RRT*-SMART: a rapid convergence implementation of RRT*

Many sampling based algorithms have been introduced recently. Among them Rapidly Exploring Random Tree (RRT) is one of the quickest and the most efficient obstacle free path finding algorithm. Although it ensures probabilistic completeness, it cannot guarantee finding the most optimal path. Rapidly Exploring Random Tree Star (RRT*), a recently proposed extension of RRT, claims to achieve convergence towards the optimal solution thus ensuring asymptotic optimality along with probabilistic completeness. However, it has been proven to take an infinite time to do so and with a slow convergence rate. In this paper an extension of RRT*, called as RRT*-Smart, has been prposed to overcome the limitaions of RRT*. The goal of the proposecd method is to accelerate the rate of convergence, in order to reach an optimum or near optimum solution at a much faster rate, thus reducing the execution time. The novel approach of the proposed algorithm makes use of two new techniques in RRT*–Path Optimization and Intelligent Sampling. Simulation results presented in various obstacle cluttered environments along with statistical and mathematical analysis confirm the efficiency of the proposed RRT*-Smart algorithm

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Memory-based crowd-aware robot navigation using deep reinforcement learning

Abstract The evolution of learning techniques has led robotics to have a considerable influence in industrial and household applications. With the progress in technology revolution, the demand for service robots is rapidly growing and extends to many applications. However, efficient navigation of service robots in crowded environments, with unpredictable human behaviors, is still challenging. The robot is supposed to recognize surrounding information while navigating, and then act accordingly. To address this issue, the proposed method crowd Aware Memory-based Reinforcement Learning (CAM-RL) uses gated recurrent units to store the relative dependencies among the crowd, and utilizes the human–robot interactions in the reinforcement learning framework for collision-free navigation. The proposed method is compared with the state-of-the-art techniques of multi-agent navigation, such as Collision Avoidance with Deep Reinforcement Learning (CADRL), Long Short-Term Memory Reinforcement Learning (LSTM-RL) and Social Attention Reinforcement Learning (SARL). Experimental results show that the proposed method can identify and learn human–robot interactions more extensively and efficiently than above-mentioned methods while navigating in a crowded environment. The proposed method achieved a success rate of greater than or equal to $$99\%$$ 99 % and a collision rate of less than or equal to $$1\%$$ 1 % in all test case scenarios, which is better compared to the previously proposed methods

Patterns of Biomass and Carbon Allocation across Chronosequence of Chir Pine (Pinus roxburghii) Forest in Pakistan: Inventory-Based Estimate

The quantitative relationship between carbon sequestration potential and stand ages of Pine (Pinus roxburghii) forest is not documented in Pakistan. Using field inventory data, this study underlines the patterns of biomass and carbon allocation across a chronosequence of Chir Pine forest. Based on the uniform shelterwood silvicultural management system, the forest was classified into three stand age classes representing the young stand ( 75 years). The results showed an increasing trend in living tree biomass carbon with stand age. However, soil carbon showed gradually decreasing trend from young to overmature stand. Similarly, deadwood, litter, and understory biomass carbon showed an increase pattern of changes. Altogether, the results highlighted that the mean carbon values of all components varied between 90.3 t·C·ha−1 in the young stand and 309.5 t·C·ha−1 in the overmature stand. Furthermore, our results confirm that the current management operations affect the forest floor and soil carbon. Therefore, we suggest that different protection measures should be considered during management operations to enhance soil and forest floor carbon

Simplified Model Predictive Current Control of Four-Level Nested Neutral Point Clamped Converter

Model predictive control (MPC) is an efficient and growing approach to power converter control. This paper proposes an improved and simplified model predictive current control (MPCC) technique for a four-level nested neutral point clamped (4L-NNPC) converter. Conventional MPCC exhibits better performances as compared to the conventional linear control system such as fast dynamic response, consideration of the system constraints, and nonlinearities. However, the application of the conventional model predictive current control (MPCC) approach on complex systems provokes a significant number of calculations, which is the main hurdle to its practical implementation. To fix this flaw, this paper proposes an effective algorithm to shorten the execution time of the conventional MPCC. In this proposed technique, 216 current predictions of the conventional MPCC are skipped and converted into one required voltage vector (RVV) prediction. With this equivalent reference voltage transformation, the calculation burden of MPCC is significantly reduced, while the output performance is not influenced. The results of the simplified MPCC for the 4L-NNPC converter are analyzed and compared with the conventional MPCC. The computational time is reduced by 19.56% using the simplified MPCC, while keeping an approximately similar error of output currents. The switching frequency and total harmonic distortion (THD) of the proposed method are reduced by 8.16% and 0.07%, respectively, as compared to the conventional technique. These results demonstrate the fact that that the performance of a conventional MPCC is enhanced with the proposed MPCC. The proposed algorithm can be applied to several inverter topologies