The risks of defensive (emergency) medicine. The laboratory perspective

Diagnostic testing is a crucial aspect of the clinical decision making, especially in emergency settings where timely and accurate diagnoses are essential for appropriate patient management. Reliable statistics attest that the vast majority of clinical decisions for diagnosis, treatment and follow-up of both acute and chronic diseases are influenced by results of laboratory analyses. As specifically concerns the emergency department, many unnecessary laboratory tests are also ordered in this healthcare setting, with unfavorable consequences on laboratory and healthcare organization. As far as the laboratory environment is concerned, defensive (emergency medicine) may be associated with incremental costs, derangement of laboratory organization, enhanced complexity of data management process, diagnostic delay attributable to performance of unnecessary testing, and litigation. Educative or even regulatory interventions are hence urgently needed to addresses problems of the current liability system, in order to decrease the detrimental effects of defensive (emergency) medicine in the laboratory

A Mixed-Integer Linear Programming Formulation for Human Multi-Robot Task Allocation

In this work, we address a task allocation problem for human multi-robot settings. Given a set of tasks to perform, we formulate a general Mixed-Integer Linear Programming (MILP) problem aiming at minimizing the overall execution time while optimizing the quality of the executed tasks as well as human and robotic workload. Different skills of the agents, both human and robotic, are taken into account and human operators are enabled to either directly execute tasks or play supervisory roles; moreover, multiple manipulators can tightly collaborate if required to carry out a task. Finally, as realistic in human contexts, human parameters are assumed to vary over time, e.g., due to increasing human level of fatigue. Therefore, online monitoring is required and re-allocation is performed if needed. Simulations in a realistic scenario with two manipulators and a human operator performing an assembly task validate the effectiveness of the approach.Comment: Accepted to 2021 IEEE International Conference on Robot and Human Interactive Communication (RO-MAN

A Data-Driven Approach for Contact Detection, Classification and Reaction in Physical Human-Robot Collaboration

This paper considers a scenario where a robot and a human operator share the same workspace, and the robot is able to both carry out autonomous tasks and physically interact with the human in order to achieve common goals. In this context, both intentional and accidental contacts between human and robot might occur due to the complexity of tasks and environment, to the uncertainty of human behavior, and to the typical lack of awareness of each other actions. Here, a two stage strategy based on Recurrent Neural Networks (RNNs) is designed to detect intentional and accidental contacts: the occurrence of a contact with the human is detected at the first stage, while the classification between intentional and accidental is performed at the second stage. An admittance control strategy or an evasive action is then performed by the robot, respectively. The approach also works in the case the robot simultaneously interacts with the human and the environment, where the interaction wrench of the latter is modeled via Gaussian Mixture Models (GMMs). Control Barrier Functions (CBFs) are included, at the control level, to guarantee the satisfaction of robot and task constraints while performing the proper interaction strategy. The approach has been validated on a real setup composed of a Kinova Jaco2 robot.Comment: Accepted to 2021 IEEE International Conference on Robotics and Automatio

Ensemble Latent Space Roadmap for Improved Robustness in Visual Action Planning

Planning in learned latent spaces helps to decrease the dimensionality of raw observations. In this work, we propose to leverage the ensemble paradigm to enhance the robustness of latent planning systems. We rely on our Latent Space Roadmap (LSR) framework, which builds a graph in a learned structured latent space to perform planning. Given multiple LSR framework instances, that differ either on their latent spaces or on the parameters for constructing the graph, we use the action information as well as the embedded nodes of the produced plans to define similarity measures. These are then utilized to select the most promising plans. We validate the performance of our Ensemble LSR (ENS-LSR) on simulated box stacking and grape harvesting tasks as well as on a real-world robotic T-shirt folding experiment

Relationship between ABO blood group and von Willebrand factor levels: from biology to clinical implications

Although a number of studies have demonstrated the influence of ABO blood group on plasma levels of von Willebrand factor (VWF), the nature of this association and its clinical importance is still largely unknown

Augment-Connect-Explore: a Paradigm for Visual Action Planning with Data Scarcity

Visual action planning particularly excels in applications where the state of the system cannot be computed explicitly, such as manipulation of deformable objects, as it enables planning directly from raw images. Even though the field has been significantly accelerated by deep learning techniques, a crucial requirement for their success is the availability of a large amount of data. In this work, we propose the Augment-Connect-Explore (ACE) paradigm to enable visual action planning in cases of data scarcity. We build upon the Latent Space Roadmap (LSR) framework which performs planning with a graph built in a low dimensional latent space. In particular, ACE is used to i) Augment the available training dataset by autonomously creating new pairs of datapoints, ii) create new unobserved Connections among representations of states in the latent graph, and iii) Explore new regions of the latent space in a targeted manner. We validate the proposed approach on both simulated box stacking and real-world folding task showing the applicability for rigid and deformable object manipulation tasks, respectively

Comparison of platelet function between sedentary individuals and competitive athletes at rest

BACKGROUND: There are controversial evidences on the effect of different types and workloads of physical exercise on primary hemostasis. In particular, little is known on the chronic influence of a strenuous and regular aerobic training regimen on platelet function. METHODS: The aim of this investigation was to compare platelet function between sedentary controls and trained athletes at rest and to evaluate whether a greater amount of exercise performed in professional cyclists may contribute to increased platelet chronic responsiveness compared to both elite cyclists and sedentary individuals. Platelet's ability to adhere and aggregate was assayed following a 12–24 h resting period in 49 active professional male road cyclists, 40 elite male cyclists and 43 matched sedentary healthy male volunteers, by the platelet function analyzer 100 (PFA-100). RESULTS AND DISCUSSION: Mean values of the collagen-epinephrine test did not differ between controls and athletes (sedentary controls: 111 ± 33 s; elite athletes: 113 ± 26 s, p = 0.93; professional athletes: 120 ± 33 s; p = 0.33), whereas mean values of the collagen-ADP test displayed a slightly but significant trend towards decreased values when comparing sedentary controls (83 ± 21 s) with either elite (77 ± 11 s, p < 0.01) or professional (75 ± 16 s, p < 0.01) athletes. CONCLUSION: The trend towards slightly lower collagen-ADP values are suggestive for a modest but significant chronic activation of primary hemostasis, highlighting the need to set appropriate reference ranges for the PFA-100 when evaluating primary hemostasis in physically active subjects

Enabling Robot Manipulation of Soft and Rigid Objects with Vision-based Tactile Sensors

Endowing robots with tactile capabilities opens up new possibilities for their interaction with the environment, including the ability to handle fragile and/or soft objects. In this work, we equip the robot gripper with low-cost vision-based tactile sensors and propose a manipulation algorithm that adapts to both rigid and soft objects without requiring any knowledge of their properties. The algorithm relies on a touch and slip detection method, which considers the variation in the tactile images with respect to reference ones. We validate the approach on seven different objects, with different properties in terms of rigidity and fragility, to perform unplugging and lifting tasks. Furthermore, to enhance applicability, we combine the manipulation algorithm with a grasp sampler for the task of finding and picking a grape from a bunch without damaging~it.Comment: Published in IEEE International Conference on Automation Science and Engineering (CASE2023

Plasma D-dimer concentration in patients with systemic sclerosis

BACKGROUND: Systemic sclerosis (SSc) is an autoimmune disorder of the connective tissue characterized by widespread vascular lesions and fibrosis. Little is known so far on the activation of the hemostatic and fibrinolytic systems in SSc, and most preliminary evidences are discordant. METHODS: To verify whether SSc patients might display a prothrombotic condition, plasma D-dimer was assessed in 28 consecutive SSc patients and in 33 control subjects, matched for age, sex and environmental habit. RESULTS AND DISCUSSION: When compared to healthy controls, geometric mean and 95% confidence interval (IC95%) of plasma D-dimer were significantly increased in SSc patients (362 ng/mL, IC 95%: 361–363 ng/mL vs 229 ng/mL, IC95%: 228–231 ng/mL, p = 0.005). After stratifying SSc patients according to disease subset, no significant differences were observed between those with limited cutaneous pattern and controls, whereas patients with diffuse cutaneous pattern displayed substantially increased values. No correlation was found between plasma D-dimer concentration and age, sex, autoantibody pattern, serum creatinine, erythrosedimentation rate, nailfold videocapillaroscopic pattern and pulmonary involvement. CONCLUSION: We demonstrated that SSc patients with diffuse subset are characterized by increased plasma D-dimer values, reflecting a potential activation of both the hemostatic and fibrinolytic cascades, which might finally predispose these patients to thrombotic complications

Non-commutability of results of highly sensitive troponin I and T immunoassays

Introduction: The measurement of cardiospecific troponins is pivotal in the diagnostic and prognostic approach of patients with suspected acute myocardial infarction (AMI). However, no information is available on the commutability of results between the novel highly-sensitive (HS) troponin T (TnT) and I (TnI) immunoassays. Materials and methods: The study population consisted in 47 consecutive patients presenting at the emergency department (ED) of the Academic Hospital of Parma with suspected AMI. TnI was measu-red with the novel prototype Beckman Coulter HS-AccuTnI immunoassay on Access 2, whereas TnT was measured with the Roche HS-TnT immunoassay on Cobas. Results: Eight out of the 47 patients (17%) were finally diagnosed as having an AMI. The overall cor-relation between TnT and TnI for total patient group was acceptable (r = 0.944; P < 0.01). Neverthe-less, when the analysis of data was carried out in separate groups according to the final diagnosis of AMI, two different equation results were obtained, i.e., HS-TnT = HS-AccuTnI x 0.349 + 20 (r = 0.823; P < 0.01) in non-AMI patients, and HS-TnT = HS-AccuTnI x 0.134 + 67 (r = 0.972; P < 0.01) in those with AMI. Conclusions: This study suggests the existence of two biological relationships between TnI and TnT in plasma, depending on the source of release from the myocardium. Moreover, the non-commutability of data between HS-TnT and HS-AccuTnI jeopardizes the clinical decision making, makes it impossible to calculate the delta or reference change value using the two biomarkers and to finally establish a reliable kinetics of troponin release from the injured myocardium