General practitioners can evaluate the material, social and health dimensions of patient social status

OBJECTIVE: To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.DESIGN: Cross-sectional ulticentric survey. SETTING: Fourty-seven primary care private offices in Western Switzerland. PARTICIPANTS: Random sample of 2030 patients ≥ 16, who encountered a general practitioner (GP) between September 2010 and February 2011. MAIN MEASURES: PRIMARY OUTCOME: patient social status perceived by GPs, using the MacArthur Scale of Subjective Social Status, ranging from the bottom (0) to the top (10) of the social scale.Secondary outcome: Difference between GP's evaluation and patient's own evaluation of their social status. Potential patient correlates: material and social deprivation using the DiPCare-Q, health status using the EQ-5D, sources of income, and level of education. GP characteristics: opinion regarding patients' deprivation and its influence on health and care. RESULTS: To evaluate patient social status, GPs considered the material, social, and health aspects of deprivation, along with education level, and amount and type of income. GPs declaring a frequent reflexive consideration of their own prejudice towards deprived patients, gave a higher estimation of patients' social status (+1.0, p = 0.002). Choosing a less costly treatment for deprived patients was associated with a lower estimation (-0.7, p = 0.002). GP's evaluation of patient social status was 0.5 point higher than the patient's own estimate (p<0.0001). CONCLUSIONS: GPs can perceive the various dimensions of patient social status, although heterogeneously, according partly to their own characteristics. Compared to patients' own evaluation, GPs overestimate patient social status

Significance of the compliance of the joints on the dynamic slip resistance of a bioinspired hoof

Robust mechanisms for slip resistance are an open challenge in legged locomotion. Animals such as goats show impressive ability to resist slippage on cliffs. It is not fully known what attributes in their body determine this ability. Studying the slip resistance dynamics of the goat may offer insight toward the biologically inspired design of robotic hooves. This article tests how the embodiment of the hoof contributes to solving the problem of slip resistance. We ran numerical simulations and experiments using a passive robotic goat hoof for different compliance levels of its three joints. We established that compliant yaw and pitch and stiff roll can increase the energy required to slide the hoof by ≈ 20% compared to the baseline (stiff hoof). Compliant roll and pitch allow the robotic hoof to adapt to the irregularities of the terrain. This produces an antilock braking system-like behavior of the robotic hoof for slip resistance. Therefore, the pastern and coffin joints have a substantial effect on the slip resistance of the robotic hoof, while the fetlock joint has the lowest contribution. These shed insights into how robotic hooves can be used to autonomously improve slip resistance

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

A State-Dependent Damping Method to Reduce Collision Force and Its Variability

This paper investigates the effect of biologically inspired angle-dependent damping profile in a robotic joint primarily on the magnitude and the variability of the peak collision force. Joints such as the knee that experience collision forces are known to have an angle-dependent damping profile. In this paper, we have quantified and compared three damping profiles. Our numerical and experimental results show that the proposed hyperbolic angle-dependent damping profile can minimize both the magnitude and the variability of the peak collision force(average magnitude and variability reduction of 26% and 47% compared to the peak constant damping profile). Very often, the variability of the force across the collision between the robot and the environment cause uncertainty about the state variables of the robotic joint. We show that by increasing the slope of the proposed hyperbolic angle-dependent damping profile, we can also reduce the variability and the magnitude of post-collision peak displacement and peak velocity compared to those of constant damping profile. This was achieved while reducing the mean root square of power consumed by the robotic joint

A stiffness controllable multimodal whisker sensor follicle for texture comparison

Mammals like rats, who live in dark burrows, heav-ily depend on tactile perception obtained through the vibrissalsystem to move through gaps and to discriminate textures. Theorganization of a mammalian whisker follicle contains multiplesensory receptors and glands strategically organized to capturetactile sensory stimuli of different frequencies. In this paper, weused a controllable stiffness soft robotic follicle to test the hy-pothesis that the multimodal sensory receptors together with thecontrollable stiffness tissues in the whisker follicle form a physicalstructure to maximize tactile information. In our design, the ringsinus and ringwulst of a biological follicle are represented by alinear actuator connected to a stiffness controllable mechanismin-between two different frequency-dependent data capturingmodules. In this paper, we show for the first time the effectof the interplay between the stiffness and the speed of whiskingon maximizing a difference metric for texture classification

Nonlinear position and stiffness Backstepping controller for a two Degrees of Freedom pneumatic robot

This paper presents an architecture of a 2 Degrees of Freedom pneumatic robot which can be used as a haptic interface. To improve the haptic rendering of this device, a nonlinear position and stiffness controller without force measurement based on a Backstepping synthesis is presented. Thus, the robot can follow a targeted trajectory in Cartesian position with a variable compliant behavior when disturbance forces are applied. An appropriate tuning methodology of the closed-loop stiffness and closed-loop damping of the robot is given to obtain a desired disturbance response. The models, the synthesis and the stability analysis of this controller are described in this paper. Two models are presented in this paper, the first one is an accurate simulation model which describes the mechanical behavior of the robot, the thermodynamics phenomena in the pneumatic actuators, and the servovalves characteristics. The second model is the model used to synthesize the controller. This control model is obtained by simplifying the simulation model to obtain a MIMO strict feedback form. Finally, some simulation and experimental results are given and the controller performances are discussed and compared with a classical linear impedance controller

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

Optical properties of an ensemble of G-centers in silicon

We addressed the carrier dynamics in so-called G-centers in silicon (consisting of substitutional-interstitial carbon pairs interacting with interstitial silicons) obtained via ion implantation into a silicon-on-insulator wafer. For this point defect in silicon emitting in the telecommunication wavelength range, we unravel the recombination dynamics by time-resolved photoluminescence spectroscopy. More specifically, we performed detailed photoluminescence experiments as a function of excitation energy, incident power, irradiation fluence and temperature in order to study the impact of radiative and non-radiative recombination channels on the spectrum, yield and lifetime of G-centers. The sharp line emitting at 969 meV ($\sim$1280 nm) and the broad asymmetric sideband developing at lower energy share the same recombination dynamics as shown by time-resolved experiments performed selectively on each spectral component. This feature accounts for the common origin of the two emission bands which are unambiguously attributed to the zero-phonon line and to the corresponding phonon sideband. In the framework of the Huang-Rhys theory with non-perturbative calculations, we reach an estimation of 1.6$\pm$0.1 \angstrom for the spatial extension of the electronic wave function in the G-center. The radiative recombination time measured at low temperature lies in the 6 ns-range. The estimation of both radiative and non-radiative recombination rates as a function of temperature further demonstrate a constant radiative lifetime. Finally, although G-centers are shallow levels in silicon, we find a value of the Debye-Waller factor comparable to deep levels in wide-bandgap materials. Our results point out the potential of G-centers as a solid-state light source to be integrated into opto-electronic devices within a common silicon platform