Granular jamming based controllable organ design for abdominal palpation

Medical manikins play an essential role in the training process of physicians. Currently, most available simulators for abdominal palpation training do not contain controllable organs for dynamic simulations. In this paper, we present a soft robotics controllable liver that can simulate various liver diseases and symptoms for effective and realistic palpation training. The tumors in the liver model are designed based on granular jamming with positive pressure, which converts the fluid-like impalpable particles to a solid-like tumor state by applying low positive pressure on the membrane. Through inflation, the tumor size, liver stiffness, and liver size can be controlled from normal liver state to various abnormalities including enlarged liver, cirrhotic liver, and multiple cancerous and malignant tumors. Mechanical tests have been conducted in the study to evaluate the liver design and the role of positive pressure granular jamming in tumor simulations

Conditioned haptic perception for 3D localization of nodules in soft tissue palpation with a variable stiffness probe

This paper provides a solution for fast haptic information gain during soft tissue palpation using a Variable Lever Mechanism (VLM) probe. More specifically, we investigate the impact of stiffness variation of the probe to condition likelihood functions of the kinesthetic force and tactile sensors measurements during a palpation task for two sweeping directions. Using knowledge obtained from past probing trials or Finite Element (FE) simulations, we implemented this likelihood conditioning in an autonomous palpation control strategy. Based on a recursive Bayesian inferencing framework, this new control strategy adapts the sweeping direction and the stiffness of the probe to detect abnormal stiff inclusions in soft tissues. This original control strategy for compliant palpation probes shows a sub-millimeter accuracy for the 3D localization of the nodules in a soft tissue phantom as well as a 100% reliability detecting the existence of nodules in a soft phantom

The Mechanical Behaviour of Ultra Fine Grained Titanium Alloys at High Strain Rates

Within this study the mechanical behaviour of ultra-fine grained Ti-6-22-22S titanium alloy was investigated and compared to coarse grained material. By severe plastic deformation using the cyclic channel die compression process, grain sizes between 300 and 500 nm were obtained. The mechanical behaviour was studied over a wide range of strain rates from 10^(-3) - 107 s^(-1) under compressive loading using different experimental techniques. A significant increase of flow stress with decreasing grain size compared to the coarse grain state was found. An evaluation of the strain hardening behaviour of the UFG material shows a significant increase of the strain hardening coefficient at high strain rates for low plastic deformation. The strain rate sensitivity of the material is found to be constant within a range of strain rates from 10^(-3) to 106 s^(-1) but increases at higher plastic strains. However, compressive deformability is nearly constant up to 102 s-1 and decreased disproportionately at higher rates of strain. With decreasing grain size a significant decrease of compressive deformability was found. The strength at failure is increased with increasing strain rate

Automating Agential Reasoning: Proof-Calculi and Syntactic Decidability for STIT Logics

This work provides proof-search algorithms and automated counter-model extraction for a class of STIT logics. With this, we answer an open problem concerning syntactic decision procedures and cut-free calculi for STIT logics. A new class of cut-free complete labelled sequent calculi G3LdmL^m_n, for multi-agent STIT with at most n-many choices, is introduced. We refine the calculi G3LdmL^m_n through the use of propagation rules and demonstrate the admissibility of their structural rules, resulting in auxiliary calculi Ldm^m_nL. In the single-agent case, we show that the refined calculi Ldm^m_nL derive theorems within a restricted class of (forestlike) sequents, allowing us to provide proof-search algorithms that decide single-agent STIT logics. We prove that the proof-search algorithms are correct and terminate

Modelling of the Mechanical Behaviour of Ultra-Fine Grained Titanium Alloys at High Strain Rates

Results of numerical simulations of the mechanical behaviour of coarse grained and UFG titanium alloys under quasi-static uniaxial compression and plane shock wave loading are presented in this paper. Constitutive equations predict the strain hardening behaviour, the strain rate sensitivity of the flow stress and the temperature softening of titanium alloys with a range of grain sizes from 20 µm to 100 nm. Characteristics of the mechanical behaviour of UFG a and a+ß titanium alloys in wide range of strain rates are discussed

Coherent broadband light source for parallel optical coherence tomography

A Ti:sapphire planar waveguide is rib structured by Ar ion milling to provide parallel channel waveguides. By coupling high-power pump light through a microlens array into the waveguides, a novel broadband luminescent parallel emitter is demonstrated as a light source for parallel optical coherence tomography using smart detector arrays

Le diabète dans le canton de Vaud : évaluation de la pratique des professionnel(le)s de santé et de la collaboration interprofessionnelle

Contexte: Le Programme cantonal diabète se développe depuis 2010 dans le canton de Vaud. Il a pour objectif de limiter l'évolution de l'incidence du diabète et d'améliorer la prise en charge des patients diabétiques. - Méthodes: Cette étude vise à recueillir des données concernant : 1) la collaboration interprofessionnelle, 2) la pratique professionnelle au regard du « Chronic care model », ainsi que 3) la connaissance et la mise en pratique des recommandations pour la pratique clinique (RPC) auprès du patient diabétique. Les professionnels de santé (PdS) suivant ont été sollicités pour participer à cette étude : médecins et infirmier(ère)s spécialisé(e)s en diabétologie, médecins de premiers recours et infirmier(ère)s en soins généraux. Cette étude comporte un volet quantitatif où les PdS étaient invités à répondre à un questionnaire sur Internet, et un volet qualitatif où des PdS ont été réunis lors de trois focus groups pour recueillir leurs avis sur les trois thématiques de l'étude

Sickness certification in primary care: a survey on views and practices among Swiss physicians.

QUESTIONS UNDER STUDY: Studies from several countries (Scandinavia, United Kingdom) report that general practitioners (GPs) experience problems in sickness certification. Our study explored views of Swiss GPs towards sickness certification, their practice and experience, professional skills and problematic interactions with patients. METHODS: We conducted an online survey among GPs throughout Switzerland, exploring behaviour of physicians, patients and employers with regard to sickness certification; GPs' views about sickness certification; required competences for certifying sickness absence, and approaches to advance their competence. We piloted the questionnaire and disseminated it through the networks of the five Swiss academic institutes for primary care. RESULTS: We received 507 valid responses (response rate 50%). Only 43/507 GPs experienced sickness certification as problematic per se, yet 155/507 experienced problems in sickness certification at least once a week. The 507 GPs identified estimating a long-term prognosis about work capacity (64%), handling conflicts with patients (54%), and determining the reduction of work capacity (42%) as problematic. Over 75% would welcome special training opportunities, e.g., on sickness certifications during residency (93%), in insurance medicine (81%), and conflict management (80%). CONCLUSION: Sickness certification as such does not present a major problem to Swiss GPs, which contrasts with the experience in Scandinavian countries and in the UK. Swiss GPs did identify specific tasks of sickness certification as problematic. Training opportunities on sick-leave certification and insurance medicine in general were welcomed