1,337 research outputs found

    Ergonomics in laparoscopic surgery: a work system analysis to reduce work-related musculoskeletal disorders across surgeons in Peruvian hospitals

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    Laparoscopic surgery, also called minimally invasive surgery, is a type of surgery in which the surgeon operates by viewing the surgery on a screen that projects images from a camera inserted into the patient's abdomen. Laparoscopic tools are long (usually up to 35 cm) and require fine motor skills and visual perception for manipulation, restricting the degrees of freedom to move within the patient. This restriction causes surgeons to operate with limited vision and restricted movement and force them to work with assistants who assist in conducting the cameras, acting as "the surgeons' eyes". Because of its minimally invasive nature, laparoscopic surgery is well accepted by patients but is challenging and complex for the surgeon. This is due to the restriction of movement and perception that forces surgeons to adopt awkward postures with high exposition, which increases the likelihood of work-related musculoskeletal disorders (WRMSD). WRMSDs are detrimental to surgeons' health and potentially may impact patient safety. Studies often highlight the problems of surgeons in high-income countries, whose solutions and clinical guides often cannot be applied to countries like Peru, which have severe deficiencies in its healthcare system. For this reason, the thesis proposes a contextualised investigation of the Peruvian surgical work system to investigate the main factors contributing to the development of WRMSD in laparoscopic surgeons, which may affect patient safety. The analysis aimed to propose possible recommendations to support redesigning the laparoscopic surgery work system in Peruvian hospitals. Five studies were developed to achieve the aims based on the Systems Engineering Initiative for patient safety model, an ergonomics model for healthcare systems analysis. The first three studies were developed parallel with a mixed convergent design approach concluding in an integrating study. The last two studies (study four and five) had a quantitative approach. The first study used a qualitative approach by collecting information through interviews with laparoscopic surgeons and observing their work in real surgeries. The second study adopted a quantitative approach through a questionnaire-based survey applied to 140 surgeons in Peru. The third study analysed the extent to which the postures adopted by surgeons in real surgeries increase the risk of WRMSD and their association with factors in the work system using the RULA method. The results of the three studies were integrated into an integrative study, concluding that the raised height of the operating table and other system factors related to tasks, person and technology raises the risk of WRMSD. Based on these results, the fourth study analysed the relationship between surgeons and operating tables to understand how many surgeons could reach suitable working heights. The study concluded that no operating table available in Peruvian hospitals nor in the market would be suitable for 90% of Peruvian surgeons. The tables were too high to accommodate surgeons with optimal working surface height to perform laparoscopic surgery. Then, a fifth study was conducted to determine an acceptable working height based on surgeon preferences and system factors and concluded that surgeons would accept a working height between 49 cm to 70 cm in height, which is lower than current operating tables. The lowest height was reached when surgeons had to operate on obese patients and perform intracorporeal suturing tasks. Finally, the thesis concludes with recommendations for redesigning working heights for 90% of the Peruvian medical population, considering work system elements of the Peruvian context

    Soft pneumatic muscles for post-stroke lower limb ankle rehabilitation: leveraging the potential of soft robotics to optimize functional outcomes

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    Introduction: A soft pneumatic muscle was developed to replicate intricate ankle motions essential for rehabilitation, with a specific focus on rotational movement along the x-axis, crucial for walking. The design incorporated precise geometrical parameters and air pressure regulation to enable controlled expansion and motion.Methods: The muscle’s response was evaluated under pressure conditions ranging from 100-145 kPa. To optimize the muscle design, finite element simulation was employed to analyze its performance in terms of motion range, force generation, and energy efficiency. An experimental platform was created to assess the muscle’s deformation, utilizing advanced techniques such as high-resolution imaging and deep-learning position estimation models for accurate measurements. The fabrication process involved silicone-based materials and 3D-printed molds, enabling precise control and customization of muscle expansion and contraction.Results: The experimental results demonstrated that, under a pressure of 145 kPa, the y-axis deformation (y-def) reached 165 mm, while the x-axis and z-axis deformations were significantly smaller at 0.056 mm and 0.0376 mm, respectively, highlighting the predominant elongation in the y-axis resulting from pressure actuation. The soft muscle model featured a single chamber constructed from silicone rubber, and the visually illustrated and detailed geometrical parameters played a critical role in its functionality, allowing systematic manipulation to meet specific application requirements.Discussion: The simulation and experimental results provided compelling evidence of the soft muscle design’s adaptability, controllability, and effectiveness, thus establishing a solid foundation for further advancements in ankle rehabilitation and soft robotics. Incorporating this soft muscle into rehabilitation protocols holds significant promise for enhancing ankle mobility and overall ambulatory function, offering new opportunities to tailor rehabilitation interventions and improve motor function restoration

    Data ethics : building trust : how digital technologies can serve humanity

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    Data is the magic word of the 21st century. As oil in the 20th century and electricity in the 19th century: For citizens, data means support in daily life in almost all activities, from watch to laptop, from kitchen to car, from mobile phone to politics. For business and politics, data means power, dominance, winning the race. Data can be used for good and bad, for services and hacking, for medicine and arms race. How can we build trust in this complex and ambiguous data world? How can digital technologies serve humanity? The 45 articles in this book represent a broad range of ethical reflections and recommendations in eight sections: a) Values, Trust and Law, b) AI, Robots and Humans, c) Health and Neuroscience, d) Religions for Digital Justice, e) Farming, Business, Finance, f) Security, War, Peace, g) Data Governance, Geopolitics, h) Media, Education, Communication. The authors and institutions come from all continents. The book serves as reading material for teachers, students, policy makers, politicians, business, hospitals, NGOs and religious organisations alike. It is an invitation for dialogue, debate and building trust! The book is a continuation of the volume “Cyber Ethics 4.0” published in 2018 by the same editors

    Improving Automated Operations of Heavy-Duty Manipulators with Modular Model-Based Control Design

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    The rapid development of robotization and automation in mobile working machines aims to increase productivity and safety in many industrial sectors. In heavy-duty applications, hydraulically actuated manipulators are the common solution due to their large power-to-weight ratio. As hydraulic systems can exhibit nonlinear dynamic behavior, automated operations with closed-loop control become challenging. In industrial applications, the dexterity of operations for manipulators is ensured by providing interfaces to equip product variants with different tool attachments. By considering these domain-specific tool attachments for heavy-duty hydraulic manipulators (HHMs), the autonomous robotic operating development for all product variants might be a time-consuming process. This thesis aims to develop a modular nonlinear model-based (NMB) control method for HHMs to enable systematic NMB model reuse and control system modularity across different HHM product variants with actuators and tool attachments. Equally importantly, the properties of NMB control are used to improve the high-performance control for multi degrees-of-freedom robotic HHMs, as rigorously stability-guaranteed control systems have been shown to provide superior performance. To achieve these objectives, four research problems (RPs) on HHM controls are addressed. The RPs are focused on damping control methods in underactuated tool attachments, compensating for static actuator nonlinearities, and, equally significantly, improving overall control performance. The fourth RP is introduced for hydraulic series elastic actuators (HSEAs) in HHM applications, which can be regarded as supplementing NMB control with the aim of improving force controllability. Six publications are presented to investigate the RPs in this thesis. The control development focus was on modular NMB control design for HHMs equipped with different actuators and tool attachments consisting of passive and actuated joints. The designed control methods were demonstrated on a full-size HHM and a novel HSEA concept in a heavy-duty experimental setup. The results verified that modular control design for HHM systems can be used to decrease the modifications required to use the manipulator with different tool attachments and floating-base environments

    Vibrations of cable-suspended rehabilitation robots

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    Rehabilitation robots help the treatment of diseases by performing cyclic exercises for a long period of time. These exercises must perform movements of the patient's limbs; thus, the robots are required to be flexible and safe. Among rehabilitation robots, cable robots are widely used due to their unique properties, such as being lightweight and the possibility of being equipped with magnetic hooks to improve both safety and ease of use. However, the elasticity and flexibility of cables result in vibrations of the payload and hooks. In this paper, the forced vibrations due to rehabilitation exercises are studied. Since the previous studies of the authors showed a weak coupling between longitudinal and transverse vibrations, a two-cable planar model for the study of transverse vibrations is developed. The model makes it possible to study the forced transverse vibrations due to both cable motion and robot motion. Stiffness and damping of the patient's arm are considered. Results show that the cable system exhibits a simple linear behavior when excited by robot motion and a non-linear behavior when excited by cable motion

    Continuum robot actuation by a single motor per antagonistic tendon pair: Workspace and repeatability analysis [Kontinuumsroboter-Aktuierung mittels eines Motors pro antagonistischen Kabelpaar. Arbeitsraum- und Wiederholgenauigkeitsanalyse]

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    Kontinuumroboter sind stark im Fokus aktueller medizinrobotischer Forschung. Da die meisten der in der Literatur vorgestellten Systeme jedoch komplexe und große Aktoreinheiten aufweisen, kann das Erstellen eines solchen Systems in aufwendigen, kostenintensiven und sperrigen Aufbauten resultieren, welche ungeeignet für die räumlichen Anforderungen des Einsatzes in medizinischen Szenarien sind. In dieser Arbeit wird ein einfaches, effizientes kontinuumrobotisches System vorgestellt, in welchem ein antagonistisches Paar von Kabelzügen durch einen Servomotor bewegt wird, anstatt jedes Kabel durch einen einzelnen Motor zu treiben. Auf diese Weise kann die Grundfläche der Aktoreinheit klein gehalten werden und die Methode resultiert in einem einfacheren Aufbau. Der resultierende 260 mm lange Roboter mit 9,9 mm Durchmesser erreicht eine Wiederholgenauigkeit von 1,8 % seiner Länge. In zukünftigen Arbeiten dient er als Basis für die Integration von verschiedener Sensormodalitäten in Kontinuumroboter und zur Evaluation von Steueralgorithmen

    Anàlisi d'utilització de recursos i energia en el procés productiu de l'empresa KH Lloreda

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    Aquest treball de fi de grau consisteix en una auditoria energètica realitzada a l'empresa KH-7, per tal d'identificar oportunitats d'estalvi energètic i econòmic mitjançant l'anàlisi previ del consum energètic de l’empresa i posteriorment es presenten diferents propostes de millora. L'auditoria consta d’una anàlisi detallada de la facturació i consum energètics de l'empresa mitjançant l'avaluació dels equips i sistemes energètics en ús. A partir dels resultats obtinguts, s'identifiquen les potencials mancances en eficiència energètica i es proposen mesures com ara la utilització de fonts d'energia renovable. El resultat final del treball és un informe que resumeix els resultats de l'auditoria i les propostes de millora corresponents. Aquest informe proporciona una clara visió de la situació energètica de l'empresa i les solucions per millorar l'eficiència energètica i generar potencials estalvis econòmics i energètics a llarg termini.Este trabajo de fin de grado consiste en una auditoría energética realizada en la empresa KH-7, con el fin de identificar oportunidades de ahorro energético y económico mediante el análisis previo del consumo energético de la empresa y posteriormente se presentan diferentes propuestas de mejora. La auditoría consta de un análisis de la facturación y consumo energéticos de la empresa mediante la evaluación de los equipos y sistemas energéticos en uso. A partir de los resultados obtenidos, se identifican las potenciales carencias en eficiencia energética y se proponen medidas tales como la utilización de fuentes de energía renovable. El resultado final del trabajo es un informe que resume los resultados de la auditoría y las correspondientes propuestas de mejora. Este informe proporciona una visión clara de la situación energética de la empresa y las soluciones para mejorar la eficiencia energética y generar potenciales ahorros económicos y energéticos a largo plazo.This project consists of an energy audit carried out in the company KH-7 its objective is to identify opportunities for energetic and the consequent economic savings through the previous analysis of the energy consumption of the company. Then, various proposals for improvement are made. The audit consists of a detailed analysis of the company's energy billing and consumption by evaluating the energy equipment and systems in use. Based on the results obtained, potential improvements in energy efficiency are identified and measures such as the use of renewable energy sources. The result of this project is a report summarizing the results of the audit and the corresponding proposals for improvement. This report provides a clear view of the company's energy situation and solutions for improving energy efficiency and generating long-term economic and energy savings
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