High Speed Lunar Navigation for Crewed and Remotely Piloted Vehicles

Increased navigation speed is desirable for lunar rovers, whether autonomous, crewed or remotely operated, but is hampered by the low gravity, high contrast lighting and rough terrain. We describe lidar based navigation system deployed on NASA's K10 autonomous rover and to increase the terrain hazard situational awareness of the Lunar Electric Rover crew

Thermoset Shape Memory Polymer Variable Stiffness 4D Robotic Catheters

Variable stiffness catheters are typically composed of an encapsulated core. The core is usually composed of a low melting point alloy (LMPA) or a thermoplastic polymer (TP). In both cases, there is a need to encapsulate the core with an elastic material. This imposes a limit to the volume of variable stiffness (VS) material and limits miniaturization. This paper proposes a new approach that relies on the use of thermosetting materials. The variable stiffness catheter (VSC) proposed in this work eliminates the necessity for an encapsulation layer and is made of a unique biocompatible thermoset polymer with an embedded heating system. This significantly reduces the final diameter, improves manufacturability, and increases safety in the event of complications. The device can be scaled to sub-millimeter dimensions, while maintaining a high stiffness change. In addition, integration into a magnetic actuation system allows for precise actuation of one or multiple tools

Gesneriaceae da Serra do Relógio, Descoberto, Estado de Minas Gerais, Brasil

The Serra do Relógio is located in the municipality of Descoberto, Zona da Mata in the State of Minas Gerais. There is two important conservation units in this region, Reserva Biológica da Represa do Grama and Reserva Particular do Patrimônio Natural Alto da Boa Vista. Both Conservation Units together cover a total area of ~403 ha of vegetation, mainly semi-deciduous seasonal forest. The Gesneriaceae is represented in the area by eight species, distributed in the genus Besleria (2 spp.), Nematanthus (3 spp.), Paliavana (1 spp.), Sinningia (1 spp.) and Vanhouttea (1spp.). We present descriptions, identification key, comments on taxonomy, distribution and ecology as well as photos of all recorded species.A Serra do Relógio está localizada no município de Descoberto, Zona da Mata no Estado de Minas Gerais. Há duas importantes Unidades de Conservação, a Reserva Biológica da Represa do Grama (RBRG) e a Reserva Particular do Patrimônio Natural Alto da Boa Vista (RPPNABV). Juntas abrangem uma área total de 402,6 hectares, sendo composta, predominantemente pela Floresta Estacional Semidecidual baixo-montana. Gesneriaceae está representada na área por oito espécies, distribuídas nos gêneros Besleria (2 spp.), Nematanthus (3 spp.), Paliavana (1 spp.), Sinningia (1 spp.) e Vanhouttea (1 spp.). Neste trabalho são apresentadas descrições, chave de identificação, comentários sobre taxonomia, distribuição e ecologia assim como fotos para todas as espécies

Fluorescence‐based bowel anastomosis perfusion evaluation: results from the IHU‐IRCAD‐EAES EURO‐FIGS registry

Background: Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Near-infrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry. Methods: Analysis of data prospectively collected by the registry members provided patient and procedural data along with the ICG dose, timing, and consequences of NIRF imaging. Among the included upper-GI, colorectal, and bariatric surgeries, subgroup analysis was performed to identify risk factors associated with complications. Results: A total of 1240 patients were included in the study. The included patients, 74.8% of whom were operated on for cancer, originated from 8 European countries and 30 hospitals. A total of 54 surgeons performed the procedures. In 83.8% of cases, a pre-anastomotic ICG dose was administered, and in 60.1% of cases, a post-anastomotic ICG dose was administered. A significant difference (p < 0.001) was found in the ICG dose given in the four pathology groups registered (range: 0.013–0.89 mg/kg) and a significant (p < 0.001) negative correlation was found between the ICG dose and BMI. In 27.3% of the procedures, the choice of the anastomotic level was guided by means of NIRF imaging which means that in these cases NIRF imaging changed the level of anastomosis which was first decided based on visual findings in conventional white light imaging. In 98.7% of the procedures, the use of ICG partly or strongly provided a sense of confidence about the anastomosis. A total of 133 complications occurred, without any statistical significance in the incidence of complications in the anastomoses, whether they were ICG-guided or not. Conclusion: The EURO-FIGS registry provides an insight into the current clinical practice across Europe with respect to NIRF imaging of anastomotic perfusion during digestive tract surgery

Non-response to citalopram in depressive patients: pharmacokinetic and clinical consequences of a fluvoxamine augmentation

The effect of comedication with fluvoxamine on the plasma concentrations of the enantiomers of citalopram and its metabolites in dextromethorphan/mephenytoin phenotyped patients pretreated with citalopram (CIT) was studied: seven female patients (45.1 +/- 13.9 years) suffering from a major depressive episode [ICD-10: F32.2 (n = 3 patients), F33.2 (n = 2), F32.10 (n = 1) or F32.11 (n = 1)], who were non-responders to a 3-week treatment with 40 mg/day CIT (From day-21 to day 0) (day 0: MADRS score > or = 12), were co-medicated for another 3 weeks with fluvoxamine (50 mg/day from day 1-7, 100 mg/day from day 14-21). All patients were extensive metabolizers of mephenytoin (CYP2C19) and dextromethorphan (CYP2D6), except one patient, who had a genetic deficiency of CYP2D6. There was a significant increase of the plasma concentrations of S- and R-citalopram from day 0 (27 +/- 14 micrograms/l and 55 +/- 23 micrograms/l, respectively) to day 21 (83 +/- 38 micrograms/l and 98 +/- 44 micrograms/l, respectively), after addition of fluvoxamine (P < 0.02, for each comparison), and the mean ratio S/R-citalopram increased from 0.48 to 0.84. S-Citalopram inhibits more potently 5-HT uptake than R-citalopram: therefore, fluvoxamine increases the pharmacologically more active S-citalopram with some stereoselectivity. According to a previous in vitro study, this pharmacokinetic interaction occurs on the level of CYP2C19, but also of CYP2D6 and CYP3A4 which, in contrast to CYP1A2, contribute to the N-demethylation of citalopram and which are stereoselectively inhibited by fluvoxamine. All but one patient showed clinical improvement by a decrease of the MADRS score by at least 50% and a final score < or = 13 (mean +/- SD: day 0:30.6 +/- 9.2; day 21:11.0 +/- 6.5). Some patients showed minor symptoms, such as nausea and tremor, but the combined treatment was generally well tolerated

Automated tracheal intubation in an airway manikin using a robotic endoscope: a proof of concept study

Robotic endoscope-automated via laryngeal imaging for tracheal intubation (REALTI) has been developed to enable automated tracheal intubation. This proof-of-concept study using a convenience sample of participants, comprised of trained anaesthetists and lay participants with no medical training, assessed the performance of a robotic device for the insertion of a tracheal tube into a manikin. A prototype robotic endoscope device was inserted into the trachea of an airway manikin by seven anaesthetists and seven participants with no medical training. Each individual performed six device insertions into the trachea in manual mode and six in automated mode. The anaesthetists succeeded with 40/42 (95%) manual insertions (median (IQR [range]) 17 (12-26 [4-132]) s) and 40/42 (95%) automated insertions (15 (13-18 [7-25]) s). The non-trained participants succeeded in 41/42 (98%) manual insertions (median (IQR [range]) 18 (13-21 [8-133]) s) and 42/42 (100%) automated insertions (16 (13-23 [10-58])] s). The duration of insertion did not differ between groups. An effect of increasing experience was observed in both groups in manual mode. A Likert scale for 'ease of use' (0 = very difficult to 10 = very easy) showed similar results within the two groups; the mean (SD) was 5.9 (2.1) for the anaesthetists and 6.9 (1.3) for the non-trained participants. We have successfully performed the first automated tracheal device insertion in a manikin with comparable results in a convenience sample of anaesthetists and lay participants with no medical training