One-shot additive manufacturing of robotic finger with embedded sensing and actuation

A main challenge in the additive manufacturing (AM) field is the possibility to create structures with embedded actuators and sensors: addressing this requirement would lead to a reduction of manual assembly tasks and product cost, pushing AM technologies into a new dimension for the fabrication of assembly-free smart objects. The main novelty of the present paper is the one shot fabrication of a 3D printed soft finger with an embedded shape memory alloy (SMA) actuator and two different 3D printed sensors (strain gauge and capacitive force sensor). 3D printed structures, fabricated with the proposed approach, can be immediately activated after their removal from the build plate, providing real-time feedback because of the embedded sensing units. Three different materials from two nozzles were extruded to fabricate the passive elements and sensing units of the proposed bioinspired robotic finger and a custom-made Cartesian pick and place robot (CPPR) was employed to integrate the SMA spring actuator into the 3D printed robotic finger during the fabrication processes. Another novelty of the present paper is the direct integration of SMA actuators during the 3D printing process. The low melting thermoplastic polycaprolactone (PCL) was extruded: its printing temperature of 70 °C is lower than the SMA austenitic start temperature, preventing the SMA activation during the manufacturing process. Two different sensors based on the piezoresistive principle and capacitive principle were studied, 3D printed and characterized, showing respectively a sensitivity ratio of change in resistance to finger bending angle to be 674.8 Ω∘Angle and a capacitance to force ratio of 0.53pFN . The proposed manufacturing approach paves the way for significant advancement of AM technologies in the field of smart structures with embedded actuators to provide real-time feedback, offering several advantages, especially in the soft robotics domain

The Restoration Interventions of “Forte Marghera” in Venice

In the framework of the Strategic Masterplan Cultural Heritage 2014-2018 of the Italian Ministry of Culture, a specific attention for the strengthening and constitution of relevant urban cultural centers is sought through the restoration and re-use of structural complexes of great architectural and historic value such as the case of Forte Marghera (Marghera Fort) of Venice. The need to build a fortress at the point where the mainland approached Venice was understood, after the fall of the “Serenissima” Republic (1797), by the Austrian Empire. The fort was therefore built in a marshy area on the edge of the Venice lagoon, crossed by a maze of canals. The works started in 1805. On the area there was already the old village of Malghera, home to warehouses and customs, which was incorporated into the Fort. However, the return of Napoleon's troops in 1806 surprised the works still in a early stage. The fortified work was then revised according to the plans of the French architect Marescò and conducted under the guidance of the general and military engineer François-Joseph Chaussegros de Léry and later the Chasseloup. The most significant buildings still present in the fortress – object of the current restoration works - are the two French barracks (1805-1814), located on the front near the dock. They are two-storey brickwork masonry structures with a 83x15 m rectangular plan and perimeter walls reaching a 3 m thickness, provided with decorative elements made of Istria stone. Visible decay is present in both two massive buildings, due to differential settlements mainly visible the long sides of both buildings, especially affecting the West one, also partially subjected to local collapse. A wide investigation campaign, aiming to the adequate characterization of the constituting materials and building techniques, was carried out in order to properly feed the design of conservative restoration interventions. Results indicate the use of good quality materials and proper layout also in the foundation system, indicating in the poor soil mechanical characteristics the main structural deficiency leading to the visible settlements. To date, the detailed design stage was reached for just one of the three buildings involved in the restoration, while the two remaining buildings are still in a preliminary design phase

Conservative surgery with and without radiotherapy in elderly patients with early-stage breast cancer: a prospective randomised multicentre trial.

ABSTRACT Breast conserving therapy (BCT) including postoperative irradiation of the remaining breast tissue is generally accepted as the best treatment for the majority of patients with early-stage breast cancer. The question is whether there is a necessity for irradiating all patients. Between 2001 and 2005, 749 women aged 55–75 years with infiltrating breast carcinoma were randomly assigned to breast conservative surgery, with or without radiotherapy (RT), to evaluate the incidence of in-breast recurrence (IBR). After 5 years of median follow-up, the cumulative incidence of IBR was 2.5% in the surgery-only arm and 0.7% in the surgery plus RT arm. There are no differences in terms of overall survival and distant disease-free survival. The preliminary evaluation suggests that breast irradiation after conservative surgery can be avoided without exposing these patients to an increased risk of distant-disease recurrence. Prolonged follow-up will further clarify the possible risks and late sequelae potentially induced by breast RT

Toxicity and Clinical Results after Proton Therapy for Pediatric Medulloblastoma: A Multi-Centric Retrospective Study

Medulloblastoma is the most common malignant brain tumor in children. Even if current treatment dramatically improves the prognosis, survivors often develop long-term treatment-related sequelae. The current radiotherapy standard for medulloblastoma is craniospinal irradiation with a boost to the primary tumor site and to any metastatic sites. Proton therapy (PT) has similar efficacy compared to traditional photon-based radiotherapy but might achieve lower toxicity rates. We report on our multi-centric experience with 43 children with medulloblastoma (median age at diagnosis 8.7 years, IQR 6.6, M/F 23/20; 26 high-risk, 14 standard-risk, 3 ex-infant), who received active scanning PT between 2015 and 2021, with a focus on PT-related acute-subacute toxicity, as well as some preliminary data on late toxicity. Most acute toxicities were mild and manageable with supportive therapy. Hematological toxicity was limited, even among HR patients who underwent hematopoietic stem-cell transplantation before PT. Preliminary data on late sequelae were also encouraging, although a longer follow-up is needed

I-Support: A robotic platform of an assistive bathing robot for the elderly population

In this paper we present a prototype integrated robotic system, the I-Support bathing robot, that aims at supporting new aspects of assisted daily-living activities on a real-life scenario. The paper focuses on describing and evaluating key novel technological features of the system, with the emphasis on cognitive human–robot interaction modules and their evaluation through a series of clinical validation studies. The I-Support project on its whole has envisioned the development of an innovative, modular, ICT-supported service robotic system that assists frail seniors to safely and independently complete an entire sequence of physically and cognitively demanding bathing tasks, such as properly washing their back and their lower limbs. A variety of innovative technologies have been researched and a set of advanced modules of sensing, cognition, actuation and control have been developed and seamlessly integrated to enable the system to adapt to the target population abilities. These technologies include: human activity monitoring and recognition, adaptation of a motorized chair for safe transfer of the elderly in and out the bathing cabin, a context awareness system that provides full environmental awareness, as well as a prototype soft robotic arm and a set of user-adaptive robot motion planning and control algorithms. This paper focuses in particular on the multimodal action recognition system, developed to monitor, analyze and predict user actions with a high level of accuracy and detail in real-time, which are then interpreted as robotic tasks. In the same framework, the analysis of human actions that have become available through the project’s multimodal audio–gestural dataset, has led to the successful modeling of Human–Robot Communication, achieving an effective and natural interaction between users and the assistive robotic platform. In order to evaluate the I-Support system, two multinational validation studies were conducted under realistic operating conditions in two clinical pilot sites. Some of the findings of these studies are presented and analyzed in the paper, showing good results in terms of: (i) high acceptability regarding the system usability by this particularly challenging target group, the elderly end-users, and (ii) overall task effectiveness of the system in different operating modes

Subacute Sclerosing Panencephalitis in Papua New Guinean Children: The Cost of Continuing Inadequate Measles Vaccine Coverage

Subacute sclerosing panencephalitis (SSPE) is a disabling and usually fatal brain disorder that typically occurs 3–10 years after acute measles infection. Papua New Guinea (PNG) has particularly high rates of SSPE. We report 22 cases of PNG children presenting to the provincial referral hospital in Madang Province who probably contracted acute measles when <12 months of age during a national epidemic in 2002 and who developed SSPE 5–7 years later. Based on these cases, the estimated annual SSPE incidence in Madang province in 2007–2009 was 54/million population aged <20 years. Four sub-districts had an annual incidence >100/million population aged <20 years, the highest rates ever reported. Young PNG children do not respond well to measles vaccine. Because of this, efforts such as supplementary measles immunisation programs should continue in order to reduce the pool of non-immune older people surrounding the youngest and most vulnerable members of PNG communities

Treatment of loco-regional recurrence of nasopharyngeal carcinoma in a non-endemic area: oncologic outcomes, morbidity, and proposal of a prognostic nomogram

Introduction: The study assessed outcomes and toxicities of different treatment modalities for local and/or regional recurrent nasopharyngeal carcinoma (NPC) in a non-endemic area. Methods: Patients treated with curative intent for recurrent NPC with salvage surgery, photon-based radiotherapy, proton therapy (PT), with or without chemotherapy, at different Italian referral centers between 1998 and 2020 were included. Adverse events and complications were classified according to the Common Terminology Criteria for Adverse Events. Characteristics of the patients, tumors, treatments, and complications are presented along with uni- and multivariate analysis of prognostic factors. A survival predictive nomogram is also provided. Results: A total of 140 patients treated from 1998 to 2020 were retrospectively assessed. Cases with lower age, comorbidity rate, stage, and shorter disease-free interval (DFI) preferentially underwent endoscopic surgery. More advanced cases underwent re-irradiation, fairly distributed between photon-based radiotherapy and PT. Age and DFI were independent factors influencing overall survival. No independent prognostic effect of treatment modality was observed. No significant difference in the morbidity profile of treatments was observed, with 40% of patients experiencing at least one adverse event classified as G3 or higher. Conclusion: Recurrent NPC in a non-endemic area has dissimilar aspects compared to its endemic counterpart, suggesting the need for further studies that can guide the choice of the best treatment modality

Multi-fingered haptic palpation utilizing granular jamming stiffness feedback actuators

This paper describes a multi-fingered haptic palpation method using stiffness feedback actuators for simulating tissue palpation procedures in traditional and in robot-assisted minimally invasive surgery. Soft tissue stiffness is simulated by changing the stiffness property of the actuator during palpation. For the first time, granular jamming and pneumatic air actuation are combined to realize stiffness modulation. The stiffness feedback actuator is validated by stiffness measurements in indentation tests and through stiffness discrimination based on a user study. According to the indentation test results, the introduction of a pneumatic chamber to granular jamming can amplify the stiffness variation range and reduce hysteresis of the actuator. The advantage of multi-fingered palpation using the proposed actuators is proven by the comparison of the results of the stiffness discrimination performance using two-fingered (sensitivity: 82.2%, specificity: 88.9%, positive predicative value: 80.0%, accuracy: 85.4%, time: 4.84 s) and single-fingered (sensitivity: 76.4%, specificity: 85.7%, positive predicative value: 75.3%, accuracy: 81.8%, time: 7.48 s) stiffness feedback

Conservative surgery with and without radiotherapy in elderly patients with early-stage breast cancer: a prospective randomised multicentre trial. Breast 2009

a b s t r a c t Breast conserving therapy (BCT) including postoperative irradiation of the remaining breast tissue is generally accepted as the best treatment for the majority of patients with early-stage breast cancer. The question is whether there is a necessity for irradiating all patients. Between 2001 and 2005, 749 women aged 55-75 years with infiltrating breast carcinoma were randomly assigned to breast conservative surgery, with or without radiotherapy (RT), to evaluate the incidence of in-breast recurrence (IBR). After 5 years of median follow-up, the cumulative incidence of IBR was 2.5% in the surgery-only arm and 0.7% in the surgery plus RT arm. There are no differences in terms of overall survival and distant disease-free survival. The preliminary evaluation suggests that breast irradiation after conservative surgery can be avoided without exposing these patients to an increased risk of distant-disease recurrence. Prolonged follow-up will further clarify the possible risks and late sequelae potentially induced by breast RT

Subacute Sclerosing Panencephalitis: Results of the Canadian Paediatric Surveillance Program and review of the literature

BACKGROUND: Subacute Sclerosing Panencephalitis (SSPE) is so rare in developed countries with measles immunization programs that national active surveillance is now needed to capture sufficient number of cases for meaningful analysis of data. Through the Canadian Paediatric Surveillance Program (CPSP), the SSPE study was able to document a national incidence and determine the epidemiology of affected Canadian children. METHODS: Between 1997 and 2000, the CPSP surveyed monthly 1978 to 2294 Canadian pediatricians and sub-specialists for SSPE cases. The response rate varied from 82–86% over those years. RESULTS: Altogether, four SSPE cases were reported to the CPSP: one case before, two during and one after the study period. The incidence of SSPE in Canadian children was 0.06/million children/year. Of the four cases, diagnosed between ages four and 17 years, three children had measles infection in infancy. All children showed a progressive course of dementia, loss of motor skills and epilepsy. Two children were treated with isoprinosine and intraventricular interferon but died in less than three years from disease onset. One child did not have any treatment and died after seven years of illness. One child received intraventricular ribavirin and remains alive, but markedly impaired, nine years following diagnosis. CONCLUSION: The CPSP has demonstrated that Canadian paediatricians and paediatric neurologists may encounter cases of SSPE. This report highlights the clinical course of affected Canadian children and provides a review of the disease and its management