Endoscopic Camera Control by Head Movements for Thoracic Surgery

In current video-assisted thoracic surgery, the endoscopic camera is operated by an assistant of the surgeon, which has several disadvantages. This paper describes a system which enables the surgeon to control the endoscopic camera without the help of an assistant. The system is controlled using head movements, so the surgeon can use his/her hands to oper- ate the instruments. The system is based on a flexible endoscope, which leaves more space for the surgeon to operate his/her instruments compared to a rigid endoscope. The endoscopic image is shown either on a monitor or by means of a head- mounted display. Several trial sessions were performed with an anatomical model. Results indicate that the developed concept may provide a solution to some of the problems currently encountered in video-assisted thoracic surgery. The use of a head-mounted display turned out to be a valuable addition since it ensures the image is always in front of the surgeon’s eyes

Design and Evaluation of a Magnetic Rotablation Catheter for Arterial Stenosis

Arterial stenosis is a high-risk disease accompanied by large amounts of calcified deposits and plaques that develop inside the vasculature. These deposits should be reduced to improve blood flow. However, current methods used to reduce stenosis require externally-controlled actuation systems resulting in limited workspace or patient risks. This results in an unexplored preference regarding the revascularization strategy for symptomatic artery stenosis. In this paper, we propose a novel internally-actuated solution: a magnetic spring-loaded rotablation catheter. The catheter is developed to achieve stenosis-debulking capabilities by actuating drill bits using two internal electromagnetic coils and a magnetic reciprocating spring-loaded shaft. The state-space model of the catheter is validated by comparing the simulation results of the magnetic fields of the internal coils with the experimental results of a fabricated prototype. Contact forces of the catheter tip are measured experimentally, resulting in a maximum axial force of 2.63 N and a torque of 5.69 mN-m. Finally, we present interventions in which the catheter is inserted to a vascular target site and demonstrate plaque-specific treatment using different detachable actuator bits. Calcified deposits are debulked and visualized via ultrasound imaging. The catheter can reduce a stenosis cross-sectional area by up to 35%, indicating the potential for the treatment of calcified lesions, which could prevent restenosis

Magnetic motion control and planning of untethered soft grippers using ultrasound image feedback

Soft miniaturized untethered grippers can be used to manipulate and transport biological material in unstructured and tortuous environments. Previous studies on control of soft miniaturized grippers employed cameras and optical images as a feedback modality. However, the use of cameras might be unsuitable for localizing miniaturized agents that navigate within the human body. In this paper, we demonstrate the wireless magnetic motion control and planning of soft untethered grippers using feedback extracted from B-mode ultrasound images. Results show that our system employing ultrasound images can be used to control the miniaturized grippers with an average tracking error of 0.4±0.13 mm without payload and 0.36±0.05 mm when the agent performs a transportation task with a payload. The proposed ultrasound feedback magnetic control system demonstrates the ability to control miniaturized grippers in situations where visual feedback cannot be provided via cameras

Gastric Cancer Screening in Low­-Income Countries: System Design, Fabrication, and Analysis for an Ultralow-Cost Endoscopy Procedure

Gastric adenocarcinoma is the fifth most common malignancy in the world and the third leading cause of cancer death in both women and men. In 2012, its estimated global incidence was 952,000 new cases with an estimated 723,000 deaths worldwide. It is projected to rise from 14th to eighth in all-cause mortality in the near term, primarily due to the growing and aging populations in high-incidence areas, such as Latin America and eastern Asia. Unlike any other major cancer, gastric cancer demonstrates marked geographic variability in regions and within countries, with more than 70% of incident cases concentrated in lowand middle-income countries (LMICs)

Nanoparticle “switch-on” by tetrazine triggering

This work describes how a small-molecule chemical trigger, reacting through the mediatory of an inverse electron demand Diels–Alder reaction, results in enhanced cellular uptake and selective nanoparticle disintegration and cargo liberation, via gross polymeric morphological alterations. The power of these responsive nanoparticles is demonstrated through encapsulation of the anti-cancer agent doxorubicin and its triggered release, allowing controlled cell death in response to a small-molecule chemical trigger

Panoptica -- instance-wise evaluation of 3D semantic and instance segmentation maps

This paper introduces panoptica, a versatile and performance-optimized package designed for computing instance-wise segmentation quality metrics from 2D and 3D segmentation maps. panoptica addresses the limitations of existing metrics and provides a modular framework that complements the original intersection over union-based panoptic quality with other metrics, such as the distance metric Average Symmetric Surface Distance. The package is open-source, implemented in Python, and accompanied by comprehensive documentation and tutorials. panoptica employs a three-step metrics computation process to cover diverse use cases. The efficacy of panoptica is demonstrated on various real-world biomedical datasets, where an instance-wise evaluation is instrumental for an accurate representation of the underlying clinical task. Overall, we envision panoptica as a valuable tool facilitating in-depth evaluation of segmentation methods.Comment: 15 pages, 6 figures, 3 table

Cystatin C is glucocorticoid responsive, directs recruitment of Trem2+ macrophages, and predicts failure of cancer immunotherapy

Cystatin C (CyC), a secreted cysteine protease inhibitor, has unclear biological functions. Many patients exhibit elevated plasma CyC levels, particularly during glucocorticoid (GC) treatment. This study links GCs with CyC’s systemic regulation by utilizing genome-wide association and structural equation modeling to determine CyC production genetics in the UK Biobank. Both CyC production and a polygenic score (PGS) capturing predisposition to CyC production were associated with increased all-cause and cancer-specific mortality. We found that the GC receptor directly targets CyC, leading to GC-responsive CyC secretion in macrophages and cancer cells. CyC-knockout tumors displayed significantly reduced growth and diminished recruitment of TREM2+ macrophages, which have been connected to cancer immunotherapy failure. Furthermore, the CyC-production PGS predicted checkpoint immunotherapy failure in 685 patients with metastatic cancer from combined clinical trial cohorts. In conclusion, CyC may act as a GC effector pathway via TREM2+ macrophage recruitment and may be a potential target for combination cancer immunotherapy.publishedVersio