Augmented reality (AR) for surgical robotic and autonomous systems: State of the art, challenges, and solutions

Despite the substantial progress achieved in the development and integration of augmented reality (AR) in surgical robotic and autonomous systems (RAS), the center of focus in most devices remains on improving end-effector dexterity and precision, as well as improved access to minimally invasive surgeries. This paper aims to provide a systematic review of different types of state-of-the-art surgical robotic platforms while identifying areas for technological improvement. We associate specific control features, such as haptic feedback, sensory stimuli, and human-robot collaboration, with AR technology to perform complex surgical interventions for increased user perception of the augmented world. Current researchers in the field have, for long, faced innumerable issues with low accuracy in tool placement around complex trajectories, pose estimation, and difficulty in depth perception during two-dimensional medical imaging. A number of robots described in this review, such as Novarad and SpineAssist, are analyzed in terms of their hardware features, computer vision systems (such as deep learning algorithms), and the clinical relevance of the literature. We attempt to outline the shortcomings in current optimization algorithms for surgical robots (such as YOLO and LTSM) whilst providing mitigating solutions to internal tool-to-organ collision detection and image reconstruction. The accuracy of results in robot end-effector collisions and reduced occlusion remain promising within the scope of our research, validating the propositions made for the surgical clearance of ever-expanding AR technology in the future

MoBateriE: A Personalised Profile-Based Intelligent and Adaptive Energy Manager

Increasing electronic waste has forced the mobile phone industry to move into a new era of energy consumption awareness. Trends show that mobile phone manufacturers are implementing more and more features on a single device. Using these features has led to an increase in electricity consumed by mobile phones, thus forcing users to charge them more frequently. Studies have shown that one can maximise a phone's battery life by limiting the number of charging cycles (Columbus, 2013). In this study, a survey was conducted in order to collect mobile phone usage behaviour. Data concerning most frequently used mobile features together with their usage frequency were collected. Based on the information gathered, a mobile application, MoBateriE, was designed. This application consists of an expert system which at first studies users’ behaviour and later imitates them whenever needed. MoBateriE has been designed for smart phone users who want to make extensive use of the features available on their phones without exhausting the battery efficiency of the phone. This application was distributed to a large number of users. Usage logs of thirty-three users were collected and analysed. Results obtained show that after using MoBateriE, users enjoyed a four per cent increase in usage time per charging cycle.Keywords: Electronic Waste, Battery Life, Charging Cycle, Mobile Applicatio

Postmortem tissue distribution of morphine and its metabolites in a series of heroin related deaths

The abuse of heroin (diamorphine) and heroin deaths are growing around the world. The interpretation of the toxicological results from suspected heroin deaths is notoriously difficult especially in cases where there may be limited samples. In order to help forensic practitioners with heroin interpretation we determined the concentration of morphine (M), morphine‐3‐glucuronide (M3G) and morphine‐6‐glucuronide (M6G) in blood (femoral and cardiac), brain (thalamus), liver (deep right lobe), bone marrow (sternum), skeletal muscle (psoas) and vitreous humor in 44 heroin related deaths. The presence of 6‐monoacetylmorphine (6‐MAM) in any of the postmortem samples was used as confirmation of heroin use. Quantitation was carried out using a validated LC‐MS/MS method with solid phase extraction. We also determined the presence of papaverine, noscapine and codeine in the samples, substances often found in illicit heroin and that may help determine illicit heroin use. The results of this study show that vitreous is the best sample to detect 6‐MAM (100% of cases), and thus heroin use. The results of the M, M3G and M6G quantitation in this study allow a degree of interpretation when samples are limited. However in some cases it may not be possible to determine heroin/morphine use as in 4 cases in muscle (3 cases in bone marrow) no morphine, morphine‐3‐glucuronide or morphine‐6‐glucuronide was detected, even though they were detected in other case samples. As always postmortem cases of suspected morphine/heroin intoxication should be interpreted with care and with as much case knowledge as possible

Progress Towards a Multi-Modal Capsule Endoscopy Device Featuring Microultrasound Imaging

Current clinical standards for endoscopy in the gastrointestinal (GI) tract combine high definition optics and ultrasound imaging to view the lumen superficially and through its thickness. However, these instruments are limited to the length of an endoscope and the only clinically available, autonomous devices able to travel the full length of the GI tract easily offer only video capsule endoscopy (VCE). Our work seeks to overcome this limitation with a device (“Sonopill”) for multimodal capsule endoscopy, providing optical and microultrasound (μUS) imaging and supporting sensors1. μUS transducers have been developed with multiple piezoelectric materials operating across a range of centre frequencies to study viability in the GI tract. Because of the combined constraints of μUS imaging and the low power / heat tolerance of autonomous devices, a hybrid approach has been taken to the transducer design, with separate transmit and receive arrays allowing multiple manufacturing approaches to maximise system efficiency. To explore these approaches fully, prototype devices have been developed with PVDF, high-frequency PZT and PMN-PT composites, and piezoelectric micromachined ultrasonic transducer arrays. Test capsules have been developed using 3D printing to investigate issues including power consumption, heat generation / dissipation, acoustic coupling, signal strength and capsule integrity. Because of the high functional density of the electronics in our proposed system, application specific integrated circuits (ASICs) have been developed to realise the ultrasound transmit and receive circuitry along with white-light and autofluorescence imaging with single-photon avalanche detectors (SPADs). The ultrasound ASIC has been developed and the SPAD electronics and optical subsystem have been validated experimentally. The functionality of various transducer materials has been examined as a function of frequency and ultrasound transducers have been developed to operate at centre frequencies in the range 15 - 50 MHz. Ex vivo testing of porcine tissue has been performed, generating images of interest to the clinical community, demonstrating the viability of the Sonopill concept

A calibration method for broad-bandwidth cavity enhanced absorption spectroscopy performed with supercontinuum radiation

An efficient calibration method has been developed for broad-bandwidth cavity enhanced absorption spectroscopy. The calibration is performed using phase shift cavity ring-down spectroscopy, which is conveniently implemented through use of an acousto-optic tunable filter (AOTF). The AOTF permits a narrowband portion of the SC spectrum to be scanned over the full high-reflectivity bandwidth of the cavity mirrors. After calibration the AOTF is switched off and broad-bandwidth CEAS can be performed with the same light source without any loss of alignment to the set-up. We demonstrate the merits of the method by probing transitions of oxygen molecules O-2 and collisional pairs of oxygen molecules (O-2)(2) in the visible spectral range

Phenazepam is currently being misused in the UK

Phenazepam is a benzodiazepine not currently controlled in the United Kingdom, mainland Europe, or the United States. Developed in the 1970s for the treatment of epilepsy, alcohol withdrawal syndrome, insomnia, and anxiety,1 2 it is currently prescribed only in the former Soviet Bloc. However, recent reports from Sweden, Finland, and the US describe its illicit use.3 In the UK concern over the safety of phenazepam was raised in 2010, when three people in the East Midlands and six people in Scotland were admitted to hospital after phenazepam overdoses.4 5 These cases and increased seizures of the drug by police led the Scottish Government to issue warnings about phenazepam. Having been alerted about its presence, we began screening necropsy blood samples for phenazepam in our forensic toxicology laboratory in Dundee from the end of January 2011. To date, we have identified nine cases in which postmortem blood samples contained phenazepam. There was a history of drug misuse in all cases, and they occurred in men and women aged 31 to 45. Death was from the adverse effects of opiates in seven cases and from non-drug related causes in two. This many cases suggests that the use of phenazepam by drug misusers in the UK is on the rise. Phenazepam can be obtained legally on the internet so it could become more widely used as substitute for controlled benzodiazepines or designer drugs such as mephedrone. Doctors should be aware of both the availability and illicit use of phenazepam in the UK

Deaths associated with new designer drug 5-IT

5-IT or 5-API is the common name for a newly emerging designer drug.1 It is a positional isomer of the tryptamine drug α-methyltryptamine and has the chemical structure (1H-indol-5-yl)propan-2-amine. Currently not controlled in Europe, it is covered, however, by the federal analogue acts in the USA2 and Australia.3 Very little is known about the acute or chronic effects of 5-IT. An oral dose of 20 milligrams is said to produce long lived stimulant effects, including increased heart rate, anorexia, diuresis, and slight hyperthermia for about 12 hours.4 Recently we identified 5-IT in postmortem blood samples of two young adults. The substance was found in combination with other drugs in one case. In the other, 5-APB/6-APB (a designer drug similar in some respects to the chemical structure of 3,4-methylenedioxyamphetamine (MDA)) was also found. The National Board of Forensic Medicine in Sweden has recently identified the drug in 14 deaths and 5-IT was said to be the direct cause of death in two of these cases.5 5-IT is inexpensive, easily available online as a so called research chemical and therefore has the potential for becoming a replacement for other recently banned designer drugs. The medical community should be aware of both the availability and use of 5-IT within the UK. The drug needs to be banned, but again regulatory control in the UK will be chasing designer drug innovation

Phenazepam:The drug that came in from the cold

Phenazepam [7-bromo-5-(2-chlorophenyl)-1, 3-dihydro-2H-1,4-benzodiazepine-2-one], sometimes called fenazepam (Fig. 1A), is part of the 1,4-benzodiazepine group of benzodiazepines along with drugs such as diazepam, nordazepam, oxazepam and temazepam. It is however one of very few of the 1,4-benzodiazepine group to contain a bromine atom, along with the active form of gidazepam, another soviet-developed benzodiazepine5 and bromazepam. As with other benzodiazepines, it is used clinically for its anxiolytic, anticonvulsant, muscle-relaxing and sedating properties,6 and is available as 0.5-mg and 1-mg tablets,6 injectable solutions (0.1%, 0.3%) or transdermal patches (Phenopercuten).7 Clinically the dose of phenazepam that is given depends on what condition is being treated but does not exceed 10 mg day−1, and is usually not more than 5 mg day−1. Illicitly, phenazepam has been reported being sold as a powder, tablets, in the USA, spiked in lysergic acid diethylamide (LSD) mimic blotters8 and 9 and in New Zealand phenazepam has been found in a synthetic cannabinoid mix called ‘Kronic’.10 Reported recreational doses of phenazepam are around 2–10 mg, but sometimes more.