Stiffness control of pneumatic actuators to simulate human tissues behavior on medical haptic simulators

In order to increase the realism of medical simulators, haptic interfaces could be used to simulate the patient's body behavior. It is especially interesting to reproduce the stiffness of different soft tissues with corresponding haptic behaviors. In this paper, two control laws, impedance control and back-stepping associated with a closed-loop stiffness tuning, are introduced and applied to a pneumatic actuator. Both controllers have been obtained by using the A-T transform which is suitable to model the behavior of a pneumatic system, in a strict-feedback form. Both control laws allow to tune the system stiffness. A comparison of their performances is presented, based on experimental results

A Biomimetic steering robot for Minimally invasive surgery application

International audienceMinimally Invasive Surgery represents the future of many types of medical inter- ventions such as keyhole neurosurgey or transluminal endoscopic surgery. These procedures involve insertion of surgical instruments such as needles and endoscopes into human body through small incision/ body cavity for biopsy and drug delivery. However, nearly all surgical instruments for these procedures are inserted manually and there is a long learning curve for surgeons to use them properly. Many research efforts have been made to design active instruments (endoscope, needles) to improve this procedure during last decades. New robot mechanisms have been designed and used to improve the dexterity of current endoscope. Usually these robots are flexible and can pass the constrained space for fine manipulations. In recent years, a con- tinuum robotic mechanism has been investigated and designed for medical surgery. Those robots are characterized by the fact that their mechanical components do not have rigid links and discrete joints in contrast with traditional robot manipula- tors. The design of these robots is inspired by movements of natural animals such as tongues, elephant trunks and tentacles. The unusual compliance and redundant degrees of freedom of these robots provide strong potential to achieve delicate tasks successfully even in cluttered and unstructured environments. This chapter will present a complete application of a continuum robot for Mini- mally Invasive Surgery of colonoscopy. This system is composed of a micro-robotic tip, a set of position sensors and a real-time control system for guiding the explo- ration of colon. Details will be described on the modeling of the used pneumatic actuators, the design of the mechanical component, the kinematic model analysis and the control strategy for automatically guiding the progression of the device inside the human colon. Experimental results will be presented to check the perfor- mances of the whole system within a transparent tube

Novel application of local GAC adsorption to remove organic matters and pesticides in rural drinking water treatment

Novel application of granular activated carbon (GAC) using renewable and low cost materials to remove pesticides and organic matters was studied in the rural water treatment plant (WTP), in Hai Duong province, Vietnam. The treatment efficiencies of the a series of processes such as coagulation/ flocculation, horizontal sedimentation, rapid sand filtration and adsorption using three types of GAC (activated carbon from bituminous coal, from bamboo and from coconut shell) and the overall treatment trains were evaluated by studying several parameters such as turbidity, COD, pesticides (chlorpyrifos, diazinon, carbofuran). Results show that the two locally produced adsorbents have a similar efficiency to commercial activated carbon for adsorption. The removal efficiency was somewhat lower for both materials, but in the same order of magnitude. The removal of pesticides and organic matter with a column filled with activated carbon derived from bamboo was found the best among the two locally produced materials, approximately 30% and 23% higher than those observed for the column filled with activated carbon from coconut shells. It concludes that bamboo-derived activated carbon adsorption can be employed on an alternative to commercial activated carbon and could be a feasible option for drinking water treatment

Nasal high flow in room air for hypoxemic bronchiolitis infants

Background: Bronchiolitis is the most common reason for hospital admission in infants, with one third requiring oxygen therapy due to hypoxemia. It is unknown what proportion of hypoxemic infants with bronchiolitis can be managed with nasal high-flow in room air and their resulting outcomes. Objectives and Settings: To assess the effect of nasal high-flow in room air in a subgroup of infants with bronchiolitis allocated to high-flow therapy in a recent multicenter randomized controlled trial. Patients and Interventions: Infants allocated to the high-flow arm of the trial were initially treated with room air high-flow if saturations were ≥85%. Subsequently, if oxygen saturations did not increase to ≥92%, oxygen was added and FiO2 was titrated to increase the oxygen saturations. In this planned sub-study, infants treated during their entire hospital stay with high-flow room air only were compared to infants receiving either standard-oxygen or high-flow with oxygen. Baseline characteristics, hospital length of stay and length of oxygen therapy were compared. Findings: In the per protocol analysis 64 (10%) of 630 infants commenced on high-flow room air remained in room air only during the entire stay in hospital. These infants on high-flow room air were on average older and presented with moderate hypoxemia at presentation to hospital. Their length of respiratory support and length of stay was also significantly shorter. No pre-enrolment factors could be identified in a multivariable analysis. Conclusions: In a small sub-group of hypoxemic infants with bronchiolitis hypoxemia can be reversed with the application of high-flow in room air only

Effectiveness of cervical pessary compared to cervical cerclage with or without vaginal progesterone for the prevention of preterm birth in women with twin pregnancies and a short cervix : Study protocol for a two-by-two factorial randomised clinical trial

Peer reviewedPublisher PD

EFFECT OF CORTISOL TREATMENT ON HORMONAL RELATIONSHIPS IN CONGENITAL ADRENAL HYPERPLASIA

The temporal relationship between administration of cortisol and serum 17Α-hydroxyprogesterone was investigated in five patients aged 9-19 years with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. There was marked variability in the 17Α-hydroxyprogesterone response (determined hourly for 24 h) of individual patients to administration of cortisol. Mean concentration was less than 0.030 Μmol/l in one patient but 0.519Μ mol/l in another. Levels were higher in all patients while off treatment, and were greatest in those with salt-losing adrenal hyperplasia. Growth hormone secretion was not suppressed by treatment with cortisol. Withdrawal of cortisol for 3 days resulted in a significant decrease in the mean serum FSH/LH ratio and a rise in serum testosterone in all subjects. Episodic release of gonadotrophins persisted in the adolescent patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75713/1/j.1365-2265.1977.tb02002.x.pd

Anisotropy studies around the galactic centre at EeV energies with the Auger Observatory

Data from the Pierre Auger Observatory are analyzed to search for anisotropies near the direction of the Galactic Centre at EeV energies. The exposure of the surface array in this part of the sky is already significantly larger than that of the fore-runner experiments. Our results do not support previous findings of localized excesses in the AGASA and SUGAR data. We set an upper bound on a point-like flux of cosmic rays arriving from the Galactic Centre which excludes several scenarios predicting sources of EeV neutrons from Sagittarius $A$. Also the events detected simultaneously by the surface and fluorescence detectors (the `hybrid' data set), which have better pointing accuracy but are less numerous than those of the surface array alone, do not show any significant localized excess from this direction.Comment: Matches published versio