Elongation Modeling and Compensation for the Flexible Tendon-Sheath System

In tendon-driven systems, the elongation of the tendon would result in inaccuracy in the position control of the system. This becomes a critical challenge for those applications, such as surgical robots, which require the tendon-sheath system with flexible and even time-varying configurations but lack of corresponding sensory feedback at the distal end due to spatial restrictions. In this paper, we endeavor to address this problem by modeling the tendon elongation in a flexible tendon-sheath system. Targeting at flexibility in practical scenarios, we first derived a model describing the relationship between the overall tendon elongation and the input tension with arbitrary route configurations. It is shown that changes in the route configuration would significantly affect the tendon elongation. We also proposed a remedy to enhance the system tolerance against potential unmodeled perturbations along the transmission route during operation. A scaling factor S was introduced as a design guideline to determine the scaling effect. A dedicated platform that was able to measure the tensions at both ends and the overall tendon elongation was designed and set up to validate the new findings. Discussions were made on the performance and the future implementation of the proposed models and remedy.published_or_final_versio

Total mesorectal excision using a soft and flexible robotic arm: a feasibility study in cadaver models

The research leading to these results has received funding from the European Commission’s Seventh Framework Programme under Grant Agreement 287728 in the framework of EU Project STIFF-FLOP

Nck adapter proteins: functional versatility in T cells

Nck is a ubiquitously expressed adapter protein that is almost exclusively built of one SH2 domain and three SH3 domains. The two isoproteins of Nck are functionally redundant in many aspects and differ in only few amino acids that are mostly located in the linker regions between the interaction modules. Nck proteins connect receptor and non-receptor tyrosine kinases to the machinery of actin reorganisation. Thereby, Nck regulates activation-dependent processes during cell polarisation and migration and plays a crucial role in the signal transduction of a variety of receptors including for instance PDGF-, HGF-, VEGF- and Ephrin receptors. In most cases, the SH2 domain mediates binding to the phosphorylated receptor or associated phosphoproteins, while SH3 domain interactions lead to the formation of larger protein complexes. In T lymphocytes, Nck plays a pivotal role in the T cell receptor (TCR)-induced reorganisation of the actin cytoskeleton and the formation of the immunological synapse. However, in this context, two different mechanisms and adapter complexes are discussed. In the first scenario, dependent on an activation-induced conformational change in the CD3ε subunits, a direct binding of Nck to components of the TCR/CD3 complex was shown. In the second scenario, Nck is recruited to the TCR complex via phosphorylated Slp76, another central constituent of the membrane proximal activation complex. Over the past years, a large number of putative Nck interactors have been identified in different cellular systems that point to diverse additional functions of the adapter protein, e.g. in the control of gene expression and proliferation

Height and timing of growth spurt during puberty in young people living with vertically acquired HIV in Europe and Thailand

Objective: The aim of this study was to describe growth during puberty in young people with vertically acquired HIV. Design: Pooled data from 12 paediatric HIV cohorts in Europe and Thailand. Methods: One thousand and ninety-four children initiating a nonnucleoside reverse transcriptase inhibitor or boosted protease inhibitor based regimen aged 1-10 years were included. Super Imposition by Translation And Rotation (SITAR) models described growth from age 8 years using three parameters (average height, timing and shape of the growth spurt), dependent on age and height-for-age z-score (HAZ) (WHO references) at antiretroviral therapy (ART) initiation. Multivariate regression explored characteristics associated with these three parameters. Results: At ART initiation, median age and HAZ was 6.4 [interquartile range (IQR): 2.8, 9.0] years and -1.2 (IQR: -2.3 to -0.2), respectively. Median follow-up was 9.1 (IQR: 6.9, 11.4) years. In girls, older age and lower HAZ at ART initiation were independently associated with a growth spurt which occurred 0.41 (95% confidence interval 0.20-0.62) years later in children starting ART age 6 to 10 years compared with 1 to 2 years and 1.50 (1.21-1.78) years later in those starting with HAZ less than -3 compared with HAZ at least -1. Later growth spurts in girls resulted in continued height growth into later adolescence. In boys starting ART with HAZ less than -1, growth spurts were later in children starting ART in the oldest age group, but for HAZ at least -1, there was no association with age. Girls and boys who initiated ART with HAZ at least -1 maintained a similar height to the WHO reference mean. Conclusion: Stunting at ART initiation was associated with later growth spurts in girls. Children with HAZ at least -1 at ART initiation grew in height at the level expected in HIV negative children of a comparable age

Modeling and motion compensation of a bidirectional tendon-sheath actuated system for robotic endoscopic surgery

Recent study shows that tendon-sheath system (TSS) has great potential in the development of surgical robots for endoscopic surgery. It is able to deliver adequate power in a light-weight and compact package. And the flexibility and compliance of the tendon-sheath system make it capable of adapting to the long and winding path in the flexible endoscope. However, the main difficulties in precise control of such system fall on the nonlinearities of the system behavior and absence of necessary sensory feedback at the surgical end-effectors. Since accurate position control of the tool is a prerequisite for efficacy, safety and intuitive user-experience in robotic surgery, in this paper we propose a system modeling approach for motion compensation. Based on a bidirectional actuated system using two separate tendon-sheaths, motion transmission is firstly characterized. Two types of positional errors due to system backlash and environment loading are defined and modeled. Then a model-based feedforward compensation method is proposed for open-loop control, giving the system abilities to adjust according to changes in the transmission route configuration without any information feedback from the distal end. A dedicated experimental platform emulating a bidirectional TSS robotic system for endoscopic surgery is built for testing. Proposed positional errors are identified and verified. The performance of the proposed motion compensation is evaluated by trajectory tracking under different environment loading conditions. And the results demonstrate that accurate position control can be achieved even if the transmission route configuration is updated

Adaptive control of position compensation for cable-conduit mechanisms used in flexible surgical robots

Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a method that allows for performing complex operations via natural orifices without skin incisions. Its main tool is a flexible endoscope. Cable-Conduit Mechanisms (CCMs) are often used in NOTES because of its simplicity, safety in design, and easy transmission. Backlash hysteresis nonlinearities between the cable and the conduit pose difficulties in the motion control of the NOTES system. It is challenging to achieve the precise position of robotic arms when the slave manipulator inside the humans body. This paper presents new approaches to model and control for pairs of CCMs. It is known that the change of cable-conduit configuration will affect the backlash hysteresis nonlinearities. To deal with such change, a new nonlinear and adaptive control scheme will be introduced. The backlash hysteresis parameters are online estimated under the assumption of availability of output feedback and unknown bound of nonlinear parameters. To validate the proposed approach, a prototype of single-DOF-Master-Slave system, which consists of a master console, a telesurgical workstation, and a slave manipulator, is also presented. The proposed compensation scheme is experimentally validated using the designed system. The results show that the proposed control scheme efficiently improves the tracking performances of the system regardless of the change of endoscope configuration.Published versio