.9). In the subsequent sessions there were 712/7248 harmful changes. This gives a proportion of 9.8% (95% CI SEM 9.1-10.5). Comparing the two unpaired proportions gives a difference of -0.08% with a 95% CI of the SE of the difference of -2.5 to +1.2. Hypothesis 3 is rejected. Fisher’s exact test gives a result of p=0.68, reinforcing the lack of significant variance. <b>Conclusions:</b> Our results reject the claims that using haemodialysis is an inherently unstable choice of therapy. Although proportionally more of the initial sessions are classed as unstable, the majority of MAP and HR changes are beneficial in nature

Pacing with restoration of respiratory sinus arrhythmia improved cardiac contractility and the left ventricular output: a translational study

Introduction: Respiratory sinus arrhythmia (RSA) is a prognostic value for patients with heart failure and is defined as a beat-to-beat variation of the timing between the heart beats. Patients with heart failure or patients with permanent cardiac pacing might benefit from restoration of RSA. The aim of this translational, proof-of-principle study was to evaluate the effect of pacing with or without restored RSAon parameters of LV cardiac contractility and the cardiac output

Energy Harvesting and Energy Storage Systems

This book discuss the recent developments in energy harvesting and energy storage systems. Sustainable development systems are based on three pillars: economic development, environmental stewardship, and social equity. One of the guiding principles for finding the balance between these pillars is to limit the use of non-renewable energy sources