Advanced grasping with the Pisa/IIT softHand

This chapter presents the hardware, software and overall strategy used by the team UNIPI-IIT-QB to participate to the Robotic Grasping and Manipulation Competition. It relies on the PISA/IIT SoftHand, which is underactuated soft robotic hand that can adapt to the grasped object shape and is compliant with the environment. It was used for the hand-in-hand and for the simulation tracks, where the team reached first and third places respectively

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Advances in the surgical treatment of Crohn's disease

Despite the advances in medical treatment of Crohn’s disease (CD), most of the patients require one or more surgical bowel resections during their life for complicated disease. Surgery for CD has gone through progressive technical refinement over time. Minimally invasive surgery and bowel-sparing techniques have been validated with regard to surgical trauma reduction, and their role has been clearly defined in the current guidelines. Nevertheless, continuous technology advancement has further expanded the surgical tools with single-access and robotic-assisted surgery. With the aim of further reducing the impact of surgery, the concept of “strategic surgery” has been explored. On the one hand, patients’ optimization before surgery has the potential to reduce post-operative complications. On the other, early intervention for the uncomplicated disease before medical therapy escalation has been demonstrated equally reliable with respect to biologics in terms of quality of life and advantageous in terms of health-care costs. Ultimately, a better comprehension of the pathological mechanisms underlying the disease is the key to radically changing the surgical management of both abdominal and perianal CDs. In fact, novel surgical strategies aiming at reducing disease recurrence which take into account the anastomotic configuration and the role of the mesentery as an active player in the disease process have been pursued in the past decade. The purpose of this review is to describe the recent innovations in the surgical treatment of CD focusing on their potential impact on the short- and long-term outcomes

Low-cost, fast and accurate reconstruction of robotic and human postures via IMU measurements

In this paper, we present a method to reconstruct the configurations of kinematic trees of rigid bodies not using measurements of relative angles (such as, e.g. rotary encoders at joints) but absolute posture sensors (such as IMUs) along with suitable filter algorithms. We argue that the relatively larger inaccuracies shown by absolute sensors can be compensated by suitable processing, such as a passive complementary filters exploiting the Mahony-Hamel formulation. The proposed method is applicable to systems where measurements of relative angles is not feasible or convenient, or where the joint kinematics are not lower pairs: for example, human body parts or soft robotic devices. In the paper, we make explicit reference to the reconstruction of posture of the compliant, underactuated Pisa/IIT SoftHand. Quantitative comparisons with ground truth data in grasping tests are used to validate the proposed method. The resulting hardware design is mechanically robust, cheap and can be easily adapted to robotic hands with different structures, as well as to sensorizing gloves for studying human grasping strategies

Unfused Epiphyses Due to Unrecognized and Untreated Congenital Hypogonadotropic Hypogonadism (HH): Evidence for an E2 Threshold for Bone Maturation in Men

The study identify a threshold for serum estradiol below which bone maturation in men is not possible

Lower serum testosterone and estradiol (E2) in adult men with unfused epiphyses due to unrecognized and untreated congenital hypogonadotropic hypogonadism: evidence for an E2 threshold for bone maturation in men

This study confirms that estrogen and relative estrogen deficiency are responsible for the lack of bone maturation in men with severe hypogonadis

Lower serum testosterone (T) and estradiol (E2) in adult men with infuse epiphyses due to unrecognized and untreated congenital hypogonadotropic hypogonadism (HH): evidence for an E2-threshold for bone maturation in men

Estrogens rather than androgens are able to complete bone maturation only if the value is above a thresholds. In men with hypogonadotropic hypogonadism who have a serum estrogen below this threshold the growth plate does not fuse and the patient continues to growth in height

Different Oncologic Outcomes in Early-Onset and Late-Onset Sporadic Colorectal Cancer: A Regression Analysis on 2073 Patients

The incidence of colorectal cancer (CRC) is increasing in the population aged ≤ 49 (early-onset CRC-EOCRC). Recent studies highlighted the biological and clinical differences between EOCRC and late-onset CRC (LOCRC-age ≥ 50), while comparative results about long-term survival are still debated. This study aimed to investigate whether age of onset may impact on oncologic outcomes in a surgical population of sporadic CRC patients. Patients operated on for sporadic CRC from January 2010 to January 2022 were allocated to the EOCRC and LOCRC groups. The primary endpoint was the recurrence/progression-free survival (R/PFS). A total of 423 EOCRC and 1650 LOCRC was included. EOCRC had a worse R/PFS (p p p = 0.014), and early age of onset was an independent predictor for recurrence (p = 0.035). Early age of onset was an independent predictor for worse prognosis, this effect was stronger in stage I patients suggesting a potentially—and still unknown—more aggressive tumoral phenotype in EOCRC