A development of assistant surgical robot system based on surgical-operation-by-wire and hands-on-throttle-and-stick

BACKGROUND: Robot-assisted laparoscopic surgery offers several advantages compared with open surgery and conventional minimally invasive surgery. However, one issue that needs to be resolved is a collision between the robot arm and the assistant instrument. This is mostly caused by miscommunication between the surgeon and the assistant. To resolve this limitation, an assistant surgical robot system that can be simultaneously manipulated via a wireless controller is proposed to allow the surgeon to control the assistant instrument. METHODS: The system comprises two novel master interfaces (NMIs), a surgical instrument with a gripper actuated by a micromotor, and 6-axis robot arm. Two NMIs are attached to master tool manipulators of da Vinci research kit (dVRK) to control the proposed system simultaneously with patient side manipulators of dVRK. The developments of the surgical instrument and NMI are based on surgical-operation-by-wire concept and hands-on-throttle-and-stick concept from the earlier research, respectively. Tests for checking the accuracy, latency, and power consumption of the NMI are performed. The gripping force, reaction time, and durability are assessed to validate the surgical instrument. The workspace is calculated for estimating the clinical applicability. A simple peg task using the fundamentals of laparoscopic surgery board and an in vitro test are executed with three novice volunteers. RESULTS: The NMI was operated for 185 min and reflected the surgeon’s decision successfully with a mean latency of 132 ms. The gripping force of the surgical instrument was comparable to that of conventional systems and was consistent even after 1000 times of gripping motion. The reaction time was 0.4 s. The workspace was calculated to be 8397.4 cm(3). Recruited volunteers were able to execute the simple peg task within the cut-off time and successfully performed the in vitro test without any collision. CONCLUSIONS: Various experiments were conducted and it is verified that the proposed assistant surgical robot system enables collision-free and simultaneous operation of the dVRK’s robot arm and the proposed assistant robot arm. The workspace is appropriate for the performance of various kinds of surgeries. Therefore, the proposed system is expected to provide higher safety and effectiveness for the current surgical robot system

Three-Dimensional Carbon Nanostructures for Advanced Lithium-Ion Batteries

Carbon nanostructural materials have gained the spotlight as promising anode materials for energy storage; they exhibit unique physico-chemical properties such as large surface area, short Li+ ion diffusion length, and high electrical conductivity, in addition to their long-term stability. However, carbon-nanostructured materials have issues with low areal and volumetric densities for the practical applications in electric vehicles, portable electronics, and power grid systems, which demand higher energy and power densities. One approach to overcoming these issues is to design and apply a three-dimensional (3D) electrode accommodating a larger loading amount of active anode materials while facilitating Li+ ion diffusion. Furthermore, 3D nanocarbon frameworks can impart a conducting pathway and structural buffer to high-capacity non-carbon nanomaterials, which results in enhanced Li+ ion storage capacity. In this paper, we review our recent progress on the design and fabrication of 3D carbon nanostructures, their performance in Li-ion batteries (LIBs), and their implementation into large-scale, lightweight, and flexible LIBs

Blood Flow Restriction Improves Vascular Circulation

Purpose - The present study aimed to investigate the effects of low-intensity resistance training with blood flow restriction (BFR resistance training) on vascular endothelial function and peripheral blood circulation. Methods - Forty healthy elderly volunteers aged 71 ± 4 years were divided into two training groups. Twenty subjects performed BFR resistance training (BFR group), and the remaining 20 performed ordinary resistance training without BFR. Resistance training was performed at 20 % of each estimated one-repetition maximum for 4 weeks. Measurements were taken for lactate (Lac), norepinephrine (NE), vascular endothelial growth factor (VEGF) and growth hormone (GH) before and after the initial resistance training. Results - Lac, NE, VEGF and GH increased significantly from 8.2 ± 3.6 mg/dLm, 619.5 ± 243.7 pg/mL, 43.3 ±15.9 pg/mL, and 0.9 ± 0.7 ng/mL to 49.2 ± 16.1 mg/dL, 960.2 ±373.7 pg/mL, 61.6 ± 19.5 pg/mL and 3.1 ± 1.3 ng/mL, respectively, in the BFR group (each P \u3c 0.01). RHI and Foot-tcPO2 increased significantly from 1.8 ± 0.2 and 62.4 ± 5.3 mmHg to 2.1 ± 0.3 and 68.9 ± 5.8 mmHg, respectively, in the BFR group (each P \u3c 0.01). VWF decreased significantly from 175.7 ± 20.3 to 156.3 ± 38.1% in the BFR group (P \u3c 0.05)

Ultra-Thin ReS2 Nanosheets Grown on Carbon Black for Advanced Lithium-Ion Battery Anodes

ReS2 nanosheetsaregrownonthesurfaceofcarbonblack(CB)viaanefficienthydrothermal method. We confirmed the ultra-thin ReS2 nanosheets with≈1–4 layers on the surface of the CB (ReS2@CB) by using analytical techniques of field emission scanning electron microscopy (FESEM) and high-resolution transmission electron microscopy (HRTEM). The ReS2@CB nanocomposite showed high specific capacities of 760, 667, 600, 525, and 473 mAh/g at the current densities of 0.1 (0.23 C), 0.2 (0.46 C), 0.3 (0.7 C), 0.5 (1.15 C) and 1.0 A/g (2.3 C), respectively, in conjunction with its excellent cycling performance (432 mAh/g at 2.3 C; 91.4% capacity retention) after 100 cycles. Such LIB performance is greatly higher than pure CB and ReS2 powder samples. These results could be due to the following reasons: (1) the low-cost CB serves as a supporter enabling the formation of ≈1–4 layered nanosheets of ReS2, thus avoiding its agglomeration; (2) the CB enhances the electrical conductivity of the ReS2@CB nanocomposite; (3) the ultra-thin (1–4 layers) ReS2 nanosheets with imperfect structure can function as increasing the number of active sites for reaction of Li+ ions with electrolytes. The outstanding performance and unique structural characteristics of the ReS2@CB anodes make them promising candidates for the ever-increasing development of advanced LIBs. © 2019 by the authors. © 2019 by the authors

In situ fabrication of a graphene-coated three-dimensional nickel oxide anode for high-capacity lithium-ion batteries

The high theoretical specific capacity of nickel oxide (NiO) makes it attractive as a high-efficiency electrode material for electrochemical energy storage. However, its application is limited due to its inferior electrochemical performance and complicated electrode fabrication process. Here, we developed an in situ fabrication of a graphene-coated, three-dimensional (3D) NiO-Ni structure by simple chemical vapor deposition (CVD). We synthesized NiO layers on Ni foam through a thermal oxidation process; subsequently, we grew graphene layers directly on the surface of NiO after a hydrogen-assisted reduction process. The uniform graphene coating renders high electrical conductivity, structural flexibility and high elastic modulus at atomic thickness. The graphene-coated 3D NiO-Ni structure delivered a high areal density of ∼23 mg cm-2. It also exhibits a high areal capacity of 1.2 mA h cm-2 at 0.1 mA cm-2 for its Li-ion battery performance. The high capacity is attributed to the high surface area of the 3D structure and the unique properties of the graphene layers on the NiO anode. Since the entire process is carried out in one CVD system, the fabrication of such a graphene-coated 3D NiO-Ni anode is simple and scalable for practical applications. © 2018 The Royal Society of Chemistry1

Three-Dimensional Carbon Nanostructures for Advanced Lithium-Ion Batteries

This review contains the authors' recent progress on the design and fabrication of 3D carbon nanostructures, their performance in Li-ion batteries (LIBs), and their implementation into large-scale, lightweight, and flexible LIBs

Association between Glasgow Coma Scale in Early Carbon Monoxide Poisoning and Development of Delayed Neurological Sequelae: A Meta-Analysis

A significant number of people experience delayed neurologic sequelae after acute carbon monoxide (CO) poisoning. The Glasgow Coma Scale (GCS) can be used to predict delayed neurologic sequelae occurrence efficiently and without any restrictions. Here, we investigated the association between a low GCS score observed in cases of early CO poisoning and delayed neurologic sequelae development through a meta-analysis. We systematically searched MEDLINE, EMBASE, and the Cochrane Library for studies on GCS as a predictor of delayed neurologic sequelae occurrence in patients with CO poisoning in June 2021. Two reviewers independently extracted study characteristics and pooled data. We also conducted subgroup analyses for the cutoff point for GCS. To assess the risk of bias of each included study, we used the quality in prognosis studies tool. We included 2328 patients from 10 studies. With regard to patients with acute CO poisoning, in the overall pooled odds ratio (OR) of delayed neurologic sequelae development, those with a low GCS score showed a significantly higher value and moderate heterogeneity (OR 2.98, 95% confidence interval (CI) 2.10–4.23, I2 = 33%). Additionally, in subgroup analyses according to the cutoff point of GCS, the development of delayed neurologic sequelae was still significantly higher in the GCS < 9 group (OR 2.80, 95% CI 1.91–4.12, I2 = 34%) than in the GCS < 10 or GCS < 11 groups (OR 4.24, 95% CI 1.55–11.56, I2 = 48%). An initial low GCS score in patients with early CO poisoning was associated with the occurrence of delayed neurologic sequelae. Additionally, GCS was quickly, easily, and accurately assessed. It is therefore possible to predict delayed neurologic sequelae and establish an active treatment strategy, such as hyperbaric oxygen therapy, to minimize neurological sequelae using GCS

Recurrent Pulseless Ventricular Tachycardia Induced by Commotio Cordis Treated with Therapeutic Hypothermia

The survival rate of commotio cordis is low, and there is often associated neurological disability if return of spontaneous circulation (ROSC) can be achieved. We report a case of commotio cordis treated with therapeutic hypothermia (TH) that demonstrated a favorable outcome. A 16-year-old female was transferred to our emergency department (ED) for collapse after being struck in the chest with a dodgeball. She has no history of heart problems. She was brought to our ED with pulseless ventricular tachycardia (VT), and ROSC was achieved with defibrillation. She was comatose at our ED and was treated with TH at a target temperature of 33°C for 24 hours. After transfer to the intensive care unit, pulseless VT occurred, and defibrillation was performed twice. She recovered to baseline neurologic status with the exception of some memory difficulties

Ultra-Thin ReS₂ Nanosheets Grown on Carbon Black for Advanced Lithium-Ion Battery Anodes

ReS2 nanosheets are grown on the surface of carbon black (CB) via an efficient hydrothermal method. We confirmed the ultra-thin ReS2 nanosheets with ≈1–4 layers on the surface of the CB (ReS2@CB) by using analytical techniques of field emission scanning electron microscopy (FESEM) and high-resolution transmission electron microscopy (HRTEM). The ReS2@CB nanocomposite showed high specific capacities of 760, 667, 600, 525, and 473 mAh/g at the current densities of 0.1 (0.23 C), 0.2 (0.46 C), 0.3 (0.7 C), 0.5 (1.15 C) and 1.0 A/g (2.3 C), respectively, in conjunction with its excellent cycling performance (432 mAh/g at 2.3 C; 91.4% capacity retention) after 100 cycles. Such LIB performance is greatly higher than pure CB and ReS2 powder samples. These results could be due to the following reasons: (1) the low-cost CB serves as a supporter enabling the formation of ≈1–4 layered nanosheets of ReS2, thus avoiding its agglomeration; (2) the CB enhances the electrical conductivity of the ReS2@CB nanocomposite; (3) the ultra-thin (1–4 layers) ReS2 nanosheets with imperfect structure can function as increasing the number of active sites for reaction of Li+ ions with electrolytes. The outstanding performance and unique structural characteristics of the ReS2@CB anodes make them promising candidates for the ever-increasing development of advanced LIBs

Impact of a Smart-Ring-Based Feedback System on the Quality of Chest Compressions in Adult Cardiac Arrest: A Randomized Preliminary Study

This study aimed to assess the effectiveness of a novel chest compression (CC) smart-ring-based feedback system in a manikin simulation. In this randomized, crossover, controlled study, we evaluated the effect of smart-ring CC feedback on cardiopulmonary resuscitation (CPR). The learnability and usability of the tool were evaluated with the System Usability Scale (SUS). Participants were divided into two groups and each performed CCs with and without feedback 2 weeks apart, using different orders. The primary outcome was compression depth; the proportion of accurate-depth (5–6 cm) CCs, CC rate, and the proportion of complete CCs (≤1 cm of residual leaning) were assessed additionally. The feedback group and the non-feedback group showed significant differences in compression depth (52.1 (46.3–54.8) vs. 47.1 (40.5–49.9) mm, p = 0.021). The proportion of accurate-depth CCs was significantly higher in the interventional than in the control condition (88.7 (30.0–99.1) vs. 22.6 (0.0–58.5%), p = 0.033). The mean SUS score was 83.9 ± 8.7 points. The acceptability ranges were ‘acceptable’, and the adjective rating was ‘excellent’. CCs with smart-ring feedback could help achieve the ideal range of depth during CPR. The smart-ring may be a valuable source of CPR feedback