230 research outputs found

    Swarm robotics in wireless distributed protocol design for coordinating robots involved in cooperative tasks

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    The mine detection in an unexplored area is an optimization problem where multiple mines, randomly distributed throughout an area, need to be discovered and disarmed in a minimum amount of time. We propose a strategy to explore an unknown area, using a stigmergy approach based on ants behavior, and a novel swarm based protocol to recruit and coordinate robots for disarming the mines cooperatively. Simulation tests are presented to show the effectiveness of our proposed Ant-based Task Robot Coordination (ATRC) with only the exploration task and with both exploration and recruiting strategies. Multiple minimization objectives have been considered: the robots' recruiting time and the overall area exploration time. We discuss, through simulation, different cases under different network and field conditions, performed by the robots. The results have shown that the proposed decentralized approaches enable the swarm of robots to perform cooperative tasks intelligently without any central control

    Comparison of bio-inspired algorithms applied to the coordination of mobile robots considering the energy consumption

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    Many applications, related to autonomous mobile robots, require to explore in an unknown environment searching for static targets, without any a priori information about the environment topology and target locations. Targets in such rescue missions can be fire, mines, human victims, or dangerous material that the robots have to handle. In these scenarios, some cooperation among the robots is required for accomplishing the mission. This paper focuses on the application of different bio-inspired metaheuristics for the coordination of a swarm of mobile robots that have to explore an unknown area in order to rescue and handle cooperatively some distributed targets. This problem is formulated by first defining an optimization model and then considering two sub-problems: exploration and recruiting. Firstly, the environment is incrementally explored by robots using a modified version of ant colony optimization. Then, when a robot detects a target, a recruiting mechanism is carried out to recruit a certain number of robots to deal with the found target together. For this latter purpose, we have proposed and compared three approaches based on three different bio-inspired algorithms (Firefly Algorithm, Particle Swarm Optimization, and Artificial Bee Algorithm). A computational study and extensive simulations have been carried out to assess the behavior of the proposed approaches and to analyze their performance in terms of total energy consumed by the robots to complete the mission. Simulation results indicate that the firefly-based strategy usually provides superior performance and can reduce the wastage of energy, especially in complex scenarios

    Pain Distraction During Awake Major Colorectal Surgery: Supporting Patients Beyond the COVID-19 Era. Preliminary Findings

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    Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, hospitals rapidly ran out of intensive care beds. Because minimally invasive surgery and general anaesthesia are both aerosol-generating procedures, their use has become controversial. We report a case series of awake undelayable colorectal surgeries which, innovatively, took advantage of intraoperative pain distraction. Moreover, we describe our frugal solution to social distancing in psychological support of inpatients. Methods: Between October 2020 and February 2021, five patients underwent acute-care colorectal surgery under locoregional anaesthesia in our department. A 3D mobile theatre (3DMT) was used during the operation to distract the patients from pain. Vital signs, pain intensity, ergonomic comfort/discomfort, sense of presence and distress were intraoperatively monitored. A postoperative “cuddle delivery” service was instituted: video messages from relatives and close friends were delivered daily to the patient through the 3DMT. Emotional effects were investigated through clinical interviews conducted by a psychologist at our hospital. Results: Both intraoperative and postoperative pain were always well controlled. Conversion to general anaesthesia and postoperative intensive support/monitoring were never necessary. The “cuddle delivery” initiative helped patients fill the emotional gap created by the strict containment measures implemented inside the hospital, distracting them from emotional anxiety and physical pain. Conclusions: During the next phase of the COVID-19 pandemic and even after the COVID-19 era, awake laparotomy under locoregional anaesthesia may be a crucial option for delivering acute-care surgery to selected patients when intensive care beds are unavailable and postponing surgery is unacceptable. We also introduce a new modality for the provision of emotional support during postoperative inpatient care as a countermeasure to the restrictions imposed by social distancing measures

    Does the Presence of an Iliac Aneurysm Affect Outcome of Endoluminal AAA Repair? An Analysis of 336 Cases

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    AbstractObjective: to determine whether the presence of an iliac aneurysm compromises outcome of endovascular exclusion of AAA and to ascertain the fate of the iliac aneurysmal sac.Patients and methods: between April 1997 and March 2001, data on 336 consecutive patients undergoing endovascular repair for AAA were entered in a prospective database. Suitability for endovascular repair was assessed by preoperative contrast-enhanced computed tomography. A maximum common iliac artery (CIA) diameter ≄20mm was defined as iliac aneurysm. Patients with and without iliac aneurysms were compared to early (immediate conversion or perioperative death) and late failure (increase in aneurysm diameter or persisting graft-related endoleak, or late AAA rupture or conversion).Results: fifty-nine patients (18%) had iliac aneurysms, 19 were bilateral, for a total of 78 aneurysmal iliac arteries (median diameter 23mm; range 20–50mm). A distal seal was achieved by landing in 33 external iliac arteries, in 20 ectatic CIAs, and in 25 normal CIAs. Operating time differed significantly between patients with and without CIA aneurysms (153±71 vs 123±55min,p =0.0001), whereas no statistically significant differences were found with respect to early and late failure (2% vs 3%, p=0.5 and 14% vs 8%, p=0.11, respectively). There were no cases of buttock or colon necrosis. At a median follow-up of 14 months (range 0–46; i.q.r. 7–27 months) common iliac diameter decreased ≄2mm in 49 cases, remained stable in 25, and increased ≄2mm in 3.Conclusion: the presence of iliac aneurysm rendered endoluminal AAA repair more complex but did not affect feasibility and long-term outcome of the procedure. In our experience internal iliac exclusion was never associated with significant morbidity. These data may be useful when considering endovascular repair in high-risk patients with challenging anatomy

    Role of Duplex Scan in Endoleak Detection After Endoluminal Abdominal Aortic Aneurysm Repair

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    AbstractObjective: to validate the role of duplex scan in endoleak detection in postoperative surveillance of endoluminal abdominal aneurysm repair (EAAR). Patients and methods between April 1997 and March 1999, 103 patients were eligible for duplex and computed tomography (CT) scan after EAAR. Mean follow-up was 8 months (range 1–24 months). The study protocol comprised concurrent examination with colour-duplex and CT scan at 1, 6, and 12 months after EAAR, for a total of 198 concurrent examinations. All duplex scan examinations were performed by two vascular surgeons with the same machine (ATL HDI 3000). Interobserver agreement in endoleak detection (Îș=1) and in type of endoleak (Îș=0.7) was evaluated in 50 random duplex examinations. Endoleak detection was examined comparatively in duplex and CT scan, the latter being the gold standard. Sensitivity and specificity tests together with negative- and positive-predictive values (NPV and PPV) were calculated. Results duplex scan was not feasible in one patient. On CT scan the endoleak rate was 4% at one month, 3% at 6 months, and 4% at one year. Overall, CT scan detected 12 endoleaks. With respect to endoleak detection, duplex scan revealed a great ability in ruling out false-negative results (sensitivity 91.7%, NPV 99.4%), but overestimated the presence of endoleak (specificity 98.4%, PPV 78.6%). Regarding type of endoleak, the ability of duplex scan to identify the source of endoleak was low (sensitivity 66.7%). Conclusions duplex scan, if validated, appears to be a reliable means for excluding the presence of endoleak after EAAR

    Are confidence levels of hospital pharmacists different from other pharmacists in the management of anticoagulation therapy? Preliminary results from a multinational pharmacists needs assessment survey

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    Poster presented at the 22nd Congress of the EAHP (European Association of Hospital Pharmacists): Hospital pharmacists – catalysts for change, 22-24 March 2017, Cannes, FranceN/

    IP6K3 and IPMK variations in LOAD and longevity: evidence for a multifaceted signaling network at the crossroad between neurodegeneration and survival

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    Several studies reported that genetic variants predisposing to neurodegeneration were at higher frequencies in centenarians than in younger controls, suggesting they might favor also longevity. IP6K3 and IPMK regulate many crucial biological functions by mediating synthesis of inositol poly- and pyrophosphates and by acting non-enzymatically via protein–protein interactions. Our previous studies suggested they affect Late Onset Alzheimer Disease (LOAD) and longevity, respectively. Here, in the same sample groups, we investigated whether variants of IP6K3 also affect longevity, and variants of IPMK also influence LOAD susceptibility. We found that: i) a SNP of IP6K3 previously associated with increased risk of LOAD increased the chance to become long-lived, ii) SNPs of IPMK, previously associated with decreased longevity, were protective factors for LOAD, as previously observed for UCP4. SNP-SNP interaction analysis, including our previous data, highlighted phenotype-specific interactions between sets of alleles. Moreover, linkage disequilibrium and eQTL data associated to analyzed variants suggested mitochondria as crossroad of interconnected pathways crucial for susceptibility to neurodegeneration and/or longevity. Overall, data support the view that in these traits interactions may be more important than single polymorphisms. This phenomenon may contribute to the non-additive heritability of neurodegeneration and longevity and be part of the missing heritability of these traits

    Cognitive performance in elderly patients undergoing carotid endarterectomy or carotid artery stenting: A twelve-month follow-up study

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    Background: It is still a matter of debate if and to what extent carotid endarterectomy (CEA) and carotid artery stenting (CAS) impair cognitive functioning in the elderly. Methods: We conducted a nonrandomized clinical trial on subjects with asymptomatic carotid artery stenosis comparing CEA (n = 28; 24 males and 4 females; 72.6 ± 5.8 years old) with CAS (n = 29; 17 males and 12 females; 75.1 ± 5.7 years old). Cognition, mood and functional status were evaluated by a broad spectrum of tests performed on the day prior to carotid reopening as well as 3 and 12 months after. Results: No significant differences in scores on cognitive tests including the Babcock story recall test and Rey's auditory verbal learning test (memory), category naming test (verbal fluency), trail-making test parts A and B (attention and executive function) and controlled oral word association test (executive functioning) were observed 3 and 12 months after carotid reopening independent of the technique used. Only scores on the copy drawing test (visuospatial and constructional abilities) slightly but significantly (p < 0.05) worsened in the CAS group 12 months after the intervention. No significant differences between the CEA and CAS groups were detected regarding mood and functional status after 3 and 12 months. Conclusions: CEA and CAS seem to be safe procedures in elderly patients in terms of cognitive, mood and functional status in the short and long term. CAS might be preferred for the shorter hospital stay, but further studies with a larger number of old and oldest old subjects with a longer follow-up are needed to better understand the cost-effectiveness of both treatments

    Inositol Polyphosphate Multikinase (IPMK), a Gene Coding for a Potential Moonlighting Protein, Contributes to Human Female Longevity

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    Biogerontological research highlighted a complex and dynamic connection between aging, health and longevity, partially determined by genetic factors. Multifunctional proteins with moonlighting features, by integrating different cellular activities in the space and time, may explain part of this complexity. Inositol Polyphosphate Multikinase (IPMK) is a potential moonlighting protein performing multiple unrelated functions. Initially identified as a key enzyme for inositol phosphates synthesis, small messengers regulating many aspects of cell physiology, IPMK is now implicated in a number of metabolic pathways affecting the aging process. IPMK regulates basic transcription, telomere homeostasis, nutrient-sensing, metabolism and oxidative stress. Here, we tested the hypothesis that the genetic variability of IPMK may affect human longevity. Single-SNP (single nuclear polymorphism), haplotype-based association tests as well as survival analysis pointed to the relevance of six out of fourteen genotyped SNPs for female longevity. In particular, haplotype analysis refined the association highlighting two SNPs, rs2790234 and rs6481383, as major contributing variants for longevity in women. Our work, the first to investigate the association between variants of IPMK and longevity, supports IPMK as a novel gender-specific genetic determinant of human longevity, playing a role in the complex network of genetic factors involved in human survival
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