Towards vision-based robotic skins: a data-driven, multi-camera tactile sensor

This paper describes the design of a multi-camera optical tactile sensor that provides information about the contact force distribution applied to its soft surface. This information is contained in the motion of spherical particles spread within the surface, which deforms when subject to force. The small embedded cameras capture images of the different particle patterns that are then mapped to the three-dimensional contact force distribution through a machine learning architecture. The design proposed in this paper exhibits a larger contact surface and a thinner structure than most of the existing camera-based tactile sensors, without the use of additional reflecting components such as mirrors. A modular implementation of the learning architecture is discussed that facilitates the scalability to larger surfaces such as robotic skins.Comment: Accompanying video: https://youtu.be/lbavqAlKl9

The Axis “Human Papillomavirus - Anal Squamous Cell Carcinoma”: A Review

Background: Anal Squamous Cell Carcinoma (ASCC) is an infrequent neoplasia that represents 2% of the digestive tumors and it has a growing incidence. Objective: This investigation (i) studies the pathogenesis of an increasingly prevalent disease, (ii) its treatment and prognosis along with (iii) a bibliographical review of the main characteristics of the Human Papillomavirus (HPV) as well as its effects on humans. Methods: A literature review is performed, comprising articles up to 2019 and cross-research manuscripts with the initial research. Results: Several studies demonstrate the HPV role as a significant risk factor to the development of ASCC, as well as its higher incidence in HIV-positive individuals and in those who engage in receptive anal intercourse. Future trends in theragnostic using information technology are examined. Conclusions: ASCC is a neoplasm mostly associated with HPV. Many studies are needed to improve the treatment as well as in the evaluation of the tumor characteristics

Histology: An Identification Manual

This brand-new, user-friendly text takes you effortlessly through the step-by-step process you need to accurately distinguish the various components of each and every tissue, organ, and system under consideration. Each chapter contains a “commonly misdiagnosed” section to help you avoid the usual pitfalls in identification, and a “logic tree” maps out the questions you should be asking yourself as you go through the identification process. Accurately identify a structure with step-by-step guidance instructing you on when to use a low magnification or high magnification objective. Focus on the parts of the micrograph you should be assessing via the help of large format micrographs accompanied by pen and ink drawings. Avoid pitfalls thanks to a “commonly misdiagnosed” section at the end of the each chapter. Obtain expert guidance on practical matters in the lab using an appendix on techniques and stain procedures. A clear page design, concise text, and practical binding make this resource an indispensable friend in the lab. It’s almost like having your own personal histology instructor at your side. This text was originally published by Mosby, Inc., an affiliate of Elsevier Inc. All rights have been reverted to the original author. Reviews: I went through it and found it an excellent histology manual not only for the students but for the instructors as well. Brilliant job, Prof. - Dr. Hanna L. Koubish, MD, MSc, PhD., Kuwait Universityhttps://digitalcommons.augustana.edu/open_textbooks/1000/thumbnail.jp

Recommendations for the surgical treatment of endometriosis. Part 2: deep endometriosis

Study question: How should surgery for endometriosis be performed? / Summary answer: This document provides recommendations covering technical aspects of different methods of surgery for deep endometriosis in women of reproductive age. / What is known already: Endometriosis is highly prevalent and often associated with severe symptoms. Yet compared to equally prevalent conditions it is poorly understood and a challenge to manage. Previously published guidelines have provided recommendations for (surgical) treatment of deep endometriosis, based on the best available evidence, but without technical information and details on how to best perform such treatment in order to be effective and safe. / Study, design, size, duration: A working group of the European Society for Gynaecological Endoscopy (ESGE), European Society of Human Reproduction and Embryology (ESHRE) and the World Endometriosis Society (WES) collaborated on writing recommendations on the practical aspects of surgery for treatment of deep endometriosis. / Participants, materials, setting, methods: This document focused on surgery for deep endometriosis, and is complementary to a previous document in this series focusing on endometrioma surgery. / Main results and the role of chance: The document presents general recommendations for surgery for deep endometriosis, starting from preoperative assessments and first steps of surgery. Different approaches for surgical treatment are discussed and are respective of location and extent of disease; uterosacral ligaments and rectovaginal septum with or without involvement of the rectum, urinary tract or extrapelvic endometriosis. In addition, recommendations are provided on the treatment of frozen pelvis and on hysterectomy as a treatment for deep endometriosis. / Limitations, reasons for caution: Owing to the limited evidence available, recommendations are mostly based on clinical expertise. Where available, references of relevant studies were added. / Wider implications of the findings: These recommendations complement previous guidelines on management of endometriosis and the recommendations for surgical treatment of ovarian endometrioma. / Study funding - Competing interest(s): The meetings of the working group were funded by ESGE, ESHRE and WES

Thiel embalmed cadaveric tissue : a model for surgical simulation and research

Le Collège royal des médecins et chirurgiens du Canada met actuellement en place des curriculums basés sur les compétences, plutôt que sur le temps, dans toutes les spécialités médicales et chirurgicales. La transition devrait être complétée en 2022. Les programmes de formation en chirurgie plastique au Canada devront repenser leurs curriculums pour se plier aux directives nationales. La simulation est la pierre angulaire du modèle de formation des résidents basé sur les compétences puisqu'elle permet aux résidents d'apprendre et d'améliorer leurs compétences dans un contexte éthique, sécuritaire, et mesurable objectivement. Un consensus récent des directeurs de programme canadiens en chirurgie plastique a nommé 154 procédures essentielles de bases que les résidents doivent maîtriser avant la fin de leur formation. Nous proposons l'utilisation du modèle cadavérique Thiel pour la simulation haute fidélité des procédures en plastie. Les spécimens Thiel ont déjà été introduits dans une multitude de spécialités, incluant la plastie pour la dissection de lambeaux et la réparation de tendons. Nous nous sommes concentrés sur l'évaluation des spécimens Thiel pour la maîtrise des anastomoses vasculaires, la réparation des nerfs périphériques, et la réparation des tendons fléchisseurs. Par ailleurs, nous avons développé des instruments d'évaluation pour chacun de ces domaines de simulation. Des trois instruments, nous avons validé les échelles d'évaluation des anastomoses vasculaires et nerveuses. Ces deux échelles ont démontré d'excellents degrés de fiabilité et de reproductibilité et sont bien corrélés avec le niveau de formation et d'expérience des sujets. Le modèle de réparation des tendons fléchisseurs a démontré un degré plus élevé de variaiblité inter-évaluateur, et, quoique prometteur, il n'a pas pu être complètement validé basé sur les données actuelles. De plus, nous avons utilisé les vaisseaux Thiel comme un modèle de recherche pour l'investigation de nouvelles techniques microvasculaires. Notre expérience montre que les spécimens cadavériques Thiel sont un excellent modèle de simulation pour la chirurgie microvasculaire et la réparation des nerfs périphériques et des tendons fléchisseurs. Nous proposons des instruments d'évaluation pour assister à l'implémentation de ces modèles de simulation dans les curriculums basés sur les compétences en chirurgie plastique.The Royal College of Physicians and Surgeons is currently implementing a major shift from a time based to a competence based curriculum in all medical and surgical specialties. By 2022 the transition is to be complete. The plastic surgery training programs in Canada will have to rethink their curriculum in order to comply with the national directives. Simulation is a cornerstone of the competence based model of resident training as it not only allows residents to safely learn and hone their skill in a setting that is ethical and promotes patient safety, but it allows for objective evaluation of their performance. A recent consensus statement from the Canadian plastic surgery program directors identified 154 essential core procedures for residents to master by the end of their training. We propose the use of the Thiel cadaveric model for high fidelity simulation of plastic surgery procedures. While Thiel cadaveric specimens have been proposed for use in a multitude of specialties, including in plastic surgery for flap dissection and tendon repair, we focused on evaluating the use of the Thiel embalmed specimens on three core procedures: microvascular anastomoses, peripheral nerve repair, and flexor tendon repair. In addition, we designed evaluation instruments for each of these three simulation areas to help grade performance and aid in the feedback/debriefing process. Of the three evaluation instruments, we successfully validated the microvascular evaluation and micro-neurorrhaphy evaluation scales. Both of these scales showed excellent degrees of reliability and reproducibility and correlated well with the level of training and self-declared experience of the subjects. The flexor tendon evaluation scale showed a higher degree of inter-rater variability and, while it shows promise with a larger cohort of participants and additional calibration, it could not be validated fully based on the available data. Additionally, we used the Thiel embalmed cadaveric vessels as a research model for the investigation of new microvascular techniques. Our experience shows the Thiel cadaveric specimens to provide an excellent model for simulating microvascular, peripheral nerve and flexor tendon repairs. We propose evaluation instruments to assist in the implementation of these simulation models in a comprehensive, competence based curriculum in plastic surgery

Towards tactile sensing active capsule endoscopy

Examination of the gastrointestinal(GI) tract has traditionally been performed using tethered endoscopy tools with limited reach and more recently with passive untethered capsule endoscopy with limited capability. Inspection of small intestines is only possible using the latter capsule endoscopy with on board camera system. Limited to visual means it cannot detect features beneath the lumen wall if they have not affected the lumen structure or colour. This work presents an improved capsule endoscopy system with locomotion for active exploration of the small intestines and tactile sensing to detect deformation of the capsule outer surface when it follows the intestinal wall. In laboratory conditions this system is capable of identifying sub-lumen features such as submucosal tumours.Through an extensive literary review the current state of GI tract inspection in particular using remote operated miniature robotics, was investigated, concluding no solution currently exists that utilises tactile sensing with a capsule endoscopy. In order to achieve such a platform, further investigation was made in to tactile sensing technologies, methods of locomotion through the gut, and methods to support an increased power requirement for additional electronics and actuation. A set of detailed criteria were compiled for a soft formed sensor and flexible bodied locomotion system. The sensing system is built on the biomimetic tactile sensing device, Tactip, \cite{Chorley2008, Chorley2010, Winstone2012, Winstone2013} which has been redesigned to fit the form of a capsule endoscopy. These modifications have required a $360^{o}$ cylindrical sensing surface with $360^{o}$ panoramic optical system. Multi-material 3D printing has been used to build an almost complete sensor assembly with a combination of hard and soft materials, presenting a soft compliant tactile sensing system that mimics the tactile sensing methods of the human finger. The cylindrical Tactip has been validated using artificial submucosal tumours in laboratory conditions. The first experiment has explored the new form factor and measured the device's ability to detect surface deformation when travelling through a pipe like structure with varying lump obstructions. Sensor data was analysed and used to reconstruct the test environment as a 3D rendered structure. A second tactile sensing experiment has explored the use of classifier algorithms to successfully discriminate between three tumour characteristics; shape, size and material hardness. Locomotion of the capsule endoscopy has explored further bio-inspiration from earthworm's peristaltic locomotion, which share operating environment similarities. A soft bodied peristaltic worm robot has been developed that uses a tuned planetary gearbox mechanism to displace tendons that contract each worm segment. Methods have been identified to optimise the gearbox parameter to a pipe like structure of a given diameter. The locomotion system has been tested within a laboratory constructed pipe environment, showing that using only one actuator, three independent worm segments can be controlled. This configuration achieves comparable locomotion capabilities to that of an identical robot with an actuator dedicated to each individual worm segment. This system can be miniaturised more easily due to reduced parts and number of actuators, and so is more suitable for capsule endoscopy. Finally, these two developments have been integrated to demonstrate successful simultaneous locomotion and sensing to detect an artificial submucosal tumour embedded within the test environment. The addition of both tactile sensing and locomotion have created a need for additional power beyond what is available from current battery technology. Early stage work has reviewed wireless power transfer (WPT) as a potential solution to this problem. Methods for optimisation and miniaturisation to implement WPT on a capsule endoscopy have been identified with a laboratory built system that validates the methods found. Future work would see this combined with a miniaturised development of the robot presented. This thesis has developed a novel method for sub-lumen examination. With further efforts to miniaturise the robot it could provide a comfortable and non-invasive procedure to GI tract inspection reducing the need for surgical procedures and accessibility for earlier stage of examination. Furthermore, these developments have applicability in other domains such as veterinary medicine, industrial pipe inspection and exploration of hazardous environments

Ubiquitous haptic feedback in human-computer interaction through electrical muscle stimulation

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